Efeito dose-resposta de uma formulação de dentifrício com concentração reduzida de fluoreto - estudo in vitro.

The utilization of dentifrices with low fluorine concentration, for children under 6 years of age, has been suggested to reduce the risks of dental fluorosis. However, in order to have anticariogenic potential, the dentifrice should form loosely-bound fluorine (CaF2) on dental enamel. Considering that the formation of CaF2 is a function inversely related to pH, dentifrices with pH 5.5, with 275, 550 and 1,100 ppm F (NaF/silica) were developed in order to assess dose-response effects. A comparison between those dentifrices, a placebo product and the Crest toothpaste (positive control - standard) was carried out. Furthermore, the bioavailability of dentifrices, in terms of formation of total fluorine (TF), CaF2, and fluorapatite (FA) on human dental enamel, was evaluated. An ion-specific electrode was utilized for the determination of the dosage of fluorine. The results revealed that the dentifrice with 550 ppm F was more effective than both the placebo and the dentifrice with 275 ppm, presenting no difference in relation to the positive control (p > 0.05). A dose-effect correlation was observed as to the CaF2 formed. In conclusion, the modified formulation with 550 ppm F can be considered as effective as the standard dentifrice with 1,100 ppm, and its utilization would be safer with regard to dental fluorosis.

Microbiologic and radiographic analysis of ligature-induced peri-implantitis with different dental implant surfaces

Purpose: The goal of this study was to evaluate microbiota and radiographic peri-implant bone loss associated with ligature-induced peri-implantitis. Materials and Methods: Thirty-six dental implants with 4 different surfaces (9 commercially pure titanium, 9 titanium plasma-sprayed, 9 hydroxyapatite, and 9 acid-etched) were placed in the edentulous mandibles of 6 dogs. After 3 months with optimal plaque control, abutment connection was performed. On days 0, 20, 40, and 60 after placement of cotton ligatures, both microbiologic samples and periapical radiographs were obtained. The presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Campylobacter spp, Capnocytophaga spp, Fusobacterium spp, beta-hemolytic Streptococcus, and Candida spp were evaluated culturally. Results: P intermedia/nigrescens was detected in 13.89% of implants at baseline and 100% of implants at other periods. P gingivalis was not detected at baseline, but after 20 and 40 days it was detected in 33.34% of implants and at 60 days it was detected in 29.03% of dental implants. Fusobacterium spp was detected in all periods. Streptococci were detected in 16.67% of implants at baseline and in 83.34%, 72.22%, and 77.42% of implants at 20, 40, and 60 days, respectively. Campylobacter spp and Candida spp were detected in low proportions. The total viable count analysis showed no significant differences among surfaces (P = .831), although a significant difference was observed after ligature placement (P < .0014). However, there was no significant qualitative difference, in spite of the difference among the periods. The peri-implant bone loss was not significantly different between all the dental implant surfaces (P = .908). Discussion and Conclusions: These data suggest that with ligature-induced peri-implantitis, both time and periodontal pathogens affect all surfaces equally after 60 days.

Systemic and local teething disturbances: Prevalence in a clinic for infants

The aim of this study was to present data as reported by parents on primary tooth eruption and the occurrence of local and systemic manifestations in children ages 0 to 3 years seen at the baby clinic of the Araçatuba Dental School, UNESP, São Paulo, Brazil. Data from 1,813 records were analyzed, yielding 1,165 records suitable for review. Some type of local and/or systemic manifestation during primary tooth eruption was reported for 95% (1,129) children studied. The predominant manifestation was gingival irritation (85%), while the least frequent symptom (26%) was a runny nose.

Electromyographic muscle EMG activity in mouth and nasal breathing children

Mouth breathing may cause changes in muscle activity, because an upper airway obstruction leads may cause a person to extend his/her head forward, demanding a higher inspiratory effort on the accessory muscles (sternocleidomastoids). This purpose of this study is to compare, using electromyography (EMG), the activity pattern the sternocleidomastoid and upper trapezius muscles in mouth breathing children and nasal breathing children. Forty-six children, ages 8-12 years, 33 male and 13 female were included. The selected children were divided into two groups: Group I consisted of 26 mouth breathing children, and Group II, 20 nasal breathing children. EMG recordings were made using surface electrodes bilaterally in the areas of the sternocleidomastoideus and upper trapezius muscles, while relaxed and during maximal voluntary contraction. The data were analyzed using the Kruskall-Wallis statistical test. The results indicated higher activity during relaxation and lower activity during maximal voluntary contraction in mouth breathers when compared to the nasal breathers. It is suggested that the activity pattern of the sternocleidomastoid and upper trapezius muscles differs between mouth breathing children and nasal breathing children. This may be attributed to changes in body posture which causes muscular imbalance. Because of the limitations of surface EMG, the results need to be confirmed by adding force measurements and repeating the experiments with matched subjects. Copyright © 2004 by CHROMA, Inc.

