O clareamento dentário é a maneira mais conservadora e barata de melhorar a satisfação dos pacientes com o seu sorriso. Entretanto existem poucos estudos que correlacionam a eficácia clareadora com a satisfação dos pacientes e a maneira como eles percebem a mudança das cores. OBJETIVO: Investigar a relação entre mudança de cor e satisfação e a percepção da mudança de cor pelos pacientes e operador treinado comparado a um método instrumental. MATERIAIS E MÉTODOS: Uma pesquisa clínica randomizada duplo-cega foi conduzida com 100 pacientes que atendiam os critérios de inclusão e exclusão. Eles foram divididos em 5 grupos randomizados: Peróxido de hidrogênio 4%, peróxido de carbamida 15%, peróxido de carbamida 16%, Peróxido de carbamida 16% experimental e placebo. Foi tomada a cor base dos dentes através de tomadas objetivas com Vita Easyshade e subjetivas com a escala Vita BleachGuide 3D. Eles foram submetidos à terapia clareadora recebendo uma seringa de gel clareador por semana durante 3 semanas e preencheram avaliação sobre sua sensibilidade e avaliações sobre satisfação e percepção de mudança de cor. Foi um total de 11 visitas por paciente: entrevista inicial e triagem, moldagem e profilaxia, tomada de cor e entrega de clareador, controles de 7, 14, 21, 30, 60, 90, 120 e 180 dias. Nos retornos todas as etapas de tomada e controle de cor pelo paciente e pelo mesmo operador treinado, objetiva e subjetiva foram repetidas. RESULTADOS maiores valores de ?E* na sem 1, ANOVA mostrou que eles foram diferentes entre si (P=0.001), valor que não se repete a partir da segunda semana na análise entre os grupo (P=0.275). Maiores ?E* foram os géis à base de peróxido de carbamida (PC15, PC16 e PC16EX). ?E* Final foi maior no grupo PC15, PC16 e PC16EX e esses 3 grupos foram estatísticamente semelhantes. Os menores valores foram para o grupo placebo que não foi semelhante a nenhum outro grupo e nem entre os tempos. A análise de variância entre os 5 grupos mostrou diferenças para percepção cega (p=0.001), percepção orientada (p=0.001), e expectativa (p=0.603. Fica claro que a satisfação do paciente é crescente em todos os grupos da primeira a terceira semana de terapia. A ordem de satisfação dos pacientes foi PC15, PC16EX, PC16, PH4 e PLAC. No último período representado, terceira semana ao fim do acompanhamento de 6 meses, verificamos que a satisfação diminui no período pós-terapia, principalmente para o grupo PLAC e para o grupo PC16EX. Mesmo o grupo PLAC (que representa o placebo) também teve satisfação crescente. No arco inferior os maiores resultados para sensibilidade ficaram também com PH4, PC15 e PC16..CONCLUSÕES: Os clareadores baseados em peróxido de carbamida tiverem as maiores variações de cor, sendo os mais efetivos. Em comparação ao paciente, o operador treinado tem uma capacidade de avaliação de cor mais próxima dos valores aferidos instrumentalmente. A satisfação do paciente aumenta com todos os grupos, inclusive o placebo, porém declina no período pós terapia. Os pacientes tendem a enxergar os dentes mais escuros do que realmente são e criam expectativas por cores mais claras. Todos os grupos causaram sensibilidade, inclusive o placebo, semelhantes para maxila e mandíbula. / Tooth whitening is the most conservative and inexpensive way to improve patient satisfaction with your smile. However there are few studies that correlate the whitening efficacy with patient satisfaction and how they perceive the change of colors. To investigate the relationship between color change and satisfaction and perception of color change by patients and trained operator compared to an instrumental method. MATERIALS AND METHODS: A double-blind randomized clinical trial was conducted with 100 patients who met the inclusion and exclusion criteria. They were divided into five randomized groups: Hydrogen peroxide 4%, 15% carbamide peroxide, 16% carbamide peroxide, 16% carbamide experimental and placebo. It was made the base color of the teeth through objective taken with Vita Easyshade and subjective with the Vita BleachGuide 3D scale. They underwent therapy Clarifying getting a whitening gel syringe per week for 3 weeks and completed evaluation of its sensitivity and reviews of satisfaction and perception of color change. There were a total of 11 visits