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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 8
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- Relationship between internal root resorption and dens in dente(2020) Pérez Alfayate, Ruth; Mercadé, Montse; Vera, JorgeThe aim is to report the treatment and follow-up of three lateral incisors with internal root resorption and dens in dente as a possible cause for their development, managed by root canal treatment and apical obturation with MTA or gutta-percha. This case report presents three clinical cases in which dens invaginatus type 2 is shown as a potential cause for the development of internal root resorption. Two cases were filled with a MTA apical plug technique and one with gutta-percha, and all were follow-up through time. The incidence of the association of internal root resorption with dens invaginatus may be underestimated and should be studied.
- Precision and practical usefulness of intraoral scanners in implant dentistry : a systematic literature review(2020) García Gil, Ignacio; Cortés-Bretón Brinkman, Jorge; Jiménez García, Jaime; Peláez Rico, Jesús; Suárez García, María JesúsThis systematic review aimed to evaluate the efficiency and accuracy of digital impression techniques for implant-supported restorations, and to assess their economic feasibility. Two independent electronic database searches were conducted in the Pubmed/MedLine, Cochrane Library, and Lilacs databases complimented by a manual search, selecting relevant clinical and in vitro studies published between 1st January 2009 and 28st February 2019. All type of studies (in vivo and in vitro) were included in this systematic review. Twenty-seven studies (8 in vivo and 19 in vitro studies) fulfilled the inclusion criteria. No meta-analysis was performed due to a large heterogeneity of the study protocols. The passive fit of superstructures on dental implants presented similar results between digital and conventional impression techniques. The studies considered that several factors influence the accuracy of implant impression taking: distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody, and operator experience. Regarding the economic viability of intraoral scanning systems, only one study reported any benefit in comparison with conventional techniques. Digital impressions of dental implants can be considered a viable alternative in cases of one or two contiguous dental implants. However, more studies are needed to evaluate the accuracy of digital techniques in full-arch implant-supported restorations.
- Oral hygiene and habits of children with autism spectrum disorders and their families(2020) Hage, Simone R. V.; Lopes-Herrera, Simone A.; Santos, Thais-Helena F.; Defense-Netvral, Danielle A.; Martins, Aline; Sawasaki, Lidiane Y.; Fernandes, Fernanda D. M.Children with Autism Spectrum Disorders (ASD) frequently receive poorer health care then the general population. Frequently the speech-language pathologist is the only health professional that follows the child?s everyday life and therefore is the only resource for guidance regarding basic health habits. Poor oral health may result in severe discomfort and other health problems that can be prevented by simple routine habits and adequate professional follow-up. The aim of the present study was to gather information about oral hygiene and dental care habits of children with ASD and their families. The hypothesis was that these children have poorer oral care habits than their families. Participants were parents of 120 children with autism, aged 4 to 12 years in two different cities of the state of Sao Paulo. They answered to a simple questionnaire about oral hygiene and health care habits. Indicated that there is a significant difference (p< 0.001) between the children and their families regarding basic oral hygiene habits, such as brushing and flossing, as well as routine visits to the dentist. This information clearly indicates the need for education programs aiming to encourage the inclusion children with ASD in the basic habits of oral care carried-out by the families.
- Xerostomia in patients with sleep apnea-hypopnea syndrome : a prospective case-control study(2020) Picó Orozco, Josep; Carrasco Llatas, Marina; Silvestre Donat, Francisco Javier; Silvestre Rangil, JavierTo describe the characteristics of xerostomia (dry mouth) in the population with sleep apnea-hypopnea syndrome (SAHS) and contrast its prevalence versus that found in healthy subjects, and to compare the frequency of xerostomia in SAHS patients with and without continuous positive airway pressure (CPAP) treatment. A prospective comparative study was made between adults recently diagnosed with SAHS in a public hospital (n=60) and healthy individuals (n=54). The presence of xerostomia was assessed on waking up and during the day, using a frequency scale from 0 (?never?) to 3 (?always?). The prevalence of xerostomia on waking up in the SAHS group was 45%, versus 20.4% among the controls. During the rest of the day the prevalence of the symptom decreased in both the SAHS group (21.7%) and among the controls (9.3%). Multiple binary logistic regression analysis found body mass index (BMI) to be correlated to the association SAHS-xerostomia on waking up (p=0.007). Patients with moderate SAHS had a greater frequency of xerostomia than those with mild SAHS (p=0.022). The frequency of xerostomia on waking up was significantly greater in patients using CPAP than in those without such treatment (57.1% versus 16.7%, respectively) (p=0.008). The frequency of xerostomia was greater in patients with SAHS, particularly on waking up and in those receiving CPAP. The symptom was more prevalent in individuals with moderate to severe SAHS than in those with mild SAHS, and was significantly influenced by BMI.
