USE OF DIAGNODENT? FOR DIAGNOSIS OF NON-CAVITATED OCCLUSALDENTIN CARIES

The purpose of this study was to evaluate the use of a laser fluorescence device for detection of occlusal caries in permanent teeth. One hundred and ninety-nine non-cavitated teeth from 26 patients aged 10 to 13 years were selected. After dental prophylaxis, two previously calibrated dentists examined the teeth. Visual inspection, radiographic examination and laser measurements were performed under standardized conditions. The validation method was cavity preparation with a small cone-shaped diamond bur, when the two examiners agreed about the presence of dentin caries. It was found that the laser detection method produced high values of sensitivity (0.93) and specificity (0.75) and a moderate positive predictive value (0.63). The laser device showed the lowest value of likelihood ratio (3.68). Kappa coefficient showed good repeatability for all methods. Although the laser device had an acceptable performance, this equipment should be used as an adjunct method to visual inspection to avoid false positive results.     

Q289P mutation in FGFR2 gene causes Saethre-Chotzen syndrome: some considerations about familial heterogeneity.

OBJECTIVE: To describe the first report on a three-generation family presenting typical features of Saethre-Chotzen syndrome, in which the Q289P mutation in the FGFR2 gene was detected. DESIGN: Dysmorphological evaluation was performed by a clinical geneticist. Direct sequencing of the polymerase chain reaction-amplified coding region of TWIST and screening for the P250R mutation in the FGFR3 gene were performed. Exons IIIa and IIIc of FGFR2 were sequenced also. The mutation was confirmed by both restriction-enzyme digestion and allelic-specific polymerase chain reaction. RESULTS: Neither TWIST gene analysis nor analysis of the P250R mutation on gene FGFR3 showed mutation within the coding sequence. A nucleotide change from CAG to CCG in exon IIIa of the FGFR2 gene that caused a Q289P mutation was detected, although exon IIIc in the propositus was normal. These same results were detected in his mother, but no other members of the kindred presented clinical features consistent with Saethre-Chotzen syndrome. CONCLUSIONS: This mutation was previously reported in individuals with Crouzon and Jackson-Weiss syndromes. The FGFR2 mutation in the family with Saethre-Chotzen syndrome herein reported reinforces the idea of an interaction among TWIST and FGFR genes during development. Absence of the Q289P mutation in some affected individuals in this family is discussed.     

Contact stomatitis due to palladium in dental alloys: a clinical report

A patient was treated with a maxillary gold-palladium alloy fixed partial denture (FPD). Shortly after placement, the patient contracted severe contact mucositis. Patch-testing revealed a positive reaction to palladium chloride (PdCl 2 , 1% petrolatum) but not to any other component of the prosthesis. After removal of the FPD and placement of a provisional acrylic resin restoration, all signs and symptoms disappeared. A definitive metal-ceramic (titanium-porcelain) prosthesis was placed, and no signs of lesions appeared. This clinical report demonstrates that titanium may be a satisfactory alternative for patients who require prostheses and are sensitive to other metals.     

Transcervical submandibular sialoadenectomy

The submandibular glands are subject to several pathologies that require excision. The most common problem that affects these salivary glands is sialadenitis combined with sialolithiasis. This problem occurs in the submandibular gland 10 times more frequently than it does in the parotid gland. Other illnesses frequently involving the submandibular glands are represented by sialadenosis and benign, malign, and intermediate neoplasms.Diagnosis of any disturbance in the submandibular gland involves both a clinical and instrumental (echography, traditional radiography [ortopantomography] and eventually computed tomography (CT) or magnetic resonance imaging) assessment. Surgery is the usual method of treatment of both chronic sialadenitis and neoplasms in the submandibular gland. A submandibular gland surgical approach can be cervical, intraoral, or endoscopic.The authors present their clinical experience with a total of 40 patients with illnesses involving the submandibular gland treated with submandibular gland excision by a transcervical approach. Their experience suggests that this approach entails a relatively simple procedure, involves low risks for the nerve structure around the gland, permits wide resection margins for neoplasms, and incurs little aesthetic damage.     

Smile reconstruction through bilateral muscular transplants neurotized by hypoglossal nerves

Free transplant of gracilis muscle is the criterion-standard technique in dynamic rehabilitation of long-standing facial paralysis in which the facial musculature is atrophied. When the facial nerve is not available because of a bilateral lesion, other sources are the masseteric, hypoglossal, or accessory nerves. Although the use of hypoglossal nerve has been relegated to the background because of the morbidity caused by its loss, there are special situations in which the hypoglossal nerve should be considered the first option as donor motor nerve. The present article discusses the case of a patient with dynamic reanimation of bilateral facial paralysis with free-muscle transfer neurotized to the hypoglossal nerve. End-to-side coaptation of gracilis motor nerve and hypoglossal motor nerve allows neurotization of the transplanted muscle with minimum repercussion in speech or swallowing and can provide an adequate spontaneous smile with time.     

