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Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

Objectives Mandibular advancement device therapy is effectively used in the treatment of obstructive sleep apnea, but also several side effects in the masticatory system have been reported. The aim of this study was to evaluate the subjective symptoms and clinical signs of temporomandibular disorders connected to mandibular advancement device therapy. Material and Methods The material consisted of 15 patients (9 men and 6 women, mean age 51.1 years, range 21 to 70 years) diagnosed with obstructive sleep apnea (OSA). Subjective symptoms and clinical temporomandibular disorders (TMD) signs were recorded at the beginning of the treatment (baseline) and at 1-month, 3-month, 6-month and 24-month follow-ups. The degree of TMD was assessed using the anamnestic (Ai) and the clinical dysfunction index (Di) of Helkimo. For assessing the effect of TMD the patients were divided in discontinuing and continuing groups. Results According to Ai and Di, the severity of TMD remained unchanged during the follow-up in most of the patients. Temporomandibular joint (TMJ) crepitation was found more frequently in discontinuing patients at all follow-ups. The difference was statistically significant (P < 0.05) at the six-month follow-up. Masticatory muscle pain during palpation was a frequent clinical sign at the baseline and during the follow-up period but the difference between discontinuing and continuing patients was not significant. Conclusions It seems that signs and symptoms of temporomandibular disorders do not necessarily increase during long-term mandibular advancement device therapy. However, it seems that patients with clinically assessed temporomandibular joint crepitation may discontinue their mandibular advancement device therapy due to temporomandibular disorders.

Objectives The purpose of this study was to develop and validate the mouthwash use questionnaire to determine the lifetime exposure to alcohol from mouthwash and verify that it was suitable for use in general population. Material and Methods Data were available from three consecutive studies, all collecting information on mouthwash use. In addition, supermarkets and online stores were screened for the brands of mouthwash they sold. Alcohol content of mouthwash was identified from various sources, including laboratory measurements. Alcohol-containing mouthwash use was converted to glasses of wine equivalent. Results Mouthwash was used by 62% of the participants, and the main benefits reported were refreshment of bad breath (75%), elimination of bacteria (68%) and reduction of plaque formation (47%). Majority mouthwashes used by the participants contained alcohol (61%). Life-time exposure from alcohol in mouthwash was relatively small for most of the study participants: 79% had rinsed for less than one year with alcohol equivalent of one glass of wine per day. There was substantial agreement in mouthwash reporting between different occasions (Kappa > 0.62). Conclusions The questionnaire can be used to investigate mouthwash use in the general population and to measure alcohol intake from mouthwash.

Objectives The aim of this study was to assess the clinical outcomes achieved with Computer-Assisted Design/Computer-Assisted Manufacturing implant abutments in the anterior maxilla. Material and Methods Nineteen patients with a mean age of 41 (range form 26 to 63) years, treated with 21 single tooth implants and 21 Computer-Assisted Design/Computer-Assisted Manufacturing (CAD/CAM) abutments in the anterior maxillary region were included in this study. The patients followed 4 criteria of inclusion: (1) had a single-tooth implant in the anterior maxilla, (2) had a CAD/CAM abutment, (3) had a contralateral natural tooth, (4) the implant was restored and in function for at least 6 months up to 2 years. Cases without contact point were excluded. Presence/absence of the interproximal papilla, inter tooth-implant distance (ITD) and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB) were accessed. Results Forty interproximal spaces were evaluated, with an average mesial CPB of 5.65 (SD 1.65) mm and distal CPB of 4.65 (SD 1.98) mm. An average mesial ITD of 2.49 (SD 0.69) mm and an average distal ITD of 1.89 (SD 0.63) mm were achieved. Papilla was present in all the interproximal spaces accessed. Conclusions The restoration of dental implants using CAD/CAM abutments is a predictable treatment with improved aesthetic results. These type of abutments seem to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration teeth relation.

Objectives To evaluate the amount and nature of adult facial trauma in Aberdeen, Scotland's third largest city, that requires referral to Aberdeen Royal Infirmary oral and maxillofacial surgery department by the Emergency Department and Grampian's telemedicine service over a six month period. Material and Methods A retrospective audit using oral and maxillofacial surgery trauma clinic and theatre records to identify Emergency Department (ED) notes for those patients presenting with facial trauma. ED notes were examined to extract demographic data on each patient as well as information on the nature and outcomes of the facial trauma. This data was compared with previously published national and international statistics. Results 137 patients were identified with a mean age of 33.7 years with a standard deviation of 16.7. 83.2% of facial trauma victims were male and 62% of facial injuries were caused by alleged assault. Only 1 patient was referred to Aberdeen Royal Infirmary by telemedicine. Conclusions Aberdeen has a high number of injuries caused by interpersonal violence. Telemedicine is an underused resource in the referral and review of facial trauma at Aberdeen Royal Infirmary.

Objectives The purpose of the present study was to translate and perform a cross-cultural adaptation of Manchester Orofacial Pain Disability Scale to the Portuguese language. Material and Methods A synthesis of two independent translations done by bilingual translators whose mother tongue was the Portuguese language began the process of translation. From the synthesis of the translated version and totally blind to the original version, two different non-native English language teachers without dental knowledge translated the questionnaire back to English. The pre-final version was done by an Expert committee: the researchers, two other non-native English language teachers and one native English language speaker. The new questionnaire was then piloted among 8 patients from the target setting that were interviewed to probe it on their perceived meaning of each question. The Manchester Orofacial Pain Disability Scale (MOPDS) thus translated was called Brasil-MOPDS and was validated in 50 patients with Orofacial pain from TMJ and Occlusion clinic ambulatory of São Paulo University School of Dentistry. The Brasil-MOPDS was administered twice by an interviewer (15 - 20 day interval) and once by a second independent interviewer. The Brazilian version of the short form oral health impact profile (OHIP-14) questionnaire and the visual analogue pain scale (VAS) were applied on the same day. Results Internal consistency (Cronbach's α = 0.9), inter-observer (ICC = 0.92) and intra-observer (ICC = 0.98) correlations presented high scores. Validity of Brasil-MOPDS compared to OHIP-14 (r = 0.85) and VAS (r = 0.75) shown high correlations. Conclusions Brasil-MOPDS was successfully translated and adapted to be applied to Brazilian patients, with satisfactory internal and external reliability.

Objectives There is alarming rise in number of people with diabetes mellitus over these years. If glucose in saliva is linked to glucose in blood it can be used to detect diabetes mellitus at an early stage. The present study is undertaken with the aim to assess the correlation of salivary glucose level with blood glucose level in people with diabetes mellitus. Material and Methods For investigations, 2 sets of samples of people with diabetes and the age and sex matched non-diabetic subjects were recruited. The salivary glucose was analyzed in unstimulated whole saliva samples using glucose oxidase method. Pearson's correlation coefficient test was applied to assess the correlation between salivary glucose level and blood glucose level. Results The significant (P < 0.05) positive correlation of salivary glucose level and fasting blood glucose level was observed in people with uncontrolled diabetes in both the sets of samples. Conclusions Although study suggests some potential for saliva as a marker in monitoring of diabetes mellitus, there are many aspects that need clarification before we reach to a conclusion.

