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.

Cortical Bone Stress Distribution in Mandibles with Different Configurations Restored with Prefabricated Bar-Prosthesis Protocol: A Three-Dimensional Finite-Element Analysis

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

All-Ceramic Crowns Over Single Implant Zircon Abutment. Influence of Young's Modulus on Mechanics

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

Conforto e fonação com a nova geração de bráquetes ortodônticos linguais individualizados

TEMA: recentemente o número de pacientes desejando um tratamento ortodôntico e estético ao mesmo tempo aumentou consideravelmente. A técnica lingual oferece a opção mais estética de tratamento ortodôntico, pois os bráquetes ficam invisíveis colados na superfície lingual dos dentes e os lábios não ficam protuberantes. Apesar da grande vantagem estética, essa terapia possui desvantagens como restrição no conforto oral, na fala, na higiene, irritações na língua, restrição no espaço da língua e dificuldades na alimentação. Para amenizar essas desvantagens uma nova geração de bráquetes linguais otimizados ao máximo através da individualização das bases dos bráquetes, da posição de colagem e dos fios utilizados no tratamento ortodôntico foi desenvolvida recentemente. OBJETIVO: realizar uma revisão sistemática da literatura para verificar a adaptação do paciente a diferentes dispositivos ortodônticos linguais e a influência desses dispositivos no conforto e na fala, principalmente. CONCLUSÃO: atualmente a literatura suporta que os bráquetes linguais de última geração individualizados por computador proporcionam maior conforto e facilidade na fonação quando comparados aos bráquetes tradicionais da técnica lingual. No entanto, o sucesso na terapia requer orientações detalhadas sobre o potencial de restrição do conforto oral, articulação de palavras, mastigação e higiene oral, independente do sistema de bráquetes a ser utilizado.

Effect of different adhesive systems on microleakage in class II composite resin restorations

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

Protective efficacy of Psidium cattleianum and Myracrodruon urundeuva aqueous extracts against caries development in rats

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

Clinical Approach of Ankyloglossia in Babies: Report of Two Cases

Ankyloglossia is a developmental anomaly of the tongue characterized by a short lingual frenum, resulting in restricted movement of the tongue. Its etiology is undefined and there is no gender preference. Few studies are available in the literature and the diagnosis and management of ankyloglossia in infants remains controversial. We report two cases of infants submitted to lingual frenectomy, emphasizing the management of ankyloglossia and its implications in breast-feeding.

Immediate reimplantation of primary teeth: a histological study in dogs

Reimplantation of primary teeth has been the subject of various clinical and histological studies, but very little is known about the effect of this treatment on primary teeth. The aim of the present study was to histologically evaluate the biological response of dog primary teeth after immediate reimplantation. Twelve dogs were divided into two groups according to postoperative time: 1 week and 3 weeks. Twenty-one upper and lower intermediate incisors were extracted and submitted to endodontic treatment, reimplantation and splinting. The 21 homologous teeth not submitted to treatment served as controls. The animals were killed after the respective experimental periods, and the obtained specimens were processed for histological analysis. Most dogs of the 1-week group exhibited the following alterations: gingival epithelium was inserted in the cemento-enamel junction, with a small number of chronic inflammatory cells being observed in the gingival corium; the periodontal ligament was partially reestablished, with a more expressive chronic inflammatory infiltrate being observed in the apical third; small root resorption was observed on the palatine/lingual side in the apical third. In contrast, in 3-week animals, gingival epithelial insertion was predominantly absent on the buccal side, and a moderate chronic inflammatory infiltrate was present; the periodontal ligament generally showed no bone-cementum reinsertion especially on the palatine/lingual side, with an expressive inflammatory infiltrate in the apical region, and large root resorption was mainly observed on the palatine and lingual sides. In conclusion, reimplantation causes histological alterations in the tooth and its supporting periodontal structures that suggest the impossibility of its maintenance.

Congenital fistulae of the lower lip in Van der Woude syndrome: A histomorphological study

Objective: To evaluate a significant number of cases of fistulae of the lower lip with the light microscope in order to investigate the histological variation and to attempt to define the histopathological pattern of the lesion.Methods: Congenital fistulae of the lower lips of 17 patients with Van der Woude syndrome were analyzed by light microscopy,Results and Conclusion: the walls of most of the fistulae consisted of stratified nonkeratinized squamous epithelium and a lamina propria of dense connective tissue with areas of lymphohistiocytic inflammatory infiltrates. Bundles of striated muscle fibers, blood vessels, nerves, adipose tissue, and mixed acinar glands were observed. These glands surrounded the entire wall of the lesion, and their excretory ducts opened into the lumen of the fistula, explaining the clinical observation of elimination of mucous secretion through the opening of the fistula, Two microform cases of fistula were analyzed that presented only a depression in the epithelium at the site corresponding to the opening of the fistula.

