Gliding Mentoplasty: A New Technique

The goal of mentoplasty is to improve chin projection. Traditionally, this is accomplished by either mandibular osteotomy or alloplastic implants. However, these procedures are not free of complications. This report describes gliding mentoplasty, a novel, simple technique for chin projection.The 12 patients in this study underwent gliding mentoplasty. By means of a 2-cm intraoral incision, a subcutaneous dissection was made in the caudal direction. The dissection then proceeded in the subperiosteal plane, leaving a 1-cm cuff of muscle attached to the bone, and advanced toward the lower border of the chin. Subsequently, the dissection was extended laterally, and the whole mental area was dissected from the surrounding tissue. Three 2-0 monofilament nylon sutures were placed in the submandibular periosteum and connected through the remaining muscle cuff to the periosteum. These key sutures allowed the submandibular region to slide forward, project the subcutaneous tissue and mentalis muscle, define the labiomental fold, and improve the pogonion projection.Gliding mentoplasty resulted in a symmetric projection of the chin in all cases. In two patients, a submandibular dimple developed, which spontaneously resolved in 1 month. No revision surgery was performed, and no tissue relapse was noted. The mean follow-up period was 24.7 +/- A 5.17 months (range 19-33 months). All the patients were satisfied with the result.Gliding mentoplasty is a simple, easy-to-perform, rapid surgical technique of chin projection that produces low pain, rapid recovery, and excellent cosmetic results.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Procedures to Evaluate the Efficiency of Protective Clothing Worn by Operators Applying Pesticide

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

Time needed to schedule dermatological consultations in Brazil

BACKGROUND: It is not clear what the population's demand for dermatologists is, nor how many professionals are needed in order to provide adequate care in this area of expertise. Knowledge of the flow of patients at dermatological clinics throughout the country allows for the formation of expansion and distribution policies regarding professionals, and provides backing for the decision to increase medical residency places. OBJECTIVES: To evaluate the time it takes to schedule a private dermatological consultation in Brazil, and other factors concerning consultations. METHODS: Survey with a random sample of 14% of Brazilian dermatologists, simulating the scheduling of emergency clinical and cosmetic consultations, and botulinum toxin procedures. Also, details relating to cost and professionals, were studied. Data were adjusted for each region of the country. RESULTS: A total of 873 dermatologists were evaluated. Full SBD members represented 85%, and 66% were women. The median time to schedule a consultation ranged from 6 (out-of-pocket payment) to 7 (medical insurance) consecutive working days. Times varied depending on the region. A multivariate analysis showed that out-of-pocket consultations and procedures were scheduled sooner than with medical insurance, regardless of whether they were clinical or cosmetic. CONCLUSION: The characteristics of dermatologists are varied throughout regions of the country. Private consultations and procedures are scheduled sooner than with insurance companies.

Can Heat Treatment Procedures of Pre-hydrolyzed Silane Replace Hydrofluoric Acid in the Adhesion of Resin Cement to Feldspathic Ceramic?

