Gustavo Antônio Martins Brandão

Does the time interval after bleaching influence the adhesion of orthodontic brackets

Objective To test the null hypothesis that no difference exists between the effects of at-home bleaching and in-office bleaching on shear bond strength (SBS) with bracket bonding at 4 different time intervals after dental bleaching. Methods Ninety extracted human premolars were randomly divided into 9 groups (n = 10) according to the bleaching methods used (at-home bleaching and in-office bleaching) and the storage time in artificial saliva (30 min, 1 day, 2 weeks, and 3 weeks before bonding). The control group was stored in artificial saliva for 7 days. Brackets were bonded with the Transbond XT adhesive system, and SBS testing was performed. The adhesive remnant index (ARI) was used to assess the amount of resin remaining on the enamel surfaces after debonding. The SBS data were analyzed by analysis of variance (ANOVA) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed. Significance for all statistical tests was predetermined to be p < 0.05. Results The SBS of the unbleached group was significantly higher (p < 0.05) than that of the bleached groups (except for the group bonded 30 min after at-home bleaching). Conclusions The null hypothesis was not totally rejected. All bleaching groups tested had decreased SBS of the brackets to the enamel, except for the group bonded 30 min after at-home bleaching. The SBS returned to values close to those of the unbleached enamel within 3 weeks following bleaching.

Factors influencing orthodontic treatment time for non-surgical Class III malocclusion

ABSTRACT To improve orthodontic treatment efficiency, orthodontists must know which variables could interfere with orthodontic treatment time. Objective: To identify variables and their effect size on orthodontic treatment time of Class III malocclusion. Material and Methods: Forty-five Class III malocclusion cases were selected from 2008 patients’ records. Clinical charts, cephalometric radiographs, and pre and posttreatment dental casts were evaluated. Age, sex, PAR index at T1 and T2, overjet, missing teeth, extractions, number of treatment phases, missed appointments, appliance breakages, and cephalometric variables SNA, SNB, ANB, Wits, SnGoGn, CoA, CoGn, IMPA, 1.PP were investigated by multiple linear regression analysis and stepwise method at p<0.05. The sample was also divided into two groups: Group 0-2 (patients who had missed two clinical appointments or less) and Group >2 (patients who missed more than 2 appointments), to detect the influence of this data on treatment time and the quality of the treatment (PAR T2). Results: Average treatment time was 30.27 months. Multiple regression analysis showed that missed appointment (R2=0.4345) and appliance breakages (R2=0.0596) are the only variables able to significantly predict treatment duration. Treatment time for patients who missed more than 2 appointments was nearly one year longer. However, no significant influence on PAR T2 was observed for those patients. Conclusion: Orthodontic treatment duration in Class III patients is mainly influenced by factors related to patient compliance. Patients who missed more appointments did not show worse orthodontic finishing, but longer treatment. No occlusal, cephalometric, or demographic variable obtained before treatment was able to give some significant prediction about treatment time in Class III patients.

Does the bracket composition material influence initial biofilm formation

CONTEXT Orthodontic treatment has been reported to contribute to the development and accumulation of dental biofilm, which is commonly found on bracket and adjacent surfaces. AIMS The aim of this work is to test the hypothesis if there are differences in dental biofilm formation on the surface of orthodontic brackets according to the type of composition material. SUBJECTS AND METHODS Three bracket types (metallic, composite, and ceramic) had been evaluated. Subjects wore acrylic palatal orthodontic appliances, containing 6 brackets each, for two 3-day cycles. On the end of first cycle, the amount of dental biofilm formed on the samples was extracted using 1.0-M NaOH and analyzed by spectrophotometry for quantification. An additional cycle was carried out to verify the dental biofilm formation using scanning electronic microscope analysis. STATISTICAL ANALYSIS USED Three-way ANOVA was used to analyze the difference among the materials (metallic, ceramic and composite) concerning the dental biofilm absorbance spectrum. Multiple comparisons were made using the Tukeys test (α =0.05). RESULTS Composite brackets showed greater values concerning biofilm formation, when compared with the metallic and ceramic ones, both of which presented similar scores. The hypothesis is accepted. There are differences on the biofilm formation according to the type of material. CONCLUSIONS The in situ model tested was found to be effective in evaluating the accumulation and development of biofilm on orthodontic brackets. In the quantitative analysis, composite brackets showed greater biofilm adhesion values while metallic and ceramic presented similar biofilm absorbance spectrum.