Objectives To compare cleft lip and palate patients' satisfaction with aesthetics and functional parameters after conventional advancement of the maxilla or by the use of distraction osteogenesis. Material and methods Case series observational study. Group of distraction osteogenesis (DO) consisted of 15 patients treated with distraction osteogenesis while group conventional (CONV) included 10 patients treated with traditional advancement of the maxilla. Patients were asked to fill out a questionnaire about their subjective evaluation of satisfaction with facial aesthetics and functional parameters on a continuous visual analog-scale (VAS) when the treatment was finished. Results The total response rate was 76%. Preoperatively the two groups did not differ significantly according to group characteristics. At follow-up both groups were satisfied with aesthetics and functional parameters. The DO group was less satisfied with the duration of the treatment than the CONV group. There were no statistically significant differences among the groups regarding functional parameters or facial aesthetics. Conclusions Cleft lip and palate patients experienced a high level of satisfaction with functional parameters and aesthetics as a result of surgical maxillary advancement. The patients treated with distraction osteogenesis were less satisfied with the duration of the treatment. Further studies are needed.

Objectives The aim of this study is to compare two commercially available screw-type sandblasted and acid-etched (SLA) Ti implant systems from Eckermann Laboratorium S.L., with similar geometry and distinct microtopography, regarding surface properties and osteoblastic cytocompatibility. Material and Methods Implant I (referred as a conventional SLA system) and Implant II (a system patented as Eckcyte®) were characterized for macro and microtopograpphy, surface roughness and chemical composition. For the cytocompatibility studies, human bone marrow osteoblastic cells were seeded over the implants' surface, and the cell response was assessed for cell adhesion and proliferation, alkaline phosphatase (ALP) activity and matrix mineralization. Results Implant I presented a rough surface with irregularly shaped and sized cavities among flatter-appearing areas, whereas Implant II exhibited a homogeneous rough microporous surface. Compared to Implant I, Implant II presented higher Ra values (0.8 [SD 0.008] μm and 1.21 [SD 0.15] μm, respectively, P < 0.05) and also increased values of Rz, Rt and Rsm, a more negative value of Rsk, and similar RKu values. XPS showed the expected presence of Ti, O, C and N; Al, Si, F, P and Ca were detected in low concentrations. Implant II exhibited significantly lower Al levels. Both implants supported the adhesion, proliferation and differentiation of osteoblastic cells. Implant II showed a thicker fibrilar cell layer and an earlier onset and more abundant matrix mineralization. Conclusions The homogeneous rough and microporous surface of Implant II is most probably a main contributor for its improved cell response.

Objectives Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Material and Methods Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS) confirmed by polysomnography in whom ODI-4 (oxygen desaturation index) was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS) as initial therapy. Results In the group A mean ODI-4 was 17.8 (SD 12) before treatment and 3.5 (SD 3.4) at 5-year follow-up (P = 0.018 in paired differences t-test). In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6) to 96.3% (SD 2), P = 0.115 and in group B from 96.3% (SD 1.2) to 97.8% (SD 1.7), P = 0.056 (in paired differences t-test). The static charge sensitive bed evaluation showed improvement in all patients except one. Conclusions Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.

Objectives The iliac crest is the standard site for harvesting bone; however, this procedure may require another specialist and a general anaesthetic. The proximal tibial bone harvest has gained popularity for harvesting autogenous bone. An analysis of the clinical literature regarding the various regions for harvesting bone demonstrates that the use of the proximal tibia led to shorter hospital stays, lower morbidity rates, and a shorter learning curve for the surgeon. The purpose of this study was to analyze the clinical anatomy of a proximal tibial bone harvest graft to provide the anatomical architecture supporting a safe procedure. Materials and Methods Dissection of 58 lower limbs from embalmed cadavers was conducted to determine the anatomy of a proximal tibial bone harvest (PTBH). Results Dissection revealed that the medial approach has fewer clinically relevant neurovascular structures in harms way, and a larger surface area, providing the clinician a confident surgical window to perform the procedure. Conclusions The anatomical basis of this study suggests that the medial proximal tibial bone harvest approach would have fewer serious structures in harm's way compared to the lateral; however, the lateral approach may be preferred for a subgroup of patients.

Objectives To assess the efficacy and safety of rebamipide in preventing chemoradiotherapy-induced oral mucositis in patients with oral cancer. Material and Methods Patients with oral cancer treated with chemoradiotherapy (daily radiotherapy plus docetaxel hydrate once a week) were enrolled for this study. They were assigned in a double-blind fashion to receive either rebamipide gargle or placebo on the days of chemoradiotherapy. Oral mucositis was assessed using the WHO grading system. The primary endpoint of this study was the incidence of grade 3 - 4 mucositis after exposure to 40 Gy radiation (4 weeks). The secondary endpoint was the effect of rebamipide gargle on tumour response to chemoradiotherapy. Results Twenty-four patients were randomly assigned to receive rebamipide gargle (n = 12) or placebo-gargle (n = 12) during chemoradiotherapy. The number of patients with severe mucositis (WHO ≥ 3) was higher in the placebo group than in the rebamipide group (83.3% vs. 33.3%, P = 0.036). In addition, no effect of rebamipide gargle on tumour response to chemoradiotherapy was recognized compared with the placebo group. Conclusions For patients with oral cancer undergoing chemoradiotherapy, rebamipide gargle may contribute to decrease the severity of oral mucositis.

Objectives Implant placement in molar extraction sockets can be difficult due to complex multi-root anatomy and the lack of predictable primary stability. The aim of this study was to evaluate the outcome of an 8 - 9 mm diameter tapered implant, designed to be placed in molar extraction sockets. Material and methods Patients treated at least 1 year before with a Max® implant (Southern Implants, Irene, South Africa) were invited for a clinical examination. Variables collected were surgical and prosthetic protocol, implant dimension and smoking habits. Peri-implant bone level was determined on peri-apical radiographs and compared to baseline, being implant insertion. Results 98 implants had been placed in 89 patients. One implant had failed. Thirty eight patients representing 47 implants (maxilla 26, mandible 21) were available for clinical examination. Mean bone loss was 0.38 mm (SD 0.48; range - 0.50 – 1.95) after a mean follow-up of 20 months (range 12 - 35). Implant success was 97.9%. Around 30 implants, a bone substitute was used to fill the residual space, but this did not affect the bone loss outcome. Bone loss was only significantly different between maxilla and mandible (0.48 mm vs. 0.27 mm) and between the 8 and 9 mm diameter implants (0.23 mm vs. 0.55 mm). A full papilla was present at 71% of the interproximal sites and irrespective of bone loss. Conclusions The Max® implant demonstrated good primary stability, when placed in molar extraction sockets, with limited bone loss over time.

Objectives The objective of this study was to investigate the effect of a laminin coating on calcium phosphate precipitation on three potentially bioactive titanium surfaces in simulated body fluid. Material and Methods Blasted titanium discs were prepared by alkali and heat treatment (AH), anodic oxidation (AO) or hydroxyapatite coating (HA) and subsequently coated with laminin. A laminin coated blasted surface (B) served as a positive control while a blasted non coated (B-) served as a negative control. Surface morphology was examined by Scanning Electron Microscopy (SEM). The analysis of the precipitated calcium and phosphorous was performed by Energy Dispersive X-ray Spectroscopy (EDX). Results The thickness of the laminin coating was estimated at 26 Å by ellipsometry. Interferometry revealed that the coating process did not affect any of the tested topographical parameters on µm level when comparing B to B-. After 2 weeks of incubation in SBF, the alkali-heat treated discs displayed the highest calcium phosphate deposition and the B group showed higher levels of calcium phosphate than the B- group. Conclusions Our results suggest that laminin may have the potential to be used as a coating agent in order to enhance the osseoinductive performance of biomaterial surfaces, with the protein molecules possibly functioning as nucleation centres for apatite formation. Nevertheless, in vivo studies are required in order to clarify the longevity of the coating and its performance in the complex biological environment.

