Rodrigo Galo

Unusual Orofacial Manifestations of Histoplasmosis in Renal Transplanted Patient

Histoplasmosis is a fungal infection caused by the Histoplasma capsulatum. Mucosal manifestations are uncommon, but, when present, they are usually associated with pulmonary or chronic disseminated infection. The course of the disease is often related to the host immune response. The purpose of this article is to describe the clinical and microscopic findings of unusual involvement of nasal cartilage and septal destruction, and oral lesions of histoplasmosis in an immunosuppressed patient who presented an unusual form of the disease.

Effects of chemical composition on the corrosion of dental alloys

The aim of this study was to determine the effect of the oral environment on the corrosion of dental alloys with different compositions, using electrochemical methods. The corrosion rates were obtained from the current-potential curves and electrochemical impedance spectroscopy (EIS). The effect of artificial saliva on the corrosion of dental alloys was dependent on alloy composition. Dissolution of the ions occurred in all tested dental alloys and the results were strongly dependent on the general alloy composition. Regarding the alloys containing nickel, the Ni-Cr and Ni-Cr-Ti alloys released 0.62 mg/L of Ni on average, while the Co-Cr dental alloy released ions between 0.01 and 0.03 mg/L of Co and Cr, respectively.The open-circuit potential stabilized at a higher level with lower deviation (standard deviation: Ni-Cr-6Ti = 32 mV/SCE and Co-Cr = 54 mV/SCE). The potenciodynamic curves of the dental alloys showed that the Ni-based dental alloy with >70 wt% of Ni had a similar curve and the Co-Cr dental alloy showed a low current density and hence a high resistance to corrosion compared with the Ni-based dental alloys. Some changes in microstructure were observed and this fact influenced the corrosion behavior for the alloys. The lower corrosion resistance also led to greater release of nickel ions to the medium. The quantity of Co ions released from the Co-Cr-Mo alloy was relatively small in the solutions. In addition, the quantity of Cr ions released into the artificial saliva from the Co-Cr alloy was lower than Cr release from the Ni-based dental alloys.

Effect of laser acupuncture and auricular acupressure in a child with trismus as a sequela of medulloblastoma

In several countries the most common cause of death in young people is cancer. Patients with head and neck cancer often have complications after cancer treatment. Radiation therapy can cause oral trismus, which is related to high doses of radiation. Although acupuncture is reported to be effective and is widely used for the treatment of peripheral facial paralysis by promoting an improvement of motor functions, few reports in the literature demonstrate its effectiveness. We report a case in which the symptoms of a patient with facial paralysis after surgical cancer treatment associated with chemotherapy and radiotherapy improved after laser treatment at acupuncture points. Ten weekly sessions of laser therapy were conducted, using the Twin laser device, applied to systemic acupuncture points (LR3, LI4, LI18, LI19, LI20, SI17, SI19, ST4, ST6, ST7, GV20), together with 10 weekly sessions of auricular acupressure. Significant improvement of the trismus was seen, confirmed by the increase in mouth opening from 33.26 to 53.3 mm. The patients family also noted reduced anxiety and hyperactivity. These results suggest that laser acupuncture and auricular acupressure for trismus and facial paralysis following cancer treatment is worth further investigation.

Thermal alteration and morphological changes of sound and demineralized primary dentin after Er:YAG laser ablation

