Comparative therapeutic use of Risedronate and Calcarea phosphorica--allopathy versus homeopathy--in bone repair in castrated rats

Osteoporosis, a disease characterized by progressive bone loss, has been the target of several studies in the past few years. It results in a much higher risk for fractures and might cause slower bone lesion healing. The aim of this work was to study the effects of Risedronate (allopathic medicine) and Calcarea phosphorica 6CH (homeopathic medicine) on the repair of bone lesions in male rats with osteoporosis induced by castration. Eighty-four three-month-old rats were used divided into four groups of twenty-one animals each. Three groups where castrated and one group was submitted to Sham surgery. One month later, cortical lesions were made in all animals' tibiae and, after one day, the different experimental treatments began according to the following groups: CR--castrated/Risedronate (1 mg/kg/day); CCp--castrated/Calcarea phosphorica 6CH (3 drops/day); CP--castrated/placebo and SP--Sham/placebo. The animals were sacrificed at seven, fourteen and twenty-eight days after the beginning of the treatments and had their tibiae removed. Digital radiographs of the tibiae were taken and analyzed in order to evaluate the optical density of the defect area. Then, they were decalcified and processed for histological and histomorphometrical analysis. The data were submitted to ANOVA, and to the Tukey and Dunnett tests (5%). The allopathic and homeopathic treatments led to different bone formation as regards remodeling and maturation aspects. Further research is necessary to access the resistance and quality of the newly formed bone.     

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation

OBJECTIVE: The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. STUDY DESIGN: The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. RESULTS: The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CONCLUSION: CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.     

Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

Objectives

The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes.

Material and Methods

Pregnant patients during the 1^st and 2^nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG – "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% significance level.

Results

No significant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001), except for PI. Significant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001). The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02].

Conclusions

Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.     

Rhabdomyosarcoma of the oral tissues--two new cases and literature review

Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm consisting of cells derived from the primitive mesenchyme that exhibit a profound tendency to myogenesis. About 35% of RMS arises in the head and neck, being classified as parameningeal and non-orbital non-parameningeal forms. Parameningeal tumors carry the worst prognosis. The use of contemporary, multi-agent chemotherapy, radiotherapy, and surgery has made treatment of the disseminated disease possible, and has significantly improved overall survival from 25% in 1970 to 70% in 1991. Here, we present the management of two cases of orofacial RMS in adolescents: an 18-year-old, white female that had a 9-month history of a nodule in the left buccal mucosa, and a 19-year-old, white male who had been aware of a nodule in the left, posterior maxillary ridge with progressive growth for 4 months. Before final diagnosis, both cases were previously treated as inflammatory lesions. Their clinicopathological aspects, treatment, and poor survival as a consequence of delays in diagnosis are discussed.     

EFFECT OF CARBAMIDE PEROXIDE-BASED BLEACHING AGENTS CONTAINING FLUORIDE OR CALCIUM ON TENSILE STRENGTH OF HUMAN ENAMEL

Objective:

The aim of this study was to evaluate the effects of carbamide peroxide-based bleaching agents (CPG) containing fluoride (CF) or calcium (CCa) on the ultimate tensile strength of enamel (UTS).

Method:

A "cube-like" resin composite structure was built-up on the occlusal surface of twenty-two sound third molars to facilitate specimen preparation for the micro-tensile test. The restored teeth were serially sectioned in buccal-lingual direction in slices with approximate 0.7 mm thickness. Each slice was trimmed with a fine diamond bur to reduce the buccal, internal slope enamel of the cusps to a dumb-bell shape with a cross-sectional area at the "neck" of less than 0.5 mm². The samples were randomly divided into 12 groups (n=11). The control groups were not submitted to the bleaching regimen. Specimens were treated with 10% CPG gel or with 10% CPG formulations containing CF (0.2% and 0.5%) or CCa (0.05% and 0.2%). Bleached groups received the application of the 10% CPGs for 6 hours/day at 37° C, during 14 consecutive days and were stored in artificial saliva (AS) or 100% relative humidity (RH) among each application. After bleaching, specimens were tested with the microtensile method at 0.5 mm/min. Data were analyzed by two-way ANOVA and Tukey test (5%).

Results:

No significant difference was observed between groups stored in AS or RH. Specimens treated with CF or CCa presented similar UTS as unbleached control groups.

