RESUMO Objetivo: Avaliar a altura, a espessura e a densidade cortical do osso palatino em adultos com diferentes padrões faciais verticais, utilizando a tomografia computadorizada de feixe cônico (TCFC). Métodos: O presente estudo analisou 75 TCFCs de pacientes com idades entre 18 e 35 anos (45 homens e 30 mulheres). As TCFCs foram classificadas em três grupos, de acordo com seus padrões faciais: normodivergentes, hipodivergentes e hiperdivergentes, conforme determinado na radiografia cefalométrica lateral reconstruída das TCFCs. Altura, espessura e densidade cortical do osso palatino foram aferidas a 4, 8, 12, 16 e 20 mm para posterior do forame incisivo e a 3, 6 e 9 mm lateralmente à sutura transpalatina. Os testes ANOVA e post-hoc de Tukey foram utilizados para análise dos dados, com nível de significância de p< 0,05. Resultados: O padrão hipodivergente apresentou uma diferença significativa e a maior altura e espessura cortical do osso palatino, seguido pelos padrões hiperdivergente e normodivergente. Nenhuma diferença estatisticamente significativa foi encontrada nos valores mínimos e máximos da densidade cortical. Conclusão: O osso palatino é uma área anatomicamente favorável para instalar diferentes dispositivos de ancoragem temporária. Indivíduos com padrão facial vertical hipodivergente apresentam maior altura e espessura cortical do osso palatino, seguido do padrão hiperdivergente e finalmente do padrão normodivergente. Não foi encontrada qualquer diferença significativa na densidade cortical do osso palatino entre os três padrões faciais.

ABSTRACT Objective: Evaluate the height, thickness and cortical density of the palatal bone of adults with different vertical facial patterns using Cone-Beam Computed Tomography (CBCT). Methods: This study analyzed 75 CBCTs of patients between 18 and 35 years old (45 men and 30 women). The CBCTs were classified into three groups based on their facial pattern: normodivergent, hypodivergent and hyperdivergent as determined from lateral cephalograms synthesized from the CBCTs. The height, cortical thickness and cortical density of the palatal bone were measured at 4, 8, 12, 16 and 20mm posterior to the incisive foramen, and at 3, 6 and 9mm lateral to the midpalatal suture. ANOVA with Tukey post-hoc tests were used for analysis of the data, at significance level of p< 0.05. Results: The hypodivergent pattern had a significant difference and the greatest height and cortical thickness of the palatal bone, followed by the hyperdivergent and the normodivergent patterns. No significant differences were found in minimum and maximum values of cortical density. Conclusion: The palatal bone is a favorable anatomical area to install different orthodontic temporary anchorage devices (TADs), where individuals with the hypodivergent vertical facial pattern have a higher height and cortical thickness of the palatal bone, followed by the hyperdivergent pattern and finally the normodivergent pattern. No significant differences in the cortical density of the palatal bone in the three facial patterns were found.

ABSTRACT: The result of tooth whitening treatment may be affected in patients who consume staining drinks during treatment. The aim of this work was to evaluate the in vitro effect of the exposure to purple corn extract (chicha morada) on human enamel color, during and after the treatment of teeth whitening with 35 % hydrogen peroxide. Forty-eight human teeth were used, divided into groups according to the drink to which it was exposed: Peruvian purple corn extract (MM), green tea (T) and distilled water (A); half of the specimens exposed to each drink were subjected to tooth whitening with 35 % hydrogen peroxide during the first days of exposure to pigmentation, resulting in the following groups: Group A: Without bleaching + purple corn, Group B: Without whitening + green tea, Group C: No whitening + distilled water, Group D: With whitening + purple corn, Group E: With whitening + green tea, Group F: With whitening + distilled water. The color changes were measured with a digital spectrophotometer (VITA Easyshade Advance 4.0, VITA, Germany) before bleaching, during whitening, after whitening and at the end of 36 days of exposure to pigments. According to the ∆E, the purple corn extract differs significantly with the distilled water (p <0.05). Regarding the degree of luminosity, the purple corn extract with whitening presented the lowest luminosity values (p <0.05). As for the chroma, there were no differences between the groups (p> 0.05). Exposure to purple corn extract pigments the teeth, during whitening the purple corn extract does not affect the treatment, but if the exposure continues after tooth whitening, the color of the teeth will be affected.

