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Juvenile idiopathic arthritis (JIA) is a broad term that describes a group of heterogeneous rheumatologic diseases, mainly characterized by inflammation in the joints of children and young people up to 16 years of age. Its etiology is... more
Juvenile idiopathic arthritis (JIA) is a broad term that describes a group of heterogeneous rheumatologic diseases, mainly characterized by inflammation in the joints of children and young people up to 16 years of age. Its etiology is still not well understood and the diagnosis, essentially clinical, begins with the exclusion of other joint diseases. When the disease affects the temporomandibular joint, diagnosis is a challenge, as many patients are asymptomatic. The objective of this paper is to present a case of JIA with severe involvement of the temporomandibular joint and to discuss the clinical, radiographic, laboratory findings and the importance of early diagnosis. The lack of diagnosis of active arthritis in the temporomandibular joint in patients with JIA can cause irreversible effects such as micrognathia, malocclusion and reduced maximum mouth opening. Early diagnosis of temporomandibular joint involvement in JIA is important and needs to be investigated early in the clinical manifestation of systemic disease. Laboratory tests and clinical history are important to define treatment and prognosis, but not to predict temporomandibular joint arthritis. Imaging exams are important diagnostic tools to identify morphological changes in soft and hard tissues of the temporomandibular joint.
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ObjectiveTo evaluate the effects of rapid maxillary expansion (RME) on Sleep Disturbance Scale for Children (SDSC) with maxillary atresia.Materials and MethodsThe sample consisted of 27 paediatric patients evaluated through a Brazilian... more
ObjectiveTo evaluate the effects of rapid maxillary expansion (RME) on Sleep Disturbance Scale for Children (SDSC) with maxillary atresia.Materials and MethodsThe sample consisted of 27 paediatric patients evaluated through a Brazilian version of the SDSC, answered by their guardians at the following experimental time points: T0 (before installing the Hyrax expander), T1 (on the day of expander stabilization), T2 (3 months after expander stabilization), T3 (immediately after expander removal, following 6 months of retention), and T4 (3 months post‐retention). Multilevel Poisson analysis adjusted for repeated measures was performed to compare outcomes across the assessment time points.ResultsThe mean age of patients was 9.1 years (SD = 1.46). The total SDSC scores decreased and were statistically significant from T2 onwards (P < .01), with a decrease of 24% at T4 compared with T1 (IRR 0.76; 95% CI 0.69–0.84). The mean scores at T4 were already lower than the cutoff point for risk of sleep disorders. Regarding the specific domains, there was a significant reduction in sleep breathing disorders, sleep–wake transition disorders, and disorders of excessive somnolence as of T2 (P < .01), T3 (P < .05) and T4 (P < .05), respectively.ConclusionRME in children with maxillary atresia had a positive effect on the reduction of total SDSC scores after 3 months of expander stabilization, sustained over 6 and 9 months and significant reduction in sleep breathing disorders domain, sleep–wake transition disorders domain, and disorders of excessive somnolence domain over time points.
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Objetivo: Esse estudo teve como objetivo comparar a acurácia de mensurações lineares realizadas, de acordo com o método de Moyers, em modelos de gesso pelo método manual com paquímetro em modelos digitais 3D digitalizados por scanner de... more
Objetivo: Esse estudo teve como objetivo comparar a acurácia de mensurações lineares realizadas, de acordo com o método de Moyers, em modelos de gesso pelo método manual com paquímetro em modelos digitais 3D digitalizados por scanner de mesa e em modelos digitais 3D obtidos por Tomografia Computadorizada Multislice com protocolo CTdBem. Mé- todo: Um único operador selecionou 90 modelos de gesso da arcada inferior para análise de dentição mista. Os métodos testados e o método manual foram comparados usando o teste-t pareado. Para avaliar o acordo entre os métodos, a correlação de Pearson foi utilizada. O gráfico de Bland-Altman foi construído para avaliar a diferença entre as medidas de cada amostra. Resultados: Não houve diferenças significativas entre as medidas do scanner e da Tomografia Computadorizada Multislice, quando comparadas com as medidas do método manual (p>0.05). Ambos os métodos digitais apresentaram correlação alta e significativa com o método manual com coeficientes de 0,98 e 0,97 para o scanner e a Tomografia Computadorizada Multislice, respectivamente (p<0.01). Conclusão: Os modelos digitais obtidos por scanner de mesa e por Tomografia Computadorizada Multislice com protocolo CTdBem produziram medidas lineares e com boa acurácia, compatíveis com as medidas manuais realizadas em modelo de gesso.
