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Language Journal of Clinical and Experimental Dentistry. 2023. Vol. 15, no. 05
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- Challenging of treating patients with exfolliative cheilittis: Report of two cases(2023) Santos,Lilian-Rocha; Dick,Thaylla-Nunez-Amin; Candreva,Monique-Santana; Marques,Leticia-Cogo; Milagres,Adrianna; Rozza-de-Menezes,Rafaela-Elvira; Junior,Arley-Silva; Cunha,Karin-Soares; Conde,Danielle-CastexCheilitis is a term given to the inflammation that occurs in the vermillion of the lips. The exfoliative type is an uncommon form of cheilitis, which is characterized by inflammation and desquamation of the lip. It can cause aesthetic problems and compromise daily eating and phonation. The aim of this paper is to describe two cases of exfoliative cheilitis in young persons under periods of emotional stress and parafunctional habits. A 22-year-old white male and an 18-year-old black female presenting edema, intense dryness, and slight desquamation on the vermilion of the lips. In the second case, fissures with bleeding were also observed. Oral lesions were associated with intense emotional stress. The diagnosis of both was made based on the clinical presentation and the exclusion of other conditions. Although the patients have presented a significant improvement after the corticosteroid treatment, they still have a recurrence in stressful episodes. Detailed clinical examination and complementary exams are fundamental for determining associated factors and correctly diagnosing exfoliative cheilitis. Treatment can be challenging, especially in the face of relapses. Key words:Cheilitis, exfoliative cheilitis, oral lesions, stress psychological.
- Topical treatment of oral chronic graft-versus-host- disease in hematopoietic stem cell transplant recipients: A systematic review(2023) Haas,Livia; Cruz-Pamplona,MartaOral graft-versus-host disease (GVHD) is a common complication of hematopoietic stem cell transplantation. This study systematically reviewed Randomized Controlled Trials (RCTs) with the objective to investigate the effectiveness and side effects of topical agents used for the treatment of oral GVHD. MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed to perform this study. An electronic search of four databases was conducted. RCTs published between January 2011 and March 2022 were included that were carried out on hematopoietic stem cell transplant recipients receiving topical treatment for oral GVHD. The Critical Appraisal Skills Program (CASP) standard checklist for RCTs was used for the bias risk evaluation. RESULTS: Five RCTs were included for the qualitative synthesis of results. Two RCTs were linked to a certain risk of bias. Budesonide caused the highest overall treatment response. Malic acid, clobetasol, and dexamethasone increased resting salivary flow rates. Curcumin in orabase shows similar results to corticosteroid treatment. Adverse effects were observed in populations receiving budesonide, dexamethasone, clobetasol, and tacrolimus. Most frequent adverse effects were burning sensations, fungal infections, and gastrointestinal disorders, but none of them were severe. CONCLUSIONS: Given the small number of RCTs performed and the heterogeneity of the different study designs, it is difficult to draw direct comparisons. Malic acid appears to be effective for the treatment of graft-versus-host disease-induced xerostomia. Budesonide had the highest overall response rates but was also associated with the highest number of adverse effects. Further research is needed to manifest those findings. Key words:Hematopoietic stem cell transplant, oral graft-versus-host disease, topical treatment.
- Wet-bonding technique with ethanol may reduce protease activity in dentin-resin interface following application of universal adhesive system(2023) Telles,Claudia-Cristina-da Costa; Basting,Rosanna-Tarkany; Bridi,Enrico-Coser; Franca,Fabiana-Mantovani-Gomes; do Amaral,Flavia-Lucisano-Botelho; Basting,Roberta-TarkanyGreater degradation of the hybrid layer is expected when a universal adhesive system is used, especially ie conventional application strategy. Therefore, it would important to evaluate the effect of the ethanol (ETH) and a potential matrix protease inhibitor (caffeic acid phenethyl ester/ CAPE) to maximize the ability to achieve stable dentin bond strength. The aim of this study was to evaluated the effect of ETH on a wet-bonding technique, and dentin pretreatments with different concentrations of CAPE in ethanolic solution, followed by application of a universal adhesive system (Single Bond Universal) to inhibit proteolytic activity. MATERIAL AND METHODS: Dentin blocks were allocated to eight experimental groups according to the strategy (total-etch our self-etch) and treatments: ETH, or dentin pretreatment with CAPE (at 0.5%, 2.5%; and 5.0%). Half of each block (each hemiblock) served as the control (without dentin pretreatments) for the same group. The bonding strategy was performed (adhesive system/ restoration with composite resin). Two slices were obtained from each hemiblock and evaluated using in situ zymography. The proteolytic activity was analyzed by quantifying the green photons of the images obtained under a fluorescence microscope in three dentin locations close to the dentin-resin interface: hybrid layer (HL), underlying dentin (UD) and deep dentin (DD). RESULTS: Wilcoxon tests (for comparison between experimental and control groups) and Friedman and Nemenyi tests (for comparisons between interface locations) showed that there was no difference between the groups with different CAPE concentrations and the respective control groups (p>0.05). ETH reduced the proteolytic activity at the HL and UD (p<0.05). CONCLUSIONS: The wet-bonding technique with ETH proved effective in reducing the proteolytic activity. The use of CAPE in different concentrations solubilized in ethanol did not have a favorable effect on proteolytic inhibition. Key words:Adhesives, Hybrid layer, Dentin, Metalloproteinases.
