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Language Journal of Clinical and Experimental Dentistry. 2019. Vol. 11, no. 12
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- Influence of Hyrax screw position on dental movement and cortical bone : a study of finite elements(2019) Gómez Gómez, Sandra Liliana; Villarraga Ossa, Junes; Arcila-Monsalve, Juan-Camilo; Moreno-Garzón, Diana-Marcela; Ardila Medina, Carlos MartínRapid maxillary expansion (RME) has effects on the dental and periodontal structures of the parts involved, which vary according to the design and position of the expansion screw. The purpose of the study was to determine the optimal three-dimensional position of the Hyrax screw to obtain precise control of the dental movement and effect on the bone cortex using the finite element method (FEM). RME was performed from the patient whom two Cone-Beam computerized tomography scans (CBCT) were obtained: T1 before expansion, and T2 three months after stabilization of RME. The FEM model was designed with T1 and of Hyrax photographs. FEM was obtained by comparing the simulation, T2, and clinical results. Three sagittal screw positions (anterior-middle-posterior) and vertical (upper-medium-low) were evaluated. A coronal- buccal displacement of premolars and first molars was found which decreased in the occlusal-apical direction, presenting different types of dental movement in the screw positions; besides, a tendency of translational movement in the posterior-high location was observed. In the posterior-high position a higher concentration of efforts and homogeneous deformations in the periodontal ligament and vestibular cortex of the cervical area of first molars, first and second premolars were observed, with variations according to the screw position and the distribution of stresses. The ideal location of the expansion screw for controlling dental movement and periodontal side effects was the high-posterior position.
- Stress distribution of complete-arch implant-supported prostheses reinforced with silica-nylon mesh(2019) Paes-Junior, Tarcisio-José de A.; Tribst, João Paulo Mendes; Dal Piva, Amanda-Maria-de Oliveira; Amaral, Marina; Borges, Alexandre- Luiz-Souto; Gonçalves, Fernanda-de-Cássia-PapaizThis study evaluated the presence of a silica-nylon mesh and two cantilever lengths on the biomechanical behavior of complete-arch implant-supported prostheses. Twenty-four (24) complete mandibular arch implant-supported prostheses were divided into 4 groups according to the presence of reinforcing mesh (with or without) and the cantilever length (molar ? 15 mm or premolar ? 5 mm). The specimens were submitted to strain gauge analysis (30-kgf, 10 s) at different points (molar and premolar). Three-dimensional models were created based on the in vitro specimens, and the results in the bone (microstrain), prostheses (tensile stress), implants and prosthetic screws (von-Mises stress) were evaluated using the finite element method (FEM). All materials were considered homogeneous, isotropic and linear. Strain gauge data were submitted to 3-way analysis of variance and the Tukey test (?=.05). FEM results were qualitatively analyzed using colorimetric graphs. The microstrain magnitude for the prostheses with reinforcement was 519.91±359 and 583.33±661 without reinforcement (p=.001). The microstrain values for loading on the molar was 867.49±784 and on the premolar was 235.75±145. FEM corroborated with the in vitro findings for the bone behavior. The load application in the premolar showed reduced stress concentration, and a significant difference was observed between the presence or absence of the reinforcement for the prostheses. Silica-nylon mesh reduced the peri-implant microstrain and the prosthesis stress regardless of the cantilever extension. For temporary complete-arch implant-supported prostheses, the limitation of the cantilever to the premolar region improves the biomechanical response during load application.
- Diagnosis and treatment for central Mucoepidermoid Carcinoma in the mandible : report of a clinical case in a young patient(2019) Hernandez Arenas, Yuritza Yoleinnis; Alvarez Martínez, Efraín; Ardila Medina, Carlos MartínA clinical case of a 13 year old male patient with a malignant tumor in the mandibular body area with two years of evolution and associated pain is reported. It was initially diagnosed as low grade central mucoepidermoid carcinoma through Hematoxylin and Eosin (H-E) staining in multiple biopsies. Considering the clinical and radiographic characteristics of the lesion, it was necessary to confirm the diagnosis through Periodic acid-Schiff (PAS). The treatment involved hemimandibulectomy, neck emptying, and complementary radiotherapy. This article aims to present a rare occurrence of this type of intraosseous malignant tumor of glandular origin in a young patient.