- The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients(2020) Caminha, Raquel; Alcantara, Patricia-Lopes; Carvalho, Caroline-Gomes; Reia, Verônica-Caroline-Brito; Capelozza, Ana-Lucia-Alvares; Santos, Paulo Sergio da SilvaTo evaluate the impact of oral health on the quality of life (QOL) of individuals undergoing cancer treatment at the time of diagnosis of medication-related osteonecrosis of the jaw (MRONJ). The present cross-sectional study analyzed patients with MRONJ from 2013 to 2019. The collected data included demographic data, base disease, medications associated with MRONJ, route of administration and time of use, signs, symptoms, and tomographic features of acute MRONJ, staging according to American Association of Oral and maxillofacial Surgeons position paper 2014 (AAOMS), type of dental treatment performed, outcome, and the responses to the Oral Health Impact Profile questionnaire (OHIP-14). Statistical analysis was performed using the Tukey test to study the association between oral condition and the QOL. A p-value of less than 0.05 was considered statistically significant. The sample consisted of 16 medical records of patients with MRONJ. Psychological discomfort showed alarmingly significant results (p< 0.001) with strong negative impact on the QOL of the patients. Functional limitation was the least affected dimension (p = 0.747). The other dimensions did not show statistically significant results. MRONJ compromises oral health and negatively impacts the QOL, especially with respect to the psychological discomfort (worry and stress). The OHIP-14 questionnaire proved to be an effective tool in the assessment of this impact.
- Detection of mast cells in ameloblastomas and odontogenic keratocysts(2020) dos Santos, Erison-Santana; de Andrade, Richard-Ribeiro-Alonso; Sampaio, Gerhilde-Callou; Catunda, Raisa Queiroz; Andrade, Emanuel Sávio de SousaMCs (MCs) have been ascribed to mediating several diseases, including malignant neoplasms. These cells can play a role in angiogenesis, tissue remodeling and immune modulation and favor neoplasm progression. Despite the studies analyzing the contribution of MCs in odontogenic lesions, its biological behavior in ameloblastomas (AMBs) and odontogenic keratocysts (OKCs) remains unclear. This study aims to detect MCs in OKCs and AMBs and clarify the role of MCs in these lesions. A total of 40 odontogenic lesions were analyzed. This included 20 OKCs and 20 AMBs, 10 being the solid type and the other 10 being the unicystic type of AMB. All cases were histologically reviewed in hematoxylin-eosin. Clinical data, such as age, gender, location, size, radiographic presentation and, histologic patterns were collected from the clinical charts. The Mann?Whitney U test (MWU) was used verify the hypothesis, through inferential statistics. The level of significance used in the statistical test was 0.5%. MCs were observed in 60% of OKCs, and 35% of AMBs. The ratio of MCs observed in OKCs was 0.37, 0.48 in solid AMBs and 0.01 in unicystic AMBs. There was no significant difference between number of MCs in AMBs and OKCs, however, a significant difference was observed between solid and unicystic AMBs (p ? 0.01). MCs may play an important role in the biological behavior of AMBs and OKCs. However, in this study it was not possible to confirm the contribution of MCs in the biological behavior of these lesions and more studies are needed to clarify this relation.
- Influence of thickness and translucency of lithium disilicate ceramic on degree of conversion of resinous materials(2020) Liporoni, Priscila-Christiane-Suzy; Ponce, Alcira-Cinthia-Rodríguez; de Freitas, Maiara-Rodrigues; Zanatta, Rayssa-Ferreira; Pereira, Maria-Clara-Santos; Catelan, AndersonIn this study was assessed the degree of conversion (DC) of amine-free resin cements light cured through lithium disilicate-reinforced ceramics at different thicknesses and translucency. Specimens were divided into 21 groups (n = 5) according to luting agent used: Variolink Esthetic LC (Light shade), RelyX Ultimate (A1 shade), and Filtek Z350 XT Flow (A1 shade); the ceramic translucency: low (LT) and high (HT); and the ceramic thickness: no ceramic (control), 0.5 mm, 1 mm, and 2 mm. A Teflon mold with (5 x 5 x 0.5 mm) was used to standardize the cement and over it the ceramic block from each group was placed. Set was cured using a polywave LED light (1200 mW/cm2 - Bluephase G2) for 40 s. FTIR spectra of uncured and cured materials was obtained and DC calculated from the height of the peaks 1610 and 1640 cm-1. Data were submitted to ANOVA followed by Tukey?s test (? = 0.05). There was a significant difference for luting agents (p< 0.0001) and translucency (p = 0.025), but not for thickness (p = 0.73). Dual amine-free RelyX Ultimate showed the lowest DC values and higher translucency promoted higher DC. Dual amine-free cement showed the lowest monomer conversion and higher translucency ceramics promoted a higher DC.
