Oral complaints in progressive systemic sclerosis: two cases report

Progressive systemic sclerosis is a chronic sclerotic disease which causes diffuse, increased deposition of extracellular matrix in connective tissue with vascular abnormalities, resulting in tissue hypoxia. Aesthetic and facial dysfunction are followed by important oral and facial manifestation of disturbances such as xerostomia, the lack of saliva in the mouth, and its associated complications. Most clinical manifestations begin with tongue rigidity. The facial skin changes and bone resorption of mandible angle are often reported. Other systemic changes include the involvement of internal organs which leads to serious complications as well as disorders in the cardiac muscle and Raynaud's phenomenon. The objective of the this paper is to report two cases of systemic sclerosis in patients with oral and facial manifestations of the disease. A brief review of the literature, focusing on deontological alterations is also presented.     

Effects of the solvent evaporation technique on the degree of conversion of one-bottle adhesive systems

This study evaluated the effect of four methods of solvent evaporation on the degree of conversion (DC) of seven one-bottle adhesive systems: Excite (EX), ONE-STEP (OS), Optibond Solo Plus (OB), Prime&Bond 2.1 (PB), Prime&Bond NT (NT), Single Bond (SB) and Single Bond Plus (SP) using Fourier Transform Infrared Analysis (FTIR). Adhesive resins were: 1) applied to KBr pellet surfaces and left undisturbed for 30 seconds (condition 1), 2) left undisturbed for 30 seconds and air-dried with an air stream for 10 seconds (condition 2), 3) left undisturbed for 60 seconds (condition 3) and 4) left undisturbed for 60 seconds and air-dried for 10 seconds (condition 4) before curing. FTIR spectra were obtained and the DC was calculated by comparing the ratio of aliphatic/aromatic double carbon bonds before and after light-activation for 10 seconds (XL 3000, 3M). The results of each product were analyzed by one-way repeated measure ANOVA and post-hoc Tukey's test (p<0.05). The DC of PB, NT, OB and SP adhesives was not affected by the four evaporation conditions, while the DC of EX, OS and SB changed according to the evaporation method. The results suggested that the DC of some adhesives was similar regardless of the evaporation method when no water from dentin or rinsing was involved. Other bonding agents showed higher DC after specific conditions of solvent evaporation.     

The application of microscopic surgery in dentistry

The use of the microscope as a tool for practising Medicine, especially in surgical specialisations, has been established for decades. The microscope was first used in OdontologyDentistry back to the 1970s and 1980s, and was introduced more widely (although it was still far from being in general use) during 1990s. The purpose of this article is to describe the main applications of the microscope in OdontologyDentistry today, as well as providing odontologists and stomatologists, whether specialists or in general practice, with information about microscopic OdontologyDentistry for better patient care. This work also gives particular importance to matters needed to achieve the necessary manual dexterity to work in a magnified operating field using a surgical microscope (SM).     

Successful minimally invasive management of primary maxillary central incisors after lateral luxation: a case report

Lateral luxation in primary maxillary incisors is a traumatic injury that can lead to darkening of the tooth, pulp necrosis, root resorption, and damage to the permanent teeth. Management of this kind of trauma typically includes pulpectomy or extraction in cases of root resorption. However, in young children, removal of the tooth may be psychological stressing, especially for the parents, while increased mobility can make immediate endodontic treatment difficult to perform. This article outlines a severe palatal luxation on the maxillary right central incisor treated with conservative management in a 2-year-old boy. At the one-year follow-up appointment, the surrounding bone was healthy, the roots displayed physiological resorption, the crowns showed color improvement, and there was no radiographically noticeable damage to the permanent teeth.     