Objectives The aim of this study was to compare microbiological, histological, and mechanical findings from tissues around osseointergrated dental implants in patients who had undergone tumour resection and subsequent bone grafting with non bone grafted patients without a history of oral cancer and to develop an effective tool for the monitoring of the peri-implant tissues. A third aim was to assess and compare the masticatory function of the two patient groups after reconstruction with dental implants. Material and Methods A total of 20 patients were divided into 2 groups. The first group was edentulous and treated with dental implants without the need for bone grafting. The second edentulous group, with a history of oral cancer involving the mandible, received onlay bone grafts with concurrent placement of dental implants. Microbiological, histological, mechanical and biochemical assessment methods, crevicular fluid flow rate, hygiene-index, implant mobility, and the masticatory function were analysed and compared in both patient groups. Results The microbiological examinations showed no evidence of the three most common pathogenic bacteria: Porphyromonas gingivalis, Prevotella intermedius, Actinobacillus actinomycetencomitans. A causal relationship between specific microbes and peri-implant inflammation could not be found. All biopsies in both patient groups revealed early signs of soft tissue peri-implant inflammation. Conclusions The crevicular fluid volume and grade of gingival inflammation around the dental implants were related. Peri-implant tissue findings were similar in the two patient groups despite the history of oral cancer and the need for bone grafting at the time of dental implant placement.

Objectives We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods. Material and Methods Twenty-six patients (mean age 25.5, standard deviation (SD) 5.2 years) with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years) who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded. Results Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007;) and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043) compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039). Conclusions Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

Objectives The aim of this pilot study was to evaluate the effectiveness of cutting needle biopsy in the diagnosis of solid oral lesions. Material and Methods The biopsies were carried out on seven patients who presented with solid oral lesions with sizes ranging from 2 to 6 cm. Specimens were obtained from each lesion before conventional biopsies using a cutting needle with 18-gauge x 9 cm (MD TECH, Gainesville, FL, USA). A total of 64 specimens processed by hematoxylin-eosin staining method, were obtained. Afterwards, the analysis was performed by an oral pathologist, in two different stages, with and without the clinical history of each lesion. Then, these answers were compared with the final histological diagnosis. Results Results presented by the descriptive analysis showed that the correct diagnosis using cutting needle biopsy without the clinical history of lesions was registered in 37.5% of cases, while with the clinical history in 76.6%. Conclusions Despite the promising results as a potential technique for biopsies and histological diagnosis of oral lesions, the cutting needle biopsy should be analyzed carefully in those cases.

Objectives Locally used doxycycline has been shown to concentrate in crevicular fluid and demonstrates a wide spectrum of activity against the periodontal pathogens. The aim of the present clinical study was to evaluate the efficacy of doxycyline hyclate 10% as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Material and Methods 60 systemically healthy, chronic periodontitis patients were included in the study. Randomized clinical trial was performed over the 6 month period. Test group was treated by scaling and root planing followed by local delivery of doxycycline hyclate 10%, while the control group was treated by scaling and root planing along with placebo. Results Significantly greater (P < 0.001) reduction in the mean probing pocket depth was demonstrated in the test group (3.03 ± 0.92 mm) when compared with the control group (2.3 ± 0.65 mm). When the differences in clinical attachment level gain for the test group (2.0 ± 0.64 mm) versus control group (1.13 ± 1.07 mm) were analyzed by Student's unpaired t-test, test group showed statistically greater clinical attachment level gain (0.87 ± 0.22 mm, P < 0.001). Conclusions From the analysis of the results it can be concluded that the use of doxycyline hyclate 10% as an adjunct to scaling and root planing provides more favourable and statistically significant (P < 0.001) reductions in probing pocket depth and gains in clinical attachment level compared to scaling and root planing alone.

Objectives The aim of the present study was to evaluate calcium phosphate precipitation and the amount of precipitated protein on three potentially bioactive surfaces when adding laminin in simulated body fluid. Material and Methods Blasted titanium discs were prepared by three different techniques claimed to provide bioactivity: alkali and heat treatment (AH), anodic oxidation (AO) or hydroxyapatite coating (HA). A blasted surface incubated in laminin-containing simulated body fuid served as a positive control (B) while a blasted surface incubated in non laminin-containing simulated body fuid served as a negative control (B-). The immersion time was 1 hour, 24 hours, 72 hours and 1 week. Surface topography was investigated by interferometry and morphology by Scanning Electron Microscopy (SEM). Analysis of the precipitated calcium and phosphorous was performed by Energy Dispersive X-ray Spectroscopy (EDX) and the adsorbed laminin was quantified by iodine (125I) labeling. Results SEM demonstrated that all specimens except for the negative control were totally covered with calcium phosphate (CaP) after 1 week. EDX revealed that B- demonstrated lower sum of Ca and P levels compared to the other groups after 1 week. Iodine labeling demonstrated that laminin precipitated in a similar manner on the possibly bioactive surfaces as on the positive control surface. Conclusions Our results indicate that laminin precipitates equally on all tested titanium surfaces and may function as a nucleation center thus locally elevating the calcium concentration. Nevertheless further studies are required to clarify the role of laminin in the interaction of biomaterials with the host bone tissue.

Objectives To evaluate the efficacy of locally delivered doxycycline as an adjunct to non-surgical treatment with the use of an ultrasonic device compared to scaling and root planing using hand instruments, by means of clinical and microbiological criteria. Material and Methods Thirty three patients with chronic periodontitis participated in this cohort study and were divided into two groups. Patients in control group received scaling and root planing using hand instruments, whereas patients in control group received ultrasonic debridement and 8.8% doxycycline gel was applied after initial therapy and at 3 months at preselected sites. Clinical recordings concerning probing pocket depth, clinical attachment level, plaque index and gingival bleeding index were performed at baseline, 3 and 6 months after baseline. Subgingival samples were analysed using the "checkerboard" DNA-DNA hybridisation technique for Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Results Both treatments resulted in significant improvement in all clinical recordings. Six months after the treatment a statistically significant decrease was observed for Porphyromonas gingivalis in both of groups and Treponema denticola in the control group (P < 0.05). No inter-group differences were observed (P < 0.05). Conclusions Both treatment modalities provided comparable clinical and microbiological results in the treatment of chronic periodontitis.

