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Language Journal of Clinical and Experimental Dentistry. 2023. Vol. 15, no. 08
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- Intraoral and facial rehabilitation retained with zygomatic implants and magnets after complete resection of the maxilla, lip and nose: a clinical report(2023) Alfenas, Elizabeth; Silva, Isadora; Oliveira, Davidson; Tanner, Paul; Jardilino, Francisca; Bhering, Cláudia; Moreno, AmáliaProsthetic rehabilitation is an option available for patients with extensive maxillofacial defects with the ability to restore esthetics and function. The surgical procedure can result in anatomical and functional sequelae leading to functional, psychological and aesthetic disorders. This clinical case report describes the unique and highly-specialized fabrication method of an oral and facial prosthesis for a patient with a near total maxillectomy, excision of upper lip, rhinectomy and radiotherapy for treatment of an extensive malignant neoplasm. Four carefully placed zygomatic implants were used to retain an oral obturator and an external mid-facial prosthesis. A well-functioning maxillofacial prosthesis is essential for improving quality of life, psychological adjustment to cancer and cancer related disabilities, and a positive coping response. The prosthetic rehabilitation allowed the patient’s reintegration into society accompanying the satisfactory restoration of aesthetics, phonetics, mastication, and deglutition.
- Adenomatoid odontogenic tumor associated to reactive fibro-osseous lesion: a case report(2023) Jara, René; Martinez, Paz-; Rees, Victoria; Donoso-Martínez, Benjamin; González-Providell, SergioAn adenomatoid odontogenic tumor (AOT) is a benign epithelial lesion, being the fourth most common among all odontogenic tumors. Usually presents as slow painless growth that sometimes leads to facial asymmetry. Many cases are detected by radiographic studies, and the indication for biopsy and surgery is secondary to this finding.We report a case of a 17-year-old man with a history of left mandibular painless swelling since 4 months ago, associated with facial asymmetry and hard consistency. An imaging study showed an extensive unilocular radiolucent lesion to the basilar arch, with defined limits and with peripheral hyperdense areas located only vestibular to the lesion. The histopathology was composed of odontogenic epithelial cell proliferation, with epithelial nodular and duct-like structures, rosettes of spindled epithelial cells with eosinophilic material, calcifications, and fibro-osseous reaction. Surgical conservative excision including the affected tooth is the treatment of choice and recurrence is rare. The histologic findings of reactive fibro-osseous proliferation in AOT should be interpreted as a reactive change in the tumor capsule and not as an adnexal lesion.We present an atypical case of AOT with reactive fibro-osseous reaction. Despite clinical aggressive behavior, conservative surgical treatment could be the treatment of choice. Additionally, we emphasize the importance of histopathological examination together with the imaging study of radiolucent lesions of the maxillary bones.
- Influence of sociodemographic factors and Family Health Strategy coverage on oral health promotion procedures: an analysis of Brazilian municipalities in 2019(2023) Paredes, Suyene-de Oliveira; de Lucena, Edson Hilan Gomes; Guimaraes Abreu, Mauro Henrique Nogueira; Forte, Franklin-Delano-SoaresThe aim of the study was to investigate associations between sociodemographic factors and municipal Family Health Strategy (FHS) coverage and oral health promotion (OHP) procedures in Brazil.Data were obtained using public information systems and by direct request to the Ministry of Health. Clinical and collective OHP procedures performed in 2019 were analyzed, and sociodemographic covariates were associated with FHS coverage (population covered by FHS teams [FHST] and oral health teams [OHT]). Negative binomial regression models associated outcomes with covariates and estimated the prevalence ratio (PR) and confidence intervals (95%CI).A total of 4,913 municipalities were included. Municipalities with low-income inequality (PR=1.04, 95%CI 1.01 to 1.08), high illiteracy rate (RP=1.06, 95%CI 1.00 to 1.13), and population size of 10,001 to 50,000 inhabitants (PR=1.07, 95%CI 1.02 to 1.12) and 50,001 to 100,000 (PR=1.21, 95%CI 1.12 to 1.30) showed a higher frequency of clinical procedures. In contrast, a low frequency of clinical procedures was associated with reduced vulnerability to poverty (PR=0.83, 95%CI 0.78 to 0.89) and low OHT coverage (PR=0.39, 95%CI 0.33 to 0.45). Regarding collective procedures, the final model showed associations between low frequency and reduced income inequality (PR=0.91, 95%CI 0.87 to 0.95), low per capita income (PR=0.84, 95%CI 0.81 to 0.88), and low (PR=0.53, 95%CI 0.35 to 0.80) and medium Human Development Index (PR=0.79, 95%CI 0.71 to 87).Clinical and collective OHP procedures were associated with sociodemographic conditions and OHT coverage in the FHS.