- A comparative evaluation of frictional resistance and surface roughness of silver coated and uncoated stainless-steel bracket wire assembly- An in-vitro study(2023) Shah, Pooja; Sharma, Padmaja; Naik, Harshit; Patel, Kalpesh; Panchal, ChetanSilver ions act as potent antimicrobial agents. Silver coating of brackets and the archwires can help reduce the formation of white spot lesions and caries which is commonly seen with fixed orthodontic treatment. However, this may affect the friction and surface roughness of the bracket-wire assembly which in turn affects the biological tooth movement. MATERIAL AND METHODS: A total of 60 samples were included in the study which was divided into four groups. Group-1: * 15 silver coated 0.022 x 0.028" slot MBT prescription maxillary central incisor brackets * 15 silver coated 0.019 x 0.025" stainless-steel wires; Group-2: * 15 uncoated 0.022 x 0.028" slot MBT prescription maxillary central incisor brackets * 15 silver coated 0.019 x 0.025" stainless-steel wires; Group-3: * 15 silver coated 0.022 x 0.028" slot MBT prescription maxillary central incisor brackets * 15 uncoated 0.019 x 0.025" stainless-steel wires; Group-4: * 15 uncoated 0.022x0.028" slot MBT prescription maxillary central incisor brackets * 15 uncoated 0.019 x 0.025" stainless-steel wires. All brackets and wires used were of American Orthodontics, St. Paul, USA. Surface modification of wires and brackets was carried out using the Vacuum Coating Unit model by Thermal Vacuum Evaporation method with silver nanoparticles (10 nm size). The frictional resistance of all brackets and wires was checked using Universal Testing Machine. RESULTS: On comparison of maximum load, it was found that friction was highest in group 3, followed by group 1, group 4 and group 2. The mean difference between all groups was found to be statistically significant with a P value Group 1> Group 2> Group 3 *Wire roughness: Group 4> Group 1> Group 2> Group 3. CONCLUSIONS: This study concluded that friction was least when only the wire was coated with silver and the bracket was uncoated and it was the most when the bracket was coated and the wire was uncoated. The surface roughness after the friction test was the least when the wire was uncoated. Key words:Silver nanoparticles, Frictional Resistance, Surface Roughness.
- A rare case of mucoepidermoid carcinoma ex-pleomorphic adenoma of the hard palate(2023) Nogueira,Daniel-Pitanga-de Sousa; Chagas-Neto,Jose-Lacerda; Silva,Decio-Fragata; Duarte,Ivisson-Xavier; Cunha,John-Lennon-Silva; Dos Santos-Neto,Agenor-Gomes; Gondak,Rogerio-Oliveira; de Albuquerque-Junior,Ricardo-Luiz-CavalcantiCarcinoma Ex-Pleomorphic Adenoma (CExPA) is a salivary gland carcinoma derived from a primary or recurrent benign pleomorphic adenoma (PA) extremely rare in minor salivary glands. In this paper, we report the case of a male afrodescendant patient, 37 years old, presenting a palatal irregular nodular lesion with approximately 3.5 cm diameter. The lesion had over two years of evolution, but started growing faster and presenting pain and ulceration in the last two months. The incisional biopsy revealed a typical pleomorphic adenoma with focal areas of nests of epidermoid and mucous cells, as well as microcyst formations, resembling the mucoepidermoid carcinoma (MEC). Immunohistochemical analysis revealed positivity for CK7, CK13, CK 14, p63 and Ki67 (about 30%), whereas alpha-SMA was restricted to the PA component. The diagnosis was CExPA (MEC-type). A discussion on the histopathological and immunohistochemical criteria for differential diagnosis of CExPA is provided in this work, hoping to contribute to a better knowledge and understanding of this rare malignant tumor. Key words:Salivary gland neoplasms, pleomorphic adenoma, adenocarcinoma, mucoepidermoid carcinoma, pathology, differential diagnosis.