Objectives The purpose of this study was to determine the pattern of mouthwash use and to investigate the associated factors in general population. Material and Methods An Adult Dental Health Survey was conducted on 3,022 residents of Grampian region of Scotland (adjusted participation rate 58.2%). Participants received a questionnaire consisting of questions on oral health and behavioural factors. Results The majority of participants (38.1%) have never used mouthwash, 17.5% used mouthwash less than once a month, 19.4% used mouthwash once every few days and 25.1% used mouthwash daily. Prevalence of use decreased with age (P < 0.001). Woman were more likely to use mouthwash than men (P = 0.004). Mouthwash use decreased with decrease in the level of deprivation (P < 0.001). Never-smokers were less likely to use mouthwash (40.3%) compared to smokers (53.1%) or those who stopped smoking (46.5%) (P < 0.001). Mouthwash was used by smaller proportion of people drinking alcohol on daily basis (36.6%), than by abstainers (42.2%) (P = 0.012). There was a positive relationship between flossing or brushing pattern and mouthwash use (P < 0.001). There was statistically significant relationship between mouthwash use and reasons for the last dental visit (P = 0.009). When compared to healthy individuals, mouthwash was used by higher proportion of people reporting that they had gum disease (P = 0.001), ulcers (P = 0.001), oral infections or swelling (P = 0.002) or other problems (P = 0.025). Conclusions Mouthwash use in general population is associated with socio-demographic, health and behavioural factors.

Objectives To observe the early adsorption of extracellular matrix and blood plasma proteins to magnesium-incorporated titanium oxide surfaces, which has shown superior bone response in animal models. Material and Methods Commercially pure titanium discs were blasted with titanium dioxide (TiO2) particles (control), and for the test group, TiO2 blasted discs were further processed with a micro-arc oxidation method (test). Surface morphology was investigated by scanning electron microscopy, surface topography by optic interferometry, characterization by X-ray photoelectron spectroscopy (XPS), and by X-ray diffraction (XRD) analysis. The adsorption of 3 different proteins (fibronectin, albumin, and collagen type I) was investigated by an immunoblotting technique. Results The test surface showed a porous structure, whereas the control surface showed a typical TiO2 blasted structure. XPS data revealed magnesium-incorporation to the anodic oxide film of the surface. There was no difference in surface roughness between the control and test surfaces. For the protein adsorption test, the amount of albumin was significantly higher on the control surface whereas the amount of fibronectin was significantly higher on the test surface. Although there was no significant difference, the test surface had a tendency to adsorb more collagen type I. Conclusions The magnesium-incorporated anodized surface showed significantly higher fibronectin adsorption and lower albumin adsorption than the blasted surface. These results may be one of the reasons for the excellent bone response previously observed in animal studies.

Objectives The purpose of this study is to analyze the morphological change of cell nuclei and the change of proliferating activity of oral malignancy and epithelial dysplasia between before and after photodynamic therapy in order to predict recurrence. Material and methods We experienced 14 cases of oral squamous cell carcinoma, one case of verrucous carcinoma and seven cases of epithelial dysplasia treated by photodynamic therapy (PDT). The mean nuclear area (NA) and coefficient of variation of the nuclear area (NACV) of 100 nuclei per slide were calculated using computer-assisted image analysis in hematoxylin and eosin stained biopsy specimens before and after PDT. Additionally, proliferating cell nuclear antigen (PCNA) immunohistochemistry was carried out in each specimen. Results The mean NA after PDT was significantly lower than that before PDT in the nonrecurrent group. However, there was no significant difference in mean NA before and after PDT in the recurrent group. There were no significance differences in NACV before and after PDT in either the nonrecurrent or recurrent group. Furthermore, the PCNA labelling indices of the specimens after PDT was significantly lower than that before PDT in both the nonrecurrent and the recurrent group. Conclusions Mean nuclear area in the biopsy specimen after photodynamic therapy is likely to be a predictive marker for the recurrence of oral squamous cell carcinoma or epithelial dysplasia subjected to photodynamic therapy, while coefficient of variation of the nuclear area and proliferating cell nuclear antigen labelling indices are less helpful in predicting the recurrence of such lesions.

Objectives To systematize the clinico-radiological symptoms and course of bisphosphonate-related osteonecrosis of jaw bone and toevaluate the diagnostic potential of various radiological techniques to detect mild osteonecrosis in each stage of the disease. Material and Methods The sample consisted of 22 patients previously diagnosed with extraoral malignant disease. Diagnosis was based on a clinical examination in conjunction to digital panoramic radiography and cone beam computed tomography (CBCT). Two dentomaxillofacial radiologists reviewed all images. Results Twenty patients showed mandibular involvement clinically, while two others had a maxillary involvement. Four stages of the disease were proposed based on the clinico-radiological findings. Subclinical cortical and lamina dura thickening was detected with only three-dimensional CBCT and periapical images, while ulceration and cortical bone thickening was detected only by three-dimensional CBCT. Mixed sclerotic, lytic bone destruction involving alveolar and basal bone with or without encroachment on the mandibular canal, pathological mandibular fractures were detected by two-dimensional panoramic and three-dimensional CBCT images. Other findings are non healing extraction sockets, periapical radiolucencies, osteolysis, sequestra, oroantral fistula, and periosteal new bone formation. Conclusions The present study showed that bisphosphonate-related osteonecrosis of jaw bone occurs in four distinct clinico-radiological stages. For mild cases, panoramic image diagnosis was much less obvious, whereas cone beam computed tomography was able to fully characterise the bony lesions and describe their extent and involvement of neighbouring structures in all cases. Thus cone beam computed tomography might better contribute to the prevention of bisphosphonate-related osteonecrosis of jaw bone as well to the disease management.

Objectives The aim of the current study was to investigate whether there was a relationship between a history of third molar removal and the prevalence of orofacial pain in a sample of the general population. Material and methods A survey was conducted in South East Cheshire, United Kingdom (81% participation rate). Information was collected using postal questionnaires (n = 1510) and dental records (n = 809). Results Participants who reported third molar extractions were more likely to report orofacial pain (RR = 1.29; 95% confidence interval [CI] 1.01 - 1.65). Participants with a more recent history of extractions (< 8 years ago) as recorded in dental records were more likely to report orofacial pain compared to those who had all third molar present (RR = 1.91; 95% CI 1.10 - 3.32). Conclusions This research suggests that self-reported third molar removal is linked to self-reported orofacial pain, however evidence from one study is not sufficient to give an unequivocal answer.

Objectives The purpose of the present study was to investigate the reliability of both periapical radiographs and orthopantomograms for exact detection of tooth root protrusion in the maxillary sinus by correlating the results with cone beam computed tomography. Material and Methods A database of 1400 patients scanned with cone beam computed tomography (CBCT) was searched for matching periapical (PA) radiographs and orthopantogram (OPG) images of maxillary premolars and molars. Matching OPG images datasets of 101 patients with 628 teeth and PA radiographs datasets of 93 patients with 359 teeth were identified. Four observers assessed the relationship between the apex of tooth root and the maxillary sinus per tooth on PA radiographs, OPG and CBCT images using the following classification: root tip is in the sinus (class 1), root tip is against the sinus wall (class 2) and root tip is not in the sinus (class 3). Results Overall correlation between OPG and CBCT images scores was 50%, 26% and 56.1% for class 1, class 2 and class 3, respectively (Cohen's kappa [weighted] = 0.1). Overall correlation between PA radiographs and CBCT images was 75.8%, 15.8% and 56.9% for class 1, class 2 and class 3, respectively (Cohen's kappa [weighted] = 0.24). In both the OPG images and the PA radiographs datasets, class 1 correlation was most frequently observed with the first and second molars. Conclusions The results demonstrated that both periapical radiographs and orthopantomograms are not reliable in determination of exact relationship between the apex of tooth root and the maxillary sinus floor. Periapical radiography is slightly more reliable than orthopantomography in determining this relationship.

