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Language Journal of Clinical and Experimental Dentistry. 2018. Vol. 10, no. 11
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- Tongue metastasis of cutaneous melanoma : report of two cases and literature review(2018) Markman, Renata Lucena; Rosa, Giuliano-Augusto-Belizario; Cardili, Leonardo; Simonato, Luciana Estevam; Brandao, Thais-Bianca; Ribeiro, Ana-Carolina-PradoMalignant metastases to the oral cavity are rare and metastatic melanomas of the tongue are considered exceptionally uncommon, with less than 10 cases published in the English literature so far. Two female patients in the 7th decade of life presented to our dental service with nodules in the tongue. Both patients had multiple metastases at the time of oral diagnosis and primary melanoma originated on the skin. An intra-oral incisional biopsy was performed under local anesthesia and the histopathologic analysis was characterized by the proliferation of atypical epithelioid cells displaying a poorly delimited cytoplasm and hyperchromatic nucleus which contained eosinophilic macronucleoli. Immunohistochemistry was performed in both cases to confirm the clinical hypothesis of metastatic melanoma. After the diagnosis of oral metastatic melanoma, the patients were maintained under palliative care and close medical follow-up. Both patients died four and a half months and 20 months after the diagnosis of tongue metastasis. Although rare, metastatic melanoma should be included in the differential diagnosis of tongue lesions detected in patients with a previous medical history of cutaneous melanoma.
- Dental approach of orofacial pain in head and neck cancer patients(2018) Arantes, Diele; Costa, Náira; Resende, Tacyana; Mikulas, Karina; da Silva Júnior, Pierre; Brito, Rafael; Noronha, Vladimir R. A. S.; Pedras, Roberto; Corrêa, LucianaOrofacial pain (OFP) is an undesirable sensation frequently associated with head and neck cancer (HNC) and its treatment. OFP negatively impacts the quality of life of oncological patients. The approach to OFP diagnosis and management can differ if the patient visits a dentist or physician. The aim of this study was to present a case series of HNC with OFP managed by a dentist team and to discuss its role in the management of OFP. We recruited twenty-two adult patients with OFP and previous diagnosis of HNC referred to an academic dental clinic from 2015 to 2017. Nociceptive was more frequent than mixed and neuropathic pain, however 54,4% of the cases showed a neurological component. All types of pain were managed by dentist through removal of pain?s cause and appropriated local and systemic treatment. The intensity of pain was reduced in 86,3% of patients, and 45,4% of them reported absence of pain at the end of treatment. Dentist?s assessment plays a distinct and crucial role in the diagnosis and management of OFP in HNC patients throughout the oncological treatment.
- Evaluation of the antibacterial activity of a new ozonized olive oil against oral and periodontal pathogens(2018) Pietrocola, Giampiero; Ceci, Matteo; Preda, Francesco; Poggio, Claudio; Colombo, MarcoIn the present study, the antimicrobial properties of a new ozonized olive oil (O-zone gel) against oral and periodontal pathogens will be evaluated and compared with that of common CHX-based agents. O-zone gel was compared with two agents based on chlorhexidine digluconate (CHX): Corsodyl Dental Gel and Plak Gel. A. actinomycetemcomitans, P. intermedia and S. mutans, were selected and the antibacterial capability of the compounds was tested by using direct contact agar diffusion test (DCT) and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) evaluations. Differences between specific means were analyzed by a one-way analysis of variance (ANOVA). Group means were compared using a one-way ANOVA and Tukey?s test (P<0.05). O-zone gel reported inhibition zones which correspond to 33% and 43% of that achieved by the CHX agents. No inhibition of bacterial growth (MIC) on the Gram-positive strain by using O-zone gel was found and no antimicrobial effect (MBC) was observed by using O-zone gel on both Gram-negative and -positive strains. The new ozonated oil was a relatively moderate antiseptic. Gram-negative bacteria proved to be more sensitive to ozonized olive oil than Gram-positive ones. The ozonized olive oil demonstrated a lower antibacterial activity if compared to the CHX-based agents tested.