- Influence of different adhesion strategies on glass fiber post retention(2023) Nadler, Ana-Michelle-Oliveira; da Silva, Evair-Josino; Lins-Filho, Paulo-Cardoso; Dias, Marlon-Ferreira; Guimarães, Renata-Pedrosa; Silva, Claudio Heliomar Vicente; Silva, Sérgio-dos Santos; Gomes, Anderson S. L.Failures in glass fiber post (GFP) retention may be associated with low adhesion achieved in root dentin.55 single-rooted premolars were endodontically treated and distributed according to different adhesion strategies (n=11): G1: RelyX ARC (3M ESPE; etch-rinse strategy); G2: Relyx Ultimate (3M ESPE; etch-rinse strategy); G3: AllCem (FGM; etch-rinse strategy); G4: Relyx Ultimate (3M ESPE; self-etching strategy); G5: RelyX U200 (3M ESPE; self-adhesive strategy). For Bonding Strength (BS) analysis, the roots were sectioned in slices (1.0mm thickness) corresponding to each root third and submitted to push-out test. The type of failure was assessed by scanning electron microscopy (SEM).The highest BS averages were found in G2 and G3. However, in the middle and apical root thirds, G3 showed statistically similar results to G4 and G5. In the cervical and middle third, G1 was statistically similar to G4 and G5. The mixed type of failure was the most common in all groups.Self-etching (G4) and self-adhesive resin (G5) cements, showed similar BS results of immediate bonding in the cementation of GFP compared to conventional resin cements (G1, G2, G3).
- Which irrigating provides a better bond strength in glass fiber posts: Chlorhexidine or Sodium Hypochlorite? A systematic review with meta-analysis(2023) Júnior, Eneas-Pereira-da Silva; Araújo, Sarah-Freitas; de Assis, Cláudio-Paulo-Pereira; da Silva, André-Rodrigo-Justino; Lago, Maria-Catarina-Almeida; Braz, RodivanThe aim of this systematic review and meta-analysis was to evaluate the influence of the use of chlorhexidine on endodontic instrumentation on the bond strength of glass fiber posts with resin cements. The guiding question of the study was: “Is the bond strength of glass fiber posts greater when using chlorhexidine as an irrigator in endodontic treatment instead of sodium hypochlorite?”.This study was conducted according to Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). In vitro studies were included that have compared chlorhexidine and sodium hypochlorite as an endodontic irrigator in the chemical-mechanical preparation.Eight studies were included in the qualitative analysis and seven in the meta-analysis. Both the analysis by subgroups and the total analysis, using a random effect model, showed no statistically significant differences between the groups (p> 0.05), either in the specific analysis for cervical root third (p = 0.30; 95% CI = -2.11, 6.91) or medium (p = 0.05; 95% CI = -0.03, 4.56), or nonspecific regarding the third to the root third (p = 0.48; 95% CI = -4.00, 1.86).There are no statistically significant differences in the bond strength of glass fiber posts and resin cements in teeth endodontically treated under irrigation by both chlorhexidine and sodium hypochlorite.
- Critical appraisal of systematic reviews of intervention studies in periodontology using AMSTAR 2 and ROBIS tools(2023) Pereira, Alexandre-Godinho; Martins, Carolina-Castro; Campos, Julya-Ribeiro; Faria, Sandro-Felipe-Santos; Notaro, Sarah-Queiroz; Poklepović-Peričić, Tina; Costa, Lidiane-Cristina-Machado; Costa, Fernando-Oliveira; Cota, Luis O. M.Systematic reviews of intervention studies are used to support treatment recommendations. The aim of this study was to assess the methodological quality and risk of bias of systematic reviews of intervention studies in in the field of periodontology using AMSTAR 2 and ROBIS.Systematic reviews of randomized and non-randomized clinical trials, published between 2019 and 2020, were searched at MedLine, Embase, Web of Science, Scopus, Cochrane Library, LILACS with no language restrictions between October 2019 to October 2020. Additionally, grey literature and hand search was performed. Paired independent reviewers screened studies, extracted data and assessed the methodological quality and risk of bias through the AMSTAR 2 and ROBIS tools.One hundred twenty-seven reviews were included. According to AMSTAR 2, the methodological quality was mainly critically low (64.6%) and low (24.4%), followed by moderate (0.8%) and high (10.2%). According to ROBIS, 90.6% were at high risk of bias, followed by 7.1% low, and 2.4% unclear risk of bias. The risk of bias decreased with the increased in the impact factor of the journal.Current systematic reviews of intervention studies in periodontics were classified as low or critically low methodological quality and high risk of bias. Both tools led to similar conclusions. Better adherence to established reporting guidelines and stricter research practices when conducting systematic reviews are needed.
