An effective technique to posterior resin composite restorations

AIM: The aim of this study is to present a clinical case in which an occlusal matrix device was used in a patient who needed to restore a posterior tooth. MATERIAL AND METHODS: A direct duplicate occlusal appliance was used (biteperf) in a patient who needed an occlusal restoration in two posterior teeth. RESULTS: Using the matrix helps having fast and accurate reproduction of the original anatomical details of the occlusal surface. The final result surprised with the presented restoration in terms of esthetic quality, despite the simplicity of the technique. CONCLUSION: Posterior teeth with initial lesions were confined to the occlusal surface of anatomically complex or fissured anatomy with or without signs of proximal caries wich are ideal candidates for this technique. The overlying enamel surface must be relatively intact; lesions of hidden or occult caries. CLINICAL SIGNIFICANCE: The aesthetic and time-saving benefits of the occlusal device (biteperf) are immediately clear. The matrix allows the fast and accurate reproduction of the anatomic details of the original occlusal surface of the tooth. The professionals who lack an artistic penchant and marked manual ability will be able to carry out excellent posterior resin composite restorations.

Pistas diretas para o tratamento de mordida cruzada posterior

The malocclusions are one focus of discussions in public health, due to which it is necessary to incorporate correction procedures that are inexpensive, easy to perform and which can be made in health services. Planas Direct Tracks meet such characteristics which make them advantageous for the crossbite correction. The aim of this study was to present a case in which correction of unilateral crossbite was performed with the resources available in a public clinic. This is a 6 year-old patient who presented functional unilateral crossbite in canines and posterior teeth. A cross decreased maxillary arch leading to a condition of unilateral posterior crossbite was detected. Occlusal adjustments were performed in canine and posterior teeth; however it was not enough to restore the occlusal balance. It was decided to prepare Planas Direct Tracks in canines, allowing functional balance, which prevented masticatory movement alteration during the growth phase and malocclusion correction. Controls were performed every six months to evaluate the patient's progress and whether or not new occlusal adjustments were necessary. Monitoring and treatment were conducted for 5 years, until stabilization of the permanent dentition ensuring treatment. It is concluded that Planas Direct Tracks were effective for the correction of unilateral posterior crossbite. So, it is essential to note that this procedure can be performed in public services.

Mordida cruzada posterior, correccion y consideraciones: caso clínico con 7 años de seguimiento

Early treatment of functional unilateral posterior crossbite during the mixed dentition is extremely important for contemporary Orthodontics, provides the correct positioning of osseous bases, teeth and temporomadibular joint when the stomatognathic system is in growth and development. These results generally develop into an adequate craniofacial relationship, reducing the necessity for more complex treatments at permanent dentition. The subject of this paper was to report patient 8 years old, diagnosed with functional unilateral posterior crossbite, and was treated by an expander appliance type Quad-helix emphasizing the long-term stability. The malocclusion was corrected in 3 months of active use of the appliance, 3 months for retention purposes and followed up during 7 years post-treatment. The stability in long term of functional unilateral posterior crossbite treated is closely related with early diagnostic, the elimination of the etiological factor associated with a correct appliance and the mechanic of treatment.

Analysis of association between posterior crossbite, median line deviation and facial asymmetry

Facial asymmetry is a common human characteristic and can occur on many levels, originate of genetic factors, and can be caused by traumas or due to cross bite and/or muscular disability. The aim of this study was to evaluate the relation between posterior crossbite, median line deviation and facial asymmetry. For this study 70 children aged between 3 and 10 years-old were examined and photographed. Using Microsoft Office Power Point 2007, horizontal lines and one vertical line on median line were drawn, to subjectively analyze facial discrepancies. In relation to overjet, the majority of children (78.6%) showed normal relation, followed by high overjet (17.1%), anterior crossbite (4.3%). In relation to overbite, the majority of children (60%) showed normal relation, 27.1% anterior opened bite (negative overbite), and 12.9% showed high overbite. Posterior crossbite was present in 27.1% of children. Among them, 68.4% showed unilateral crossbite on right side, 21.1% bilateral crossbite and 10.5% unilateral crossbite on left side. The relation between posterior crossbite and facial asymmetry, according to Fisher´s Exact Test (p=0.0970), there was no statistically significant association. In relation to median line, the association was statistically significant with posterior crossbite (p=0.0109) and with facial asymmetry (p=0.0310). There was association between posterior crossbite and median line deviation. There was no association between posterior crossbite and facial asymmetry.

