Tratamento da sindrome da apnéia e hipopnéia obstrutiva do sono (sahos) com aparelhos intrabucais

The apnea and hypopnea sleep obstructive syndrome is a disorder that affects part of adult population. Some characteristics can come with this syndrome that cause social problems such as snoring and excessive daytime sleepiness, associated many times with pulmonary hypertension and cardiac insufficiency. The dentist who is inserted into a multidisciplinary team is a professional highly regarded for diagnosis and treatment of sleep disorders. Among treatments recommended, therapy with intraoral appliance shows an excellent non invasive alternative, achieving satisfactory results.

Utilização do bite block para correção da mordida aberta anterior

Bite block is a functional orthodontic appliance that promotes relative intrusion or dental eruption inhibition. The purpose of this study is to present the effects of bite block on the treatment of an open bite case report.

Variáveis que afetam o procedimento de colagem direta ortodôntica: procedimentos clinicos

Direct bonding of orthodontics attachments to the teeth or restoration has become a routine in fixed appliance therapy. The technique used seems to be simple, but meticulous attention to detail and steps, a thorough understanding of factors involved are needed to ensure a successful outcome into different surfaces. It is the purpose of this article to review concerning aspects to orthodontic bonding in enamel and restorations fabricated from different materials; affording assistance to the reader wiser accomplishment and successful procedure.

Descrição do aparelho VABB (Vertically Activated Bite Block) para o tratamento da mordida aberta anterior

Nowadays, the correction of skeletal vertical dysplasia is considered a great challenge in Orthodontics. The skeletal open bite treatment presents limitations related to vertical growth pattern, the extension of open bite and especially the stability, which is very questioned. The treatment of skeletal open bite is mostly realized by the inhibition of vertical alveolar posterior development (relative intrusion) or absolute intrusion of posterior teeth, through vertical forces, generated by the action of masticatory muscles. The purpose of this article is to present a new appliance for the treatment of skeletal open bite, the VABB (Vertically Activated Bite Block) or modified Bite Block, whose action mechanism is to limit the vertical development of the molars, by the action of facial muscles and two bilateral expansion screws that provide a counterclockwise rotation of the mandible. It will also be presented a clinical case and the technical steps for the construction of this appliance.

Tratamento da má oclusão de classe II com aparelho Jasper Jumper

The Jasper Jumper appliance was developed as a fixed orthopedic device that is connected to the upper and lower leveling arches to promote the Class II correction by restricting the maxillary growth (headgear effect), mandibular growth inducement (activator effect) and dentoalveolar changes.

Redução do medo durante o tratamento odontológico utilizando pontas ultrassônicas

Over the last few years, new technologies have been developed to making cavity preparations, among which the diamond burs CVDentus® (CVDentus, São José dos Campos, Brazil) are outstanding. These points are produced by chemical deposition from the vapor phase, forming a single diamond stone, with greater durability than the conventional diamond burs. Coupled to the ultrasound appliance, they have several clinical applications in Dentistry with advantages over conventional rotary instruments, such as lower pressure, noise, vibration and heat, as well as reducing the need to use local anesthesia, contributing to minimize patient’s fear and anxiety. The aim of this study was to present the complete restorative dental treatment performed with this system in a child patient with a prior history of non-cooperative behavior. The use of this new technology offered the patient greater comfort, making it possible recondition the patient’s attitude to dental treatment, in addition to favoring conservative cavity preparations to be made.

Avaliação radiográficada fusão das corticias lateral e medial do ramo mandibular: estudo em mandíbulas secas

Purpose: to radiographically evaluate the distance between mandibular lingula and the exact spot where buccal and lingual cortical bone plates merge in the mandibular ramus. Materials and Methods: 54 dry mandibles, divided into 3 subgroups (SG1: dentate, SG2: partially dentate and SG3: edentulous) were used in this study. Lingula position was marked with a metallic sphere and radiographs were taken. The distance between mandibular notch and lingula (I/L) and the distance between mandibular lingula and cortical bone plates fusion (L/FC) were measured. Statistical analysis was applied to the values obtained. Results: mean values for L/FC were 8,18mm, 7,30mm and 8,98mm for SG1, SG2 e SG3 respectively. Moreover, mean values for I/L were 14,02mm, 13,90mm and 12,34mm for SG1, SG 2 and SG3 respectively. The results also showed that cortical bone plates fusion took place in half I/L distance in 28,57% of the mandibles in SG1, in 46,67% of the mandibles in SG2 and in 9,09% of the pieces in SG3. Conclusions: there were no statistically significant differences in the height where cortical bone plates took place in all 3 subgroups. In SG3, the correlation between the mean value for L/FC and the mean value for I/L suggests a reduction in bone density and bone mass, which can correlate to the evaluation of older mandibles in this subgroup.

