Dental Elements Research Articles

Root-retained overdentures as the first choice in the rehabilitation of partially edentulous patients: case report / Sobredentadura sobre raízes como primeira escolha na reabilitação de pacientes parcialmente edêntulos: relato de caso

This case report aimed to describe the oral rehabilitation after the loss of multiple dental elements due to chronic periodontal involvement, with complaints of aesthetics, and loss of masticatory function. The patient, CRT, to 55 years old, presented, in maxillary, dental elements 13 and 23, horizontal bone loss and 1/3 of the roots' bone insertion. In the lower arch, the dental elements presents were 45, 44, 31, 32, 33, 34, and 35. Among these, the teeth 44, 33, 34, and 35 showing no loss of protective and support tissue, while teeth 45, 31, and 32 had more than half of the lost support bone and dental extrusion. Therefore, a complete upper denture and an overdenture were made with additional retention utilizing spherical retainers (o'rings) installed in the dental roots. The treatment involved a multidisciplinary approach with indication the support periodontal, endodontic, oral and maxillofacial surgery, and prosthesis. Despite the lack of support tissue, the patient reported excellent retention and stability of new dentures. Mandibular overdenture with additional retention on roots provide greater retention to the complete dentures, returning aesthetics, function, and comfort to the patient, and should be considered as the first rehabilitation option in several clinical cases, especially when there are clinical, individual, and socioeconomic conditions related to patients who cannot install osseointegrated implants.

Sr/Ca and Ba/Ca ratios support trophic partitioning within a Silurian conodont community from Gotland, Sweden

AbstractConodonts were a highly diverse and abundant vertebrate group whose fossils are found in marine Paleozoic and Triassic strata around the world. They inhabited environments ranging from lagoons to open oceans and are represented by a wide variety of dental morphologies. Conodonts may have filled many different ecological niches and represent a significant proportion of nekton before the Devonian. Despite this, very little is known about trophic ecology of conodonts. While morphological diversity suggests a complex trophic structure within conodont communities, there is little evidence to support dietary niche partitioning among conodonts.We tested the hypothesis that individual conodont taxa occupied different trophic niches, using Sr/Ca and Ba/Ca ratios preserved in the dental elements of assemblages from Silurian strata of Gotland, Sweden. Sr/Ca and Ba/Ca have been shown to vary in vertebrate skeletal tissues depending on trophic positioning, although biological and environmental conditions can affect these ratios. Environmental influences were minimized by examining entire conodont communities from a tropical epeiric sea and by measuring strontium isotope ratios using thermal ionization mass spectrometry in the most metropolitan taxon (Ozarkodina confluens). Composition of white matter, a tissue unique to conodonts, was also analyzed using microprobe analysis, revealing significantly lower Sr concentrations than in surrounding lamellar tissue, suggesting taxon-specific histology should be considered when analyzing conodonts for geochemical data. Excluding taxa with highly variable quantities of white matter, the results show that each taxon preserves different Sr/Ca and Ba/Ca ratios with limited overlap, indicating variation in trophic positioning.

Facial Asymmetry: A Narrative Review of the Most Common Neurological Causes

Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. Most people have some slight facial asymmetry, and this is the normal biological situation in humans. Abnormalities from soft tissue, dental, and skeletal elements lead to facial asymmetry. Asymmetry has many causal factors, and its aetiology includes both congenital and acquired conditions. Neurological facial asymmetry is scarcely addressed in the dental literature. In this narrative review, we focus on the most common neurological causes of facial asymmetry. From a neurological point of view, facial asymmetry can result from disturbances of the cranial nerves, developmental disorders, or myopathies. In the broad range of differential diagnostics of facial asymmetry, neurological abnormalities should be taken into consideration. The treatment must be related to the underlying cause. Complete knowledge of the aetiological factors and the character of the asymmetry plays a crucial role in formulating a treatment plan.

Analysis of the Dental Caries Epidemiological Profile in Children of Benguela city, Angola.