Análise da distribuição de tensões em reabilitação com implantes cone morse em maxilar posterior: estudo pelo MEF 3D não linear

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

Bidirectional Barbed Suture for Bladder Neck Reconstruction, Posterior Reconstruction and Vesicourethral Anastomosis During Robot Assisted Radical Prostatectomy

Background: The urethrovesical anastomosis is a particular challenging step of robot assisted radical prostatectomy (RARP). Failure to achieve a watertight anastomosis is associated with postoperative urinary leak and its consequences, which include paralytic ileus, prolonged catheterization, urinary peritonitis and possibly re-intervention. The bidirectional barbed suture is a new technology that may lead to improve the quality of the urethrovesical anastomosis. Objective: To present our surgical technique of urethrovesical anastomosis, bladder neck reconstruction and posterior reconstruction, using a bidirectional barbed suture. Material and methods: The bladder neck reconstruction, posterior reconstruction and vesicourethral anastomosis were performed using a 2-0 synthetic absorbable bidirectional monofilament barbed suture Results: All cases were finished successfully without major complication or conversion to laparoscopic or open surgery. Conclusion: The authors successfully modified their RARP technique to take advantage of the properties of the bidirectional barbed suture. Comparative studies that evaluate objective outcomes such as leakage rates and operative time are needed to definitely establish the benefits of this device in comparison to the traditional absorbable monofilament. (C) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.

Influence of pulp condition on the accuracy of an electronic foramen locator in posterior teeth: an in vivo study

The aim of this study was to assess, in vivo, the accuracy of the NovApex (R) electronic foramen locator in determining working length (WL) in vital and necrotic posterior teeth. The NovApex (R) was used in 144 canals: 35 teeth with vital pulps (68 canals) and 42 teeth with necrotic pulps (76 canals). WL was measured with the NovApex (R) locator and confirmed using the radiographic method. Differences between electronic and radiographic measurements ranging between 0.0 and 0.4 millimeters were classified as acceptable; differences equal to or greater than 0.5 millimeter were considered unacceptable. Pearson's chi-square test was used to assess the influence of pulp condition on the accuracy of NovApex (R) (alpha = 0.05). Regardless of pulp condition, differences between electronic and radiographic WL measurements were acceptable in 73.61% of the canals. No statistically significant differences in accuracy were observed when comparing vital and necrotic canals (p > 0.05). There were 38 unacceptable measurements. In none of these cases was the file tip located beyond the radiographic apex; in 32, it was located short of the NovApex (R) measurement. Pulp condition had no significant effect on the accuracy of NovApex (R).

Maxillary sinus and posterior teeth: accessing close relationship by cone-beam computed tomographic scanning in a brazilian population

Introduction: This study aimed to evaluate the close proximity established between the maxillary sinus floor and posterior teeth roots apices by using cone-beam computed tomographic scanning. Methods: The relationship of maxillary sinuses and posterior teeth roots, which were divided into 2 groups, was analyzed using i-CAT Vision software (Imaging Sciences, Hatfield, PA). Group 1 included all root apices found in close contact with the maxillary sinus floor without sinus floor elevation, whereas group 2 included all root apices that were protruded within the sinus producing an elevation of the bony cortical. Results: A total of 100 maxillary sinuses and 601 roots apices were evaluated. Group 1 presented 130 of 601 (21.6%) roots and group 2 presented 86 of 601 (14.3%) roots. Conclusions: The second molar mesiobuccal root apex is frequently found in close proximity with the sinus floor, and the relation between these anatomic structures should be considered in order to prevent an iatrogenic procedure and minimize the risks from an infectious disease within the sinus

