Comparative study of 2 software programs for predicting profile changes in Class III patients having double-jaw orthognathic surgery

Introduction: Computer software can be used to predict orthognathic surgery outcomes. The aim of this study was to subjectively compare the soft-tissue surgical simulations of 2 software programs. Methods: Standard profile pictures were taken of 10 patients with a Class III malocclusion and a concave facial profile who were scheduled for double-jaw orthognathic surgery. The patients had horizontal maxillary deficiency or horizontal mandibular excess. Two software programs (Dentofacial Planner Plus [Dentofacial Software, Toronto, Ontario, Canada] and Dolphin Imaging [version 9.0, Dolphin Imaging Software, Canoga Park, Calif]) were used to predict the postsurgical profiles. The predictive images were compared with the actual final photographs. One hundred one orthodontists, oral-maxillofacial surgeons, and general dentists evaluated the images and were asked whether they would use either software program to plan treatment for, or to educate, their patients. Results: Statistical analyses showed differences between the groups when each point was judged. Dolphin Imaging software had better prediction of nasal tip, chin, and submandibular area. Dentofacial Planner Plus software was better in predicting nasolabial angle, and upper and lower lips. The total profile comparison showed no statistical difference between the softwares. Conclusions: The 2 types of software are similar for obtaining 2-dimensional predictive profile images of patients with Class III malocclusion treated with orthognathic surgery. (Am J Orthod Dentofacial Orthop 2010; 137: 452.e1-452.e5)

A modified approach for vestibuloplasty in severely resorbed mandible using an implant-retained postoperative stent: a case report

Background. Severely resorbed mandibles often present a short band of keratinized tissue associated with a shallow vestibule. As a result, prominent muscle insertions are present, especially in the mental region of the mandible. This case report describes the deepening of the vestibular sulcus in an atrophic mandible by combining free gingival grafts harvested from the palate and a postoperative acrylic resin stent screwed on osseointegrated implants placed at the anterior region of the mandible.Study design. During the second-stage surgery, a split-thickness labial flap was reflected and apically sutured onto the periosteum. Two free gingival grafts were obtained and then sutured at this recipient site. A previously custom-made acrylic stent was then screwed onto the most distally positioned implants. To document the procedure's stability over time, a metal ball was placed in the most apical part of the vestibule and standardized cephalometric radiographs were taken before and 6 months after the procedure. Linear measurements of vestibular depths over the observation time were realized using specific software for radiographic analysis.Results. The proposed technique augmented the band of attached masticatory mucosa, deepened the vestibule and prevented the muscle reinsertion. The difference between the 2 measurements of vestibular depths was 9.39 mm (initial 20.88 mm, final 11.49 mm) after a 6-month postoperative period.Conclusion. The technique, in combination with palatal mucosal graft and use of a postoperative stent, decreased the pull of mentalis muscle and provided a peri-implantally stable soft tissue around implants. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: e7-e14)

Tissue reaction of the EndoREZ in root canal fillings short of or beyond an apical foramenlike communication

This study evaluated the response of periapical tissues to the endodontic sealer EndoREZ in root canal fillings short of or beyond the apical foramenlike communication. Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to create an apical foramenlike communication, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramenlike opening by the lateral condensation of gutta-percha and EndoREZ, originating 2 experimental groups: G1, EndoREZ/short of the apical foramenlike opening, and G2, EndoREZ/beyond the apical foramenlike opening. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown and Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramenlike communication and apical opening of accessory canals, apical cementum resorptions, intensity of the inflammatory infiltrate, presence of giant cells, and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (P = .05). Comparing the 2 groups, the best result (P = .05) was obtained with root canal filling with EndoREZ short of the apical foramenlike opening. In conclusion, limiting the filling material to the root canal space apically was important to determine the best treatment outcome when EndoREZ was used as the sealer. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e94-e99)

Reaction of rat connective tissue to a new calcium hydroxide-based sealer

The aim of this study was to histopathologically examine the reaction of the connective tissue of rats to 2 calcium hydroxide-based sealers, Acroseal and Sealapex. Dentin tubes containing the materials and empty control tubes were implanted into the dorsal connective tissue of 36 Wistar albino rats. The animals were killed after 7 or 30 days, and the specimens were prepared for histologic analysis with hematoxylin and eosin, Von Kossa technique, and polarized light. Results were statistically analyzed using Kruskal-Wallis test. Both materials caused mild or moderate inflammatory reactions on the 7th day, but these reactions decreased by the 30th day with no significant difference at any time (P > .05). Mineralization of the subcutaneous tissue of the rats was observed only with Sealapex.

Transdentinal protective role of sodium ascorbate against the cytopathic effects of H2O2 released from bleaching agents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Human pulp responses to in-office tooth bleaching

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Cytotoxic effect of a 35% hydrogen peroxide bleaching gel on odontoblast-like MDPC-23 cells

Objective. This study evaluated transenamel and transdentinal cytotoxic effects of a bleaching gel on the MDPC-23 cell line.Study design. Discs obtained from bovine incisors were placed in a metallic device to simulate an in vivo pulp chamber. Groups were formed according to the enamel surface treatment: G1: 35% H(2)O(2) bleaching gel; G2: 35% H2O2 bleaching gel + halogen light; G3: halogen light; and G4: control. Cell metabolism was evaluated by the methyltetrazolium assay and cell morphology by scanning electron microscopy.Results. Cell metabolism decreased by 31.7%, 41.6%, and 11.5% in G1, G2, and G3, respectively. Cytotoxic effects observed in G2 were significantly more severe compared with G3 and G4. In G1 and G2, a smaller number of viable cells with major morphologic alterations remained adhered to dentin.Conclusion. The bleaching gel associated with light presented transenamel and transdentinal cytotoxic effects characterised by direct damage to odontoblasts and decrease of their metabolic activity. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 458-464)