- Comparative analysis of the remineralization potential of CPP?ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX ? An in vitro study(2019) Thimmaiah, Charisma; Shetty, Priya; Shetty, Sowmya B.; Natarajan, Srikant; Thomas, Nithya-AnnieIn recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX). 40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX. The Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP. CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface.
- The effect of preheating of composite resin on its color stability after immersion in tea and coffee solutions : an in-vitro study(2019) Darabi, Farideh; Seyed-Monir, Ali; Mihandoust, Sanaz; Maleki, DinaOne of the concerns in using composite resins is color change. The aim of this study was to investigate the effect of preheating on color stability of composite resins when immersed in coffee and tea. This experimental study included 60 composite disks. The samples were divided into 2 groups, one group prepared at room temperature and the other prepared at 68 °C. After curing, the samples were placed in 37 °C distilled water for 24 hours. The color of the samples was measured (t0) using spectrophotometer according to CIE-L*a*b* system. The samples of each group were then divided into 3 subgroups and respectively immersed in distillated water, coffee and tea for 30 days and the final color (t1) was measured. The difference between the measured colors was calculated (?E) and the results were analyzed using version 21.0 of SPSS software, Paired t-test, ANOVA, Tukey?s test, and Dunnett t-test. The preheated composites showed significantly lower staining in the coffee solution than the room temperature composites (p<0.0001). In contrast, no statistically significant difference was observed for the tea solution (p =0.317). The staining of the preheated composites in distillated water was higher than those in the room temperature, however, the difference was not significant (p =0.99). Within the limits of this study, preheating was effective to improve color stability of composite resin after long time immersion in coffee solution.
- Stem cells and oral surgery : a systematic review(2019) Mosquera Perez, Regina; Fernández Olavarria, Ana; Diaz Sanchez, Rosa Maria; Gutiérrez Pérez, José Luis; Serrera Figallo, María Angeles; Torres Lagares, DanielConsidering the structural loss that occurs after surgical procedures for cystic and tumoral pathology, in periodontitis, as well as the maxillary atrophy that determines the rehabilitation with dental implants, it is imperative to find satisfactory solutions. The opportunity provided by the findings in stem cells is a recent introduction in the field of oral surgery, based on the regenerative potential that these cells possess in order to restore defects at different levels of the oral cavity. The aim of this systematic review is to discover the real applications that stem cells may have in our treatments in the near future. We made a systematic review of the literature on the subject of stem cells to know the publications relating to them in the field of oral surgery since 2000. PRISMA statement was accomplished, as its official flow chart is used. This article draws clinical conclusions from basic research and those conducted in the first clinical cases to apply them in a short period of time to our patients in order to achieve excellence in regenerative therapies. To summarize, stem cells may be a turning point in tissue regeneration, though the major challenge is to overcome the remaining obstacles before they become a realistic therapeutic alternative.
- Clinicopathologic data of individuals with oral lichen planus : a Brazilian case series(2019) de Lima, Sara-Lia-Gonçalves; Arruda, José A.; Abreu, Lucas G; Mesquita, Ricardo Alves; Ribeiro Rotta, Rejane Faria; Mendonça, Elismauro Francisco; Arantes, Diego-Antônio-Costa; Batista, Aline CarvalhoThe aim of the present series was to analyze the sociodemographic characteristics, clinicopathologic features, and oral health-related quality of life of 41 individuals with oral lichen planus (OLP). In a retrospective analysis (1998-2018), individuals with a clinical diagnosis of OLP from a referral service of Oral Medicine of Brazil were invited for follow-up. The individuals were assessed using the Oral Health Impact Profile-14 (OHIP-14) form. Histopathological data were reviewed according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016). This series mainly consisted of females (70.7%) in their forties (31.7%). The buccal mucosa (68.2%) was the most commonly affected site. Reticular (56.1%) and erosive (34.3%) appearances were the most frequent. According to OHIP-14, individuals with OLP at multiple sites in the oral cavity showed worse values in the handicap domain and those who did not respond to corticosteroids showed a higher score on the psychological discomfort domain. The findings of the present study, using the AAOMP/2016 criteria, agree with case series and retrospective studies reported in the literature. Besides, OLP in its more severe clinical forms had an influence on patient quality of life.
