Luiz Gustavo de Sousa

Educational material of dental anatomy applied to study the morphology of permanent teeth

The purpose of this report is to present educational material that would allow the dental student to learn to easily identify the morphologic characteristics of permanent teeth, and how they fit together (occlusion). In order to do this, macro models of permanent teeth with no attrition were carved in wax and later molded with alginate. These molds were filled with plaster, dental stone and/or cold-cured acrylic resin. The large individual dental stone tooth models were mounted on a wax base, thus obtaining maxillary and mandibular arches which were occluded. These dental arches were molded with plaster or dental stone. The authors suggest that these types of macro models allow an excellent visualization of the morphologic characteristics of permanent teeth and occlusion. Dental students are able to carve the permanent dentition in wax with great facility when they can observe macro models.

Electromyographic Activity of Masticatory Muscles in Women with Osteoporosis

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

Macroscopic and microscopic aspects of the temporomandibular joint related to its clinical implication.

In order to obtain a precise diagnosis and treatment for temporomandibular dysfunctions, it is necessary to have morphological and functional knowledge of the temporomandibular joint. Anatomic components are important to the understanding of the complexity of temporomandibular joint. Nonetheless, just as important are the anatomic relationships that this joint has with the neighboring structures. Thus, the aim of this study was to present the anatomic relationships of the temporomandibular joint in its various surfaces: external or lateral, anterior, posterior, medial, superior, and posterosuperior, considering the morphological and histological aspects. Nine human heads, fixed in formalin (10%) underwent sagittal medial section and were subsequently dissected, evidencing the anatomic components of all surfaces to be analyzed. Components of the external surface were: skin, subcutaneous tissue, lymphatic ganglia, parotid gland, superficial temporal artery, transverse facial artery, zygomatic-orbital artery, superficial temporal vein, facial and auriculotemporal nerves, masseter muscle, and pre-auricular lymphonodus. The anterior surface comprised the masseter and lateral pterygoid muscles (upper and inferior heads), pterygoid venous plexus, mandibular notch, posterior deep temporal artery, masseteric nerve, and deep posterior temporal branches. Medial surface components were: internal maxillary artery, of which middle meningeal artery was one of the closest branches to the TMJ, anterior tympanic artery, inferior alveolar, lingual, auriculotemporal, and chorda tympani nerves, which belonged to the surface posterior to the anterior wall of the auditory duct; auricolotemporal nerve, parotid gland; and petrotympanic fissure. The cerebral fossa (meninges and encephalon) belonged to the superior surface and the ear belonged to the posterosuperior surface. Histologically, the temporomandibular joint is composed by different tissues that compound the mandibular head, mandibular fossa, and articular eminence of the temporomandibular joint. It was concluded that the temporomandibular joint is a complex structure and the clinician must have the ability to formulate the diagnosis based on the understanding of morphological aspects of the structures that compose the stomatognatic system.

Application of Low-Level Laser Irradiation (LLLI) and rhBMP-2 in Critical Bone Defect of Ovariectomized Rats: Histomorphometric Evaluation

OBJECTIVES The aim of this study was to evaluate the osteogenic potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) and low-level laser irradiation (LLLI), isolated or combined in critical bone defects (5 mm) in parietal bone using ovariectomized female rats as an experimental animal model. MATERIALS AND METHODS Forty-nine female Wistar rats, bilaterally ovariectomized (OVX), were divided into seven treatment groups of seven animals each: (I) laser in a single application, (II) 7 μg of pure rhBMP-2, (III) laser and 7 μg of pure rhBMP-2, (IV) 7 μg of rhBMP-2/monoolein gel, (V) laser and 7 μg of rhBMP-2/monoolein gel, (VI) laser and pure monoolein gel, and (VII) critical bone defect controls. The low-level laser source used was a gallium aluminum arsenide semiconductor diode laser device (λ = 780 nm, D = 120 J/cm(2)). RESULTS Groups II and III presented higher levels of newly formed bone than all other groups with levels of 40.57% and 40.39%, respectively (p < 0.05). The levels of newly formed bone of groups I, IV, V, and VI were similar with levels of 29.67%, 25.75%, 27.75%, and 30.64%, respectively (p > 0.05). The area of new bone formation in group VII was 20.96%, which is significantly lower than groups I, II, III, and VI. CONCLUSIONS It was concluded that pure rhBMP-2 and a single dose of laser application stimulated new bone formation, but the new bone formation area was significantly increased when only rhBMP-2 was used. Additionally, the laser application in combination with other treatments did not influence the bone formation area.

