Immunohistochemical, tomographic and histological study on onlay bone graft remodeling. Part II: calvarial bone

Objectives Little information is available on the molecular events that occur during graft incorporation over time. The calvarial bone (Cb) grafts have been reported to produce greater responses compared with other donor regions in maxillofacial reconstructions, but the scientific evidences for this are still lacking. The objectives of this study are (1) to study the morphological pattern of Cb onlay bone grafts and compare them with the biological events through immunohistochemical responses and (2) to establish the effects of perforations in maintaining the volume and bone density of the receptor bed. Material and methods Sixty New Zealand White rabbits were submitted to Cb onlay bone grafts on the mandible. In 30 rabbits, the receptor bed was perforated (perforated group), while for the remaining animals the bed was kept intact (non-perforated group). Six animals from each group were sacrificed at 5, 7, 10, 20 and 60 days after surgery. Histological sections from the grafted area were prepared for immunohistochemical and histological analyses. Immuno-labeling was found for proteins Osteoprotegerin (OPG), receptor activator of nuclear factor-kappa beta ligand (RANKL), alkaline phosphatase (ALP), osteopontin (OPN), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase (TRAP), Type I collagen (COL I) and osteocalcin (OC). The tomography examination [computerized tomography (CT) scan] was conducted just after surgery and at the sacrifice. Results The histological findings revealed that the perforations contributed to higher bone deposition during the initial stages at the graft-receptor bed interface, accelerating the graft incorporation process. The results of the CT scan showed lower resorption for the perforated group (P < 0.05), and both groups showed high bone density rates at 60 days. This set of evidences is corroborated by the immunohistochemical outcomes indicating that proteins associated with revascularization and osteogenesis (VEGF, OPN, TRAP and ALP) were found in higher levels in the perforated group. Conclusions These findings indicate that the bone volume of calvarial grafts is better maintained when the receptor bed is perforated, probably resulting from more effective graft revascularization and greater bone deposition. The process of bone resorption peaked between 20 and 60 days post-operatively in both groups although significantly less in the perforated group. To cite this article:Pedrosa Jr WF, Okamoto R, Faria PEP, Arnez MFM, Xavier SP, Salata LA. Immunohistochemical, tomographic and histological study on onlay bone grafts remodeling. Part II: calvarial bone.Clin. Oral Impl. Res. 20, 2009; 1254-1264.doi: 10.1111/j.1600-0501.2009.01747.x.

Histologic Evaluation of the Buccal and Lingual Bone Plates in Anterior Dog Teeth: Possible Influence on Implant Dentistry

Background: Recent studies in animals have shown pronounced resorption of buccal bone plate after immediate implantation. The sectioning of experimental material for histologic evaluation of the bone plates could provide valuable information about the possible effect of bone exposure in periodontal and implant surgeries. Methods: Twenty-four incisors were collected from dogs. After decalcification, the blocks were immersed in paraffin and bucco-lingual histologic sections were examined under light microscope. Some sections were reserved for immunohistochemical analysis. Results: The bone density, the width of the bone plates, and the percentage of vessels presented in the periodontal ligament and periosteum were analyzed in the buccal and lingual bone plates, which were divided corono-apically into thirds. The buccal bone plates showed statistically higher bone density compared to the lingual bone plates in the coronal thirds. The width of both bone plates increased from the coronal to the apical third, but all the buccal thirds were significantly thinner compared to the lingual thirds. No statistically significant differences were found between the bone plates for the percentage of area occupied by the blood vessels in the periodontal ligament or periosteum. Conclusion: It is reasonable to conclude that the higher bone density, represented by the lower number of marrow spaces, in association with the thinner aspect of the buccal bone plates made them more fragile to absorb compared to the lingual bone plates, especially during mucoperiosteal procedures. J Periodontol 2017;82:872-877.

Optimization in multi-implant placement for immediate loading in edentulous arches using a modified surgical template and prototyping: A case report

Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance throughout the treatment period. Placement of dental implants requires precise planning that accounts for anatomic limitations and restorative goals. Diagnosis can be made with the assistance of computerized tomographic scanning, but transfer of planning to the surgical field is limited. Recently, novel CAD/CAM techniques such as stereolithographic rapid prototyping have been developed to build surgical guides in an attempt to improve precision of implant placement. The aim of this case report was to show a modified surgical template used throughout implant placement as an alternative to a conventional surgical guide.

