Influência da clorexidina na capacidade de umectabilidade da dentina hígida e afetada por cárie por um sistema adesivo

To evaluate the effect of chlorhexidine (CHX) on the wettability of sound and caries affected dentin by a simplified adhesive system. Material and Methods: Flat coronal dentin surfaces were produced on 60 sound molars, 30 of which were artificially decayed. The teeth were divided randomly into 3 groups (n = 10) with smear layer (SL), without SL impregnated with water and without SL impregnated with chlorhexidine. The SL removal was performed by phosphoric acid etching for 15 s. 20 uL of distilled water or 2% chlorhexidine digluconate were applied on the demineralized dentin for 60 s. Then, a drop of Single Bond 2 was deposited on each surface. Contact angles between dentin surface and adhesive was measured by means of a goniometer and data were submitted to ANOVA and Tukey tests (α = 0.05). Results: Higher contact angles were obtained on sound versus caries affected dentin (p <0.05), regardeless of the surface treatment. For both substrates, contact angles statistically higher were obtained for dentin covered with SL (P <0.05). The SL removal resulted in significant reduction of the angles (P <0.05) and no difference was found among angles produced on demineralized dentin impregnated with water or chlorhexidine (p> 0.05). Conclusion: Caries affected dentin wettability was higher than sound dentin and that characteristic was not influenced by chlorhexidine application.

Avaliação da via aérea superior em pacientes classe III submetidos à cirurgia ortognática: revisão de literatura

Introduction: The configuration and dimensions of the upper airway are determined by anatomical structures such as soft tissues, muscles and craniofacial skeleton, composing or surrounding the pharynx. Anatomical abnormalities of the soft tissues and / or craniofacial skeleton may become more narrow upper airway. The orthognathic surgery, which is used in the correction of dentoskeletal deformities, also causes changes in the upper airway. Objective: In view of the facts presented, this article aims to review the literature on the changes of the upper airway in patients’ class III undergoing orthognathic surgery. Methodology: International Literature on Health Sciences (Pubmed ) and Port Journals CAPES original and review published between 1990 and 2010, in two bibliographic databases articles were selected. Results: thirty-nine (39) articles were selected for writing this review. Conclusion: The upper airway deformity and dental- skeletal class III should be carefully evaluated prior to orthognathic surgery and whenever surgical planning permit should prefer the maxillary advances to mandibular setbacks

Treatment of severe facial asymmetry secondary to osteochondroma of the mandibular condyle: case report

Osteochondroma (OC) is the most common benign tumor of long bones. However it is rarely found in the facial skeleton, being the coronoid process and mandibular condyle the most affected sites in this region. It basically consists in bone growth covered by cartilage. The etiology is still controversial: neoplastic, developmental, reparative and traumatic origins have been discussed in literature. The treatments of these lesions include total condylectomy or local resection of the lesion. This paper aims to report a case of a patient with history of trauma and possible fracture of the mandibular condyle in childhood, which in youth developed dentofacial deformity with severe facial asymmetry. The treatment consisted of resection of lesion both with maxillary and mandibular osteotomies associated with graft from the iliac crest bone. Actually, the patient is with a favorable aesthetic, without functional deficit and absence of lesion’s recurrence.

Efeito do ângulo de trabalho do ultrassom e do jato de bicarbonato sobre as superfícies ranculares

The aim of this study was to evaluate the effect of the working angle variation of the magnetoestritive ultrasonic (MU) and air polishing devices (APD) on the roughness and wear of dental root. Fifty bovine incisive teeth were used in this study. The proximal surfaces of the teeth were divided in three regions: coronal, median, and an apical. The coronal region was treated with a manual scaler, the apical region was treated with APD or with a MU and the medium region was maintained untreated to serve as a control. The teeth were divided in 11 groups according to the treatment applied: MU-0º; MU-30º; MU-45º; MU-60º; MU-90º; AP-0º; AP-30º; AP-45º; AP-60º; AP-90º; MS: manual scaler. To the statistical analysis, data submitted to the Anova and Tukey's test (p < 0.05). The manual curette promotes less roughness and higher tooth wear in comparison with the both ultrasonic and air polishing devices (p < 0.05). The angles of 45º, 60º and 90º caused higher rate of tooth wear and roughness when the MU was used (p < 0.05), while the angle of 90° caused a higher tooth wear than the angle of 30° when the APD was used (p < 0.05). The working angle variation influenced the tooth wear and roughness promoted by MU, whereas when using APD, the working angle variation influenced only the tooth wear.

