Edentulous patients' knowledge of dental hygiene and care of prostheses

Objective: The aim of this study was to analyse denture users' oral care habits with regard to the use of their prostheses. Background: Rehabilitative treatment is only successful when patients are motivated and aware of correct prosthesis use and hygiene. Materials and methods: Questionnaires were distributed to 150 complete denture users at the Federal University of Bahia School of Dentistry, the Esmeralda Natividade Health Center, the Bahian Science Development Foundation and a Salvador nursing home. The questionnaire included information on gender, age, length of prosthesis use, cleaning methods and materials, etc. The data were analysed using EpiInfo version 6 software. The chi-squared test was used for statistical analysis, with a significance level of 5%. Results: Questionnaire results showed that 78% of the subjects, with an average age of 67.3 years, had used the same complete denture for over 5 years. 64% slept with their prostheses and 44% removed them from the mouth only for cleaning. None of the patients interviewed knew anything about brushes designed specifically for complete dentures. 37.3% had a restricted diet and 44% believed that a complete denture would last for more than 10 years. Conclusion: Within the limitations of this study, it was concluded that the edentulous patients surveyed had limited awareness of prosthetic hygiene and long-term oral care despite extended periods of denture use. © 2008 The Authors.

Effect of occlusion on joint sounds in asymptomatic individuals.

Occlusion is a predisposing factor for Temporomandibular Dysfunctions (TMD) of the joint, whose first sign and/or symptom is usually joint sound. To verify the effect of occlusion on joint sounds, temporomandibular joints (TMJ) were analyzed in 78 asymptomatic individuals with various dental conditions. Electrosonography was used to determine the intensity of the vibration in the temporomandibular joint (TMJ) on opening and closing the mouth. Transducers (piezoelectric accelerometer) were placed on the right and left joints. Results were tabled and analyzed using the Kruskal-Wallis test (a=0.05). It was concluded that TMJ vibration in partly edentulous individuals from Kennedy classes I, II and III is statistically higher than in dentate and fully edentulous subjects.

Effects of mandibular fixed implant-supported prostheses on masticatory and swallowing functions in completely edentulous elderly individuals

Purpose: To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and rive men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals.

Joint sounds in complete denture wearers. Literature review.

Long-term denture wearers can present with prosthesis instability, reduced occlusal vertical dimension and incorrect positioning of the jaw. This can lead to muscular changes and joint vibration. This study presents the main considerations related to joint vibrations in partially or totally edentulous patients. Occlusal treatment improves the disc-condyle relationship in the mandibular fossa. Furthermore, a detailed clinical exam and anamnesis must be performed to identify the dysfunction and its etiology, so that appropriate treatment can be provided.

Rehabilitation with zygomatic implants: a treatment option for the atrophic edentulous maxilla--9-year follow-up.

This article reports the 9-year clinical outcome of the two-stage surgical rehabilitation of a severely atrophic edentulous maxilla with a metal-resin fixed denture supported by implants anchored in the zygomatic bone and the maxilla. After clinical and radiographic examination, zygomatic implants were inserted bilaterally and four standard implants were placed in the anterior region of the maxilla. Six months later, the implants were loaded with a provisional acrylic resin denture, and the definitive implant-supported metal-resin fixed denture was provided 1 year after implant placement. After 9 years of follow-up, no painful symptoms, peri-implant inflammation or infection, implant instability, or bone resorption was observed. In the present case, the rehabilitation of severe maxillary atrophy using the zygomatic bone as a site for implant anchorage provided good long-term functional and esthetic results. Therefore, with proper case selection, correct indication, and knowledge of the surgical technique, the use of zygomatic implants associated with standard implants offers advantages in the rehabilitation of severely resorbed maxillae, especially in areas with inadequate bone quality and volume, without needing an additional bone grafting surgery, thereby shortening or avoiding hospital stay and reducing surgical morbidity.

Implant removal by means of an expansion of the alveolar bony crest: Report of a clinical technique

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

Fate of autologous and fresh-frozen allogeneic block bone grafts used for ridge augmentation. A CBCT-based analysis

Objectives: To evaluate dimensional changes in autologous (AT) and fresh-frozen allogeneic (AL) block bone grafts 6 months after alveolar ridge augmentation. Material and methods: Twenty-six partially or totally edentulous patients treated either with fresh-frozen AL bone or AT bone onlay block grafts prior to implant placement (13 patients in each group), were included in this analysis. Patients received CBCT (i-CAT Classic) examinations prior to surgery and 14 days and 6 months after grafting. Differences in alveolar ridge area among the various observation times were evaluated by planimetric measurements on two-dimensional CBCT images of the grafted regions. Nineteen grafted blocks from each group were evaluated. Results: Significant increase in alveolar ridge dimensions, allowing implant placement, was obtained with both types of grafts 6 months after grafting; no significant differences in alveolar ridge area were observed between the groups at the various observation times. However, graft resorption in the AL group was significantly larger compared to that in the AT group at 6 months. Conclusions: Larger bone graft resorption was seen in patients treated with fresh-frozen AL bone than in those treated with AT bone 6 months following alveolar ridge augmentation. © 2011 John Wiley & Sons A/S.