Nonsurgical endodontic management using MTA for perforative defect of internal root resorption: report of a long term follow-up

Internal root resorption is an uncommon lesion following a dental injury. The use of mineral trioxide aggregate (MTA) is a conservative approach to repair lesions with periodontal communication. This case report presents a long-term follow-up of a nonsurgical endodontic management using MTA for perforative defect of internal root resorption. During the endodontic treatment, the granulation tissue was removed and the root canal prepared. Calcium hydroxide was placed as a temporary dressing for 30 days. After this period, the root canal space and the perforation defect were filled with MTA. The clinical findings and periapical radiographs indicated success of treatment until 2 years of follow-up. However, the radiograph after 8 years showed an extensive radiolucent area in the middle third of the root with separation of the apical and coronal root segments. These findings were observed more accurately by using cone-beam computerized tomography.     

The genetics of amelogenesis imperfecta: a review of the literature

A melogenesis imperfecta (AI) is a group of inherited defects of dental enamel formation that show both clinical and genetic heterogeneity. Enamel findings in AI are highly variable, ranging from deficient enamel formation to defects in the mineral and protein content. Enamel formation requires the expression of multiple genes that transcribes matrix proteins and proteinases needed to control the complex process of crystal growth and mineralization. The AI phenotypes depend on the specific gene involved, the location and type of mutation, and the corresponding putative change at the protein level. Different inheritance patterns such as X-linked, autosomal dominant and autosomal recessive types have been reported. Mutations in the amelogenin, enamelin, and kallikrein-4 genes have been demonstrated to result in different types of AI and a number of other genes critical to enamel formation have been identified and proposed as candidates for AI. The aim of this article was to present an evaluation of the literature regarding role of proteins and proteinases important to enamel formation and mutation associated with AI.     

Human peri-implant bone response to turned and oxidized titanium implants inserted and retrieved after 2 months

PURPOSE: The aim of this study was to evaluate the influence of oxidized surface on bone-to-implant contact percentage (BIC%) as well as the bone density within the threads area (BD%) in human bone after 2 months of unloaded healing. MATERIALS: Seven subjects (mean age 45.57 +/- 10.45 years) received 2 micro-implants each during conventional implant surgery in the posterior maxilla. The implants that presented turned and oxidized surfaces served as control and test, respectively. After the healing period, the implants and the surrounding tissue were removed and prepared for ground sectioning and analysis. RESULTS: Two turned implants were found to be clinically unstable at the time of retrieval. Histometric evaluation showed that the mean of BIC% was 17.40 +/- 14.16% and 32.19 +/- 15.68% to turned and oxidized surfaces, respectively. The BD% was 22.13 +/- 19.06% for turned surface and 50.40 +/- 18.35% for oxidized surface. CONCLUSION: The histologic data from this preliminary study suggest that the oxidized micro-implants surface presented better mean values of BIC% and BD% than turned micro-implants after a short healing time.     

Tooth loss and subluxation in the primary dentition: a twelve-year follow-up case report

The case of a five-year-old child is reported, who suffered dento-alveolar injury including subluxation of the right upper lateral incisor and avulsion of the upper central incisors and left upper lateral incisor and laceration in the mucosa. The case was followed for 12 years until complete root formation and alignment of the anterior permanent teeth.     

Peripheral osteoma of the mandible: case report and review of the literature.

BACKGROUND: Osteoma is a benign often asymptomatic neoplasm, consisting of well-differentiated mature bone. This paper reports a case of peripheral osteoma located in the anterior mandibular region and provides a review of the literature about this lesion in the jaws. PATIENT AND METHODS: A 43-year-old white woman presented with a swelling in the left mandible of 7 years duration. The English literature was reviewed over the past 76 years and data about location, histopathology and number of the peripheral osteomas, sex, and age of the patients were evaluated. RESULTS: Data analysis showed 69 well-documented cases of peripheral osteoma. Peripheral osteomas are more frequent in the mandible than the maxilla and the cancellous type was most frequent; males and females are equally affected in the mandible; the age range was 9-85 years. CONCLUSION: The peripheral type of osteoma is most common in the lower jaws, occurs at the surface of the cortical bone and is sessile or pedicled.