- Local complications associated with labial salivary gland biopsy for diagnosis of Sjögren?s Syndrome : a retrospective cohort study(2020) Varoni, Elena M.; Villani, Gabriele; Lombardi, Niccolò; Pispero, Alberto; Lodi, Giovanni; Sardella, Andrea; Uglietti, DanielaTo describe local or systemic complications related to the labial salivary glands biopsy (LSGB) used as diagnostic tool for the diagnosis of Sjögren?s Syndrome (SS). Clinical databases from a cohort of patients, who underwent LSGB with provisional clinical diagnosis of Sjögren?s Syndrome, were retrospectively reviewed. Pain, assessed by registering the intake of analgesic drugs in the first week following the biopsy, and any further relevant clinical information regarding complications after biopsy were recorded. 50 patients received LSGB. 10 of them (9 women and 1 man) showed histopathological findings compatible with SS. Ten patient (20%) receiving labial biopsy developed local complications: three of them (6%) reported a sensory defect at the surgical site that lasted at most few weeks; three patients (6%) reported pain sensation needing the assumption of analgesic drugs, while one patient (2%) described a transient local burning sensation, which resolved in few days. Three patients (6%) showed cutaneous haematoma in the surgical area and two patients (4%) showed mild mucosal inflammation at the biopsy site. LSGB is associated with to few and mild complications and it is a useful tool in the diagnosis of SS. The complications usually resolved in few weeks after the biopsy.
- Fracture strength of endodontically treated lateral incisors restored with new zirconia reinforced rice husk nanohybrid composite(2020) Lin, Galvin-Sim-Siang; Ghani, Nik-Rozainah-Nik-Abdul; Ismail, Noor-Huda; Singbal, Kiran; Murugeshappa, Devarasa-Giriyapura; Mamat, NoraidaThis study aimed to compare the fracture strength, fracture pattern and type of fracture of endodontically treated maxillary lateral incisors restored with new zirconia reinforced rice husk nanohybrid composite. Eighty mature permanent maxillary lateral incisors from patients age range of 30-60 years with single canal were selected and randomly divided into: Group 1 ? RCT + nanofilled composite (Filtek), Group 2 ? RCT + microhybrid composite (Zmack), Group 3 ? RCT + new nanohybrid composite (Zr-Hybrid) and Group 4 - Intact teeth (control). Standardized mesio-palatal-distal cavity was prepared, and endodontic treatment was carried out using crown-down technique until size 30, tapered 0.04. Obturation was completed using single cone technique with gutta-percha and AH plus sealer. Cavity access was restored with respective composite resins. Next, teeth were stored in incubator for 24 hours and subdivided into aged and unaged subgroups. Teeth in aged subgroups were subjected to 2500 thermal cycles for 5ºC, 37ºC and 55ºC with 30 seconds dwell time and 5 seconds transfer time. After that, root surfaces of teeth were covered with silicone-based material and placed in boxes filled with acrylic until the cemento-enamel-junction (CEJ) level. They were then tested under Universal Testing Machine until fracture occurred. Samples were then viewed under Leica microscope to determine the fracture pattern and type of fracture. Data analyzed using One-way ANOVA complimented by post hoc Tukey HSD and paired sample T test for fracture strength. Fracture pattern and type of fracture were analyzed using Chi-square test. Level of significance was set at p<0.05. Significant differences were observed (p<0.05) with Group 3 demonstrating the highest fracture strength followed by Group 4, Group 1 and lastly Group 2 in both aged and unaged subgroups respectively. A significant decreased in fracture strength was noted in Group 1 and Group 2 (p<0.05) as number of thermocycle increased but no significant differences were noted in Group 3 and Group 4 (p>0.05). Besides, Group 3 and Group 4 showed higher rate of favorable fracture pattern, followed by Group 1 and lastly Group 2. Most favorable fracture pattern was noted to exhibit horizontal fracture type (86.36%), whereas most unfavorable fracture pattern exhibited vertical fracture type (77.78%). Endodontically treated teeth restored with new zirconia reinforced rice husk nanohybrid composite (Zr-Hybrid) demonstrated higher fracture strength than commercialized composite resins especially after artificial ageing. Zr-Hybrid showed similar fracture pattern to those of intact teeth with higher rate of horizontal fracture type.