Purpose: To evaluate the influence of heat treatment (HT) procedures of a pre-hydrolyzed silane on bond strength of resin cement to a feldspathic ceramic.Materials and Methods: Ceramic and composite blocks (N = 30) were divided into six groups (n = 5) and subjected to the following conditioning procedures: G1: 9.6% hydrofluoric acid (HF) for 20 s + silane (RelyX Ceramic Primer, 3M ESPE) + resin cement (Panavia F2.0, Kuraray) (control); G2: HF (20 s) + silane + heat treatment in furnace (HTF) (100 degrees C, 2 min) + resin cement; G3: silane + HTF + resin cement; G4-HF (20 s) + silane + heat treatment with hot air (HTA) (50 +/- 5 degrees C for 1 min) + resin cement; G5: silane + HTA + resin cement; G6: silane + resin cement. The microtensile bond strength (MTBS) test was performed using a universal testing machine (1 mm/min). After debonding, the substrate and adherent surfaces were analyzed using a stereomicroscope and SEM to categorize the failure types. The data were statistically evaluated using one-way ANOVA and Tukey's test (5%).Results: The control group (G1) showed no pre-test failures and presented significantly higher mean MTBS (16.01 +/- 1.12 MPa) than did other groups (2.63 +/- 1.05 to 12.55 +/- 1.52 MPa) (p = 0.0001). In the groups where HF was not used, HTF (G3: 12.55 +/- 1.52 MPa) showed significantly higher MTBS than did HTA (G5: 2.63 +/- 1.05 MPa) (p < 0.05). All failure types were mixed, ie, adhesive between the resin cement and ceramic accompanied by cohesive failure in the cement.Conclusion: Heat treatment procedures for the pre-hydrolyzed silane either in a furnace or with the application of hot air cannot replace the use of HF gel for the adhesion of resin cement to feldspathic ceramic. Yet when mean bond strengths and incidence of pre-test failures are considered, furnace heat treatment delivered the second best results after the control group, being considerably better than hot air application.

Quantification of Endotoxins in Infected Root Canals and Acute Apical Abscess Exudates: Monitoring the Effectiveness of Root Canal Procedures in the Reduction of Endotoxins

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparison of the performance of natural latex membranes prepared with different procedures and PTFE membrane in guided bone regeneration (GBR) in rabbits

This work assessed the performance of membranes made of natural latex extracted from Hevea brasiliensis prepared with three different methods: polymerized immediately after collection without the use of ammonia (L1); polymerized after preservation in ammonia solution (L2); and polymerized after storage in ammonia, followed by Soxhlet technique for the extraction of substances (L3). Polytetrafluoroethylene (PTFE) membrane was used as control. Two 10-mm diameter bone defects were surgically made in the calvaria of thirty adult male New Zealand rabbits. Defects (total n = 60) were treated with guided bone regeneration (GBR) using L1, L2, L3 or PTFE membranes (n = 15 for each membrane). Ten animals were euthanized after 7, 20 and 60 days postoperatively so that five samples (n = 5) of each treatment were collected at each time, and bone regeneration was assessed microscopically. The microscopic analysis revealed defects filled with blood clot and new bone formation at the margins of the defect in all 7-day samples, while 20-day defects were mainly filled with fibrous connective tissue. After 60 days defects covered with L1 membranes showed a significantly larger bone formation area in comparison to the other groups (P < 0.05, ANOVA, Tukey). Additionally, bone tissue hypersensitization for L1 and PTFE membranes was also investigated in six additional rabbits. The animals were subjected to the same surgical procedure for the confection of one 10-mm diameter bone defect that was treated with L1 (n = 3) or PTFE (n = 3). Fifty-three days later, a second surgery was performed to make a second defect, which was treated with the same type of membrane used in the first surgery. Seven days later, the animals were euthanized and samples analyzed. No differences among L1 and PTFE samples collected from sensitized and non-sensitized animals were found (P > 0.05, Kruskal-Wallis). Therefore, the results demonstrated that latex membranes presented performance comparable to PTFE membranes, and that L1 membranes induced higher bone formation. L1 and PTFE membranes produced no hypersensitization in the bone tissue.

Effects of aging procedures on the topographic surface, structural stability, and mechanical strength of a ZrO2-based dental ceramic