The purpose of this study was to assess the influence of Er:YAG laser pulse repetition rate on the thermal alterations occurring during laser ablation of sound and demineralized primary dentin. The morphological changes at the lased areas were examined by scanning electronic microscopy (SEM). To this end, 60 fragments of 30 sound primary molars were selected and randomly assigned to two groups (n = 30); namely A sound dentin (control) and B demineralized dentin. Each group was divided into three subgroups (n = 10) according to the employed laser frequencies: I–4 Hz; II–6 Hz, and III–10 Hz. Specimens in group B were submitted to a pH‐cycling regimen for 21 consecutive days. The irradiation was performed with a 250 mJ pulse energy in the noncontact and focused mode, in the presence of a fine water mist at 1.5 mL/min, for 15 s. The measured temperature was recorded by type K thermocouples adapted to the dentin wall relative to the pulp chamber. Three samples of each group were analyzed by SEM. The data were submitted to the nonparametric Kruskal‐Wallis test and to qualitative SEM analysis. The results revealed that the temperature increase did not promote any damage to the dental structure. Data analysis demonstrated that in group A, there was a statistically significant difference among all the subgroups and the temperature rise was directly proportional to the increase in frequency. In group B, there was no difference between subgroup I and II in terms of temperature. The superficial dentin observed by SEM displayed irregularities that augmented with rising frequency, both in sound and demineralized tissues. In conclusion, temperature rise and morphological alterations are directly related to frequency increment in both demineralized and sound dentin. Microsc. Res. Tech., 2011.

CO2 Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

This study evaluated the effect of CO2 laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3 × 3 × 2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n = 10): L: CO2 laser (λ = 10.6 μm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2 laser was applied with 0.5 W power and 0.44 J/cm2 energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 μm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P ≤ 0.05) that showed the lowest microhardness values. It was concluded that CO2 laser can be an additional resource in caries control progression on primary teeth enamel.

Influence of the casting processing route on the corrosion behavior of dental alloys

Casting in the presence of oxygen may result in an improvement of the corrosion performance of most alloys. However, the effect of corrosion on the casting without oxygen for dental materials remains unknown. The aim of this study was to investigate the influence of the casting technique and atmosphere (argon or oxygen) on the corrosion behavior response of six different dental casting alloys. The corrosion behavior was evaluated by electrochemical measurements performed in artificial saliva for the different alloys cast in two different conditions: arc melting in argon and oxygen-gas flame centrifugal casting. A slight decrease in open-circuit potential for most alloys was observed during immersion, meaning that the corrosion tendency of the materials increases due to the contact with the solution. Exceptions were the Co-based alloys prepared by plasma, and the Co-Cr-Mo and Ni-Cr-4Ti alloys processed by oxidized flame, in which an increase in potential was observed. The amount of metallic ions released into the artificial saliva solution during immersion was similar for all specimens. Considering the pitting potential, a parameter of high importance when considering the fluctuating conditions of the oral environment, Co-based alloys show the best performance in comparison with the Ni-based alloys, independent of the processing route.

Effect of laser welding on the titanium ceramic tensile bond strength

Titanium reacts strongly with elements, mainly oxygen at high temperature. The high temperature of titanium laser welding modifies the surface, and may interfere on the metal-ceramic tensile bond strength. Objective The influence of laser welding on the titanium-ceramic bonding has not yet been established. The purpose of this in vitro study was to analyze the influence of laser welding applied to commercially pure titanium (CpTi) substructure on the bond strength of commercial ceramic. The influence of airborne particle abrasion (Al2O3) conditions was also studied. Material and Methods Forty CpTi cylindrical rods (3 mm x 60 mm) were cast and divided into 2 groups: with laser welding (L) and without laser welding (WL). Each group was divided in 4 subgroups, according to the size of the particles used in airborne particle abrasion: A - Al2O3 (250 µm); B - Al2O3 (180 µm); C - Al2O3 (110 µm); D - Al2O3 (50 µm). Ceramic rings were fused around the CpTi rods. Specimens were invested and their tensile strength was measured at fracture with a universal testing machine at a crosshead speed of 2.0 mm/min and 200 kgf load cell. Statistical analysis was carried out with analysis of variance and compared using the independent t test (p≤0.05). Results Significant differences were found among all subgroups (p<0.05). The highest and the lowest bond strength means were recorded in subgroups WLC (52.62 MPa) and LD (24.02 MPa), respectively. Conclusion Airborne particle abrasion yielded significantly lower bond strength as the Al2O3 particle size decreased. Mechanical retention decreased in the laser-welded specimens, i.e. the metal-ceramic tensile bond strength was lower.

