The maxillary lateral incisor in the rehabilitation of cleft lip and palate

This study analyzed the maintenance of lateral incisors in the dental rehabilitation of individuals with cleft lip and palate. Material and Methods: The study was conducted on a tertiary craniofacial center and comprised retrospective analysis of panoramic and periapical radiographs of Caucasoid individuals with non-syndromic complete unilateral cleft lip and palate, analyzing all radiographs available on the records of each individual, from the first to the last up to 12 years of age. Overall, 2,826 records were reviewed to achieve a sample of 1,000 individuals. Among these, 487 individuals presented the permanent lateral incisors on both cleft and non-cleft sides, which were included in this study. Results: The results were evaluated in percentages and by descriptive statistics. The association between maintenance of the lateral incisor and timing of alveolar bone graft were analyzed by the t test. Among the 487 individuals, 265 had not completed treatment, 62 presented insufficient information, and 44 concluded the treatment elsewhere. Among the remaining 116 individuals, the lateral incisor was extracted from 88 (75.86%) of them on the cleft side (CS) and from 23 (19.83%) people on the non-cleft side (NCS). The age at accomplishment of alveolar bone graft was significantly associated with maintenance of the lateral incisor on the cleft side (p<0.01). Most extractions were indicated because of the inadequate positioning on the CS and for midline correction on the NCS. Rehabilitation was primarily completed by orthodontic movement (53 individuals on the CS and 13 individuals on the NCS). Conclusion: In conclusion, the lateral incisor on the cleft side was not maintained in most individuals. Positive relationship was observed between extraction of the lateral incisor and age at accomplishment of the alveolar bone graft, suggesting the need to anticipate the initial radiographic evaluation to enhance its maintenance and reduce the procedures required for rehabilitation

Influence of removing excess of adhesive materials applied to eroded enamel on the resistance to erosive challenge

O uso de materiais resinosos sobre o tecido dentário é uma alternativa para a prevenção da progressão da erosão, contudo existem poucas informações sobre o efeito da infiltração resinosa na lesão de erosão. O objetivo deste estudo foi avaliar o efeito dos materiais resinosos sobre (sem remoção de excesso) e supostamente dentro (com remoção de excesso) do esmalte previamente erodido, submetido a desafio erosivo subsequente. Os blocos de esmalte bovino foram imersos em HCl 0,01 M, pH 2,3 durante 30 segundos para a formação de lesão inicial de erosão. Em seguida, os blocos foram divididos aleatoriamente e tratados de acordo com 8 grupos (n=12): Cc e Cs- controle sem tratamento, Hc e Hs- selante de fossas e fissuras (Helioseal Clear®), Ac e As- adesivo autocondicionante (Adhese®), Ic e Is- infiltrante (Icon®); sendo c- com remoção de excesso e s- sem remoção de excesso do material. Os materiais foram aplicados de acordo com as recomendações dos fabricantes. Nos grupos com remoção de excesso, após a aplicação dos materiais houve a remoção de seu excesso da superfície de esmalte com um cotonete, anteriormente a fotopolimerização. Após o tratamento, todos os espécimes foram submetidos à ciclagem erosiva, por meio da imersão em ácido clorídrico (0,01M; pH 2,3) por 2 minutos, seguida da imersão em saliva artificial por 120 minutos, 4 vezes ao dia, durante 5 dias. A espessura de material e o desgaste dentário foram analisados por meio da perfilometria e os resultados submetidos ao teste ANOVA a dois critérios e teste de Tukey (p0,05), constatando-se a presença de material sobre o esmalte prevenindo a perda da estrutura dentária. Os grupos nos quais o excesso de material sobre o esmalte foi removido (Hc, Ac, Ic) resultaram em perda de esmalte após a aplicação. Além disso, esses grupos (Hc, Ac, Ic) não foram capazes de proteger o esmalte contra a erosão, uma vez que após o desafio erosivo o desgaste do esmalte destes grupos foi semelhante ao grupo controle. Com base nos resultados do presente estudo, conclui-se que os materiais resinosos são capazes de proteger o esmalte contra a erosão dentária somente quando estão presentes sobre a superfície dentária, formando uma barreira mecânica.The use of resin-based materials over the dental tissue is an alternative for erosion progression prevention, however there is little information regarding the effect of resin infiltration into erosive lesion. The aim of this study was to evaluate the effect of resin-based materials over (without excess removal) and into (with excess removal) previously eroded enamel, subjected to erosive challenge. Bovine enamel blocks were immersed in HCl 0.01 M, pH 2.3 for 30 seconds for the formation of softened erosion lesion. Then the blocks were random divided and treated according to 8 groups (n=12): Cc and Cs- control without treatment, Hc and Hs- fissure resin sealant (Helioseal Clear®), Ac and As- self-etch adhesive (Adhese®), Ic and Isinfiltrant (Icon®); being c- with excess removal and s- without excess removal of the material. The materials were applied according to manufacture instructions. The groups with excess received the same materials, however before light curing the excess of material over enamel was gently removed with a cotton roll. After treatment, the blocks were immersed in HCl for 2 min, followed by immersion in artificial saliva for 120 min, 4 times per day, during 5 days (erosive cycling). Enamel wear and material thickness were analyzed using profilometry and the results submitted to two-way ANOVA and Tukeys test (p<0.05). Groups Hs, As, Is, resulted in the formation of a layer of material over enamel, being effective in inhibiting erosion progression. Groups in which the material over enamel was removed (Hc, Ac, Ic), resulted in enamel loss after application. In addition, they (Hc, Ac, Ic) were not able to protect enamel, since after the erosive challenge enamel wear of these groups was similar to control. Based on the results of this study, resin-based materials are able to protect enamel against erosion only when they are present over enamel, forming a mechanical barrier

