Laboratory testes with quality data in Dentistry

In laboratory tests, just following the manufacturer’s instructions of materials or equipments may not be enough to obtain reliable data. Thus, intra and inter-examiners studies may be required. The aim of this study was to illustrate the application of the Intraclass Correlation Coefficient (r) in a study related to the color changing and hardness of composite resin conducted by two examiners. The color and hardness of 10 specimens of composite resin were evaluated by a colorimetric spectrophotometer and hardness tester, respectively, at two different times. Two trained examiners performed two measurements with an interval of one week. Specimens were stored in artificial saliva at 37±1ºC for 7 days. The Intraclass Correlation was used for analysis of intra and inter-examiner reproducibility. The intra-examiner reproducibility was 0.79, 0.44 and 0.76 for L, a and b color coordinates for the examiner 1 and 0.84, 0.23, 0.21 for examiner 2. For hardness, r-values were 0.00 and 0.23 for the examiner 1 and 2, respectively, showing unsatisfactory agreement on color and hardness evaluation for both examiners. It was noted that only the observation of protocol for use of equipment and examiners training were not sufficient to collect reliable information. Thus, adjustments in the experimental protocol were made and devices were produced to standardize the measurements. The reproducibility study was performed again. For examiner 1, values as 0.90, 0.59 and 0.79 were verified for L, a and b coordinates and, for examiner 2 were obtained values of 0.90, 0.75, 0.95. In relation to hardness, r-values of 0.75 and 0.71 were obtained for examiners 1 and 2, respectively. The inter-examiner reproducibility was 0.86, 0.87, 0.91 for L, a and b coordinates and 0.79 for hardness. It was concluded that intra and inter-examiner calibration is essential for obtaining quality measurements in laboratory tests.

Early loading of 6-mm-short implants with a moderately rough surface supporting single crowns: a prospective 5-year cohort study

AimTo evaluate prospectively the clinical and radiographic outcomes after 5years of early loading of 6-mm implants with a moderately rough (SLActive((R))) surface supporting single crowns in the posterior regions.Material and methodsThirty-five consecutive patients received 40 SLActive((R)) (Straumann) 6-mm implants with a diameter of 4.1mm (n=19) or 4.8mm (n=21). Insertion torque and resonance frequency analysis (RFA) were measured at implant installation. RFA was also measured at abutment connection. SynOcta abutments were tightened with 35Ncm after 6weeks of healing, and single porcelain fuse to metal crowns was cemented within 1week. Implant survival rate and marginal bone loss were evaluated at various time intervals until 5years after loading. The clinical crown/implant ratio was calculated as well.ResultsTwo of 40 implants were lost before loading (incorporation rate 95%), and no further implant loss or technical complications were encountered during the 5-year follow-up period. A mean marginal bone loss of 0.70.6mm was found after 5years of function. The clinical crown/implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2 after 5years of loading.ConclusionSix millimeter implants with a SLActive((R)) moderately rough surface supporting single crowns in the posterior region and loaded after 6-7weeks maintained full function for at least 5year with low marginal bone resorption.

Visualisation and reconstruction in dentistry

Visualisation in the field of dentistry has nor, thus far, reached the same development as other medical fields. Potential applications of visualisation techniques in this area, however, are many, ranging from educational displays to training for delicate procedures. This paper reports on the investigation of techniques for handling three-dimensional models of teeth, aiming at investigation of dental structures. An algorithm was implemented for this purpose, which reconstructs three-dimensional teeth models from two-dimensional contour slices. Results employing various data sets are presented, including the output of VRML models for exploration.

Oral rehabilitation with implantations: association of fixed partial prosthesis, UCLA system, and EsthetiCone

The objective of modern odontology is to reconstitute to the patient the comfort, the function, the aesthetic form, the phonetic capability, and normal health. However, the more the patient is toothless, the more this objective becomes difficult inside traditional dentistry. As a result of continuous research of materials and techniques, permissible success is now a reality, whitewashing many challenging clinical situations. Thus, the objective of the article was to present a clinical case where association of the universal cast to long abutment pillars and EsthetiCone were used for aesthetic whitewashing. A man presented to the clinic of the Faculty of Dentistry, Universidade Estadual Paulista. After clinical examination and radiographic evaluation evidenced the necessity of substitution of fixed prostheses (15-25), he was presented with disadaptation and a favorable aesthetic solution. Ahead of the evaluated picture and considering the extension of the toothless space made, it was opted more, to the accomplishment of surgery, the setting of 2 implantations in the region and 2 in each edentate side of the posterior portion of the jaw. On 6 implants and 2 teeth, 10 metal ceramic crowns had been confectioned: 4 of them being joined in the region of the 12 to the 22 and the other 6 as unit crowns in the region of the 13, the 14, the 15, the 23, the 24, and the 25. The carried-through treatment was capable to return the aesthetic form, the function, the phonetic capability, the comfort, and the health of the verbal socket.

