978 resultados para Adjacent teeth
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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The literature has shown a relation between periodontics and the removable partial denture (RPD), with progressive destruction observed in the support structures. The aim of this study was to clinically assess periodontal condition in users of removal partial denture (RPD), and compare right abutments teeth, indirect abutments and controls before installation and after 1 year, in addition to comparing tooth-supported and tooth mucosa-supported abutments. A total of 50 patients, 32 women and 18 men, mean age of 45 years, took part in the study. The patients were examined by a single examiner at prosthesis installation and after 3, 6, 9 and 12 months. The following were verified at each examination: Probe Depth (PD), Plaque Index (PI), Gingival Index (GI), the amount of Keratinized Mucosa (KM), Gingival Recession (GR) and Dental Mobility (DM); in addition patients received oral hygiene orientation, accompanied by prophylaxis, periodontal scaling and root planing (PSRP), when necessary. Analysis of Variance (ANOVA) with Tukey-Kramer post test was used to assess the dependent variables (PD, PI, KM, GR) of the three groups over time while Friedman s test was used for GI. To assess the outcomes of prosthesis type in the right abutment group, a confidence interval-based analysis was performed. The results showed that the control group was the least compromised in all the variables studied. With respect to development of the groups over time, it was verified that the measures for GR, PD, GI and KM increased from initial examination to 1 year of use in all the groups, but only PI showed a significant increase. There was a non-discriminatory low prevalence of dental mobility. The tooth mucosa-supported prosthesis had significantly higher values for GR, GI and PI and significantly lower ones for KM when compared to tooth-supported. Over time, both types of prostheses showed no significant differences from initial to final examination for the variables GR, PD, KM and GI, with PI significant only for tooth-supported. The results showed that the teeth most involved in RPD design had greater potential of periodontal damage, probably because of greater dental biofilm accumulation. Abutments elements adjacent to the free extremities had less favorable periodontal condition than those adjacent to interpolated spaces, but the use of RPD did not worsen the initial condition
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Dental follicle is a component of tooth germs, which remain adjacent to the crown of unerupted or impacted teeth. Under the influence of pathologic changes, however, dental follicles that possess reduced epithelium can proliferate into stratified squamous epithelium as far as originate dental cysts. In order to clarify the role of apoptosis and cellular proliferation herein, expression of p53 and PCNA was examined in epithelial components of dental follicles associated with impacted third molars by means of immunohistochemistry. A total of 40 cases was included in this study being 22 cases with reduced epithelium and 18 cases with stratified epithelium. Expression of p53 expression was weak or not detected in dental follicles with reduced and stratified squamous epithelium. By contrast, PCNA positive cells were evidenced in basal and supra basal layers of the stratified squamous epithelium and in reduced epithelium of dental follicles, but without any significant statistically differences between them (P > 0.05). In conclusion, these data suggest that dental follicles possess proliferative activity as depicted by PCNA-positive nuclei in some epithelial cells. However, the biological behavior of dental follicles during the late stage of dental eruptive process may not be associated with deregulation of death and/or cell proliferation.
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Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkeys teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex (R)). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.
Microscopic evaluation of induced tooth movement in traumatized teeth: an experimental study in rats
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The clinical management of orthodontic patients with dental trauma before or during the treatment is mainly founded on clinical experience, expert opinions, and individual case reports. It is proposed in the literature that teeth sustaining mild trauma with minor damage to the periodontium (e.g. subluxation) should be followed for a period of time before being subjected to orthodontic forces. A minimum period of 3 months has been proposed. In this study, we used an animal model to investigate whether shorter observation periods could be established in case of mild trauma. The periradicular region of rat molars was examined microscopically to determine the biological events of tooth movement started 15 and 30 days after intentional subluxation using an experimental method to induce dentoalveolar trauma. Thirty adult male Wistar rats were assigned to 6 groups (n = 5): Group 1 (control no trauma/orthodontic movement); Group 2: the animals received an orthodontic device and were sacrificed after 7 days; Groups 3 and 4: dentoalveolar trauma (subluxation) was experimentally induced by the application of an axial force of 900 cN on the occlusal surface of the maxillary right first molar, and the animals were sacrificed after 22 and 37 days, respectively; and Groups 5 and 6: 15 and 30 days, respectively, after force application, an orthodontic device was installed and the rats were sacrificed 7 days later. In G5 and G6, the periodontal ligament and pulp tissue were rich in cellular elements and blood vessels, the alveolar bone was preserved, and the root surface presented only very small areas of surface resorption (cementum), maintaining the characteristics of normality. In conclusion, the microscopic alterations in the gingival and periodontal tissues in response to an experimentally induced mild dentoalveolar trauma simulating subluxation were not sufficient to contraindicate starting the orthodontic movement 15 and 30 days after trauma.
