993 resultados para POSITIONED FLAP


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A new species of the genus Moenkhausia is described from the middle portions of the Rio Tocantins and tentatively from the Río Apure in Venezuela, Río Orinoco drainage. It is diagnosed by the presence of a dark spot in the half proximal length of the upper caudal-fin lobe, and by the presence of a large, irregularly shaped humeral spot located above the sixth to ninth perforated lateral line scale which is more posteriorly positioned along the body side in relation to other members of the genus. The distribution pattern of the new species is discussed. Copyright © 2007. Magnolia Press.

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Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

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Aim: The aim of this study was to assess the thermoplasticity of materials used in root canal filling. Methods: Specimens with standardized dimensions were fabricated using Tanari, Roeko and Activ Point gutta-percha cones, as well as Microseal and TC gutta-percha. After 24 hours, the specimens were placed in water at 70 °C for 60 seconds and positioned between two glass slabs. Each set was compressed by a 5 g weight. Digital images of the specimens before and after compression were obtained and analyzed. The thermoplasticity was evaluated based on the difference between the final and initial areas. Data were statistically analyzed using ANOVA and Tukey's tests at a 5% significance level. Results: TC and Microseal gutta-percha presented the highest thermoplasticity (p < 0.05). Among the gutta-percha cones, Tanari and Roeko presented the highest thermoplasticity and differed when compared to Activ Point (p < 0.05). Conclusions: The results of the present study showed that TC and Microseal gutta-percha filling systems present better thermoplastic properties.

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The presence of porosities at the dentin/adhesive interface has been observed with the use of new generation dentin bonding systems. These porosities tend to contradict the concept that etching and hybridization processes occur equally and simultaneously. Therefore, the aim of this study was to evaluate the micromechanical behavior of the hybrid layer (HL) with voids based on a self-etching adhesive system using 3-D finite element (FE) analysis. Three FE models (Mr) were built: Mr, dentin specimen (41x41x82 μm) with a regular and perfect (i.e. pore-free) HL based on a self-etching adhesive system, restored with composite resin; Mp, similar to M, but containing 25% (v/v) voids in the HL; Mpp, similar to Mr, but containing 50% (v/v) voids in the HL. A tensile load (0.03N) was applied on top of the composite resin. The stress field was obtained by using Ansys Workbench 10.0. The nodes of the base of the specimen were constrained in the x, y and z axes. The maximum principal stress (σmax) was obtained for all structures at the dentin/adhesive interface. The Mpp showed the highest peak of σmax in the HL (32.2 MPa), followed by Mp (30 MPa) and Mr (28.4 MPa). The stress concentration in the peritubular dentin was high in all models (120 MPa). All other structures positioned far from voids showed similar increase of stress. Voids incorporated into the HL raised the σmax in this region by 13.5%. This behavior might be responsible for lower bond strengths of self-etching and single-bottle adhesives, as reported in the literature.

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This paper analyses the static and dynamic behavior of the railroad track model in laboratory. Measurements of stresses and strains on a large-scale railroad track apparatus were studied. The model includes: compacted soil, representing the final layers of platform, ballast layer, and ties (steel, wooden, and pre-stressed concrete). The soil and soil ballast interface were instrumented with pneumatic stress gauge. Settlement measurement device were positioned at the same levels as the load cells. Loads were applied by hydraulic actuators, statically and dynamically. After the prescribed number of load cycles, in pre-determined intervals, stresses and strains were measured. Observations indicate that stress and strain distributions, transmitted by wooden or steel ties, behave similarly. A more favorable behavior was observed with pre-stressed concrete mono block ties. Non-linear response was observed after a threshold numbers of cycles were surpassed, showing that the strain modulus increases with the numbers of cycles. © 2009 IOS Press.