per patient: initial interview and sorting, forming and prophylaxis, making color and delivery bleaching 7 controls 14, 21, 30, 60, 90, 120 and 180 days. In returns all steps taken and color control by the patient and by the same trained operator, objective and subjective were repeated. RESULTS larger ?E * values in no 1, ANOVA showed that they were different (P = 0.001), a figure that is not repeated from the second week on the analysis of the group (P = 0.275). Larger ?E * the gels were carbamide peroxide-based (PC15, PC16 and PC16EX). ?E * Final was higher in the group PC15, PC16 and PC16EX and these 3 groups were statistically similar. The lowest values were for the placebo group was not similar to any other group or between the times. Analysis of variance among the five groups showed differences to blind perception (p = 0.001), oriented perception (p = 0.001) and expectation (p = 0.603. It is clear that patient satisfaction is increasing in all of the first groups third week of therapy. the order of patient satisfaction was PC15, PC16EX, PC16, PH4 and PLAC. in the latter represented period, the third week after the 6-month follow-up, we found that satisfaction decreases in the post therapy period, mainly for PLAC group and the group PC16EX Even the PLAC group (representing placebo) also had increasing satisfaction in the lower arch greater results for sensitivity were also PH4, PC15 and PC16..CONCLUSÕES: carbamide peroxide have the greater color variations, the most effective being. compared to the patient, the trained operator has a capacity assessment of the closest color of the measured values instrumentally. patient satisfaction increases with all the groups, including the placebo, but declines in the period post therapy. Patients tend to see the darker teeth than they really are and create expectations for lighter colors. All groups sensitivity caused, including placebo, similar to maxilla and mandible.

nÃo hà / A estimativa da idade cronolÃgica pode ser conceituada como o processo que consiste em avaliar o estÃgio de evoluÃÃo ou involuÃÃo de um organismo. O exame para estimativa da idade cronolÃgica do indivÃduo pela avaliaÃÃo dentÃria constitui uma perÃcia que pela lei do exercÃcio profissional da Odontologia pode ser realizada pelo CirurgiÃo-Dentista. Este exame corresponde a um percentual significativo dos exames realizados nos Institutos MÃdicos Legais (IML). No IML de Fortaleza â CearÃ, este percentual representa 32,4% dos exames realizados. Este estudo teve como objetivo analisar os procedimentos de estimativa da idade cronolÃgica do indivÃduo pela avaliaÃÃo dentÃria realizado no IML de Fortaleza, com embasamento nos procedimentos e mÃtodos de estimativa da idade cronolÃgica descritos na literatura. Foi realizado um levantamento bibliogrÃfico sobre o tema onde se constatou que a estimativa da idade cronolÃgica tem diversas nuances, à estudada hà bastante tempo e existem mÃtodos com resultados com alto grau de confianÃa, sendo bastante solicitada em processos policiais e judiciais. Os dados de importÃncia para a estimativa da idade pelo exame dos dentes permanentes se distribuem nas etapas de sua evoluÃÃo: mineralizaÃÃo, erupÃÃo e modificaÃÃes dentÃrias tardias. O termo DENTIÃÃO tem um sentido dinÃmico, uma vez que define uma sÃrie de fases desde o espessamento do epitÃlio da camada basal atà a perda do dente. Jà DENTADURA à estÃtico, pois define somente uma determinada fase da vida do indivÃduo: à o conjunto dos dentes naquele momento. Neste Ãltimo caso, na perÃcia para estimativa de idade examina-se a dentadura do indivÃduo naquele momento. O desenvolvimento da radiologia odontolÃgica introduziu novos mÃtodos à estimativa de idade, que aumentaram o grau de confianÃa da mesma. A inspeÃÃo direta dos dentes à o mÃtodo atualmente utilizado para realizar a estimativa da idade cronolÃgica dos indivÃduos no IML â Fortaleza. Este estudo concluiu que tais procedimentos necessitam ser complementados por exames radiolÃgicos para que os resultados sejam mais fidedignos, os quais irÃo propiciar a determinaÃÃo da idade cronolÃgica dos indivÃduos com maior acurÃcia. / The estimation of chronological age can be defined as the process that evaluates the stage of evolution or involution of a body. The age determination by a