O tratamento da apneia obstrutiva do sono e a utilização de implantes osseointegráveis: revisão da literatura

The obstructive sleep apnea syndrome affects millions of people around the world. The mandibular repositioning devices have been indicated in cases of mild/moderate syndrome; however in edentulous patients its use is deficient since there is no retention. Therefore the objective of this study was to conduct a review on the use of this treatment method combined to osseointegrated implants. A search on the theme: Dental implant and sleep apnea syndromewas performed in the Medline/PubMed, ISI, Cochrane, Dentistry Oral Science, Clinical Trials, Controlled Trials, and Bireme-BvS, databases, and 22 articles were found. After anevaluation 2 studies were selected and the review was complemented with an analysis of randomized controlled trials in the previous seven bases using the key-words: Sleep apnea syndrome, Oral appliance and Randomized controlled trial. The search returned 37 articles, and after they were submitted to inclusion criteria 17 studies were selected. There are a small number of studies presenting the use of dental implants as a mean to assist the stabilization of the mandibular repositioning appliances; those that are available are case reports that focusing on the effectiveness of the technique. Studies examining the effect these appliances in dentate patients indicate improvement in the levels of apnea and snoring. The use of mandibular repositioning appliances in dentate patients is an effective technique in treatment of patients with obstructive sleep apnea syndrome mild/moderate. Randomized controlled trialsare required in order to enable an analysis of the use of mandibular repositioning devices with the aid of dental implants .

Effect of toothpastes with different abrasives on eroded human enamel: an in situ/ex vivo study

The aim of the present study was to investigate the abrasive effect of CaCO3 and SiO2-based fluoride-free experimental toothpastes on eroded human permanent dental enamel and evaluate the effectiveness of waiting periods between acid exposure and tooth brushing. Twelve volunteers wore palatal appliances containing human enamel blocks for two periods of five days each. The appliances were immersed in a soft drink for five minutes four times a day (9:00 am, 11:00 am, 2:00 pm and 4:00 pm). On two occasions, two blocks were not submitted to additional treatment; two blocks were brushed (30 s) either with a CaCO3 or SiO2 toothpaste immediately after erosion and two blocks were brushed 1 h after erosion. Thus, the sample was divided into six groups: erosion alone (CaCO3 and SiO2 control); brushing with fluoride- free toothpaste (CaCO3 immediate and 1 h after erosion; SiO2 immediate and 1 h after erosion). Significant differences in wear depth were found between the enamel blocks in the CaCO3 immediate and 1 h after erosion groups and the blocks in the CaCO3 control group (p=0.001; p=0.022). No significant differences were found regarding the change in roughness and wear depth between blocks submitted to immediate abrasion and 1 h after erosion (CaCO3 and SiO2). The data revealed that surface roughness and wear depth is increased when erosion is combined with dental abrasion, regardless of the abrasive used. Waiting for 1 h to brush the eroded blocks offered no protective effect.

Tratamento compensatorio da má oclusnao de classe lll: revisão de literatura

Class III malocclusion is less common occlusal relationship, covering less than 5% of the population. There are various forms of treatment in Class III malocclusion. Depending on how the form is expressed Class III and age of the patient, the therapy may be orthopedic and orthodontic surgical orthodontics. The objective was to review the literature of the last 10 years about ways to compensatory treatment of Class III malocclusion. Several articles were published between 04/2003 and 04/2013 in the Pubmed database from the keyword "Class III malocclusion". However, only 19 articles that addressed the compensatory treatment of Class III were selected. Based on the selected items it was concluded that the treatment of Class III malocclusions in children before the peak of pubertal growth has better prognosis with greater effects orthopedic and orthodontic minor effects. The ideal treatment option for this condition is the Rapid maxillary expansion associated with maxillary protraction of the same. The treatment of Class III malocclusion in young people after the peak of pubertal growth is doubtful prognosis. You can opt to treat rapid maxillary expansion and maxillary protraction of the same or fixed appliance, however, orthopedic effects can be the same or smaller than the orthodontic effects, depending on the age of the patient. Depending on the degree of Class III malocclusion in adults, the treatment will consist of dental compensations or orthognathic surgery.