Prototipagem como forma alternativa para realização de cranioplastia com metilmetacrilato: Nota técnica

The prototyping is a method for reconstruction of human body segments by computer software. It has been used in neurosurgery for cranial reproduction in patients allowing the programming of surgical procedures and the production of prosthesis to reconstruct bone failures in the skull. We present two cases of cranioplasty performed with the use of acrylic prosthesis constructed by prototyping. After 10 months of follow-up, they donot present signs of infection and show good aesthetic result. The advantages pointed at the literature for this method (reduction of surgical time, easy technical handle, and good aesthetic result) were confirmed.

Treatment options for the occlusal surface of first permanent molars

Restorative dentistry has been increasingly concerned with preservation of the dental structure. For that reason, ultraconservative cavity preparations have been performed with air abrasion systems. The aim of this study was to present treatment options for the occlusal surface of first permanent molars with employment of the conventional method and the air abrasion system for accomplishment of the cavity preparation and a composite occlusal matrix for an accurate reproduction of the tooth surface.

Análise retrospectiva da toxicidade de gotas otológicas, medicamentos tópicos nasais e orofaríngeos registrada na Grande São Paulo.

BACKGROUND: Retrospective analysis of human toxicity files involving topical medicines for treatment of upper airways diseases (eardrops, topical nasal medicines, lozenges, drops and sprays for oropharyngeal affections). METHODS: Thirty-four brands of eardrops, 48 of topical nasal medicines and 22 of tablets, lozenges and sprays for oropharyngeal affections were selected, from a total of 104 products available in Brazil. We analyzed the registries in the electronic database from the Poison Control Centre of São Paulo (CCI-Jabaquara), Brazil, for the period from January 1996 through December 2000. The cases related to selected pharmaceuticals were collected. RESULTS: 10,823 cases of human toxicity caused by medicines were voluntarily reported to CCI-Jabaquara. Topical medicines for treatment of upper airways diseases accounted for 291 cases (2.68%), from which 240 (82.5%) represented poisoning; 12 (4.1%) involved ear drops, 268 (92%), topical nasal medicines and 11 (3.9%), topical medicines for oropharyngeal affections. Among topical nasal medicines, vasoconstrictors predominated (233 cases), and among medicines for oropharyngeal affections, it was tetracaine (four cases). Considering age distribution, toxicity predominated significantly in children aged from 1 to 4 years (p=0.0003). The main causes of toxicity were: accidental intake of medicines (43%) and error in drug administration (14.8%). Hypereflexia and vomiting were the most frequent symptoms related to toxicity. CONCLUSIONS: There was significant incidence of systemic toxicity due to eardrops, topical nasal and oropharyngeal medicines in children 1 to 4 years-old, whose main cause was accidental intake of these medicines.

Experimental peri-implant tissue breakdown around different dental implant surfaces: Clinical and radiographic evaluation in dogs

Purpose: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. Materials and Methods: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. Results: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r 2 = 0.81; P = .014) and between mobility and vertical bone loss (r 2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. Discussion and Conclusions: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.

Evaluation of transfer impressions for osseointegrated implants at various angulations

The accuracy of impressions that transfer the relationship of the implant to the metal framework of the prosthesis continues to be a problem. This study was designed to evaluate the accuracy of the transfer process under variable conditions with regard to implant analog angulations, impression materials, and techniques. Replicas (n = 60) of a metal matrix (control) containing four implants at 90°, 80°, 75°, and 65° in relation to the horizontal surface were obtained by using three impression techniques: T1 - indirect technique with conical copings in closed trays; T2 - direct technique with square copings in open trays; and T3 - square copings splinted with autopolymerizing acrylic resin; and four elastomers: P-polysulfide; I-polyether; A-addition silicone; and Z-condensation silicone. The values of the implant analog annulations were assessed by a profilometer to the nearest 0.017°, then submitted to analysis of variance for comparisons at significance of 5% (P < .05). For implant analog at 90°, the material A associated with T2 and material Z with T3 behaved differently (P < .05) from all groups. At 80°, all materials behaved differently (P < .01) with T1. At 75°, when T1 was associated, materials P and A showed similar behavior, as well as materials I and Z; however, P and A were different from I and Z (P < .01). When T3 was associated, all experimental groups behaved differently among them (P < .01). At 65°, the materials P and Z behaved differently (P < .01) from the control group with T1, T2, and T3; the materials I and A behaved differently from the control group (P < .01) when T1 and T2, respectively, were associated. The more perpendicular the implant analog annulation is in relation to the horizontal surface, the more accurate the impression. The best materials were material I and A and the most satisfactory technique was technique 3.