- Microleakage in indirect onlay restorations cemented with three different types of adhesives: an in vitro study(2023) Sinche-Ccahuana, Isabel; Ladera Castañeda, Marysela Irene; Paucar-Rodríguez, Elizabeth; Aliaga Mariñas, Ana Sixtina; Dapello-Zevallos, Giannina; Cervantes Ganoza, Luis; Cayo Rojas, César FélixTo evaluate the in vitro degree of marginal microleakage in indirect Class II onlay restorations cemented with dual self-adhesive, universal adhesive and dual adhesive.In the present in vitro experimental study, a total of 54 human premolar teeth were prepared and divided into three equal groups (n = 18) for placement of onlay-type restorations cemented with A: Allcem™ dual-cure adhesive cement), B: RelyX™U200 dual-cure self-adhesive cement and C: RelyX™ Ultimate universal adhesive cement. All restorations were subjected to 10,000 thermocycles between 5°C and 55°C and immersed in a 1M silver nitrate solution for 6 hours. The crowns were then sectioned mesiodistally and observed under a stereo microscope to determine the degree of marginal microleakage in the cervical area.The onlay restorations cemented with RelyX Ultimate did not present microleakage in the majority of cases (77.8%). Restorations cemented with RelyX U200 showed predominantly microleakage up to the pulp floor in 83.3% of the total, being this significantly higher microleakage than in restorations cemented with RelyX Ultimate and Allcem Dual (p<0.001 and p<0.001 respectively). There was no significant difference in microleakage between the last two mentioned cements (p=0.255) Allcem dual adhesive cement and RelyX Ultimate universal adhesive showed significantly less microleakage than RelyX U200 dual-curing self-adhesive cement at the cervical level, with predominantly no microleakage and microleakage down to the enamel, respectively. The use of RelyX Ultimate cement in indirect restorations is recommended as it showed better marginal adaptation.
- Comparison of the posterior teeth angulations in orthodontic patients with different facial growth patterns(2023) Ledesma-Peraza, Oscar; Sánchez-Tito, MarcoDental relationships can be affected according to the pattern of facial growth. Thus, the aim of this study was to compare the angulations of posterior teeth in patients with different patterns of facial growth.A total of 412 lateral head radiographs were included. The facial skeletal growth pattern was evaluated with the Björk-Jarabak analysis. For the angular measurements of the posterior teeth, the apex-cusp inclination of the premolars and the long axes of the molars were considered, with respect to the occlusal, palatal and mandibular plane. The intraclass correlation coefficient (ICC) was used to evaluate the intra-examiner concordance. One way ANOVA was used to compare the values between the patterns of facial growth. A significance level was set at 0.05.A high intra-examiner correlation was observed (0.75). Subjects with horizontal and normal growth presented significantly different angulations for the first and second premolars in relation to the palatal plane than the vertical growth (p<0.05). Subjects with horizontal growth pattern showed greater angulation of the teeth with respect to the occlusal plane than the other groups (p<0.05). The angulations of all mandibular teeth related to the mandibular plane were significantly higher for the group with horizontal growth (p<0.05).The first and second premolars presented greater angulations in subjects with horizontal and normal growth than in those with vertical growth. The angulations of all mandibular teeth were significantly higher in the horizontal growth according to the mandibular plane.
- Incisors’ bone height and inclination changes after orthodontic treatment with a self-ligating passive system(2023) Pinzan-Vercelino, Célia-Regina-Maio; Freitas, Karina-Maria-Salvatore; Secco, Monique; Pinzan, Arnaldo; Cotrin, Paula; Valarelli, Fabricio-Pinelli; Janson, Guilherme; de Freitas, Marcos-RobertoThis study aimed to evaluate changes in the alveolar buccal bone height of maxillary and mandibular incisors after orthodontic treatment with a self-ligating passive system and to assess the correlation between bone height and incisor inclination.Pre (T1) and post-treatment (T2) cone-beam computed tomography images of patients treated with the Damon 3MX appliance system were measured to quantify the alveolar buccal bone height of the maxillary incisors. The incisor’s inclination was measured in digital models. Paired t-test was used to evaluate the changes between T1 and T2, and Pearson’s coefficient was used to test the correlation.All teeth presented statistically significant alveolar buccal bone loss at T2. A statistically significant buccal inclination was observed only for the lower left lateral incisors. There was no correlation between bone height changes and incisor inclination.Orthodontic treatment with a self-ligating passive system showed changes in alveolar height, but these changes were not correlated with incisor inclination.