Objective. To determine the effects of different aging methods on the degradation and flexural strength of yttria-stabilized tetragonal zirconia (Y-TZP)Methods. Sixty disc-shaped specimens (0, 12 mm; thickness, 1.6 mm) of zirconia (Vita InCeram 2000 YZ Cubes, VITA Zahnfabrik) were prepared (ISO 6872) and randomly divided into five groups, according to the aging procedures (n=10): (C) control; (M) mechanical cycling (15,000,000 cycles/3.8 Hz/200N); (T) thermal cycling (6,000 cycles/5-55 degrees C/30 s); (TM) thermomechanical cycling (1,200,000 cycles/3.8 Hz/200N with temperature range from 5 C to 55 C for 60s each); (AUT) 12h in autoclave at 134 degrees C/2 bars; and (STO) storage in distilled water (37 degrees C/400 days). After the aging procedures, the monoclinic phase percentages were evaluated by X-ray diffraction (XRD), and topographic surface analysis was performed by 3D profilometry. The specimens were then subjected to biaxial flexure testing (1 mm/min, load 100 kgf, in water). The biaxial flexural strength data (MPa) were analyzed by 1-way ANOVA and Tukey's test (alpha = 0.05). The data for monoclinic phase percentage and profilometry (Ra) were analyzed by Kruskal-Wallis and Dunn's tests.Results. ANOVA revealed that flexural strength was affected by the aging procedures (p = 0.002). The M (781.6 MPa) and TM (771.3 MPa) groups presented lower values of flexural strength than did C (955 MPa), AUT (955.8 MPa), T (960.8 MPa) and STO (910.4 MPa). The monoclinic phase percentage was significantly higher only for STO (12.22%) and AUT (29.97%) when compared with that of the control group (Kruskal-Wallis test, p = 0.004). In addition, the surface roughnesses were similar among the groups (p = 0.165).Signcance. Water storage for 400 days and autoclave aging procedures induced higher phase transformation from tetragonal to monoclinic; however, they did not affect the flexural strength of Y-TZP ceramic, which decreased only after mechanical and thermomechanical cycling. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Analysis of the procedures used to evaluate suicide crime scenes in Brazil: A statistical approach to interpret reports

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

Balanced anesthesia with sevoflurane does not alter redox status in patients undergoing surgical procedures

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

Minimally Invasive Selective Neck Dissection: A Prospective Study of Endoscopically Assisted Dissection via a Small Submandibular Approach in cT(1-2)N(0) Oral Squamous Cell Carcinoma

Selective neck dissection (SND) in clinical N-0 (cN(0)) cases of oral squamous cell carcinoma (SCC) has been performed by surgeons using a retroauricular or modified facelift approach with robotic or endoscopic assistance. However, these procedures provide cosmetic satisfaction at the cost of possible maximal invasiveness. In this prospective study, we introduced and evaluated the feasibility as well as surgical invasiveness and cosmetic outcome of endoscopically-assisted SND via a small submandibular approach.Forty-four patients with cT(1-2)N(0) oral SCC (OSCC) were randomly divided into two groups of endoscopically-assisted SND and conventional SND. Perioperative and postoperative outcomes of patients were evaluated, including the length of the incision, operating time for neck dissection, estimated blood loss during the operation, amount and duration of drainage, total hospitalization period, total number of lymph nodes retrieved, satisfaction scores based on the cosmetic results, perioperative local complications, shoulder syndrome, and follow-up information.The mean operation time in the endoscopically-assisted group (126.04 +/- A 12.67 min) was longer than that in the conventional group (75.67 +/- A 16.67 min). However, the mean length of the incision was 4.33 +/- A 0.76 cm in the endoscopically-assisted SND group, and the amount and duration of drainage, total hospital stay, postoperative shoulder pain score, and cosmetic outcomes were superior in the endoscopically-assisted SND group. Additionally, the retrieved lymph nodes and complications were comparable.Endoscopically-assisted SND via a small submandibular approach had a longer operation time than the conventional approach. However, endoscopically-assisted SND was feasible and reliable while providing minimal invasiveness and satisfactory appearance.