- Use of surgical bone cement to increase the projection of the nasomaxillary buttress in a case of orthognathic surgery. Technical note(2023) Aragon-Nino,Inigo; Guinales-Diaz de Cevallos,Jorge; Del Castillo-Pardo de Vera,Jose-Luis; Garcia-Lopez-Chicharro,Alba; Cuesta-Urquia,Carolina; Pampin-Martinez,Marta-Maria; Cebrian-Carretero,Jose-LuisThe soft tissue outcome of the projection at the level of the nasomaxillary buttress is difficult to manage in cases of severe hypoprojection, being orthognathic surgery resolutive at the occlusal level but sometimes insufficient at the level of esthetic outcome. The literature describes the use of alloplastic prostheses and autologous bone grafts, but there are few documented cases of the use of premolded surgical cement for this purpose. The main advantage of the use of bone cement over the alternatives described is its ability to be premolded for customization, low cost, easy availability, speed of preparation and minimal comorbidity. This technical note describes the surgical steps and outcome of the use of surgical bone cement for projection augmentation at this level, including notes on preparation, premolding and fixation. Key words:Orthognathic surgery, maxillary surgery, surgical bone cement, nasomaxillary buttress.
- Low-level laser therapy in the management of muscle fatigue caused after long Endodontic procedure(2023) Gaikwad,Trupti-Vijay; Maini,Anuj-Paul; Das,Sukanya; Gupta,Subhadeep; Sarma,Arunima; Dighe,AshutoshThe masticatory muscles may undergo fatigue due to prolonged mouth opening during the endodontic procedures. Low-level laser can be used to treat muscle fatigue due its capacity to produce reactive oxygen species and improve function of mitochondria. Aim: To determine the effectiveness of low-level laser therapy in the management of masticatory muscle fatigue caused after long endodontic procedure under Local anesthesia. MATERIAL AND METHODS: 44 patients complaining of reduced mouth opening and pain while mouth opening, after long endodontic therapy were considered for the study and were randomly allocated into study and control group. In the study group, low-level laser was applied while patients of control group didn't receive any therapy. In the study group, Visual analogue scale (VAS) score of pain was taken after endodontic therapy, immediately after laser therapy and 4 hours after endodontic therapy. Mouth opening of the patients was measured, before and after endodontic procedure and immediately after laser therapy. In the control group, VAS score of pain was recorded immediately after endodontic therapy and 4 hours after endodontic therapy. Statistical analysis used: ANOVA test and un-paired t-test was used for the data analysis. RESULTS: When both groups were compared, a statistically significant (P=0.0000) reduction with fatigue was found. CONCLUSIONS: The low-level laser can be a useful procedure immediately post long endodontic procedure causing masticatory muscle fatigue. Hence, this therapy can be considered as an add-on therapeutic procedure along with prolonged endodontic appointments to relieve the patient from the discomfort. Key words:Muscle fatigue, Masticatory muscles, Low-level laser therapy.
- Analysis of the association between facial biotype, overbite and overjet in the permanent dentition(2023) Chite-Quispe,Liz; Sanchez-Tito,MarcoTo determine the association between the facial biotype, the overbite and the overjet in digital lateral skull radiographs. MATERIAL AND METHODS: 230 digital skull lateral radiographs of patients with permanent dentition with 18 to 55 years old were used as sample. The VERT index and the Ricketts analysis were considered to identify the facial biotype, overbite and overjet. RESULTS: The facial biotype with the highest prevalence was dolichofacial with 36.52% (n=84), being more frequent in the female sex. However, the mesofacial biotype predominated in the male sex. On the other hand, the normal overbite presented the highest percentage with 66.08% (n=152) and the deep bite was more frequent than the open bite. Regarding the overjet, the normal overjet was the most prevalent with 68.70% (n=158), followed by the decreased overjet. Differences were found between the overbite values of males with brachyfacial biotype versus mesofacial and dolichofacial (p<0.05). A strong positive correlation was observed between overbite and overjet in mesofacial biotype (Rho=0.83, sig=<0.001). The predominant vertical malocclusion in the dolichofacial biotype was open bite and deep bite in the brachyfacial biotype. Regarding the facial biotype and the overjet, a significant association was found only in the male sex (p<0.05). CONCLUSIONS: With the results obtained, it is concluded that there is an association between facial biotype, overbite and overjet. Key words:Facial biotype, overbite, ovejet.