Morphological and morphometric analyses of crushed sciatic nerves after application of a purified protein from natural latex and hyaluronic acid hydrogel.

Abstract Hyaluronic acid hydrogels (HAHs) have been used as a carrier of substances and factors in the repair of nervous tissue. Natural latex protein (Hevea brasiliensis, F1) has shown positive effects in treating various types of tissues, including peripheral nerves. This study evaluated the F1 associated with a HAH in a controlled crush injury (axonotmesis) of the sciatic nerve in Wistar rats. The samples were photomicrographed for morphometric and quantitative analyzes using ImageJ 1.47k software (NIH, Bethesda, MD). Morphological, quantitative (myelin area/nerve area ratio and capillary density) and morphometric (minimum nerve fiber diameter, G-Ratio) data revealed an improvement in the recovery of the sciatic nerve with the application of HAH and the combination of HAH and F1 after 4 and 8 weeks of nerve injury. The most efficacious results were observed with the combination of both substances, F1 and HAH, revealing the regenerative capacity of this new biomaterial, which was hardly tested on nerve tissue.

Anatomic variation of cranial parasympathetic ganglia

Having broad knowledge of anatomy is essential for practicing dentistry. Certain anatomical structures call for detailed studies due to their anatomical and functional importance. Nevertheless, some structures are difficult to visualize and identify due to their small volume and complicated access. Such is the case of the parasympathetic ganglia located in the cranial part of the autonomic nervous system, which include: the ciliary ganglion (located deeply in the orbit, laterally to the optic nerve), the pterygopalatine ganglion (located in the pterygopalatine fossa), the submandibular ganglion (located laterally to the hyoglossus muscle, below the lingual nerve), and the otic ganglion (located medially to the mandibular nerve, right beneath the oval foramen). The aim of this study was to present these structures in dissected anatomic specimens and perform a comparative analysis regarding location and morphology. The proximity of the ganglia and associated nerves were also analyzed, as well as the number and volume of fibers connected to them. Human heads were dissected by planes, partially removing the adjacent structures to the point we could reach the parasympathetic ganglia. With this study, we concluded that there was no significant variation regarding the location of the studied ganglia. Morphologically, our observations concur with previous classical descriptions of the parasympathetic ganglia, but we observed variations regarding the proximity of the otic ganglion to the mandibular nerve. We also observed that there were variations regarding the number and volume of fiber bundles connected to the submandibular, otic, and pterygopalatine ganglia.

Morphometric and high resolution scanning electron microscopy analysis of low-level laser therapy and latex protein (Hevea brasiliensis) administration following a crush injury of the sciatic nerve in rats.

This study evaluated the effect of low-level laser therapy (LLLT; 15 J/cm(2)) and a latex protein (F1) on a crush injury of the sciatic (ischiadicus) nerve. Seventy-two rats (male, 250 g) were divided into 6 groups: CG, control; EG, exposed nerve; IG, injured nerve without treatment; LG, injured nerve with LLLT; HG, injured nerve with F1; and LHG, injured nerve with LLLT and F1. After 4 or 8 weeks, the animals were euthanized and samples of the sciatic nerve were collected for morphometric and high-resolution scanning electron microscopy (HRSEM) analysis. After 4 weeks, the morphometry revealed improvements in the treated animals, and the HG appeared to be the most similar to the CG; after 8 weeks, the injured groups showed improvements compared to the previous period, and the results of the treatment groups were more similar to one another. At HRSEM after 4 weeks, the treated groups were similar and showed improvement compared to the IG; after 8 weeks, the LHG and HG had the best results. In conclusion, the treatments resulted in improvement after the nerve injury, and this recovery was time-dependent. In addition, the use of the F1 resulted in the best morphometric and ultrastructural findings.

