Conservative management of severe intrusion in a primary tooth: A 4-year follow-up

The purpose of this report was to describe the case of an 18-month-old boy who was referred to the pediatric clinic of the School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil, 3 days after sustaining severe trauma that led to the complete intrusion of the primary maxillary right lateral incisor, a crown fracture of the primary maxillary right central incisor without pulp involvement, and disruption of the superior labial frenum. Four months later, spontaneous re-eruption was observed in the intruded tooth and no endodontic intervention was necessary in either traumatized teeth. Four years after the trauma, a morphological change in the germ of the permanent successor was noted. Clinical follow-up and periodic radiographies are necessary after traumatic intrusion of primary teeth to monitor possible sequelae in the permanent successors.

Severe fracture of the maxillary alveolar process associated with extrusive luxation and tooth avulsion: A case report

Aim: The aim of this report is to present a case of severe fracture of the maxillary anterior alveolar process with substantial bone dislodgement associated with extrusive tooth luxation and avulsion. Background: Dentoalveolar trauma is a challenge to dentistry, especially in young patients, for it can lead to early tooth loss which compromises oral function, esthetics, self-esteem, and alter the long-term plan of care for the victim. Case Report: A 12-year-old girl with severe dentoalveolar trauma to the maxillary anterior region presented for emergency care for her injury. Treatment consisted of fracture reduction of the alveolar process, repositioning of the teeth that had suffered extrusive luxation, placement of a semi-rigid splint, and suturing of soft tissue lacerations. The traumatized teeth presented with pulpal necrosis and were treated endodontically. After 24 months of follow up, the fracture of the alveolar process was completely healed and the displaced teeth presented no signs of ankylosis or root resorption. Summary: First-aid care contributed remarkably to this case allowing the re-establishment of esthetics, function, and patient's self-esteem. In spite of trauma extension the treatment outcomes were favorable. Clinical Significance: Cases of dentoalveolar trauma should be evaluated on an individual basis. However, early emergency management and adequate follow-up can prevent further complications and contribute to treatment success.

Comparison of resin push-out strength to root dentin of bovine- and human-teeth

Aim : To compare the push-out strength of bovine- and human-root dentin and, thus, evaluate the suitability of bovine-root dentin to substitute human-root dentin for bond strength testing. Materials and Methods : Ten single-rooted human-teeth and ten bovine incisors were prepared using a #3 bur of a fiber post system (12 mm long). The posts were duplicated with resin cement (Duolink). The root canals were treated with All Bond 2 adhesive system and the resin posts were cemented using Duolink. The specimens were cut perpendicular to their long axis, yielding disc-specimens with 1.5 mm thickness, which were submitted to a push-out test (1 mm/min). Ten bond strength values per group (n = 10) were used for statistical analysis (Student t test, a =.05). Results : Statistically significant differences were found for the bond strength values between bovine- (4.1 1.3 MPa) and human-root dentin (8.6 5.7 MPa) (P =.0001). Conclusion : The push-out strengths of bovine- and human-root dentin were statistically different.

Integrated clinical treatment of gingival recession secondary to root perforation: case report.

Among the factors that influence the success of treatment of a root perforation, its location and possibility of contamination are determinant because the interaction of these 2 factors may result in significant periodontal injury. The management of cases of hard-to-reach contaminated perforations depends on the choice of an adequate technique. In the case reported in this article, controlled orthodontic tooth extrusion was successfully performed to treat gingival recession secondary to root perforation. The outcomes showed that this technique preserves the zone of attached gingiva, maintains the crown height, and prevents the involvement of the supporting bone tissue. The favorable clinical and radio?graphic conditions after 7 years of follow-up demonstrate the viability of this treatment approach.

The preparation of inventories and balance sheets of the natural and cultural heritage

Includes bibliography

Assessment of the apical seal of root canals using different filling techniques.