Influence of working length and foraminal enlargement on foramen morphology and sealing ability

Aim: The present study evaluated the influence of the working length and foraminal enlargement on the sealing ability and anatomy of the apical region of the root. Materials and Methods: Fifty-five roots were divided into three groups: G1, instrumentation 1 mm short of the major foramen; G2, instrumentation in the limit of the apical foramen; and G3, instrumentation 1 mm beyond the foramen. All groups were prepared using nickel-titanium rotary files and obturated with AH Plus and Gutta-percha. Photomicrographs were taken using a scanning electron microscopy (SEM) before instrumentation, after instrumentation with each file, and after root canal filling. Moreover, bacterial microleakage with Enterococcus faecalis was performed. Results: The results were analyzed using Mann-Whitney, Friedman, Kruskal-Wallis and Kaplan-Meier tests at a significance level of 5%. The cemental canal was uninstrumented in G1. No statistical differences regarding foramen deviation was observed when compared G2 and G3 (P > 0.05). SEM analysis showed that G2 and G3 resulted in good apical foramen obturation. Microleakage showed no statistically significant differences between all of the groups tested. Conclusions: Under the conditions of this study, it can be concluded that foramen enlargement resulted in more apical deviation; however, no differences in bacterial microleakage was observed among the experimental groups.

Evaluation of ionic degradation and slot corrosion of metallic brackets by the action of different dentifrices

OBJECTIVE To evaluate the in vitro ionic degradation and slot base corrosion of metallic brackets subjected to brushing with dentifrices, through analysis of chemical composition by Energy Dispersive Spectroscopy (EDS) and qualitative analysis by Scanning Electron Microscopy (SEM). METHODS Thirty eight brackets were selected and randomly divided into four experimental groups (n = 7). Two groups (n = 5) worked as positive and negative controls. Simulated orthodontic braces were assembled using 0.019 x 0.025-in stainless steel wires and elastomeric rings. The groups were divided according to surface treatment: G1 (Máxima Proteção Anticáries®); G2 (Total 12®); G3 (Sensitive®); G4 (Branqueador®); Positive control (artificial saliva) and Negative control (no treatment). Twenty eight brushing cycles were performed and evaluations were made before (T0) and after (T1) experiment. RESULTS The Wilcoxon test showed no difference in ionic concentrations of titanium (Ti), chromium (Cr), iron (Fe) and nickel (Ni) between groups. G2 presented significant reduction (p < 0.05) in the concentration of aluminium ion (Al). Groups G3 and G4 presented significant increase (p < 0.05) in the concentration of aluminium ion. The SEM analysis showed increased characteristics indicative of corrosion on groups G2, G3 and G4. CONCLUSION The EDS analysis revealed that control groups and G1 did not suffer alterations on the chemical composition. G2 presented degradation in the amount of Al ion. G3 and G4 suffered increase in the concentration of Al. The immersion in artificial saliva and the dentifrice Máxima Proteção Anticáries® did not alter the surface polishing. The dentifrices Total 12®, Sensitive® and Branqueador® altered the surface polishing.