Fine needle aspiration biopsy in the oral cavity and head and neck region

The objective of the current study was to evaluate the sensitivity, specificity and accuracy of fine needle aspiration biopsy (FNAB) of submucous nodules from the oral cavity and head and neck region as an auxiliary diagnostic tool. Fifty patients with nodule lesions in the oral cavity and the head and neck region were selected. All of them were submitted to FNAB and to either incisional or excisional biopsy. The diagnoses from the FNABs were compared with the biopsy diagnosis as the gold standard. All the cases of FNAB were analyzed by a single oral pathologist prior to the biopsy diagnosis. The results showed that the sensitivity of FNAB was 75%, its specificity was 96% and its accuracy was 58.8%. The false positive and false negative rates were 6.7% and 13.3%, respectively. The positive predictive value was 86% and the negative predictive value was 93%. The inconclusive rate was 16/50. FNAB displayed a high success rate for identifying both malignant and benign lesions, but a low accuracy for making a final diagnosis.     

Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography

The purpose of this retrospective radiographic study was to analyze the thickness of the facial bone wall at teeth in the anterior maxilla based on cone beam computed tomography (CBCT) images, since this anatomical structure is important for the selection of an appropriate treatment approach in patients undergoing postextraction implant placement. A total of 125 CBCT scans met the inclusion criteria, resulting in a sample size of 498 teeth. The thickness of the facial bone wall in the respective sagittal scans was measured perpendicular to the long axis of the tooth at two locations: at the crest level (4 mm apical to the cementoenamel junction; MP1) and at the middle of the root (MP2). No existing bone wall was found in 25.7% of all teeth at MP1 and in 10.0% at MP2. The majority of the examined teeth exhibited a thin facial bone wall (< 1 mm; 62.9% at MP1, 80.1% at MP2). A thick bone wall (? 1 mm) was found in only 11.4% of all examined teeth at MP1 and 9.8% at MP2. There was a statistically significant decrease in facial bone wall thickness from the first premolars to the central incisors. The facial bone wall in the crestal area of teeth in the anterior maxilla was either missing or thin in roughly 90.0% of patients. Both a missing and thin facial wall require simultaneous contour augmentation at implant placement because of the well-documented bone resorption that occurs at a thin facial bone wall following tooth extraction. Consequently, radiographic analysis of the facial bone wall using CBCT prior to extraction is recommended for selection of the appropriate treatment approach.     

A possible mechanism of low molecular weight protein tyrosine phosphatase (LMW-PTP) activity modulation by glutathione action during human osteoblast differentiation

Objective

Low molecular weight protein tyrosine phosphatases (LMW-PTPs) are a family of enzymes strongly involved in the regulation of cell growth and differentiation. Since there is no information concerning the relationship between osteoblastic differentiation and LMW-PTP expression/activity, we investigated its involvement during human osteoblast-like cells (hFOB 1.19) differentiation. It is known that LMW-PTP is regulated by an elegant redox mechanism, so we also observed how the osteoblastic differentiation affected the reduced glutathione levels.

Design

hFOB 1.19 cells were cultured in DMEM/F12 up to 35 days. The osteoblast phenotype acquisition was monitored by measuring alkaline phosphatase activity and mineralized nodule formation by Von Kossa staining. LMW-PTP activity and expression were measured using the p-nitrophenylphosphate as substrate and Western blotting respectively. Crystal violet assay determined the cell number in each experimental point. Glutathione level was determined by both HPLC and DNTB assays.

Results

LMW-PTP modulation was coincident with the osteoblastic differentiation biomarkers, such as alkaline phosphatase activity and presence of nodules of mineralization in vitro. Likewise LMW-PTP, the reduced glutathione-dependent microenvironment was modulated during osteoblastic differentiation. During this process, LMW-PTP expression/activity, as well as alkaline phosphatase and glutathione increased progressively up to the 21st day (p < 0.001) of culturing, decreasing thereafter.

Conclusions

Our results clearly suggest that LMW-PTP expression/activity was rigorously modulated during osteoblastic differentiation, possibly in response to the redox status of the cells, since it seems to depend on suitable levels of reduced glutathione. In this way, we pointed out LMW-PTP as an important signaling molecule in osteoblast biology and bone formation.