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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 1
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- Effect of preemptive analgesia with ibuprofen in the control of postoperative pain in dental implant surgeries : a randomized, triple-blind controlled clinical trial(2020) Pereira, Gustavo-Mattos; Cota, Luis O.M.; Lima, Rafael-Paschoal-Esteves; Costa, Fernando-OliveiraPreemptive analgesia has as its basic principle the administration of analgesics before the onset of painful stimuli, in order to reduce or prevent postoperative pain, but this question is little explored in implantology. Thus, this study was conducted in order to evaluate the clinical efficacy of ibuprofen in pain prevention after unit implant surgery. For this triple-blind, parallel, placebo-controlled and randomized clinical trial, 54 insertion surgeries of unitary implants were performed. Two groups have received two different protocols 1 hour before surgery: Ibuprofen group (IBU) 600 mg of ibuprofen; and (2) placebo group (maize starch). The intensity of the pain was evaluated through the visual analogue scale (VAS) in 6 times (1, 6, 12, 24, 48 and 72 hours after the surgery). Patients were instructed to take 750 mg of paracetamol as rescue medication, if necessary. The occurrence and the intensity of pain were analyzed by means of an analysis of variance ANOVA with repeated measurements using the general linear model procedure. The IBU group had significantly lower VAS scores overall (IBU = 0.30, ± 0.57; placebo = 1.14, ± 1.07; p<0.001) and at all times in the intra, intergroup comparisons and time/group interaction than the placebo group (p<0.001). The use of rescue medication was significantly lower and the postoperative time was longer in the IBU group compared to placebo (p = 0.002). The single use of ibuprofen was found to be significantly superior in reducing pain after unit implant surgery compared to placebo.
- Genioplasty with surgical guide using 3D-printing technology : a systematic review(2020) Oth, Olivier; Durieux, Valérie; Orellana, Maria-Fernanda; Glineur, RégineThe purpose of this systematic review is to evaluate the current state of the art of making genioplasties using 3D printing technology. A multi-database single-reviewer systematic review identified sixteen papers that fulfilled the selection criteria. There were mainly case series and case reports available (Level IV of the Oxford Evidence-based medicine scale); only two prospective study (Level III) evaluated this subject. These articles are analyzed in details and summarized in this review. The realization of genioplasties with surgical guide using 3D-printing technology could improve predictability and accuracy. It protects anatomical structures in the environment of the surgery, reducing by this way the morbidity and providing safer results. The type of printer and material used as well as the sterilization techniques should be further developed by the authors. The use of open-access software should also be further explored to allow the use of these new technologies by the largest number of surgeons. Finally, prospective multi-center studies with larger samples should be performed to definitively conclude the benefits of this new technology and allow for its routine use. This article is the first systematic review on this topic.
- Virulence of Streptococcus mutans : an intrafamilial cohort study on transmission of genotypes(2020) Cota, Ana-Lídia-Soares; Silva, Valter; da Silva, Salete-Moura-BonifácioThe main aims of this cohort study were to measure the intrafamilial risk of transmission, sharing and stability of the most virulent S. mutans genotypes. A total of 392 clinical isolates of S. mutans obtained from caries-active adults and genotyped to evaluate their transmissibility over time. After extraction of the chromosomal DNA, PCR were performed to detect the genes involved in the production of GbpA (gbpA) and mutacin types I, II, III and IV (mutAI, mutAII, mutAIII and mutAIV). The gbpA, mutAI, mutAII, mutAIII and mutAIV genes were detected in 77.3, 12.5, 51, 16.6 and 89.8% of S. mutans isolates, respectively. The virulence of S. mutans was associated with its transmission (P< 0.01) and stability (P = 0.01), with the most virulent genotypes having higher transmissibility (RR = 1.83, 95% CI 1.44 to 2.32) and higher stability in the oral cavity (RR = 1.52, 95% CI 1.06 to 2.19). Genotypes with the genetic information to synthesize GbpA and mutacins present an important ecological advantage in the process of colonization by S. mutans; they remain stable among the oral microbiota of the host and favor intrafamilial transmission.