- Chemical composition and roughness of enamel and composite after bleaching, acidic beverages and toothbrushing(2019) Pinelli, Marília-de-Morais; Catelan, Anderson; de Resende, Luís-Felipe-Marques; Soares, Luís-Eduardo-Silva; Aguiar, Flávio Henrique Baggio; Liporoni, Priscila-Christiane-SuzyIn this study was assessed the surface roughness and chemical composition of tooth enamel and composite resin after bleaching treatment, immersion in acidic beverages, and simulated toothbrushing. One hundred and twenty dental blocks (10 x 10 x 3 mm) were randomly assigned (n = 10) according to surface treatment [none (N), bleaching (B), toothbrushing (T), and B+T] and storage medium [saliva (S), whiskey (W), and orange juice (O)]: experimental groups - N+S, N+W, N+O, B+S, B+W, B+O, S+T, W+T, O+T, B+S+T, B+W+T, and B+O+T. Two bleaching sessions were conducted using 38% hydrogen peroxide (3 applications). Surface roughness was measured using a roughness tester and composition was determined by micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) before and after treatments. Calcium/phosphorus (Ca/P) ratio in enamel and silica (Si) content in composite were evaluated. Data were statistically analyzed by ANOVA and Tukey?s test (? = 0.05). Overall, increased values of surface roughness for enamel and composite were observed mainly after immersion in orange juice and bleaching/toothbrushing association. Moreover, this association and immersion in whiskey resulted in lower Ca/P ratio and after aging methods, bleached and bleached/toothbrushed groups showed decreased in Ca/P ratio compared to initial values. All groups showed Si content decrease at the end, except the group without surface treatment and immersed in saliva, and bleaching followed by immersion in orange juice and toothbrushing caused the highest Si reduction. Bleaching and toothbrushing combination strengthened the effects caused by acidic drinks on roughness and chemical composition of enamel and composite.
- Contribution of benzodiazepines in dental care of patients with special needs(2019) Picciani, Bruna-Lavinas-Sayed; dos Santos, Bruna-Michalski; Silva-Júnior, Geraldo-Oliveira; Marinho, Marcello-Alves; Papa, Eliane-Garritano; Faria, Marcelo-Daniel-Brito; Bastos, Luciana-Freitas; de Gouvêa, Cresus-Vinícius-DepesConscious sedation in dental treatment of patients with special needs (PNEs) has the purpose of controlling events such as anxiety and fear, as well as promoting muscle relaxation and mastery of uncoordinated movements. Benzodiazepines (BZDs) are among the most used drugs due to their anxiolytic, hypnotic and sedative properties. The objective of this investigation is to demonstrate a study on the contribution of conscious sedation with BZD in PNEs. The study included 40 PNEs, non-collaborators, submitted to conscious oral sedation with Midazolam (0.5 mg/kg) for dental treatment, receiving vital signs monitoring in the pre, trans and postoperative periods. Male patients were more frequent with 70% of the cases, with a mean age of 18 years. As for medical diagnosis, autism and mental deficiency were the most prevalent. The most performed procedures were restoration (32%) and exodontia (30%). There was a statistically significant reduction in systolic and diastolic blood pressure parameters (p<0.05) in the transoperative and postoperative periods when compared to the preoperative period. Conscious sedation with BZDs resulted in 83% positive responses. The results demonstrate that this technique is safe and effective, and can be used in outpatient care for PNEs. However, the risk/benefit ratio should be correctly evaluated.
- Oral health knowledge in relation to educational level in an adult population in Spain(2019) Márquez-Arrico, Cecilia-Fabiana; Almerich Silla, José Manuel; Montiel Company, José MaríaTo analyze the relationship between oral health knowledge and educational level among an adult population in Spain, and between oral health knowledge and subjects? oral hygiene practices, dietary habits, toxic habits, and oral quality of life. This transversal study used the Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire to evaluate subjects? knowledge and understanding of oral health, and the World Health Organization oral health questionnaire for adults to evaluate dietary, oral hygiene, toxic habits, and oral quality of life. Participants (n=400) gave their informed consent and data release permission before taking part in the study, which was approved by the University of Valencia Ethics Committee (certificate No.: H145160675341). Statistical analysis was performed using SPSS v22.0 software, applying Student?s t-test, ANOVA, and chi2 test, with significance set at p<0.05. Oral health knowledge results were: low 41.5% and high 58.5%. An association was found between educational level and oral health knowledge (Chi2: p=0.000). Oral hygiene habits presenting an association with higher levels of oral health knowledge were dental floss use, a higher number of teeth present, and lower prevalence of partial prostheses. A significant association was found between oral quality of life and oral health knowledge. Oral health knowledge is associated with the individual subject?s educational level. But oral health knowledge is not necessarily reflected in the practice of healthy habits.