Effect of Er : YAG and diode laser irradiation on the root surface: Morphological and thermal analysis

Background: the aim of the present study was to compare the effects of Er:YAG and diode laser treatments of the root surface on intrapulpal temperature after scaling and root planing with hand instruments.Methods: Fifteen extracted single-rooted teeth were scaled and root planed with hand instruments. The teeth were divided into 3 groups of 5 each and irradiated on their buccal and lingual surfaces: group A: Er:YAG laser, 2.94 mum/100 mJ/10 Hz/ 30 seconds; group B: diode laser, 810 nm/1.0 W/0.05 ms/30 seconds; group C: diode laser, 810 nm/1.4 W/0.05 ms/30 seconds. The temperature was monitored by means of a type T thermocouple (copper-constantan) positioned in the pulp chamber to assess pulpal temperature during and before irradiation. Afterwards, the specimens were longitudinally sectioned, and the buccal and lingual surfaces of each root were analyzed by scanning electron microscopy.Results: In the Er:YAG laser group, the thermal analysis revealed an average temperature of -2.2 +/- 1.5degreesC, while in the diode laser groups, temperatures were 1.6 +/- 0.8degreesC at 1.0 W and 3.3 +/- 1.0degreesC at 1.4 W. Electronic micrographs revealed that there were no significant morphological changes, such as charring, melting, or fusion, in any group, although the specimens were found to be more irregular in the Er:YAG laser group.Conclusions: the application of Er:YAG and diode lasers at the utilized parameters did not induce high pulpal temperatures. Root surface irregularities were more pronounced after irradiation with an Er:YAG laser than with a diode laser.

Treatment of gingival fibromatosis associated with Zimmermann-Laband syndrome

Background: Gingival fibromatosis is a rare condition characterized by a generalized enlargement of the buccal and lingual aspects of the attached and marginal gingiva.Methods: This case report describes the periodontal management of a 13-year-old female patient with gingival fibromatosis associated with Zimmermann-Laband syndrome. The patient presented with gingival enlargement involving the maxillary and the mandibular arches, anterior open bite, and non-erupted teeth. Periodontal treatment included gingivectomy in all four quadrants.Results: Histopathologic evaluation of the excised tissue supported the diagnosis of gingival flbromatosis. A significant improvement in esthetic appearance and eruption of the non-erupted teeth were obtained. The patient was referred for appropriate orthodontic treatment and has been closely followed for the earliest signs of recurrence of gingival enlargement.Conclusions: the successful therapy for gingival fibromatosis depends on correctly identifying the etiological factors and improving the impaired function and esthetic appearance through surgical intervention and adjunctive orthodontics. Maintaining treatment results depends on preservation of periodontal health.

Morphometric study of the root anatomy in furcation area of mandibular first molars

Furcation involvement in periodontal disease has been a challenge for the dentist. Objective: The aim of this study was to investigate root dimensions in the furcation area of 233 mandibular first molars. Material and Methods: Digital photomicrographs were used to obtain the following measurements on the buccal and lingual surfaces of each tooth: root trunk height (RT), horizontal interadicular distance obtained 1 mm (D1) and 2 mm (D2) below the fornix and interadicular angle (IA). Results: Mean standard deviation of buccal and lingual furcation measurements were, respectively, 1.37 +/- 0.78 mm and 2.04 +/- 0.89 mm for RT; 0.86 +/- 0.39 mm and 0.71 +/- 0.42 mm for D1; 1.50 +/- 0.48 mm and 1.38 +/- 0.48 mm for D2; 41.68 +/- 13.20 degrees and 37.78 +/- 13.18 degrees for IA. Statistically significant differences were found between all measured parameters for buccal and lingual sides (p<0.05, paired t test). Conclusions: In conclusion, the lingual furcation of mandibular first molars presented narrower entrance and longer root trunk than the buccal furcation, suggesting more limitation for instrumentation and worse prognosis to lingual furcation involvements in comparison to buccal lesions.