Percepções de estudantes de graduação em Odontologia sobre o Sistema de Saúde Brasileiro

Oral health policies prior to implementation of the Unified Health System (SUS), were considered mutually exclusive and directed to healing practices. Indicators showed little contribution to the improvement of oral health. The SUS institution allowed the direction of Brazilian public health to preventive, humane and integrated actions. The aim of this study was to analyze the profile of the dental student of the Federal University of Para according with the professional interests and the performance in the SUS. We used an inductive approach with procedure statistical-comparative and extensive direct technique observation through a questionnaire. From the sample universe of 478 students enrolled of 1st to 10th semester, extracted a sample of 240 students (confidence level 95%). It was found that for 93.8% the SUS construction dependent of the union of users, government and professionals interested in offering best services. The students say that training in dentistry at is directed to the work in the SUS and the human sciences are important for professional practice. The subjects addressed and practical activities developed were considered insufficient for professional practice.

Knowledge and Attitudes of Pregnant Women About Oral Health

Hay evidencia de que los perfiles, habitos y conocimientos de la salud influyen en la salud oral de los ninos. El objetivo de este estudio fue evaluar el conocimiento de las mujeres embarazadas en las practicas de higiene oral y el cuidado de la cavidad oral del bebe. Una encuesta epidemiologica se llevo a cabo en 147 mujeres embarazadas. La muestra estuvo compuesta predominantemente por mujeres jovenes, de las cuales el 33,33 % no habia completado la escuela primaria y la mayoria eran amas de casa con ingresos familiares entre 1-2 salarios minimos. La familia fue considerado el principal medio de transmision de informacion sobre la higiene oral.

Deflection test evaluation of different lots of the same nickel-titanium wire commercial brand

Introduction: The aim of this in vitro study was to compare the elastic properties of the load-deflection ratio of orthodontic wires of different lot numbers and the same commercial brand. Methods: A total of 40 nickel-titanium (NiTi) wire segments (Morelli OrtodontiaTM - Sorocaba, SP, Brazil), 0.016-in in diameter were used. Groups were sorted according to lot numbers (lots 1, 2, 3 and 4). 28-mm length segments from the straight portion (ends) of archwires were used. Deflection tests were performed in an EMIC universal testing machine with 5-N load cell at 1 mm/minute speed. Force at deactivation was recorded at 0.5, 1, 2 and 3 mm deflection. Analysis of variance (ANOVA) was used to compare differences between group means. Results: When comparing the force of groups at the same deflection (3, 2 and 1 mm), during deactivation, no statistical differences were found. Conclusion: There are no changes in the elastic properties of different lots of the same commercial brand; thus, the use of different lots of the orthodontic wires used in this research does not compromise the final outcomes of the load-deflection ratio.

Coesão familiar associada à saúde bucal, fatores socioeconômicos e comportamentos em saúde

A doenca de Parkinson e universal, sendo a segunda doenca neurodegenerativa mais comum em idosos e tem alta prevalencia, afetando entre 0,5 e 1% da populacao com idade entre 65 e 69 anos. A adesao a terapia medicamentosa e considerada o principal determinante para a efetividade do tratamento, porem apenas recentemente vem sendo estudado em pacientes com doenca de Parkinson. Trata-se de estudo transversal e descritivo que avaliou a adesao a terapia com levodopa em 112 pacientes com doenca de Parkinson que frequentavam regularmente o ambulatorio de disturbios do movimento do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo utilizando o teste Morisky e Green e o instrumento que avalia atitudes frente a tomada dos remedios (IAAFTR). Dos pacientes entrevistados, 53% nao apresentaram adesao ao tratamento e 52% nao tomam a medicacao no horario correto. Os pacientes devem ser orientados sobre a importância de ingerir sua medicacao no horario correto, entendendo os beneficios que a adesao pode proporcionar estando cientes de que doses nao tomadas, tomadas em excesso, ou em horarios diferentes dos prescritos podem diminuir sua resposta ao tratamento, afetando negativamente sua evolucao clinica e qualidade de vida, gerando maiores custos a saude publica do pais.Pesquisas sobre saude geral tem relacionado coesao familiar a fatores socioeconomicos e comportamentais. O objetivo deste estudo foi investigar a associacao entre coesao familiar e fatores socioeconomicos, comportamentais e de saude bucal. Este foi um estudo transversal com amostra por conglomerados em dois estagios. A amostra randomizada de 524 adolescentes era proveniente de escolas publicas da cidade de Piracicaba-SP. As variaveis foram avaliadas por questionarios autoaplicaveis e os dados de saude bucal, pelos indices CPO e CPI. A coesao familiar percebida pelo adolescente foi avaliada por meio da escala de adaptabilidade e coesao familiar. Analise univariada e regressao logistica multinominal mostraram que adolescentes com baixa coesao familiar apresentaram mais chance de terem baixa renda (OR 2,28 IC95% 1,14-4,55), presenca de carie (OR 2,23 IC95% 1,21-4,09) e baixa frequencia de escovacao diaria (OR 1,91 IC95% 1,03-3,54). Adolescentes com alta coesao familiar apresentaram mais chance que adolescentes com media coesao de terem alta renda e fator de protecao contra o habito de tabagismo. Desta forma, a coesao familiar percebida pelo adolescente associou-se com variaveis comportamentais, socioeconomicas e de saude bucal, indicando a importância de uma abordagem integral da saude do paciente.Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescents perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.