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator

Objective: To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Materials and Methods: Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. Results: TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. Conclusions: This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

Quad-Helix vs placa removible con tornillo de expansion

The different kind of appliances for the treatment of posterior crossbite make that the orthodontist assess some criterions for their selection and success for the treatment. The aim of this paper was to compare two methods of treatment of the posterior crossbite by two case reports treated with Quad-helix and removable plate. Concluding that the Quad-helix is the appliance of first choice in relation of the removable plate for the short time of active treatment, the less visits and chair time, the fewer cost of treatment and the smaller cooperation of the patient.

Evaluation in situ of tag formation in dental enamel submitted to microabrasion technique: effect of two etching times

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Aplicação da tecnologia 4G em projetos de telefonia

This paper presents a study based on bibliographic research on LTE technology, chosen for the fourth generation of mobile phones, and the current status of implementation of 4G network in Brazil. The change in user behavior, which now uses data over the voice services, requires transmission networks to be increasingly robust and fast to enable the viewing of videos and use of other platforms that require internet connection. The retrospective of the development of mobile technologies, from 1G up to 4G that is currently used, shows the long road until it came to appliances and how the phone is used nowadays. Finally, the popularity of smartphones and hence the growing number of people with access to 4G networks, demanded new researchs for the development of future generations technologies in order to achieve the demand for speed enabling significant changes in user experience

Aplicação da tecnologia 4G em projetos de telefonia

This paper presents a study based on bibliographic research on LTE technology, chosen for the fourth generation of mobile phones, and the current status of implementation of 4G network in Brazil. The change in user behavior, which now uses data over the voice services, requires transmission networks to be increasingly robust and fast to enable the viewing of videos and use of other platforms that require internet connection. The retrospective of the development of mobile technologies, from 1G up to 4G that is currently used, shows the long road until it came to appliances and how the phone is used nowadays. Finally, the popularity of smartphones and hence the growing number of people with access to 4G networks, demanded new researchs for the development of future generations technologies in order to achieve the demand for speed enabling significant changes in user experience

Treatment times of Class II malocclusion: four premolar and non-extraction protocols

The purpose of this study was to retrospectively compare the treatment times of Class II division 1 malocclusion subjects treated with four first premolar extractions or a non- extraction protocol and fixed edgewise appliances. Eighty- four patients were selected and divided into two groups. Group 1, treated with four first premolar extractions, consisted of 48 patients (27 males and 21 females) with a mean age of 13.03 years and group 2, treated without extractions, consisted of 36 patients (18 males and 18 females) with a mean age of 13.13 years. Group 2 was subdivided into two subgroups, 2A consisting of 16 patients treated in one phase and 2B consisting of 20 patients treated in two phases. The initial and final Treatment Priority Index (TPI), initial ages, initial mandibular crowding, and treatment times of groups 1 and 2 were compared with t- tests. These variables were also compared between group 1 and the subgroups with analysis of variance followed by Tukey's tests. The treatment times for groups 1 and 2 and subgroups 2A and 2B were 2.36, 2.47, 2.25, and 2.64 years, respectively, which were not significantly different. Treatment times with non-extraction and four premolar extraction protocols are similar.

Molecular detection of in-vivo microbial contamination of metallic orthodontic brackets by checkerboard DNA-DNA hybridization

