Dental anomalies in Richieri-Costa-Pereira syndrome

Objective. The objective of this study was to investigate the prevalence of dental anomalies in individuals with Richieri-Costa-Pereira syndrome. Study Design. A total of 13 individuals with Richieri-Costa-Pereira syndrome who were older than 8 years with at least 1 available panoramic radiograph were assessed. Dental anomalies were evaluated clinically and radiographically and classified as hyperplastic, hypoplastic, or heterotopic and as alterations of shape, number, position, and structure. Enamel alterations were classified by the DDE index. Results. All individuals exhibited anomalies, with predominance of hypoplastic disorders, mainly agenesis of mandibular incisors and second premolars and demarcated creamy-white enamel opacities primarily affecting the maxillary premolars. Conclusions. Individuals with Richieri-Costa Pereira syndrome exhibit high prevalence of tooth agenesis, especially mandibular incisors and premolars, as well as high frequency of enamel opacities. These findings are compatible with the mandibular cleft observed in all individuals and also reflect the hypoplastic characteristic of the syndrome. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:99-106)

Validation of fingernail fluoride concentration as a predictor of risk for dental fluorosis

The aim of this study was to validate the use of fingernail fluoride concentrations at ages 2-7 years as predictors of the risk for developing dental fluorosis in the permanent dentition. Fifty-six children of both genders (10-15 years of age) had their incisors and premolars examined for dental fluorosis using the Thylstrup-Fejerskov index. Fingernail fluoride concentrations were obtained from previous studies when children were 2-7 years of age. Data were analyzed by unpaired t test, ANOVA, and Fisher's exact test when the fingernail fluoride concentrations were dichotomized (<= 2 or > 2 mu g/g). Children with dental fluorosis had significantly higher fingernail fluoride concentrations than those without the condition, and the concentrations tended to increase with the severity of fluorosis (r(2) = 0.47, p < 0.0001). Using a fingernail fluoride concentration of 2 mu g/g at ages 2-7 years as a threshold, this biomarker had high sensitivity (0.84) and moderate specificity (0.53) as a predictor for dental fluorosis. The high positive predictive value indicates that fingernail fluoride concentrations should be useful in public health research, since it has the potential to identify around 80% of children at risk of developing dental fluorosis. Copyright (C) 2012 S. Karger AG, Basel

Foreign Body Ingestion During Dental Implant Procedures

Two cases of swallowing of foreign material related to dental implants during dental practice are described. A conservative approach by clinical-radiographic follow-up was performed in both cases; however, one of the patients required colonoscopy under general anesthesia for the removal of the impacted foreign body from the intestinal region. These complications not only have associated economic cost but also carry the risk of malpractice litigation against the professional; thus, the surgeon was responsible for all the costs of hospital and surgery management of this case. Details of the clinical signs, radiographic examinations, type of treatment, and follow-up are presented.

Felypressin Increases Blood Pressure During Dental Procedures in Hypertensive Patients

Background: Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients. Objective: To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP. Methods: 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety. Results: Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels. Conclusion: Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety. (Arq Bras Cardiol 2012;99(2):724-731)

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross-sectional survey was conducted with 376 children aged 3659 months who attended the National Day of Childrens Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.

In vitro analysis of the influence of surface treatment of dental implants on primary stability

Surface treatment interferes with the primary stability of dental implants because it promotes a chemical and micromorphological change on the surface and thus stimulates osseointegration. This study aimed to evaluate the effects of different surface treatments on primary stability by analyzing insertion torque (IT) and pullout force (PF). Eight samples of implants with different surface treatments (TS - external hexagon with acid surface treatment; and MS - external hexagon, machined surface), all 3.75 mm in diameter x 11.5 mm in length, were inserted into segments of artificial bones. The IT of each sample was measured by an electronic torquemeter, and then the pullout test was done with a universal testing machine. The results were subjected to ANOVA (p < 0.05), followed by Tukey's test (p < 0.05). The IT results showed no statistically significant difference, since the sizes of the implants used were very similar, and the bone used was not highly resistant. The PF values (N) were, respectively, TS = 403.75 +/- 189.80 and MS = 276.38 +/- 110.05. The implants were shown to be different in terms of the variables of maximum force (F = 4.401, p = 0.0120), elasticity in maximum flexion (F = 3.672, p = 0.024), and relative stiffness (F = 4.60, p = 0.01). In this study, external hexagonal implants with acid surface treatment showed the highest values of pullout strength and better stability, which provide greater indication for their use.