Margareth Maria Gomes de Souza

In vitro antioxidant potential of medicinal plant extracts and their activities against oral bacteria based on Brazilian folk medicine

BACKGROUND AND OBJECTIVES This study aims to determine antibacterial activities of Cocos nucifera (husk fiber), Ziziphus joazeiro (inner bark), Caesalpinia pyramidalis (leaves), aqueous extracts and Aristolochia cymbifera (rhizomes) alcoholic extract against Prevotella intermedia, Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus mutans and Lactobacillus casei. The antioxidant activity and acute toxicity of these extracts were also evaluated. MATERIAL AND METHODS The plant extracts antibacterial activity was evaluated in vitro and the minimal inhibitory concentration (MIC) was determined by the broth micro-dilution assay. The bacterial killing kinetic was also evaluated for all extracts. In addition, the antibacterial effect of the extracts was tested in vitro on artificial oral biofilms. The acute toxicity of each extract was determined in according to Lorke [Lorke D. A new approach to practical acute toxicity testing. Arch Toxicol 1983;54:275-87] and the antioxidant activity was evaluated by DPPH photometric assay [Mensor LL, Menezes FS, Leitão GG, Reis AS, Santos TC, Coube CS, et al. Screening of Brazilian plants extract for antioxidant activity by the use of DPPH free radical method. Phytother Res 2001;15:127-30]. RESULTS MIC and the bactericidal concentrations were identical, for each evaluated extract. However, microbes of artificial biofilms were less sensitive to the extracts than the planktonic strains. A. cymbifera extract induced the highest bactericidal effect against all tested bacteria, followed by C. nucifera, Z. joazeiro and C. pyramidalis extracts, respectively. All extracts showed good antioxidant potential, being C. nucifera and C. pyramidalis aqueous extracts the most active ones. CONCLUSION In conclusion, all oral bacteria tested (planktonic or in artificial biofilms) were more susceptible to, and rapidly killed in presence of A. cymbifera, C. pyramidalis and C. nucifera than Z. joazeiro extracts, respectively. Thus, these extracts may be of great interest for future studies about treatment of oral diseases, considering their potent antioxidant activity and low toxicity.

Bone mineral density

OBJECTIVE To verify whether bone mineral density (BMD) of cortical bone, trabecular bone, and total bone influence the primary stability of orthodontic miniscrews and to verify whether there is a correlation between the measurement of BMD by cone-beam computed tomography (CBCT) and central dual-energy x-ray absorptiometry (DEXA). MATERIALS AND METHODS Twenty bovine bone sections were extracted from the pubic and iliac bones from regions with cortical thicknesses of approximately 1 mm. The BMD of the total bone block was evaluated using two methods: CBCT and DEXA. The BMD of cortical, trabecular, and total bone in the region of interest (ROI) were also evaluated by CBCT. After scanning the bone blocks, 20 self-drilling miniscrews (INP®) 1.4 mm in diameter and 6 mm long were inserted into them. The peak implant insertion torque (IT) was registered. After this, the pull-out test (PS) was performed and the maximum force registered. The Pearson correlation test was applied to verify the correlations between variables. RESULTS The BMD of the total bone block verified by CBCT and DEXA showed a positive and strong correlation (r  =  0.866, P  =  .000). The BMD of the ROI for cortical bone influenced the IT (r  =  0.518, P  =  .40) and the PS of miniscrews (r  =  0.713, P  =  .001, Table 2). However, the total bone BMD (verified by CBCT and DEXA) and trabecular bone BMD presented weak and not statistically significant correlations with primary stability. CONCLUSIONS There was a positive correlation between total bone block BMD measured by DEXA and CBCT. The cortical BMD influenced the IT and PS.

Does rapid maxillary expansion have long-term effects on airway dimensions and breathing?