Periodontal status of children with cleft lip and palate

O periodonto saudável é um pré-requisito importante para uma dentição saudável e manutenção da saúde bucal e sistêmica. As afecções bucais induzidas por placa são encontradas com mais frequência em indivíduos com fissuras labiopalatinas. No entanto, pesquisas científicas relacionadas aos problemas de saúde bucal de crianças com fissuras labiopalatinas são escassas e carecem de estudos relativos à condição periodontal das mesmas. Nesse sentido, o objetivo deste estudo foi avaliar a condição periodontal de crianças com fissuras labiopalatinas e compará-la com um grupo controle. O presente estudo foi realizado em 108 pacientes com idades variando entre 6 e 12 anos, com dentadura mista, divididas em três grupos: G1= crianças com fissura de lábio e rebordo com ou sem fissura de palato, unilaterais ou bilaterais (n=36), G2= crianças com fissuras somente de palato (n= 36) e G3= crianças sem fissura (n= 36). A condição periodontal foi avaliada por parâmetros clínicos clássicos: Índice Gengival e três índices de placa: PHP, OLeary e IP. Os resultados obtidos foram submetidos a análise estatística, sendo que para índice PHP foi utilizado o teste ANOVA e os outros três índices foram submetidos ao teste Kruskal-Wallis. Nos três grupos também foi aplicado o teste das comparações de paridade; para as correlações entre os grupos foi utilizada a correlação de Spearman. Foi adotado nível de significância de 5%. Os resultados demonstraram que não houve diferença estatisticamente significativa entre os três grupos analisados quando avaliados pelos índices IP (p= 0,784) e IG (p=0,418). Com relação ao índice PHP também não foi observado diferença estatisticamente significativa (p= 0,126). Os dados revelaram diferenças estatisticamente significativas entre os grupos na avaliação através do índice de O Leary. A diferença encontrada foi entre os grupos 1 e 3 (p=0,026) tendo o grupo 3 apresentado a pior condição de higiene bucal. Os resultados do presente estudo permitem concluir que as crianças com fissuras labiopalatinas não apresentaram pior condição periodontal comparadas às crianças sem fissuras labiopalatinas.The healthy periodontium is an important requirement for maintaining healthy teeth and oral and systemic health. Plaque-induced oral disorders are observed more frequently in individuals with cleft lip and palate. However, scientific research related to oral health problems of children with cleft lip and palate are scarce, and there is lack of studies on their periodontal status. Therefore, this study evaluated the periodontal status of children with cleft lip and palate, compared to a control group. The study was conducted on 108 patients aged 6 to 12 years, in the mixed dentition, divided into three groups: G1= children with cleft lip and alveolus with or without cleft palate, unilateral or bilateral (n=36), G2= children with isolated cleft palate (n= 36); and G3= children without clefts (n= 36). The periodontal status was evaluated by acknowledged clinical parameters: Gingival index, and three plaque indices: PHP, OLeary and IP. The results were statistically analyzed; the PHP was assessed by the ANOVA test, and the other three indices were analyzed by the Kruskal-Wallis test. The three groups were also submitted to pairwise comparison; correlations between groups were assessed by the Spearman correlation. All tests were applied at a significance level of 5%. The results demonstrated no statistically significant difference between the three groups for the indices IP (p=0.784) and IG (p=0.418). Concerning the PHP index, there was also no statistically significant difference (p=0.126). Data revealed statistically significant differences in the evaluation by the OLeary index, evidencing difference between groups 1 and 3 (p=0.026), with worse oral hygiene for group 3. It was concluded that children wwith cleft lip and palate did not presente worse periodontal status comapred to children without clefts