Objectives: The purpose of the present study was to determine the measurement accuracy and subjective image quality for periodontal disease diagnosis when using two X-ray tube voltages with a digital photostimulable storage phosphor sensor. Material and Methods: A digital photostimulable storage phosphor (PSP) sensor (Vistascan) and a multipulse X-ray generator (Prostyle Intra) with two tube voltages were used in this study. The front, premolar and molar region of two adult human cadaver skulls jaws were imaged using the X-ray tube at 63 kV and 70 kV, both at 8 mA and decreasing exposure times (160 ms, 120 ms and 80 ms). A standardized exposure protocol containing waxed occlusal keys and an aiming device ensured proper and reproducible beam alignment. Three observers assessed the digital radiographs for 31 selected periodontal bone loss sites. Radiographic measurements were compared to physical measurements (Standard). Subjective ratings of lamina dura, crater defect and furcation involvement visibility, contrast perception and bone quality were also performed. Results: Multiple regression equation of the variables kV and exposure time demonstrated no significant difference for the periodontal bone level measurements (P>0.05). In 90.3% and 96.7% of the measurements for 70 kV and 63 kV respectively, deviation was within 1 mm. The subjective ratings produced similar findings in terms of image quality for both tube voltages and the three exposure times. Conclusions: The results of the present study revealed that tube voltages of 63 kV and 70 kV provided similar accuracy and image quality for periodontal disease diagnosis. ispartof: Journal of Oral and Maxillofacial Research vol:1 issue:1 pages:e5- ispartof: location:Lithuania status: published

Objectives Peptide-15 (P-15) is an analogue of the cell binding domain of collagen. P-15 has been shown to facilitate physiological to process in a way similar to collagen, to serve as anchorage for cells, and to promote the binding, migration and differentiation of cells. However, how P-15 alters osteoblast activity to promote bone formation is poorly understood. To study the osteoinductive properties of peptide P-15, we analyzed the expression levels of bone related genes in human mesenchymal stem cells treated with this biomaterial. Material and Methods Using real time Reverse Transcription-Polymerase Chain Reaction the quantitative expression of specific genes, like transcriptional factors (RUNX2 and SP7), bone related genes (SPP1, COL1A1, COL3A1, BGLAP, ALPL, and FOSL1) and mesenchymal stem cells marker (ENG) were examined. Results P-15 causes a considerable induction of osteoblast transcriptional factor like osterix (SP7) and of the bone related genes osteopontin (SPP1) and osteocalcin (BGLAP). In contrast the expression of endoglin (ENG) was markedly decreased in stem cells treated with P-15 respect to untreated cells, indicating the differentiation effect of this biomaterial on stem cells. Conclusions The present study shows the effect of P-15 on mesenchymal stem cells in the early differentiation stages: P-15 is an inducer of osteogenesis on human stem cells as indicated by the activation of bone related markers SP7, SPP1 and BGLAP.The results may allow a better understanding of the molecular mechanism of bone regeneration and as a model for comparing other materials with similar clinical effects.

Objectives: The purpose of the present study was to explore the maxillary sinus anatomy, its variations and volume in patients with a need for maxillary implant placement. Materials and Methods: Maxillary sinus data of 101 consecutive patients who underwent spiral computed tomography (CT) scans for preoperative implant planning in the maxilla at the Department of Periodontology, University Hospital, KULeuven were retrospectively evaluated. The alveolar bone height was measured on serial cross-sectional images between alveolar crest and sinus floor, parallel to the tooth axis. In order to describe the size of the maxillary sinus anteroposterior (AP) and mediolateral (ML) diameters of the sinus were measured. Results: The results indicated that the alveolar bone height was significantly higher in the premolar regions in comparison to the molar region (n = 46, P4 mm) mucosal thickening mostly at the level of the sinus floor. The present sample did not allow revealing any significant difference (P>0.05) in maxillary sinus dimensions for partially dentate and edentulous subjects. Conclusions: Cross-sectional imaging can be used in order to obtain more accurate information on the morphology, variation, and the amount of maxillary bone adjacent to the maxillary sinus ispartof: Journal of Oral and Maxillofacial Research vol:1 issue:1 pages:e7- ispartof: location:Lithuania status: published

The study of brainstem auditory evoked potentials (BAEP) allows obtaining the electrophysiological activity generated in the cochlear nerve to the inferior colliculus. In the first months of life, a period of greater neuronal plasticity, important changes are observed in the absolute latency and inter-peak intervals of BAEP, which occur up to the completion of the maturational process, around 18 months of life in full-term newborns, when the response is similar to that of adults. Objective: The goal of this study was to establish normal values of absolute latencies for waves I, III and V and inter-peak intervals I-III, III-V and I-V of the BAEP performed in full-term infants attending the Infant Hearing Health Program of the Speech-Language Pathology and Audiology Course at Bauru School of Dentistry, Brazil, with no risk history for hearing impairment. Material and Methods: The stimulation parameters were: rarefaction click stimulus presented by the 3A insertion phone, intensity of 80 dBnHL and a rate of 21.1 c/s, band-pass filter of 30 and 3,000 Hz and average of 2,000 stimuli. A sample of 86 infants was first divided according to their gestational age in preterm (n = 12) and full-term (n=74), and then according to their chronological age in three periods: P1: 0 to 29 days (n=46), P2: 30 days to 5 months 29 days (n=28) and P3: above 6 months (n= 12). Results: The absolute latency of wave I was similar to that of adults, generally in the 1st month of life, demonstrating a complete process maturity of the auditory nerve. For waves III and V, there was a gradual decrease of absolute latencies with age, characterizing the maturation of axons and synaptic mechanisms in the brainstem level. Conclusion: Age proved to be a determining factor in the absolute latency of the BAEP components, especially those generated in the brainstem, in the first year of life.

The aim of this study was to carry out a situation analysis of: a) prevalence of ART training courses; b) integration of ART into the oral healthcare systems and; c) strengths and weaknesses of ART integration, in Latin American countries. Materials and Methods: A structured questionnaire, consisting of 18 questions, was emailed to directors of national or regional oral health departments of all Latin American countries and the USA. For two countries that had not responded after 4 weeks, the questionnaire was sent to the Dean of each local Dental School. The questions were related to ART training courses, integration of ART in the dental curriculum and the oral healthcare system, barriers to ART implementation in the public health system and recommendations for ART implementation in the services. Factor analysis was used to construct one factor in the barrier-related question. Means and percentages were calculated. Results: The response rate, covering 55% of all Latin American countries, was 76%. An ART training course had been given in all Latin American countries that responded, with more than 2 having been conducted in 64.7% of the respondent countries. ART was implemented in public oral health services in 94.7 % of the countries, according to the respondents. In 15.8% of the countries, ART was applied throughout the country and in 68.4%, in some areas or regions of a country. ART had been used for more, or less, than three years in 42.1% and 47.4% of the countries, respectively. evaluation and monitoring activities to determine the effectiveness of ART restorations and ART sealants had been carried out in 42.1% of the countries, while evaluation training courses had taken place in only 3 countries (15.8%). Respondents perceived the “increase in the number of treated patients” as the major benefit of ART implementation in public oral health services. The major perceived barrier factors to ART implementation were “operator opinion” and “high patient load”, followed by “lack in supplies of materials and instruments and operators” and “lack of ART training”. Respondents recommended that the number of ART courses should be increased. Conclusions: The introduction of ART into the public oral health systems in Latin American countries has taken place but is still in its infancy. More ART training courses need to be organized if the approach is to be adopted in oral health service systems in these countries.