- Effect of dry needling and instrumental myofascial release on masticatory, facial, and cervical muscles of patients with temporomandibular disorders of muscular origin(2023) Junior, Paulo-Roberto-Quiudini; Siessere, Selma; de Mello, Edneia-Correa; Rodrigues, Sergio; Regalo, Isabela; Goncalves, Ligia-Maria-Napolitano; Arnoni, Veridiana-Wanshi; Palinkas, Marcelo; Regalo, SimoneTo evaluate the effectiveness of dry needling (DN) and instrumental myofascial release (IMR) therapies in the cervico-cranio-mandibular system through pain, bite force, and distribution of occlusal contacts in patients with muscular temporomandibular disorders. MATERIAL AND METHODS: Thirty patients were divided into treatment groups: DN (n=15) and IMR (n=15). Therapeutic efficacy regarding pain perception and tolerance of masticatory, facial, and cervical muscles, bite force, and distribution of occlusal contacts were analyzed in this observational longitudinal clinical study pre/post-intervention and pre/post one month of therapeutic intervention. The data were tabulated and statistically analyzed (repeated measures and Bonferroni post-hoc test, p<0.05). RESULTS: There was a statistically significant difference in pain between the groups in the comparison of pre- and post-intervention with effect on time versus intervention in the head and neck. Pain perception and tolerance showed a statistical effect of time on the temporal, suboccipital, sternocleidomastoid, mental (right and left), right masseter, and left trapezius muscles. There was a statistically significant effect of the intervention on the mentalis, supraorbital, and infraorbital (right and left) muscles. There was a statistically significant effect of the interaction on the upper masseter (right and left), anterior temporal (left), suboccipital, sternocleidomastoid, and mentalis (left) muscles. There was an increase in post-intervention molar bite force in the groups, with a statistical effect on time versus intervention in the right and left regions. Contact of occlusal forces at the maxilla/mandible interface showed a difference between the mean times on teeth 26-36 after versus 1 month after the intervention. CONCLUSIONS: The two therapeutic techniques are viable for the treatment of muscular temporomandibular disorders; however, IMR proved to be more effective immediately after the intervention and after one month. Key words:Temporomandibular disorders, pain, masticatory muscles, facial muscles, cervical muscles, dry needling, instrumental myofascial release.
- Vertical augmentation of the atrofic posterior mandibular ridges with onlay grafts: Intraoral blocks vs. guided bone regeneration. Systematic review(2023) Robert, Louise; Aloy Prósper, Amparo; Arias-Herrera, SantiagoThe high resorption rate of intra-oral Onlay block grafts, coupled with morbidity and limited bone availability, means that the use of guided bone regeneration (GBR) may be preferable for vertical augmentation of mandibular atrophic posterior sectors. Aims: To evaluate the bone gain and surface resorption of the intraoral Onlay block graft compared to the GBR; as well as to study postoperative complications, survival and success rates of dental implant, and peri-implant marginal bone loss. MATERIAL AND METHODS: An electronic search was performed in the PubMed, Scopus, and Web Of Science databases on bone augmentation with intraoral autologous onlay block graft or GBR until December 2021. RESULTS: Of 214 potentially eligible papers, 11 complied with the inclusion criteria: 5 studies on block graft technique, 5 on GBR technique and 1 was a comparison of both treatment groups. In the block graft group, the mean vertical bone gain was 4.05mm with a mean resorption of 0.84mm (17.70%); the complication rate was 20%; the survival and success rates were 100% and 92.23% respectively and the mean peri-implant bone loss was 0.22mm at 12 months. For the GBR group, the mean bone gain was 4.7mm with a mean resorption of 0.33mm (15.08%); the complication rate was 11.6%; the survival rate was 100% and the mean peri-implant bone loss was 0.95mm at 12 months. CONCLUSIONS: Despite the limitations, the GBR technique seems to achieve greater bone gain with less superficial resorption as well as fewer complications, but it presents a greater peri-implant loss at 12 months. Key words:Onlay block graft, Guided Bone Regeneration, intraoral bone, augmentation procedure.
