Ultrasound guidance is not necessary during easy embryo transfers

Purpose: To determine whether the use of ultrasound (US) to guide embryo transfer (ET) in a population previously defined as likely to have easy transfer would change the implantation and pregnancy rates in an ICSI program.Methods: A total of 100 patients identified as likely to have easy transfer after mock transfer were divided into two groups: Group I, US-guided ET (N = 50) and Group II, ET without the aid of US (N = 50).Results: Implantation and pregnancy rates were similar (p = 0.51, p = 0.29) for Group I (19.6%,42%) and Group II (16.3%,30%), as also was the abortion rate (p = 0.55) (Group I: 1/21; Group II: 2/15).Conclusion: As long as previous mock transfers are routinely performed during a cycle preceding assisted reproduction and the clinician considers transfer to be easy, ultrasound does not benefit the process of embryo transfer.

Absence of TGF-beta RII predicts bone and lung metastasis and is associated with poor prognosis in stage III breast tumors

In the case of operated breast cancer (BC), prognostic markers help to determine if the patient needs additional treatment and predictive markers help the clinician to decide which treatment to use. Thus, a better knowledge of known predictive and prognostic markers and the identification of new markers, may improve the treatment of BC patients. The transforming growth factor-beta type II receptor (TGF-beta RII), a main receptor of transforming growth factor beta pathway, is a potential new prognostic marker. The aims of the present study were to investigate both the predictive and prognostic impact of TGF-beta RII in BC samples. TGF-beta RII protein expression was evaluated using immunohistochemistry on a tissue microarray containing 110 TNM stage III BC samples obtained prior to doxorubicin-based neoadjuvant chemotherapy (NAC). Our results demonstrate that TGF-beta RII did not predict the response to NAC. on the other hand, an association between TGF-beta RII-negative tumor and higher risk of metastasis to lungs and bones was verified. TGF-beta RII negativity was an independent prognostic factor for decreased disease-free and overall survival.

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.

Esthetic Interim Acrylic Resin Prosthesis Reinforced with Metal Casting

Fabrication of an interim prosthesis is an important procedure in oral rehabilitation because it aids in determining the esthetics, phonetics, and occlusal relationship of the definitive restoration. The typical material (acrylic resin) used in interim prostheses commonly fails due to fractures. During extended oral rehabilitation with fixed partial prostheses, high strength interim prostheses are often required to protect hard and soft tissues, avoid dental mobility, and to allow the clinician and patient a chance to evaluate cosmetics and function before the placement of the definitive prosthesis. Furthermore, a satisfactory interim prosthesis can serve as a template for the construction of the definitive prosthesis. The maintenance of this prosthesis is important during treatment for protection of teeth and occlusal stability. Procedures to reinforce interim prostheses help to improve performance and esthetics in long-term treatment. Due to the low durability of acrylic resin in long-term use, the use of reinforcing materials, such as metal castings or spot-welded stainless steel matrix bands, is indicated in cases of extensive restoration and long-term treatment. This paper describes an easy technique for fabricating a fixed interim prosthesis using acrylic resin and a cast metallic reinforcement.

Surface Roughness Analysis of Four Restorative Materials Exposed to 10% and 15% Carbamide Peroxide

The aim of this study was to evaluate the effects of carbamide peroxide (CP) on surfaces of different restorative materials. Porcelain, composite resin, glass ionomer, and amalgam were analyzed in this study. Surface roughness (Ra) was measured before and after treatment with 10% and 15% CP. Fifteen percent CP increased Ra values in both the glass ionomer and amalgam subgroups, while 10% CP increased Ra values in the glass ionomer subgroup only. Changes in restorative material surfaces can be more severe when bleaching is completed without a clinician's supervision. Hence, thorough patient examinations must be done before, during, and after bleaching treatment. Int J Prosthodont 2011;24:155-157