To analyse the epidemiological profile of dental caries in children aged 5 and 12 years in the city of Benguela, Angola. This was an observational, analytical, cross-sectional study conducted in 2019 with 190 12-year-old schoolchildren and 240 5-year-old schoolchildren from the public education system in Benguela, Angola. The relationship between dental caries and dental characteristics, sociodemographic factors, access to dental services, oral hygiene practices, and eating habits was analysed. Dental condition was evaluated using the dmft and decayed, missing, and filled teeth (DMFT) indices. It was found that 62.63% (n = 119) of 12-year-old students and 42.08% (n = 101) of 5-year-old students were free from dental caries. The average DMFT was 0.76 + 1.35 and dmft was 2.19 + 2.95. The majority of children (56.51%) had never been to the dentist, had no dental elements restored, and none of the students used dental floss. The proportion of students who consumed sweets every day was higher at 5 years of age (46.25%) than at 12 years of age (22.63%). There was a statistically significant association (P = 0.01) between the higher incidence of dental caries and peri-urban location among 5-year-old schoolchildren. This study showed that the prevalence of dental caries in the permanent dentition of schoolchildren in Benguela is very low; however, the situation is critical in the primary dentition, especially in the peri-urban area. The limited access to dental surgeons and lack of treatment for affected teeth highlight the need to implement and develop public policies to promote oral health.

Bone regeneration processes with the use of biomaterials and molecular and cellular constituents for dental implants

Introduction: When a dental element is lost in the posterior region of the maxilla, there is a natural reabsorption of the alveolar process and, at the same time, pneumatization of the maxillary sinus will occur. For this reason, the maxillary sinus floor elevation procedure should be performed, or short implants when possible. Often the focus is on the type of biomaterial to be used and the success and predictability of our results does not depend only on the biomaterial. It is also necessary to consider the type of defect to be treated, its morphology. The characteristics of the biomaterials to be used must be considered, as well as the characteristics of the bed and the bone defect for treatment. Objective: It was to carry out a concise systematic review of bone regeneration processes using biomaterials and the main molecular and cellular constituents for subsequent dental implantation. Methods: The present study followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias of the included studies. Results and Conclusion: 152 articles involving implantology and biomaterials were found. A total of 64 articles were fully evaluated and 28 were included in the present study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 5 studies with high risk of bias (studies with small sample size) and 3 studies with uncertain risk (studies with results without statistical significance). The search for a solution for large bone defects directed studies to tissue regeneration therapy or bone regeneration. These studies can promote the use of fillers and epithelial barriers that help in the treatment as an adjuvant to bone graft techniques, favoring greater predictability in alveolar and peri-implant reconstructions and with a good prognosis. The main filler biomaterials can be fibrin-rich plasma, Bio-Oss®. However, it is necessary to understand the chemical, physical and biological processes of both the biological material and the biological niche of the host. Crossing compatible information between microenvironments allows cell recognition and signaling cascades for neovascularization and regeneration and bone filling for successful posterior dental implant.

Teeth as time capsules: isotope research

Teeth and molars are of extraordinary value to archaeology and forensic science. They are small time capsules that, through isotope analysis, reveal their secrets about where people come from, what path they followed during childhood, and what kind of food they ate. Because teeth are so resistant to physical degradation and diagenesis, even millennia-old dental elements can still provide information about human populations. Isotope analysis is also used in forensic science to obtain information about the origins of unidentified individuals, in order to push an investigation in a (new) direction. Isotope research is based on the premise 'you are what you eat'; the isotope ratios of the food consumed are reflected in the tooth enamel. If the isotopic composition of the tooth enamel is compared with the expected composition of the geologic substrate, insight can be gained into the origin of an individual.

