Restoration of sensitivity after removal of the sural nerve: a new application of lateroterminal neurorraphy

Os autores propõem o emprego da neurorrafia término-lateral do coto distal do nervo sural na face lateral do nervo fibular superficial para evitar anestesia ou hipoestesia na face lateral do pé após a retirada do nervo sural para enxertia. A proximidade anatômica entre os nervos em questão tornam o procedimento simples, sem aumentar o tempo cirúrgico. A neurorrafia término-lateral proposta não prejudica as estruturas inervadas pelo nervo doador .

Mechanical removal of necrotic periodontal ligament by either Robinson bristle brush with pumice or scalpel blade. Histomorphometric analysis and scanning electron microscopy

One of the important factors accounting for successful delayed replantation of avulsed teeth is seemingly the type of root surface treatment. Removal of necrotic cemental periodontal ligament remnants may prevent the occurrence of external root resorption, which is the major cause of loss of teeth replanted in such conditions. The purpose of this study was to compare the efficacy of two mechanical techniques for removal of root-adhered periodontal ligament. Preservation or removal of the cementum layer concomitantly with these procedures was also assessed. Forty-five roots of healthy premolars extracted for orthodontic purposes were selected. After extraction, the teeth were kept dry at room temperature for 1 h and then immersed in saline for rehydration for an additional 10 min. Thereafter, the roots were assigned to three groups, as follows: group 1 (control) - the cemental periodontal ligament was preserved; group 2 - removal of the periodontal ligament by scraping root surface with a scalpel blade (SBS); group 3 - periodontal ligament remnants were removed using a Robinson bristle brush at low-speed with pumice/water slurry (RBP). The specimens were analysed histomorphometrically and examined by scanning electron microscopy. The quantitative and qualitative analyses of the results showed that the RBP technique was significantly more effective than the SBS technique for removal of the periodontal ligament remnants adhered to root surface. Both techniques preserved the cementum layer.

Comparative analysis of root surface smear layer removal by different etching modalities or erbium:yttrium-aluminum-garnet laser irradiation. A scanning electron microscopy study

The purpose of this study was to evaluate the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser (2.94 mu m) irradiation on the removal of root surface smear layer of extracted human teeth and to compare its efficacy with that of citric acid, ethylenediamine tetra-acetic acid (EDTA), or a gel containing a mixture of tetracycline hydrochloride (HCl) and citric acid, using scanning electron microscopy (SEM). Thirty human dentin specimens were randomly divided into six groups: G1 (control group), irrigated with 10 ml of physiologic saline solution; G2, conditioned with 24% citric acid gel; G3, conditioned with 24% EDTA gel; G4, conditioned with a 50% citric acid and tetracycline gel; G5, irradiated with Er:YAG laser (47 mJ/10 Hz/5.8 J/cm(2)/pulse); G6, irradiated with Er:YAG laser (83 mJ/10 Hz/10.3 J/cm(2)/pulse). Electron micrographs were obtained and analyzed according to a rating system. Statistical analysis was conducted with Kruskal-Wallis and Mann-Whitney tests (P < 0.05). G1 was statistically different from all the other groups; no statistically significant differences were observed between the Er:YAG laser groups and those undergoing the other treatment modalities. When the two Er:YAG laser groups were compared, the fluency of G6 was statistically more effective in smear layer removal than the one used in G5 (Mann-Whitney test, P < 0.01). Root surfaces irradiated by Er:YAG laser had more irregular contours than those treated by chemical agents. It can be concluded that all treatment modalities were effective in smear layer removal. The results of our study suggest that the Er:YAG laser can be safely used to condition diseased root surfaces effectively. Furthermore, the effect of Er:YAG laser irradiation on root surfaces should be evaluated in vivo so that its potential to enhance the healing of periodontal tissues can be assessed.

Oral Rehabilitation After Surgical Removal of Pleomorphic Adenoma

Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient's quality of life, allowing the patient's reinsertion into society, and reducing the surgical treatment sequelae.

Orthodontic treatment of a midline diastema related to mesiodens and thumb-sucking habit

OBJETIVO: A associação de mesiodens com hábito de sucção digital como fatores etiológicos de diastemas medianos é uma situação clínica incomum e, quando presente, provoca um comprometimento estético e funcional. O objetivo desse trabalho é descrever o caso clínico de um paciente, aos 9 anos de idade, com mordida aberta anterior e um diastema mediano de 9 mm. DESCRIÇÃO do CASO: Após o diagnóstico ortodôntico, a conduta terapêutica foi a exodontia do mesiodens e instalação de uma grade palatina fixa para controle do hábito de sucção digital. em seguida, bráquetes ortodônticos foram colados nos incisivos centrais superiores e o diastema foi fechado possibilitando a irrupção espontânea dos incisivos laterais. Quando adequados níveis de trespasse vertical e horizontal entre os incisivos foi alcançado e o hábito removido, o tratamento foi finalizado. CONCLUSÃO: É importante ressaltar que com o objetivo de alcançar resultados estéticos e funcionais satisfatórios, minimizando sequelas ao desenvolvimento da oclusão deve-se realizar o diagnóstico precoce e intervenção imediata dos diastemas medianos patológicos.