Prosthetic rehabilitation of a patient with gastroesophageal reflux disease: 4-year followup

The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

Noninvasive and multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta: a pediatric case report

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

Management of accidental swallowing in implant dentistry

This report describes a protocol for managing the accidental swallowing of dental instruments in implant dentistry, illustrated by a patient who accidentally swallowed a hexagonal wrench. The first step was to refer the patient to the medical emergency hospital service for radiographic and clinical evaluation. The hexagonal wrench was located in the stomach and was immediately removed with an endoscopic procedure. The gastric mucosa was sampled via biopsy and the sample submitted to the urease test, which was positive for Helicobacter pylori. Triple treatment was instituted for gastritis caused by H pylori to avoid exposing the patient to unnecessary risk. Removal of a foreign body by means of an endoscopic procedure constitutes a safe and effective treatment.

The importance of the lifelike esthetic appearance of all-ceramic restorations on anterior teeth

The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient's satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success.

Sexual haressement in dentistry: prevalence in dental school

OBJECTIVE: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. MATERIAL AND METHODS: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82% (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. RESULTS: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR=2.910 (1.113-7.611)]. Additionally, 25.4% of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. CONCLUSION: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Brazilian dentistry profiles and workforce

The aim of this study was to assess the dentistry profile, based on social and demographic data, post-graduation formation, and to verify the insertion of dental graduates in the labour force. The participants were professionals graduated from a Brazilian Public Dental School, between 2000 and 2010. An instrument was sent by mail and/or e-mail to them. It was used Kruskal Wallis Test. Among 1047 questionnaires, 189 returned and 65.6% were answered by female. In relation to post-graduation course, 57.7% of professionals performed it, however 56.9% not attended only in their area; 66.6% of professionals are concentrated in cities larger than 100 thousand habitants. There was association between income and gender, and others. The predominant work modality was self-employed. Among the total, 36.5% want to work part-time in dentistry. The female gender was predominant and there was wage discrepancy between genders. The professionals have been concentrated in largest cities.

Qualitative methodogy: revealing a new path for research in dentistry

Currently, it is easy to find health professionals who not only attach importance to qualitative methods, but also recognize their help to better understand their patients' lives. However, its use in dentistry is still incipient, either due to ignorance or because of technical / operational difficulties in identifying possibilities for their use in research. Thus, the purpose of this study was to review the literature on the characteristics and peculiarities of the qualitative methodology, demonstrating their techniques of collecting, recording and analyzing data. For this, we performed a descriptive literature, from a survey in the "LILACS", "BBO" and "PUBMED" databases, by keywords related to the theme, selecting only the papers that mentioned the "importance" of qualitative research, the "characteristics and fundamentals," and the "techniques of collecting, recording and data analysis" involving this methodology. It was found that all studies have highlighted the importance of qualitative research to the construction of new knowledge that cannot be achieved by quantitative data. We found many different techniques to gather, record and analyze qualitative data applied to the dentistry field. It was concluded that qualitative research represents a new path to be followed by dentistry, so that we are able to plan actions in ethical and humane public health dentistry, bringing better results to the population, because of the depth of knowledge that your date can.

Leakage of Saliva Through the Implant-Abutment Interface: In Vitro Evaluation of Three Different Implant Connections Under Unloaded and Loaded Conditions

Purpose: Bacterial leakage along the implant-abutment interface, with consequent species harboring the inner parts of two-part dental implant systems, has been reported in the literature. The aim of this in vitro study was to evaluate bacterial leakage from human saliva to the internal part of the implants along the implant-abutment interface under loaded and unloaded conditions using DNA Checkerboard. Materials and Methods: Sixty denial implants-20 each of external-hexagon, internal-hexagon, and Morse cone-connection designs-and their conical abutments were used in this study. Each group was subdivided into two groups of 10 loaded and 10 unloaded implants. The assemblies were immersed in human saliva and either (1) loaded with 500,000 cycles at 120 N (experimental group) or (2) incubated in static conditions for 7 days at 35 degrees C (unloaded control group). Results: Microorganisms were found in the internal surfaces of all types of connections. The Morse cone connection presented the lowest count of microorganisms in both the unloaded and loaded groups. Loaded implants presented with higher counts of microorganisms than unloaded implants for external- and internal-hex connections. Conclusion: Bacterial species from human saliva may penetrate along the implant-abutment interface under both unloaded and loaded conditions for all connections evaluated. Morse cone-connection implants showed the lowest counts of microorganisms for both conditions. External- and internal-hex implants showed a higher incidence of bacteria and higher bacterial counts after simulated loading. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:551-560.