1
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Sohn C, Ryu J, Nam I, Shin SH, Lee JY. Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases. J Korean Assoc Oral Maxillofac Surg 2022; 48:342-347. [PMID: 36579905 PMCID: PMC9807379 DOI: 10.5125/jkaoms.2022.48.6.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.
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Affiliation(s)
- Changmo Sohn
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jihye Ryu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Inhye Nam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae-Yeol Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea,Jae-Yeol Lee, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea, TEL: +82-55-360-5100, E-mail: , ORCID: https://orcid.org/0000-0003-0678-2499
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2
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Ghafouri-Fard S, Atarbashi-Moghadam S, Taheri M. Genetic factors in the pathogenesis of ameloblastoma, dentigerous cyst and odontogenic keratocyst. Gene 2020; 771:145369. [PMID: 33346102 DOI: 10.1016/j.gene.2020.145369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/28/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023]
Abstract
Ameloblastoma (AB), dentigerous cyst (DC) and Odontogenic keratocyst (OKC) are odontogenic lesions with propensity to malignant transformation or local invasion. The molecular mechanisms of development of these lesions are not fully understood. However, some researches have reported dysregulation of tumor suppressor genes or oncogenes in these lesions. Down-regulation of P53 gene has been reported in AB, DC and OKC. Moreover, several long non-coding RNAs such as ENST00000512916 and KIAA0125 have been dysregulated in AB tissues. Single nucleotide polymorphisms within a variety of genes have been associated with certain types of odontogenic lesions. In the current review, we summarize the current data about the expression pattern of genes in these lesions and the observed association between genetic polymorphisms and development of these lesions.
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Affiliation(s)
- Soudeh Ghafouri-Fard
- Dental Research Center, Research Institute for Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saede Atarbashi-Moghadam
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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3
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Bergamini ML, Sanches GT, Pina PSS, D'Avila RP, Canto AMD, Ogawa CM, Braz-Silva PH, Costa ALF. Unusual multiple dentigerous cysts evaluated by cone beam computed tomography: a case report on a non-syndromic patient. Braz J Otorhinolaryngol 2020; 87:110-113. [PMID: 32595080 PMCID: PMC9422655 DOI: 10.1016/j.bjorl.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/04/2020] [Accepted: 05/18/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mariana Lobo Bergamini
- Universidade de São Paulo (USP), Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, SP, Brazil.
| | - Guilherme Trafani Sanches
- Universidade de São Paulo (USP), Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, SP, Brazil
| | - Paulo Sergio Souza Pina
- Universidade de São Paulo (USP), Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, SP, Brazil
| | - Ricardo Pimenta D'Avila
- Universidade de São Paulo (USP), Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, SP, Brazil
| | | | - Celso Massahiro Ogawa
- Universidade Cruzeiro do Sul (UNICSUL), Programa de Pós-Graduação em Odontologia, São Paulo, SP, Brazil
| | - Paulo Henrique Braz-Silva
- Universidade de São Paulo (USP), Faculdade de Odontologia, Departamento de Estomatologia, São Paulo, SP, Brazil; Universidade de São Paulo (USP), Instituto de Medicina Tropical de São Paulo, Laboratório de Virologia, São Paulo, SP, Brazil
| | - Andre Luiz Ferreira Costa
- Universidade Cruzeiro do Sul (UNICSUL), Programa de Pós-Graduação em Odontologia, São Paulo, SP, Brazil
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4
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Aboujaoude S, Ziade M, Aoun G. Five Years Follow-up of a Spontaneous Eruption of an Impacted Mandibular Premolar Associated with a Dentigerous Cyst Treated by Marsupialization. Cureus 2020; 12:e7370. [PMID: 32226697 PMCID: PMC7093914 DOI: 10.7759/cureus.7370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Dentigerous cysts (DC) are developmental odontogenic cysts associated with impacted or partially erupted teeth; they can occur at any location of the jaw. Being generally asymptomatic, they are fortuitously discovered when radiographs are taken to investigate a tooth eruption failure. In this report, we present a case of a 10-year-old girl presented with the absence of the right second mandibular premolar and retention of the right second primary molar. After clinical and radiological examinations a preliminary diagnosis of the DC was made and confirmed later histopathologically. The lesion was treated by marsupialization to allow eruption of the affected tooth and followed up for five years with no evidence of recurrence.