Damage of the medial preoptic area impairs peripheral pilocarpine-induced salivary secretion

The existence of neural connections between the medial preoptic area (MPOA) and the salivary glands and the increase in salivation by thermal or electrical stimulation of the MPOA have suggested an important role of MPOA in the control of salivary gland function. Although direct cholinergic activation of the salivary glands induces salivation, recent studies have suggested that salivation produced by i.p. pilocarpine may also depend on the activation of central mechanisms. Therefore, in the present study, we investigated the effects of bilateral electrolytic lesions of the MPOA on the salivation induced by i.p. pilocarpine. Adult male Holtzman rats (n = 11-12/group) with bilateral sham or electrolytic lesions of the MPOA were used. One, five, and fifteen days after the brain surgery, under ketamine anesthesia, the salivation was induced by i.p. pilocarpine (1 mg/kg of body weight), and saliva was collected using preweighted small cotton balls inserted into the animal's mouth. Pilocarpine-induced salivation was reduced 1 and 5 days after MPOA lesion (341 +/- 41 and 310 +/- 35 mg/7 min, respectively, vs. sham lesions 428 +/- 32 and 495 +/- 36 mg/7 min, respectively), but it was fully recovered at the 15th day post-lesion (561 +/- 49 vs. sham lesion: 618 27 mg/7 min). Lesions of the MPOA did not affect baseline non-stimulated salivary secretion. The results confirm the importance of MPOA in the control of salivation and suggest that its integrity is necessary for the full sialogogue effect of pilocarpine. However, alternative mechanisms probably involving other central nuclei can replace MPOA function in chronically lesioned rats allowing the complete recovery of the effects of pilocarpine. (c) 2006 Published by Elsevier B.V.

Sympathetic mediation of salivation induced by intracerebroventricular pilocarpine in rats

Central cholinergic activation by pilocarpine induces salivation dependent on the integrity of forebrain areas. The present work investigates the autonomic mediation of this salivation. Pilocarpine (500 nmol/rat) was injected into the lateral ventricle (LV) of tribromoethanol-anesthetized adult male rats. Preweighed cotton balls were inserted into the oral cavity and weighed again 7 min later. ol-adrenoceptor antagonists (3-50 mu mol/kg) prazosin (alpha(1)), yohimbine (alpha(2)) or propranolol (beta) injected intraperitoneally (i.p.) produced, 80%, 20% and 0% inhibition respectively of the LV pilocarpine-induced salivation. Intracerebroventricular injections (160 nmol) of the antagonists did not alter the effects of pilocarpine injected into the LV. Bilateral section of chorda tympani nerve or bilateral sympathetic cervical ganglionectomy produced 0% and 40% inhibition of pilocarpine-induced salivation, respectively. Ganglionectomy did not alter salivation induced by i.p, injection of pilocarpine (4 mu mol/kg). The results indicate that there is a large sympathetic contribution to the salivation induced by central cholinergic activation. (C) 1999 Elsevier B.V. B.V. All rights reserved.

Lesions of the lateral hypothalamus impair pilocarpine-induced salivation in rats

In the present study we investigated the effects of electrolytic lesions of the lateral hypothalamus (LH) in the salivation induced by intracerebroventricular (i.c.v.) or intraperitoneal (i.p.) injection of the cholinergic agonist pilocarpine. Rats with sham or LH lesions and stainless steel cannulas implanted into the lateral ventricle (LV) were used. In rats anesthetized with urethane (1.25 mg/kg of body weight) saliva was collected using pre-weighed cotton balls inserted in the animal mouth during a period of 7 min following i.c.v. or i.p. injection of pilocarpine. Injection of pilocarpine (1 mg/kg of body weight) i.p. in sham-operated rats (6 h, 2, 7, and 15 days after the surgery) induced salivation (497+/-24, 452+/-26, 476+/-30, and 560+/-75 mg/7 min, respectively). The effects of i.p. pilocarpine was reduced 6 h, 2 and 7 days after LH lesions (162+/-37, 190+/-32, and 229+/-27mg/7 min, respectively), not 15 days after LH lesions (416+/-89mg/7 min). Injection of pilocarpine (120 mug/mul) i.c.v., in sham-operated rats (6 h, 2, 7, and 15 days after the surgery) also produced salivation (473 20, 382 16, 396 14, and 427 47 mg/7 min, respectively). The salivation induced by i.c.v. pilocarpine was also reduced 6 h, 2 and 7 days after LH lesions (243+/-19, 278+/-24, and 295+/-27 mg/7 min, respectively), not 15 days after LH lesions (385 48 mg/7 min). The present results show the participation of the LH in the salivation induced by central or peripheral injection of pilocarpine in rats, reinforcing the involvement of central mechanisms on pilocarpine-induced salivation. (C) 2002 Elsevier B.V. All rights reserved.