Comparative evaluation of two different vestibuloplasty surgical procedures in cleft patients: a pilot study.

OBJECTIVE: Patients with a cleft lip or palate often present alterations in the labial aspect of the ridge, resulting in a shallow vestibule. This study compares the results of two different surgical procedures on deepening of the labial sulcus. INTERVENTIONS: Ten patients with a cleft lip and palate were separated into two groups and underwent different vestibuloplasty procedures. An experimental group used a removable retention splint. Preoperative and 4-month postoperative sulcus heights were measured and analyzed statistically. RESULTS: No statistically significant differences could be detected between groups. CONCLUSION: The results indicated that to reach consistent results, a larger number of patients must be submitted to this evaluation.     

Distribution of plaque and gingivitis and associated factors in 3- to 5-year-old Brazilian children

This cross-sectional study investigated the distribution of plaque and gingivitis and its association with demographic, socioeconomic, and orthodontic variables (spacing in anterior teeth, anterior open bite, and crossbite), and visible plaque level (low, medium, high) in Brazilian preschoolers. The sample comprised 490 3- to 5-year-old children from nursery schools in Canoas, a city in southern Brazil. One single, trained observer examined children's oral cavities and determined visible plaque index (VPI) and gingival bleeding index (GBI). Results showed that 99% of the children had visible plaque and 77% had gingivitis (GBI>0). A positive (r(s)=0.32) and significant correlation was found between VPI and GBI. VPI and GBI were significantly higher in posterior teeth and buccal and lingual surfaces. VPI was significantly higher in boys, children of low-income families, and without spacing in maxillary anterior teeth. Gingivitis was associated with absence of spacing in maxillary anterior teeth and plaque level. The most prevalent areas of plaque and gingivitis identified in this study should be taken in consideration during oral hygiene instructions, which should be given to children and mothers-particularly those with a low socioeconomic status--to motivate self-care and prevent gingivitis.     

Gingival fibrous hamartoma associated with natal teeth

A variety of gingival enlargements can occur in children, but they are rarely observed in the infant. The aim of this study is to present a case of a ten-month old male patient, with an anterior mandibular hamartoma associated to natal teeth, and to describe the clinical and histological characteristics of this anomaly and the treatment performed.     

Oral lichen planus: a clinical and morphometric study of oral lesions in relation to clinical presentation

Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as reticular or atrophic-erosive. Sixty-two OLP patients were studied to evaluate the clinical-pathologic characteristics of their OLP lesions and to investigate possible differences in their biological behavior. The most common clinical presentation was the reticular type (62.9% vs 37.1%). Atrophic-erosive presentations showed significantly longer evolution (chi square=4.454; p=0.049), more extensive lesions (chi square=16.211; p=0.000) and more sites affected than reticular ones (chi square=10.048; p=0.002). Atrophic-erosive OLP was more frequently found on the tongue, gingiva and floor of the mouth. No statistically significant differences could be identified between reticular and atrophic-erosive clinical presentations in terms of age, sex, tobacco habit, plasma cortisol level and depth of inflammatory infiltrate. We concluded that the classification of OLP lesions as reticular vs atrophic-erosive is a simple, easy to use classification that can identify clinical presentations with different biological behavior.     

Clinical evaluation of ceramic inlays and onlays made with two systems: a one-year follow-up

PURPOSE: The aim of this study was to evaluate the clinical performance of ceramic inlays and onlays made with two systems: sintered (Duceram [D], DeguDent) and pressable (IPS Empress [IPS], Ivoclar-Vivadent) after 1 year. MATERIALS AND METHODS: Seventy-four restorations - 37 IPS and 37 D - were cemented in 34 patients. Twenty-four premolars and 50 molars received Class II cavity preparations, totaling 28 onlays and 46 inlays. The restorations were evaluated by two independent investigators at baseline, 6 months, and 1 year, according to modified USPHS criteria. Fisher and McNemar statistical tests were employed to assess the survival rate. RESULTS: After one year, 100% of the restorations were assessed and all the restorations were considered clinically excellent or acceptable. Among the analyzed criteria, only the following received "Bravo" ratings: marginal discoloration: IPS (24.32%), D (13.51%); marginal integrity: IPS (10.81%), D (8.11%); color match: IPS (5.41%), D (5.41%); surface texture: IPS (2.70%), D (10.81%). No "Charlie" or "Delta" scores were given to the restorations. CONCLUSION: Among the analyzed criteria, only marginal discoloration differed statistically significantly from the results of the baseline examination for IPS Empress ceramic restorations (p = 0.008). No significant differences were found between the two ceramics. The two ceramic systems demonstrated excellent clinical performance after a period of 1 year.     

