1
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Penha ESD, Filho NADF, Medeiros LADMD, Rosendo RA, Silva MADD, Barbosa WT, García-Carrodeguas R, Rodríguez MA, Münchow EA, Lacerda-Santos R, Fook MVL. Analysis of Tissue Repair of a New Cement Based on Calcium and Strontium Aluminates: A Triple-Blinded, Randomized, Controlled Trial in an Animal Model. Eur J Dent 2024. [PMID: 38776981 DOI: 10.1055/s-0044-1786875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The focus of this triple-blind randomized study was to evaluate the biocompatibility of a new root canal filling sealer (RCFS) based on tristrontium aluminate and dodecacalcium hepta-aluminate in living tissue. MATERIAL AND METHODS Forty-five Wistar rats (Rattus norvegicus) were divided into three groups: control (polyethylene), sealer (Bio-C Sealer, Londrina, PR, Brazil), and experimental (tristrontium aluminate and dodecacalcium hepta-aluminate). The tissues were analyzed under an optical microscope to assess different cellular events at different time intervals (7, 15, and 30 days). STATISTICAL ANALYSIS Data were analyzed using the Kruskal-Wallis and Dunn (p < 0.05) tests. RESULTS In the initial period, a moderate inflammatory infiltrate was observed, similar between the endodontic cements groups (p = 0.725). The intensity of the infiltrate decreased with time, with no significant difference among the groups (p > 0.05). The number of young fibroblasts was elevated in all groups evaluated at 7 days. The experimental group showed the highest number of cells at all time intervals, but the difference with the sealer group at 7 (p = 0.001) and 15 days (p = 0.002) and the control group at 30 days was not significant (p = 0.001). Regarding tissue repair events, the amount of collagen fibers increased over the experimental intervals, with no significant difference between the sealer and control groups (p > 0.05). CONCLUSION The experimental RCFS based on calcium and strontium aluminates proved to be biocompatible for use in close contact with periapical tissue, inducing a low inflammatory reaction and favoring rapid tissue repair.
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Affiliation(s)
- Elizandra Silva da Penha
- Department of Dentistry, Dental School, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | | | | | - Rosana Araújo Rosendo
- Department of Dentistry, Dental School, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | | | - Willams Teles Barbosa
- SENAI Institute of Innovation (ISI) in Forming and Joining (CIMATEC ISI F&J), Salvador, Bahia, Brazil
| | | | | | - Eliseu Aldrighi Münchow
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Marcus Vinícius Lia Fook
- Department of Materials Engineering, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
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2
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de Morais Sampaio GA, de Meneses IHC, Vieira RA, Pithon MM, Alves PM, Lacerda-Santos R. Influence of chlorhexidine digluconate on biocompatibility of cements: Morphological and immunohistochemistry analysis. Microsc Res Tech 2022; 85:2438-2445. [PMID: 35244313 DOI: 10.1002/jemt.24099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/31/2021] [Accepted: 02/24/2022] [Indexed: 11/09/2022]
Abstract
In this study, the in vivo biocompatibility was evaluated by using conventional ionomer cements modified with Chlorhexidine (CHX) in different time intervals. In total, 105 male Wistar rats were randomized into seven groups: control, groups M, M10, M18 and groups RL, RL10, RL18 (M-Meron and RL-RivaLuting, and added CHX-10% and CHX-18%, respectively). Histological analyses of inflammatory infiltrate and collagen fibers, and immunohistochemistry of CD68+ for macrophages (MOs) and multinucleated giant cells (MGCs) were performed. Data were analyzed using the Kruskal-Wallis and Dunn (p < .05) tests. Intense inflammatory infiltrate was demonstrated in Group Riva CHX-18% within 7 and 15 days (p < .05), without differences after 30 days. For collagenization, healing of the groups was compatible with that of control in 15 and 30 days (p > .05). Immunomarking of CD68+ was more significant in the groups with higher concentration of CHX. There was significant difference in quantity of MGCs in groups with 18% CHX, Meron (p = .001) in 7 days, and in Riva at 30 days (p = .001). Significant difference was also found in quantities of MOs in Groups Meron and Riva in 7 days (p = .001), and only in Riva at 15 and 30 days (p = .001). The cements with addition of CHX demonstrated biocompatibility with tissues. Riva CHX-18% had the most effect on cells of the inflammatory process but showed satisfactory tissue repair.