Atraumatic Restorative Treatment (ART) is considered to be well accepted, both by children and by adult patients. The objective of this review is to present and discuss the evidence regarding the acceptability of ART, from the patient's perspective. Aspects related to dental anxiety/fear and pain/discomfort have been highlighted, to facilitate better understanding and use of the information available in the literature. Conclusions: The ART approach has been shown to cause less discomfort than other conventional approaches and is, therefore, considered a very promising “atraumatic” management approach for cavitated carious lesions in children, anxious adults and possibly, for dental-phobic patients.

The CD-ROM “Voice Assessment: Speech-Language Pathology and Audiology & Medicine” was developed as a teaching tool for people interested in the production of the spoken or sung human voice. Its content comprises several subjects concerning the anatomy and physiology of spoken and sung voice. A careful assessment becomes necessary in order to ensure the effectiveness of teaching and learning educational materials, whether related to education or health, within the proposal of education mediated by technology. Objective: This study aimed to evaluate the efficacy of the Virtual Man Project’s CD-ROM “Voice Assessment: Speech-Language Pathology and Audiology & Medicine”, as a self-learning material, in two different populations: Speech-Language Pathology and Audiology students and Lyrical Singing students. The participants were instructed to study the CD-ROM during 1 month and answer two questionnaires: one before and another one after studying the CD-ROM. The quantitative results were compared statistically by the Student’s t-test at a significance level of 5%. Results: Seventeen out of the 28 students who completed the study, were Speech-Language Pathology and Audiology students, while 11 were Lyrical Singing students (dropout rate of 44%). Comparison of the answers to the questionnaires before and after studying the CD-ROM showed a statistically significant increase of the scores for the questionnaire applied after studying the CD-ROM for both Speech-Language Pathology and Audiology and Lyrical Singing students, with p

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:24:05Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:41:09Z : No. of bitstreams: 1 2-s2.0-78650794943.pdf: 425622 bytes, checksum: ce5d06fc0bcff878b9bc63d3233eaf35 (MD5) Made available in DSpace on 2014-05-27T11:24:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-01 The presence of porosities at the dentin/adhesive interface has been observed with the use of new generation dentin bonding systems. These porosities tend to contradict the concept that etching and hybridization processes occur equally and simultaneously. Therefore, the aim of this study was to evaluate the micromechanical behavior of the hybrid layer (HL) with voids based on a self-etching adhesive system using 3-D finite element (FE) analysis. Three FE models (Mr) were built: Mr, dentin specimen (41x41x82 μm) with a regular and perfect (i.e. pore-free) HL based on a self-etching adhesive system, restored with composite resin; Mp, similar to M, but containing 25% (v/v) voids in the HL; Mpp, similar to Mr, but containing 50% (v/v) voids in the HL. A tensile load (0.03N) was applied on top of the composite resin. The stress field was obtained by using Ansys Workbench 10.0. The nodes of the base of the specimen were constrained in the x, y and z axes. The maximum principal stress (σmax) was obtained for all structures at the dentin/adhesive interface. The Mpp showed the highest peak of σmax in the HL (32.2 MPa), followed by Mp (30 MPa) and Mr (28.4 MPa). The stress concentration in the peritubular dentin was high in all models (120 MPa). All other structures positioned far from voids showed similar increase of stress. Voids incorporated into the HL raised the σmax in this region by 13.5%. This behavior might be responsible for lower bond strengths of self-etching and single-bottle adhesives, as reported in the literature.

The aim of this study was to evaluate the teaching of the Atraumatic Restorative Treatment (ART) approach in Brazilian dental schools. Materials and Methods: A questionnaire on this subject was sent to Pediatric Dentistry, Operative Dentistry and Public Health Dentistry professors. The questions approached the followig subjects: the method used to teach ART, the time spent on its teaching, under which discipline it is taught, for how many years ART has been taught and its effect on the DMFT index. Results: A total of 70 out of 202 dental schools returned the questionnaire. The ART approach is taught in the majority of the Brazilian dental schools (96.3%), and in most of these schools it is taught both in theory and in clinical practice (62.9%). The majority (35.3%) of professors teach ART for 8 hours, and most often as part of the Pediatric Dentistry discipline (67.6%). It has been taught for the last 7 to 10 years in 34.3% of dental schools. Most professors did not observe a change in the DMFT index with this approach. There is a diversity in the teaching of ART in Brazil in terms of the number of hours spent, the teaching method (theory and practice), and the disciplines involved in its teaching. Conclusions: It is necessary to address the training of professors in the ART approach for the whole country. An educational model is proposed whereby a standard ART module features as part of other preventive and restorative caries care educational modules. This will facilitate and standardize the introduction and adoption of the ART approach in undergraduate education in Brazil.

In order to microscopically analyze the pulpal effects of orthodontic movement, 49 maxillary first molars of rats were submitted to orthodontic appliance composed of a closed coil spring anchored to the maxillary incisors, placed for the achievement of mesial movement. Material and Methods: Ten animals were used as the control group and were not submitted to orthodontic force; the other animals were divided into groups according to the study period of tooth movement, namely 1, 2, 3, 4, 5, 6 and 7 days. The investigation of pulp and periodontal changes included hyalinization, fibrosis, reactive dentin and vascular congestion. Statistical evaluation was performed between control and experimental groups and between periods of observation using non-parametric chi-square, Kruskal-Wallis and Dunn tests. Results: There was no statistically significant difference concerning pulpal changes between control and experimental groups nor between periods of observation. The control group, at 3 and 5 days, revealed greater hyalinization of the periodontal ligament (p

Background: The color change on post-endodontic treated teeth can be overcome by intracoronal tooth bleaching using walking bleach. Some agents used in walking bleach are combination of sodium peroxide and hydrogen peroxide, and combination of sodium perborate and water. Purpose: The objective of this review is to provide information and consideration of using safe and effective bleaching agents in the field of dentistry. Reviews: On one side, the use of sodium perborate and water combination does not cause the reduction of dentin hardness, enamel decay, and root resorbtion. On the other side, the use of sodium perborate and 30% hydrogen peroxide combination indicates that it takes longer time in yielding the proper color of teeth. Conclusion: The use of sodium perborate and water combination as bleaching agents is effective and safe.

Selection of the whitening technique for tooth whitening in pediatric use should be based on the types of the stains and discolorations, and depth of the stains. If superficial, stains can be removed by microabrasion, but for deeper stains bleaching materials must be used. Use the bleaching materials or bleaching product should also be based on the concentration of active ingredient, the viscosity of the product, and tooth sensitivity.

The vital steps in any endodontic treatment are thorough mechanical shaping and chemical cleaning followed by obtaining a fluid tight impervious seal by an inert obturating material. For the past two decades, introduction and use of rotary nickel-titanium (Ni-Ti) files have changed our concepts of endodontic treatment from conventional to contemporary. They have reported good success rates, but still have many drawbacks. The Self-Adjusting File (SAF) introduces a new era in endodontics by performing the vital steps of shaping and cleaning simultaneously. The SAF is a hollow file in design that adapts itself three-dimensionally to the root canal and is a single file system, made up of Ni-Ti lattice. The case series presented in the paper report the clinical experience, while treating primary endodontic cases with the SAF system in India.

