General and oral aspects in Apert syndrome: report of a case

Background: The present paper describes the general and oral manifestations in a 32-year-old man previously diagnosed with Apert syndrome. Clinical examination revealed features of acrocephalosyndactyly. The patient was found to have a flattened occiput with frontal prominence, abnormal contour of head (brachycephaly), shallow and downward slanting orbits with bilateral proptosis, hypertelorism, retruded midface, and prognathic mandible.Dental anormalies were present in a patient. Intraoral evaluation revealed normal mouth opening with anterior severe skeletal open bite and Byzantine-arch palate, maxillary alveolar ridges with crowding of maxillary and mandibular teeth, poor hygiene with heavy dental calculus and periodontal pseudopocket, dental caries, severe anterior open bite and crossbite, macroglosia and smooth tongue. The high prevalence of dental anomalies and ectopic eruption may suggest a possible etiologic relationship with the Apert syndrome. Keywords Acrocephalosyndactylia, Craniosynostosis, Tooth abnormalities, Mouth abnormalities, Apert Syndrom

Función de las sustancias antioxidantes sobre esmalte blanqueado con peróxido de hidrógeno ante la adhesión inmediata de composites y sus cambios estructurales y morfológicos superficiales

[spa] OBJETIVOS: Determinación del grado de adhesión inmediata de resinas compuestas a esmalte blanqueado y sus características estructurales y morfológicas superficiales con y sin aplicación de sustancias antioxidantes. MATERIALES Y MÉTODOS: Se emplearon 75 molares humanos recientemente extraídos, en diferentes condiciones experimentales; Grupo 1: peróxido de hidrógeno (PH)/ ascorbato de sodio, Grupo 2:PH/ peroxidasa, Grupo 3: PH/catalasa, Grupo 4: PH/agua, Grupo 5:Control, a los cuales se adhirieron bloques estandarizados de composites, para luego, mediante una máquina de pruebas universales, determinar la Fuerza Adhesiva Tensional (FAT) entre los diferentes grupos de estudio. Posteriormente, en las mencionadas muestras se procedió a la visualización de la penetración de los "tags" de resina, previo procedimiento de corte, por medio de Microscopia Confocal (MC) o Electrónica de Barrido (MEB). El estudio estructural y morfológico superficial del esmalte fue efectuado utilizando Espectrometría de fotoelectrones y Microscopia Confocal respectivamente. RESULTADOS: En cuanto a FAT, no existieron diferencias estadísticamente significativas entre los grupos 1, 3 y 5 (p=0,05).Así mismo, Los "tags" de resina compuesta en estos grupos se presentaron uniformes, regulares, estructuralmente completos y bien definidos. A nivel estructural, los grupos sometidos a peróxido de hidrógeno, mostraron algún nivel de afectación leve a nivel de esmalte superficial, comparado al grupo sometido a refresco (Coca Cola®), que afectó el esmalte tanto a nivel superficial, como subsuperficial. CONCLUSIONES: Los agentes blanqueadores de peróxido de hidrógeno son capaces de alterar adversamente los mecanismos de adhesión resina compuesta- esmalte. Por otro lado, las sustancias antioxidantes, pueden ser capaces de revertir este efecto, pudiendo así mismo, proteger al esmalte a nivel morfológico y estructural.[eng] "FUNCTION OF THE ANTIOXIDANTS IN THE INMEDIATE BONDING OF COMPOSITES IN POST- BLEACHED ENAMEL AND THE MICROSTRUCTURAL AND MORPHOLOGICAL CHANGES". PURPOSE: The purpose of this in vitro study was to investigate the effectiveness of the antioxidants used immediately after tooth bleaching on the tensile bond strength of resin restorations. In addition to the studying the morphology of the resin tags in bleached and unbleached enamel and to determine the adverse effects of Hydrogen Peroxide (HP) on enamel, to morphological and microstructure level and the function of certain antioxidants in the reversal of those affects. MATERIAL AND METHOD: Human teeth (n=75) were divided into five groups (1 to 5). Group 1 (n=15)Hydrogen peroxide/ sodium ascorbate). Group 2 (n=15) Hydrogen Peroxide/peroxidase, Group 3 (n=15) Hydrogen Peroxide/ Catalase. Group 4 (n=15) Hydrogen Peroxide/water and Group 5 (n=15)Control. Post- bleaching resin cylinders were located on the surface of the enamel immediately after the respective treatment of each group, and subjected to load testing. After load testing- for the Electron Microscopy Scanning (SEM) and Confocal Laser Scanning Microscope (CLSM) study of the appearance of the resin "tags". By other hand, the microstructure and morphology of enamel was examined under spectrometry and CLSM, respectively. RESULTS: The average values of the tensile bond strength diminished significantly in groups 2 and 4. There was no statistical difference between the groups 1, 3 and 5. differences in the number and the depth of the "tags" occurred within one specimen and groups of specimens. Groups 1, 3 and 5 showed "tags" well defined and structurally intact. With relation to microstructure of enamel, the lowest concentration of C and N was seen in group 2, while in the groups treated with antioxidants maintained the aprismatic surface portion. Groups 2 and 3 showed lower concentrations of Ca and P. Groups 1 and 4 showed regular enamel features and presence, and the aprismatic surface was intact. In Trail 2, the soft drink presented a partial removal of the aprismatic surface and minor concentrations of Ca and P. The groups 1, 3 and 5 demonstrates a uniformity of the aprismatic surface layer under CLSM. CONCLUSIONS: The hydrogen peroxide bleaching agents adversely affect the bond strength of composite to acid etching enamel. The complementary use of antioxidant substances reduced this effect and the adverse affects on the chemical compositions and morphology of the enamel

General and oral aspects in Apert syndrome: report of a case

Background: The present paper describes the general and oral manifestations in a 32-year-old man previously diagnosed with Apert syndrome. Clinical examination revealed features of acrocephalosyndactyly. The patient was found to have a flattened occiput with frontal prominence, abnormal contour of head (brachycephaly), shallow and downward slanting orbits with bilateral proptosis, hypertelorism, retruded midface, and prognathic mandible.Dental anormalies were present in a patient. Intraoral evaluation revealed normal mouth opening with anterior severe skeletal open bite and Byzantine-arch palate, maxillary alveolar ridges with crowding of maxillary and mandibular teeth, poor hygiene with heavy dental calculus and periodontal pseudopocket, dental caries, severe anterior open bite and crossbite, macroglosia and smooth tongue. The high prevalence of dental anomalies and ectopic eruption may suggest a possible etiologic relationship with the Apert syndrome. Keywords Acrocephalosyndactylia, Craniosynostosis, Tooth abnormalities, Mouth abnormalities, Apert Syndrom