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Affiliation(s)
| | | | - Rayssa Amaral Vieira
- Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, State University of the Southwest of Bahia, Jequié, Bahia, Brazil
| | - Polliana Muniz Alves
- Department of Pathology, Dental School, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
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3
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Araújo JLDS, Alvim MMA, Campos MJDS, Apolônio ACM, Carvalho FG, Lacerda-Santos R. Analysis of Chlorhexidine Modified Cement in Orthodontic Patients: A Double-Blinded, Randomized, Controlled Trial. Eur J Dent 2021; 15:639-646. [PMID: 34428840 PMCID: PMC8630966 DOI: 10.1055/s-0041-1727556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. MATERIALS AND METHODS Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design (n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. STATISTICAL ANALYSIS The Friedman and Dunn's tests, Mann-Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t-tests (p< 0.05) were used. RESULTS In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control (p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control (p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals (p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 (p = 0.022). The tooth enamel color (p = 0.366) and ARI (p = 0.343) values demonstrated no significant changes. CONCLUSION The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
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Affiliation(s)
- José Lucas Dos Santos Araújo
- Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.,Rua José Lourenço Kelmer, São Pedro, Brazil
| | - Mariana Massi Afonso Alvim
- Rua José Lourenço Kelmer, São Pedro, Brazil.,Pharmacy School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Márcio José da Silva Campos
- Rua José Lourenço Kelmer, São Pedro, Brazil.,Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Ana Carolina Morais Apolônio
- Rua José Lourenço Kelmer, São Pedro, Brazil.,Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Fabíola Galbiatti Carvalho
- Rua José Lourenço Kelmer, São Pedro, Brazil.,Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Rogério Lacerda-Santos
- Rua José Lourenço Kelmer, São Pedro, Brazil.,Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
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4
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Dantas MVO, Nogueira PL, Lima FDO, Oliveira DCP, Gomes ENS, Rodrigues JFB, Amoah SKS, Rosendo RA, da Penha ES, Dantas AFM, Fook MVL, Lacerda-Santos R, Melquiades de Medeiros LAD. In vivo Hemostatic Activity of Jatropha mollissima: A Triple-Blinded, Randomized, Controlled Trial in an Animal Model. Eur J Dent 2021; 15:741-745. [PMID: 34428842 PMCID: PMC8630936 DOI: 10.1055/s-0041-1729677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective
The objective of this study was to evaluate the hemostatic activity of the sap from
Jatropha mollissima
(Pohl) Baill. in rats.
Materials and Methods
Twenty-four Wistar rats were randomized into four groups (
n
= 6): the JM25 and JM40 groups were treated with ethanolic extract from the sap of
J. mollissima
, in a concentration of 25 and 40 mg·mL
1
, respectively; the MO group was treated with Monsel’s solution and the control group SC with a 0.9% sodium chloride solution.
Statistical Analysis
Data were submitted to the Kurskal–Wallis’ test, followed by Dunn’s post hoc (
p
< 0.05).
Results
There was a significant reduction in the bleeding time of the group from the JM25 extract (
p
= 0.001) when compared with MO and SC. There were no statistically significant differences between groups JM25 and JM40 (
p
> 0.05). The JM25 group did not present rebleeding, a result significantly different from the MO group (
p
= 0.001). Monsel’s solution showed significant bleeding, six times greater than the control group SC.
Conclusion
The
J. mollissima
extract, in the concentration of 25 mg·mL
1
, showed the highest hemostatic efficiency and was found to be a promising biomaterial for the elaboration of a hemostatic product.
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Affiliation(s)
| | | | | | | | | | | | - Solomon Kweku Sagoe Amoah
- Academic Unit of Materials Engineering, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
| | - Rosana Araújo Rosendo
- Academic Unit of Biological Sciences - Dentistry, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | - Elizandra Silva da Penha
- Academic Unit of Biological Sciences - Dentistry, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | | | - Marcus Vinícius Lia Fook
- Academic Unit of Materials Engineering, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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5
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de Meneses IHC, de Morais Sampaio GA, Vieira RA, da Silva Campos MJ, Alves PM, Pithon MM, Lacerda-Santos R. Effect of Yellow Propolis on Biocompatibility of Cements: Morphological and Immunohistochemistry Analysis. Eur J Dent 2021; 16:130-136. [PMID: 34428843 PMCID: PMC8890933 DOI: 10.1055/s-0041-1731888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objective
The focus of this study was to evaluate the biocompatibility of ionomer cements modified with ethanolic extracts of propolis (EEP) in different concentrations and time intervals.
Materials and Methods
In total, one hundred and thirty-five male Wistar rats were randomized into nine groups: Control, Groups Meron, and Groups Ketac (conventional, and added with 10, 25, 50% EEP, respectively). Histological analyses of inflammatory infiltrate and collagen fibers, and immunohistochemistry of CD68+ for macrophages (MOs) and multinucleated giant cells (MGCs) were performed.
Statistical Analysis
Data were analyzed using the Kruskal—Wallis and Dunn (
p
< 0.05) tests.
