Ectopic Thyroid at the Base of the Tongue of a Young Patient

Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base and it is uncommonly observed in clinical practice and is rare in children. This paper describes the surgical treatment of ectopic thyroid at the base of the tongue in a child. The chief complaint of the 12-year-old, melanodermic female patient was the difficulty to swallow for 15 days. The intraoral physical examination barely showed a nodular lesion at tongue base. The CT scan showed a round, well defined hyperdense lesion of approximately 25.8 mm at its largest diameter, with infiltrative growth in the posterior region of the base of the tongue. The proposed treatment was complete resection of the lesion. The histopathological diagnosis was lingual thyroid. After the diagnosis was established, the patient was referred to an endocrinologist for exams and medical follow-up. Lingual thyroid is a rare condition and its diagnosis in children is even rarer. Its approach should be transdisciplinary and should take into consideration the hormonal aspects of the patient in addition to the clinical condition of the lesion. In the presented case, the removal of the alteration was performed via conservative surgical procedure followed by immediate referral of the patient to the endocrinologist for a follow-up

Evaluation of Selective Physicochemical and Biological Properties of Different Root Canal Sealers

Introduction: This in vitro study aimed to evaluate the chemical composition, water solubility, radiopacity, pH, electrical conductivity and cytotoxicity of four different root canal sealers. Methods and Materials: Four materials were tested including an epoxy resin-based sealer (AH-Plus), a calcium silicate-based sealer (MTA Fillapex), a calcium hydroxide-based sealer (Sealapex) and a zinc-oxide-eugenol-based sealer (Endofill). The materials were submitted to energy-dispersive x-ray microanalysis for elemental chemical composition. Solubility and radiopacity were evaluated according to ANSI/ADA. The pH and electrical conductivity were measured at different periods of time. L929 immortalized mouse fibroblast line were used for cytotoxicity evaluation. Statistical analyses were carried out using the ANOVA and Tukey’s test. Results: The main elements were found to be silicon and calcium in MTA Fillapex, calcium and bismuth in Sealapex, zirconium and tungsten in AH-Plus and zinc and bismuth in Endofill. Sealapex had the highest value for solubility (P<0.05), AH-Plus showed the highest radiopacity value (P<0.05) while MTA Fillapex had the highest pH and electrical conductivity values (P<0.05). AH-Plus showed the highest rate of cell viability (P<0.05). Conclusion: Based on the results of this in vitro study, it was possible to conclude that Endofill and Sealpex did not meet the requirements for water solubility. The tested sealers were alkaline and showed radiopacity in accordance with ANSI/ADA standards. AH-Plus showed to be less cytotoxic than other tested root canal sealers. Keywords: Biological Assay; Endodontics; Root Canal Filling Materials; Root Canal Obturatio

The effect of facial fractures on mouth opening range: a case series

Introduction: Facial fractures can result in limitation of mouth opening range, which consequently leads to functional impairments. Objective: To identify the influence of facial fractures and their corrective surgery on mouth opening range. Material and methods: Consecutive patients submitted to maxillofacial surgery had their mouth opening range measured at four different moments: preoperative (T0), immediate post-operative (within 24 hours afteroperation) (T1), one-week post-operative (T2) and one-month postoperative (T3). Eighteen subjects composed the sample, majorly represented by male gender, fractures caused by direct trauma as in traffic accidents, age among 21-30 years old and presenting mandible fracture. Results: Mouth opening at T0 demonstrated a mean value of 26.63 mm, T1 decreased to a mean of 22.59 mm, T2 mean value evolved to 26.42 mm and T3 displayed mean value of34.57 mm. Statistical evaluation demonstrated overall significance forthe comparison among all different periods, particularly for isolated mandible fractures, except between T0 and T2. Conclusion: It can be suggested that fracture itself and surgery for its correction have a negative effect on mouth opening range; however, the capacity of mouth opening presents signs of recovery since the first post-operative week, with notable progression until one month after surgery.Introduction: Facial fractures can result in limitation of mouth opening range, which consequently leads to functional impairments. Objective: To identify the influence of facial fractures and their corrective surgery on mouth opening range. Material and methods: Consecutive patients submitted to maxillofacial surgery had their mouth opening range measured at four different moments: preoperative (T0), immediate post-operative (within 24 hours afteroperation) (T1), one-week post-operative (T2) and one-month postoperative (T3). Eighteen subjects composed the sample, majorly represented by male gender, fractures caused by direct trauma as in traffic accidents, age among 21-30 years old and presenting mandible fracture. Results: Mouth opening at T0 demonstrated a mean value of 26.63 mm, T1 decreased to a mean of 22.59 mm, T2 mean value evolved to 26.42 mm and T3 displayed mean value of34.57 mm. Statistical evaluation demonstrated overall significance forthe comparison among all different periods, particularly for isolated mandible fractures, except between T0 and T2. Conclusion: It can be suggested that fracture itself and surgery for its correction have a negative effect on mouth opening range; however, the capacity of mouth opening presents signs of recovery since the first post-operative week, with notable progression until one month after surgery