Application of a Low-Level Laser Therapy and the Purified Protein from Natural Latex (Hevea brasiliensis) in the Controlled Crush Injury of the Sciatic Nerve of Rats: A Morphological, Quantitative, and Ultrastructural Study

This study analyzed the effects of a low-level laser therapy (LLLT, 15 J/cm2, 780 nm wavelength) and the natural latex protein (P1, 0.1%) in sciatic nerve after crush injury (15 Kgf, axonotmesis) in rats. Sixty rats (male, 250 g) were allocated into the 6 groups (n = 10): CG—control group; EG—nerve exposed; IG—injured nerve without treatment; LG—crushed nerve treated with LLLT; PG—injured nerve treated with P1; and LPG—injured nerve treated with LLLT and P1. After 4 or 8 weeks, the nerve samples were processed for morphological, histological quantification and ultrastructural analysis. After 4 weeks, the myelin density and morphological characteristics improved in groups LG, PG, and LPG compared to IG. After 8 weeks, PG, and LPG were similar to CG and the capillary density was higher in the LG, PG, and LPG. In the ultrastructural analysis the PG and LPG had characteristics that were similar to the CG. The application of LLLT and/or P1 improved the recovery from the nerve crush injury, and in the long term, the P1 protein was the better treatment used, since only the application of LLLT has not reached the same results, and these treatments applied together did not potentiate the recovery.

The effect of a Lucia jig for 30 minutes on neuromuscular re-programming, in normal subjects

The Lucia jig is a technique that promotes neuromuscular reprogramming of the masticatory system and allows the stabilization of the mandible without the interference of dental contacts, maintaining the mandible position in harmonic condition with the musculature in normal subjects or in patients with temporomandibular dysfunction (TMD). This study aimed to electromyographically analyze the activity (RMS) of the masseter and temporal muscles in normal subjects (control group) during the use of an anterior programming device, the Lucia jig, in place for 0, 5, 10, 20 and 30 minutes to demonstrate its effect on the stomatognathic system. Forty-two healthy dentate individuals (aged 21 to 40 years) with normal occlusion and without parafunctional habits or temporomandibular dysfunction (RDC/TMD) were evaluated on the basis of the electromyographic activity of the masseter and temporal muscles before placement of a neuromuscular re-programming device, the Lucia jig, on the upper central incisors. There were no statistically significant differences (p < 0.05) in the electromyographic activity of the masticatory muscles in the different time periods. The Lucia jig changed the electromyographic activity by promoting a neuromuscular reprogramming. In most of the time periods, it decreased the activation of the masticatory muscles, showing that this device has wide applicability in dentistry. The use of a Lucia jig over 0, 5, 10, 15, 20 and 30 minutes did not promote any statistically significant increase in muscle activity despite differences in the data, thus showing that this intra-oral device can be used in dentistry.

Poly(Vinylidene Fluoride-Trifluorethylene)/barium titanate membrane promotes de novo bone formation and may modulate gene expression in osteoporotic rat model

Osteoporosis is a chronic disease that impairs proper bone remodeling. Guided bone regeneration is a surgical technique that improves bone defect in a particular region through new bone formation, using barrier materials (e.g. membranes) to protect the space adjacent to the bone defect. The polytetrafluorethylene membrane is widely used in guided bone regeneration, however, new membranes are being investigated. The purpose of this study was to evaluate the effect of P(VDFTrFE)/BT [poly(vinylidene fluoride-trifluoroethylene)/barium titanate] membrane on in vivo bone formation. Twenty-three Wistar rats were submitted to bilateral ovariectomy. Five animals were subjected to sham surgery. After 150 days, bone defects were created and filled with P(VDF-TrFE)/BT membrane or PTFE membrane (except for the sham and OVX groups). After 4 weeks, the animals were euthanized and calvaria samples were subjected to histomorphometric and computed microtomography analysis (microCT), besides real time polymerase chain reaction (real time PCR) to evaluate gene expression. The histomorphometric analysis showed that the animals that received the P(VDF-TrFE)/BT membrane presented morphometric parameters similar or even better compared to the animals that received the PTFE membrane. The comparison between groups showed that gene expression of RUNX2, BSP, OPN, OSX and RANKL were lower on P(VDF-TrFE)/BT membrane; the gene expression of ALP, OC, RANK and CTSK were similar and the gene expression of OPG, CALCR and MMP9 were higher when compared to PTFE. The results showed that the P(VDF-TrFE)/BT membrane favors bone formation, and therefore, may be considered a promising biomaterial to support bone repair in a situation of osteoporosis.