Detection of periapical lesion development by conventional radiography or computed tomography

Objective. The aim of this study was to detect the development of experimentally induced periapical lesions using conventional radiography and computed tomography.Study design. The root canals of dogs' teeth were exposed to the oral environment for 7 days for contamination and then sealed for 7 days (GI), 15 days (GII), 30 days (GIII), and 60 days (GIV). Immediately after each experimental period, radiographs and tomograms were taken in order to detect the occurrence of periapical bone resorption. The periapical radiographs were digitized and areas of bone resorption were measured using the VIXWIN 2000 software. Scores were assigned to the tomograms based on the progression of periapical bone resorption. The specimens were evaluated by calibrated examiners who were blinded to the groups. The radiographic results were analyzed by ANOVA and Tukey's test (P <.05) and the tomographic results were analyzed by Kruskal-Wallis and Dunn's tests (P <.05).Results. The radiographic evaluation did not reveal periapical lesions at the 7-day control. Lesions were radiographically visible at 15 and 30 days (47.4% and 77.8% of the cases, respectively) and presented similar dimensions (P <.05). At 60 days, lesions were detected in all specimens, presenting larger dimensions than those of the earlier evaluation periods (P <.05). The tomographic evaluation detected lesions at 7 and 15 days (32.5% and 83.3% of the cases, respectively). Lesions were detected in all specimens at the 30- and 60-day periods, when the greatest values of bone resorption were observed (P <.05).Conclusions. Tomography was able to detect periapical lesion development in its initial stages, even when the lesions were undetectable radiographically.

Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Candida spp. prevalence in well controlled type 2 diabetic patients with denture stomatitis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Denture stomatitis treated with photodynamic therapy: five cases

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Bacterial leakage evaluation of root canals filled with different endodontic sealers

Objective. The objective of this study was to evaluate the sealing ability of AH Plus, Epiphany, Acroseal, Endofill, and Polifil after active lateral condensation technique, by using a bacterial test, during 64 days.Study design. One hundred bovine incisors were cleaned and shaped; then they were filled with the endodontic sealers and adapted into a microcentrifuge tube. The setup root/microcentrifuge tube was added to glass flasks containing Brain Heart Infusion broth. A culture of Enterococcus faecalis was inserted into the upper chamber of each assembly. Daily leakage was evaluated through the broth turbidity.Results. The results were submitted to statistical analysis (Kaplan-Meier method, Kruskal-Wallis and Dunn tests).Conclusions. AH Plus and Endofill had the worst sealing ability when compared with Polifil, which showed the least leakage. Acroseal and Epiphany showed a tendency toward having an intermediate behavior; however, there was no significant difference among Acroseal, Epiphany, and the other sealers. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e56-e60)

Direct pulp capping with a self-etching adhesive system: Histopathologic evaluation in dogs' teeth

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Radiographic effect of different radiopacifiers on a potential retrograde filling material

Objective. The objective of this study was to evaluate the radiopacity of white Portland cement (PC) associated with bismuth oxide (Bi(2)O(3)), barium sulfate (BaSO(4)), iodoform (CHI(3)), and zirconium oxide (ZrO(2)). White mineral trioxide aggregate (WMTA) and PC without radiopacifier were used as positive and negative controls, respectively.Study design. Following International Organization for Standardization (ISO) 6876/2001, 5 circular specimens (10 x 1 mm) were made from each material. After the materials set, radiographs were taken using occlusal film and a graduated aluminum step-wedge varying in thickness from 2 to 16 mm. The dental X-ray unit (GE1000) was set at 50 Kvp, 10 mA, 18 pulses/s, and distance of 33.5 cm. The radiographs were digitized, and radiopacity was compared with the aluminum step-wedge, using Wixwin-2000 software (Gendex). Data (mm Al) were analyzed using analysis of variance and Tukey tests.Results. The PC + Bi(2)O(3) and WMTA samples presented greater radiopacity (5.88 and 5.72 mm Al, respectively), followed by PC + ZrO(2) (3.87 mm Al) and PC + CHI(3) (3.50 mm Al). The PC + BaSO(4) and PC samples presented the lowest radiopacity values (2.35 and 1.69 mm Al, respectively), which were below the minimum value recommended by the ISO.Conclusion. Analysis of the present results led to the conclusion that all of the materials tested presented acceptable radiopacity, except PC + BaSO(4) and pure PC. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 628-632)

Comparability of results from two leakage models

Objective. The goal of this study was to check whether leakage results of the same specimens measured by 2 different leakage models are similar.Study design. Canine root canals were prepared and filled with cold gutta-percha cones and 1 of 4 sealers (20 canals for each sealer). The 80 specimens were first connected to a fluid transport model where air-bubble movement was measured. The same specimens were later connected to a glucose penetration model where the concentration of glucose was measured. In both models, a headspace pressure of 30 kPa was used to accelerate leakage.Results. In both models, 4 sealers ranked the same regarding the leakage they allowed, and a significant correlation between the results of the 2 models was confined (Spearman test coefficient = 0.65; P = .000001).Conclusion. Under the conditions of this study, leakage results of 80 specimens recorded in the fluid transport model and glucose penetration model were similar.