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Affiliation(s)
- Samia Aboujaoude
- Pediatric Dentistry and Public Dental Health, Lebanese University, Beirut, LBN
| | | | - Georges Aoun
- Oral Medicine and Maxillofacial Radiology, Lebanese University, Beirut, LBN
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5
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Vasiapphan H, Christopher PJ, Kengasubbiah S, Shenoy V, Kumar S, Paranthaman A. Bilateral Dentigerous Cyst in Impacted Mandibular Third Molars: A Case Report. Cureus 2018; 10:e3691. [PMID: 30761243 PMCID: PMC6368363 DOI: 10.7759/cureus.3691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A dentigerous cyst is an odontogenic cyst, associated with the crown of an impacted or unerupted tooth. The occurrence of bilateral dentigerous cysts is uncommon among the odontogenic cysts of the jaw, as they are usually solitary. Multiple cysts, when reported, are generally associated with syndromes such as cleidocranial dysplasia, Maroteaux-Lamy syndrome, and systemic diseases like mucopolysaccharidosis. This article presents a case of bilateral mandibular dentigerous cysts in a nonsyndromic patient, along with a review of the literature and an examination of the treatment modality.
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Affiliation(s)
- Haymenth Vasiapphan
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
| | - Pradeep J Christopher
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
| | - Srivatsa Kengasubbiah
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
| | - Vandana Shenoy
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
| | - Senthil Kumar
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
| | - Ashwan Paranthaman
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College & Hospital, Chennai, IND
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6
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Bi-maxillary dentigerous cyst in a non-syndromic child - review of literature with a case presentation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:45-48. [PMID: 28330574 DOI: 10.1016/j.jormas.2016.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/12/2016] [Indexed: 11/21/2022]
Abstract
Dentigerous cysts are the most common developmental odontogenic cysts of the jaw, which usually occur in the second and third decade of life. It is most frequently associated with impacted mandibular third molar teeth and impacted canines. Bilateral/multiple dentigerous cysts are rare and typically associated with developmental syndromes. Non-syndromic dentigerous cyst occurring bilaterally or involving both arches at the same time is very rare. Here, we discuss the review of literature with a case of unusual occurrence of non-syndromic bi-maxillary dentigerous cysts in a child.
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7
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Jeon JY, Park CJ, Cho SH, Hwang KG. Bilateral dentigerous cysts that involve all four dental quadrants: a case report and literature review. J Korean Assoc Oral Maxillofac Surg 2016; 42:123-6. [PMID: 27162755 PMCID: PMC4860379 DOI: 10.5125/jkaoms.2016.42.2.123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/17/2015] [Accepted: 12/01/2015] [Indexed: 11/07/2022] Open
Abstract
Dentigerous cysts are common odontogenic cysts that are associated with the crown of the tooth and typically develop from single lesions. Bilateral and multiple dentigerous cysts are very rare and occur in patients with syndromic conditions. This paper presents a case report of a 15-year-old male patient that experienced non-syndromic bilateral dentigerous cysts that simultaneously occurred in all four dental quadrants around the unerupted third molars. Clinicians should confirm the extent of cystic lesions using a panoramic view and computed tomography, and should keep the possibility of bilateral dentigerous cysts in mind as a potential diagnosis, even in a non-syndromic patient.