- Influence of core color on final shade reproduction of zirconia crown in single central incisor situation ? An in vivo study(2020) Ayash, Ghada M.; Ossman, Essam; Segaan, Lucette G.; Rayyan, Mohammad; Joukhadar, ChristelleA lot of shaded zirconia blocks are being introduced into the market. Their effect on the final shade of the restoration is yet uncertain. Twenty-four zirconia crowns were fabricated for 8 patients who needed to restore a single maxillary central incisor, and divided into 3 groups according to the color and type of the zirconia (Zr) used (white Zr core, colored Zr core, and monolithic high translucency (ht) Zr crowns). Using Easyshade spectrophotometer, delta E color difference was calculated between fabricated crown and adjacent tooth. The ?Es obtained were assessed based on 1.6 ?E which represented the color difference that could not be detected by the human eye and considered clinically acceptable. No statistically significant values were found between the 3 groups related to different Zr color and type. Within the limitations of this study, it could be concluded that the shade of the zirconia blank had no significant effect on the final color of the crown. This raises reasonable doubt about the necessity to use colored zirconia blanks or use of dip-in solutions. The clinical implications were that, there was no need to use colored zirconia cores to get more esthetically pleasing restorations with respect to color perception. The use of monolithic high translucent zirconia crowns gained the advantages of high translucency and color reproduction.
- In vitro bond strengths post thermal and fatigue load cycling of sapphire brackets bonded with self-etch primer and evaluation of enamel damage(2020) Ibrahim, Ali I.; Al-Hasani, Noor R.; Thompson, Van P.; Deb, SanjuktaThis in vitro study compares a self-etch primer (SEP) to an etch-and-rinse (EaR) for bonding sapphire brackets by evaluation of the enamel etch-pattern, shear bond strength, amount of remnant adhesive and enamel surface damage following thermal and fatigue cyclic loading. Ceramic (sapphire) brackets were bonded to 80 extracted human premolars using two enamel etching protocols: conventional EaR using 37% phosphoric acid (PA) gel (control), and a SEP (Transbond Plus). Each group was subdivided into two subgroups (n=20 teeth) according to the time of bracket debonding: after 24 h water storage or following 5000 thermo-cycles plus 5000 cycles fatigue loading, to determine the shear bond strength (SBS), adhesive remnant index (ARI score), with scanning electron microscopy (SEM) evaluation of enamel condition. The control subgroups consistently exhibited significantly higher (p<0.05) SBS mean values (23.4-29.8 MPa) than the SEP subgroups (15.1-22.4 MPa) at both bracket debonding time points. However, the SEP subgroups yielded milder etch-patterns and attained SBS values above the minimum requirement range for clinical performance. In addition, the higher SBS of control subgroups was accompanied with higher ARI scores and enamel damage grades than SEP subgroups as confirmed by SEM. Thermocycling and fatigue significantly reduced the SBS of all subgroups, with a non-significant drop in the amount of adhesive residue or enamel damage. The use of SEP can be a suitable alternative to the conventional PA gel for sapphire bracket bonding as it maintains suitable bond strength and has the potential to produce both less remnant adhesive and enamel damage.
- Transoral surgical approach to solitary fibrous tumors in buccal space with infratemporal tumor extension : a case report(2020) Rizqiawan, Andra; Zahratur-Rasyida, Anindita; Mulyawan, IndraA solitary fibrous tumour (SFT) is a rare spindle-cell neoplasm of mesenchymal origin usually located in the pleura. It has been recently described as occurring in various head and neck sites, including the oral cavity. The purpose of this article is to report a case of SFT originating in the buccal space and extending into the infratemporal space treated by means of transoral approach surgery. A 25-year-old female patient reported to the Department of Oral and Maxillofacial Surgery, Universitas Airlangga Hospital, chiefly complaining of a painless lump in the left cheek which had been present for nine months. The diagnosis was arrived at on the basis of a combination of clinical investigation, imaging studies and histopathological examination (biopsy). The surgical approach involved transoral incision through the buccal mucosa. An SFT of buccal space may extend to nearby structures producing the anatomical challenge of removal through a transoral approach. Excisional biopsy involving a transoral approach is, nevertheless, considered appropriate because it produces an attractive aesthetic appearance, reduces morbidity from nerve/ vascular/ gland injury and promotes more effective healing.
