Brazilian Journal of Implantology and Health Sciences
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Estudo clínico e radiográfico da região peri-implantar ao redor de implantes dentários curtos em pacientes diabéticos, pré-diabéticos e não-diabéticos tipo 2.
Full text linkIntroduction: The clinical and radiographic status surrounding short dental implants in patients with different blood glucose levels remains unexplored.
Objective: To determine the clinical and radiographic bone level (RBL) around short dental implants in patients with type 2 diabetes mellitus (DM2), pre-diabetics and non-diabetics.
Materials and methods: Participants were grouped into three groups based on HbA1c levels: T2DM (Group - 1); pre-diabetic patients (Group - 2); and non-diabetics (Group 3). Clinical records included evaluation of the peri-implant plaque index (PI), bleeding on probing (BOP), depth of probing (PD). Radiographic analysis included the evaluation of standardized periapical digital radiographs using specialized software and image analyzer.
Results: Peri-implant clinical parameters, including PI and BOP, were statistically higher in group 1 (P <0.01) and in group 2 (P <0.05) compared to group 3. Mean SD was statistically significantly higher in group 1 patients compared to group 3 (P <0.01). Radiographic bone loss was significantly greater in patients in group 1 (P <0.01) and in group 2 (P <0.05) compared to patients in group 3. The RBL showed a statistically significant difference between patients with DM2, even after adjusting for HbA1c, total cholesterol and body mass index (P <0.05) and a statistically significant difference in pre-diabetic patients after adjusting only for HbA1c (P <0.05).
Conclusion: The clinical and radiographic parameters of the peri-implant are compromised around short dental implants in patients with type 2 diabetes mellitus. Additional longitudinal studies are needed to compare the clinical performance of short dental implants with standard dental implants placed in patients with different glycemic levels.Introdução: O estado clínico e radiográfico em torno de implantes dentários curtos em pacientes com diferentes níveis glicêmicos permanece inexplorado.
Objetivo: Determinar o nível ósseo clínico e radiográfico (RBL) em torno de implantes dentários curtos em pacientes com diabetes mellitus tipo 2 (DM2), pré-diabéticos e não diabéticos.
Materiais e métodos: Os participantes foram agrupados em três grupos com base nos níveis de HbA1c: T2DM (Grupo ‐ 1); pacientes pré-diabéticos (Grupo ‐ 2); e não diabéticos (Grupo 3). Os registros clínicos incluíram a avaliação do índice de placa peri-implantar (PI), sangramento na sondagem (BOP), profundidade da sondagem (DP). A análise radiográfica incluiu a avaliação de radiografias digitais periapicais padronizadas usando software especializado e analisador de imagens.
Resultados: Os parâmetros clínicos peri-implantes, incluindo PI e BOP, foram estatisticamente maiores no grupo 1 ( P <0,01) e no grupo 2 ( P <0,05) em comparação ao grupo 3. A DP média foi estatisticamente significativamente maior nos pacientes do grupo 1 em comparação ao grupo 3 ( P <0,01). A perda óssea radiográfica foi significativamente maior nos pacientes do grupo 1 ( P <0,01) e do grupo 2 ( P <0,05) em comparação aos pacientes do grupo 3. A RBL mostrou diferença estatisticamente significativa entre os pacientes com DM2, mesmo após o ajuste para HbA1c, colesterol total e índice de massa corporal ( P <0,05) e diferença estatisticamente significante em pacientes pré-diabéticos após o ajuste apenas para HbA1c ( P <0,05).
Conclusão: Os parâmetros clínicos e radiográficos do peri-implante estão comprometidos em torno de implantes dentários curtos em pacientes com diabetes mellitus tipo 2. Estudos longitudinais adicionais são necessários para comparar o desempenho clínico de implantes dentários curtos com implantes dentários padrão colocados em pacientes com diferentes níveis glicêmicos
Enxerto ósseo autógeno com dentes: uma revisão de literatura
Full text linkTooth-derived bone graft material, which has proven to be rich in bone growth factors and bone morphogenic proteins (BMPs), is becoming a practical substitute for bone graft. It can also be used as a carrier of growth factors and stem cells, as reported in many recent studies. The technique of autogenous tooth bone grafting is significant, as this biomaterial has excellent bone regeneration capacity and also relatively inexistent chances of antigenicity, genetic diseases and disease transmission. In this article, a broad overview of published findings is discussed regarding the properties and uses of tooth-derived regenerative bone graft.O material de enxerto ósseo derivado de dente, que provou ser rico em fatores de crescimento ósseo e proteínas morfogênicas ósseas (BMPs), vem se tornando um substituto prático do enxerto ósseo. Também pode ser usado como portador de fatores de crescimento e células-tronco, como relatado em muitos estudos recentes. A técnica de enxerto ósseo de dente autógeno é significativa, pois esse biomaterial possui excelente capacidade de regeneração óssea e também chances relativamente inexistentes de antigenicidade, doenças genéticas e transmissão de doenças. Neste artigo, é discutida uma ampla visão geral das descobertas publicadas com relação às propriedades e usos do enxerto ósseo regenerativo derivado de dente
Interactive E-Module Model of Transformation Geometry Based on Case (Creative, Active, Systematic, Effective) as A Practical and Effective Media to Support Learning Autonomy and Competence.