Comparative analysis of the anterior and posterior length and deflection angle of the cranial base, in individuals with facial pattern I, II and III

Objective: This study evaluated the variations in the anterior cranial base (S-N), posterior cranial base (S-Ba) and deflection of the cranial base (SNBa) among three different facial patterns (Pattern I, II and III). Method: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III) of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G’.Sn.Pg’). To compare the mean values obtained from (SNBa, S-N, S-Ba) each group measures, the ANOVA test and Scheffé’s Post-Hoc test were applied. Results and Conclusions: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III). There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.

Panic-like defensive behavior but not fear-induced antinociception is differently organized by dorsomedial and posterior hypothalamic nuclei of Rattus norvegicus (Rodentia, Muridae)

The hypothalamus is a forebrain structure critically involved in the organization of defensive responses to aversive stimuli. Gamma-aminobutyric acid (GABA)ergic dysfunction in dorsomedial and posterior hypothalamic nuclei is implicated in the origin of panic-like defensive behavior, as well as in pain modulation. The present study was conducted to test the difference between these two hypothalamic nuclei regarding defensive and antinociceptive mechanisms. Thus, the GABA A antagonist bicuculline (40 ng/0.2 µL) or saline (0.9% NaCl) was microinjected into the dorsomedial or posterior hypothalamus in independent groups. Innate fear-induced responses characterized by defensive attention, defensive immobility and elaborate escape behavior were evoked by hypothalamic blockade of GABA A receptors. Fear-induced defensive behavior organized by the posterior hypothalamus was more intense than that organized by dorsomedial hypothalamic nuclei. Escape behavior elicited by GABA A receptor blockade in both the dorsomedial and posterior hypothalamus was followed by an increase in nociceptive threshold. Interestingly, there was no difference in the intensity or in the duration of fear-induced antinociception shown by each hypothalamic division presently investigated. The present study showed that GABAergic dysfunction in nuclei of both the dorsomedial and posterior hypothalamus elicit panic attack-like defensive responses followed by fear-induced antinociception, although the innate fear-induced behavior originates differently in the posterior hypothalamus in comparison to the activity of medial hypothalamic subdivisions.

Effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors

The purpose of this study was to compare the effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors during leveling phase. Twenty-three subjects with Class I and Class II malocclusion were treated with first premolars extraction using preadjusted appliances (MBT 0.022-inch brackets). The leveling phase was performed with stainless steel archwires only. The sample was divided into 2 groups: 14 subjects received active lacebacks (Group 1) and 9 subjects received passive lacebacks (Group 2). Lacebacks were made from 0.008-inch ligature wire. Lateral cephalometric radiographs were taken pre- and post-leveling phase. Student's t-test was applied to determine the differences between pre- and post-leveling mean values and to determine the mean differences between groups. In Group I, the first molars showed a significant mesial movement, whereas no change was observed in Group 2. In both groups, maxillary central incisor crowns moved to lingual side. In conclusion, active laceback produced anchorage loss of maxillary first molars whereas passive laceback did not affect the position of these teeth. Active and passive lacebacks were effective in preventing central incisor proclination.

Width of buccal and posterior corridors: differences between cases treated with asymmetric and symmetric extractions

OBJECTIVE: To verify if there is difference in the buccal and posterior corridor width in cases treated with extraction of one and four premolars. METHODS: Through posed smile photographs of 23 Class II patients, subdivision, treated with extraction of one premolar and 25 Class I and Class II patients, subdivision, treated with extraction of four premolars, the percentage of buccal and posterior corridor width was calculated. The two protocols of extractions were compared regarding the buccal and posterior corridor width by independent t tests. RESULTS: There was no statistically significant difference on the buccal and posterior corridor widths between patients treated with symmetric and asymmetric extraction. CONCLUSION: The buccal and posterior corridor did not differ between the evaluated protocols of extractions.