The most commonly used procedure for root surface debridement is mechanical scaling and root planing using hand instruments. Periodontal files are used as a part of treatment introduced in subgingivally pockets. The difficult lies in stablishing an analogy of this depth measurement to the probe by a PCP 12 and the corresponding input of this files at the same distance. The authors present new files, similar to Hirschfeld, have been modified with external marking at 12mm, allowing the Periodontist this analogy, and facilitating the process. On the other hand a specific small diameter PHenriques 6 and PHenriques 7 files, to instrument more easily this complex region. Consist of a series of 3 blades, and its sharp edges in 270 degrees around the active tip, reaching the root trunk, fornix and neighbor´s surfaces. They are extremely useful especially in Class III involvement and sharpening in the same way as conventional files.
Since discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium the 1960s. In 1977, the first extraoral titanium implant was inserted for craniofacial rehabilitation aims. Craniofacial implants start to be popular for craniofacial reconstruction and rehabilitation. Craniofacial implants become as revaluation in rehabilitation fields, to day even large facial defect can be reconstructed via this surgical –prosthetic technique. The aim of this review is to explain and clarify the indications and techniques for such procedure.
Computer-Aided-Design/Computer-Aided-Manufacture or in short CAD/CAM technology is a revolutionary method which was utilized in dentistry in order to achieve more efficient and precise work that not only reduce time but also produce more patient satisfaction on the short and long term. Computer-Aided-Design (CAD) can be done by utilizing a specially designed software and an intraoral scanners or laboratory scanners which can construct a three dimensional image of scanned mouth or impression. Computer-Aided-Manufacture (CAM) on the other hand, can be done by subtractive or additive manufacturing. Subtractive manufacturing is done either by spark erosion or by a milling machine. Additive manufacturing on the other hand is made by layering technique in a step by step vertical buildup of the object or restoration. This review illustrates the indications, advantages, and limitations of CAD/CAM technology in construction of different types of restorations and the possible future of this technology.
Positive Effect of Injectable Platelet Rich Fibrin (i-PRF) on Vital Bone Formation in Graft Reconstruction of the Mandible: A Histologic and Histomorphometric Study
In this clinical case series, relative centrifugation force (RCF) and centrifugation time (CT) were reduced to produce the liquid form of platelet rich fibrin (i-PRF). The goal of this study is to histologically evaluate if the liquid form of PRF has a positive effect on vital bone formation in the grafted mandible using mineralized freeze-dried allogeneic bone. Materials and Methods: Forty-two patients completed immediate bone grafting after a non-restorable endodontically treated molar tooth was extracted in preparation for future implant surgery. Each bone graft was augmented with i-PRF. To process i-PRF, relative centrifugation force (RCF) was reduced from 2,700 RPM to 700 RPM (60g). Centrifugation time was reduced from 12 minutes to 3 minutes. After an average bone graft healing time of 8 to 12 weeks, bone core samples were obtained at the time of implant surgery for histological and histomorphometric analysis. Results: Forty-two bone cores were harvested at the time of implant surgery for histological and histomorphometric analysis. The liquid form of PRF resulted in greater percentages of vital bone formation (average 87.4 %) compared to the existing published literature. Conclusion: i-PRF resulted in greater percentages of new vital bone formation compared to the published literature. This could be due to the continuous slow release and delivery of growth factors in i-PRF. Further clinical use of iPRF is needed to evaluate the full potential of bone regeneration.
The cleft lip nasal deformity has been well described in respect to the facial aesthetics and plays an important role in social interactions. Rhinoplasty for patients with CLP is of immense challenge for the basic fact of the complexity in pathology, and also variation of growth potential of individual. The surgical correction for treatment of variation in nose morphology in patients with CLP is Rhinoplasty, which becomes a challenging task, keeping in mind the difficulty in evaluating the outcome. Many methods are available in the literature for nasal assessment evaluation in patients with CLP. However due to the pros and cons of different methods, aesthetic evaluation of the nose among these patients remain problematical. The purpose of this literature review was to overview the different nasal assessment methods in patients with CLP so as to analyse and identify the most objective method for such evaluation in order plan the treatment and to compare the aesthetic results.
Clinical governance is a comprehensive approach that is not given its weight as a subject at the undergraduate level because either the syllabus is full or there is not enough time. This article aims to facilitate the understanding of clinical governance in the dental office by drawing modules. These color modules and the ease of structure will tempt the eyes of undergraduate dental students. The benefit is also extended to include the general population to inform them about the importance of dental hospitals to practice a high level of clinical care, thus increasing awareness. Improving the quality of life depends on policies and procedures built on the contemporaneous reliable, evidence-based information. The teaching of clinical governance and legislation and ethics at the undergraduate level should be included in the dental syllabus. This article will cast a glance at the future of professionalism against the background of increasing expectations from patients.