- Marginal and internal fit evaluation of conventional metal-ceramic versus zirconia CAD/CAM crowns(2020) Paul, Nayana; Raghavendra Swamy, K. N; Dhakshaini, M. R; Sowmya, Sanjukta; Ravi, M. BThe purpose of this in vivo study was to compare the marginal and internal gap widths of monolithic zirconia crowns fabricated by CAD/CAM technique and metal-ceramic crowns fabricated by conventional technique. 10 participants needing a single restoration were selected. Zirconia crowns using CAD/CAM technology (Group A) (n=10) and metal-ceramic crowns (Group B) (n=10) using lost wax casting technique were fabricated for each selected tooth. The marginal and internal gaps of crowns were recorded using a replica technique with light body silicone material stabilized with a regular set putty. Each replica was sectioned buccolingually and mesiodistally and then evaluated at five pre-determined sites. The points measured were PM for marginal gap, PA for axial gap, PAO for axio-occlusal transition gap and PO and PCO for occlusal gaps using a stereomicroscope at 30× magni?cation. The Paired Sample (t) test was used to detect significant differences between the two groups in terms of marginal and internal fit (?= 0.05). The mean for the marginal gap was 77.42?m (±39.5?m) for Group A compared with 95.86?m (±55.12?m) for Group B. Mean values for internal gap was 87.24 (±21.7 µm) for Group A and 132.91 µm (± 50.63 µm) for Group B. Significant differences were observed between both the groups for marginal (p=.010) and internal (p=.000) fit. The CAD/CAM fabricated zirconia crowns demonstrated a better accuracy of fit when compared to metal-ceramic crowns fabricated by conventional technology.
- Infectious postoperative complications in oral surgery. An observational study(2020) Dallaserra, Matías; Poblete, Francisca; Vergara N., Cristian; Cortés, Ricardo; Araya, Ignacio; Yanine, Nicolás; Villanueva, JulioThe main objective of this investigation was to determine the incidence of infectious postoperative complications in oral surgery. A observational and descriptive study was developed, with the use of prospective registry of the patients admitted for oral surgery at the San Borja Arriarán Hospital Complex during twelve months observation period (April 2017 to March 2018). The sample consisted of 532 patients undergoing surgical procedures of oral surgery and 19 cases of infectious postoperative complications. The incidence of complications reached 3,57% and it was observed predominantly in exodontic type interventions. The most commonly observed complication was dry socket, reaching 2,5% of third molar surgeries and 3,7% of extractions of other teeth. Other postoperative complication were 7 cases of facial spaces abscesses, also observed predominantly in exodontic type interventions. The results were similar to those reported in the literature both in their frequency and in the type of complication.
- Squamous cell carcinoma related with dental implants. A clinical cases report(2020) Granados, Francisco; Santos Ruiz, Leonor; Contreras Morillo, Marian; Mellado, Jose; Martin, Gregorio; Bermudo Añino, Lucas; Ruiz Delgado, F.; Aguilar, Yolanda; Yáñez Vilas, José IgnacioOne third of all cases of head and neck carcinoma (CA) concern the oral mucosa. The use of dental implants (DI) for dental rehabilitation is widely extended. However, a few studies have reported some cases with neoplasic alterations, among the tissue surrounding implants. Our aim was to analyze possible alterations at the bone-implant interface in patients with oral squamous cell carcinoma (SCC), providing new evidence that could relate or discard a possible link between these factors. We used, for the first time, different techniques, including electron microscopy and histology, to analyze the implant ´s surface and the surrounding tissue from four clinical cases with neoplasic alterations surrounding DI. Histologically, ample inflammatory tissue was found in direct contact with the implant surface. Surface analysis of this tissue, revealed titanium percentages. According to our study, no oncological relation with deterioration of the implant surface was found, although DI were constantly related with peri-implantitis, a chronic trauma of the oral mucosa that could involve a neoplastic factor.
- Mechanical behavior of implant assisted removable partial denture for Kennedy class II(2020) Tribst, João Paulo Mendes; de Araújo, Rodrigo-Máximo; Ramanzine, Naiara-Pires; Santos, Natália-Ribeiro; Dal Piva, Amanda-Maria-de Oliveira; Borges, Alexandre- Luiz-Souto; da Silva, João-Mauricio-FerrazThis study evaluated the mechanical response of a removable partial denture (RPD) in Kennedy Class II according to being associated or not with implants. Four RPDs were manufactured for a Kennedy Class II: CRPD - Conventional RPD, RPD+1M, RPD+2M and RPD+12M, respectively, signifying implant assisted RPDs with the implant installed in the first molar, second molar, and in the first and second molars. The finite element method was used to determine the most damaged support tooth under compressive load (300N, 10s) and strain gauge analysis was used to evaluate the microstrain. All groups were submitted to a retentive force analysis (0.5 mm/mm, 100kgf). Microstrain and retentive force data were submitted to One-way ANOVA and the Tukey test, all with ?=5%. High microstrain was observed in the second premolar adjacent to the edentulous space under compression load (p< 0.01). RPD+12M presented lower microstrain, however being similar to RPD+2M. RPD+1M presented a higher mean value of retentive force, but similar to RPD+12M. FEM showed RPD assisted by implants concentrates less stress in the periodontal ligament. The association of two implants was sufficient to decrease the stress generated in the implants. The most stressed region for the o-ring abutment was the threads, and the group with two implants showed the lowest stress concentration. In cases of Kennedy Class II, the association of RPD with implants in the molar region is a favorable option for patient rehabilitation, reducing the movement of the direct retainer adjacent to the edentulous space, increasing the removal force and decreasing the stress magnitude in the periodontal ligament.