Full text linkThis study aims to develop an interactive e-module of Transformation Geometry based on some principles, e.g. creative, active, systematic, and effective (CASE) as a teaching material to support learning autonomy and student’s competence. In this research and development study includes some steps, e.g. preliminary study, product design and development (model), and product testing and assessment. In the preliminary study, based on student’s needs analysis, it was shown that most students were more interested in Transformation Geometry session by using interactive emodule as the teaching materials as it may enable the students to learn independently and understand easily. Therefore, it is necessary to develop an interesting and easily-understood teaching material model in the form of an interactive e-module. In the designing step, the initial draft produced a model with a systematic: introduction (instructions for using e-modules, material descriptions, prerequisites, learning objectives), learning activities that include: a description of the material and examples of questions, problem training, summaries, competency tests, instructions for practice answers, feedback, and reference lists. In product development (model), CASE-based interactive e-module models covering Transformation Geometry topic was created. The results of the product review by experts indicate that the product (model) has fulfilled in terms of validity. The product testing results showed that the interactive e-module model Transformation Geometry developed in this study is as the teaching material model that supports learning independence and has met the criteria of a practical and effective model.This study aims to develop an interactive e-module of Transformation Geometry based on some principles, e.g. creative, active, systematic, and effective (CASE) as a teaching material to support learning autonomy and student’s competence. In this research and development study includes some steps, e.g. preliminary study, product design and development (model), and product testing and assessment. In the preliminary study, based on student’s needs analysis, it was shown that most students were more interested in Transformation Geometry session by using interactive emodule as the teaching materials as it may enable the students to learn independently and understand easily. Therefore, it is necessary to develop an interesting and easily-understood teaching material model in the form of an interactive e-module. In the designing step, the initial draft produced a model with a systematic: introduction (instructions for using e-modules, material descriptions, prerequisites, learning objectives), learning activities that include: a description of the material and examples of questions, problem training, summaries, competency tests, instructions for practice answers, feedback, and reference lists. In product development (model), CASE-based interactive e-module models covering Transformation Geometry topic was created. The results of the product review by experts indicate that the product (model) has fulfilled in terms of validity. The product testing results showed that the interactive e-module model Transformation Geometry developed in this study is as the teaching material model that supports learning independence and has met the criteria of a practical and effective model
Mini-implants: changing the paradigms of orthodontic mechanics.
Full text linkA new concept of anchoring and directing force was introduced in orthodontics, using a mini-implant. Its small size and high strength have made this device the greatest evolution of all time in the field of orthodontic anchorage. The various installation sites have expanded the possibilities for creating the most diverse types of mechanics, providing a secure anchorage, resulting in more effective and brief treatments.
Factors such as facial harmony, functional occlusion, acceptable aesthetics and stability after treatment are essential for the success of the daily orthodontic clinic. For such results to be achieved, a rigorous and judicious planning must be elaborated, envisioning a tooth movement with the minimum of side effects. The displacement of a determined group of teeth, without changing the correct positioning of the system's resistance elements, has always been desired by orthodontists. Mini-implants irreversibly changed the paradigms of orthodontic mechanics, truly representing a "watershed". This is true, mainly due to factors such as clinical effectiveness, ease of handling, low cost and absence of the need for collaboration on the part of the patient.
I have heard some questions regarding the stability of this product. Mini-implants are made from titanium alloy grade V, with no osseointegration. What we can expect is a primary stability, mainly due to the contact between the device and the cortical bone. Therefore, the greater the thickness of the cortical bone, the better the final stability of the mini-implants. Another relevant issue is that they can be divided into two formats: self-tapping and self-tapping. The seconds provide greater primary stability and eliminate the need for previous perforations, shortening and facilitating the surgical procedure. I emphasize that a correct selection protocol, adopting only self-perforating devices, the exclusion of areas with little cortical bone thickness (maxillary tuber for example), a correct surgical protocol and good hygiene guidelines, would almost totally eliminate the possibilities of losses.