Radiopacity evaluation of Portland and MTA-based cements by digital radiographic system

OBJECTIVE: The aim of the present study was to evaluate the radiopacity of Portland and MTA-based cements using the Digora TM digital radiographic system. MATERIAL AND METHODS: The performed tests followed specification number 57 from the American National Standard Institute/American Dental Association (2000) for endodontic sealing materials. The materials were placed in 5 acrylic plates, especially designed for this experiment, along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The set was radiographed at a 30 cm focus-object distance and with 0.2 s exposure time. After the radiographs were taken, the optical laser readings of radiographs were performed by Digora TM system. Five radiographic density readings were performed for each studied material and for each step of the aluminum scale. RESULTS: White ProRoot MTA (155.99±8.04), gray ProRoot MTA (155.96±16.30) and MTA BIO (143.13±16.94) presented higher radiopacity values (

Physicochemical Properties of MTA and Portland Cement after Addition of Aloe Vera

Introduction: The aim of this in vitro study was to determine the liquid-powder ratio, setting time, solubility, dimensional change, pH, and radiopacity of white structural and non-structural Portland cement, ProRoot MTA and MTA Bio, associated with a 2% glycolic solution containing Aloe Vera, as vehicle. Methods and Materials: Five samples of each material were used for each test, according to the American National Standards Institute/American Dental Association (ANSI/ADA) specification No. 57. Statistical analyses were performed using ANOVA and Tukey’s test at 5% significance. When sample distribution was not normal, non-parametric analysis of variance and the Kruskal-Wallis test were used (α=0.05). Results: No statistical differences were found in liquid-powder ratios among the tested materials. ProRoot MTA showed the longest setting time. Dimensional change values were acceptable in all groups. Also, no significant differences were found in pH values and pH was alkaline in all samples throughout the experiment. Mean radiopacity results obtained for white Portland cements did not meet ANSI/ADA requirements, and were significantly lower than those obtained for MTA-based cements. Finally, Portland cements showed significantly higher mean solubility values compared to the other samples. Conclusion: The physicochemical properties of the tested materials in association with Aloe Vera were compatible with ANSI/ADA requirements, except for the white Portland cements, which failed to meet the radiopacity specification.Keywords: Aloe Vera; MTA; Physicochemical Properties; Portland Cemen

Shear Bond Strength of Orthodontic Brackets Fixed with Remineralizing Adhesive Systems after Simulating One Year of Orthodontic Treatment

The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n=16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p<0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance

Repair of Iatrogenic Furcal Perforation with Mineral Trioxide Aggregate: A Seven-Year Follow-up

Teeth with furcal perforation present difficult resolution and dubious prognosis. Several materials have been proposed and calcium silicate-based cements such as mineral trioxide aggregate (MTA) are the most recommended. However, its long-term clinical behavior still remains poorly understood. The present study reports a clinical case of furcal perforation repair using Angelus MTA, with a 7-year follow-up. Patient sought treatment 2 months after iatrogenic accident. First lower right molar presented clinical signs such as fistula and bone loss between mesial and distal roots. Firstly, all root canals were treated and then furcal perforation was sealed with MTA Angelus and the dental crown was restored with composite resin. Radiographic evaluation was immediately performed to analyze the furcal perforation filling. After 7 years, a new clinical and imaging evaluation using periapical radiography and cone-beam computed tomography (CBCT) showed absence of clinical signs and symptoms, and alveolar bone reconstitution with periodontal space reduction. Angelus MTA presented good clinical behavior in the iatrogenic furcal perforation resolution based on long-term clinical evidence.Keywords: Endodontics; Furcation Perforation; Mineral Trioxide Aggregate; Root Canal Treatment; Root Perforation; Tooth Perforation

Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy

The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals