Odontoma em pacientes odontopediátrico: diagnóstico e tratamento. Relato de caso clínico.

Odontoma is a term that refers to a benign tumor of odontogenic and mixed nature, composed of epithelial and mesenchymal components. Histologically, they are compounds of different configurations including dental enamel, dentin, cementum and in some cases the pulp tissue. A slow growing asymptomatic tumor, odontoma is usually discovered through routine radiographic examination. A 3-year old male patient sought care at the School of Dentistry’s Baby Clinic (UNESP-Araçatuba), complaining of “small ball close to the teeth.” During the interview, the mother reported that the lesion was observed soon after a trauma, and evolved in less than one month. An ulcerated lesion with a 0.8 cm diameter was found during intraoral clinical examination. It was located in the inferior and anterior region of the mouth, between teeth 81 and 82, and there was also crown distalization. A radiographic examination showed a radiolucent area and root distance. In the absence of clinical and radiographic characteristics suggesting a case of odontoma, the differential diagnosis was peripheral giant cell lesion and pyogenic granuloma. So the area was punctured. Nonetheless, due to the absence of liquid, the surgical removal of the lesion was performed, followed by histological examination, which showed the definite diagnosis of a suggestive case of emerging odontoma.

Protective efficacy of psidium cattleianum (Sabine) and myracrodruon urundeuva (Allemao) leaf extracts against caries development in rats

This study evaluated the influence of Psidium cattleianum Sabine (Myrtaceae) and Myracrodruon urundeuva Allemão (Anacardiaceae) aqueous extracts on S. mutans counts and dental enamel micro-hardness of rats submitted to a cariogenic challenge. Sixty Wistar rats were distributed in three groups and received water (control) or aqueous extracts of Psidium cattleianum or Myracrodruon urundeuva as hydration solution. Initially the animals had their sublingual and submandibular salivary glands surgically removed and the parotid ducts ligated. Then the rats were inoculated with 106 CFU of Streptococcus mutans ATCC 35668 and were fed with a cariogenic diet. To detect and quantify the presence of S. mutans, oral biofilms were sampled and microbial DNA was extracted and submitted to amplification by means of real-time PCR (Polymerase Chain Reaction). After seven weeks the animals were sacrificed and enamel demineralization was analyzed by cross-sectional micro-hardness. Both extracts produced a significant reduction on S. mutans counts and decreased the enamel demineralization. It can be concluded that the extracts tested had a significant effect on S. mutans in oral biofilm of the rats, decreasing S. mutans accumulation and enamel demineralization.

Different esthetic techniques used in combination to improve the smile

This is a clinical case report of a patient who presented with dental stains in the buccal and proximal aspects of the anterior teeth. Buccal stains were removed using the enamel microabrasion technique, and vital tooth bleaching with carbamide peroxide was also performed. Restorative procedures employing composite resin were done for a better result in the proximal aspect of teeth. Clinical significance: The authors observed the combination of these esthetic techniques improved the patient's smile. Today, dental esthetics attempts to imitate natural teeth by making them white, well-shaped, and aligned with no spots. This has enabled the development of several esthetic techniques, such as microabrasion to remove dental enamel surface stains and surface irregularities,1-6 and vital tooth bleaching to treat yellowish teeth.7 The enamel microabrasion technique uses different abrasive agents associated with chemical solutions,1,2,4,6 allowing the removal of intrinsic, hard-texture stains, and different coloring spots on the enamel surface, as well as correction of irregularities on the dental buccal surface.1,8 The various microabrasive products include the Opalustre® (Ultradent Products, http://www.ultradent.com)or Prema® Compound (Premier Dental Products, http://www.premusa.com), a low-concentration hydrochloric acid product associated with silica microparticles that is certainly effective for microabrasion technique,4,6,9,10 providing a good safety profile for the patient and professional. The microabrasion technique also promotes micro-reduction on the adamantine surface.4,5,10 In some cases, after its completion, microabrasion may cause teeth to become darker or yellowish because of the thinner remaining enamel surface, leading to more evident observation of the dentinal tissue, which in general determines tooth color. In these clinical conditions, correction of the color pattern of dental elements can be obtained with carbamide peroxide products applied in custom trays, such as the bleaching products Whiteness Perfect at 10% or 16% (FGM Productos Odontologicos, http://www.fgm.ind.br) or Opalescence® at 10% or 15% (Ultradent Products), with a considerable margin of clinical success, provided it is well indicated, well performed, and supervised by the professional.4,6,9,10 Considering all the aforementioned aspects, the authors present a clinical case about a dental-enamel microabrasion technique used to remove buccal enamel surface stains associated with dental vital bleaching and restorative procedures in the proximal aspect of anterior teeth. - See more at: https://www.dentalaegis.com/cced/2010/08/different-esthetic-techniques-used-in-combination-to-recover-the-smile#sthash.McFoH7El.dpuf