- Salivary levels of IgE and ECP in patients with recurrent aphthous stomatitis(2020) Farhad Mollashahi, Leila; Honarmand, Marieh; Nakhaee, Alireza; Kamalzadeh, Shahram; Amini, SanazRecurrent aphthous stomatitis is a common oral mucosa disease, with no specific etiology. Atopy has been implicated in the development of this disease. In this study, the salivary levels of immunoglobulin E (IgE) and eosinophil cationic protein (ECP) were measured as allergy-related biomarkers in patients with aphthous stomatitis. In this case-control study, non-stimulated saliva was collected from 85 participants and IgE and ECP were measured. Data were analyzed in SPSS 20 through the Mann-Whitney test, and p<0.05 was considered significant. The salivary levels of IgE and ECP were 1.11±0.65 Iu/ml and 26.93±6.95 ng/ml in the case group and 0.73±0/39 Iu/ml and 21.97±6.72 ng/ml in the control group. There was a significant difference between the two groups in terms of salivary levels of IgE and ECP (p=0.001). The results showed that patients with oral aphthous had higher levels of salivary IgE and ECP than controls. Therefore, measurement of these biomarkers may be useful in the initial evaluation of patients with aphthous stomatitis.
- Clinical effect of diode laser on peri-implant tissues during non-surgical peri-implant mucositis therapy : randomized controlled clinical study(2020) Sánchez-Martos, Rebeca; Samman, Andrea; Bouazza Juanes, Kheira; Díaz Fernández, José María; Arias Herrera, Santiago EmilioThe aim of this study is to evaluate the response to the non-surgical treatment of peri-implant mucositis using the diode laser as an adjuvant therapy in patients with implant-supported restorations, in terms of clinical variables, with respect to those patients in whom conventional non-surgical therapy is used. Randomized controlled clinical trial with simple blind 3 months follow-up. Two groups of patients were established, the non-surgical mechanical debridement of the affected implants was performed in the control group (n = 34) and the diode laser therapy was also performed in the test group (n = 34). The implant was considered the study subject; the variables considered were plaque index, bleeding on probing depth, depth of probing and recession of the peri-implant mucosa. The t-Student test was used to establish the intergroup statistical differences and the analysis of variance (ANOVA) was used to measures intragroup differences over time. In the revaluation at 6 weeks, we observed statistically significant differences (p<0.05) between the variables of plaque index and depth of probing between both groups. The test group obtained an average of 0.248 ± 0.3155 in plaque index and 0.833 ± 0.374mm in the depth of probing compared to the results obtained in the control group that was 0.558 ± 0.526 and 1,137 ± 0.222mm respectively. In the 3-month reevaluation, was also obtained great statistical significance between both groups for bleeding on probing (p<0.001), with values of 0.568 ± 0.282 for the control group and 0.480 ± 0.336 for the test group. The use of diode laser as an adjunctive therapy to the conventional treatment of peri-implant mucositis showed promising results, being more effective reducing the inflammation of the peri-implant tissue, positioning itself as a valuable tool for the treatment of peri-implant pathologies.