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Affiliation(s)
- Jae-Yun Jeon
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - Chang-Joo Park
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - Seok Hyun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea
| | - Kyung-Gyun Hwang
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
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8
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Devi P, Thimmarasa VB, Mehrotra V, Agarwal M. Multiple dentigerous cysts: a case report and review. J Maxillofac Oral Surg 2015; 14:47-51. [PMID: 25861182 DOI: 10.1007/s12663-011-0280-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 08/22/2011] [Indexed: 11/29/2022] Open
Abstract
Dentigerous cysts are one of the common cysts of the jaws. Bilateral dentigerous cysts generally occur in association with a developmental syndrome or systemic diseases. Bilateral dentigerous cyst in absence of a syndrome is rare and to date only 18 cases have been reported. After reviewing the literature, no case reports of dentigerous cysts involving all the quadrants of the jaws were reported. As far as our knowledge, this is the first case to be reported.
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Affiliation(s)
- Parvathi Devi
- Department of Oral Medicine & Radiology, Rama Dental College, Hospital & Research Centre, A/1-8 Lakhanpur, Kanpur, 208024 India
| | - V B Thimmarasa
- Department of Oral Medicine & Radiology, Rama Dental College, Hospital & Research Centre, A/1-8 Lakhanpur, Kanpur, 208024 India
| | - Vishal Mehrotra
- Department of Oral Medicine & Radiology, Rama Dental College, Hospital & Research Centre, A/1-8 Lakhanpur, Kanpur, 208024 India
| | - Mayuri Agarwal
- Department of Oral Medicine & Radiology, Rama Dental College, Hospital & Research Centre, A/1-8 Lakhanpur, Kanpur, 208024 India
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9
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Cura N, Hanttash A, Inceoglu B, Orhan K, Oncul AMT. Dentigerous cysts in four quadrants of a nonsyndromic patient: case report and literature review. Oral Radiol 2014. [DOI: 10.1007/s11282-014-0171-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Shirazian S, Agha-Hosseini F. Non-syndromic bilateral dentigerous cysts associated with permanent second premolars. Clin Pract 2011; 1:e64. [PMID: 24765325 PMCID: PMC3981367 DOI: 10.4081/cp.2011.e64] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 08/22/2011] [Indexed: 11/23/2022] Open
Abstract
The dentigerous cyst is one of the most common developmental odontogenic cysts in the jaw. Occurrence of the bilateral dentigerous cyst is uncommon, and frequently associated with syndromes like basal cell nevus syndrome or cleidocranial dysplasia. There are few reports on the presence of bilateral dentigerous cyst in nonsyndromic patients, and most of these are associated with first and third molars. The reported case in this paper is bilateral dentigerous cysts associated with mandibular permanent second premolars, in the absence of any signs of syndrome. To our knowledge bilateral dentigerous cysts in these locations have not been previously reported.
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Affiliation(s)
- Shiva Shirazian
- Oral medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Agha-Hosseini
- Oral medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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11
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Akay MC, Kaya E, Zeytinoğlu M. Treatment of nonsyndromic dentigerous cysts in primary dentition. Clin Cosmet Investig Dent 2011; 3:17-23. [PMID: 23674910 PMCID: PMC3652361 DOI: 10.2147/cciden.s17091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They usually occur singly and are located in the mandible. Nonsyndromic bilateral dentigerous cysts (NSBDC) are rarely seen during childhood. The aim of this study was to determine the long-term effects of the marsupialization technique in growing children with NSBDC. Study design Seven patients with NSBDC (4 female, 3 male) ranging in age from 7 to 9 years (mean 8.35 years) were involved in the study. All the individuals were treated by marsupialization. Space-maintaining appliances were applied during permanent teeth eruption. Intraoral photographs, and panoramic and periapical films were taken before surgery and during healing. Results The NSBDC were successfully treated by the marsupialization technique and rapid healing period was observed in the growing patients, without any loss of permanent teeth. No recurrence was seen in the long-term follow-up period (3–10 years). Conclusion Our clinical and radiological results revealed that using the marsupialization technique in children with NSBDC provided safe healing of permanent teeth around the dentigerous cysts in a short period. However, treatment planning and regular clinical follow-ups are necessary to ensure clinical success.