Use of HEPG2 cells to assay the safety of cosmetic active substances

The importance of this study is based on the need to obtain simple and efficient in vitro models to predict the in vivo toxicity of cosmetics, aiming not to use animals as experimental model. Here, we proposed the use of HepG2 cells, which are widely applied to simulate the hepatic function of the human organism in vitro. This cell line was chose since recent studies have shown that the liver is potentially the most frequently targeted organ by cosmetic ingredients, and beyond that, considering the widely application of in vitro assays to test the cutaneous permeation of cosmetic products, including the assays applying modified Franz cells, this technique becomes indispensable. Three different cosmetic active substances were used, and the toxicity to HepG2 cells was assessed by the MTT method. The treatment with hyaluronic acid showed no toxicity to HepG2 cells. Treating the cells with P. guajava L. extract were verified that increasing the amount of the extract in the media, the cellular viability decreased, and finally, the treatment of alpha-lipoic acid showed a cytoprotective effect in relation to the treatment with propylene glycol. The study demonstrated the suitability in using HepG2 cells to assess the safety of cosmetic active substances, helping in the prediction of if the substance could be hepatotoxic if could reach the bloodstream

Alternative approach to the management of postoperative pain after pediatric surgical procedures

This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children.

Clareamento interno em dentes despolpados como alternativa a procedimentos invasivos: relato de caso

The increasing interest of patients for a better aesthetic appearance of their smile, associated with the development of new materials and techniques, encouraged by media couverage of this concept of beauty, provided an important evolution of cosmetic dentistry. As the darkness of a single anterior tooth or a group of teeth, in most cases, impairs the appearance of the smile and there is growing appreciation of the less invasive procedures, the technique of tooth bleaching is an important option for aesthetic treatment. To have success in the bleaching treatment, it is important to have knowledge of the origin, nature and composition of the stain. Among the causes of color changes acquired post-eruptive, dental trauma, with or without pulp necrosis, is one of the most commonly encountered etiologies, characterized by a reddish-brown color. Current techniques of bleaching for teeth treated endodontically employ oxidative agent hydrogen peroxide. The objective of this paper is to describe the immediate technique of bleaching non-vital tooth by presenting a clinical case.

Chemical and morphological features of nanofilled composite resin: influence of finishing and polishing procedures and fluoride solutions

This study evaluated the influence of finishing and polishing procedures and differ-ent fluoride solutions on superficial morphology and chemistry of the nanofilled composite resinSupreme XT (3M) through the EDX analysis and SEM evaluation. Circular specimens (n 5 30) of 10mm diameter and 2 mm thickness were prepared, with half of the sample assays finished and polishedwith Super-Snap1sandpaper. The experimental groups were divided according to the presence or ab-sence of finishing and polishing and solutions (arti ficial saliva, 0.0 5% of manipulated sodium fluoridesolution, Fluordent Re ach, Oral B, Fluorgard). Specimens were immersed in each respective solutionfor 1 min per day, during 60 days and stored in artificial saliva at 37 6 18C between immersion peri-ods. Topography and chemical analysis was qualitative. It was observed that specimens submitted tofinishing and polishing procedures had lower superficial degradation. Fluoride solutio ns promoted su-perficial alterations on specimens, being the highest degradation obtained with Fluordent Reach. Itca n be concluded that finishing and polishing procedures and the immersion media influence the su-perficial morphology of composite resin tested; the Fluordent Reach was the flu oride solution thatmo st affected the material’s surface.

Recobrimento radicular para o tratamento de hipersensibilidade dentinária cervical persistente

Gingival recession has a high prevalence in the population. This alteration may promote several complications such as cervical dentinal hypersensitivity (HSDC), carious and non-carious cervical lesions, and cosmetic changes due to the increase of the clinical crown length. To treat HSDC there are several therapeutic possibilities that should aim to eliminate pain after external stimulus. Treatment of this alteration can be performed by a conventional or invasive procedure, depending on the clinical condition and patients' desires. In situations where aesthetics is not the main complaint and HSDC persists even after conservative procedures, it is possible to indicate a procedure to achieve root coverage in Miller's Class I and II recessions. The aim of this paper is to report a case where the HSDC was not eliminated by conventional methods, which was resolved only after performing a minimally invasive surgery that promoted total root coverage.