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This paper reports a case of tooth replantation in which the splinting was performed with stainless steel orthodontic wire and a widely marketed brand of quick-setting cyanoacrylate ester adhesive (Super Bonder((R))). The long-term clinical and radiographic success of the case reported in this paper indicates that the splinting technique using a quick-setting cyanoacrylate ester adhesive may be a feasible option for making a rapid, simple and efficient contention of replanted teeth in situations where the routinely used materials are not readily available.
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The teeth most commonly affected by trauma are the maxillary central incisors. The most frequent types of traumatic dental injuries to permanent teeth are enamel fractures, enamel and dentine fractures, and enamel and dentine fractures with pulp involvement. This article describes three clinical cases with different levels of traumatized maxillary incisors and several cosmetic approaches for recovery of the esthetics and the masticatory function, as well as the social/psychological aspects of treatment. All cases involved young adult men. The three clinical cases involve dentin and enamel fractures, dentin and enamel fractures with pulp exposure, and dentin and enamel fractures with pulp exposure associated with root fracture. The cosmetic treatments used to resolve fractures were direct composite resin by layering technique, indirect all-ceramic restorations (laminate veneer and ceramic crowns over the teeth), and immediate implant after extraction followed by immediate loading (ceramic abutments with ceramic crown over implant). In all three cases, excellent functional and esthetic results were achieved by use of these treatment modalities. The patients were very satisfied with the results.
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This study evaluated periapical tissue healing and orthodontic root resorption of endodontically treated teeth sealed with calcium hydroxide in dogs. The sample consisted of three contralateral pairs of maxillary incisors and two contralateral pairs of mandibular incisors in each of two dogs using a split mouth design. After biomechanical preparation of the teeth in the first group (n = 10), a Ca(OH)(2) dressing was placed for 14 days before root canal filling with Ca(OH)(2)-based sealer (Sealapex) and gutta-percha points. In the second group (n = 10), root canals were obturated immediately after the mechanical preparation with gutta-percha points and zinc oxide and eugenol (ZOE)-based sealer (Endofill). After completion of endodontic treatment, the teeth were moved with an orthodontic appliance with a calibrated force of 200 g, reactivated every 21 days. After 105 days, the animals were killed and the teeth were removed upon completion of active treatment, without a period of recovery, and prepared for histomorphological analysis. All sections of each tooth were graded subjectively on a scale from one to four to obtain the average of the 16 histomorphological parameters analysed. Evaluation of the differences between the two treatment protocols was made with Mann-Whitney U-test. It was observed that the teeth treated with Ca(OH)(2)-based materials provided better outcomes (P = 5%), with complete repair of all root resorption areas, high rate of biological closure of the main canal and apical accessory canals by newly formed cementum, less intense and extensive chronic inflammatory infiltrate, and better organization of the periodontal ligament. Under the tested conditions, Ca(OH)(2)-based materials had a favourable action on periapical tissue healing and repair of orthodontic root resorption in endodontically treated dogs' teeth.
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The maintenance of the avulsed teeth in appropriate media for preserving the cellular viability has been important for repairing the periodontal ligament and preventing the root resorption after tooth reimplantation. Propolis is a substance capable of preserving cellular viability. This study aimed to analyze the propolis substance as a storage media for maintaining the avulsed teeth, besides to determine the ideal time period for keeping the tooth inside it. Thus, 60 maxillary right central incisors of rats were extracted and divided into five groups. In groups I and II, teeth were kept in propolis for 60 min and 6 h, respectively; in group III, teeth were kept in milk for 6 h; in group IV, teeth were kept dry for 60 min; and in group V, they were immediately reimplanted. All teeth had their root canals filled with calcium hydroxide paste. Following, teeth were reimplanted in their sockets. After 15 and 60 days, animals were killed and the obtained samples were processed in laboratory for microscopic and morphometric analyzing. The results showed that the occurrence of inflammatory resorption, dental ankylosis and the formation of the connective tissue parallel to the root surface were similar among groups. It could be verified a greater occurrence of replacement resorption in group IV when comparing to other groups. In groups I and IV, the presence of periodontal ligament-like connective tissue was substantially smaller than the other groups. Regarding to the cementum amount over the root, it could be observed that this was present in smaller amount in groups I and IV. Group II was similar to groups III and IV. Therefore, according to the results of this study, the use of propolis as a storage media for maintaining avulsed teeth could be highlighted, and the 6-h period was more appropriate than the 60-min period.