Tratamento de recessões gengivais múltiplas: uma abordagem mais conservadora

Periodontal therapy has undergone significant changes in recent decades. While in the past the only goal was to restore gingival health, with no concern about the possible consequences of the disease treatment, currently the procedures are performed in a less invasive manner, to maintain aesthetic periodontal results or even recover them. Gingival recession is an alteration frequently found in patients and may be a complaint for causing various complications. For their treatment, several surgical techniques are reported in the literature. The techniques that are more predictable are those that associate a subepithelial connective tissue graft and a coronally repositioned flap. The original technique consists in performing two vertical incisions for an extensive release of the flap and its stabilization in a coronal position. Although this procedure is extremely widespread in the literature, the search for less invasive surgeries without the use of vertical incisions are the current aim of periodontal plastic surgeries, since they present several advantages. The aim of this paper is to demonstrate a case where adjacent, deep and multiple recessions were present resulting in aesthetic problems, which was resolved by a less invasive approach using a surgical technique in envelope and a subepithelial connective tissue graft.

Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

Reabilitação oral de paciente com sequela cirúrgica utilizando a técnica da zona neutra: relato de caso clínico

Objective and Case report: The purpose of this paper is to describe the neutral zone technique in a patient with oral deformity on the right labial commissure due to the resection of an oral cancer, enhancing the difficulty resulting from mouth limited opening and the use of tissue conditioner material to determine the neutral zone. Complete denture was obtained through this technique, providing good retention and stability which made functional rehabilitation feasible to patient of his or her masticatory function. Final considerations: The neutral zone technique in complete dentures will determine a specific intraoral area for tooth position and denture base contour where the forces generated by lips, cheeks and tongue are neutralized. The objective of this technique is to provide an alternative approach for patients who presented an historic instability of lower complete denture: atrophic ridge, oral deformities and also with disorder problems. An oral rehabilitation using this technique improves comfort to the patient providing retention and stability of mandibular complete dentures.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.

Modelo de conductancia hidráulica de la dentina humana ex vivo

The main objective of this work was to mount and test an experimental model to measure the hydraulic conductance of ex vivo dentin. Seventeen healthy third molars, with indication of extraction of healthy donors aged between 15 and 30 years were obtained by informed consent. After cleaning them, disinfecting them, including them in resin epoxy and cutting them, there were 17 samples of dentin, corresponding to a disk of resin with a coronal section of tooth showing the dentin exposed on both sides of it. Three machines to measure the hydraulic conductance of the dentin were assembled according to the description of the model of Pashley. Samples were installed in a Chamber of diffusion, connected by using silicone tubes to a graduated transfer pipette and a 20cm water column. Through the displacement of a bubble of water in the inside of the pipette, the hydraulic conductance of each sample was measured 3 times on the 14th, 21st, 28th and 35th day post extraction. The data were tabulated and analyzed statistically. There is no SS difference in the rate of flow of a measured sample in the three machines (p=0.5937). There is no SS difference in measurements of the hydraulic conductance of 13 samples of human dentin measured in days 14, 21, 28 and 35 postextraction (p=0.0704). It is possible to mount an experimental model to study the hydraulic conductance of dentin ex vivo, based on the model of Pashley. The model seems to be reliable, but more research is needed in order to validate its reliability.

Efeitos da aplicação de resina hidrofóbica sobre a resistência de união de adesivos autocondicionantes de frasco único

Introduction: It is known that self-etching adhesive systems can act as semi-permeable membranes. Objective: Evaluate the effects of additional layer of hydrophobic resin on the microtensile bond strength of self-etching one-bottle adhesives. Material and method: Sixty bovine incisors were used in this study. The facial enamel surfaces of the crowns were abraded with silicon carbide paper to expose flat, mid-coronal dentin surfaces. The following adhesives were used: Clearfil Tri S Bond (CTSB), AdheSE One (ADH) and One Coat  7.0 (OC). Each material was tested with and without applying an additional layer of hydrophobic material from the same manufacturer. Z-350 composite resin was inserted in three 1 mm increments. All adhesive restorative procedure was performed under simulated pulpal pressure and the microtensile test was performed immediately after curing the composite resin. Data were submitted to ANOVA and Tukey test (p < 0.05). Result: For all adhesives tested, the worst results were observed in groups which the additional layer of hydrophobic resin was not applied. Conclusion: The application of additional layer of hydrophobic material can improve the adhesion of self-etching all-in-one adhesive systems.

Tratamento estético periodontal: revisão de literatura sobre alguns tipos de cirurgias

Currently, periodontal aesthetics has been prized for harmony of the smile. The clinical crown lengthening, gingival excess or altered passive eruption, is effectively corrected by periodontal surgery. The purpose of this paper is to show, through a literature review, some types of surgery on clinical crown lengthening and root coverage. Clinical crown lengthening is done to Change the size of the anterior teeth and to optimize the cosmetic result of treatment with new coronal restoration and other cosmetic dental care. In general, the treatment plan and the choice of operative technique begin with careful clinical examination. Recessions tissue can be defined as a displacement of the gingival margin toward the junction mucogingival exposing the root surface. These, when present, impacting on patient comfort by providing the occurrence of cervical dentin hypersensitivity, and the esthetic, the amendment of the gum line. Successful treatment of recessions is based on knowledge of its etiology and assessment of predictability of surgical techniques that aim to root coverage. Through literature review, we can conclude that the types of surgery most often used are: 1) to increase the clinical crown, gingivectomy, flap surgery and gingivoplasty osteotomy, and 2) for root coverage, the use will depend on the amount of gum keratinized and especially the classification of Miller.

