Gross and microscopic observations on the lingual structure of the franciscana (Pontoporia blainvillei-gervais and d'orbigny, 1844)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desempenho auditivo ao longo do tempo e satisfação dos usuários de implante coclear com perda auditiva pós-lingual

Most cochlear implant (CI) users, who suffer from post lingual hearing loss, are able to perceive sounds and comprehend speech after the implant. The prediction of maximal benefit over time, with the use of CI, can be useful for counseling patients about their expectations in using the new device. The measurement of satisfaction should be of primary interest in medical intervention, as the results may be used for intervention feedback. The purpose of this study is to analyze auditory performance of CI over time, as well as to evaluate users‟ satisfaction. Therefore two types of study designs were employed: a) retrospective cohort study with the analysis of medical records from 59 subjects about auditory performance before and after surgery. Results were submitted to the Kaplan -Meier estimator of cumulative probability and compared to prognostic factors of auditory performance using the logrank test. b) A sectional study design was conducted to evaluate the satisfaction of 51 subjects. The instrument consists of two specific questionnaires: Satisfaction with Amplification in Daily Life SADL and International Outcome Inventory Cochlear Implant IOI- CI. Results show statistical significant differences (p<0,001) in auditory performance before and after CI. The majority obtained satisfactory results of CI use during the first six months. Logrank tests does not indicate significant correlation between the analyzed covariates and the time in which adequate speech perception occurs. SADL e IOI-CI questionnaires indicate that most of the CI users are satisfied with their devices. The SADL detected a 27, 5% insatisfaction amongst CI users in relation to services and costs involved with the CI. The results of the IOI show 4% of insatisfaction with the use of CI and the social environment. In conclusion CI is capable to rehabilitate social auditory function in a short period of time and CI users demonstrate satisfaction with auditory, social and psychological gain offered through CI device

Conforto e fonação com a nova geração de bráquetes ortodônticos linguais individualizados

TEMA: recentemente o número de pacientes desejando um tratamento ortodôntico e estético ao mesmo tempo aumentou consideravelmente. A técnica lingual oferece a opção mais estética de tratamento ortodôntico, pois os bráquetes ficam invisíveis colados na superfície lingual dos dentes e os lábios não ficam protuberantes. Apesar da grande vantagem estética, essa terapia possui desvantagens como restrição no conforto oral, na fala, na higiene, irritações na língua, restrição no espaço da língua e dificuldades na alimentação. Para amenizar essas desvantagens uma nova geração de bráquetes linguais otimizados ao máximo através da individualização das bases dos bráquetes, da posição de colagem e dos fios utilizados no tratamento ortodôntico foi desenvolvida recentemente. OBJETIVO: realizar uma revisão sistemática da literatura para verificar a adaptação do paciente a diferentes dispositivos ortodônticos linguais e a influência desses dispositivos no conforto e na fala, principalmente. CONCLUSÃO: atualmente a literatura suporta que os bráquetes linguais de última geração individualizados por computador proporcionam maior conforto e facilidade na fonação quando comparados aos bráquetes tradicionais da técnica lingual. No entanto, o sucesso na terapia requer orientações detalhadas sobre o potencial de restrição do conforto oral, articulação de palavras, mastigação e higiene oral, independente do sistema de bráquetes a ser utilizado.

Accidental swallowing of orthodontic expansion appliance key

Ingestion of a foreign object, including a dental object, can lead to a trip to the emergency room. This article describes the accidental swallowing of a key that was used to activate a rapid maxillary expander. An orthodontic patient swallowed the key while trying to activate the appliance at home. The object's trajectory was followed on radiographs until it was eliminated. Possible clinical complications, legal implications of this situation, and practices for prevention are described. (Am J Orthod Dentofacial Orthop 2011;140:266-8)

In Vitro Assessment of Chemical Activation Efficiency During In-office Dental Bleaching

Purpose: This study compared five types of chemical catalyzing agents added to 35% hydrogen peroxide gel, with regard to their capacity of intensifying in-office dental bleaching results.Methods: One-hundred and twenty bovine incisors were used, of which the crowns and roots were cut in the incisor-apical direction, to acquire the dimensions of a human central incisor. The specimens were sectioned in the mesiodistal direction by means of two longitudinal cuts, the lingual halves being discarded. The vestibular halves received prophylaxis with a bicarbonate jet, ultrasound cleaning and acid etching on the dentinal portion. Next, the specimens were stored in receptacles containing a 25% instant coffee solution for two weeks. After the darkening period, initial measurement of the shade obtained was taken with the Easy Shade appliance, which allowed it to be quantified by the CIELab* method. The samples were divided into six groups, corresponding to the chemical activator used: a) none (CON); b) ferric chloride (CF); c) ferrous sulphate (SF); d) manganese gluconate (GM); e) manganese chloride (CM); f) mulberry root extract (RA). Each group received three 10-minute applications of the gels containing the respective activating agents. Next, a new shade measurement was made.Results: The Analysis of Variance and Tukey tests (alpha=5%) showed statistically significant differences for the shade perception values (p=0.002). Groups GM, CM and RA showed significantly higher means than the control group.Conclusion: The presence of some chemical activators is capable of resulting in a significant increase in tooth shade variation.