Further analyses of the structural organization of Homo luzonensis teeth: Evolutionary implications

The species Homo luzonensis has recently been described based on a set of dental and postcranial elements found at Callao Cave (Northern Luzon, Philippines) and dated to at least 50–67 ka. Seven postcanine maxillary teeth are attributed to this taxon, five of them belonging to the same individual (CCH6) and representing the holotype of H. luzonensis, whereas the isolated upper premolar CCH8 and the upper third molar CCH9 are paratypes of the species. The teeth are characterized by their small dimensions associated with primitive features, as also found in Homo floresiensis, another hominin having evolved in an insular environment of Southeast Asia. Postcranial bones of the hands and feet of H. luzonensis and H. floresiensis show Homo habilis–like or australopith-like features, whereas cranial and dental morphology are more consistent with the Asian Homo erectus morphology. Due to this mosaic morphology, the origin and phylogenetic relationships of both H. luzonensis and H. floresiensis are still debated. To test the hypotheses that H. luzonensis derives from H. erectus or from an earlier small-brained hominin, we analyzed the µCT scans of the teeth. We investigated both external and internal tooth structure using morphometric methods including: crown outline shape, tooth crown tissue proportions, enamel-dentine junction shape, and pulp morphology. Homo luzonensis external crown morphology aligns more with H. erectus than with H. habilis/H. rudolfensis. The internal structural organization of H. luzonensis teeth exhibits more affinities with that of H. erectus and H. floresiensis than with Neanderthals and modern humans. Our results suggest that both H. floresiensis and H. luzonensis likely evolved from some H. erectus groups that dispersed in the various islands of this region and became isolated until endemic speciation events occurred at least twice during the Pleistocene in insular environments.

Trauma dentoalveolar induzido por intubação em cirurgia bucomaxilofacial de urgência: relato de caso

ABSTRACT Dental trauma is a common complication in general anesthesia, especially when using nasotracheal intubation during the classic laryngoscopy. Risk factors range from difficult intubation through difficult airways to occlusal changes in the patient, with incisors being widely affected by dental elements. Tooth avulsion is the most frequent type of trauma, followed by lateral dislocation and root fracture. Male patient, 39 years old, presented at the Emergency and Trauma Hospital in Caruaru/PE, a motorcycle accident victim with a bilateral jaw fracture. Given the need to fix fractures, the patient underwent a surgical procedure under general anesthesia. During laryngoscopy, heavy bleeding was observed in the oral cavity. After inspection, root fracture of lateral incisor and avulsion of right central incisor were noted. The avulsionated tooth was not found. An orthopedic image intensifier was used to locate the dental element in the thoracic region. However, it was not possible to determine its location. Therefore, an upper gastrointestinal (UGI) endoscopy was requested, and the dental element was in the digestive tract at the esophagus level. The tooth was removed, and the surgical procedure for osteosynthesis of bilateral mandible fracture was carried on. Dentoalveolar traumas induced by general anesthesia are frequent and require preventive measures since they can directly affect the patient’s physical, economic, and medical conditions, along with anesthesiologists and maxillofacial surgeon’s risk of receiving a civil lawsuit.

Relationship between the Shape of the Dental Arch and the Presence of Traumatic Lesions on the Lateral Borders of the Tongue

The aim of this descriptive, prospective, cross-sectional study was to evaluate clinical signs, to relate the shape of the dental arches with the occurrence of lesions of traumatic origin on the lateral borders of the tongue, and then determine which form of dental arches is prevalent in relation to the development of lesions of traumatic origin on the borders of the tongue. Each of the forms of the dental arch described in the work, present a different way in which they relate to the tongue. The link between the hard structures (dental arches) and the voluminous soft mobile structure (tongue) lead us to suspect that each of the forms found, may develop a lesion of relative importance. Chronic trauma of the oral mucosa, is the result of the irritative and repeated mechanical action of an aggressive intraoral agent, in this case the teeth, acting individually or together, causing mechanical irritation. The risk factors that stimulate carcinogenesis, classically described in the literature, are tobacco and alcohol, but nowadays it is known that there are other emerging risks such as chronic mechanical irritation, caused by dental elements. Conclusion: It is apparent, through the patients studied, that there is a relationship between certain forms of arches and the development of lesions of traumatic origin on the border of the tongue.

