Etiene de Andrade Munhoz

Long-term rabbits bone response to titanium implants in the presence of inorganic bovine-derived graft

This study evaluated bone responses to titanium implants in the presence of an inorganic graft material. The bilateral mandible incisors of 24 rabbits were surgically extracted and one of the exposed sockets, chosen at random, was filled with an inorganic xenogenic bone graft (Gen-ox®), whereas the remaining socket was left to heal naturally and served as a control. After 60 days, titanium implants were inserted in the specific areas, and on days 0, 30, 60, and 180 after the implant insertions, six animals of each group were killed. Digital periapical radiography of implant region was obtained and vertical bone height (VBH) and bone density (BD) were evaluated by digital analysis system. In the undecalcified tissue cuts, bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were evaluated and compared statistically by means of two-way ANOVA and Tukey’s test (ρ < 0.05). No significant differences were detected in VBH and BA, either between groups or between different experimental intervals. The BD was significantly higher in the experimental group than in the control group in all the intervals tested, but there were no significant differences by interval. The BIC was statistically lower in the control group on day 0; however, a significant increase was observed on days 60 and 180 (ρ < 0.05). The use of an inorganic xenograft prior to insertion of a titanium implant did not interfere with the course of osseointegration.

Biomechanical and Microscopic Response of Bone to Titanium Implants in the Presence of Inorganic Grafts

This study evaluated the biomechanical and microscopic response of previously grafted bone to titanium implants. The lower incisors of 16 rabbits were surgically extracted, and bilateral perforations communicating with the remaining sockets were created distally. A socket/perforation defect on each mandible was chosen at random to be immediately filled with a xenogenic graft, whereas the contralateral perforation was left to heal naturally and served as a paired control. After 60 days, titanium implants were installed in the previously operated areas. After periods of 2 and 6 months, the animals were killed, and the force necessary to retrieve implants as well as the bone-implant contact (BIC) and bone mass (BM) were quantified and statistically compared by 2-way analysis of variance and Tukeys test (α  =  .05). No significant differences in removal torque were observed, either by time or by treatment condition. Differences in BIC and BM between experimental and control groups were not statistically significant through the intervals studied (P < .05). The presence of a xenogenic graft did not influence the microscopic tissue response to titanium implants or fixation into newly formed or mature bone.

Radiographic analysis of root canal fillings: influence of two sealers on the perception of voids

The aim of this ex vivo was to investigate if two radiopaque root canal sealers with different formulations would influence the radiographic perception of root canal fillings. The root canals of 48 extracted maxillary canines were prepared and randomly assigned to 3 groups of 16 specimens each. In each group, the root canals were filled by lateral condensation of gutta-percha and one of the tested sealers: Endométhasone, Sealer 26, or a non-radiopaque sealer. A through-and-through void was simulated in half of the specimens from each group (n=8). The buccolingual radiographic images obtained were randomly interpreted for voids existence by a radiologist and an endodontist. The differences in sensitivity and specificity between groups and examiners were compared using, respectively, Fishers Exact and McNemar tests at 5% significance level. Both radiopaque sealers caused a significant decrease in sensitivity at the coronal part of fillings. The use of Endométhasone increased specificity values for both coronal and apical portions of the root canal fillings. In conclusion, the tested sealers influenced the radiographic perceptions of laterally condensed root canal fillings in a different way.

Unilateral patent nasopalatine duct: a case report and review of the literature

A 15-year-old white female sought our institution complaining of a chirping noise during speech and swallowing. The noise was spontaneous, perceptible, and enhanced when hard suction on the anterior palate was performed. The patient reported no trauma, infection, or other clinical feature related to the noise. Clinical examination showed 2 small grooves on both sides of the midline, lateral to the incisive papilla. The left groove was visually deeper. Careful probing with a gutta-percha cone revealed the existence of a communication on this side extending from the mouth to the nasal cavity, which was confirmed clinically and radiographically. Probing was not possible on the right side. The diagnosis was unilateral patent nasopalatine duct, which was surgically treated. We report here a new case of patent nasopalatine duct and also present a review of the pertinent literature.