- Comparative evaluation of the effect of impression materials and trays on the accuracy of angulated implants impressions(2018) Siadat, Hakimeh; Saeidi, Zeinab; Alikhasi, Marzieh; Zeighami, SomayehVinyl Polyether Siloxane is a newly introduced impression material and studies on that is scarce. Implant insertion in posterior mandible might be angulated due to anatomical considerations. The purpose of this study was to compare the dimensional and angular accuracy of impressions using full-arch versus sectional tray and Vinyl Polysiloxane versus Vinyl Polyether Siloxane in angulated implants. Four implants were placed in dental areas #19, #21, #28 and #30 of a Kennedy class I mandibular acrylic model with 30° lingual angulation. Twenty sectional and 20 full-arch open trays were made on the primary cast. Impressions were taken using Vinyl Polysiloxane and Vinyl Polyether Siloxane (n=10 in 4 groups); and were poured with type IV dental stone. The coordinate measuring machine was used to measure displacements in the X, Y and Z axes and rotational discrepancies of implants. The data were analyzed using SPSS 22 and two-way ANOVA. Type of tray had no significant effect on the dimensional and angular accuracy of impressions (p >0.05). Type of impression material significantly affected linear displacement (?r) (P <0.05); but it did not significantly affect the rotational displacement (P >0.05). Vinyl Polysiloxane yielded more accurate impressions of angulated implants.
- Successful conservative treatment of a mandibular unicystic ameloblastoma : 13-year follow-up(2018) Isolan, Cristina-Pereira; Moreira, Andressa-Goicochea; Etges, Adriana; Kirst-Post, Letícia; Aitken Saavedra, JuanAmeloblastoma is an uncommon, locally aggressive benign odontogenic tumor and can reach considerable dimensions causing facial deformity and functional impairment. They are characterized by local aggressiveness. It is recommended that maxillary ameloblastomas be treated aggressively due to proximity of various vital structures. Conservative treatments such as marsupialization, enucleation and curettage while preserving bone integrity seem to be associated with a high rate of recurrence. Treatment evaluation of ameloblastomas is a complex issue, as ideally it should not be so destructive due to the benign nature of this lesion, but should be extensive enough to avoid recurrences. The present study is about a clinical case of a 16-year- old man with a unicystic ameloblastoma treated successfully with marsupialization. Patient was followed up every 12 months. About 13 years after diagnosis, the patient is clinically healthy and radiographically it is possible to observe evidence of bone repair.
- Florid cemento-osseous dysplasia : report of 2 cases(2018) Toledano-Serrabona, Jorge; Núñez Urrutia, S.; Vegas Bustamante, Erika; Sánchez Torres, Alba; Gay Escoda, CosmeFlorid cemento-osseous dysplasia is a non-neoplastic fibro-osseous lesion which often has an asymptomatic slow growth. Unfortunately, these lesions are usually diagnosed through routine radiographic examination. The aim of this study was to describe the main clinical, radiological and histological characteristics of two case reports diagnosed with florid cemento-osseous dysplasia. Two cases of florid cemento-osseous dysplasia with different clinical and radiological features were presented. Panoramic radiographs showed multiple radiopacities compatible with fibro-osseous lesions in distinct areas of the maxillary bones. The histological study revealed a sclerotic mass which continued imperceptibly with root cement with scarce fibrous lax tissue. The replacement of healthy bone by metaplastic bone and fibrous tissue is the main histological feature. Therapeutic abstention with active clinical and radiographic control visits is recommended in asymptomatic cases.