Efeito da adição de nanopartículas de hexametafosfato de sódio em dentifrícios fluoretados sobre a desmineralização dentária: estudo in vitro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação in vitro do tempo de fotopolimerização com led de alta potência de bráquetes ortodônticos e remoção de adesivo remanescente sob luz ultravioleta

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito da adição de flúor e cálcio no gel clareador a base de peróxido de hidrogênio na penetração, cor e microdureza

The objective of this study was to evaluate the effect of adding calcium ions and fluoride in the formulation of a whitening gel 35% hydrogen peroxide in its penetration through the dental structure, whitening efficacy and surface hardness of dental enamel. 80 teeth bovine incisors were used, which were obtained enamel and dentin disks of the buccal surface with 6mm diameter and 2mm thick (1 mm of enamel and dentin 1mm). The samples were divided into four groups stratified according to the protective substance / remineralizing added to the gel of hydrogen peroxide 35%: Group Ca - Calcium gluconate 0.5%; Group F - Sodium fluoride 0.2%; Group Ca + F - Calcium gluconate 0.5% and Sodium Fluoride 0.2%; Control group - no substance was added. The initial color of the samples and the hardness of the enamel were measured before the bleaching procedures. The specimens from each group were placed on a metallic support on which there was a simulated pulp chamber, which was filled with acetate buffer to collect and stabilize the penetrated peroxide. The respective bleaching treatments were applied 3 times, total of 30 minutes of application. The amount of peroxide which passed through the samples was determined by absorbance spectrophotometry. The hardness of the samples was measured immediately after bleaching. Next, the samples were immersed in artificial saliva for 7 days, after which the final color was evaluated. Data were statistically analyzed adopting a 5% significance level

Efeito da adição de flúor e cálcio no gel clareador a base de peróxido de hidrogênio na penetração, cor e microdureza

The objective of this study was to evaluate the effect of adding calcium ions and fluoride in the formulation of a whitening gel 35% hydrogen peroxide in its penetration through the dental structure, whitening efficacy and surface hardness of dental enamel. 80 teeth bovine incisors were used, which were obtained enamel and dentin disks of the buccal surface with 6mm diameter and 2mm thick (1 mm of enamel and dentin 1mm). The samples were divided into four groups stratified according to the protective substance / remineralizing added to the gel of hydrogen peroxide 35%: Group Ca - Calcium gluconate 0.5%; Group F - Sodium fluoride 0.2%; Group Ca + F - Calcium gluconate 0.5% and Sodium Fluoride 0.2%; Control group - no substance was added. The initial color of the samples and the hardness of the enamel were measured before the bleaching procedures. The specimens from each group were placed on a metallic support on which there was a simulated pulp chamber, which was filled with acetate buffer to collect and stabilize the penetrated peroxide. The respective bleaching treatments were applied 3 times, total of 30 minutes of application. The amount of peroxide which passed through the samples was determined by absorbance spectrophotometry. The hardness of the samples was measured immediately after bleaching. Next, the samples were immersed in artificial saliva for 7 days, after which the final color was evaluated. Data were statistically analyzed adopting a 5% significance level

Effect of different restorative procedures on the fracture resistance of teeth submitted to internal bleaching