- Maxillofacial and dental-related injuries from a Brazilian forensic science institute : victims and perpetrators characteristics and associated risk factors(2020) Sá, Carlos-Diego-Lopes; Silva, Paulo-Goberlânio-de Barros; Correia, Adriana-de Moraes; Soares, Eduardo Costa Studart; Bezerra, Tácio Pinheiro; Melo, Radamés-Bezerra; Bitú, Heide-dos Santos; Gurgel Costa, Fábio WildsonTrauma due to external causes represents one of the greatest challenges for public health services in different regions around the world. This study aimed to determine the prevalence of facial trauma, associated risk factors, and classification of body injuries in individuals who underwent forensic examination in a Brazilian center. Data were collected at the Ceará State Forensic Medicine unit in a 12-year period. Sociodemographic data related to the etiological agent and lesions resulting from the bodily injury were recorded. Among 1,031 physical injury exams, physical aggression (p<0.001), male victims aged between 21 and 30 years (p<0.001), salaried workers (p<0.001), and soft tissue and dentoalveolar injuries were significant findings. Regarding aggression, domestic violence was prevalent (p<0.001), perpetrated by the victim?s partner (p<0.001), using a blunt instrument during the aggression (p<0.001), and directly associated with soft tissue injury (p<0.001). In traffic accidents, the most common type was motorcycle accident (p<0.001), on weekdays (p=0.036), at nighttime (p=0.134), showing a significant association with bone fractures (p=0.001). Oral and maxillofacial injuries obtained from a Brazilian forensic science center were significantly associated with sociodemographic and etiological factors.
- Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery : an institution's experience(2020) Sahin, Onur; Tatar, Birkan; Ekmekcioglu, Ceren; Aliyev, Toghrul; Odabasi, OnurDentoalveolar surgery is a predisposing factor for medication related osteonecrosis of the jaw (MRONJ). The aim of our study was to evaluate the described surgical procedures to prevent the development of MRONJ after dentoalveolar surgery in patients receiving bisphosphonates. In this retrospective study, sixty-three dentoalveolar surgeries were performed on 44 patients taking bisphosphonate in accordance with the treatment procedures we described. The following procedures were applied to patients 1) use of antibiotics 2) performed dentoalveolar surgical procedures 3) fill the socket with leukocyte- and platelet-rich fibrin (L-PRF) 4) post-operative application of low level laser therapy through Nd: YAG laser 5) sutures were removed on post-op 14th day 6) long-term results were evaluated. Healing of all patients was uneventful. Complete mucosal healing was achieved in all patients at 1 month. There is no failure was observed in long-term follow-up. Because of the pathophysiology of MRONJ is not fully understood and has many risk factors, definitive protocols on prevention and treatment have not been established yet. Personal risk assessment is required for the prevention and treatment of MRONJ. The described surgical protocol may be considered to reduce the risk of developing MRONJ after dentoalveolar surgery due to its high success rate.
- Simulated root canals preparation time, comparing ProTaper Next and WaveOne Gold systems, performed by an undergraduate student(2020) Conceição, Inês; Ferreira, Inês; Braga, Ana Cristina; Pina-Vaz, IreneThe aim of this study was to compare the WaveOne Gold and ProTaper Next systems regarding the time spent preparing simulated canals performed by an inexperienced student. 0 simulated L-shaped canals were randomly divided into two groups (n = 40) and numbered in order of instrumentation. Canals were instrumented with WaveOne Gold (group 1) and ProTaper Next (group 2) systems. The effective instrumentation time and the number of instrumentation cycles were recorded. All procedures were performed by the same operator. Statistical analysis was obtained by the Mann - Whitney, Kruskal - Wallis test with significance of p<0.05. There were no statistically significant differences regarding the mean instrumentation time between the two instrumentation systems. The instrumentation time decreased over the experimental period, regardless of the technique used. Through a short learning curve, an inexperienced operator can prepare simulated canals in a very predictable time. Time spent was similar in a multi-file instrument system (ProTaper Next) and a single-file system (WaveOne Gold).