A survey of the management of patients with temporomandibular disorders by general dental practitioners in southern Brazil

Purpose: Temporomandibular disorders (TMD) are recognized as one of the mostcontroversial topics in dentistry, despite the fact that both basic science and clinicalresearchers have currently reached some degree of consensus. This study aimed toconduct a questionnaire-based survey about the management of TMD patients bygeneral dental practitioners (GDPs).Materials and Methods: One hundred fifty-one GDPs with a private practice in a cityof southern Brazil were included, independent of school of origin, gender, graduationyear, and curriculum content. All participants were administered a questionnaire aboutthe management of patients with TMD, and the responses were analyzed by binomialand chi-square tests (α = 0.05).Results: Of the GDPs, 88.7% received TMD patients, who were primarily diagnosedon the basis of medical history (36.6%) or physical examination (30.4%). Of these,65.4% referred the patients elsewhere, primarily to specialists in occlusion (36.1%) ororthodontics (29.7%). Occlusal splinting was the most commonly used managementmodality (20.8%), followed by occlusal adjustment (18.1%) and pharmacotherapy(16.6%). Splints were fabricated in maximum habitual intercuspation or centric re-lation depending on individual patient (54.8%). The hard stabilization form was themost common type of appliance used (35.0%). Moreover, 73.8% of the GDPs didnot employ semi-adjustable articulators, and 69.5% adjusted the appliances at thetime of fixing. The duration of splint use and the frequency of follow-up were con-sidered patient dependent by 62.1% and 72.8%, respectively. GDPs considered thetwo major TMD etiologic categories as multifactorial (20.8%) and occlusion (19.9%).Multidisciplinary medical and dental treatment was considered necessary by 97.9%.Conclusions: The evaluated general dental practitioners manage TMD patients ac-cording to international guidelines.

Correction of malpositioned implants through periodontal surgery and prosthetic rehabilitation using angled abutment

When dental implants are malpositioned in relation to the adjacent teeth and alveolar bone or in an excessive buccal or lingual position, the final prosthesis rehabilitation impairs the peri-implant health of the gingival tissues and the aesthetics of the patient. Thus, the purpose of this case was to report and discuss a multidisciplinary protocol for the treatment of a compromised maxillary tooth in a patient with an abscess in his right central incisor due to an excessive buccal implant position. The patient presented with an implant-supported provisional restoration on his right maxillary central incisor and a traumatic injury in his left central incisor. The treatment protocol consisted in (i) abutment substitution to compensate the incorrect angulation of the implant, (ii) clinical crown lengthening, (iii) atraumatic extraction of the left central incisor, and (iv) immediate implant placement. Finally, (v) a custom abutment was fabricated to obtain a harmonious gingival contour around the prosthetic crown. In conclusion, when implants are incorrectly positioned in relation to the adjacent teeth, associated with soft-tissue defects, the challenge to create a harmonious mucogingival contours may be achieved with an interdisciplinary approach and with the placement of an appropriate custom abutment.

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.

Avaliação da eficácia de limpeza de quatro agulhas irrigadoras endodônticas

The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. OBJECTIVE: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. MATERIAL AND METHODS: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file), root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution) and after irrigation (remnant of contrast solution), were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed by using Anova and Tukey's test. The level of significance was set at P < 0.05. RESULTS: For all root canal enlargements, 30G needles (G3 e G4) presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. CONCLUSION: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

Influência da agulha irrigadora e da dilatação do canal radicular na eficácia da irrigação endodôntica

Introduction: The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. Objective: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. Material and methods: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file), root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution) and after irrigation (remnant of contrast solution), were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed by using Anova and Tukey’s test. The level of significance was set at P < 0.05. Results: For all root canal enlargements, 30G needles (G3 e G4) presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. Conclusion: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

Matriz Bertholdo/Ricci/Barrotte (BRB): uma simplificação de técnica para obtenção de guia de estratificação com compósitos

Advanced Layering composite resins can be facilitated by a technique called "Lingual Matrix", where a guide is made of elastomer by molding a previously waxed tooth or sculped in an intraoral test drive restoration. This technique has many advantages to sophisticated layering, facilitation stratification, anatomic construcrion and the stages of finishing and polishing. However, in some clinical situations, the unfolding of the steps to obtains this matrix can be time consuming or even infeasible. To facilitate the achievement of this apparatus, a technique was idealized allowing significant reducrion in clinical time. This matrix, called the "BRB Matrix" is widly discussed in a didactic and clinical manner in this article, presenting its advantages in clinical cases where it is imperative to use a guide for conduction a controlled layering. The simplicity of this approach, as well as reduced clinical time and finacial costs turn it feasible in an everyday clinical practice.

The effect of chlorhexidine on plaque index and mutans streptococci in orthodontic patients: A pilot study

Aim: The purpose of this study was to assess chlorhexidine effects on plaque index and salivary levels of mutans streptococci (MS) when used as the immersion solution for removable orthodontic appliances and added to their acrylic resin composition. Methods: Forty-five patients (6 to 12 years old) were randomly assigned into three groups with 15 patients each. Group I (control)—without orthodontic appliances disinfection; Group II—removable orthodontic appliances which had been immersed in 0.12% chlorhexidine digluconate overnight (8 hours), and Group III—orthodontic appliances in which 0.12% chlorhexidine digluconate solution had been incorporated into their resin composition. Saliva was collected for quantification of MS and evaluation of plaque index was performed before and after installation of orthodontic appliance at 0, 2, 4, 6, 8, and 10 weeks. Data were analyzed by using analysis of variance. Results: Number of MS colonies in saliva and plaque index showed no statistically differences among groups at the different periods (p > 0.05). Conclusions: It could be concluded that chlorhexidine incorporation into the acrylic resin of removable orthodontic appliances at 0.12% concentration and immersion of the appliance into 0.12% chlorhexidine solution were not effective in reducing plaque index and the number of MS in saliva.

Avaliação tomográfica no tratamento com Herbst em adulto jovem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)