The aim of this study was to evaluate the influence of different restorative procedures on the fracture resistance of endodontically treated teeth submitted to intracoronal bleaching. Fifty upper central incisors were distributed into 5 groups: GI - healthy teeth; GII - endodontically treated teeth sealed with Coltosol; GIII - endodontically treated teeth bleached and sealed with Coltosol; GIV - endodontically treated teeth bleached and restored with composite resin; and GV - endodontically treated teeth bleached and restored with a fiberglass post and composite resin. In the bleached specimens, a cervical seal was made prior to bleaching with 38% hydrogen peroxide. The gel was applied on the buccal surface and in the pulp chamber, and was then light-activated for 45 s. This procedure was repeated three times per session for four sessions, and each group was submitted to the restorative procedures described above. The specimens were submitted to fracture resistance testing in a universal testing machine. There were statistically significant differences among the groups (p < 0.05). The mean value found for GIII was the lowest (0.32 kN) and was significantly different from the values found for GI (0.75 kN), GII (0.67 kN), GIV (0.70 kN), and GV (0.72 kN), which were not significantly different from each other (p > 0.05). The restorative procedures using composite resin were found to successfully restore the fracture resistance of endodontically treated and bleached teeth.

Erosive potential of different types of grape juices

The purpose of the present study was to evaluate the erosive potential of different types (concentrated and powdered) and commercial brands of industrialised grape juices. The pH of all five fruit drinks was measured at two time points: immediately after preparation and 24 hours later. Sixty specimens of bovine enamel were randomly allocated and immersed in different types of grape juice (n = 10) for 10 minutes four times a day for fifteen days. The enamel alteration was analysed using surface Knoop microhardness (KHN) and surface roughness (R-a) tests at baseline and on the 5th, 10th and 15th days of the experiment. Two way ANOVA, Tukey's post hoc and Pearson's correlation tests were used for statistical analysis (alpha = 5%). The grape juices presented pH values ranging from 2.9 to 3.5. All of the tested juices promoted significant enamel mineral loss (p < 0.05) on the first evaluation (5th day of immersion) and produced a significant increase in the mean roughness from the 10th day on when compared to the control group (p < 0.05). By the 15th day, all of the beverages had produced surface roughnesses that were significantly higher than that of the control group. The results suggest that all grape juices, regardless of their commercial presentation, present erosive potential.

Clinical Performance of Porcelain Laminate Veneers: Outcomes of the Aesthetic Pre-evaluative Temporary (APT) Technique

This article evaluates the long-term clinical performance of porcelain laminate veneers bonded to teeth prepared with the use of an additive mock-up and aesthetic pre-evaluative temporary (APT) technique over a 12-year period. Sixty-six patients were restored with 580 porcelain laminate veneers. The technique, used for diagnosis, esthetic design, tooth preparation, and provisional restoration fabrication, was based on the APT protocol. The influence of several factors on the durability of veneers was analyzed according to pre- and postoperative parameters. With utilization of the APT restoration, over 80% of tooth preparations were confined to the dental enamel. Over 12 years, 42 laminate veneers failed, but when the preparations were limited to the enamel, the failure rate resulting from debonding and microleakage decreased to 0%. Porcelain laminate veneers presented a successful clinical performance in terms of marginal adaptation, discoloration, gingival recession, secondary caries, postoperative sensitivity, and satisfaction with restoration shade at the end of 12 years. The APT technique facilitated diagnosis, communication, and preparation, providing predictability for the restorative treatment. Limiting the preparation depth to the enamel surface significantly increases the performance of porcelain laminate veneers. (Int J Periodontics Restorative Dent 2012;32:625-635.)

Celiachia e difetti dello smalto in età evolutiva: correlazione tra periodo di esposizione al glutine, forme cliniche di celiachia e aplotipo HLA

The association between celiac disease (CD) and dental enamel defects (DED) is well known. AIM: This study was designed to investigate the prevalence of DED in CD children and to specifically find a possible correlation between DED and gluten exposure period, CD clinical forms, HLA class II haplotype. MATERIALS AND METHODS: This study was designed as a matched case-control study: 374 children were enrolled (187 celiac and 187 non celiac). Data about age at CD diagnosis, CD clinical form and HLA haplotype were recorded. RESULTS: DED were detected in 87 celiac subject while no dental lesions were found in the remaining 100 patients; in 187 healthy controls enamel lesion were significantly less frequent (5.3 % versus 46.5% ; p<0.005).We found a correlation between DED and gluten exposure period, since among CD patients the mean age at CD diagnosis was significantly (p= 0.0004) higher in the group with DED (3.41± 1.27) than without DED (1.26± 0.7). DED resulted more frequent in atypical and silent forms than in the typical one. The presence of HLA DR 52-53 and DQ7 antigens significantly increased the risk of DED (p=0.0017). CONCLUSIONS: Our results confirmed a possible correlation between CD clinical form, age at CD diagnosis, HLA antigens and DED. The origin of DED in CD children is due to multifactorial events and further studies are needed to investigate other determinants.