Conclusion:

Either 10% CPG formulations containing CF or CCa can preserve the UTS after bleaching regimen.     

Comparative study of chemical and mechanical retentive systems for bonding of indirect composite resin to commercially pure titanium

This study evaluated the effect of chemical and mechanical surface treatments for cast metal alloys on the bond strength of an indirect composite resin (Artglass) to commercially pure titanium (cpTi). Thirty cylindrical metal rods (3 mm diameter x 60 mm long) were cast in grade-1 cpTi and randomly assigned to 6 groups (n=5) according to the received surface treatment: sandblasting; chemical treatment; mechanical treatment - 0.4 mm beads; mechanical treatment - 0.6 mm beads; chemical/mechanical treatment - 0.4 mm; and chemical/mechanical treatment - 0.6 mm beads. Artglass rings (6.0 mm diameter x 2.0 mm thick) were light cured around the cpTi rods, according manufacturer's specifications. The specimens were invested in hard gypsum and their bond strength (in MPa) to the rods was measured at fracture with a universal testing machine at a crosshead speed of 2.0 mm/min and 500 kgf load cell. Data were analyzed statistically by one-way ANOVA and Tukey test (a=5%). The surface treatments differed significantly from each other (p<0.05) regarding the recorded bond strengths. Chemical retention and sandblasting showed statistically similar results to each other (p=0.139) and both had significantly lower bond strengths (p<0.05) than the other treatments. In conclusion, mechanical retention, either associated or not to chemical treatment, provided higher bond strength of the indirect composite resin to cpTi.     

Short-term clinical and immunologic effects of scaling and root planing with Er:YAG laser in chronic periodontitis

BACKGROUND: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis. METHODS: Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P <0.05). RESULTS: Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P <0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P <0.05); and BOP decreased for SRPL, L, and SRP groups (P <0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P <0.05). PD decreased in treated groups (P <0.001), and differences were found between SRPL and C groups (P <0.05). CAL gain was significant only for the SRP group (P <0.01). GR increased for SRPL and L groups (P <0.05). No difference in IL-1beta was detected among groups and periods. CONCLUSION: Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.     

Pediatric oral lesions: a 15-year review from São Paulo,Brazil

There are few studies on pediatric oral pathologies in the literature. This study presents data from a review of 2,356 biopsies of young patients (birth to 14 years) received over 15 years (1985-2000) in the Oral Pathology Service at the University of Sao Paulo, Brazil. Information about patients (sex, age, race) and histopathological diagnosis was retrieved. Diagnosis data of 2,356 biopsies were classified into 20 groups. There was no significant difference between male (50.0%) and female (49.0%) patients. White is the predominant race (69.0%), and patients ages were concentrated between 9 and 14 years old (70%). Mucocele was the most frequent (13.5%), followed by dentigerous cyst (6.5%) and fibrous hyperplasia (5.4%). Papilloma and Langerhans cells histiocytosis were the most common non-odontogenic benign and malignant tumors, respectively. In the group of odontogenic tumors, odontoma was the most frequent, and ameloblastoma had a significant incidence (27 cases). These data are important in order to detect differences in geographic areas, diagnosis line tendencies and for clinicians to perform judgment to evaluate of the pediatric patients before the biopsy and management of pediatric oral lesions.     

Preliminary clinical reports of a novel night-guard tooth bleaching technique modified by casein phosphopeptide-amorphous calcium phosphate (CCP-ACP)

Although supervised night-guard bleaching has proved successful for whitening teeth, both mineral loss and tooth sensitivity are still common problems. The present study introduces a novel remineralizer as well as describes the utilization of a possibly low sensitivity supervised night-guard vital tooth bleaching technique. A 22% carbamide peroxide gel was mixed with the casein phosphopeptide-amorphous calcium phosphate-containing MI Paste. The peroxide/MI Paste mixture was prepared with 1 ml of each material until obtaining a homogeneous paste. Five patients were instructed to follow a home bleaching protocol for 3 weeks. The outcome was assessed visually with a Vitapan scale. All subjects presented reduction of at least two Vitapan scale units after bleaching and no sensitivity was reported. The concomitant use of MI Paste and peroxide might not affect the gel effectiveness and still reduce hypersensitivity levels.