- Anterior teeth root inclination prediction derived from digital models : a comparative study of plaster study casts and CBCT images(2018) Dastoori, Mahmoud; Bouserhal, Joseph P.; Halazonetis, Demetrios J.; Athanasiou, Athanasios E.To assess the accuracy of digital models generated using commercially available software to predict anterior teeth root inclination characteristics and compare the results to relevant data obtained from CBCT images. Following sample size calculation and after application of inclusion and exclusion criteria, pre-treatment maxillary and mandibular plaster models and the corresponding CBCT scans of 31 patients attending a private orthodontic clinic were selected. The subjects were 10 males and 21 females with age range 12 to 40 years. Plaster models were scanned using the high resolution mode of an Ortho Insight 3D scanner and CBCT scans were taken using a Kodak 9500 Cone Beam 3D System machine. The teeth on the digital scans were segmented and virtual roots were predicted and constructed by the Ortho Insight 3D software. The long axes of the predicted roots and the actual roots, as segmented from the CBCT images, were computed using best-fit lines. The inter-axis angle was used to assess error in root inclination prediction by the software. Mann-Whitney and Kruskal-Wallis tests were used. Intra-examiner error was evaluated using the Bland-Altman method. The maximum disparity in angle between images derived from digital models and CBCT data was almost 40 degrees (upper left canine). The upper and lower canines produced the worst results, followed by the lower lateral incisors. The upper central incisors showed the best results, although the maximum angle of difference exceeded 20 degrees (with the median around 8 degrees). Root morphology imaging prediction is not a primary function of this software and this study confirmed its limitation as a sole tool in routine clinical applications. At present these predictions cannot be considered accurate or reliable unless correlated clinically with a radiographic image.
- Atypical intraosseous mucoepidermoid carcinoma with two years of evolution and cutaneous infiltration(2018) Assao, Agnes; de Souza, Talita-da Silva-Nery; Freitas, Diogo-Loureiro; Oliveira, Denise TostesThe intraosseous mucoepidermoid carcinoma is a rare lesion that frequently affects the posterior region of the mandible. This case reports a multilocular osteolytic radiolucency with two years of evolution, that expanded and perforated the cortical bone, with irregular and indefinite margins, that extended from the mandibular angle to the ascendant ramus, with cutaneous ulceration, detected in a 51 years-old male. An incisional biopsy was performed and confirmed the diagnosis of low-grade intraosseous mucoepidermoid carcinoma. The patient was submitted to partial mandibulectomy, neck dissection and post-operative radiotherapy. In three years of follow-up, there was no evidence of tumor recurrence. This case report reinforces that even a low-grade intraosseous mandibular mucoepidermoid carcinoma tends to expand and to perforate the bone cortical, infiltrating to adjacent soft tissues, in long time of evolution.
- Maximum occlusal bite force in pre-school children with different occlusal patterns(2018) Abu Alhaija, Elham; Owais, Arwa I.; Obaid, HibaThis study was carried out to record maximum occlusal bite force (MOBF) in pre-school children with different occlusal patterns. A randomly selected sample of 1085 kindergarten children in primary dentition stage were selected. The age of subjects ranged between 3-6 years (averaged 4.90 ± 0.86 years). The subjects were divided into 3 groups according to molar relationship; flush terminal (n=335; 165 males and 170 females), distal step (n=450; 200 males and 250 females), mesial step (n=300; 150 males and 150 females) molar relationship. Clinical examination involved the record of molar relationship, overjet, overbite and the presence of wearing facets. Occlusal bite force was measured using a hydraulic occlusal force gauge. The means of MOBF for the different occlusal relationship were: - 193.47N (± 60.98), 179.20N (±56.80) and 245.11N (±69.45) for flush terminal, mesial and distal step molar relationships, respectively. Significant differences between studied groups were detected (P<0.01; P<0.001). MOBF were higher in subjects with distal step molar relationship, increased overjet and increased overbite. Gender differences were detected in flush terminal and distal step molar relationships. MOBF was affected by the different occlusal relationships. Children with distal step and mesial step molar relationship had the highest and the lowest MOBF, respectively. MOBF was similar in children with/without wearing facets.