dental evaluation is a technical inspection that can be performed by a Surgeon-Dentist, in accordance with the law of dentistry practice. This examination is carried through in legal medicine institutes with high frequency. In the Institute of Legal Medicine (IML) of Fortaleza - CearÃ, this percentage is 32.4% of all examinations. This study aimed to analyze the procedures for estimation of chronological age by dental evaluation conducted in IML of Fortaleza, based on procedures and methods for estimating the chronological age as described in literature. A literature review was performed and it has demonstrated that the estimation of chronological age has different nuances, it has been studied for a long time, and there are methods with accurate results that are required in many policy and judicial court processes. The most important information for age determination by examination of permanent teeth is distributed in their evolution stages: mineralization, dental eruption and dental late alterations. The technical term DENTITION has a dynamic sense, since it defines several stages from the thickening of the epithelium of the basal layer to the dental loss. DENTURE is static, as it defines only a phase of life of the individual: it is all the teeth at that time. The development of dental radiology has introduced new methods for estimating age, which increased the age determination accuracy. The oral examination is the only method currently used to age determination in the IML - Fortaleza. This study concluded that the oral examination procedures need to be complemented by radiological examinations that show reliable results and accurate age determination.

Para este estudo foram utilizadas 30 coroas de dentes decíduos e 16 diferentes resinas compostas de diversas marcas comerciais. O objetivo foi comparar, in vitro, com o uso do espectrofotômetro, a diferença de unidades de cor (DE) de dentes decíduos e resinas compostas e, também, selecionar, in vitro, através de análise visual de três examinadores, as resinas compostas cujas cores mais se assemelhavam à cor dos dentes, utilizando as mesmas amostras do item anterior. Os resultados apontaram que apenas as resinas Herculite cor B1, Durafill cor SL e Filtek A110 cor B0,5 apresentaram DE menor ou igual a 3,5, demonstrando o restrito número de opções para uso em odontopediatria. Houve uma grande variação de tonalidades das resinas dentro da mesma designação de cor em diferentes marcas comerciais, o que indica a dificuldade do uso da escala de cor. A análise estatística mostrou haver diferença estatisticamente significante na comparação dos DE entre as diferentes resinas, (P £ 0,05). Na análise visual, os três examinadores consideraram a resina Durafill, cor SL, como a resina que mais se aproximou à cor dos dentes, seguida da Filltek Z250, cor B0,5 para os examinadores 1 e 3, e Filtek A110 cor B0,5 para o examinador 2. Na comparação realizada entre os resultados do espectrofotômetro com os examinadores para indicação da resina mais adequada, houve baixa concordância, em média 26, 4%. / 30 primary teeth crowns and 16 composites were used in this investigation. The aim was to compare, in vitro, with a spectrofotometer, the colour unit difference (DE) of the primary teeth and the composites, and also compare, in vitro, through visual analisys, the choice of 3 examinators, the same specimens used in the first test; to compare the spectrofotometric analisys with the visual analisys. The results showed that only the composites Herculite B1, Durafill SL and Filtek A110 B0,5 showed DE lower or equal to 3,5, making clear the restrict colour options in pedodontics. There was a large difference in colour grade among the available commercial brands for the same colour name. The statistical analisys showed that there is significant difference to the comparison of the DE between the different composites (P £ 0,05). By the visual analisys, all the 3 examinators considered the composite Durafill SL, the most close to the teeth colour, followed by the Filltek Z250 B0,5 for examinators 1 and 3 and Filtek A110 B0,5 for examinator 2. In the comparison between the spectrofotometric results and the examinators for the composite that better matched the teeth, there was low agreement with 26,4% in average.