Computerized identification of motor complications in Parkinson's disease

Objective: To investigate whether spirography-based objective measures are able to effectively characterize the severity of unwanted symptom states (Off and dyskinesia) and discriminate them from motor state of healthy elderly subjects. Background: Sixty-five patients with advanced Parkinson’s disease (PD) and 10 healthy elderly (HE) subjects performed repeated assessments of spirography, using a touch screen telemetry device in their home environments. On inclusion, the patients were either treated with levodopa-carbidopa intestinal gel or were candidates for switching to this treatment. On each test occasion, the subjects were asked trace a pre-drawn Archimedes spiral shown on the screen, using an ergonomic pen stylus. The test was repeated three times and was performed using dominant hand. A clinician used a web interface which animated the spiral drawings, allowing him to observe different kinematic features, like accelerations and spatial changes, during the drawing process and to rate different motor impairments. Initially, the motor impairments of drawing speed, irregularity and hesitation were rated on a 0 (normal) to 4 (extremely severe) scales followed by marking the momentary motor state of the patient into 2 categories that is Off and Dyskinesia. A sample of spirals drawn by HE subjects was randomly selected and used in subsequent analysis. Methods: The raw spiral data, consisting of stylus position and timestamp, were processed using time series analysis techniques like discrete wavelet transform, approximate entropy and dynamic time warping in order to extract 13 quantitative measures for representing meaningful motor impairment information. A principal component analysis (PCA) was used to reduce the dimensions of the quantitative measures into 4 principal components (PC). In order to classify the motor states into 3 categories that is Off, HE and dyskinesia, a logistic regression model was used as a classifier to map the 4 PCs to the corresponding clinically assigned motor state categories. A stratified 10-fold cross-validation (also known as rotation estimation) was applied to assess the generalization ability of the logistic regression classifier to future independent data sets. To investigate mean differences of the 4 PCs across the three categories, a one-way ANOVA test followed by Tukey multiple comparisons was used. Results: The agreements between computed and clinician ratings were very good with a weighted area under the receiver operating characteristic curve (AUC) coefficient of 0.91. The mean PC scores were different across the three motor state categories, only at different levels. The first 2 PCs were good at discriminating between the motor states whereas the PC3 was good at discriminating between HE subjects and PD patients. The mean scores of PC4 showed a trend across the three states but without significant differences. The Spearman’s rank correlations between the first 2 PCs and clinically assessed motor impairments were as follows: drawing speed (PC1, 0.34; PC2, 0.83), irregularity (PC1, 0.17; PC2, 0.17), and hesitation (PC1, 0.27; PC2, 0.77). Conclusions: These findings suggest that spirography-based objective measures are valid measures of spatial- and time-dependent deficits and can be used to distinguish drug-related motor dysfunctions between Off and dyskinesia in PD. These measures can be potentially useful during clinical evaluation of individualized drug-related complications such as over- and under-medications thus maximizing the amount of time the patients spend in the On state.

g-acceleration of gravity: its measurement from the shape of water by using a computerized rotational system

This paper proposes a different experimental setup compared with the traditional ones, in order to determine the acceleration of gravity, which is carried out by using a fluid at a constant rotation. A computerized rotational system-by using a data acquisition system with specific software, a power amplifier and a rotary motion sensor-is employed in order to evaluate the angular velocity and g. An equation to determine g is inferred from fluid mechanics. For this purpose, the fluid's parabolic shape inside a cylindrical receptacle is considered using a rotational movement.

Ergonomics work analysis applied to dentistry - a Brazilian case study

This paper presents the Ergonomic Work Analysis method in a Brazilian Dentist's office. Through the study, the constraints and the strategies in avoiding them were identified. It was found that dentists hardly use the position most indicated by the International Organization for Standardization (ISO) and the Federation Dentaire Internacionale (FDI) for both the patient and the dentist, which is respectively supine and 9 o'clock, due to the limited space and layout. Five types of treatments performed by the professional have been studied. The frequency and duration of actions in these treatments were accounted for and the standard positions adopted were identified. The AET was found to be a very suitable method to grasp the dentist's activity and build a point of view of the profession, which is characterized as: stressful, perfectionist and restrictive. Time management is presented as an important strategy to control the tension arising from performing the treatments.