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Objective – The aim of this study was evaluate the effect of etching with different hydrofluoric acid (HF) concentrations on the shear bond strength between glazed feldspathic ceramic and metal brackets. Materials and Methods –... more
Objective – The aim of this study was evaluate the effect of etching with different hydrofluoric acid (HF) concentrations on the shear bond strength between glazed feldspathic ceramic and metal brackets. Materials and Methods – Seventy-five blocks of glazed feldspathic ceramic were produced and randomly allocated to 5 groups: Ctrl- silane application only; HF1- HF1%+silane; HF3- HF3%+silane; HF5- HF5%+silane; HF10- HF10%+silane (standard procedures: etching for 1 min + washing + drying + silanization). Metal brackets for upper central incisors (Edgewise Standard) were bonded on the ceramic surface with the use of an adhesive system and light-cured composite resin (TransbondTM XT, 3M). The specimens were aged for 60 days (thermocycling: 10000x at 5-55 °C; stored in distilled water at 37 °C). Shear testing was performed, and specimens were classified for their Adhesive-Remnant-Index (ARI). Topographical inspection and contact angle analysis of the etched ceramic surfaces were perform...
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Objective: The aim of the present study was to evaluate the color stability of Filtek Z350 XT, Filtek Z250 XT, Z100 resin composites and Transbond XT orthodontic resin, all used in orthodontic attachments, when immersed in popular... more
Objective: The aim of the present study was to evaluate the color stability of Filtek Z350 XT, Filtek Z250 XT, Z100 resin composites and Transbond XT orthodontic resin, all used in orthodontic attachments, when immersed in popular beverages. Methods: Thirty disk-shaped specimens of each resin composite (2 x 5mm) were manufactured and randomly divided into six groups according to immersion solutions: coffee, red wine, white wine, regular beer, dark beer and deionized water (control). The specimens were fully immersed in each of the solutions for six days at 37°C, representing approximately six months of consumption. The color measurements were evaluated by a reflection spectrophotometer, at baseline (before immersion) and after staining. L*a*b* coordinates were measured and the color change (ΔE00) was calculated using the CIEDE2000 formula. The data were analyzed by ANOVA/Tukey tests at a significance level of 0.05. Results: The resin composites immersed in white wine and regular bee...
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BACKGROUND Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE To evaluate the association between marital status and temporomandibular disorder-related chronic... more
BACKGROUND Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE To evaluate the association between marital status and temporomandibular disorder-related chronic pain. METHODS Patients diagnosed with temporomandibular disorder (TMD) through Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were assessed for chronic pain and marital and socioeconomic status, according to Axis II. Multinomial logistic regression models assessed the association between chronic pain and the predictive variables. RESULTS Three hundred and ten patients were included in the sample, the majority being female (74.5%), single (52.3%), and diagnosed with chronic pain (85.1%). The adjusted analysis showed about a 5-time greater chance of chronic pain occurrence with high disability in individuals who were married or in a common-law marriage (OR 5.99; 95% CI 1.45-24.73). Also, women were 7.62 times more likely to develop chronic pain with high disability (OR 7.62; 95% CI 2.03-28.52). CONCLUSION Marital status showed an impact on chronic pain, with married individuals and those in a common-law marriage being the most affected by high disability chronic pain.
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A disfunção temporomandibular (DTM) é composta por um conjunto de sinais e sintomas envolvendo músculos mastigatórios, articulação temporomandibular e estruturas orofaciais. Devido à etiologia multifatorial da DTM e à variedade de... more
A disfunção temporomandibular (DTM) é composta por um conjunto de sinais e sintomas envolvendo músculos mastigatórios, articulação temporomandibular e estruturas orofaciais. Devido à etiologia multifatorial da DTM e à variedade de apresentações clínicas, o tratamento desse distúrbio é extenso e diversificado. Entre as modalidades de tratamento de DTM, o uso de laser de baixa intensidade alcançou grande popularidade devido à sua natureza conservadora, porém na literatura, existe grande variedade de protocolos de irradiação e grande variedade nas amostras, portanto não há consenso sobre o protocolo ideal. Este estudo avaliou os resultados de um protocolo rápido de duas sessões para o tratamento com laser em pacientes com dor miofascial e limitação de abertura de boca. Dez pacientes adultos, de ambos os sexos foram avaliados e diagnosticados pelos Critérios de Diagnóstico para Pesquisa em Disfunção Temporomandibular (RDC/TMD) e anamnese básica. Os pacientes foram tratados com o disposi...