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Aim: To evaluate the influence of implant positioning into extraction sockets on osseointegration. Material and methods: Implants were installed immediately into extraction sockets in the mandibles of six Labrador dogs. In the control sites, the implants were positioned in the center of the alveolus, while in the test sites, the implants were positioned 0.8 mm deeper and more lingually. After 4 months of healing, the resorptive patterns of the alveolar crest were evaluated histomorphometrically. Results: All implants were integrated in mineralized bone, mainly composed of mature lamellar bone. The alveolar crest underwent resorption at the control as well as at the test sites. After 4 months of healing, at the buccal aspects of the control and test sites, the location of the implant rough/smooth limit to the alveolar crest was 2±0.9 mm and 0.6±0.9 mm, respectively (P<0.05). At the lingual aspect, the bony crest was located 0.4 mm apically and 0.2 mm coronally to the implant rough/smooth limit at the control and test sites, respectively (NS). Conclusions: From a clinical point of view, implants installed into extraction sockets should be positioned approximately 1 mm deeper than the level of the buccal alveolar crest and in a lingual position in relation to the center of the alveolus in order to reduce or eliminate the exposure above the alveolar crest of the endosseous (rough) portion of the implant. © 2009 John Wiley & Sons A/S.

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This study evaluated the effect of different light energy densities on conversion degree (CD) and Knoop hardness number (KHN) of RelyX ARC (RLX) resin cement. After manipulation according to the manufacturer's instructions, RLX was inserted into a rubber mold (0.8 mm X 5 mm) and covered with a Mylar strip. The tip of the lightcuring unit (LCU) was positioned in contact with the Mylar surface. Quartz-tungsten-halogen (QTH) and light-emitting diode (LED) LCUs with light densities of 10, 20 and 30 J/cm2 were used to light-cure the specimens. After light curing, the specimens were stored dry in lightproof containers at 37°C. After 24 hours, the CD was analyzed by FT-Raman and, after an additional 24-hours, samples were submitted to Knoop hardness testing. The data of the CD (%) and KHN were submitted to two-way ANOVA and the Tukey's test (α=0.05). QTH and LED were effective light curing units. For QTH, there were no differences among the light energy densities for CD or KHN. For LED, there was a significant reduction in CD with the light energy density set at 10 J/cm2. KHN was not influenced by the lightcuring unit and by its light energy density. © Operative Dentistry.

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The frequency of simultaneously impacted second and third molars in teenagers is increasing and becoming a common occurrence in adolescent oral surgery practice. The traditional treatment is the removal of the third molar by conventional access but repositioning of the surgical flap to the distal face of the first molar can predispose to complications such as pericoronitis and delayed healing of the attached gingiva. We present a case in which we use the germectomy approach to remove the impacted third molar for the eruption of the second molar through a vestibular incision. This incision offers excellent bone exposure and exit route for the third molar without disturbing the gingiva attached architecture on the distal face of the first molar providing good healing environment.

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AIM: This study evaluated the temperature rise of the adhesive system Single Bond (SB) and the composite resins Filtek Z350 flow (Z) and Filtek Supreme (S), when polymerized by light-emitting diode (LED XL 3000) and quartz-tungsten halogen (QTH Biolux). METHODS: Class V cavities (3 yen2 mm) were prepared in 80 bovine incisors under standardized conditions. The patients were divided as follows: G1: Control; G2: SB; G3: SB + Z; G4: SB + S. The groups were subdivided into two groups for polymerization (A: QTH, B: LED). Light curing was performed for 40 s and measurement of temperature changes during polymerization was performed with a thermocouple positioned inside the pulp chamber. Data were statistically analyzed using ANOVA and Tukey tests. RESULTS: The factors material (P<0.00001) and curing unit (P<0.00001) had significant influence on temperature rise. The lowest temperature increase (0.15 degrees C) was recorded in G2 B and the highest was induced in G1 A (0.75 degrees C, P<0.05). In all groups, lower pulp chamber temperature measurements were obtained when using LED compared to QTH (P<0.05). CONCLUSION: QTH caused greater increases in tooth temperature than LED. However, both sources did not increase pulpal temperature above the critical value that may cause pulpal damage.

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Background: Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. Methods: For this prospective, double-masked, crossover, placebo-controlled, randomized clinical trial, open-flap debridement surgeries were performed on 15 patients (eight males and seven females, age range 20 to 56 years: mean age ± SD: 40 ± 9.7 years) who presented with chronic periodontitis after nonsurgical periodontal therapy at three quadrants. Each patient underwent three surgical procedures at intervals of 30 days and received one of the following premedication protocols 1-hour before surgery: group 1 = placebo, group 2 = 8 mg dexamethasone, and group 3 = 120 mg etoricoxib. Rescue medication (750 mg acetaminophen) was given to each patient who was instructed to take it when necessary. Pain intensity and discomfort were evaluated by a 101-point numeric rate scale and a four-point verbal rate scale, respectively, hourly for the first 8 hours after surgery and three times a day on the following 3 days. Results: The results demonstrate that groups 2 and 3 present reduced postoperative pain-intensity levels compared to group 1. There were statistically significant differences at the 4, 5, 6, 7, and 8 hour-periods after surgery (Friedman test; P<0.05). Furthermore, rescue-medication intake was significantly lower for groups 2 and 3 than for group 1 (analysis of variance; P<0.02). Conclusion: The adoption of a preemptive medication protocol using etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.