Comparing the Teaching-Learning Process With and Without the Use of Computerized Technological Resources

Computerized technological resources have become essential in education, particularly for teaching topics that require the performance of specific tasks. These resources can effectively help the execution of such tasks and the teaching-learning process itself. After the development of a Web site on the topic of nursing staff scheduling, this study aimed at comparing the development of students involved in the teaching-learning process of the previously mentioned topic, with and without the use of computer technology. Two random groups of undergraduate nursing students from a public university in São Paulo state, Brazil, were organized: a case group (used the Web site) and a control group (did not use the Web site). Data were collected from 2003 to 2005 after approval by the Research Ethics Committee. Results showed no significant difference in motivation or knowledge acquisition. A similar performance for the two groups was also verified. Other aspects observed were difficulty in doing the nursing staff scheduling exercise and the students' acknowledgment of the topic's importance for their training and professional lives; easy access was considered to be a positive aspect for maintaining the Web site.

Survey radiography and computerized tomography imaging of the thorax in female dogs with mammary tumors

Background: Accurate early diagnosis of lung metastases is important for establishing therapeutic measures. Therefore, the present study aimed to compare survey thoracic radiographs and computerized tomography (CT) scans to specifically identify lung metastases in female dogs with mammary tumors.Methods: Twenty-one female dogs, weighing 3 to 34 kg and aged from 5 years to 14 years and 10 months, with mammary tumors were studied. In all dogs before the imaging examinations, fine-needle aspiration cytology of the mammary tumors was performed to confirm the diagnosis. Three-view thoracic radiographs were accomplished: right lateral, left lateral and ventrodorsal views. Sequential transverse images of the thorax were acquired on a spiral Scanner, before and after intravenous bolus injection of nonionic iodine contrast. Soft-tissue and lung windows were applied. All the mammary tumors were surgically removed and examined histologically.Results: The correlation between the cytological and histological results regarding presence of malignancy was observed in only 17 cases. In radiographic examinations, no dog displayed signs of lung metastases or thorax chest lesions. CT detected lung metastasis in two cases, while small areas of lung atelectasis located peripherally were found in 28.57% of the dogs.Conclusion: In this study population, spiral CT showed higher sensitivity than chest radiographies to detect lung metastasis; this indicates that CT should be performed on all female dogs with malignant mammary tumors.

Prosthetic Platforms in Implant Dentistry

The use of implant-supported prosthesis to replace missing teeth became a predictable treatment. Although high success rate has been reported, implant treatment is suitable to complications, failures, and limitations such as peri-implant bone loss after implant loading. Stress evaluation on the bone-abutment-implant interface has been carried out to develop new designs of prosthetic platform and to understand the stress distribution in this interface. Several types of prosthetic platforms are available such as external and internal hexagon, Morse cone connection, and the concept of platform switching. Therefore, this study aimed to critically describe the different options of prosthetic platforms in implant dentistry, by discussing their biomechanical concepts, clinical use, and advantages and disadvantages. It was observed that all types of prosthetic platforms provided high success rate of the implant treatment by following a strict criteria of indication and limitation. In conclusion, a reverse planning of implant treatment is strongly indicated to reduce implant overload, and the use of advanced surgical-prosthetic techniques is required to obtain a long-term success of oral rehabilitations.

Crown and crown-root fractures: an evaluation of the treatment plans for management proposed by 154 specialists in restorative dentistry

Traumatic tooth injuries involve function and aesthetics and cause damage that range from minimal enamel loss to complex fractures involving the pulp tissue and even loss of the tooth crown. Technical knowledge and clinical experience are essential to establish an accurate diagnosis and provide a rational treatment. The purpose of this study was to evaluate the knowledge of Restorative Dentistry specialists about the management of crown and crown-root fractures based on treatment plans proposed by these professionals for these cases. A descriptive questionnaire was mailed to 245 Restorative Dentistry specialists with questions referring to their professional profile and the treatment plans they would propose for the management of crown and crow-root fractures resulting from dental trauma. One hundred and fifty-four questionnaires were returned properly filled. The data were subjected to descriptive statistics and the chi-square test was used to determine the frequency and the level of the significance among the variables. The analysis of data showed that in spite of having a specialist title, all interviewees had great difficulty in planning the treatments. As much as 42.8% of the participants were unable to treat all types of dental trauma. Complicated and uncomplicated crown-root fractures posed the greatest difficulties for the dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis.