Research Interests: Dentistry, Medicine, Breastfeeding, Malocclusion, Crossbite, and 4 moreOverjet, Odds ratio, Pacifier, and OverBite
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood and often involves the temporomandibular joint (TMJ). Herein we present a case of a 9-year-old female patient who sought a rheumatologist with a main... more
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood and often involves the temporomandibular joint (TMJ). Herein we present a case of a 9-year-old female patient who sought a rheumatologist with a main complaint of hip pain and was diagnosed with JIA. On that occasion, the TMJ was not evaluated. The disease was controlled with nonsteroidal anti-inflammatory drugs and methotrexate, and the patient was monitored through laboratory tests. Three years after the initial diagnosis, during a dental appointment, facial asymmetry was observed, without painful symptomatology. The clinical examination revealed mandibular retrognathism and malocclusion, with midline deviation to the right. Image studies showed erosion and important flattening of the right condyle. The orthodontic treatment allowed correction of malocclusion, but facial asymmetry persisted. TMJ should always be evaluated in patients with JIA, regardless of the presence of signs or symptoms, beca...
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Objectives To evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children. Materials and Methods A total of 547 school children in... more
Objectives To evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children. Materials and Methods A total of 547 school children in the mixed dentition, in the age range between 7 and 13 years, were evaluated by means of questionnaire and clinical examination. Binomial and multinomial logistic regression models were used to evaluate the associations between breastfeeding and finger and pacifier sucking habits, the malocclusion characteristics of posterior crossbite, and excessive or deficient overjet and overbite. Results Individuals who had nonnutritive sucking habits had 2.16 times greater chance of having anterior open bite (odds ratio [OR] 2.16; 95% confidence interval [CI], 1.07–4.33) and 2.39 times greater chance of having posterior crossbite (OR 2.39; 95% CI, 1.56–5.49). Children who were exclusively breastfed up to at least 6 months of age had a higher frequency of norma...
Research Interests: Dentistry, Medicine, Breastfeeding, Malocclusion, Crossbite, and 4 moreOverjet, Odds ratio, Pacifier, and OverBite
Introduction: Orthodontic mini-implants (MI) are a reliable alternative to provide temporary orthodontic anchorage. Prior to miniscrew insertion, the best approach would be to evaluate each possible insertion site and measure the cortical... more
Introduction: Orthodontic mini-implants (MI) are a reliable alternative to provide temporary orthodontic anchorage. Prior to miniscrew insertion, the best approach would be to evaluate each possible insertion site and measure the cortical bone thickness, and verify whether it would provide adequate primary stability. Objective: This study aimed to evaluate the difference in cortical bone thickness in areas of mini-implants insertion in patients of different ages, by means of cone beam computed tomography (CBCT). Methods: The sample of this retrospective study was composed of 123 CBCT scans, which were used to measure cortical bone thickness in the buccal and palatal inter-radicular space in the mesial region of the first permanent molars. These measures were compared by using the Student’s t-test, ANOVA/Tukey tests, and Linear regression between male and female subjects, from 12 to 30 years old. Results: No significant difference was found in cortical bone thickness between sex, rac...
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The aim of this study was to evaluate enamel roughness, quality of the enamel surfaces and time duration comparing different orthodontic adhesive removal protocols. Premolars were used to test three adhesive removal methods ( = 20):... more
The aim of this study was to evaluate enamel roughness, quality of the enamel surfaces and time duration comparing different orthodontic adhesive removal protocols. Premolars were used to test three adhesive removal methods ( = 20): five-blade carbide bur, 30-blade carbide bur, and ultrasonic diamond bur. Bracket was bonded using Transbond XT adhesive. Roughness with different parameters was measured before bracket bonding and after adhesive remnants removal. Micromorphological analysis of enamel surface ( = 5) was performed by SEM images and categorized in enamel damage index-"perfect"; "satisfying"; "imperfect"; and "unacceptable". Time was measured in seconds. All removal methods caused increased roughness in relation to , , and parameters ( axis) comparing to healthy enamel surface. Enamel surface resulted from removal using five-blade burs was scored as satisfactory. Carbide bur groups decreased the roughness values of , , and parameters ...
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PURPOSE: To evaluate the shear bond strength (SBS) of metallic brackets bonded with Transbond Plus Self-Etching Primer (TPSEP) and Transbond Plus Color Change (TPCC) under contamination with a mixture of saliva and blood. MATERIALS AND... more
PURPOSE: To evaluate the shear bond strength (SBS) of metallic brackets bonded with Transbond Plus Self-Etching Primer (TPSEP) and Transbond Plus Color Change (TPCC) under contamination with a mixture of saliva and blood. MATERIALS AND METHODS: 42 human premolars were randomly divided into 2 groups (n=21). Group 1 (G1) were bonded under no contamination, and Group 2 (G2) was contaminated with saliva/blood before bonding. Both groups were bonded according to the manufacturer’s instructions and were cleaned with pumice before bonding. The shear bond strength (SBS) tests were performed after 24 hours in distilled water at 37°C and after thermocycling. RESULTS: Both groups showed a homogeneous distribution in the Levene’s test (p>0.05). The main shear bond strength value of G1 was 8.89 MPa with a standard deviation of 2.27; the value for G2 was 6.00 MPa with a standard deviation of 2.62 MPa. There was a significant difference between G1 and G2 (t-student test p<0.05). IRA scores i...