Incomplete vertical root fracture associated with lateral compaction technique: a microscopic analysis

Objective: This study evaluated the effects of root canal obturation employing lateral compaction technique and spreader load of 1.5 kg on the incidence of complete (CVRF) or incomplete vertical root fractures (IVRF). Material and Methods: Twenty-seven distal roots of extracted human mandibular molars were used. All root canals were prepared by biomechanical step-back technique and obturated by lateral compaction technique. The prepared roots were distributed into two groups: G1- experimental (n = 17) and G2- control (n = 10). During obturation, load of 1.5 kg was applied to a size # 30 finger spreader. Pre- and post-obturation images of the coronal portion of the roots were captured by inverted digital microscopy and analyzed by one trained examiner. Data were evaluated by Fisher’s test (p < 0.05) using GrapH Pad Prism 5.0. Results: No roots exhibited CVRF. All fractures observed before and after obturation were IVRF or “other defects”. In G2 (control group), there was no increase of IVRF number. Interestingly, G1 presented an increase in the IVRF number to 70.59% in the 12 teeth out of 17 teeth studied. The statistical analysis showed that the mean of IVRF increased significantly in G1 when compared to G2 (p < 0.05). Conclusion: The application of a 1.5 kg spreader load during lateral compaction technique does not produce complete vertical root fractures, but may produce incomplete fractures or “other defects”.

Effect of two formulations of 10% sodium ascorbate on fracture resistance of endodontically treated tooth submitted to dental bleaching with hydrogen peroxide associated titanium dioxide nanoparticles

Purpose: This study evaluated the effect of 10% sodium ascorbate (10SA), in gel (10SAg) or aqueous solution (10SAs) formulations, on fracture resistance of endodontically treated tooth submitted to dental bleaching procedures with 15% hydrogen peroxide associated with titanium dioxide (15HP-TiO2) nanoparticles and photoactivated by LED-laser. Material and methods: Forty maxillary premolars were endodontically-treated and embedded in acrylic resin up to the cement-enamel junction. The specimens were divided into four groups (n=10): G1 (negative control): no bleaching, coronal access restored with composite resin; G2 (positive control): three dental bleaching sessions using 15HP-TiO2 and LED-laser photoactivation and restored with composite resin (positive control); G3 (10SAg): similar procedures to G2, but applied 10SA, in gel formulation, for 24 hours before restoration; G4 (10SAs): similar procedures to G3, but applied 10SA, in aqueous solution formulation. The 15HP-TiO2 was applied on buccal and lingual surfaces of the crown tooth and inside the pulp chamber and photoactivated by LED-laser. Between each bleaching session, the teeth were maintained in artificial saliva, at 37oC, for 7 days. In sequence, the teeth were submitted to fracture resistance testing using an eletromechanical machine test. The data was analyzed using Kruskal Wallis test (p = 0.05) Results: There are no differences significant among the groups in relation to fracture resistance of endodontically treated teeth (p>0.05). Conclusions: The use of 10% sodium ascorbate, in gel or aqueous solution formulations, did not interfered on the fracture resistance teeth after dental bleaching using 15HP-TiO2 and LED-laser photoactivation.

Filling of simulated lateral canals with gutta percha or resilon when using thermomechanical compaction

Aims: To evaluate the filling of simulated lateral canals with gutta-percha or Resilon when using thermomechanical compaction. Setting and Design: Forty-five human single-rooted teeth were subjected to tooth decalcification and clearing. Materials and Methods: After root canal preparation, artificial lateral canals were made at 2, 5, and 8 mm from the working length (WL), corresponding to the apical, middle, and cervical thirds, respectively. The specimens were divided (n = 15) according to the filling material: Dentsply gutta-percha (GD), Odous gutta-percha (GO), and Resilon cones (RE). Root canals were obturated by thermomechanical compaction using a #45 compactor and no sealer. Lateral canals were analyzed by digital radiography and digital images after tooth decalcification and clearing using the Image Tool software. Statistical Analysis Used: Data were subjected to the Kruskal-Wallis and Dunn tests at 5% significance. Results: In the coronal third, RE and GO presented more filling ability than GD (P < 0.05). In the middle and apical thirds, RE presented the best results. Conclusions: Resilon demonstrated filling ability as material for root canal obturation by using thermomechanical compaction.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.