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Affiliation(s)
- Mehmet Cemal Akay
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ege University, Bornova, Izmir, Turkey
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12
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Tamgadge A, Tamgadge S, Bhatt D, Bhalerao S, Pereira T, Padhye M. Bilateral dentigerous cyst in a non-syndromic patient: Report of an unusual case with review of the literature. J Oral Maxillofac Pathol 2011; 15:91-5. [PMID: 21731287 PMCID: PMC3125666 DOI: 10.4103/0973-029x.80017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth and impacted canines. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The occurrence of bilateral dentigerous cysts is rare and, to date, only 21 cases have been reported in literature till 2009. Here, we report a case of bilateral dentigerous cysts in maxillae of non-syndromic 10-year-old patient with brief review of literature.
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Affiliation(s)
- Avinash Tamgadge
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
| | - Sandhya Tamgadge
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
| | - Daivat Bhatt
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
| | - Sudhir Bhalerao
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
| | - Treville Pereira
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
| | - Mukul Padhye
- Department of Oral Pathology and Microbiology, Dr D.Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India
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13
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Abstract
Dentigerous cysts are one of the common cysts of the jaws and are associated with the crowns of permanent teeth, most frequently with impacted mandibular third molars. Bilateral dentigerous cysts generally occur in association with a developmental syndrome or systemic diseases. Bilateral dentigerous cysts in absence of a syndrome is a rare condition. There are only 18 cases reported in the literature till date (Dinkar et al. J Indian Soc Pedod Prev Dent 25:56-59, 2007). There are no cases reported with multiple dentigerous cyst involving all the four quadrants.
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14
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Prasad LK, Chakravarthi PS, Sridhar M, Ramakumar Y, Kattimani V. Nonsyndromic Bilateral Maxillary and Unilateral Mandibular Multiple Dentigerous Cysts in a Young Girl: Report of a Rare Case. Int J Clin Pediatr Dent 2010; 3:219-23. [PMID: 27616848 PMCID: PMC4993832 DOI: 10.5005/jp-journals-10005-1082i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Accepted: 06/28/2010] [Indexed: 11/23/2022] Open
Abstract
Dentigerous cyst is a benign odontogenic cyst associated with the crowns of permanent teeth. It is usually single in occurrence and located in the mandible of middle-aged persons. The teeth commonly affected are in order of frequency, the mandibular third molars, maxillary canines, maxillary third molars and, rarely central incisors. The present case report describes the surgical enucleation of the huge bilateral maxillary dentigerous cysts involving permanent maxillary canines associated with unilateral mandibular lateral incisor, cuspid and bicuspids in a young girl. To our knowledge, bilateral maxillary and unilateral mandibular multiple dentigerous cysts in a nonsyndromic patient have not been reported previously in the literature.
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Affiliation(s)
- L Krishna Prasad
- Professor and Head, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - P Srinivas Chakravarthi
- Professor, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - M Sridhar
- Professor, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Y Ramakumar
- Reader, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Vivekanand Kattimani
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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15
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Freitas DQ, Tempest LM, Sicoli E, Lopes-Neto FC. Bilateral dentigerous cysts: review of the literature and report of an unusual case. Dentomaxillofac Radiol 2007; 35:464-8. [PMID: 17082341 DOI: 10.1259/dmfr/26194891] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Dentigerous cysts are common cysts of the jaws. They are associated with the crowns of permanent teeth, most frequently associated with impacted mandibular third molars. Bilateral dentigerous cysts are rare and generally occur in association with a developmental syndrome or systemic disease, such as mucopolysaccharidosis and cleidocranial dysplasia. Bilateral dentigerous cysts in the absence of a syndrome are rare and to date only 17 cases have been described. The following is a report of a case of unusual bilateral non-syndromic dentigerous cysts associated with mandibular second molar and maxillary third molar and a review of the literature. Bilateral dentigerous cysts in these locations have not been previously reported.
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Affiliation(s)
- D Q Freitas
- Piracicaba Dental School, University of Campinas-UNICAMP, Department of Oral Radiology, Dental School, University Center of São José do Rio Preto-UNIRP, Brazil.
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