Biomechanics Studies in Dentistry: Bioengineering Applied in Oral Implantology

The application of engineering knowledge in dentistry has helped the understanding of biomechanics aspects related to osseointegrated implants. Several techniques have been used to evaluate the biomechanical load oil implants comprising the use of photoelastic stress analysis, finite element stress analysis, and strain-gauge analysis. Therefore, the purpose of this Study was to describe engineering methods used in dentistry to evaluate the biomechanical behavior of osseointegrated implants. Photoelasticity provides good qualitative information oil the overall location and concentration of stresses but produces limited quantitative information. The method serves as ail important tool for determining the critical stress points in a material and is often used for determining stress concentration factors in irregular geometries. The application of strain-gauge method oil dental implants is based oil the use of electrical resistance strain gauges and its associated equipment and provides both in vitro and vivo measurements strains under static and dynamic loads. However, strain-gauge method provides only the data regarding strain at the gauge. Finite element analysis can Simulate stress using a computer-created model to calculate stress, strain, and displacement. Such analysis has the advantage of allowing several conditions to be changed easily and allows measurement of stress distribution around implants at optional points that are difficult to examine clinically All the 3 methodologies call be useful to evaluate biomechanical implant behavior close to the clinical condition but the researcher should have enough knowledge in model fabrication (experimental delineation) and results analysis.

Art in the inclusion of children with special needs in dentistry

A proposta deste estudo é relatar a utilização da arte e seus segmentos, como recurso para inclusão da criança portadora de necessidades especiais ao ambiente odontológico. Foi utilizado como método a aplicação da arte em atividades de socioterapia e oficinas, divididas em módulos: sessão de socialização, oficinas de arte e atividades complementares, visando à elaboração de uma anamnese cultural por meio de questionários e a obtenção das preferências artísticas dos 313 participantes, previamente às suas assistências odontológicas no CAOE (Centro de Assistência Odontológica a Portadores de Necessidades Especiais) FOA/Unesp. de acordo com os questionários respondidos, a música e a pintura, segundo a preferência dos participantes, são os segmentos artísticos que mais auxiliam nas atividades de inclusão e adaptação. Concluímos que a utilização da arte na adaptação e inclusão ambiental do paciente, previamente à assistência odontológica, é favorável e eficaz.

Sexual harassment in Dentistry: prevalence in dental school

Objective: Sexual harassment is unlawful in all work and educational environments in most nations of the world. The goals of this study were to describe the sexual harassment prevalence and to evaluate the experiences and attitudes of undergraduate students in one dental school in Brazil. Material and Methods: An 18-item questionnaire was administered to 254 dental students with a completion rate of 82% (208). Students were requested to respond to questions about their background and academic level in dental school, their personal experiences with sexual harassment and their observation of someone else being sexually harassed. Bivariate statistical analyses were performed. Results: Fifteen percent of the students reported being sexually harassed by a patient, by a relative of a patient or by a professor. Male students had 3 times higher probability of being sexually harassed than female student [OR = 2.910 (1.113-7.611)]. Additionally, 25.4% of the students reported witnessing sexual harassment at the school environment. The majority of students did not feel professionally prepared to respond to unwanted sexual behaviors. Conclusion: These findings demonstrate that sexual harassment can occur in a dental school setting. There is a need for ongoing sexual harassment education programs for students and university staff. Increased knowledge of sexual harassment during graduation can better prepare dental professionals to respond to sexual harassment during their practice.

Dentistry in Brazil: Its History and Current Trends

The objectives of this article are to provide a short history of dentistry and dental education in Brazil and to analyze the nature of its development to date. The databases consulted are those provided by the Brazilian Federal Council of Dentistry, Brazilian Ministry of Health, Brazilian Ministry of Education, National Institute of Studies and Educational Research Anisio Teixeira, and Brazilian Institute of Geography and Statistics. Formal dental education in Brazil started in the late nineteenth century with the creation of courses annexed to existing schools of medicine in Rio de Janeiro and Bahia. Today, there are 191 institutions of higher education nationwide granting degrees in dentistry (137 private [71.7 percent] and fifty-four public [28.3 percent]), with a total of 17,157 student positions offered annually. These schools graduate around 10,000 professionals per year-one of the highest rates in the world. Both the distribution of schools of dentistry and of dentists varies among the regions of the country, with the greatest concentrations in major metropolitan centers with high population density, resulting in limited coverage in the more deprived regions. A review of epidemiological data for oral health and distribution of dentists in Brazil indicates that there is a lack of systematic planning for the allocation of the dental workforce and a lack of consideration of regional needs in the development of dental training programs in Brazil today.