Objective: To assess and compare the salivary flow rate (SFR), pH and taste perception among oral submucous fibrosis (OSMF) and apparently healthy subjects. Materials and Methods: Ninety subjects (45 OSMF + 45 controls) were enrolled in the study for estimating and analogizing the SFR, pH, and taste perception executing modified Schirmer, pH, and taste strips. The SFR, pH, and taste perception were evaluated and compared between 14 Stage I and 31 Stage II OSMF subjects. The entered data were analyzed using SPSS 21.0 software. Results: A statistically significant decrease in SFR among OSMF group (23.4 mm at 3rd min) and hypogeusia to salty (62.2%), and dysgeusia to sour taste (40%) when compared to apparently healthy subjects (30.7 mm at 3rd min) was noted. Statistical significance (P < 0.05%) inferring hyposalivation in Stage II OSMF (24.1 mm at 3rd min) juxtaposing with Stage I OSMF (31.4 mm at 3rd min). Statistically significant hypogeusia to salty (n = 23) and sweet (n = 16) and dysgeusia (n = 14) to sour among Stage II OSMF when differentiated with Stage I OSMF. The mean pH among the OSMF and control groups demonstrated no statistical significance. Conclusion: The findings from the study demonstrated marked decrease of SFR and taste perception to salty and sour among Stage II OSMF when compared to Stage I OSMF subjects.

A 6-year-old boy was brought to the dental department with a history of toothache in the anterior maxillary region. Intraoral examination revealed caries in the deciduous upper central and lateral incisor teeth. Radiological evaluation revealed the silhouette of a metallic paper clip in the pulp chamber of the deciduous right maxillary central incisor. The tooth was extracted as the permanent incisor was erupting below. Children often avoid informing their parents regarding such incidents due to fear of punishment.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:58:28Z No. of bitstreams: 1 S0103-06631999000400008.pdf: 5807934 bytes, checksum: 88dc5f1283bc129c080f8e670fc9b02f (MD5) Made available in DSpace on 2013-08-22T18:58:28Z (GMT). No. of bitstreams: 1 S0103-06631999000400008.pdf: 5807934 bytes, checksum: 88dc5f1283bc129c080f8e670fc9b02f (MD5) Previous issue date: 1999-12-01 Made available in DSpace on 2013-09-30T19:54:13Z (GMT). No. of bitstreams: 2 S0103-06631999000400008.pdf: 5807934 bytes, checksum: 88dc5f1283bc129c080f8e670fc9b02f (MD5) S0103-06631999000400008.pdf.txt: 5 bytes, checksum: cc9067c2ee470dc248b14b194209a34e (MD5) Previous issue date: 1999-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:43:30Z No. of bitstreams: 2 S0103-06631999000400008.pdf: 5807934 bytes, checksum: 88dc5f1283bc129c080f8e670fc9b02f (MD5) S0103-06631999000400008.pdf.txt: 5 bytes, checksum: cc9067c2ee470dc248b14b194209a34e (MD5) Made available in DSpace on 2014-05-20T13:43:30Z (GMT). No. of bitstreams: 2 S0103-06631999000400008.pdf: 5807934 bytes, checksum: 88dc5f1283bc129c080f8e670fc9b02f (MD5) S0103-06631999000400008.pdf.txt: 5 bytes, checksum: cc9067c2ee470dc248b14b194209a34e (MD5) Previous issue date: 1999-12-01 A desinfecção de todo e qualquer molde obtido é medida de biossegurança obrigatória na atividade clínica. Tão importante quanto a desinfecção é a seleção do método e da solução desinfetante a ser utilizada para cada material de moldagem. É imperativo que a capacidade de reprodução de detalhes, a estabilidade dimensional e o grau de umedecimento (ou molhabilidade) não sejam criticamente afetados. O propósito deste trabalho foi avaliar o grau de umedecimento de uma marca comercial de poliéter (Impregum F) por três diferentes marcas comerciais de gesso tipo IV (Herostone, Durone e Polirock), após sua desinfecção por aerossóis de hipoclorito de sódio 1% (líquido de Milton) ou glutaraldeído 2% (Glutalabor II). Foram confeccionados 45 moldes de poliéter, os quais, em grupos de 15, receberam aerossóis de água (Grupo Controle), Líquido de Milton ou Glutalabor II. em seguida, sobre a superfície dos moldes foram confeccionados modelos de gesso tipo IV, em número de 5 para cada marca de gesso. Após seu seccionamento mediano e preparo da superfície de corte, os modelos foram levados ao microscópio Carl Zeiss para leitura do ângulo de contato. Os resultados obtidos permitiram concluir que: a) a capacidade de umedecimento do poliéter por diferentes marcas comerciais de gesso tipo IV variou para os gessos estudados; b) o gesso Durone adaptou-se melhor aos moldes de poliéter do que os gessos Herostone e Polirock; c) a desinfecção dos moldes com aerossóis de hipoclorito de sódio 1% (líquido de Milton) ou glutaraldeído 2% (Glutalabor) não afetou a adaptação entre os gessos e o poliéter. Impressions carried out in the dental office are potential contamination pathways. The aim of this paper was to evaluate the effects of spray disinfection on the wetting of polyether material (Impregum F) by stones. Three kinds of stones (Herostone, Durone and Polirock) and two disinfectant solutions (2% glutaraldehyde and 1% hypochlorite) were used. The impressions were submitted to spray disinfection, and the contact angles between them and their respective casts were measured. The smaller the angle, the better the adaptation of the stone to the polyether material. No adverse effects were observed with the two disinfectant solutions. Durone presented the best results. UNESP UNESP

Uvod: Cilj svakog zaposlenika jest raditi u zdravom radnom okolišu. Stomatologija je stresno zanimanje, a razloga za nezadovoljstvo je mnogo. Željelo se kod stomatologa u FBiH-u ustanoviti prediktore nezadovoljstva poslom. Materijali i postupci: U istraživanju su sudjelovala 134 stomatologa izabrana nasumičnim postupkom iz Registra stomatološke komore FBiH-a. Svi su ispunili demografski upitnik i ljestvicu zadovoljstva poslom (JSS). Rezultati: Porastom učestalosti utjecaja posla na kvalitetu života te sve češćim razmišljanjem o napuštanju posla, smanjuje se zadovoljstvo poslom. Opći stomatolozi znatno su zadovoljniji od specijalista. Značajni prediktori zadovoljstva poslom su radni status, tip prakse i zapošljavanje asistenta. Poslom su zadovoljniji opći stomatolozi koji rade u privatnoj praksi sa zaposlenim asistentom. Zaključak: Značajni prediktori zadovoljstva poslom su radni status, tip prakse i zapošljavanje asistenta. Najzadovoljniji su opći stomatolozi zaposleni u privatnoj praksi koji imaju dentalnog asistenta., Introduction: Working in a healthy work environment is the ultimate goal of every employee. Dentistry is a stressful career, and the reasons for dissatisfaction are numerous. Aim: The aim of this study was to determine the factors of work satisfaction in dental professionals of the Bosnia and Herzegovina Federation. Materials and methods: A total of 134 dental professionals selected randomly from the Registry of Dental Chamber of Bosnia and Herzegovina Federation were included in the study. All of them filled out the Demographic Questionnaire and Job Satisfaction Scale (JSS). Results: An increase in the influence of work on the quality of life as well as an increase in its frequency results in leaving the job and significantly reducing the overall job satisfaction. General dental practitioners are significantly more satisfied as compared with specialists. Significant predictors of the job satisfaction are employment status, type of the practice, and availability of dental assistants. General dental practitioners with a dental assistant employed at a private practice are more likely to be satisfied with their jobs. Conclusions: Employment status, practice type and availability of dental assistants are significant predictors of job satisfaction. General dental practitioners working in a private practice with a dental assistant are most likely to be satisfied.