Results
Intense inflammatory infiltrate was demonstrated in the cements with 10% EEP at 7 days and 15 days (
p
< 0.05), only Group Ketac 10% EEP (
p
= 0.01) at 30 days. A smaller quantity of collagen fibers was observed in the cements with 10% EEP (
p
= 0.01) at 7 days, and Group Meron 10% EEP (
p
= 0.04) at 15 days. MOs and MGCs showed significant difference for the cements with 10% EEP (
p
= 0.01) at 7 and 15 days. At 30 days, MOs persisted in the Groups with 10% EEP.
Conclusions
The concentration of 10% EEP had the greatest influence on the inflammatory and tissue repair processes. The concentrations of 25 and 50% EEP demonstrated biocompatibility similar to that of cements that did not receive EEP.
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Affiliation(s)
| | | | - Rayssa Amaral Vieira
- Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Márcio José da Silva Campos
- Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Polliana Muniz Alves
- Department of Pathology, Dental School, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, State University of the Southwest of Bahia, Jéquie, Bahia, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Minas Gerais, Brazil
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6
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Barsch F, Mamilos A, Babel M, Wagner WL, Winther HB, Schmitt VH, Hierlemann H, Teufel A, Brochhausen C. Semiautomated quantification of the fibrous tissue response to complex three-dimensional filamentous scaffolds using digital image analysis. J Biomed Mater Res A 2021; 110:353-364. [PMID: 34390322 DOI: 10.1002/jbm.a.37293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/24/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022]
Abstract
Fibrosis represents a relevant response to the implantation of biomaterials, which occurs not only at the tissue-material interface (fibrotic encapsulation) but also within the void fraction of complex three-dimensional (3D) biomaterial constructions (fibrotic ingrowth). Usual evaluation of the biocompatibility mostly depicts fibrosis at the interface of the biomaterial using semiquantitative scores. Here, the relations between encapsulation and infiltrating fibrotic growth are poorly represented. Virtual pathology and digital image analysis provide new strategies to assess fibrosis in a more differentiated way. In this study, we adopted a method previously used to quantify fibrosis in visceral organs to the quantification of fibrosis to 3D biomaterials. In a proof-of-concept study, we transferred the "Collagen Proportionate Area" (CPA) analysis from hepatology to the field of biomaterials. As one task of an experimental animal study, we used CPA analysis to quantify the fibrotic ingrowth into a filamentous scaffold after subcutaneous implantation. We were able to demonstrate that the application of the CPA analysis is well suited as an additional fibrosis evaluation strategy for new biomaterial constructions. The CPA method can contribute to a better understanding of the fibrotic interactions between 3D scaffolds and the host tissue responses.
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Affiliation(s)
- Friedrich Barsch
- Institute for Exercise and Occupational Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.,Institute of Pathology, University Regensburg, Regensburg, Germany
| | - Andreas Mamilos
- Institute of Pathology, University Regensburg, Regensburg, Germany
| | - Maximilian Babel
- Institute of Pathology, University Regensburg, Regensburg, Germany.,Central Biobank Regensburg, University Regensburg and University Hospital Regensburg, Regensburg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - Hinrich B Winther
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Volker H Schmitt
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | | | - Andreas Teufel
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University Regensburg, Regensburg, Germany.,Central Biobank Regensburg, University Regensburg and University Hospital Regensburg, Regensburg, Germany
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7
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Penha ESD, Lacerda-Santos R, de Medeiros LADM, Araújo Rosendo R, Dos Santos A, Fook MVL, de Sousa WJB, de Oliveira Firmino M, Montagna E. Effect of chitosan and Dysphania ambrosioides on the bone regeneration process: A randomized controlled trial in an animal model. Microsc Res Tech 2020; 83:1208-1216. [PMID: 32500599 DOI: 10.1002/jemt.23512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/24/2020] [Accepted: 05/01/2020] [Indexed: 11/05/2022]
Abstract
The focus of this triple-blind study was on evaluating the effect of chitosan combined with Dysphania ambrosioides (A) extract on the bone repair process in vivo. In total, 60 male Wistar rats (Rattus norvegicus albinus) weighing between 260 and 270 g were randomly selected for this study and distributed into four groups (n = 15). Group C (chitosan), Group CA5 (chitosan + 5% of D. ambrosioides), Group CA20 (chitosan + 20% of D. ambrosioides), and Group CO (Control-Blood clot). In each animal, bone defects measuring 2 mm in diameter were performed in both tibias for placement of the substances. After 7, 15, and 30 days, the animals were sedated and sacrificed using the cervical dislocation technique and the tissues were analyzed under optical microscope relative to the following events: inflammatory infiltrate, necrosis, osteoclasts, osteoblasts, fibroblasts, periosteal, and endosteal bone formation. The data were evaluated to verify distribution using the Kolmogorov-Smirnov test, and variance, using the Levene test; as distribution was not normal, data were subjected to the Kruskal-Wallis and Dunn nonparametric tests (p < .05). A significant inflammatory infiltrate was observed in Group CA5 (p = .008) in the time interval of 7 days, and in Group C at 15 (p = .009) and 30 (p = .017) days. Osteoblastic activity was more significant in Group CA20 (p = .027) compared with CA5 in the time interval of 7 days. Group CA20 demonstrated a significantly higher endosteal and periosteal bone formation value in the time interval of 7 (p = .013), 15 (p = .004), and 30 days (p = .008) compared with the other groups. The null hypothesis was refuted, bone regeneration was faster in spheres with an association of chitosan and 20% extract, and complete bone repair occurred clinically at 15 days and histologically at 30 days. The spheres proved to be a promising method for the biostimulation of alveolar bone repair and bone fractures.