Cinnamic acid is partially involved in propolis immunomodulatory action on human monocytes

Propolis is a beehive product used in traditional medicine due to its biological properties. It shows a complex chemical composition including phenolics, such as cinnamic acid (Ci). The mechanisms of action of propolis have been the subject of research recently; however, the involvement of Ci on propolis activity was not investigated on immune cells. Ci effects were evaluated on human monocytes, assessing the expression of Toll-like receptors (TLRs), HLA-DR, and CD80. Cytokine production (TNF-α and IL-10) and the fungicidal activity of monocytes were evaluated as well. Data showed that Ci downregulated TLR-2, HLA-DR, and CD80 and upregulated TLR-4 expression by human monocytes. High concentrations of Ci inhibited both TNF-α and IL-10 production, whereas the same concentrations induced a higher fungicidal activity against Candida albicans. TNF-α and IL-10 production was decreased by blocking TLR-4, while the fungicidal activity of monocytes was not affected by blocking TLRs. These results suggest that Ci modulated antigen receptors, cytokine production, and the fungicidal activity of human monocytes depending on concentration, and TLR-4 may be involved in its mechanism of action. Ci seemed to be partially involved in propolis activities. © 2013 Bruno José Conti et al.

No changes in seedling recruitment when terrestrial mammals are excluded in a partially defaunated Atlantic rainforest

One of the most intriguing questions in ecology is how to identify which and how many species will be able to inhabit human-modified landscapes. Large-bodied mammals structure plant communities by trampling, herbivory, seed dispersal and predation, and their local extinction may have pervasive consequences in plant communities due to the breakdown of key interactions. Although much attention has been given to understanding the effects of defaunation on plant communities, information on the potential impacts on plant functional groups (seed dispersal, seed size and seedling leaves defense) inhabiting continuous forests after defaunation is scarce. We conducted mammal surveys (line transects and camera trapping) to determine the defaunation status of a continuous Atlantic forest in Brazil. Then, we evaluated the effects of defaunation on seedling diversity, richness and abundance of functional groups using 15 plot-pairs (each pair with one open and one exclusion plot) monitored over 36. months. We found that the studied area is partially defaunated because it exhibits high abundance of primates, while terrestrial mammals, such as large rodents and ungulates, are rare. We found no significant changes in either seedling richness and diversity or in the seedling composition of plant functional groups in response to mammal exclosure. Seedling mortality and recruitment were similar between plot types. Our findings suggest that at semi-defaunated areas, where arboreal species are still present, terrestrial mammals have low impacts on the plant community reassembly. © 2013 Elsevier Ltd.

Immunological aspects of fresh-frozen allogeneic bone grafting for lateral ridge augmentation

Objectives: To present some immunological aspects of fresh-frozen allogeneic bone grafting for lateral bone augmentation, based on the quantitative evaluation of IL-10, IL-1β, IFN- γ and TNF- α in patients sera. Material and methods: Thirty-three partially or totally edentulous patients received fresh-frozen allogeneic bone (AL - 20 patients) or autologous bone onlay block grafts (AT - 13 patients) prior to oral implant placement. Blood samples were collected from each patient at various time-points during a 6 month-period (baseline, 14, 30, 90 and 180 days postoperatively). Quantitative evaluation of IL-10, IL-1β, IFN- γ and TNF- α was performed by enzyme linked immunosorbent assay (ELISA). Results: For all evaluated markers and at all evaluated periods, inter-group comparisons showed no statistically significant differences between the groups, while the observed values were within normal levels. For AL-treated patients, intra-group evaluation showed statistically significant increase of TNF-α from baseline to 90 (P < 0.001) and 180 (P < 0.01) days, and from 14 to 90 (P < 0.01) and 180 (P < 0.05) days. IFN- γ showed intercalated results, with a decrease from baseline to 14 days (P < 0.05), and increase from 14 to 90 days (P < 0.001) and 180 (P < 0.05) days. No differences between the periods of evaluation were found for the AT group. Conclusions: AL grafting for lateral bone augmentation, similar to AT grafting, does not seem to challenge the immune system significantly. © 2012 John Wiley & Sons A/S.