There are many mental and behavioral disorders, being necessary to understand and differentiate them and their nuances for better care and dental care. This chapter will address depression, bipolar affective disorders, schizophrenia, and attention deficit hyperactivity disorder related to oral-dental care and repercussions such as reduced salivary flow due to depression and / or medication action. In general, anxiolytics and antidepressants are used. This salivary reduction contributes to the high rate of dental caries and periodontal diseases, favors the emergence of fungal infections and makes the oral mucosa fragile and susceptible to ulceration and trauma. Health promotion, including individual and collective actions, for prevention and early detection of oral lesions and oral cancer, restorative, anatomical, biological, functional and aesthetic oral care are necessary and contribute to the improvement of the quality of life of these patients. The worst dental condition found in patients with mental disorders may be related to the symptoms and characteristics of their own psychiatric condition, the effects of medications, but also to the stigma that permeates society and the patient himself. Thus, it is imperative to eliminate this stigma in order to favor the recovery and maintenance of oral health and, consequently, the quality of life of these patients.
Introduction: Cultural factors, beliefs, and educational practices are in conflict with medical and dental practices. There are places where there is substitution of follow-up of the health team for several efficient treatments in clinical practice. The health professional, when taking cognizance of such practices should seek to prevent possible related complications, as well as to devise strategies to guide the individuals about their risks. Objective: To report cases of users of the Unified Health System (SUH) who used non-conventional methods not prescribed by dental surgeons for oral care and prosthetic oral rehabilitation. Results: The cases report behaviors, evidence habits, beliefs and customs of the population of Pernambuco that, although it is a user of SUH, has revealed to use own methods to solve oral needs. Cases 1 and 2 report adornment placement on dental prostheses, using artifacts such as orthodontic bracket and metal studs incorporated into artificial teeth. Case 3 reports the influence of popular beliefs on health care. Conclusion: The population makes use of alternative methods for oral care, especially for the control of dental pain and oral rehabilitation. It is important to consider beyond the difficulty of obtaining public assistance and resolution of the cases, also the contest involved of the population being necessary measures that correct or direct such actions.
Introduction: 95% of oral cancers are squamous cell carcinomas (SCC). Despite all advances in diagnosis and therapy, oral cavity cancer continues with an unfavorable prognosis, high rates of relapse and mortality. Case report: Patient AFL, 69 years old, caucasian, male gender, alcoholic, smoker, diabetic, with a history of ulcerated lesion on the floor of the mouth without painful symptoms was referred to the Head and Neck Surgery Service of the Oncology Center of the Hospital University of Pernambuco – CEON / HUOC / UPE, where he was diagnosed with squamous cell carcinoma moderately differentiated, ulcerated with perineural infiltration, angiolymphatic and in bone tissue, as well as lymph node metastasis. Staging IVa (T4a N1 Mx). Multimodal therapy (surgery, radiotherapy and chemotherapy with cisplatin) was performed. Dental monitoring was maintained in pre, trans and after treatment in order to carry out the previous oral adequacy and control of oral complications due to antineoplastic therapy. After 2 years and 11 months of treatment, the patient returned to the dental clinic of the CEON / HUOC / UPE, complaining of intense pain in the oral cavity, clinically verified: ulcerated lesion with areas of reddish and whitish color, base hardened to palpation in the buccal floor region. After exams, a local recurrence of the carcinoma was diagnosed, and a new therapeutic course was planned, and salvage surgery was chosen. Conclusion: Early diagnosis of oral ECC and medical and dental monitoring are factors that help reduce morbidity and mortality and improve the patient’s quality of life.
Assessment the effect of the use of bisphosphonates on dental implant rehabilitation and peri-implant tissues
Background: Long-term use of bisphosphonates (BP) has been associated with the risk of BP-related osteonecrosis of the jaw (BRONJ). The number of post-menopausal women receiving BP therapy for osteoporosis continues to increase as the life expectancy increases. Dental implant rehabilitations have progressed over the years. The purpose of the present study was to evaluate the peri-implant conditions of patients taking oral or intravenous (IV) BPs. Methods: This was a retrospective study using an ORACLE database search by means of a Procedural Language/Structured Query engine. Fifty female patients with dental implant rehabilitations and taking bisphosphonates, and fifty female patients with dental implants but not taking BP were evaluated. Peri-implant health and rehabilitation conditions were collected and statistics analyzed. Results: Data analysis revealed a strong indication (p