- Congenital lower lip pits : Van der Woude syndrome(2018) Gurpal-Chhabda, Veenu; Singh-Chhabda, GurpalThe Van der Woude syndrome is a rare autosomal dominant development malformation characterized by a paramedian lip pits and /or sinuses or conical elevation of lower lip associated with cleft lip and or palate. These congenital lip pits usually appear clinically in the vermilion border of lip, with or without secretion. The critical region of VWS has been identified to be at Iq32 to 41 with high, but incomplete penetrance and variable expressivity. Therapeutic intervention is generally required for cosmetic reason or when recurrent inflammation is present. Dental surgeon should be aware of this syndrome, as it is associated with variety of other congenital malformation. van der woude syndrome can be easily missed if it is not in the back of mind and its associated congenital malformation if present. We report a case of lower lip pits with bilateral cleft lip.
- Effect of rinsing time and surface contamination on the bond strength of silorane-based and dimethacrylate-based composites to enamel(2018) Fallahzadeh, Farnoosh; Atai, Mohammad; Ghasemi, Shirin; Mahdkhah, AilinThe aim of this study was to assess whether saliva contamination and rinsing time for 15, 30, and 60 seconds, affects the shear bond strength of silorane and methacrylate-based composites to enamel. Two light cure resin, P60 (3M ESPE) and Filtek LS Silorane were tested. 120 sound premolars were randomly divided into four groups of 30 teeth based on composite type with or without saliva contamination after etching and rinsing. Each group was further divided into three subgroups according to their rinsing time. Then a cylinder of the composite was bonded to the enamel and Shear bond strength was assessed. To determine the failure mode, the bonded surfaces were then observed under SEM. In addition, the DC of each group was measured at pH levels of 4 and 7 using FTIR spectroscopy. The data were analyzed with one-way ANOVA and post hoc analysis followed by Fisher?s least significant difference. The bond strength of the non-contaminated methacrylate group was significantly higher than the other groups (p< 0.0001). In addition, there was no significant deference between the methacrylate subgroups. In the silorane groups, the shear bond strength was higher in the rinsing time of 15 seconds. Failure pattern was mainly adhesive. The DC of the Methacrylates had no significant difference at pH 4 and pH 7, but was significantly higher than that of siloranes (p< 0.0001). While the DC of the siloranes at pH 4 was significantly higher than at pH 7 (p< 0.0001). Saliva contamination in both composites reduces bond strength. Increasing rinsing time in Methacrylates proves ineffective. In non-contaminated siloranes, excessive rinsing time reduced bond strength. The best-recommended rinsing time for both composite is 15 seconds.
- In vitro Evaluation of the Accuracy of the Root Zx in the Presence of Naocl 2.5% and Chlorhexidine 0.2%(2018) Bolbolian, Marjan; Golchin, Siamak; Faegh, SeyedmatinEstablishing the working length at the apical constriction is considered ideal for root canal therapy. Because of the limitations of radiography and complicacy of the apex of the root, electronic measurement of canal length has become valuable for endodontic treatment. This study was designed to evaluation of the accuracy of the Root zx electronic apex locator in the presence of NaOCl 2.5% and chlorhexidine 0.2%. Thirty extracted human premolars with complete root formation were enrolled. The actual length (AL) was assessed visually (under stereo microscope) and teeth mounted in the saline model. The electronic length (EL) measurements were recorded in the presence of NaOCl 2.5% and chlorhexidine 0.2% and the differences between the EL and AL were compared. By accepting the error of 0.5 and 1 mm, the accuracy of Root zx was 76.7% and 96.7% in the presence of chlorhexidine 0.2% and 90% and 100% in the presence of NaOCl 2.5%, respectively. No statistical differences was found between the measured groups (P=0.223). Our results confirmed that Root zx can accurately determine the apical constriction in presence of both NaOCl 2.5% and chlorhexidine 0.2%.