Introdução: A obturação de dentes decíduos deve ser realizada com pastas obturadoras que mantenham o dente em condições compatíveis com saúde até o período de exfoliação. Diversos são os materiais utilizados para este propósito; entretanto, as pastas iodoformadas têm estado em evidencia. A pasta Guedes Pinto é um dos materiais mais utilizados no tratamento endodôntico de dentes decíduos no Brasil. No entanto, ensaios clínicos randomizados (ECR) bem delineados não foram realizados para testar o desempenho clínico deste material. Objetivo: Este ECR de não-inferioridade triplo-cego objetivou avaliar o desempenho de dois materiais obturadores para pulpectomia em dentes decíduos durante dois anos: Pasta Guedes e Pasta Vitapex®, além de fatores relacionados com o sucesso dos tratamentos. Material e métodos: Foram incluídos dentes decíduos com necessidade de tratamento endodôntico em crianças que procuraram atendimento na Faculdade de Odontologia da Universidade de São Paulo. Os tratamentos foram realizados por uma única operadora treinada para os procedimentos, com instrumentação manual e seguindo um protocolo operatório padrão. Após o término do preparo químico mecânico os dentes eram randomizados para um dos dois grupos. A lista de randomização foi gerada em blocos de tamanhos desiguais e estratificada por dentes anteriores e posteriores. Como os dois materiais foram inseridos em seringas idênticas sem identificação relacionada ao grupo que pertenciam, apresentavam cor e radiopacidade semelhantes, o operador, as crianças que receberam o tratamento e o avaliador nos tempos de acompanhamento eram cegos em relação ao tratamento recebido. As crianças foram acompanhadas após 3, 6, 12, 18 e 24 meses com exames clínicos e radiográficos. O desfecho primário foi o sucesso do tratamento na avaliação clínica e radiográfica. Os sucessos de tratamento foram avaliados por análise de sobrevida de Kaplan-Meyer e regressão de Cox ajustada pelo efeito de conglomerado (p <0,05), tendo sido calculados os valores de Hazard Ratio (HR) e respectivos intervalos de confiança a 95% (IC95%). Resultados: Foram tratados 104 dentes de 61 crianças (3-7 anos de idade) e acompanhados por 24 meses (taxa de resposta de 98%). A taxa de sucesso da pasta Vitapex® foi de 78,4% e da pasta Guedes foi de 86,7%. Portanto, a Pasta Guedes não foi significativamente pior do que a pasta obturadora controle (HR=0,57; IC95%=0,20 a 1,60). Dentre as variáveis avaliadas, apenas o diagnóstico inicial apresentou associação significativa com os insucessos, sendo que dentes necrosados falharam mais que dentes vitais (HR=4,95; 95%IC=1,16 a 21,00). Conclusões: A pasta Guedes-Pinto tem desempenho similar à pasta Vitapex®, sendo que ambas apresentam taxa de sucesso satisfatório. Dentes necrosados apresentam um pior prognóstico do que dentes vitais. / Background: The filling procedure of primary teeth should be performed with pastes that maintain the tooth healthy until the period of exfoliation. Several materials are used for this purpose; however, iodoformed pastes have been in evidence. The Guedes Pinto paste is one of the most used materials for endodontic treatment of primary teeth in Brazil. However, well-designed randomized clinical trials (RCT) have not been performed to test this material. Aim: This triple-blind non-inferiority RCT aimed to evaluate the performance of two filling materials for pulpectomy in primary teeth during two years: Guedes paste and Vitapex® paste. Moreover, other factors associated to the treatment success. Material and methods: Primary teeth with necessity of endodontic treatment in children who looked for dental treatment at the School of Dentistry of the University of São Paulo were included. The treatments were performed by a single operator trained for the procedures, with manual instrumentation according to a standard operating protocol. After full canals instrumentation, the teeth were randomly allocated to one of two groups. Randomization was performed using permuted blocks and stratified by anterior or posterior teeth. As the two materials were stored in identical syringes, without identification related to the materials, operator, children who received the treatment and the examiner in the different follow-ups were blinded. according to the treatment received. The children were followed-up for 3, 6, 12, 18 and 24 months with clinical and radiographic assessments. The primary outcome was the success at both clinical and radiographic evaluation. Treatment successes were compared by Kaplan-Meyer survival analysis and Cox regression adjusted by cluster (p<0.05), and Hazard Ratio (HR) values and respective 95% confidence intervals (95%CI) were calculated. Results: 104 teeth from 61 children (3-7 yrs-old) were treated and followed-up (98% response rate). The success rate of the Vitapex® was 78.4% and the Guedes paste was 86.7%. Therefore, Guedes paste was not significantly inferior than the control group (HR=0.57; 95%CI=0.20 to 1.60). Considering other variables, initial diagnosis showed significant association with failures; necrotic teeth had higher failures rates than vital teeth (HR=4.95; 95%CI=1.16 to 21.00). Conclusions: Guedes-Pinto paste presents similar performance than Vitapex® paste, and both present good success rates. Necrotic teeth presents worse prognosis than vital teeth.