- Investigation of the thermal and physicochemical behavior of two types of gutta-percha cones for back-filling the root canal(2023) Aguilar-Hernandez,Jeannette; Torres-Mendez,Fernando; Mendez-Gonzalez,Maria-Veronica; Davila-Perez,Claudia-Edith; Kolosovas-Machuca,Eleazar-Samuel; Gutierrez-Sanchez,MarianaGutta-percha (Gp) is an inert thermoplastic polymer used as a filling to replace the dental pulp space, which has been reformulated to improve its three-dimensional sealing properties. Therefore, this study aimed to analyze the physical, chemical and thermal properties of two types of gutta-percha filling. As well as measuring the temperature distribution along the cone at the time of cutting through an in-situ test. MATERIAL AND METHODS: Two commercially available brands of gutta-percha point were investigated: Conform Fit TM Gutta-Percha for ProTaper Gold(R) (PTG) (Dentsply Sirona), and Hygenic Gutta-Percha (Coltene whaledent). Differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) were selected for the thermal characterization of materials, and Fourier Transform Infrared Spectroscopy (FT-IR) for the chemical analysis of Gp cones. Regarding temperature distribution, it was evaluated using a thermographic camera (FLIR ONE(R) PRO by MicroUSB P/N 435-0011-01) at 0 to 20 s after the cutting process (n=11/group). RESULTS: Both materials have three fusion endotherms associated with the three crystalline phases of Gp, with similar temperatures but enthalpies that differ by 60%, the fusion enthalpy being higher for Conform Fit. In the chemical characterization, elements such as Zn, C, O, Ba, S and Si were found in both materials but in different proportions. Regarding the content of fillers, the Conform Fit presented around 30% of Gp polymer and 25% for the Hygenic. The morphological characterization shows a microtexturized coating in the form of bars on a micrometric scale for the Conform Fit, which could favor a better three-dimensional seal. In addition to that, in heat transfer studies they showed greater temperature control. CONCLUSIONS: The characterization of the materials allowed us to see the variation in terms of their composition and configuration to the Gp cones of two commercial brands. These variations directly modify the thermal behavior of the material. Key words:Gutta-percha, Conform Fit, Infrared thermography, Differential Scanning Calorimetry, Infrared Spectroscopy.
- Comparative evaluation of Hand, Rotary and Reciprocation motion on Dentin thickness and instrumentation time in Primary anterior teeth using CBCT: An observational study(2023) Kumar,Shashank; Naik N,Sathyajith; Vashisth,Pallavi; Sharma,Shivangi; Singh,Sonal; DeepshikhaUltimate goal of BMP is to extirpate the pulp tissue completely, microorganisms, debris & shaping the canal which preserves the original course of the canal to receive an obturating material. Due to various morphological challenges present in deciduous root canal, there is high demand of an improved quality & design of file system with less working length to prevent undesirable complication & reduce treatment time. Aim: To evaluate & inter-compare the dentin thickness and instrumentation time in root dentin of deciduous teeth after BMP in Hand, Rotary & Reciprocation motion with single-file systems. MATERIAL AND METHODS: 60 extracted primary single rooted teeth with un-resorbed roots were included in the study. Teeth were divided into three groups consisting of 20 teeth in each group. In Group-1 Root canal preparation was done with pediatric Hand files, In Group-2 with pediatric Single-file system in rotary motion and in Group-3 with pediatric Single-file system in reciprocating motion. Teeth were scanned before & after preparation with CBCT. Segments were analyzed for dentin thickness at 3mm,5mm and 7mm respectively. Instrumentation time was recorded by an assistant. RESULTS: Mean instrumentation time of Rotary was least as compared to Reciprocation & Hand respectively, instrumentation time taken by hand filing was significantly higher. Reciprocating filing helps in better dentin debridement at apical and the middle third and no difference was found at the coronal third among all three groups. CONCLUSIONS: Reciprocating filing helps in better dentin debridement and rotary instrumentation requires least time for canal preparation. Key words:Hand Files, Rotary Files, Reciprocating motion, CBCT.