Different shapes of heads are currently commercialized, allowing numerous activation protocols, using elastics, springs, yarn strings and rectangular arch segments. It is up to the orthodontist to define the best option, thus optimizing the clinical result.
Movements such as opening and closing space; verticalization, distalization and molar intrusion; incisor intrusion; torques; retraction of anterior teeth and leveling of the occlusal plane can be obtained in a controlled manner, as long as the biomechanical concepts are respected. The daily clinic has demonstrated the importance of integration between implantodontists and orthodontists, enabling the use of this method with excellence.
I think the future of the mini-implant is related to revolutionary research, which seeks to create even smaller and universal devices, enabling activations with rectangular wires, elastics and springs in a multifunctional head, isolated or simultaneously, making its use simpler , with greater comfort for the patient. At the same time, this possibility would reduce the parts of the surgical kits, reduce the amount of stock and facilitate communication between the professionals involved in their applications.A new concept of anchoring and directing force was introduced in orthodontics, using a mini-implant. Its small size and high strength have made this device the greatest evolution of all time in the field of orthodontic anchorage. The various installation sites have expanded the possibilities for creating the most diverse types of mechanics, providing a secure anchorage, resulting in more effective and brief treatments.
Factors such as facial harmony, functional occlusion, acceptable aesthetics and stability after treatment are essential for the success of the daily orthodontic clinic. For such results to be achieved, a rigorous and judicious planning must be elaborated, envisioning a tooth movement with the minimum of side effects. The displacement of a determined group of teeth, without changing the correct positioning of the system's resistance elements, has always been desired by orthodontists. Mini-implants irreversibly changed the paradigms of orthodontic mechanics, truly representing a "watershed". This is true, mainly due to factors such as clinical effectiveness, ease of handling, low cost and absence of the need for collaboration on the part of the patient.
I have heard some questions regarding the stability of this product. Mini-implants are made from titanium alloy grade V, with no osseointegration. What we can expect is a primary stability, mainly due to the contact between the device and the cortical bone. Therefore, the greater the thickness of the cortical bone, the better the final stability of the mini-implants. Another relevant issue is that they can be divided into two formats: self-tapping and self-tapping. The seconds provide greater primary stability and eliminate the need for previous perforations, shortening and facilitating the surgical procedure. I emphasize that a correct selection protocol, adopting only self-perforating devices, the exclusion of areas with little cortical bone thickness (maxillary tuber for example), a correct surgical protocol and good hygiene guidelines, would almost totally eliminate the possibilities of losses.
Different shapes of heads are currently commercialized, allowing numerous activation protocols, using elastics, springs, yarn strings and rectangular arch segments. It is up to the orthodontist to define the best option, thus optimizing the clinical result.
Movements such as opening and closing space; verticalization, distalization and molar intrusion; incisor intrusion; torques; retraction of anterior teeth and leveling of the occlusal plane can be obtained in a controlled manner, as long as the biomechanical concepts are respected. The daily clinic has demonstrated the importance of integration between implantodontists and orthodontists, enabling the use of this method with excellence.
I think the future of the mini-implant is related to revolutionary research, which seeks to create even smaller and universal devices, enabling activations with rectangular wires, elastics and springs in a multifunctional head, isolated or simultaneously, making its use simpler , with greater comfort for the patient. At the same time, this possibility would reduce the parts of the surgical kits, reduce the amount of stock and facilitate communication between the professionals involved in their applications
COMPONENTES QUE AFETAM O MEDO NO TRATAMENTO DENTÁRIO EM ADULTOS: UM ESTUDO SECCIONAL
Full text linkIntroduction: The estimated prevalence of extreme dental fear and anxiety is 40% in the adult population. The patient's expressed fear of the dentist is rarely used in clinical practice to assess the patient's concerns. Objectives: The present study was conducted to identify risk factors associated with fear of the dentist and the frequency of visits to the dental office.
Methodology: The study included 98 individuals who visited a dental clinic in Federal University of Amazonas. Dental fear was measured: (What is your fear of visiting the dentist? a. Not at all, b. Little c. Much). Demographic data were collected based on the Hospital Anxiety and Depression Scale (HAD), while dental fear was assessed by the Dental Fear Questionnaire (CMD). These evaluations were made prior to the dental treatment.
Results: The results revealed that four dimensions of CMD were considered: A. accidental care, b. attitude of the dentist, c. negligence and d. organization. Only the dimensions of dentist attitude (OR = 2.4 (95% CI: 1.1-5.4); p = 0.02) and negligence (OR = 5.3 (95% CI: 2.0-13, p = 0.02); 1); p = 0.0001), along with anxiety levels (OR = 1.3 (95% CI: 1.3-1.7); p = 0.01) were independently associated with the presence of dental fear. None of the variables was associated with the frequency of dental visits.