Introduction: Knowing the microbiota that colonizes orthodontic appliances is important for planning strategies and implementing specific preventive measures during treatment. The purpose of this clinical trial was to evaluate in vivo the contamination of metallic orthodontic brackets with 40 DNA probes for different bacterial species by using the checkerboard DNA-DNA hybridization (CDDH) technique. Methods: Eighteen patients, 11 to 29 years of age having fixed orthodontic treatment, were enrolled in the study. Each subject had 2 new metallic brackets bonded to different premolars in a randomized manner. After 30 days, the brackets were removed and processed for analysis by CDDH. Data on bacterial contamination were analyzed descriptively and with the Kruskal-Wallis and Dunn post tests (alpha = 0.05). Forty microbial species (cariogenic microorganisms, bacteria of the purple, yellow, green, orange complexes, "red complex + Treponema socranskii," and the cluster of Actinomyces) were assessed. Results: Most bacterial species were present in all subjects, except for Streptococcus constellatus, Campylobacter rectus, Tannerella forsythia, T socranskii, and Lactobacillus acidophillus (94.4%), Propionibacterium acnes I and Eubacterium nodatum (88.9%), and Treponema denticola (77.8%). Among the cariogenic microorganisms, Streptococcus mutans and Streptococcus sobrinus were found in larger numbers than L acidophillus and Lactobacillus casei (P < 0.001). The periodontal pathogens of the orange complex were detected in larger numbers than those of the "red complex + T socranskii" (P < 0.0001). Among the bacteria not associated with specific pathologies, Veillonella parvula (purple complex) was the most frequently detected strain (P < 0.0001). The numbers of yellow and green complex bacteria and the cluster of Actinomyces were similar (P > 0.05). Conclusions: Metallic brackets in use for 1 month were multi-colonized by several bacterial species, including cariogenic microorganisms and periodontal pathogens, reinforcing the need for meticulous oral hygiene and additional preventive measures to maintain oral health in orthodontic patients. (Am J Orthod Dentofacial Orthop 2012;141:24-9)

Molecular detection of Aggregatibacter actinomycetemcomitans on metallic brackets by the checkerboard DNA-DNA hybridization technique

Introduction: The purpose of this randomized clinical study was to evaluate the presence of the periodontal pathogen Aggregatibacter actinomycetemcomitans on metallic brackets and the effectiveness of a 0.12% chlorhexidine digluconate mouthwash in inhibiting this microorganism. Methods: The study involved 35 patients of both sexes having orthodontic treatment with fixed appliances between the ages of 14 and 22 years, randomized into 2 groups: experimental (n = 17) and control (n = 18). Two new metallic brackets were placed on the patients' premolars, and the subjects rinsed with a solution of 0.12% chlorhexidine digluconate or a placebo solution twice a week for 30 days. After that, the brackets were removed and underwent microbiologic analysis with the checkerboard DNA-DNA hybridization technique. Data were analyzed by using the Student t, Fisher exact, and Mann-Whitney tests at the significance level of 5%. Results: The results showed that A actinomycetemcomitans was present in all brackets from the subjects in the control group vs 83% of the subjects who rinsed with chlorhexidine digluconate (P<0.0001). There were also significantly lower levels of this species in the chlorhexidine digluconate group compared with the control group (P = 0.0003). Conclusions: We concluded that 0.12% chlorhexidine digluconate rinsing, twice a week for 30 days during orthodontic treatment, is effective in reducing the presence and levels of A actinomycetemcomitans on metallic brackets. (Am J Orthod Dentofacial Orthop 2012;142:481-6)

In situ Evaluation of the Erosive Potential of Orange Juice Modified by Food Additives

The aim of this study was to evaluate the erosive potential of orange juice modified with food-approved additives: 0.4 g/l of calcium (Ca) from calcium lactate pentahydrate, 0.2 g/l of linear sodium polyphosphate (LPP) or their combination (Ca+LPP) were added to a commercially available orange juice (negative control, C-). A commercially available calcium-modified orange juice (1.6 g/l of calcium) was the positive control (C+). These juices were tested using a short-term erosion in situ model, consisting of a five-phase, single-blind crossover clinical trial involving 10 subjects. In each phase, subjects inserted custom-made palatal appliances containing 8 bovine enamel specimens in the mouth and performed erosive challenges for a total of 0 (control), 10, 20, and 30 min. Two specimens were randomly removed from the appliances after each challenge period. Enamel surface microhardness was measured before and after the clinical phase and the percentage of surface microhardness change (%SMC) was determined. Before the procedures, in each phase, the subjects performed a taste test, where the juice assigned to that phase was blindly compared to C-. Overall, C+ showed the lowest %SMC, being the least erosive solution (p < 0.05), followed by Ca+LPP and Ca, which did not differ from each other (p > 0.05). LPP and C- were the most erosive solutions (p <0.05). Taste differences were higher for C+ (5/10 subjects) and Ca (4/10 subjects), but detectable in all groups, including C- (2/10 subjects). Calcium reduced the erosive potential of the orange juice, while no protection was observed for LPP. Copyright (C) 2012 S. Karger AG, Basel

Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation

The aim of this research was to test the hypothesis that treatment with intra-oral appliances with different occlusal designs was beneficial in the management of pain of masticatory muscles compared with a control group. A total of 51 patients were analysed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to obtain the diagnosis of masticatory myofascial pain (MMP). The sample was then randomly divided into three groups: group I (n = 21) wore a full coverage acrylic stabilisation occlusal splint; group II (n = 16) wore an anterior device nociceptive trigeminal inhibitory (NTI) system; and group III (n = 14) only received counselling for behavioural changes and self-care (the control group). The first two groups also received counselling. Follow-ups were performed after 2 and 6 weeks and 3 months. In these sessions, patients were evaluated by means of a visual analogue scale (VAS) and pressure pain threshold (PPT) of the masticatory muscles. Possible adverse effects were also recorded, such as discomfort while using the appliance and occlusal changes. The results were analysed with KruskalWallis, anova, Tukeys and Friedman tests, with a significance level of 5%. Group I showed improvement in the reported pain at the first follow-up (2 weeks), whereas for groups II and III, this progress was detected only after 6 weeks and 3 months, respectively. The PPT values did not change significantly. It was concluded that behavioural changes are effective in the management of pain in MMP patients. However, the simultaneous use of occlusal devices appears to produce an earlier improvement.

Order-Disorder Transitions Govern Kinetic Cooperativity and Allostery of Monomeric Human Glucokinase

Glucokinase (GCK) catalyzes the rate-limiting step of glucose catabolism in the pancreas, where it functions as the body's principal glucose sensor. GCK dysfunction leads to several potentially fatal diseases including maturity-onset diabetes of the young type II (MODY-II) and persistent hypoglycemic hyperinsulinemia of infancy (PHHI). GCK maintains glucose homeostasis by displaying a sigmoidal kinetic response to increasing blood glucose levels. This positive cooperativity is unique because the enzyme functions exclusively as a monomer and possesses only a single glucose binding site. Despite nearly a half century of research, the mechanistic basis for GCK's homotropic allostery remains unresolved. Here we explain GCK cooperativity in terms of large-scale, glucose-mediated disorder-order transitions using 17 isotopically labeled isoleucine methyl groups and three tryptophan side chains as sensitive nuclear magnetic resonance (NMR) probes. We find that the small domain of unliganded GCK is intrinsically disordered and samples a broad conformational ensemble. We also demonstrate that small-molecule diabetes therapeutic agents and hyperinsulinemia-associated GCK mutations share a strikingly similar activation mechanism, characterized by a population shift toward a more narrow, well-ordered ensemble resembling the glucose-bound conformation. Our results support a model in which GCK generates its cooperative kinetic response at low glucose concentrations by using a millisecond disorder-order cycle of the small domain as a "time-delay loop," which is bypassed at high glucose concentrations, providing a unique mechanism to allosterically regulate the activity of human GCK under physiological conditions.

Structure- and Ligand-Based Structure-Activity Relationships for a Series of Inhibitors of Aldolase

Aldolase has emerged as a promising molecular target for the treatment of human African trypanosomiasis. Over the last years, due to the increasing number of patients infected with Trypanosoma brucei, there is an urgent need for new drugs to treat this neglected disease. In the present study, two-dimensional fragment-based quantitative-structure activity relationship (QSAR) models were generated for a series of inhibitors of aldolase. Through the application of leave-one-out and leave-many-out cross-validation procedures, significant correlation coefficients were obtained (r(2) = 0.98 and q(2) = 0.77) as an indication of the statistical internal and external consistency of the models. The best model was employed to predict pK(i) values for a series of test set compounds, and the predicted values were in good agreement with the experimental results, showing the power of the model for untested compounds. Moreover, structure-based molecular modeling studies were performed to investigate the binding mode of the inhibitors in the active site of the parasitic target enzyme. The structural and QSAR results provided useful molecular information for the design of new aldolase inhibitors within this structural class.