- Root repair after damage due to screw insertion for orthodontic miniplate placement(2019) Cornelis, Marie A.; Tepedino, Michele; Cattaneo, Paolo M.; Nyssen-Behets, CatherineThe aim of this investigation was to describe the healing reactions following root damage caused by placement of a miniplate anchorage system. In 4 beagle dogs, 4 titanium miniplates (2 self-tapping screws per miniplate) were placed in each maxilla, after drilling of pilot-holes. Six fixation screws were unintentionally inserted damaging the root of maxillary canines. Two weeks later, half of the miniplates were loaded with a coil spring. Two dogs were euthanized 7 weeks after placement of the miniplates, while the remaining two after 29 weeks. Histological sections were prepared, microradiographed, observed under U.V. light, then stained and analysed under ordinary light. Four screws caused direct root damage; one was damaged during the drilling process; one caused damage to the periodontal ligament only. Among these 6 screws, 2 were mobile and 4 were stable at sacrifice. Limited root damage showed some repair after 29 weeks, consisting in a thick layer of mineralized cementum including anchoring periodontal fibres. Tissue repair was not related to screw stability or loading status. Limited root damage has shown potential to heal, while extensive root damage has not. Precise position of insertion of the miniplates is thus of utmost importance.
- Eroded enamel rehardening using two intraoral appliances designs in different times of salivary exposure(2019) Mendonça, Fernanda-Lyrio; Jordão, Maisa-Camillo; Val, Poliana-Pacífico; Alencar, Catarina Ribeiro Barros de; Bassoto, Marcela-de Azevedo-Garcia; Honório, Heitor-Marques; Magalhães, Ana-Carolina; Buzalaf Marília, Afonso Rabel; da Silva, Thiago-Cruvinel; Rios, DanielaThe aim of this study was evaluated the eroded enamel rehardening potential using upper palatal and lower buccal removable appliances in different times of salivary exposure (30 min, 1h, 2h, 12h) after a single erosive challenge event. After initial surface hardness evaluation, bovine enamel blocks were eroded in vitro (0.01 M hydrochloric acid, pH 2.3, 30 seconds), selected (n = 160) and randomly assigned to the two appliance designs and twenty volunteers. Four enamel blocks were inserted in each removable appliance. On the in situ phase, the volunteers were instructed to use the upper palatal and lower buccal appliances simultaneously for 12 nonconsecutive hours. After each predetermined period of time of salivary exposure, the enamel blocks were removed from the appliances for immediate evaluation of surface hardness, enabling percentage of surface hardness recovery calculation (%SHR). The data were analyzed using two-way ANOVA and Tukey?s test (?=5%). The results showed no difference in the degree of enamel rehardening by the upper palatal or lower buccal appliances (p >0.0001). Regarding the time of use of the appliances, it was demonstrated that 30 minutes (upper = 21.12%, lower = 19.84%) and 1 hour (upper = 35.69%, lower = 30.50%) promoted lower hardness recovery than two hours (upper = 44.65%, lower 40.80%) of salivary exposure (p<0.0001). The use of 12 hours (upper = 49.33%, lower = 49.00%), including the sleeping time of the volunteers did not increase the %SHR. The location of the appliance does not influence the re-hardening ability of saliva and the use of intraoral appliances for 2 hours seems to be appropriate for partial rehardening of the softened enamel surface.