Endodontic therapy associated with calcium hydroxide as an intracanal dressing: microbiologic evaluation by the checkerboard DNA-DNA hybridization technique

This study evaluated the predominant microbiota of infected necrotic pulps and the effects of calcium hydroxide therapy on these microorganisms by the checkerboard DNA-DNA hybridization technique. Conventional endodontic therapy associated with calcium hydroxide as intracanal dressing was performed in 12 single-rooted teeth with pulp necrosis and periradicular bone lesion. Samples were collected from the canal at baseline and 14 days after therapy, and the presence of 44 bacterial species was determined by the checkerboard method. Significant differences in the microbiota from baseline to post-therapy were sought by the paired-samples t test. The most prevalent species included F. nucleatum ss. vincentii, C. sputigena, C. ochracea, S. constellatus, V. parvula, P. gingivalis, P. melaninogenica, and S. sanguis. Most of the microorganisms were reduced after treatment, particularly A. gerencseriae, A. israelii, A. naeslundii, C. gingivalis, C. ochracea, P. gingivalis, S. noxia, S. sanguis, and S. oralis (p < 0.05). Conversely, A. actinomycetemcomitans, C. sputigena, and E. corrodens increased in numbers after therapy. These results indicate that conventional endodontic therapy with calcium hydroxide results in the reduction of pathogenic species associated with pulp necrosis. However, its use is limited, because it did not eliminate the whole spectrum of microorganisms.     

Comparative study of retentive anchor systems for overdentures.

OBJECTIVES: This study aimed to evaluate the retention on two or four implants of eight resilient and nonresilient retentive anchors used in overdentures. METHOD AND MATERIALS: Eight groups of retentive anchors were used: Dyna and Shiner (magnets); Dalla Bona and O-Ring (balls); Ceka Revax and Zaag attachments (studs); the cast bar (Dolder type) system with plastic clips; and the milled bars system. These specimens with their respective overdentures were prepared on two similar acrylic resin models with four implants (3.75 x 13 mm). Ten tensile strength tests (Instron) were performed on each group at a speed of 3 mm per minute. The statistical analysis (one-way analysis of variance, Tukey's HSD test) was considered significant. RESULTS: The pull force values ranged between 0.400 and 3.800 daN (International System of Units). There was a significant difference in retention in favor of the milled bars in comparison with the Ceka Revax, Hader bars, Zaag attachments, O-Ring, and Dyna groups, and a marginally significant difference compared with the Dalla Bona group. There was a highly significant difference with the Shiner magnets. CONCLUSION: The milled bar system was the most retentive anchor, with the Dalla Bona, Ceka Revax, Hader Bar, Zaag attachment, and O-Ring groups being the second most retentive. The least retentive groups were the Shiner and Dyna magnets. Proper abutment placement in the mandible and the correct selection of the retentive anchor will improve overdenture retention.     

Surgical and clinical management of a patient with Glanzmann thrombasthenia: a case report.

A 6-year-old girl with Glanzmann thrombasthenia presented with caries and periapical lesions in the primary mandibular second molars and moderate gingivitis of the maxillary and mandibular anterior teeth. Dental extraction was recommended, and before every surgical intervention, the patient underwent platelet-concentrate transfusion to prevent hemorrhage. Epsilon aminocaproic acid was administered 6 hours before, and 48 hours after every dental procedure to prevent bleeding. In this case, treatment was effective in the prevention of hemorrhagic complications, during the required dental procedures.     

A comparison between cutting torque and resonance frequency in the assessment of primary stability and final torque capacity of standard and TiUnite single-tooth implants under immediate loading

PURPOSE: In this study, standard Br?nemark System implants and Br?nemark TiUnite implants were evaluated regarding primary stability and placement torque. The correlation between placement torque and primary stability as well as the influence of implant design on placement torque and primary stability were examined. MATERIALS AND METHODS: Twelve patients who presented bilateral loss of either maxillary lateral incisors or premolars were treated with 24 immediately loaded dental implants. Each patient received 1 standard 3.75 x 13-mm Br?nemark System implant and one 3.75 x 13-mm TiUnite Mk III implant. One at a time, each implant was connected by a transducer to an Osstell machine that automatically translated a resonance frequency value for the implant into an implant stability quotient value. Osseocare equipment was used to measure the placement torque for both types of implants. RESULTS: Statistical analysis showed higher mean values for standard implants in relation to placement torque and resonance frequency values. DISCUSSION: There was no overall correlation between placement torque and resonance frequency values; this finding supported previous studies. CONCLUSION: Stability was shown to be higher for the standard implants. Mean values of torque resistance were higher for the standard implants than for the TiUnite implants. Implant design appeared to influence primary stability and placement torque.     

A school-based oral health educational program: the experience of Maringa- PR, Brazil

The main purpose of this study was to evaluate the preliminary results of a school-based oral health educational strategy adopted in public primary schools from the city of Maringa, State of Parana, Brazil. The study sample was composed by 556 children and adolescents aged 6 to 17 years old, 124 schoolteachers and a group of 55 mothers. The educational approach was implemented for 18 months and consisted of reinforcements of interventions addressed to students and schoolteachers at school level and few activities targeted at the mothers, performed by means of home visits. Baseline and follow-up interviews focused on oral health care were undertaken for the entire study population. As a stimulus for the students to achieve proper oral hygiene habits, the simplified oral hygiene index was assessed at three different moments. A statistically significant improvement in their oral hygiene index (p<0.001) was recorded. The results achieved suggest an encouraging tendency towards the improvement in the levels of oral health care among the school-age youths studied. They also point out the need of intensifying the preparation of schoolteachers in oral health topics, as well the instructions to the mothers for their oral health care. Moreover, they highlight the importance of the continuous implementation of school-based programs to promote the oral health.