- Dental restoration operative time and analysis of the internal gap of conventional resins (Incremental Technique) vs. Bulk Fill (Single-Increment Technique): in vitro study(2023) Medina-Sotomayor, Priscilla; Ortega, Gabriela; Aguilar, José; Ordóñez, Paola; Rojas, Michelle; Vásquez, RoxanaTo determine the operative time and the internal restoration gap in the restoration–tooth interface in the cavity floor using an incremental technique for conventional resins and the single-increment technique for the bulk fill resin.In this in vitro experimental study, the internal gaps of the restoration–tooth interfaces in the cavity floors of two conventional resins and two bulk fill resins were microscopically analyzed, and the restoration times of the single-increment technique and the incremental technique were determined.Bulk fill resins had smaller internal gap (63.31 µm) than conventional resins (333.14 µm). Regarding the restoration time, the single-increment technique obtained the best results in operative time (3.52 minutes), with significant differences relative to the incremental technique.The Tetric N-Ceram bulk fill resin presented better performance than conventional resins relative to the internal gap of the restoration–tooth interface in the cavity floor. In addition, the single-increment technique presented a short clinical restoration time.
- Prevalence of missed canals in endodontically treated teeth: a cone-beam computed tomography study(2023) Rouhani, Armita; Aboutorabzade, Mohammadreza; Reyhani, Morteza; Kheirabadi, Nasir; Mortazavi, Samare; Navabi, SaraThis study aimed to measure the prevalence of untreated root canals and periapical lesions in endodontically treated teeth using cone-beam computed tomography (CBCT) and their association with the coronal seal.This cross-sectional study assessed CBCT images of studied patients alongside documented information from their dental examinations. The assessment method for analyzing CBCT images after including endodontically treated teeth was the presence of missed canals, and periapical lesions were analyzed in three dimensions.The evaluations from 772 teeth demonstrated that 89.4% of teeth had the proper coronal seal, 13.3% owned missed root canals, and 29.4% had periapical lesions. Most untreated canals belonged to maxillary first molars (71.8%) and mandibular lateral incisors (33.3%). The prevalence of periapical lesions was highest in mandibular lateral incisors (58.3%) and maxillary second molars (55.8%). In teeth with missed canals, the most periapical lesions were observed in the first premolars of both jaws. In teeth with the lack of proper coronal seal, the periapical lesions were observed in 55.6% of teeth with untreated root canals.The results revealed a high prevalence of missed canals and periapical lesions in endodontically treated teeth in our study population.
- Evaluation of Endo 10 mobile application as diagnostic tool in endodontics(2023) Abuabara, Allan; de Castro, Juliana-Pierdona; Locks, Maria-Eduarda-Nunis; Pezzin, Ana-Paula-Testa; Mattos, Natanael-Henrique-Ribeiro; de Araujo, Cristiano-Miranda; Küchler, Erika-Calvano; Baratto Filho, FlaresEndodontic diagnosis can be compared to a puzzle, requiring the interpretation of a series of clinical and imaging data. Mobile health, especially mobile application (apps), can assist professionals in endodontic diagnosis. This work aims to evaluate an app - Endo 10 app, designed to assist pulpal and periapical diagnosis based on the patient’s signs and symptoms and radiographic data.A total of 41 dental students and dentists with different levels of expertise (10 multi-specialty clinic professors, 17 residents in endodontics and 14 dental students) were included. The System Usability Scale (SUS) was used to evaluate usability and the Davis’ technology acceptance model was used to evaluate usefulness of Endo 10 app. The Mann-Whitney test was performed to compare SUS scores between professors and undergraduate dental students and to compare questions 6 and 7 of the utility test and verify whether participants who understood that the technology was useful also better understood the concepts of endodontic diagnosis. The agreement between professor’s diagnosis with the app and professor without the app, and between professor and residents in endodontics with the app were evaluated.The SUS score at the 50th percentile was 77.5, graded as acceptable. No significant difference was observed in the SUS scores when analyzing professors and dental students separately (p = 0.442). Usefulness test showed positive responses ranging between 72% - 100%. No statistically significant difference was observed between questions 6 and 7 of the utility test (p = 0.206), indicating that the group of participants who understood that the technology was useful in endodontic diagnosis was associated with the agreement that the application helped to better understand the concepts related. The diagnosis agreement between professor in the common diagnosis process and professor with app was 100% (31) of cases. The concordance between professor and residents in endodontics with the app was 71% (22) of cases. The differences were associated with resident’s misinterpreting the patient’s data.The Endo 10 app reached the usability and usefulness requirements. It proved accurate in diagnosing pulpal and periapical pathologies.