Today’s highly endangered orangutan populations of Sumatra and Borneo offer but a glimpse into the taxonomic diversity and vast regional distribution enjoyed by orangutans and their great ape relatives in East Asia over the past 2.5 million years—a time when tropical forest pongine habitats stretched from Java to southern China. In addition to the giant terrestrial ape Gigantopithecus, other great ape genera have been proposed to have existed within this hominid community. The taxonomic diversity of this great ape faunal array is even further complicated when the purported presence of hominins at Early Pleistocene sites older than 1.85 Ma is considered. Highly acidic, the jungle floors of East Asia are notoriously bad at fossil preservation decomposing skeletal and dental evidence quickly. Fortunately, ph-neutral limestone caves have acted to offset these forces. The outcome of this peculiar taphonomy has left us with many teeth, but very little bone. With only unassociated fossil dentition to work with, modern geometric morphometrics offers scientists one of the few cutting-edge tools capable of systematically assessing this material reliably. This dissertation applies modern geometric morphometric statistical analysis to over two thousand fossil hominid teeth (Appendix A) from the Quaternary of southern China and Southeast Asia, which offers unique insight into the taxonomic diversity present in this sole Pleistocene great ape community. This study provides a much clearer understanding of the composition, paleoecology, and regional distribution of Pleistocene great ape communities of East Asia. Concordant with previous research, the main study and pilot study conducted in this dissertation showed Homo sapiens to always be morphologically and statistically distinct from extant and fossil orangutans. In turn, Pongo pygmaeus and Pongo abelii were continuously shown to be distinct from each other as well as from fossil Pongo groups. This investigation refutes hominin assignments for several teeth previously placed within early East Asian hominins (showing them to be orangutans instead) but supports the hominin status of the Jianshi upper third premolar. In combination with a published age of 1.95–2.15 million years (Ma), the hominin assignment reaffirmed here for the Jianshi dentition originally classified as human by Liu, Clarke, & Xing (2010) may offer a challenge to evolutionary models that recognize the 1.85 Ma Dmanisi hominins as the earliest hominins outside of Africa. This fact is often lost on most contemporary scientists due to their preoccupation with the 2.5 Ma Longgupo mandibular fragment, once thought to be a hominin but now assignable to an ape. Like the Jianshi upper third premolar, it is also based on a single specimen (in this case, a mandibular fragment). This dissertation supports the existence of Ciochon’s (2009) “mystery ape”. It refutes Schwartz et al., (1995) multiple Vietnamese Pongo taxa, including the proposed genus “Langsonia,” which is reassigned here to Pongo or the “mystery ape,” while placing Vietnamese fossil orangutans into either Pongo weidenreichi or Pongo devosi. Teeth from the Ralph von Koenigswald collection originally assigned to “Hemanthropus” were also determined to be representative of either the “mystery ape” or Pongo. Indeterminate “hominin” teeth were assignable to either Homo erectus, Homo sapiens, or Pongo only; no evidence was found for any other types of hominin species present in the collections examined for this study.