Ergodic crossover in partially self-avoiding stochastic walks

Consider a one-dimensional environment with N randomly distributed sites. An agent explores this random medium moving deterministically with a spatial memory μ. A crossover from local to global exploration occurs in one dimension at a well-defined memory value μ1=log2N. In its stochastic version, the dynamics is ruled by the memory and by temperature T, which affects the hopping displacement. This dynamics also shows a crossover in one dimension, obtained computationally, between exploration schemes, characterized yet by the trajectory size (Np) (aging effect). In this paper we provide an analytical approach considering the modified stochastic version where the parameter T plays the role of a maximum hopping distance. This modification allows us to obtain a general analytical expression for the crossover, as a function of the parameters μ, T, and Np. Differently from what has been proposed by previous studies, we find that the crossover occurs in any dimension d. These results have been validated by numerical experiments and may be of great value for fixing optimal parameters in search algorithms. © 2013 American Physical Society.

Avaliação da formação óssea em implantes dentários de ratos não diabéticos, diabéticos não controlados e controlados com insulina

Pós-graduação em Bases Gerais da Cirurgia - FMB

Revisão taxonômica do gênero Hassar Eigenmann & Eigenmann, 1888, com a descrição osteológica de Hassar orestis (Steindachner, 1875) (Siluriformes, Doradidae)

O gênero Hassar (Doradidae) é um grupo natural de Siluriformes Neotropical. No presente trabalho foi realizada revisão taxonômica do referido gênero com a descrição osteológica de Hassar orestis, espécie-tipo do gênero. Este estudo foi fundamentado no levantamento e análise de caracteres morfológicos, morfométricos, merísticos e de padrão de coloração para o reconhecimento das espécies válidas e conseqüentes diagnoses e redescrições. Foram analisados 727 exemplares, provenientes de instituições nacionais e estrangeiras, envolvendo indivíduos preservados em álcool, preparados para esqueleto seco, diafanizados, radiografados e fotografados. Os exemplares foram analisados diretamente ou com auxílio de microscópio-estereoscópico e câmara clara. Medidas foram feitas, preferencialmente, do lado esquerdo do indivíduo. A descrição osteológica de Hassar orestis foi fundamentada na análise de 23 exemplares de instituições nacionais e estrangeiras e foi dividida em grupos funcionais osteológicos que são: elementos do neurocrânio, arco mandibular, arco hióide, arcos branquiais, esqueleto axial, placas nucais e nadadeira dorsal, sistema látero-sensorial e esqueleto apendicular. Os dados foram digitalizados e armazenados em formato de planilhas. Os resultados mostraram que Hassar é formado por duas espécies válidas: H. orestis e H. affinis. Hassar orestis é a espécie-tipo, tendo como sinônimo H. ucayalensis. Hassar affinis tem como sinônimos H. wilderi, H. iheringi e H. woodi. Hassar orestis e H. affinis se diferenciam pela posição do 1° espinho medial (no escudo infranucal ou entre o 1° e 8° escudo lateral vs. entre o 9° e 16° escudo lateral), número de escudos laterais providos de espinho medial (24 a 33 vs. 18 a 23) e pelos divertículos marginais filiformes da bexiga natatória (distintamente maiores vs. reduzidos ou ausentes). Os adultos (> 14 cm) de H. orestis e H. affinis diferiram pela altura do pedúnculo caudal (4,11-5,71% SL vs. 5,73 -7,63% SL) e pelo tamanho da pálpebra adiposa (conspícua e alongada na borda anterior dos olhos vs. tênue na borda anterior dos olhos). Não houve diferenças morfológicas, morfométricas e merísticas entre jovens e adultos da mesma espécie. As espécies apresentaram o mesmo padrão de coloração. Exemplares de H. orestis (N=551) possuem mancha enegrecida subterminal nos primeiros raios da nadadeira dorsal, diferentemente de H. affinis (N=176) cuja mancha pode ser subterminal ou terminal. A presença de prolongamento cartilaginoso no primeiro raio da nadadeira dorsal, em alguns machos de H. orestis, corroborou o dimorfismo sexual para espécie. Exemplares de H. orestis, provenientes dos rios Amazonas, Solimões e Negro, diferem da população do rio Branco e das Bacias dos rios Essequibo e Orinoco pela presença ou não de espinhos nos escudos timpânicos e no escudo infranucal. Não há diferença quanto à bexiga natatória dessas populações. A distribuição de H. affinis foi ampliada para os rios Solimões, Tapajós, baixo e alto Xingu, Tocantins, Araguaia, Parnaíba e Sistema Pindaré-Mearim. Hassar affinis e H. orestis apresentam ampla distribuição, parcialmente disjunta, com uma área de simpatria. A descrição osteológica da espécie-tipo proporcionou um melhor conhecimento anatômico do grupo, que serve de dado básico para trabalhos como anatomia, ontogenia, ecomorfologia e futuros eventuais trabalhos de sistemática e taxonomia.

Avaliações biomecânicas e biológicas relacionadas às próteses implanto-suportadas e aos implantes osseointegrados

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)