Effect of ceramic surface treatment on the microtensile bond strength between a resin cement and an alumina-based ceramic

Purpose: The objective of this study was to test the following hypothesis: the silica coating on ceramic surface increases the bond strength of resin cement to a ceramic. Materials and Methods: In-Ceram Alumina blocks were made and the ceramic surface was treated: G1 - sandblasting with 110-μm aluminum oxide particles; G2 - Rocatec System: tribochemicai silica coating (Rocatec-Pre powder + Rocatec-Plus powder + Rocatec-Sil); G3 - CoJet System: silica coating (CoJet-Sand) + ESPE-Sil. The ceramic blocks were cemented to composite blocks with Panavia F resin cement (under a load of 750 g/1 min). The cemented blocks were stored in distilled water at 37°C for 7 days and sectioned along the x and y axes with a diamond disk. Samples with an adhesive area of ca 0.8 mm 2 (n = 45) were obtained. The samples were attached to an adapted device for the microtensile test, which was performed in a universal testing machine (EMIC) at a crosshead speed of 1 mm/min. Results: The obtained results were submitted to ANOVA and Tukey's test. Mean values of tensile strength (MPa) and standard deviation values were: (G1) 16.8 ± 3.2; (G2) 30.6 ± 4.5; (G3) 33.0 ± 5.0. G2 and 63 presented greater tensile strength than G1. There was no significant difference between G2 and G3. All the failures took place at the ceramic/resin cement interface. Conclusion: The silica coating (Rocatec or CoJet systems) of the ceramic surface increased the bond strength between the Panavia F resin cement and alumina-based ceramic.

Temperature analysis during bonding of brackets using LED or halogen light base units

The purpose of our investigation is to compare the intrapulpal temperature changes following blue LED system and halogen lamp irradiation at the enamel surface of permanent teeth. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Several light sources can be used: halogens, arc plasma, lasers, and recently blue LED systems. An important aspect to be observed during such a procedures is the temperature change. In this study, we have used nine human extracted permanent teeth: three central incisors, three lateral incisors, and three canines. Teeth were exposed to two light sources: blue LED system (preliminary commercial model LEC 470-II) and halogen lamp (conventional photo-cure equipment). The surface of teeth was exposed for 20, 40, and 60 sec at the buccal and lingual enamel surface with an angle of 45 degrees. Temperature values measured by a thermistor placed at pulpar chamber were read in time intervals of 1 sec. We obtained plots showing the temperature evolution as a function of time for each experiment. There is a correlation between heating quantity and exposition time of light source: with increasing exposition time, heating increases into the pulpal chamber. The halogen lamp showed higher heating than the LED system, which showed a shorter time of cooling than halogen lamp. The blue LED system seems like the indicated light source for photo-cure of composite resin during the bonding of brackets. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Blue LED equipment did not heat during its use. This could permit a shorter clinical time of operation and better performance. © Mary Ann Liebert, Inc.

Restoration of severely decayed primary incisors using indirect composite resin restoration technique

Caries of primary incisors is a common problem in paediatric dentistry in some countries. The restoration of primary incisors which have been severely damaged by early childhood caries or trauma is also a difficult challenge for clinicians. This case report describes an indirect technique for the restoration of primary anterior teeth using composite resin reinforced with a fibreglass post. Over a one-year period, the crowns have demonstrated good retention and aesthetic results. The restorations were provided in two short chair-side sections, with satisfactory patient cooperation. © 2005 BSPD and IAPD.

Aesthetic and functional ocular rehabilitation

The ocular losses are embarrassing to the bearer because they commit the face which has the essential organs for the human relationship. The present study shows the multidiscipline interaction in the treatment of a child who lost his left eye victim of a fire gun and needed an ocular plastic surgery for a correct prosthesis insertion. The ocular prosthesis fills in the ocular cavity simulating the facial growth and restoring its symmetry. Therefore, there are aesthetics, anatomic and physiological improvement on the child's face that allows her to be reinstated in society without being discriminated for her differences. © 2005 Elsevier Ltd. All rights reserved.

Histomorphometric evaluation of a threaded, sandblasted, acid-etched implant retrieved from a human lower jaw: A case report

The purpose of this study was to histomorphometrically evaluate the bone-to-implant contact and bone area around a titanium implant retrieved from a human lower jaw. A screw-shaped titanium implant (sandblasted and acid-etched surface) was removed from a 68-year-old male after having been in function for 40 months because of a fracture of the abutment screw. Following the implant removal, an undecalcified section was obtained. The histomorphometric analysis showed a rate of 75.40% of bone-to-implant contact and 89.30% of bone area filling within the limits of the implant threads. The surrounding bone healed in a well-organized pattern and could not be differentiated from the anginal alveolus. The histologic evidence showed a high degree of osseointegration in a threaded, sandblasted, and acid-etched implant retrieved from a human lower jaw after functional loading for 40 months. Copyright © 2005 by Lippincott Williams & Wilkins.

Intercommissural width in 4 racial groups as a guide for the selection of maxillary anterior teeth in complete dentures

Purpose: To determine whether intercommissural width is a reliable guide for the selection of maxillary denture teeth width. Materials and Methods: Casts were made of 160 subjects from 4 different racial groups. Locations of intercommissural width landmarks (the corners of the mouth) were made on the subjects and transferred to the casts. The distances between the corners of the mouth and the distal of the canines were measured on the casts and compared. Results: A weak correlation was found between the distal of the canines and the distance between the corners of the mouth in the 4 racial groups. Conclusion: The use of the corners of the mouth for the selection of artificial teeth is generally inaccurate.