Reabilitação estético-funcional em dentes anteriores decíduos sem remoção de tecido cariado: série de casos clínicos

ABSTRACT The treatment of cavity carious lesions in anterior deciduous teeth is a frequent demand in the pediatric dentistry clinic, since the control of the disease in early childhood still presents itself as an inter-factor challenge in child health care. While the scientific evidence on the minimally invasive principles of approach in Dentistry is presented at an increasing level, the alternatives for restorative treatment in anterior deciduous teeth still face the low availability of reports that associate minimal intervention with the aesthetic needs inherent to the treatment. Thus, this article presents a series of cases in which direct restorations in composite resin, without removing carious tissue using polyvinyl matrices, were treatment alternatives for moderate and severe caries lesions in anterior deciduous teeth. It was observed, therefore, that the use of this artifact helped the rehabilitation of compromised dental elements with speed and satisfactory 50 result, suggesting that this is an appropriate approach for application in Pediatric Dentistry, 51 since it offers resistance, durability, besides providing aesthetics and functionality, it presents lower cost and agility as it eliminates the laboratory phase.

Pindborg tumor associated with a supernumerary tooth: a case report.

ABSTRACTThe calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject.

Tooth Loss, Sociodemographic Conditions and Oral Health-Related Quality of Life in the Elderly

Objective: To verify the association between impacts produced by tooth loss and sociodemographic variables in the oral health-related quality of life (OHRQoL) in the elderly. Material and Methods: This is an analytical cross-sectional study carried out in the municipality of Vitória/ES, Brazil, which sample was composed of 402 older adults. The Oral Health Impact Profile (OHIP-14) was used to measure the individuals' OHRQoL. For data analysis, descriptive and bivariate analyses were performed using the Fisher's exact test and the Mantel-Haenzsel test to assess the effects of combined dimensions. The significance level adopted was 5%. To assess the strength of association between independent variables and dimensions, Odds-Ratio (OR) with 95% confidence interval (CI) was calculated. Results: The prevalence of negative impact on OHRQoL in the elderly was 32.6%. The greatest impact perception was found in individuals with up to 10 years of schooling (p=0.021 and OR=1.602), with need for removable partial dentures (p=0.000 and OR=2.873) and those who did not accept the loss of dental elements (p=0.000 and OR=3.064). Conclusion: Older female adults with socioeconomic class C/D-E, with up to 10 years of schooling, who lost 11 or more teeth, who declared the need for removable partial dentures, suffered greater impacts caused by tooth loss on OHRQoL.

Avaliação do conhecimento dos acadêmicos dos cursos de pedagogia e educação física

Abstract Introduction Dental trauma is considered a public health problem, being the second most prominent dental emergency, whose greatest occurrence is in schools, assigning teachers the responsibility of administering first aid. Objective To evaluate the knowledge of dental trauma among final-year’s students of pedagogy and physical education courses at the Federal University of Espírito Santo. Material and method A cross-sectional descriptive study was applied. A total of 106 questionnaires were answered by 55 students from the physical education course and 51, from the pedagogy course; comprised of socio-demographic data and knowledge of dental injuries. Statistical analysis was done using the statistical package SPSS 20. Result 98.1% of the interviewees had no training on trauma, 92.5% considered themselves incapable of providing help when facing trauma, but considered the ability important (55.7%). When asked about tooth avulsion, most of them answered that they would not reimplant the tooth, were not aware of the appropriate time window to do so, or how the storage/transportation of the dental element was to be done. Conclusion These future teachers showed unpreparedness and deficient knowledge regarding trauma treatment procedures, favoring unfavorable prognoses which would negatively impact the quality of life of the victims in terms of aesthetic, functional and psychological aspects. Therefore, the need for dental trauma education during their professional training is evident.