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This study evaluated the Knoop hardness and polymerization depth of a dual-cured resin cement, light-activated at different distances through different thicknesses of composite resin. One bovine incisor was embedded in resin and its buccal surface was flattened. Dentin was covered with PVC film where a mold (0.8-mm-thick and 5 mm diameter) was filled with cement and covered with another PVC film. Light curing (40 s) was carried out through resin discs (2, 3, 4 or 5 mm) with a halogen light positioned 0, 1, 2 or 3 mm from the resin surface. After storage, specimens were sectioned for hardness measurements (top, center, and bottom). Data were subjected to split-plot ANOVA and Tukey's test (α=0.05). The increase in resin disc thickness decreased cement hardness. The increase in the distance of the light curing tip decreased hardness at the top region. Specimens showed the lowest hardness values at the bottom, and the highest at the center. Resin cement hardness was influenced by the thickness of the indirect restoration and by the distance between the light-curing unit tip and the resin cement surface.

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The aim of this study was to evaluate the efficacy of a pouring technique for implant-supported prostheses impressions. A metallic matrix (control group) with two implants positioned at 90 and 65 degrees was fabricated. The matrix was submitted to the direct transfer impression technique. In group CP (conventional pouring - n = 10), casts were obtained by the conventional pouring technique. In group EP (experimental pouring - n = 10), the analogs were embraced with latex tubes before the first pouring and then submitted to a second pouring. Vertical misfit and implants/analogs inclinations were evaluated. Data were analyzed by analysis of variance and Tukey's test (p < .05). Results demonstrated significant difference (p < .05) between control and experimental groups for misfit measurement in perpendicular implant/analog and between control group and group EP in leaning implant/analog. Considering inclination, there were significant differences (p < .05) between control and experimental groups for leaning analogs. Independently of the pouring technique, perpendicular implants produced more accurate casts.

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Aim: There is little information considering the framework association between cast clasps and attachments. The aim of this study was to evaluate the retention strength of frameworks match circumferential clasps and extra resilient attachment cast in three different alloys (cobalt-chromium, nickel-chromium titanium and commercially pure titanium), using two undercut (0.25 and 0.75 mm) and considering different period of time (0, 1/2, 1, 2, 3, 4 and 5 years). Methods: Using two metallic matrices, representing a partially edentulous mandibular right hemiarch with the first molar crown, canine root and without premolars, 60 frameworks were fabricated. Three groups (n = 20) of each metal were cast and each group was divided into two subgroups (n = 10), corresponding the molar undercut of 0.25 mm and 0.75 mm. The nylon male was positioned at the matrix and attached to the acrylic resin of the prosthetic base. The samples were subjected to an insertion and removal test under artificial saliva environment. Results: The data were analyzed and compared with ANOVAs and Tukey's test at 95% of probability. The groups cast in cobaltchromium and nickel-chromium-titanium had the highest mean retention strength (5.58 N and 6.36 N respectively) without significant difference between them, but statistically different from the group cast in commercially pure titanium, which had the lowest mean retention strength in all the periods (3.46 N). The association frameworks using nickel-chromium-titanium and cobalt-chromium could be used with 0.25 mm and 0.75 mm of undercut, but the titanium samples seems to decrease the retention strength, mainly in the 0.75 mm undercut. The circumferential clasps cast in commercially pure titanium used in 0.75 mm undercuts have a potential risk of fractures, especially after the 2nd year of use. Conclusion: This in vitro study showed that the framework association between cast clasp and an extra resilient attachment are suitable to the three metals evaluated, but strongly suggest extra care with commercially pure titanium in undercut of 0.75 mm. Clinical significance: Frameworks fabricated in Cp Ti tend to decrease in retentive strength over time and have a potential risk of fracture in less than 0.75 mm of undercut.