- Psychometric analysis of stress, anxiety and depression in patients with recurrent aphthous Stomatitis-A cross-sectional survey based study(2018) Dhopte, Ashwini; Naidu, S. Giridhar; Singh-Makkad, Ramanpal; Nagi, Ravleen; Bagde, Hiroj; Jain, SupreetRecurrent Aphthous Stomatitis is a chronic inflammatory immune mediated condition associated with single or multiple, painful recurring ulcers of the oral mucosa. Psychological stress is a common trigger factor identified for the onset and progression of this condition. The study aimed to evaluate stress, anxiety and depression using the Hospital Anxiety and Depression scale and stress by the General Health Questionnaire in subjects with Recurrent Aphthous Stomatitis (RAS). The study evaluated subjects with a history of Recurrent Aphthous Stomatitis and compared their psychological stress, anxiety and depression alteration to normal subjects. Seventy-five study subjects were divided into three groups; test group 1 (25 subjects) presenting with RAS, test group 2 (25 subjects) with a history of RAS but without oral ulcers, and 25 normal subjects with no history of RAS formed the control group. Chi square and student t test was used to determine the relationship between psychological variables and recurrent aphthous ulcers. Comparison of stress, Anxiety and Depression between test group 1 and control group, test group 2 and control group was not found to be statistically significant (p< 0.05). Hence, differences were evident when individual questions were analyzed for stress anxiety and depression. Stress and depression were more prevalent in females, students and patients with a history of RAS. Higher depression and stress levels were evident in subjects with a history of RAS. Psychological stress is a utmost trigger factor for the initiation of recurrent ulcers. Overall, test group patients had a more psychological impact on the quality of life than the control group.
- Peripheral Calcifying Odontogenic Cyst : a rare case report(2018) Costa, Liana-Cristina-Melo-Carneiro; Neto, Joaquim-Barbosa-Matias; Assis, Eliene Magda de; Gomes, Hayder-Egg; Leitão, Tiago-Johnston; Vasconcelos, Renzo-Rafael-Cevallos; Souza, Paulo Eduardo Alencar; Horta, Martinho Campolina RebelloThe Calcifying Odontogenic Cyst (COC) is a simple cyst lined by ameloblastoma-like epithelium with ghost cells. The peripheral COC is a rare lesion and few reports have been published considering its clinical and histopathological features. This article aimed to report on a case of a peripheral COC, discussing its clinical, imaginological and histopathological features. A 9-year-old male patient presented a 10x5 mm painless nodule in the palatal mucosa of the left central incisor. Panoramic, occlusal and periapical radiographs did not show alterations. A computed tomography exam showed a slight soft tissue swelling located in the palatal mucosa of the left maxillary central incisor. An excisional biopsy was performed. The histopathological analysis showed a cystic lesion adhered to an oral mucosa fragment and lined by an ameloblastoma-like epithelium with ghost cells. The diagnosis of peripheral COC was established and the patient has been disease-free for 5 years. Although rare, peripheral COC is an important lesion that should be considered as a differential diagnosis of gingival hyperplastic lesions.
- Tooth discoloration and internal bleaching after the use of ledermix paste with various bleaching agents ? An in vitro study(2018) Yogha-Padhma, Asokan; Jayasenthil, Adhikesavan; Pandeeswaran, RamarajTo assess the reversal of discolouration caused by Ledermix using various bleaching agents. Twenty six extracted human mandibular premolars were taken and divided into four groups. Six teeth were divided into three each which are taken as positive and negative controls. The remaining twenty are divided into two groups (n=10). After conventional access preparation, the Ledermix paste was sealed in the pulp chamber for twelve weeks. The paste was removed by a rinse with sodium hypochlorite (NaOCl). Then the pulp chamber was sealed with a mixture of Sodium perborate and distilled water for group 1 and group 2 was sealed with Sodium tetraborate for 1 to 12 weeks. The shade was measured by a Spectrophotometer at four time periods baseline(T0), after 12 weeks of placement of Ledermix (T1), after 4 (T2), 12 (T3) weeks of Internal bleaching with Sodium perborate and Sodium tetraborate respectively. Data were collected based on CIE-76 (L*a*b*) system and analysed using t-test and ANOVA. A significant decrease in the mean value of L*(lightness) was observed after treatment with Ledermix (T1, p<0.05). Considerable increase in these values after bleaching with Sodium perborate and Sodium tetraborate (T2, T3) were found in both groups, to the same extent. Ledermix discoloured the tooth structure but discolouration could be reversed when bleached with both Sodium perborate and Sodium tetraborate to the same extent.