The aim of this study was to investigate the apical leakage of roots filled by three different gutta-percha techniques: lateral condensation, Tagger's hybrid and E&Q Master. Forty-two extracted single-rooted teeth were used. The coronal part of each tooth was removed and the root received biomechanical preparation using a 60-K file. The roots were randomly divided into three groups according to the technique of filling the root canal: Group I, lateral condensation; Group II, Tagger's hybrid; Group III, E&Q Master. The roots were submitted to dye leakage test with Rhodamine B for 7 days, using vacuum during the initial 30 min. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown. Statistical analysis indicated that lateral condensation and E&Q Master techniques showed lower leakage than Tagger's technique (P = 0.0016). However, statistically no difference was found between lateral condensation and E&Q Master system techniques.

Knowledge on dental trauma and orthodontic tooth movement held by a group of orthodontists

The objective of this work was to assess the knowledge about orthodontic tooth movement and dental trauma held by a group of orthodontists in specific areas of Brazil. For this purpose, 166 questionnaires with 15 objective questions about this subject were distributed. One hundred and five questionnaires were properly filled and collected after 30 days. It was concluded that, except for avulsion, the knowledge on dental injuries held by the professionals interviewed was considered unsatisfactory, and about 40% of them were not acquainted with the recommendations for the orthodontic movement of traumatized teeth.

Input for the preparation of a regional agenda for the programme of action of the International Conference on Population and Development: towards 2014 and beyond

Spanish version available at the Library

Temporal localization of osteocalcin protein during healing of tooth extraction sockets in rats.

The aim of this study was to evaluate the expression of osteocalcin protein during the alveolar bone healing process in rats. Twenty four rats were used in this study and, after anesthetic induction, they had their right upper incisors extracted. At 7, 14, 21 and 28 days after the tooth extraction, the animals were injected 4% formaldehyde. The histological tissue pieces were colored in hematoxilin and eosin and the immunohistochemistry reaction for osteocalcin was performed. At seven days lesser neoformed trabeculae bone and a small quantity of osteocalcin labeling were observed. At 14 and 21 days a larger quantity of neoformed trabeculae bone and higher osteocalcin values were detected. At 28 days the largest quantity of neoformed trabeculae bone and a decrease on the amount of osteocalcin immunolabelling were noticed. According to our results and considering the limits of the present study it is possible to conclude that a greater osteocalcin expression is observed at 14 and 21 days postoperatively, characterizing the periods when intense mineralization of the bone tissue occurs during the alveolar bone healing process.

Durability of feldspathic veneering ceramic on glass-infiltrated alumina ceramics after long-term thermocycling.

This study compared the bond strength durability of a feldspathic veneering ceramic to glass-infiltrated reinforced ceramics in dry and aged conditions. Disc shaped (thickness: 4 mm, diameter: 4 mm) of glass-infiltrated alumina (In-Ceram Alumina) and glass-infiltrated alumina reinforced by zirconia (In-Ceram Zirconia) core ceramic specimens (N=48, N=12 per groups) were constructed according to the manufacturers' recommendations. Veneering ceramic (VITA VM7) was fired onto the core ceramics using a mold. The core-veneering ceramic assemblies were randomly divided into two conditions and tested either immediately after specimen preparation (Dry) or following 30000 thermocycling (5-55 oC±1; dwell time: 30 seconds). Shear bond strength test was performed in a universal testing machine (cross-head speed: 1 mm/min). Failure modes were analyzed using optical microscope (x20). The bond strength data (MPa) were analyzed using ANOVA (α=0.05). Thermocycling did not decrease the bond strength results for both In-Ceram Alumina (30.6±8.2 MPa; P=0.2053) and In-Ceram zirconia (32.6±9 MPa; P=0.3987) core ceramic-feldspathic veneering ceramic combinations when compared to non-aged conditions (28.1±6.4 MPa, 29.7±7.3 MPa, respectively). There were also no significant differences between adhesion of the veneering ceramic to either In-Ceram Alumina or In-Ceram Zirconia ceramics (P=0.3289). Failure types were predominantly a mixture of adhesive failure between the veneering and the core ceramic together with cohesive fracture of the veneering ceramic. Long-term thermocycling aging conditions did not impair the adhesion of the veneering ceramic to the glass-infiltrated alumina core ceramics tested.