- Distraction osteogenesis in dog with a tooth-borne device : histological and histomorphometric analysis(2020) do Vale, Francisco-José-Fernandes; Francisco, Inês; Cavaleiro, João; Caramelo, Francisco; Guimarães, Adriana; Brochado, JoãoThe distraction osteogenesis (DO) is the biological process of new bone formation between the surfaces of bone segments gradually separated by incremental traction. However, the lack of solid experimental studies using the tooth-borne distractor does not allow comparing this technique with the classical procedures. This study aimed to establish the effect of two different activation protocols in new bone formation, with a new intraoral tooth-borne device for dog mandibular distraction osteogenesis. Nine beagle dogs were split into 3 similar groups, Group A the control, Group B subjected to two daily activations of 0.5 mm and Group C subjected to a single daily activation of 1 mm. The distraction period was 10 days followed by a 12 weeks consolidation period. Samples where then processed and embedded in methylmethacrylate and ground to a thickness of 20µm. Toluidine blue stains were done on all specimens and histological and histomorphometric evaluation of bone tissue formed within distraction gap was performed. The statistical analysis in this manuscript was performed with IBM®-SPSS® v.20 statistics software and R software version 3.1.0. The level of significance adopted was 5 % (?=0.05). No statistically significant difference was detected by histomorphometric evaluation between the two experimental groups in what concerns the bone volume. However, significant differences were found in the coefficients of variation between the medial and buccal areas, and the buccal and lingual areas. This study shows that the mandible can be lengthened successfully using a tooth-borne distractor. Moreover, it suggested that a decrease from once to twice-daily activations might negatively change the quality and structure of newly formed bone and prompt it to instability.
- A time based objective evaluation of the erosive effects of various beverages on enamel and cementum of deciduous and permanent teeth(2020) Rajeev, Gayathri; Lewis, Amita; Natarajan, SrikantErosion of the teeth is a chronic irreversible process leading to loss of surface enamel and even the dentin, in turn causing sensitivity and pain. Increased consumption of carbonated beverages remains a major cause for dental erosion. However, many of the so called safe beverages that are consumed may also have sufficiently low pH to cause dental erosion. One of the parameters to measure the dental erosion is estimation of hardness and surface roughness. Thus, this study aims to evaluate the difference in hardness and surface roughness of enamel and cementum using three beverages namely (carbonated drink, lime soda, lime juice) in deciduous and permanent teeth. Ten permanent and three deciduous teeth samples each were kept in lime juice, lime soda, carbonated beverage and tap water. The VHN using Vickers hardness tester and Ra value using surface profilometer were assessed at baseline, 1 day and 10 days. At the end of 10 days the decrease in hardness of enamel of permanent teeth was maximum for teeth immersed in carbonated beverage followed by lime soda and lime juice. However, in the deciduous teeth it was observed that the VHN drop was maximum at 1 day in relation to teeth immersed in carbonated beverage followed by lime juice and lime soda. The hardness of cementum decreased significantly at the end of ten days both in deciduous as well as permanent teeth. The present study shows that many of the most commonly used beverages like lime juice and lime soda have a sufficiently low pH to cause erosion of the enamel surface as well as that of cementum of both deciduous and permanent teeth. Though protective mechanisms do exist in the oral cavity to neutralize the acids present in these beverages, continuous usage of these beverages leads to irreversible damage to the tooth structure.
- Bone loss around narrow implants versus standard diameter implants : retrospective 2-years case-control study(2020) Corcuera Flores, José Ramón; Pérez Fierro, Manuel; Blanco Carrión, Andrés; Torres Lagares, Daniel; Castellanos Cosano, Lizett; Machuca-Portillo, GuillermoThe objectives were to evaluate the bone loss (BL) around narrow diameter implants (3.3 mm) 2 years after implant loading and compare with the bone loss around conventional-diameter implants (4.1 mm), as well as with clinical and anatomical variables. 2-years follow-up. Cases: 20 patients either gender-age, narrow implants (Straumann TM-SLA, diameter 3.3 mm); Control: 20 patients matching for gender-age, conventional implants (Straumann TM-SLA, diameter 4.1). Total 82 implants (31 narrow implants and 51 conventional implants) in 40 patients. To avoid statistical bias, a cluster of one implant per patient was randomly selected (20 narrow implants and 20 conventional implants). To evaluate changes resulting from bone loss around the implants, a total of 80 panoramic radiographs were taken of all 40 patients; the first panoramic image was taken at the time of implant loading and the second one 2 years later. Clinical and demographic variables were obtained from the patients? medical records. Statistical method: Spearman?s correlation coefficient, chi-squared (Haberman?s post hoc), Mann-Whitney U and Kruskal-Wallis tests. Statistical significance p< 0.05. No significant differences in bone loss around were found around narrow implants versus conventional implants. Differences linked to tobacco use were found after studying one implant per patient (p< 0.05). With the limitations of the present study, no significant differences in BL were found when comparing narrow implants with conventional implants after 2 years of implant loading. There were also no differences found when accounting for other demographic and clinical variables, with the exception of tobacco use.