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Research Interests: Medicine and Ortodontia
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This in vitro study sought to evaluate how surface conditioning from bracket and mechanical cycling aging affected the bond strength between metallic brackets and bovine enamel, and to determine the adhesive remnant index. Eighty bovine... more
This in vitro study sought to evaluate how surface conditioning from bracket and mechanical cycling aging affected the bond strength between metallic brackets and bovine enamel, and to determine the adhesive remnant index. Eighty bovine incisors were embedded in acrylic resin using polyvinyl chloride rings and divided into 4 groups based on surface treatment (n = 20). Group 1 (control) received no surface treatment, Group 2 specimens were sandblasted with aluminum oxide particles, Group 3 specimens were sandblasted with silicon oxide and treated with a tribochemichemical silica coupling agent, and Group 4 specimens were primed with a multidomain protein-based agent. Half of the specimens were submitted to shear bond testing, while the others were subjected to mechanical cycling. ANOVA showed that mechanical cycling did not have a significant influence on bond strength (P = 0.9244), while surface conditioning of the brackets did (P = 0.0001). Tukey's test results were similar for...
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Objective.The purpose of this study was to present a case report that demonstrated primary failure in a tooth traction that was subsequently treated with apicotomy technique.Case Report.A 10-year-old girl had an impacted upper right... more
Objective.The purpose of this study was to present a case report that demonstrated primary failure in a tooth traction that was subsequently treated with apicotomy technique.Case Report.A 10-year-old girl had an impacted upper right canine with increased pericoronal space, which was apparent on a radiographic image. The right maxillary sinus showed an opacity suggesting sinusitis. The presumptive diagnosis was dentigerous cyst associated with maxillary sinus infection. The plan for treatment included treatment of the sinus infection and cystic lesion and orthodontic traction of the canine after surgical exposure and bonding of an orthodontic appliance. The surgical procedure, canine position, root dilaceration, and probably apical ankylosis acted in the primary failure of the orthodontic traction. Surgical apical cut of the displaced teeth was performed, and tooth position in the dental arch was possible, with a positive response to the pulp vitality test.Conclusion.Apicotomy is an ...
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Triple X syndrome (47,XXX) is a numerical chromosomal alteration that affects 1/1,000 women, in which the woman is born with an extra X chromosome. Some oral changes have been reported in the literature, as hypodontia, influence on... more
Triple X syndrome (47,XXX) is a numerical chromosomal alteration that affects 1/1,000 women, in which the woman is born with an extra X chromosome. Some oral changes have been reported in the literature, as hypodontia, influence on deposition of crown enamel and discrepancies in cephalometric measurements. Other systemic complications may lead to oral abnormalities similar to those seen in triple X patients, such as congenital hypothyroidism (CH). This paper reports a triple X syndrome case associated with CH later treated. Besides delay in cognitive and intellectual development, the patient had changes in teeth development and in cephalometric measurements with deficiencies in the maxilla and mandible. This is the first report of a triple X syndrome associated with CH. Both conditions may result in changes in dentofacial development.
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Resumo: O processo de desenvolvimento dos caninos é dentre todos os dentes o mais demorado e de trajeto mais longo. Dessa forma, não é raro que diversos fatores possam intervir na sua irrupção causando impactação dentária. A impactação de... more
Resumo: O processo de desenvolvimento dos caninos é dentre todos os dentes o mais demorado e de trajeto mais longo. Dessa forma, não é raro que diversos fatores possam intervir na sua irrupção causando impactação dentária. A impactação de caninos ...
Research Interests: Medicine and Ortodontia
BACKGROUND Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE To evaluate the association between marital status and temporomandibular disorder-related chronic... more
BACKGROUND Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE To evaluate the association between marital status and temporomandibular disorder-related chronic pain. METHODS Patients diagnosed with temporomandibular disorder (TMD) through Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were assessed for chronic pain and marital and socioeconomic status, according to Axis II. Multinomial logistic regression models assessed the association between chronic pain and the predictive variables. RESULTS Three hundred and ten patients were included in the sample, the majority being female (74.5%), single (52.3%), and diagnosed with chronic pain (85.1%). The adjusted analysis showed about a 5-time greater chance of chronic pain occurrence with high disability in individuals who were married or in a common-law marriage (OR 5.99; 95% CI 1.45-24.73). Also, women were 7.62 times more likely to develop chronic pain with high disability (OR 7.62; 95% CI 2.03-28.52). CONCLUSION Marital status showed an impact on chronic pain, with married individuals and those in a common-law marriage being the most affected by high disability chronic pain.