Avaliação da adaptação marginal das restaurações classe II realizadas em uma Faculdade no Estado do Espírito Santo

Abstract Introduction composite resins are materials widely used for Class II restorations, to restore the anatomization of the dental element. However, there are several factors that can interfere with the quality of a good restoration. Objective the objective of the present study is to carry out a retrospective evaluation of the clinical performance of Class II restorations performed by undergraduate students of Dentistry at the Escola São Francisco de Assis (ESFA), and to identify the main errors. Material and method we selected the medical records of patients treated in the disciplines of Dentistry II, Integrated I and II in the Dentistry clinic at ESFA, which presented detailed information on the Class II procedure, as well as initial radiographic examinations, using the FDI method. The sample consisted of 33 medical records that included 72 teeth. Result it was observed that more than 80% of the restorations were classified as acceptable. And, only 19.44% of the restorations were unacceptable, failing due to functional and biological properties. Conclusion it was found that undergraduate students in Dentistry at ESFA, who are guided by professors to perform treatments following pre-established clinical protocols, are capable of carrying out quality restorative procedures.

Reabilitação protética de criança com Síndrome de Rubinstein Taybi após traumatismo dentário: relato de caso

ABSTRACT Rubinstein Taybi syndrome has a genetic origin in the chromosome 16. It has physical characteristics, delay in physical and mental development, and may present oral alterations. This paper aims to report a case of prosthetic rehabilitation of a patient with syndrome who, due to dental trauma, lost dental elements early. Female patient, 4 years and 7 months old, with loss of the deciduous maxillary central incisors. The data collection was carried out through anamnesis, clinical and complementary exams. After the diagnosis and the establishment of the treatment plan, we made a Denari type prosthesis. It has a tube-bar mechanism that allows maxillary growth and development. At the end of treatment, the caregiver was instructed to make periodic visits to the dentist for clinical and radiographic follow-up of the prosthesis, as well as the need for treatment with the speech therapist. The loss of anterior deciduous teeth can be associated with trauma in this region and the dental absence can affect the development and behavior of children, promoting a change in daily life and impacting the quality of life of the whole family. The Denari prosthesis is a viable treatment option for children with this syndrome, as it accompanies the maxillary growth, restores the functions of the stomatognathic system, prevents deleterious oral habits and helps with phonetics. It is necessary for the dentist to be able to offer the best treatment for these patients, as the syndrome makes it difficult, but does not impede its execution.

Surgical - orthodontic planning of complex cases through the use of 3D models: A case report

Stereolithographic models are three-dimensional reproductions of digital data, created using CAD-CAM software. In recent years, the use of these three-dimensional models has increased as an aid in orthodontic diagnostics and in the planning of oral and maxillofacial surgery [1]. Unlike conventional diagnostic imaging techniques, such as Orthopanoramic radiographs and Cone-Beam CT (CBCT), which provide valuable digital information on bone size and geometry, stereolithographic models exhibit a physical three-dimensional reproduction of the anatomical area of interest with maximum accuracy. These truly guide both the diagnosis process and the surgical operation itself, in order to improve preoperative planning and minimize operative and postoperative morbidity. For the reproduction of these models, a CBCT scan is necessary. Through a 3D printing software, the data is converted into a stereolithographic model in scale. It is produced with transparent resin for better visualization of the bone structures and internal anatomical structures involved, such as the path of the inferior alveolar nerve or, as in this case report, the presence of dental elements totally impacted in the bone [2,3]. The use of these three-dimensional models has demonstrated a series of advantages such as a more accurate planning both orthodontic and surgical treatment, a significant reduction of operating times, a reduction in the time of exposure of the wound, better communication with colleagues and patients and more predictable surgical results [1]. Toothimpaction is defined as the failed eruption of a tooth, which remains embedded in the maxillary or mandibular bone after its period of physiological eruption. It can be partial or total and it most commonly happensto third molars, especially mandibular wisdom teeth, followed by the maxillary canines. Unlike the third molars, the maxillary canines constitute dental elements of great functional importance. They play agreat role of control in the movements of mandibular excursion. According to the classification of included maxillary canines by Yamamoto et al. there are 7 types (Figure 1), with the first three types showing more predictable results in the surgical orthodontic treatment and the following four types considered untreatable with orthodontic anchorage [4].