Conclusions: The results also revealed that the attitude and anxiety dimensions of the dentist were associated with the fear of visiting the dentist.Introdução: A prevalência estimada de extremo medo e ansiedade dentária é de 40% na população adulta. O medo expresso pelo paciente do dentista raramente é usado na prática clínica para avaliar as preocupações do paciente.
Objetivos: O presente estudo foi realizado para identificar os fatores de risco associados ao medo do dentista e a frequência de visitas ao consultório odontológico.
Metodologia: O estudo incluiu 98 indivíduos que visitaram uma clínica odontológica da Universidade Federal do Amazonas. O medo dentário foi medido: (Qual o seu medo de visitar o dentista? A. De modo algum, b. Pouco c. Muito). Os dados demográficos foram coletados com base na Escala Hospitalar de Ansiedade e Depressão (HAD), enquanto o medo dentário foi avaliado pelo Questionário de Medo Dental (CMD). Essas avaliações foram feitas antes da realização do tratamento odontológico.
Resultados: Os resultados revelaram que quatro dimensões do TMC foram consideradas: A. cuidados acidentais, b. atitude do dentista, c. negligência e d. organização. Somente as dimensões de atitude do dentista (OR = 2,4 (IC95%: 1,1-5,4); p = 0,02) e negligência (OR = 5,3 (IC95%: 2,0- 13,1); p = 0,0001), juntamente com o os níveis de ansiedade (OR = 1,3 (IC95%: 1,3-1,7); p = 0,01) foram associados independentemente à presença de medo dentário. Nenhuma das variáveis esteve associada à frequência de visitas ao dentista.
Conclusões: Os resultados revelaram ainda que as dimensões de atitude e ansiedade do dentista estavam associadas ao medo de visitar o dentista
Atitudes em saúde bucal relacionadas ao nível socioeconômico em adultos.
Full text linkIntroduction: Attitudes intervene decisively in the onset and development of oral diseases. This paper analyzes the attitudes toward the oral health and its relationship with socioeconomic status (SES) in adults from the city of Corrientes, Argentina.
Methodology: A cross-sectional study was carried out. Information on sociodemographic and oral health attitudes was collected through a household survey using the technique of direct observation by the "face to face" interviewer. The sample size was determined by establishing a confidence level of 95% for the generalization of results (381 individuals). Simple random sampling design was used for the selection of households to be surveyed, which was supplemented with a non-probability sampling procedure for selecting individuals to be interviewed, based on data provided by the 2010 census. We used a SPSS 21.0 program for the analysis of data. Differences according to the socioeconomic level were analyzed with the Kruskal-Wallis test, using U Mann-Whitney tests to assess differences between pairs.
Results: It was found that individuals from lower socioeconomic level have less favorable attitudes of oral health, particularly in regard to the attitude to dental pain and frequent reason to dentist consultation.
Conclusion: The results of this work can be considered as an important resource to design intervention strategies that address the social and cultural determinants of health-disease process.Introdução: As atitudes desempenham um papel decisivo no aparecimento e desenvolvimento de doenças bucais. O presente trabalho tem como objetivo analisar as atitudes de saúde bucal e sua relação com o nível socioeconômico (EEN) em indivíduos adultos da cidade de Corrientes; Argentina.
Metodologia: Foi realizado um estudo transversal. Por meio de uma pesquisa domiciliar, foram coletadas informações sobre dados sociodemográficos e atitudes de saúde bucal, utilizando a técnica de observação direta por meio de um entrevistador frente a frente. O tamanho da amostra foi determinado, estabelecendo um nível de confiança de 95% para a generalização dos resultados (381 indivíduos). Aplicou-se um desenho amostral aleatório simples para a seleção das residências a serem pesquisadas, complementado com uma cota não probabilística para a seleção dos indivíduos a serem entrevistados com base nos dados fornecidos pelo censo de 2010. Para a análise do dados, foi utilizado o programa SPSS 21.0. As diferenças de acordo com a NSE foram analisadas com o teste de Kruskall-Wallis,
Resultados: Verificou-se que indivíduos com um NSE específico em relação à atitude em relação à dor dentária e os motivos pelos quais o dentista geralmente é consultado.
Conclusões: Os resultados deste trabalho podem ser considerados um recurso importante para o planejamento de estratégias de intervenção que contemplem os determinantes socioculturais do processo saúde-doença
Evaluation of strontium-containing hydroxyapatite as bone substitute in sheep tibiae.