- The effect of dental chair light exposure duration on shear bond strength of orthodontic brackets : an in vitro study(2018) Andrews, Kevin M.; Roberson, Glen; Subramani, Karthikeyan; Chaudhry, KishoreThe purpose of this study is to determine if the duration of exposure to the halogen overhead dental chair light has an effect on shear bond strength (SBS) of metal orthodontic brackets. One hundred twenty extracted human lower incisor teeth were divided into six groups (n=20/group). Each group was assigned a predetermined duration of exposure to the halogen dental chair light, set at a fixed distance, before being cured. Light exposure times of 0 minutes (Group 1-Control), 1 minute (Group 2), 2.5 minutes (Group 3), 5 minutes (Group 4), 10 minutes (Group 5), and 15 minutes (Group 6) were tested. Each tooth was subjected to an exclusion criteria examination, scrubbed of all debris, and imbedded in a PVC-stone fixture with the crown of the tooth exposed above the stone surface. All groups had orthodontic brackets bonded with the same materials and process, then light cured for 6 seconds using the Valo LED curing unit after their designated light exposure time. Groups were tested using an Instron E-1000 universal testing machine with a shear load test set at a speed of 1mm/min using a knife-edged chisel. Data was analyzed using a one-way ANOVA test. The Adhesive Remnant Index (ARI) was scored under 10x magnification. The ARI data was analyzed using the Chi-square test (p-value < 0.05). All control and experimental groups for each specific tooth type tested resulted in SBS within or above the clinically acceptable range. Statistically significant differences (p<.05) were found between the control and experimental groups for dental chair light exposure times of 5 minutes, 10 minutes and 15 minutes. A chi-square test determined that there was statistical significance when evaluating the frequency of ARI scores when light exposure duration was greater than 5 minutes. It can be concluded that dental chair light exposure in the 5 minute, 10 minute and 15 minute groups produced higher shear bond strength than those of the control, 1 minute and 2.5 minute groups. The dental chair light is capable of initiating polymerization and causing higher bond strengths than the clinical acceptability of 5.8-7.9 MPa, thus continued dental chair light exposure over 5 minutes is not recommended. The ARI analysis revealed that as bond strength increased, the fracture pattern shifted from most remaining adhesive attached to the tooth toward that attached to the bracket.
- Fracture and deformation of ProTaper Next instruments after clinical use(2018) Fernández-Pazos, Gema; Martín Biedma, Benjamín; Varela Patiño, María Purificación; Ruíz Piñón, Manuel; Castelo Baz, PabloThe aim of this study was to evaluate the fracture and defects observed in ProTaper Next files discarded after a normal clinical use. 571 ProTaper Next rotary instruments were collected after clinical use from the clinic of endodontics over 12 months. The length of the files was measured using a digital caliper to determine any fracture, later all the files were evaluated under a stereomicroscope to observe defects such as unwinding, curving or fracture. The data obtained were analyzed using a chi-square and z test. 13.83% of the discarded files showed defects, the most frequent defect was fracture (7.53%). The highest rate of fracture was observed in the X1 (17.04) files (19.87%). The presence of deformations without fracture was also more frequent in the 17.04 file (11.8%). Because of the relatively high incidence of deformation of smaller files, these instruments should be considered as a single use. It is important not to exceed the maximum uses recommended by the manufacturer to reduce the risk of cyclic fatigue, the main cause of fracture of the files (79.07%). It is also important to observe each file after use to discard small defects or fractures.