Dental EHR-infused Persona Ontologies to Enrich Dental Dialogue Interaction of Agents.

The quality of patient-provider communication can predict the healthcare outcomes in patients, and therefore, training dental providers to handle the communication effort with patients is crucial. In our previous work, we developed an ontology model that can standardize and represent patient-provider communication, which can later be integrated in conversational agents as tools for dental communication training. In this study, we embark on enriching our previous model with an ontology of patient personas to portray and express types of dental patient archetypes. The Ontology of Patient Personas that we developed was rooted in terminologies from an OBO Foundry ontology and dental electronic health record data elements. We discuss how this ontology aims to enhance the aforementioned dialogue ontology and future direction in executing our model in software agents to train dental students.

Virtual occlusal record: a literature review about the digital method

To produce prostheses through the digital flow, it is essential to transfer the correct patient’s interocclusal relationship to the digital software program, enabling the articulation of virtual models. Therefore, the aim of this study was to carry out a narrative literature review to describe and discuss aspects related to the virtual occlusal record realization, as well as its precision and accuracy in different clinical situations. Searches for scientific publications were performed in different databases and only articles in English related to the topic were selected. Different methods for the alignment of virtual models are described in the literature, the main one being the scanning of the patient in occlusion, usually in a position of maximum intercuspation. However, this technique may demonstrate disagreement with the patient's actual occlusal relationship due to several factors, and therefore studies were carried out to verify the precision and accuracy of these records. Most studies use plaster models and industrial scanner to capture the record, with few studies performed with intraoral scanner in patients. Despite the various scanner systems available and the different ways of evaluating them, in general, the studies show an adequate precision and accuracy of virtual occlusal records of dentate models. However, the absence of dental elements is related to the lower accuracy of these records, it being necessary to establish an appropriate method of scanning for these clinical situations.

REABILITAÇÃO ESTÉTICA COM RESINA INDIRETA EM DENTES ANTERIORES: UM RELATO CLÍNICO

Introduction: The aesthetic rehabilitation of endodontically treated teeth depends on the degree of destruction of the crown, the tooth in question, the bone support, the type of prosthesis and the types of forces to which these teeth will be submitted. The indirect composite resins have improved physical and mechanical properties thanks to the incorporation of inorganic components and multifunctional monomers with a greater number of bonding points, making them capable of solving the problems in which ceramic restorations would be indicated. Objective: To present a clinical case report of an aesthetic rehabilitation of anterior teeth with indirect composite resin as a viable and less expensive treatment alternative. Case Report: Upon clinical examination, extensive and deficient restorations were observed in the upper anterior teeth. The proposed treatment plan aesthetic rehabilitation of dental elements with ceromeres. Conclusions: This treatment represented a viable and less expensive option that can be used both in situations of great dental destruction and in small dental absences, in substitution for ceramic restorations.

Variation in dental size between Pleistocene and living coyotes (Canis latrans Say, 1823) from México

In México, the unique living member of the genus Canis Linnaeus, 1758, is the coyote (C. latrans Say, 1823). The wolf (C. lupus Linnaeus, 1758) is not considered because it is a recently reintroduced species. Not much is known about the biology and evolution of the coyote in the Mexican territory. However, the fossil record allows us to compare between the living and past members. The aim of this work is to evidence the variation in size of the teeth of the Pleistocene coyote with respect to living populations from México. For this research, we use dental material of specimens housed at paleontological and mastozoological collections. In the results, we observed a reduction in the size of all dental elements of the current coyotes with respect to the Pleistocene ones. In the case of the first upper molar (M1), the reduction is significant. The reduction in the size of skeletal elements in C. latrans has been reported in other studios. The dental narrowing observed in this canid is probably a reflection of an alteration in the diet of this mammal, as has been observed in other mammals carnivores with a similar evolutionary history (e.g., Panthera onca).