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Affiliation(s)
- Elizandra Silva da Penha
- Postgraduate, Research and Innovation, Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Rogério Lacerda-Santos
- Department of Orthodontics and Pediatric Dentistry, Federal University of Juiz de Fora, UFJF, Governador Valadares, Brazil
| | | | | | | | - Marcus Vinícius Lia Fook
- Postgraduate Program in Materials Science and Engineering, Federal University of Campina Grande, UFCG, Campina Grande, Brazil
| | | | | | - Erik Montagna
- Postgraduate, Research and Innovation, Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, Brazil
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8
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Sampaio GADM, de Meneses IHC, de Carvalho FG, Carlo HL, Münchow EA, Barbosa TDS, Pithon MM, Alves PM, Lacerda-Santos R. Antimicrobial, mechanical and biocompatibility analysis of chlorhexidine digluconate-modified cements. J Clin Exp Dent 2020; 12:e178-e186. [PMID: 32071700 PMCID: PMC7018482 DOI: 10.4317/jced.56308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/08/2019] [Indexed: 12/02/2022] Open
Abstract
Background The focus of this study was to evaluate the antimicrobial, mechanical properties and biocompatibility of glass ionomer (GICs) modified by Chlorhexidine (CHX).
Material and Methods For biocompatibility, 105 male Wistar rats were used, divided into 7 groups (n=15): Group C (Control,Polyethylene), Groups M, M10, M18, and Groups RL, RL10, RL18 (M-Meron and RL-Riva Luting: conventional, and modified with 10%, and 18% CHX, respectively). The tissues were analyzed under optical microscope for different cellular events and time intervals. Antibacterial effect and Shear Bond Strength Test (SBST) were also analyzed. Biocompatibility was analyzed by the Kruskal-Wallis and Dunn tests; SBST one-way ANOVA and Tukey test (P<0.05). For the antibacterial effect, the Kruskal-Wallis and Friedman, followed by Dunn (P<0.05) tests were used.
Results Morphological study of the tissues showed inflammatory infiltrate with significant differences between Groups C and RL18, in the time intervals of 7(P=0.013) and 15(P=0.032) days. The antimicrobial effects of the cements was shown to be CHX concentration-dependent (P=0.001). The SBST showed no significant difference between the Groups of Meron cement (P=0.385), however, there was difference between Group RL and Groups RL10 and RL18 (P=0.001).
Conclusions The addition of CHX did not negatively influence the SBST. Meron-CHX-10% was the most biocompatible, and Riva-CHX-18% had more influence on the inflammatory process and presented slower tissue repair. Key words:Glass ionomer, chlorhexidine, biocompatibility, antimicrobial properties, microscope.
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Affiliation(s)
- Gêisa-Aiane-de Morais Sampaio
- DDS. M.Sc. Department of Clinical and Social Dentistry, Dental School, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Izaura-Helena-Chaves de Meneses
- DDS. M.Sc. Department of Clinical and Social Dentistry, Dental School, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Fabiola-Galbiatti de Carvalho
- DDS., M.Sc., Ph.D. Professor. Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Hugo-Lemes Carlo
- DDS., M.Sc., Ph.D. Professor. Department of Restorative Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Eliseu-Aldrighi Münchow
- DDS., M.Sc., Ph.D. Professor. Department of Restorative Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Taís-de Souza Barbosa
- DDS., M.Sc., Ph.D. Professor. Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Matheus-Melo Pithon
- DDS., M.Sc., Ph.D. Professor. Department of Orthodontics, Dental School, State University of the Southwest of Bahia, Jéquie, Bahia, Brazil
| | - Polliana-Muniz Alves
- DDS., M.Sc., Ph.D. Professor. Department of Patology, Dental School, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Rogério Lacerda-Santos
- DDS., M.Sc., Ph.D. Professor. Department of Orthodontics and Pediatric Dentistry, Dental School, Federal University of de Fora, Governador Valadares, Minas Gerais, Brazil
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