Effectiveness of rotary or manual techniques for removing a 6-year-old filling material

The aim of this study was to evaluate the effectiveness of manual and rotary instrumentation techniques for removing root fillings after different storage times. Twenty-four canals from palatal roots of human maxillary molars were instrumented and filled with gutta-percha and zinc-oxide eugenol-based sealer (Endofill), and were stored in saline for 6 years. Non-aged control specimens were treated in the same manner and stored for 1 week. All canals were retreated using hand files or ProTaper Universal NiTi rotary system. Radiographs were taken to determine the amount of remaining material in the canals. The roots were vertically split, the halves were examined with a clinical microscope and the obtained images were digitized. The images were evaluated with AutoCAD software and the percentage of residual material was calculated. Data were analyzed with two-way ANOVA and Tukey's test at 5% significance level. There was no statistically significant differences (p>0.05) between the manual and rotary techniques for filling material removal regardless the ageing effect on endodontic sealers. When only the age of the filling material was analyzed microscopically, non-aged fillings that remained on the middle third of the canals presented a higher percentage of material remaining (p<0.05) compared to the aged sealers and to the other thirds of the roots. The apical third showed a higher percentage of residual filling material in both radiographic and microscopic analysis when compared to the other root thirds. In conclusion, all canals presented residual filling material after endodontic retreatment procedures. Microscopic analysis was more effective than radiographs for detection of residual filling material.

Cementation of fiber post: influence of the cement insertion techniques on the bond strength of the fiber post-root dentin and the quality of the cement layer.

The aim of this study was to assess the influence of resin cement insertion methods on the bond strength of a fiber post to root dentin and quality of the cement layer. Forty bovine single-roots (length =16 mm) were randomly allocated into four groups, according to the cement insertion methods (N.=10): Gr1- Lentulo drill #40, Gr2- Centrix syringe, Gr3- Explorer #5, Gr4- fiber post. The root canals were prepared at 12 mm, using preparation bur # 3 of a cylinder quartz-FRC post (Aesthet post-plus, Bisco). The fiber posts were cemented using a multi-step etch-and-rinse adhesive system (All Bond 2®, Bisco) and a dual-cured resin cement (Duolink, Bisco). Each root was cut into seven samples: four samples of 1.8 mm thickness for push-out testing, and three with 0.5 mm for cement layer quality analyzing. One-way ANOVA was used for the push-out test values and the One-Way Kruskal-Wallis (P<0.05) and Dunn (10%) tests for the cement layer analyzes. ANOVA showed that the cement layer quality was affected by the cement insertion methods (P=0.0044): Gr1 (3.8 ± 1.3a), Gr2 (3.2 ± 1.3a), Gr3 (5.2 ± 1.5a,b) and Gr4 (5.2 ± 1.5b) (Dunn test), whereas the bond strength (MPa) was not affected by cement insertion methods: G1 (4.2 ± 1.3), G2 (3.2 ± 1.8), G3 (4.5 ± 0.9), G4 (3.1 ± 1.3). The fiber posts should be cemented with the assistance of the lentulo drill or centrix syringe to promote the best cement layer results.

Scanning electron microscopy analysis of RinsEndo system and conventional irrigation for debris removal

A new device for irrigation, which presents hydrodynamic activation based on the pressure-suction technology, has recently been introduced to the market: the Rinsendo system. This study compared the efficacy of the Rinsendo system and conventional (manualdynamic) irrigation in the removal of debris from the root canal walls, using scanning electron microscopy (SEM). Twenty mandibular premolars with completely formed roots were selected and randomly divided into group 1 (irrigation with the Rinsendo system) and group 2 (conventional irrigation). The canals were irrigated with 1 ml of saline at each change of instrument. instrumentation started with a #15 K file and continued up to a #40 K file, which was standardized as the working length instrument. Then, the teeth were sectioned in buccolingual direction and the halves were sputter-coated with gold and examined by SEM. The apical, middle and cervical root canal thirds were evaluated, and the results were analyzed statistically by the Mann-Whitney test for comparison between methods, Kruskal-Wallis test for comparison among thirds, and Miller test for individual comparisons. A significance level of 5% was set for all analyses. The results did not show significant differences (p>0.05) between methods at each third and among thirds for each technique analyzed individually. in conclusion, there was no difference in the cleaning ability of the Rinsendo system and conventional irrigation.