Tooth Abnormalities of Number and Position in the Permanent Dentition of Patients With Complete Bilateral Cleft Lip and Palate

Objective: To radiographically evaluate the prevalence of tooth abnormalities of number and position in the permanent dentition of individuals with complete bilateral cleft lip and palate. Design: Cross-sectional retrospective. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil. Patients: Two hundred five individuals with complete bilateral cleft lip and palate. Interventions: Analysis of patient records and panoramic radiographs. Main outcome measures: Evaluation of hypodontia and supernumerary teeth and analysis of the position of the permanent maxillary lateral incisor in relation to the alveolar cleft. Results: Hypodontia was observed in 144 patients (70.2%), and the highest prevalence was observed for the maxillary lateral incisor. When both lateral incisors were present (43%), they were primarily located on the distal side of the cleft (25%). Supernumerary teeth were observed in 11.7% of individuals. Conclusion: Patients with cleft lip and palate presented high prevalence of hypodontia and supernumerary teeth. The prevailing characteristics of their location may suggest the presence of a similar genetic component for the occurrence of hypodontia and cleft

The maxillary lateral incisor in the rehabilitation of cleft lip and palate

<div><p>Abstract Objective This study analyzed the maintenance of lateral incisors in the dental rehabilitation of individuals with cleft lip and palate. Material and Methods The study was conducted on a tertiary craniofacial center and comprised retrospective analysis of panoramic and periapical radiographs of Caucasoid individuals with non-syndromic complete unilateral cleft lip and palate, analyzing all radiographs available on the records of each individual, from the first to the last up to 12 years of age. Overall, 2,826 records were reviewed to achieve a sample of 1,000 individuals. Among these, 487 individuals presented the permanent lateral incisors on both cleft and non-cleft sides, which were included in this study. Results The results were evaluated in percentages and by descriptive statistics. The association between maintenance of the lateral incisor and timing of alveolar bone graft were analyzed by the t test. Among the 487 individuals, 265 had not completed treatment, 62 presented insufficient information, and 44 concluded the treatment elsewhere. Among the remaining 116 individuals, the lateral incisor was extracted from 88 (75.86%) of them on the cleft side (CS) and from 23 (19.83%) people on the non-cleft side (NCS). The age at accomplishment of alveolar bone graft was significantly associated with maintenance of the lateral incisor on the cleft side (p<0.01). Most extractions were indicated because of the inadequate positioning on the CS and for midline correction on the NCS. Rehabilitation was primarily completed by orthodontic movement (53 individuals on the CS and 13 individuals on the NCS). Conclusion In conclusion, the lateral incisor on the cleft side was not maintained in most individuals. Positive relationship was observed between extraction of the lateral incisor and age at accomplishment of the alveolar bone graft, suggesting the need to anticipate the initial radiographic evaluation to enhance its maintenance and reduce the procedures required for rehabilitation.</p></div

Susceptibility of bovine dental enamel with initial erosion lesion to new erosive challenges

<div><p>This <i>in vitro</i> study evaluated the impact of initial erosion on the susceptibility of enamel to further erosive challenge. Thirty bovine enamel blocks were selected by surface hardness and randomized into two groups (n = 15): GC- group composed by enamel blocks without erosion lesion and GT- group composed by enamel blocks with initial erosion lesion. The baseline profile of each block was determined using the profilometer. The initial erosion was produced by immersing the blocks into HCl 0.01 M, pH 2.3 for 30 seconds, under stirring. The erosive cycling consisted of blocks immersion in hydrochloric acid (0.01 M, pH 2.3) for 2 minutes, followed by immersion in artificial saliva for 120 minutes. This procedure was repeated 4 times a day for 5 days, and the blocks were kept in artificial saliva overnight. After erosive cycling, final profile measurement was performed. Profilometry measured the enamel loss by the superposition of initial and final profiles. Data were analyzed by t-test (<i>p</i><0.05). The result showed no statistically significant difference between groups (GS = 14.60±2.86 and GE = .14.69±2.21 μm). The presence of initial erosion on bovine dental enamel does not enhance its susceptibility to new erosive challenges.</p></div

Mean enamel loss and standard deviation of two groups (noneroded and eroded enamel) after the erosive cycling.

<p>Mean enamel loss and standard deviation of two groups (noneroded and eroded enamel) after the erosive cycling.</p