The prehistoric inhabitants of the Wadi Howar : an anthropological study of human skeletal remains from the Sudanese part of the Eastern Sahara

All currently available human skeletal remains from the Wadi Howar (Eastern Sahara, Sudan) were employed in an anthropological study. The study’s first aim was to describe this unique 5th to 2nd millennium BCE material, which comprised representatives of all three prehistoric occupation phases of the region. Detecting diachronic differences in robusticity, occupational stress levels and health within the spatially, temporally and culturally heterogeneous sample was its second objective. The study’s third goal was to reveal metric and non-metric affinities between the different parts of the series and between the Wadi Howar material and other relevant prehistoric as well as modern African populations. rnThe reconstruction and comprehensive osteological analysis of 23 as yet unpublished individuals, the bulk of the Wadi Howar series, constituted the first stage of the study. The analyses focused on each individual’s in situ position, state of preservation, sex, age at death, living height, living weight, physique, biological ancestry, epigenetic traits, robusticity, occupational stress markers, health and metric as well as morphological characteristics. Building on the results of these efforts and the re-examination of the rest of the material, the Wadi Howar series as a whole, altogether 32 individuals, could be described. rnA wide variety of robusticity, occupational stress and health variables was evaluated. The pre-Leiterband (hunter-gatherer-fisher/hunter-gatherer-fisher-herder) and the Leiterband (herder-gatherer) data of over a third of these variables differed statistically significantly or in tendency from each other. The Leiterband sub-sample was characterised by higher enamel hypoplasia frequencies, lower mean ages at death and less pronounced expressions of occupational stress traits. This pattern was interpreted as evidence that the adoption and intensification of animal husbandry did probably not constitute reactions to worsening conditions. Apart from that, the relevant observations, noteworthy tendencies and significant differences were explained as results of a broader spectrum of pre-Leiterband subsistence activities and the negative side effects of the increasingly specialised herder-gatherer economy of the Leiterband phase. rnUsing only the data which could actually be collected from it, multiple, separate, individualised discriminant function analyses were carried out for each Wadi Howar skeleton to determine which prehistoric and which modern comparative sample it was most similar to. The results of all individual analyses were then summarised and examined as a whole. Thus it became possible to draw conclusions about the affinities the Wadi Howar material shared with prehistoric as well as modern populations and to answer questions concerning the diachronic links between the Wadi Howar’s prehistoric populations. When the Wadi Howar remains were positioned in the context of the selected prehistoric (Jebel Sahaba/Tushka, A-Group, Malian Sahara) and modern comparative samples (Southern Sudan, Chad, Mandinka, Somalis, Haya) in this fashion three main findings emerged. Firstly, the series as a whole displayed very strong affinities with the prehistoric sample from the Malian Sahara (Hassi el Abiod, Kobadi, Erg Ine Sakane, etc.) and the modern material from Southern Sudan and, to a lesser extent, Chad. Secondly, the pre-Leiterband and the Leiterband sub-sample were closer to the prehistoric Malian as well as the modern Southern Sudanese material than they were to each other. Thirdly, the group of pre-Leiterband individuals approached the Late Pleistocene sample from Jebel Sahaba/Tushka under certain circumstances. A theory offering explanations for these findings was developed. According to this theory, the entire prehistoric population of the Wadi Howar belonged to a Saharo-Nilotic population complex. The Jebel Sahaba/Tushka population constituted an old Nilotic and the early population of the Malian Sahara a younger Saharan part of this complex. The pre-Leiterband groups probably colonised the Wadi Howar from the east, either during or soon after the original Saharo-Nilotic expansion. Unlike the pre-Leiterband groups, the Leiterband people originated somewhere west of the Wadi Howar. They entered the region in the context of a later, secondary Saharo-Nilotic expansion. In the process, the incoming Leiterband groups absorbed many members of the Wadi Howar’s older pre-Leiterband population. The increasing aridification of the Wadi Howar region ultimately forced its prehistoric inhabitants to abandon the wadi. Most of them migrated south and west. They, or groups closely related to them, probably were the ancestors of the majority of the Nilo-Saharan-speaking pastoralists of modern-day Southern Sudan and Eastern Chad.