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\ The biologic width is an essential dental space that always needs to be maintained to ensure periodontal health in any dental prosthetic restorations. An iatrogenic partial fixed prosthesis constructed in lower posterior teeth predisposed the development of subgingival caries, which induced violation of the biologic width in involved teeth, resulting in an uncontrolled inflammatory process and periodontal tissue destruction. This clinical report describes a periodontal surgical technique to recover a violated biologic width in lower posterior teeth, by crown lengthening procedure associated with free gingival graft procedure, to ensure the possibility to place a modified partial fixed prosthesis in treated area. The procedure applied to recover the biologic width was crown lengthening with some modifications, associated with modified partial fixed prosthesis to achieve health in treated area. The modified techniques in both surgical and prosthetic procedures were applied to compensate the contraindications to recover biologic width by osteotomy in lower posterior teeth. The result, after 4 years under periodic control, seems to achieve the projected goal. Treating a dental diseased area is necessary to diagnose, eliminate, or control all etiologic factors involved in the process. When the traditional methods are not effective to recover destructed tissues, an alternative, compensatory, and adaptive procedure may be applied to restore the sequelae of the disease, applying a restorative method that respects the biology of involved tissues.
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Minimal extraoral dry storage period and moist storage for the avulsed tooth are identified as key steps for the treatment protocol of tooth replantation. Among the possible moist storage media, bovine milk has stood out because of its capacity of preserving the integrity of the periodontal ligament (PDL) fibers. This condition has attracted the attention to investigate the use of powdered milk, which is one of the presentation forms of bovine milk, as a feasible storage medium in cases of delayed tooth replantation. The aim of this study was to evaluate the healing process after delayed replantation of rat teeth stored in reconstituted powdered milk and long shelf-life (ultra high temperature) whole milk. Forty maxillary right rat incisors were assigned to four groups (n = 10): group I - the teeth were extracted and immediately replanted into theirs sockets; group II - the teeth were stored for 60 min in 200 ml of freshly reconstituted powdered milk; group III - the teeth were stored for 60 min in 200 ml of long shelf-life whole milk; group IV - the teeth were kept dry for the same time. All procedures were performed at room temperature. Next, the root canals of teeth in groups II, III, and IV were instrumented, filled with a calcium hydroxide-based paste, and replanted into their sockets. All animals received systemic antibiotic therapy and were killed by anesthetic overdose 60 days after replantation. The pieces containing the replanted teeth were removed, fixed, decalcified, and paraffin-embedded. Semi-serial 6-mu m-thick sections were obtained and stained with hematoxylin and eosin for histomorphological analysis. There was statistically significant difference (P < 0.05) between groups I and IV regarding the presence of replacement resorption and PDL remnants on root surface. The powdered milk and long shelf-life whole milk presented similar results to each other and may be indicated as storage media for avulsed teeth.
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Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Bond failures at the acrylic teeth and denture base resin interface are still a common clinical problem in prosthodontics. The effect of methyl methacrylate (MMA) monomer on the bond strength of three types of denture base resins (Acron MC, Lucitone 550 and QC-20) to two types of acrylic teeth (Biotone and Trilux) was evaluated. Twenty specimens were produced for each denture base resin/acrylic tooth combination and were randomly divided into control (acrylic teeth received no surface treatment) and experimental groups (MMA was applied to the surface of the acrylic teeth for 180 s) and were submitted to shear tests (1 mm/mm). Data (MPa) were analyzed using three-way ANOVA/Student's test (alpha = 0.05). MMA increased the bond strength of Lucitone denture base resins and decreased the bond strength of QC-20. No difference was detected for the bond strength of Acron MC base resin after treatment with MMA. (C) 2008 Elsevier Ltd. All rights reserved.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)