The relationship between the fluoride content of the enamel and dentine of deciduous teeth and the number of tooth lesions/mouth was compared to fluoride treatment in Logan , Brigham City, Helper and Milford, Utah. Bone measurement data was obtained on the second metacarpal bones of the mother s of the participating children from the same communities except Brigham City. The fluoride treatment in the communities were as follows: Logan has no fluoride added to the domestic water supply but some children received fluoride treatment through tablets, drops, etc. Milford has water which naturally contains 0 . 8 ppm fluoride , Helper and Brigham City have 1 ppm fluoride added to their water ,supplies. The results showed that significantly less (P > 0.05) fluoride existed in the dentine of teeth originating from Logan children without fluoride treatment than the dentine from fluoride treated children in Logan and Brigham City. The fluoride content of the enamel showed a tendency to be increased with increasing amount of fluoride exposure. The fluoride content of the enamel and dentine from non fluoride treated Logan children was considerably less than from fluoride treated Logan children and from Brigham City children. Logan children who had received fluoride treatments had significantly (P > 0.05) fewer dental lesions/mouth compared to the nontreated Logan children. The fluoride exposed Milford and Helper children had a greater frequency of dental lesions/mouth than even nonfluoride treated Logan children . This might be explained by the socioeconomic differences existing between Logan in comparison to Helper and Milford. Midshaft bone measurements were taken on x-rays of the second metacarpal of women (average age 35.7) residing ten or more years in the respective community. When measuring cortical thickness, cortical area, medullary area, and per cent cortical area, no significant differences could be shown.

Includes bibliographical references (leaves [1-20]). A systematic analysis of wear involving the in vitro analysis of the wear of standard composite resin and glass ionomer cements restorations under controlled conditions; and, the qualitative and quantitative investigation of wear over a range of pH's and loads which might be encountered clinically in order to develop a "wear map" of the micromorphology of wearing teeth and restorations and a systematic modeling of wear rates.

Includes bibliographical references (leaves 355-403)

Summary: Some 250 Australian aboriginal skulls were studied to ascertain differences in tooth dislocation and wear in this ethnic group as compared with those manifested in the pre-European Maori, with consideration of the differences in cultural and botanical background as contributing factors. Other features were studied, including the crowding of anterior teeth, the incidence of caries and abscesses, and of mottled enamel and tooth fracture. Aspects of physical anthropology and biology were found to be relevant to this study, since they offered explanations for some previously unsolved problems such as edge-to-edge bite, and crowding of incisors in well-formed jaws. The work is supported by 28 illustrations of the dentition selected from various sources, and described in the text. Reprints of 18 other published papers reporting various dental studies of relevance to the above major publication are included in this presentation.

The pressure-tension hypothesis is the governing dogma of orthodontic tooth movement. This theory proposes that the application of loads to the crown of a tooth during orthodontic mechano-therapy results in differential site-specific reactionary strains in the para-dental tissues. Briefly, following the application of orthodontic load the bone and periodontal ligament (PDL) on one side of the tooth is placed in compression favoring bone resorption, while on the other side of the tooth they are placed in tension favoring osteogenesis The present in vitro model provides a surrogate for the PDL on the tension side of the tooth during orthodontic tooth movement and aims to identify mechanically induced changes in the expression of osteo-regulatory cytokines in human PDL cell cultures in response to tensile mechanical strain. Materials and Methods: PDL explants were obtained from pathology free bicuspids of two human subjects following extraction of the teeth for orthodontic purposes. Following serial passage, cells were plated on Uniflex� plates and consigned to either the experimental or control groups. Experimental cells were exposed to a cyclic uniaxial tensile mechanical strain for 6,12 or 24 hours using the Flexercell FX 4000 strain unit. Total RNA was extracted using a two-step procedure and samples were analysed using real-time RT-PCR assays for a range of osteo-regulatory cytokines. Results: Human PDL cells expressed mRNA for a range of cytokines of known significance to osteogenesis and osteoclastogenesis in response to mechanical stimulation. Conclusions: The production of osteo-regulatory cytokines by PDL cells in response to mechanical strain suggests that these cells have the potential to contribute to the osseous modeling of orthodontic tooth movement. The presence of osteogenic signalling drive in response to tensile strain tends to support the basic assertions of the pressure-tension hypothesis.