INTRODUCTION In this systematic review, we identified and qualified the evidence of long-term reports on the effects of rapid maxillary expansion (RME) on airway dimensions and functions. METHODS Electronic databases (Ovid, Scirus, Scopus, Virtual Health Library, and Cochrane Library) were searched from 1900 to September 2010. Clinical trials that assessed airway changes at least 6 months after RME in growing children with rhinomanometry, acoustic rhinometry, computed tomography, or posteroanterior and lateral radiographs were selected. Studies that used surgically assisted RME and evaluated other simultaneous treatments during expansion, systemically compromised subjects, or cleft patients were excluded. A methodologic-quality scoring process was used to identify which studies would be most valuable. RESULTS Fifteen articles fulfilled the inclusion criteria, and full texts were assessed. Three were excluded, and 12 were assessed for eligibility. Four articles with low methodologic quality were not considered. The remaining 8 were qualified as moderate. The posteroanterior radiographs showed that nasal cavity width increases; in the lateral radiographs, decreased craniocervical angulation was associated with increases of posterior nasal space. Cone-beam computed tomography did not show significant increases of nasal cavity volume. Rhinomanometry showed reduction of nasal airway resistance and increase of total nasal flow, and acoustic rhinometry detected increases of minimal cross-sectional area and nasal cavity volume. CONCLUSIONS There is moderate evidence that changes after RME in growing children improve the conditions for nasal breathing and the results can be expected to be stable for at least 11 months after therapy.

Selective alveolar corticotomy to intrude overerupted molars

Orthodontic intrusion of overerupted molars in adults is challenging for most clinicians. Efficient intrusion can be achieved by combining selective alveolar corticotomies with a modified full-coverage maxillary splint to reduce surgical risks, treatment time, and costs for both orthodontists and patients.

Long-term skeletal and profile stability after surgical-orthodontic treatment of Class II and Class III malocclusion

OBJECTIVE The purpose of this perspective research was to study the long-term stability of skeletal, dentoalveolar and soft tissue after orthognathic surgery in subjects presenting with Class II and Class III malocclusions. METHODS The available digitized cephalometric radiographs, including pretreatment (t0), presurgery (t1), a minimum of 12 months postsurgery (t2) and at least 3 years after the orthosurgery treatment (t3) were taken between 1998 and 2010. In Group 1 mandibular advancement and in Group 2 mandibular advancement and maxillary impaction surgery were performed for correction of Class II. In Group 3 maxillary advancement and in Group 4 surgical maxillary advancement with mandibular setback, for correction of Class III. RESULTS In all the phases mandibular length was shorter in Group 1, and the inferior third of the face was longer in Group 2. Before the surgery there was greater maxillary deficiency in Group 3 than Group 4 and mandibular length was longer in Group 4. CONCLUSION In Groups 1 and 2, at retention phase, relapse occurred due to the increase in mandibular plane, whereas the surgeries performed in Groups 3 and 4 remained stable.

Is miniscrew primary stability influenced by bone density

Primary stability is absence of mobility in the bone bed after mini-implant placement and depends on bone quality among other factors. Bone quality is a subjective term frequently considered as bone density. The aim of this preliminary study was to evaluate bone density in two bovine pelvic regions and verify the primary stability of miniscrews inserted into them. Forty bone blocks were extracted from bovine pelvic bones, 20 from iliac and 20 from pubic bone, all of them containing cortical bone about 1 mm thick. Half of the sections extracted from each bone were designated for histological evaluation of bone density (trabecular bone area - TBA) and the other half for bone mineral density (BMD) evaluation by means of central dual-energy X-ray absorptiometry (DEXA). Then, twenty self-drilling miniscrews (INP®, São Paulo, Brazil) 1.4 mm in diameter and 6 mm long were inserted into the bone blocks used for BMD evaluation. Peak implant insertion torque (IT) and pull-out strength (PS) were used for primary stability evaluation. It was found that iliac and pubic bones present different bone densities, iliac bone being less dense considering BMD and TBA values (P > 0.05). However, the miniscrew primary stability was not different when varying the bone type (P < 0.05). IT and PS were not influenced by these differences in bone density when cortical thickness was about 1 mm thick.

Does cortical thickness influence the primary stability of miniscrews? A systematic review and meta-analysis

OBJECTIVE To investigate whether there is evidence to support the association between cortical thickness (CtTh) and the primary stability of mini-implants (MI). MATERIALS AND METHODS A search was performed including articles published until September 2013. The inclusion criteria comprised observational clinical studies conducted in patients who received monocortical MI for orthodontic anchorage and in vivo or ex vivo experimental studies performed to evaluate the primary stability of MI, studies that evaluated the association between CtTh and MI primary stability, CtTh measurement performed numerically, and MI primary stability evaluated by implant stability quotient value, Periotest value , pull-out strength, or insertion torque. Studies conducted exclusively in artificial bone or finite elements were excluded. RESULTS Abstract and title reading identified 15 possible articles to be included. After reading the complete text, three were excluded. One article was found by hand searching and another excluded for an overlapping sample. Finally, 12 articles were selected. A positive correlation was found between primary stability and CtTh when studies that evaluated primary stability through PS were grouped (r  =  .409) and when studies that evaluated stability in humans were grouped (r  =  .338). CONCLUSIONS There is a positive association between MI primary stability and CtTh of the receptor site. However, there is still a lack of well-designed clinical trials.