Evaluation of enamel surface after bracket debonding and polishing

INTRODUÇÃO: a preservação da estrutura de esmalte após a remoção dos acessórios ortodônticos é obrigação do clínico. Portanto, procura-se um protocolo de descolagem com bases científicas. OBJETIVO: objetivou-se avaliar por microscopia eletrônica de varredura (MEV) a influência de quatro protocolos de remoção de braquetes e polimento da superfície do esmalte e propor um protocolo que minimize os danosà superfície do esmalte. MÉTODOS: doze incisivos permanentes bovinos foram divididos em quatro grupos de acordo com os instrumentos utilizados para a descolagem dos braquetes e remoção do remanescente adesivo. Os braquetes foram descolados com o alicate de descolagem reto (Ormco Corp.) nos grupos 1 e 2, e com o instrumento de descolagem Lift-Off (3M Unitek) nos grupos 3 e 4. Os remanescentes adesivos dos grupos 1 e 3 foram removidos com o alicate removedor de resina longo (Ormco Corp.) e dos grupos 2 e 4 com broca de carboneto de tungstênio (Beavers Dental) em alta-rotação. As superfícies, após cada etapa da descolagem e polimento, foram avaliadas em réplicas de resina epóxica e foram obtidas eletromicrografias com aumento de 50 e 200X. RESULTADOS: os quatro protocolos de remoção de acessórios ortodônticos e polimento ocasionaram irregularidades no esmalte. Conclusão: a remoção do braquete com o alicate de descolagem reto, seguido da remoção do remanescente adesivo com broca de carboneto de tungstênio e polimento final com pasta de pedra-pomes foi o procedimento que ocasionou menores danos ao esmalte, sendo o protocolo sugerido para a remoção dos acessórios ortodônticos.

Efficacy of dip slide test for mutans streptococci in caries risk assessment

The aim of this study was to evaluate the efficacy of a dip slide test for mutans streptococci in caries risk assessment, when the microbiological results were compared to well-defined clinical criteria (DCC) for caries risk, clinically measured through high and low caries activity. Eighty-one volunteers from the 6(th) to 8(th) grades from public schools of Piracicaba, São Paulo, Brazil, were evaluated for dental caries. All free smooth surfaces were evaluated to check whether or not there were white spots. Based on the subjects' caries experience, a calibrated clinician divided them into groups of high and low caries activity. The subjects were submitted to a salivary test (CARITEST SM (R)) from the same batch number. Kappa statistics (kappa) were applied to verify the reproducibility of the simplified test, checked through interexaminer agreement when the results were classified by independent and blind means. The microbiological results were validated according to expressions of sensitivity and specificity. A moderate agreement was verified as the results were classified according to 6 scores (kappa =0.55), and the agreement was substantial when the results were classified according to high and low microbiological count (kappa =0.78). The sensitivity and specificity values were 0.59 and 0.85, respectively, showing that the test was more specific than sensitive, and could thus better identify the low caries risk subjects.

Gagueira desenvolvimental persistente familial: perspectivas genéticas

A gagueira é uma desordem da comunicação oral que tem uma característica multidimensional. A predisposição biológica no desenvolvimento da gagueira ainda não é bem compreendida, mas contribuições genéticas para esta predisposição são reforçadas tanto por referências à agregação familial da gagueira, quanto à gagueira familial, que têm aparecido na literatura há mais de 70 anos. Assim, procuramos estabelecer uma revisão quanto aos prováveis fatores genéticos envolvidos com a manifestação da gagueira desenvolvimental persistente familial. A identificação de genes relacionados à gagueira, bem como de alterações em suas estruturas (por exemplo, mutações), contribuem significativamente para sua compreensão. O modelo exato de transmissão da herança genética para a gagueira ainda não está claramente definida e, provavelmente pode ser diferente entre diferentes famílias e populações. As análises genômicas demonstram, concomitantemente, a relevância dos componentes genéticos envolvidos e sua complexidade, sugerindo assim tratar-se de uma doença poligênica, na qual diversos genes de efeitos variados podem estar envolvidos com o aumento da susceptibilidade de ocorrência da gagueira. O clínico deverá estar alerta ao fato de que uma criança com histórico familial positivo para gagueira poderá ter uma forte tendência a desenvolver o distúrbio de forma crônica. É importante que o clínico esteja atento, de modo a fornecer às famílias orientações precisas sobre o distúrbio. As avaliações objetivas e os tratamentos controlados têm um papel muito importante para o domínio da evolução do distúrbio.

Mordida cruzada posterior: uma classificação mais didática

O objetivo deste trabalho é apresentar uma nova classificação de mordida cruzada posterior, sendo esta mais didática e de fácil entendimento, diferindo das demais em sua nomenclatura, preservando, no entanto, os princípios fundamentais que regem a Ortodontia. Essa classificação torna o processo de diagnóstico da mordida cruzada posterior sistematizado, tornando-o mais preciso, auxiliando o clínico na elaboração de um plano de tratamento adequado e, como conseqüência, levando a um prognóstico mais favorável dessa má oclusão.

Sobremordida exagerada: diagnóstico e estratégias de tratamento

A sobremordida exagerada é um tipo de má oclusão que apresenta etiologia multifatorial e necessita de um diagnóstico diferencial elaborado e específico. O objetivo desse artigo é descrever os principais elementos de diagnóstico facial, cefalométrico e dentário e as principais estratégias de tratamento, como a extrusão de dentes posteriores, a intrusão de dentes anteriores ou a combinação dessas. Serão apresentados seis casos clínicos, auxiliando o ortodontista no diagnóstico e na seleção da estratégia de tratamento individualizada para cada situação clínica.