[Family cohesion associated with oral health, socioeconomic factors and health behavior].

A doenca de Parkinson e universal, sendo a segunda doenca neurodegenerativa mais comum em idosos e tem alta prevalencia, afetando entre 0,5 e 1% da populacao com idade entre 65 e 69 anos. A adesao a terapia medicamentosa e considerada o principal determinante para a efetividade do tratamento, porem apenas recentemente vem sendo estudado em pacientes com doenca de Parkinson. Trata-se de estudo transversal e descritivo que avaliou a adesao a terapia com levodopa em 112 pacientes com doenca de Parkinson que frequentavam regularmente o ambulatorio de disturbios do movimento do Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo utilizando o teste Morisky e Green e o instrumento que avalia atitudes frente a tomada dos remedios (IAAFTR). Dos pacientes entrevistados, 53% nao apresentaram adesao ao tratamento e 52% nao tomam a medicacao no horario correto. Os pacientes devem ser orientados sobre a importância de ingerir sua medicacao no horario correto, entendendo os beneficios que a adesao pode proporcionar estando cientes de que doses nao tomadas, tomadas em excesso, ou em horarios diferentes dos prescritos podem diminuir sua resposta ao tratamento, afetando negativamente sua evolucao clinica e qualidade de vida, gerando maiores custos a saude publica do pais.Pesquisas sobre saude geral tem relacionado coesao familiar a fatores socioeconomicos e comportamentais. O objetivo deste estudo foi investigar a associacao entre coesao familiar e fatores socioeconomicos, comportamentais e de saude bucal. Este foi um estudo transversal com amostra por conglomerados em dois estagios. A amostra randomizada de 524 adolescentes era proveniente de escolas publicas da cidade de Piracicaba-SP. As variaveis foram avaliadas por questionarios autoaplicaveis e os dados de saude bucal, pelos indices CPO e CPI. A coesao familiar percebida pelo adolescente foi avaliada por meio da escala de adaptabilidade e coesao familiar. Analise univariada e regressao logistica multinominal mostraram que adolescentes com baixa coesao familiar apresentaram mais chance de terem baixa renda (OR 2,28 IC95% 1,14-4,55), presenca de carie (OR 2,23 IC95% 1,21-4,09) e baixa frequencia de escovacao diaria (OR 1,91 IC95% 1,03-3,54). Adolescentes com alta coesao familiar apresentaram mais chance que adolescentes com media coesao de terem alta renda e fator de protecao contra o habito de tabagismo. Desta forma, a coesao familiar percebida pelo adolescente associou-se com variaveis comportamentais, socioeconomicas e de saude bucal, indicando a importância de uma abordagem integral da saude do paciente.Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescents perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.