Clinical and microbiological performance of resin-modified glass-ionomer liners after incomplete dentine caries removal

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

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part III - Pain and dysfunction outcomes

47 end-stage TMJ patients with high occlusal plane angulation, treated with TMJ custom-fitted total joint prostheses and simultaneous maxillo-mandibular counter-clockwise rotation were evaluated for pain and dysfunction presurgery (T1) and at the longest follow-up (T2). Patients subjectively rated their facial pain/headache, TMJ pain, jaw function, diet and disability. Objective functional changes were determined by measuring maximum interincisal opening (MIO) and laterotrusive movements. Patients were divided according to the number of previous failed TMJ surgeries: Group 1 (0-1), Group 2 (2 or more). Significant subjective pain and dysfunction improvements (37-52%) were observed (<0.001). MIO increased 14% but lateral excursion decreased 60%. The groups presented similar absolute changes, but Group 2 showed more dysfunction at T1 and T2. For patients who did not receive fat grafts around the prostheses and had previous failure of proplast/teflon and or silastic TMJ implants, more than half required surgery for TMJ debridement and removal of foreign body giant cell reaction and heterotopic bone formation. End-stage TMJ patients can be treated in one operation with TMJ custom-made total joint prostheses and maxillo-mandibular counter-clockwise rotation, for correction of dentofacial deformity and improvement in pain and TMJ dysfunction; Group 1 patients had better results than Group 2 patients.

A comparative SEM study of smear layer removal by detergents and EDTA on the root surface

The present study performed an SEM evaluation of the efficiency of the following detergents on smear layer removal on the root surface: sodium lauryl sulphate, Plax, castor oil, and EDTA 24%. Sodium lauryl sulphate did not remove the smear layer and showed the worst results of all detergents tested. Plax and castor-oil detergents showed similar results represented by partial removal of the smear layer; these results were better than those obtained in the control (physiologic serum) and sodium lauryl sulphate groups. Neutral EDTA 24% was the most efficient detergent for smear layer removal.

Effect of Severe Dietary Magnesium Deficiency on Systemic Bone Density and Removal Torque of Osseointegrated Implants

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

Homeopathic Symphytum officinale increases removal torque and radiographic bone density around titanium implants in rats

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

pH changes after manual or ultrasonic instrumentation and smear layer removal with EDTA or ultrasonic

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

Persistence of endodontic methacrylate-based cement residues on dentin adhesive surface treated with different chemical removal protocols

The aim of this study was to evaluate the persistence of methacrylate-based cement residues on the dentin, after dentin surface cleaning with ethanol or acetone, with or without previous application of a dentin adhesive. Forty bovine crown fragments were obtained and the dentin surface was washed with 1.0 mL of 2.5% sodium hypochlorite (NaOCl), followed by 0.1 mL of 17% ethylenediaminetetraacetic acid application for 3 min, and final irrigation with 2.5% NaOCl. The specimens were air dried and resin-based cement was rubbed onto the dentine surface with a microbrush applicator. In 20 specimens, previously to cement, a dentin adhesive was applied in all surfaces. After 15 min, the surface was scrubbed with a cotton pellet and moistened with ethanol or acetone, compounding the following groups: G199.5% ethanol and G2acetone, without previous use of dentin adhesive; G399.5% ethanol and G4acetone, with previous use of dentin adhesive. The dentin surface was scrubbed until the cement residues could not be visually detected. Sections were then processed for scanning electron microscopy and evaluated at 500x magnification and scores were attributed to each image according to the area covered by residual sealer, and data were subjected to KruskalWallis at 5% significance. The lower residue presence was observed in G3 (P = 0.005). All surface presented cement residues when acetone was used as cleaning solution (P = 0.0005). The cleaning solutions were unable to completely remove the cement residues from both surfaces. The ethanol used after previous application of the dentin adhesive promoted the lower presence of residues.

Persistence of resinous cement residues in dentin treated with different chemical removal protocols

The aim of this study was to evaluate the persistence of resin cement residues after dentin surface cleaning with different alcohol-based solutions or an essential oil (eucalyptol). Forty bovine teeth were sectioned in order to expose pulp chamber dentin to be washed with 1.0 mL of 2.5% sodium hypochlorite (NaOCl), followed by 0.1 mL of 17% EDTA application for 3 min, and final irrigation with 2.5% NaOCl. The specimens were air dried and resin-based cement was rubbed onto the dentine surface with a microbrush applicator. After 15 min, the surface was scrubbed with a cotton pellet and moistened with different dentin cleaning solutions, compounding the following groups: G195% ethanol, G270% ethanol, G370% isopropyl alcohol, or G4eucalyptol. The dentin was scrubbed until the cement residues could not be visually detected. Sections were then processed for SEM and evaluated at x 500 magnification. Scores were attributed to each image according to the area covered by residual sealer, and data were subjected to KruskalWallis at 5% significance. Eucalyptol promoted the most adequate dentin cleaning, although no statistical difference was detected amongst the groups (P > 0.05), except between the eucalyptol and 70% ethanol groups (P < 0.05). All the evaluated dentin cleaning solutions were unable to completely remove the cement residues from the dentin surface. Microsc. Res. Tech., 2012. (C) 2012 Wiley Periodicals, Inc.