Natale und neonatale Zähne

Natal teeth have been defined as teeth which are present at birth, while neonatal teeth erupt during the first 30 days. Their occurrence is rare, the prevalence ranges from 1:2000 to 1:3000 with a higher frequency in the lip and palate clefts and syndroms. In about 85% natal or neonatal teeth are lower central incisors (60% in pairs), rare are upper teeth, molars and multiple teeth. In almost 90% they are part of the deciduous dentition. A lot of possible causes of early eruption are discussed, but only the relation to hereditary factors seems to be evident. An autosomal dominant trait is often described. The appearance of these teeth is dependent on the degree of maturity, but most of the time it is loose, small, discoloured and hypoplastic. Histologically, enamel hypoplasia with normal prism structure is apparent. No significant disturbances of the dentin structures are observed, only cervically dentin becomes atubular with spaces and enclosed cells. A large vascular pulp and failure of root formation are further investigations. Our microhardness measurements showed values from 24.3-32.4 KHN for enamel and 48.3-62.2 KHN for dentin, while normal deciduous teeth have an enamel hardness of 322.0 +/- 17.5 KHN. The thickness of enamel was never more than 280 microm compared to up to 1200 microm in normal teeth. This shows the retarded development of natal and neonatal teeth, because mineralization has not finished at the time of birth. In accordance with developmental age tooth structure and appearence are normal. In consideration of complications as Riga-Fede-disease, feeding problems, possibility of infection and hypermobility most of the time extraction is the treatment of choice, but in the interest of protecting the child this decision should be made carefully.

Erosive and buffering capacities of yogurt

OBJECTIVE: The capability of drinks and foods to resist pH changes brought about by salivary buffering may play an important role in the erosion of dental enamel. The aim of the present study was to measure the initial pH of several types of yogurt and to test the degrees of saturation (pK-pl) with respect to hydroxyapatite and fluorapatite to determine the buffering capacity and related erosive potential of yogurt. METHOD AND MATERIALS: Twenty-five milliliters of 7 types of freshly opened yogurt was titrated with 1 mol/L of sodium hydroxide, added in 0.5 mL increments, until the pH reached 10, to assess the total titratable acidity, a measure of the drink's own buffering capacity. The degrees of saturation (pK-pl) with respect to hydroxyapatite and fluorapatite were also calculated, using a computer program developed for this purpose. For statistical analysis, samples were compared using Kruskal-Wallis test. RESULTS: The buffering capacities can be ordered as follows: fruit yogurt >low-fat yogurt >bioyogurt >butter yogurt >natural yogurt >light fruit yogurt >light yogurt. The results suggest that, in vitro, fruit yogurt has the greatest buffering capacity. CONCLUSION: It can be stated that it is not possible to induce erosion on enamel with any type of yogurt.

Poly(ethylene oxide)-b-poly(3-sulfopropyl methacrylate) block copolymers for calcium phosphate mineralization and biofilm inhibition.

Poly(ethylene oxide) (PEO) has long been used as an additive in toothpaste, partly because it reduces biofilm formation on teeth. It does not, however, reduce the formation of dental calculus or support the remineralization of dental enamel or dentine. The present article describes the synthesis of new block copolymers on the basis of PEO and poly(3-sulfopropyl methacrylate) blocks using atom transfer radical polymerization. The polymers have very large molecular weights (over 10(6) g/mol) and are highly water-soluble. They delay the precipitation of calcium phosphate from aqueous solution but, upon precipitation, lead to relatively monodisperse hydroxyapatite (HAP) spheres. Moreover, the polymers inhibit the bacterial colonization of human enamel by Streptococcus gordonii, a pioneer bacterium in oral biofilm formation, in vitro. The formation of well-defined HAP spheres suggests that a polymer-induced liquid precursor phase could be involved in the precipitation process. Moreover, the inhibition of bacterial adhesion suggests that the polymers could be utilized in caries prevention.