Os efeitos dos aparelhos funcionais sobre a dimensão transversal da maxila e mandíbula

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influence of the banded Herbst appliance on dental changes in mixed dentition

OBJECTIVE: This prospective clinical study was conducted with the purpose of evaluating the influence of the banded Herbst appliance on dental changes during the early treatment of Class II malocclusion. METHOD: The sample consisted of 15 prepubertal subjects (12 boys and 3 girls, initial age: 9 years and 6 months) who were treated with the Herbst appliance. Treatment effects were compared with those of a Class II Division 1 group of 15 subjects (8 boys and 7 girls, mean initial age 9 years and 1 month), not treated orthodontically. Statistical analysis was performed using Student t-test with 5% significance level. RESULTS: The results showed that treatment with the banded Herbst appliance in the mixed dentition stage tended to upright maxillary incisors (mean: 4.14°). The maxillary molars were distalized and intruded significantly (mean 2.65 mm and 1.24 mm, respectively), the lower incisors slightly protruded anteriorly (mean 1.64 mm) and the molars showed no significant changes in the horizontal and vertical directions. Furthermore, significant improvements were noted in overbite (1.26 mm), overjet (4.8 mm) and molar relationship (12.08 mm). CONCLUSIONS: Changes in the upper dental arch were found to be greater than changes in the lower arch. Furthermore, mandibular anchorage loss was reduced due to the anchorage system used in the study.

Cephalometric evaluation of skeletal alterations induced by Herbst appliance during mixed dentition

OBJECTIVE: The present prospective clinical study was designed in order to evaluate horizontal and vertical skeletal alterations induced by the use of Herbst appliance in individuals with Class II, division 1 malocclusion during mixed dentition stage. METHODS: The sampling consisted of 15 pre-pubertal individuals (12 boys and 3 girls; initial age 9 years and 6 months), who were treated with Herbst appliance for a period of 7 months. The effects of the treatment were compared to a group of 15 individuals with Class II, division 1 malocclusion (8 boys and 7 girls, initial age averaged 9 years and 1 month), orthodontically untreated, who were followed up for a period of 12 months. Statistical analysis was performed with Student's t-test with significance level at 5%. RESULTS: It was showed that the treatment with Herbst appliance in mixed dentition stage has restricted maxilla growth. Mandibular and palatal planes have not undergone significant alteration; however, anterior and posterior facial heights have increased significantly. Facial convexity and maxillomandibular relationship were altered positively. Mandible has positioned significantly forward and its effective length increased 2.5 times more than the increase observed in control group. CONCLUSION: It was possible to conclude that Herbst appliance was able to provide satisfactory results in individuals during mixed dentition stage.

Medidas operantes de limiar auditivo em crianças com surdez pré-lingual, usuárias de implante coclear

Limiares auditivos de crianças surdas pré-linguais usuárias de implante coclear foram avaliados com estimulação elétrica em um dos eletrodos mediais. A avaliação empregou um procedimento operante do tipo go/no go para ensinar uma discriminação simples, evidenciada por uma resposta motora, entre presença e ausência do estímulo auditivo. Estabelecida a linha de base, a manipulação na intensidade do estímulo foi implementada de acordo com o método psicofísico de escada modificado, começando por uma seqüência descendente. Os sete participantes do estudo mostraram perda da precisão no responder sob controle do estímulo quando a intensidade diminuía além de um certo valor e a precisão era recuperada quando a intensidade era novamente aumentada, o que permitiu a identificação de limiares individuais. Os resultados sugerem que o método psicofísico combinado com o procedimento operante pode ser uma alternativa viável para avaliar limiar auditivo de pessoas sem linguagem em situação clínica de regulagem do implante coclear.

Treatment of posterior crossbite in mixed dentition with a removable appliance: Reports of cases

A posterior crossbite malocclusion is defined as an abnormal buccolingual relationship. One or more maxillary teeth improperly occludes with one or more mandibular teeth in centric relation. This alteration develops early and is seldom self-correcting. This study is a report of the benefits of treating posterior crossbite malocclusions in mixed dentitions using removable appliances.

Comparative study of the Frankel (FR-2) and bionator appliances in the treatment of Class II malocclusion

The purpose of this investigation was to compare the dentoalveolar and skeletal cephalometric changes produced by the Frankel (FR-2) and bionator appliances in persons with Class 11 malocclusion. Lateral cephalograms were available for 66 patients of both sexes, who were divided into 3 groups of 22. The control group included untreated Class 11 children, with an initial mean age of 8 years 7 months; they were followed without treatment for 13 months. The FR-2 appliance group had an initial mean age of 9 years; those children were treated for a mean period of 17 months. The bionator group initially had a mean age of 10 years 8 months; on average, they were treated for 16 months. The results demonstrated no significant changes in maxillary growth during the evaluation period. Both appliances showed statistically significant increases in mandibular growth and mandibular protrusion, with greater increases in patients treated in the bionator group. Both experimental groups showed an improvement in the maxillomandibular relationship. There were no significant changes in growth direction, while the bionator group had a greater increase in posterior facial height. Both appliances produced similar labial tipping and protrusion of the lower incisors, lingual inclination, retrusion of the upper incisors, and a significant increase in mandibular posterior dentoalveolar height. The major treatment effects of bionator and FR-2 appliances were dentoalveolar, with a smaller, but significant, skeletal effect.