- Therapeutic management of the odontogenic keratocyst. An energetic approach with a conservative perspective and review of the current therapeutic options(2020) Borrás Ferreres, Jordi; Sánchez-Torres, Alba; Alberdi Navarro, Javier; Aguirre Urízar, José Manuel; Mosqueda Taylor, Adalberto; Gay-Escoda, CosmeOdontogenic keratocysts (OKC) are cystic lesions appearing in the jaws, usually asymptomatic with a progressive growth into the bone. Many of them are diagnosed by a routine radiological examination. This study reports a 12-year-old girl that presented an asymptomatic large radiolucent unilocular lesion associated to the crown of 3.8 that caused displacement of the molar and the inferior alveolar canal. Differential diagnosis included OKC, unicystic ameloblastoma, ameloblastic fibroma, dentigerous cyst and orthokeratinized odontogenic cyst. Two surgical interventions were performed; first, a marsupialization, and 10 months after, the third molar extraction plus cyst enucleation, mucosa excision and the application of Carnoy?s solution. The anatomopathological exam confirmed diagnosis of OKC. There was no evidence of recurrence after 2 years of follow-up. Marsupialization followed by surgical enucleation with mucosa excision and Carnoy?s solution can help manage treatment of OKC, a lesion characterized by an aggressive behavior.
- Effects of Neuromuscular Electrical Stimulation (NMES) on salivary flow in healthy adults(2020) Koike, Joji; Nozue, Shinji; Ihara, Yoshiaki; Takahashi, KojiNeuromuscular electrical stimulation (NMES) is a method used for enhancing suprahyoid muscle activity and is widely applied as a treatment for dysphagia. Patients often complain of saliva pooling in the pharynx during NMES. Therefore, the purpose of this study was to investigate the changes in salivary flow during NMES. Twenty healthy adults participated in this study. Electrical stimulation was applied at constant strength for 60 minutes to the suprahyoid muscles using VitalStim®. Participants were examined under three conditions of NMES: sensory threshold plus 75% of the difference between sensory and pain thresholds (75% Stim), SensoryStim, and Sham. Saliva collections, using a 10-min spitting method, were performed seven times: before stimulation (S1), during stimulation (S2-S6), and 5 min after stimulation ended (S7). Significant differences were observed in saliva flow between S1 and S7, as well as S2 and S7 in 75% Stim. This study indicates that an increase in saliva flow was promoted after NMES. Therefore, NMES may have effects on patients with xerostomia.
- Assessment of cytotoxic and antimicrobial activities of two components of Cymbopogon citratus essential oil(2020) Chaves-Quirós, Carolina; Usuga-Usuga, Johnatan-Stiven; Morales-Uchima, Sandra-Milena; Tofiño Rivera, Adriana Patricia; Tobón-Arroyave, Sergio-Iván; Martínez Pabón, MaríaThere is a continuing search for compuounds to improve the chemical plaque inhibitory action of oral hygiene products. Although the antibacterial effects of chlorhexidine (CHX) and essential oils components, citral/myrcene, have been described, there is contradictory information regarding their cytotoxic effects in host tissues. This study aimed to evaluate the cytotoxic activity of the major components of the oil C. citratus, citral and myrcene on human periodontal ligament fibroblast (HPLF) cultures and their antimicrobial effect on different bacterial species present in supragingival biofilm. Cytotoxicity of the compounds to HPLF was determined by MTT assay. Antimicrobial activity was tested against reference strains of Enterococcus faecalis, Streptococcus mutans and Lactobacillus rhamnosus and for S. mutans clinical strains by broth microdilution assay. One-way analysis of variance (ANOVA) with Games-Howell post-hoc multiple comparison or unpaired t tests were used for inter- and intragroup comparisons. Overall, all of the compounds under study showed a cytotoxic effect to HPLF which varied in a dose-dependant manner. Whilst myrcene did not show bacteriostatic activity at tested concentrations, both citral and CHX exhibited bacteriostatic/bactericidal effects to all strains at specific concentrations, being CHX most effective to inhibit bacterial growth at lower concentrations than what observed for citral. Based on these findings, it would possible to conclude that whereas myrcene might be ineffective to control bacterial growth, citral could have a promising antimicrobial activity against dental colonizers with low cytotoxicity, and may be useful for preventing the onset and progression of oral diseases.