Severe manifestation of oral pemphigus

This article describes a case of pemphigus vulgaris in a relatively young patient with exacerbated characteristics, widespread lesions, and rapid evolution. A 40-year-old woman sought treatment, complaining about severe oral pain and dysphagia. Intraoral inspection revealed ulcerated lesions on the lips, buccal mucosa, and floor of the mouth. The number of lesions quickly increased and resembled erythema multiforme. She also presented blistering lesions on the back, abdomen, neck, and eyes. Incisional oral biopsy revealed pemphigus vulgaris. This report emphasizes the importance of early diagnosis of an oral biopsy in systemic diseases and the management of the lesions.

Digital radiopacity measurement of different resin- and zinc oxide-based root canal sealers

Purpose: To evaluate the radiopacity produced by seven commercially available (AH Plus, Epiphany, Sealapex, Acroseal, Sealer 26, Endomethasone and Endofill) and one experimental (MBP) root canal sealers. Methods: Sealer radiopacity testing was performed according to ANSI/ADA Specification No. 57. Specimens were radiographed with an aluminum stepwedge, and the resulting images were digitalized. Radiographic densities expressed in Aluminum mm (mm Al) were compared using an ANOVA and Tukey’s test (α=0.05). Results: AH Plus (10 mm Al) and Epiphany (9.0 mm Al) were the most radiopaque root canal sealers, followed by Sealapex (8 mm Al), Endofill (7 mm Al), Endomethasone (7 mm Al), MBP (7 mm Al) and Sealer 26 (6 mm Al). Acroseal (5 mm Al) showed the smallest radiopacity among the tested sealers (P<0.05). Conclusion: The radiopacities of the tested sealers were above the minimum level recommended by ANSI/ADA Specification No. 57.

Von Recklinghausen's Disease -Diagnosis from Oral Lesion: Neurofibromatosis I

A 35 years-old male patient was referred to your Institution due to a nodule on the palate with more than 15 years of evolution. In general physical examination noticed the presence of papules and cafe au lait (coffee with milk) pigmentation in many parts of the body. Intra oral examination found a swelling in the hard palate and resilient on palpation, asymptomatic with three centimeters of diameter. Incisional biopsy was performed and the diagnosis was neurofibroma. Complete resection of the lesion was performed confirming the initial diagnosis. The general clinical findings and the presence of neurofibroma confirmed the diagnosis of Von Recklinghausens disease. This paper emphasizes the important role of the dentist in diagnostic and follow-up of the Von Recklinghausens disease.

A bizarre extraoral fistula with intraoral manifestations

An 89 year old male patient was referred because of a 30 year old fistula. During exam we noticed skin attachments in the alveolar border. Periapical and occlusal radiographs were taken and they revealed bone loss. We surgically removed the fistula in order to improve mouth conditions and also to cosmetically improve his face. At the microscope we noticed hair follicles, sebaceous and sweat glands. The diagnosis was of fistula in a regression stage.

Impact of Inorganic Xenograft on Bone Healing and Osseointegration: An Experimental Study in Rabbits

Purpose: To evaluate if an inorganic graft applied before implant insertion interferes with osseointegration. Materials and Methods: The bilateral mandibular incisors of 12 rabbits were extracted. One of the sockets was randomly filled with an inorganic xenogenic bone graft, whereas the remaining socket was allowed to heal naturally and served as a control. After 60 days, titanium implants were inserted into healing areas. The animals were killed 60 days after. Bone depositions were marked with fluorochrome oxytetracycline, alizarin, and calcein and evaluated using confocal laser scanning microscopy. Bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were analyzed. Data were compared statically by paired t tests, one-way ANOVA, and Bonferroni post hoc tests (&agr; = 0.05). Results: No differences between the control and experimental groups in bone deposition for each marker, in either the BIC or BA analysis were observed. The bone deposition marked by alizarin (14–21 days) was the highest, followed by oxytetracycline (0 and 7 days) and calcein (45 and 52 days) in both groups (P < 0.05). Conclusion: The bone healing or the course of osseointegration was not impaired by the use of an inorganic xenogenic graft before insertion of a titanium implant.