- Dentoskeletal effects of class II malocclusion treatment with the modified Twin Block appliance(2019) Ajami, Shabnam; Morovvat, Anahita; Khademi, Bahar; Jafarpour, Dana; Babanouri, NedaThe purpose of this study was to prospectively assess the dentoskeletal effect of a modified Twin Block appliance for treatment of class II malocclusions. Lateral cephalograms of 25 Class II malocclusion patients were compared to evaluate skeletal, dentoalveolar and soft tissue changes pre- and post-treatment with a modified Twin Block appliance. A total of 33 angular and linear variables were used for analysis. The differences were calculated at the start and end of treatment. The paired T test was performed to compare the cephalometric measurements before and after treatment. Compared the pre- and post- treatment measurements, there was a significant increase in SNB (P<0.001), CO-Gn (P<0.001), ANS-Me (P=0.001), Mandibular base (P<0.001), Lower 1 to NB (°) (P=0.004), Lower 1 to NB (mm) (P<0.001), and Z-angle (P=0.001) following functional therapy with modified Twin Block appliance. On the other hand, a significant decrease was observed in ANB (P<0.001), NA-Pog (P<0.001), overjet (P<0.001), and overbite (P=0.007), Upper 1 to palatal plane (P=0.007), UL-E-line (P<0.001), LL-E-line (P=0.001), and H-angle (P=0.002) after treatment with modified Twin Block appliance. The modified Twin-Block improves facial esthetics in Class II malocclusion by a combination of changes in skeletal as well as dentoalveolar structures. The increase of mandibular unit length was observed to be due to a true mandibular growth not just a repositioning of the mandible. The modified appliance, however, did not show any superior effects in terms of less dental compensation compared to the conventional Twin?Block appliance.
- Chronic nail biting, orthodontic treatment and Enterobacteriaceae in the oral cavity(2019) Chinnasamy, Alagesan; Ramalingam, Karthikeyan; Chopra, Pallu; Gopinath, Vidhya; Bishnoi, Gyan-Prakash; Chawla, GurveenChronic nail biting is common in children and young adults. Auto inoculation of environmental pathogens can manifest as infection in distant organs. Multi-drug resistance gram negative bacteria are on the rise globally. Several of the foodborne bacteria fall within the Enterobacteriaceae family but very few studies have explored these microbes in the oral cavity of children with chronic nail-biting habit or orthodontic treatment. The study aims to investigate oral load of Enterobacteriaceae in children with chronic nail-biting habit and or those undergoing orthodontic treatment. 150 children (no nail-biting n=30, nail biting n=60, fixed orthodontic treatment n =30 and a combination of fixed orthodontic appliance use and nail-biting habit n =30) were assessed for culture based microbiological investigation. The concentrated oral rinse technique was used. The rinse was inoculated in MacConkey?s and Blood Agar. The gram stained culture was subjected to biochemical tests for sub-species identification using Biomerieux Vitek 2 Compact Automated Microbiological Analyzer. Fisher?s exact and Kruskal Wallis with post hoc analysis using Dunn method was performed to test association and difference between groups. Enterobacteriaceae was positive for 72% of the children. Of them, nail biting or orthodontic treatment group comprised 89%. Those with a combination of nail biting and undergoing orthodontic treatment exhibited highest CFU/ml and those without nail biting or orthodontic treatment exhibited the lowest. Three of the four organisms isolated tested positive in the orthodontic treatment group. E. coli was positive in 38% of the children while Klebsiella and E. cloacae were isolated exclusively in the orthodontic treatment group. Chronic nail biting or the use of fixed orthodontic appliances is associated with higher incidence of Enterobacteriaceae in the oral cavity. Oral health professionals play an important role in preventing multi drug resistance infectious diseases.
- Gingival hyperplasia as an early manifestation of acute myeloid leukemia. A retrospective review(2019) López Valverde, Nansi; López-Valverde Centeno, Antonio; Gómez de Diego, Rafael; Ramírez, Juan M.; Flores Fraile, Javier; Muriel-Fernández, JorgeWe study the prevalence of acute myeloid leukemia (AML) among patients with severe gingival enlargement. We retrospective reviewed the clinical records of patients with severe gingival enlargement, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and gingival bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique. A correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean gingival bleeding index was ?3 and the degree of dental mobility ?2.3. 1.7% of patients, with severe gingival hyperplasia were diagnosed with AML. We found a significant association between gingival bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. Severe gingival enlargement, abundant gingival bleeding, and dental mobility could be early manifestations of a blood dyscrasia.