RESUMEN: El resultado del tratamiento de blanqueamiento dental puede verse afectado en pacientes que consumen bebidas pigmentantes durante el tratamiento. El objetivo de este trabajo consistió en valuar el efecto in vitro de la exposición al extracto de maíz morado (chicha morada) sobre el color del esmalte humano, durante y después del tratamiento del blanqueamiento dental con peróxido de hidrógeno al 35 %. Se utilizaron 48 dientes humanos, divididos en grupos según la bebida a la que se expuso: Extracto de maíz morado peruano (MM), té verde (T) y agua destilada (A); la mitad de los especímenes expuestos a cada bebida fueron sometidos a blanqueamiento dental con peróxido de hidrógeno al 35 % durante los primeros días de exposición a la pigmentación, resultando en los siguientes grupos: Grupo A: Sin blanqueamiento + maíz morado, Grupo B: Sin blanqueamiento + té verde, Grupo C: Sin blanqueamiento + agua destilada, Grupo D: Con blanqueamiento + maíz morado, Grupo E: Con blanqueamiento + té verde, Grupo F: Con blanqueamiento + agua destilada. Los cambios de color se midieron con un espectrofotómetro digital (VITA Easyshade Advance 4.0, VITA, Alemania) antes del blanqueamiento, durante el blanqueamiento, finalizado el blanqueamiento y al final de los 36 días de exposición a los pigmentos. Según el ∆E, el extracto de maíz morado difiere significativamente con el agua destilada (p < 0,05). Con respecto al grado de luminosidad, el extracto de maíz morado con blanqueamiento presentó los menores valores de luminosidad (p < 0,05). En cuanto al croma, no hubo diferencias entre los grupos (p > 0,05). La exposición al extracto de maíz morado pigmenta los dientes, durante el blanqueamiento el extracto de maíz morado no afecta el tratamiento, pero si la exposición continúa luego del blanqueamiento dental, el color de los dientes se verá afectado.

Tooth discoloration varies in etiology, location and severity. It may be extrinsic, intrinsic or a combination of both. A treatment option in such cases is non-vital bleaching, which presents itself as a conservative alternative to other procedures like composite restorations, veneers or ceramic crowns, as it preserves the most of tooth structure. The aim of this paper is to report a clinical case of a patient with non vital tooth discoloration and how it was successfully treated with internal bleaching procedures; also to review the current literature discussing the etiology of discoloration in non-vital teeth, treatment options and agents available. Non-vital bleaching techniques include: In-office bleaching, walking bleach, inside/outside bleaching and finally, the combined technique. Bleaching agents are available in different concentrations for these techniques, whose effectiveness is discussed in this paper. There are several factors that could affect the effectiveness of non-vital bleaching, such as patient age, time, degree and etiology of discoloration. All of these can influence the final result and treatment longevity.

La discromia de un diente es una alteración que varía en etiología, localización y severidad. Esta puede estar relacionada a causas extrínsecas, intrínsecas o una combinación de ambos. Una manera de tratar estas piezas no vitales, es el blanqueamiento interno, el cual se presenta como una alternativa conservadora frente a otros procedimientos como restauraciones con resina, carillas o coronas cerámicas, ya que preserva al máximo la estructura dentaria. El objetivo de este trabajo es presentar un reporte de caso de una paciente con discromia de la pieza 21 y cómo fue tratada con blanqueamiento interno, además hacer una revisión de la literatura actual presentando la etiología de las alteraciones de color en dientes no vitales, las alternativas de tratamiento, así como los agentes disponibles para este fin. Las técnicas para realizar el blanqueamiento de una pieza no vital son: la técnica en consultorio o In-office bleaching, las técnicas ambulatorias (Walking bleach e inside/outside bleaching) y por último la técnica mixta. Asimismo existen agentes blanqueadores disponibles en diferentes concentraciones para realizar dichas técnicas, cuya efectividad será revisada en este trabajo. Existen diversos factores que afectarán la eficacia del blanqueamiento interno, como la edad del paciente, tiempo de oscurecimiento, el grado y origen de la discromia, que podrían afectar el resultado final y la longevidad del tratamiento.

The study aimed to evaluate the effectiveness of in-office bleaching and associated tooth sensitivity on application of nano-calcium phosphate paste as desensitizing agent. Bleaching was performed with 35% hydrogen peroxide gel in 40 patients who were randomly divided into placebo and nano-calcium phosphate paste groups. Bleaching efficacy (BE) was evaluated using a value-oriented Vita shade guide. Tooth sensitivity was recorded using a numeric rating scale (0–4) during bleaching and up to 48 h after each session. The primary outcome of absolute risk of tooth sensitivity was compared using the Fisher’s exact test (α = 0.05). The intensity of tooth sensitivity and the efficacy of in-office bleaching were also statistically evaluated. No significant differences in absolute risk and intensity of tooth sensitivity were detected between the groups (p = 1.0 and p = 0.53, respectively). BE was also found to be similar between the groups (p = 0.67). Although the use of a nano-calcium phosphate paste associated with fluoride and potassium nitrate did not influence the whitening outcome, but it also did not reduce bleaching-induced tooth sensitivity.