Effect of laser welding on the titanium composite tensile bond strength

The aim of this study was to analyze the shear bond strength between commercially pure titanium, with and without laser welding, after airbone-particle abrasion (Al(2)O(3)) and 2 indirect composites. Sixty-four specimens were cast and divided into 2 groups with and without laser welding. Each group was divided in 4 subgroups, related to Al(2)O(3) grain size: A - 250 microm; B - 180 microm; C- 110 microm; and D - 50 microm. Composite rings were formed around the rods and light polymerized using UniXS unit. Specimens were invested and their shear bond strength at failure was measured with a universal testing machine at a crosshead speed of 2.0 mm/min. Statistical analysis was carried out with ANOVA and Tukeys test (alpha=0.05). The highest bond strength means were recorded in 250 microm group without laser welding. The lowest shear bond strength means were recorded in 50 microm group with laser welding. Statistically significant differences (p<0.05) were found between all groups. In conclusion, airborne particle abrasion yielded significantly lower bond strength as the Al(2)O(3) particle size decreased. Shear bond strength decreased in the laser welded specimens.

CO2 laser emission modes to control enamel erosion

Considering the importance and prevalence of dental erosion, the aim of this in vitro study was to evaluate the influence of different modes of pulse emission of CO2 laser associated or not to acidulated phosphate fluoride (APF) 1.23% gel, in controlling enamel erosion by profilometry. Ninety‐six fragments of bovine enamel were flattened and polished, and the specimens were subjected to initial erosive challenge with hydrochloric acid (pH = 2). Specimens were randomly assigned according to surface treatment: APF 1.23% gel and gel without fluoride (control), and subdivided according to the modes of pulse CO2 laser irradiation: no irradiation (control), continuous, ultrapulse, and repeated pulse (n = 12). After surface treatment, further erosive challenges were performed for 5 days, 4 × 2 min/day. Enamel structure loss was quantitatively determined by a profilometer, after surface treatment and after 5 days of erosive challenges. Two‐away ANOVA revealed a significant difference between the pulse emission mode of the CO2 laser and the presence of fluoride (P ≤ 0.05). The Duncans test showed that CO2 laser irradiation in continuous mode and the specimens only received fluoride, promoted lower enamel loss than that other treatments. A lower dissolution of the enamel prisms was observed when it was irradiated with CO2 laser in continuous mode compared other groups. It can be concluded that CO2 laser irradiation in continuous mode was the most effective to control the enamel structure loss submitted to erosive challenges with hydrochloric acid. Microsc. Res. Tech. 78:654–659, 2015.

Influence of the Nd:YAG Laser Pulse Duration on the Temperature of Primary Enamel

The aim of this study is to evaluate the temperature change on specimens of primary enamel irradiated with different pulse duration of Nd:YAG laser. Fifteen sound primary molars were sectioned mesiodistally, resulting in 30 specimens (3.5 × 3.5 × 2.0 mm). Two small holes were made on the dentin surface in which K-type thermocouples were installed to evaluate thermal changes. Specimens were randomly assigned in 3 groups (n = 10): A = EL (extra long pulse, 10.000 μs), B = LP (long pulse, 700 μs), and C = SP (short pulse, 350 μs). Nd:YAG laser (λ = 1.064 μm) was applied at contact mode (10 Hz, 0.8 W, 80 mJ) and energy density of 0.637 mJ/mm2. Analysis of variance (ANOVA) was performed for the statistical analysis (P = 0.46). Nd:YAG laser pulse duration provided no difference on the temperature changes on primary enamel, in which the following means were observed: A = EL (23.15°C ± 7.75), B = LP (27.33°C ± 11.32), and C = SP (26.91°C ± 12.85). It can be concluded that the duration of the laser pulse Nd:YAG increased the temperature of the primary enamel but was not influenced by different pulse durations used in the irradiation.