This paper aimed to review and analysis of current literature, based on the complex evaluation of the publications in the available national and international literature, related to hospital patient safety culture. >A literature review was conducted via searching the MEDLINE, PubMed, Google Scholar and Sofia Central Medical Library electronic databases. Relevant publications were also retrieved from the paper-based collection at the Medical University in Plovdiv, using the “de visu” approach. "Patient safety", "safety culture", "hospital safety culture", "prevention of medical errors", "patient safety reporting system" and "medical error" served as search keywords. The study selection identified a total of 224 surveys. Finally, only 21 articles were examined and discussed in the review. The current literature review shows the need to develop and maintain a positive patient safety culture in the healthcare settings in Bulgaria. It requires amendments to the existing regulations, the introduction of uniform taxonomy, universal measuring instruments of patient safety culture and registration of medical errors in healthcare settings.

Background: Bitewing radiography is a technique that depicts the crown of the maxillary and mandibular teeth and the crest of the alveolar bone in the same receptor. The use of film holders and paper loops in bitewing techniques is very helpful in standardising radiographs, but it has some disadvantages, including the lack of efficiency and discomfort. Therefore, silicone has been widely used in the medical field as a replacement for paper loops. Purpose: This study was conducted to describe the compatibility of the silicone material as an alternative for bitewing radiography. Methods: This research is experimental and a one-shot case study. It used the Mann–Whitney (P < 0.05) test for statistical analysis to compare the results of the radiographs using silicone loops and paper loops and to analyse the quality of each radiograph: object coverage, density, contrast, sharpness, geometry, and overlapping. Results: The images where silicone loops were used show adequate results in six radiograph quality assessments. There was no significant difference between the radiographs that were obtained using the silicon loop and the paper loop (p > 0.05). Conclusion: Silicone loops can be an alternative tool for bitewing radiography because they result in optimal image quality.

The clinical effectiveness of adhesive agents has been mainly evaluated using class V restorations. Clinical studies evaluating adhesives in combination with posterior composites are scarce and of short-term periods. This paper is aimed to review the current literature on the clinical effectiveness of contemporary adhesives when used to restore posterior teeth (Class I and Class II). To conduct this review, Scopus, PubMed, and Google Scholar databases were used to search for peer-reviewed articles on the clinical performance of adhesive agents in posterior composite restorations. Search terms used included “adhesive agents,” “clinical evaluation,” “composite restorations,” “posterior teeth,” “self-etch adhesives,” “etch -and -rinse adhesives,” and “universal adhesives.” To enrich the results, reference mining of the articles that were identified was used to locate other papers. The process of cross-referencing continued until no new articles were identified. No limits were placed on the year of publication, but only articles in English were considered. The current review found that simplification in the adhesive technique so far seems to affect the clinical performance. There is a relative paucity of evidence relating to the performance of universal adhesive agents in posterior restorations. Further long-term clinical studies are needed to evaluate the clinical performance of adhesive agents.

Objective: The aim of the in vitro study was to compare the antibacterial efficacy of photoactivated disinfection (PAD), sonic irrigation as an adjunct to conventional irrigation against Enterococcus faecalis in vitro. Materials and Methods: A total of 75 extracted teeth were selected and prepared followed by inoculation with strains of E. faecalis, and a preirrigation sample was collected using sterile paper points. These teeth were then divided randomly into three groups for irrigation: Group I (Conventional irrigation), Group II (PAD), and Group III (EndoActivator) followed by postirrigation sample collection using the sterile paper points. The samples were swabbed on blood agar plates and incubated followed by the calculation of colony-forming units (CFU's). Results: The results were statistically analyzed using the SPSS software version 18.0. On comparing the mean values among the groups, the reduction in the number of CFU's after the treatment protocol was highly significant for all groups (P < 0.001). With the preirrigation sample, there is a statistically significant difference in the values of Group I and Group II (P = 0.047). However, in case of postirrigation samples, there is nonsignificant difference between Group II and Group III. Conclusion: PAD using 940 nm diode laser and methylene blue and endoactivator were more effective than sodium hypochlorite (NaOCl) in reducing E. faecalis counts.

This paper explores the epidemiological evidence about oral health of individuals with neurodegenerative conditions of Alzheimer's disease (AD) and dementia. PubMed, Web of Science, and Scopus were searched to identify the relevant research papers published during January 2012 to June 2020. All cross-sectional, case-control, and cohort studies reporting oral and dental morbid conditions for status and association with AD and dementia were explored. The explored literature from 22 studies shows that oral health parameters of oral health and levels of oral inflammatory markers were deranged and exaggerated in patients suffering from AD and dementia. Many studies have observed poor oral hygiene as result of lack or irregularity in toothbrushing. Regarding decayed, missing, and filled teeth status in AD/dementia populations, no significant difference is reported. Periodontal diseases have been noted at raised levels in AD and dementia patients and shown progression with aggravation in neurological disorders. Both edentulousness and low chewing efficacies are associated with low cognition. Stomatitis and coated tongue and other oral pathologies are significantly higher in AD patients. AD patients have demonstrated higher bacterial load and inflammation levels than controls, and consequently, inflammatory biomarker levels are also raised. AD patients have reduced salivary secretions and with low buffering capacity. Evidence from the current literature update postulates that individuals suffering from AD and dementia have special oral health-care needs. Appropriate oral health management may thus significantly improve their oral health-related and general quality of life.

Background To analyse via life cycle analysis (LCA) the global resource use and environmental output of the endodontic procedure. Methodology An LCA was conducted to measure the life cycle of a standard/routine two-visit RCT. The LCA was conducted according to the International Organization of Standardization guidelines; ISO 14040:2006. All clinical elements of an endodontic treatment (RCT) were input into OpenLCA software using process and flows from the ecoinvent database. Travel to and from the dental clinic was not included. Environmental outputs included abiotic depletion, acidification, freshwater ecotoxicity/eutrophication, human toxicity, cancer/non cancer effects, ionizing radiation, global warming, marine eutrophication, ozone depletion, photochemical ozone formation and terrestrial eutrophication. Results An RCT procedure contributes 4.9 kg of carbon dioxide equivalent (CO2 eq) emissions. This is the equivalent of a 30 km drive in a small car. The main 5 contributors were dental clothing followed by surface disinfection (isopropanol), disposable bib (paper and plastic), single-use stainless steel instruments and electricity use. Although this LCA has illustrated the effect endodontic treatment has on the environment, there are a number of limitations that may influence the validity of the results. Conclusions The endodontic team need to consider how they can reduce the environmental burden of endodontic care. One immediate area of focus might be to consider alternatives to isopropyl alcohol, and look at paper, single use instrument and electricity use. Longer term, research into environmentally-friendly medicaments should continue to investigate the replacement of current cytotoxic gold standards with possible natural alternatives. Minimally invasive regenerative endodontics techniques designed to stimulate repair or regeneration of damaged pulp tissue may also be one way of improving the environmental impact of an RCT.