Cytotoxicity of denture base acrylic resins: A literature review

Acrylic resins are widely used in the fabrication of denture bases and have been shown to be cytotoxic as a result of substances that leach from the resin. The primary eluate is residual monomer. Numerous reports suggest that residual monomer may be responsible for mucosal irritation and sensitization of tissues. This information is important, not only to assess the biologic effects of such materials, but also to enable a comparison among the different polymerization methods, thus assisting the clinician in selecting a material with minimal cytotoxicity. This article reviews the literature published from 1973 to 2000, selected by use of a Medline search, associated with cytotoxic effects usually ascribed to acrylic denture base materials.

Osseointegrated Implant Fracture: Causes and Treatment

Despite its high success rate, therapy with osseointegrated dental implants is not free of complications. Among the problems that may occur is fracture of implants, which, albeit a rare phenomenon, may lead to unpleasant clinical outcomes for the patient, as well as for the clinician. Thus, it is paramount to know the factors related to the biological processes involved in maintenance of osseointegration and biomechanics applied to dental implants to prevent such complications, as well as treatment options available to deal with the problem. Therefore, the objectives of this work were to investigate the literature to identify causative factors that may lead to fracture of dental implants and to discuss available procedures.

Patients' Expectations of and Satisfaction with Implant-Supported Fixed Partial Dentures and Single Crowns

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

Communication that values patient autonomy is associated with satisfaction with care: a systematic review

Question: Which communication factors used by clinicians during patient-clinician interactions are associated with satisfaction with care? Design: Systematic review with meta-analysis of studies investigating the association of verbal or nonverbal factors or interaction styles used by clinicians with patient satisfaction during an encounter between clinician and patient. Participants: Clinicians interacting with patients in primary care or rehabilitation settings. Results: Twenty-seven studies investigated 129 verbal, nonverbal, and interaction style factors. of these, 38 factors were consistently associated with satisfaction. Verbal factors concerning clinicians involving, facilitating, and supporting patients were associated with satisfaction with care. Most communication factors presented a fair correlation (r >= 0.21 but < 0.41) with satisfaction with care. Nonverbal factors such as time spent discussing prevention and time spent reading patient charts had a fair association with satisfaction with care (correlations range from 0.21 to 0.40). A moderate association was found between interaction styles such as caring (pooled r = 0.51, 95% CI 0.42 to 0.60) and satisfaction with care. Over half (58%) of the 129 identified factors never associated with satisfaction with care and the remainder associated inconsistently. Conclusion: The number of potential modifiable communication factors associated with satisfaction with care and the magnitude of their association partially support interventions to train clinicians in communication skills that value patient autonomy. [Oliveira VC, Refshauge KM, Ferreira ML, Pinto RZ, Beckenkamp PR, Negrao Filho RF, Ferreira PH (2012) Communication that values patient autonomy is associated with satisfaction with care: a systematic review. Journal of Physiotherapy 58: 215-229]

Comparative Analysis of 2 Techniques of Double-Gloving Protection During Arch Bar Placement for Intermaxillary Fixation

Purpose: This study was conducted to comparatively evaluate, in a prospective and randomized manner, 2 techniques for providing double-gloving protection during arch bar placement for intermaxillary fixation. Materials and Methods: A total of 42 consecutive patients in whom application of an Erich bar was indicated for intermaxillary fixation were equally divided into 2 groups. In group 1, 2 sterile surgical gloves were used; in group 2, a nonsterile disposable inner glove was used under a sterile surgical glove. Wilcoxon, Mann-Whitney, Kruskal-Wallis, and binomial statistical tests were used to analyze the findings. Results: A total of 103 perforations were found in the outer gloves (47 in group 1 and 56 in group 2), along with 5 perforations in inner gloves in both groups (α = .01). No significant statistical difference was found between groups in terms of inner glove perforations (α = .05). The nondominant hand presented with 70.9% of the perforations, statistically significant to 1%. Conclusions: Both double-gloving techniques were found to provide effective clinician protection. The use of a nonsterile disposable glove under the surgical glove is possible for less-invasive procedures, offering the same safety as using 2 sterile surgical gloves while decreasing operational costs. This method does not eliminate the need to change gloves when a perforation is suspected or noted during the surgery, however. © 2007 American Association of Oral and Maxillofacial Surgeons.