Is trabecular bone related to primary stability of miniscrews

OBJECTIVE To compare the primary stability of miniscrews inserted into bone blocks of different bone mineral densities (BMDs) with and without cortical bone, and investigate whether some trabecular properties could influence primary stability. MATERIALS AND METHODS Fifty-two bone blocks were extracted from fresh bovine pelvic bone. Four groups were created based on bone type (iliac or pubic region) and presence or absence of cortical bone. Specimens were micro-computed tomography imaged to evaluate trabecular thickness, trabecular number, trabecular separation, bone volume density (BV/TV), BMD, and cortical thickness. Miniscrews 1.4 mm in diameter and 6 mm long were inserted into the bone blocks, and primary stability was evaluated by insertion torque (IT), mini-implant mobility (PTV), and pull-out strength (PS). RESULTS Intergroup comparison showed lower levels of primary stability when the BMD of trabecular bone was lower and in the absence of cortical bone (P≤.05). The Pearson correlation test showed correlation between trabecular number, trabecular thickness, BV/TV, trabecular BMD, total BMD, and IT, PTV, and PS. There was correlation between cortical thickness and IT and PS (P≤.05). CONCLUSION Cancellous bone plays an important role in primary stability of mini-implants in the presence or absence of cortical bone.

Long-term fluoride release from resin-reinforced orthodontic cements following recharge with fluoride solution

The aim of this study was to test the hypothesis that there is no difference in the fluoride release behavior of resin-reinforced glass ionomer cements before or after fluoride recharge. The materials were divided into 5 groups: 2 resin-reinforced glass ionomer cements used for attaching orthodontic bands, that is, group FOB (Fuji Ortho Band) and group MCB (Multi-Cure Glass Ionomer Orthodontic Band Cement); 2 resin-reinforced glass ionomer cements and a composite used for bonding orthodontic brackets, that is, group OGLC (Ortho Glass LC), group FOLC (Fuji Ortho LC), and group TXT (Transbond XT), respectively. Fluoride release was measured during a 60-day period by using selective ion electrodes connected to an ionic analyser. After 4 weeks, the samples were exposed to 0.221% sodium fluoride solution. The results showed that cements achieved a maximum fluoride release 24 h after initial setting. No statistically significant differences were observed between groups FOB and OGLC regarding the amount of released fluoride following fluoride recharge from day 31 to day 36 (p>0.05). In conclusion, FOB and OGLC cements showed a higher capacity of capturing and releasing fluoride compared to the other cements studied.

Efeitos transversais da expansão rápida da maxila em pacientes com má oclusão de Classe II: avaliação por Tomografia Computadorizada Cone-Beam

OBJECTIVE: The aim of this study was to evaluate by Cone-Beam Computed Tomography (CBCT) transversal responses, immediately and after the retention period, to rapid maxillary expansion (RME), in Class II malocclusion patients. METHODS: Seventeen children (mean initial age of 10.36 years), with Class II malocclusion and skeletal constricted maxilla, underwent Haas´ protocol for RME. CBCT scans were taken before treatment (T1), at the end of the active expansion phase (T2) and after the retention period of six months (T3). The scans were managed in Dolphin software, where landmarks were marked and measured, on a coronal slice passing through the upper first molar. The paired Student´s t-test was used to identify significant differences (p<0.05) between T2 and T1, T3 and T2, and T3 and T1. RESULTS: Immediately after RME, the mean increase in maxillary basal, alveolar and dental width was 1.95 mm, 4.30 mm and 6.89 mm, respectively. This was accompanied by buccal inclination of the right (7.31°) and left (6.46°) first molars. At the end of the retention period, the entire transverse dimension increased was maintained and the dentoalveolar inclination resumed. CONCLUSIONS: The RME therapy was an effective procedure to increase transverse maxillary dimensions, at both skeletal and dentoalveolar levels, without causing inclination on anchorage molars in Class II malocclusion patients with skeletal constricted maxilla.