Full text linkWith the advancement of research in biomaterials, it has been suggested that the best osteoconductivity of hydroxyapatite would be achieved if its crystal were closer to the structure, size and morphology of biological apatite, that is why nano-hydroxyapatite (nano-HA) is of great importance. current interest. Strontium ions are known to reduce bone resorption, induce osteoblastic activity and stimulate bone formation. The aim of this study was to evaluate biocompatibility and osteoconduction in surgical defects filled with nano-hydroxyapatite microspheres containing 1% strontium (nano-SrHA), stoichiometric nano-HA microspheres (nano-HA) compared to the clot (control) . Four Santa Inês sheep, weighing an average of 32 kg, were anesthetized and submitted to three 2 mm diameter perforations in the medial face of the tibia. The surgical defects were filled with blood clot, microspheres of Sr-HA 1% and microspheres of HA. After 30 days the samples were drawn (6 mm), decalcified, processed for inclusion in paraffin and stained with hematoxylin and eosin (HE) for histological evaluation with light microscopy. All groups revealed bone neoformation from the periphery to the center of the defect, with the nano-SrHA group being less intense among those studied. Presence of a discrete mononuclear inflammatory infiltrate in all experimental groups. Giant foreign body cells were only observed in the HA group. Areas of bone neoformation were observed in close contact with both biomaterials. According to the results obtained, microspheres of HA and SrHA 1% are biocompatible and have osteoconductive properties.With the advancement of research in biomaterials, it has been suggested that the best osteoconductivity of hydroxyapatite would be achieved if its crystal were closer to the structure, size and morphology of biological apatite, that is why nano-hydroxyapatite (nano-HA) is of great importance. current interest. Strontium ions are known to reduce bone resorption, induce osteoblastic activity and stimulate bone formation. The aim of this study was to evaluate biocompatibility and osteoconduction in surgical defects filled with nano-hydroxyapatite microspheres containing 1% strontium (nano-SrHA), stoichiometric nano-HA microspheres (nano-HA) compared to the clot (control) . Four Santa Inês sheep, weighing an average of 32 kg, were anesthetized and submitted to three 2 mm diameter perforations in the medial face of the tibia. The surgical defects were filled with blood clot, microspheres of Sr-HA 1% and microspheres of HA. After 30 days the samples were drawn (6 mm), decalcified, processed for inclusion in paraffin and stained with hematoxylin and eosin (HE) for histological evaluation with light microscopy. All groups revealed bone neoformation from the periphery to the center of the defect, with the nano-SrHA group being less intense among those studied. Presence of a discrete mononuclear inflammatory infiltrate in all experimental groups. Giant foreign body cells were only observed in the HA group. Areas of bone neoformation were observed in close contact with both biomaterials. According to the results obtained, microspheres of HA and SrHA 1% are biocompatible and have osteoconductive properties
PHYTOTHERAPY IN DENTISTRY: SURVEY OF PRODUCTS OF PLANT ORIGIN FOR HEALTH ORAL
Full text linkIntroduction: The National Policy of Integrative and Complementary Practices (PNPIC), of the Ministry of Health, inserts the use of medicinal plants and herbal medicine in the Unified Health System (SUS) and was the recognized practice of herbal medicine by the dentist regulated in 2008. by the Federal Council of Dentistry. However, for dentistry, this therapeutic option is still little used.
Objectives: The aim of this study was to review and systematize data from the scientific literature on products of plant origin indicated for dentistry, contributing to promote their use by dentists.
Methodology: The Medline and BIREME indexing bases on the theme of phytotherapics in dentistry were searched. 230 articles were found and 15 were selected, based on the impact factor of the publications.
Conclusions: The difficulties of the use of Phytotherapy in the clinical routine are related to several aspects, such as the lack of qualification of professionals, difficulty of access to phytotherapeutic plants, cost, among others.Introduction: The National Policy of Integrative and Complementary Practices (PNPIC), of the Ministry of Health, inserts the use of medicinal plants and herbal medicine in the Unified Health System (SUS) and was the recognized practice of herbal medicine by the dentist regulated in 2008. by the Federal Council of Dentistry. However, for dentistry, this therapeutic option is still little used. Objectives: The aim of this study was to review and systematize data from the scientific literature on products of plant origin indicated for dentistry, contributing to promote their use by dentists. Methodology: The Medline and BIREME indexing bases on the theme of phytotherapics in dentistry were searched. 230 articles were found and 15 were selected, based on the impact factor of the publications. Conclusions: The difficulties of the use of Phytotherapy in the clinical routine are related to several aspects, such as the lack of qualification of professionals, difficulty of access to phytotherapeutic plants, cost, among others