Postoperative morbidity is high after dental treatment under GA, but it is not higher in disabled/medically compromised patients.

Twenty-two consecutive children with repaired cleft lip and/or palate [isolated cleft lip (CL) 6, isolated cleft palate (CP) 7, unilateral cleft lip and palate (UCLP) 7, and bilateral cleft lip and palate 2] with a mean age of 27 months underwent spectrographic measures of tape-recorded speech (DSP Sona-Graph digital unit). Controls were 22 age- and sex-matched noncleft children. Data analyzed included (1) the Spanish vocalic variables [a, i, u, e, o]: first formant, second formant, duration, and context; (2) obstruent variables [p, t, k]: burst, voice onset time, and duration, and (3) nasal variables [m]: first formant, second formant, and duration. Statistically significant differences were observed between the CL group and the control group in the first formant of [e] and in the increase of the frequency of the [t] burst. Comparison between UCLP and controls showed differences in the second formant of [a], in the first formant of [o], and in the second formant of [o]. These results suggest a small but significant influence of either the cleft lip or its repair on lip rounding for [o] and [u]. In addition, tongue position differences were most likely responsible for the differences seen with [a] and [e]. Spectrographic differences in the current patients did not contribute to meaningful differences in speech sound development. Individualized care (orthodontics, surgery, speech therapy) in children with cleft lip and/or palate attended at specialized craniofacial units contributes to normalization of speech development.

The purpose of this study was to assess the effect of dry‐heat or autoclave sterilization on the resistance to fracture in torque and angular deflection and the resistance to bending of K‐type files made of nickel‐titanium (Nitiflex, Naviflex), titanium (Microtitane) or stainless steel (Flexofile, Flex‐R). Ten K‐type files of each sort, from size 25 to 40, were tested, according to ANSI/ADA specification 28 (1988) and ISO specification 3630 (1992). Sterilization with dry heat and autoclave slightly decreased the flexibility of files made of stainless steel and nickel‐titanium for most of the sizes, although the values obtained satisfied ISO specifications. The files made of titanium showed an increased flexibility after sterilization with autoclave (sizes 30 and 35) and dry heat (sizes 30, 35 and 40). Resistance to fracture varied amongst the five groups of files tested as follows: it decreased in some sizes of stainless‐steel instruments, decreased in all sizes of titanium files assessed by the torsional moment, and either increased or decreased in some sizes of nickel‐titanium files. All files tested, however, satisfied relevant standards for angular deflection after being subjected to sterilization with an autoclave or dry heat.

The aim of this study was to evaluate the apical seal obtained with various root canal sealing cements using a new method based on the use of a radionuclide and an external detection technique. A total of 150 maxillary incisors and canines, which had been kept in saline solution, were used. The root canals were instrumented with a stepback technique and circumferential filing. Six experimental groups and two control groups were randomly formed. Each experimental group was obturated by a lateral condensation technique with gutta-percha points and a different sealing cement (two based on zinc oxide-eugenol cement, two based on resins and two on calcium hydroxide); the positive control used gutta-percha without sealing cement, while in the negative control the apex was covered with nail varnish, leaving the root canal empty. The apical leakage was measured using an external detection technique after submerging the root apices in a solution containing the radioisotope metastable 99Tc. No leakage was observed in the negative control group. There was a large difference between the leakage observed in the positive control group and the experimental groups. The best seal was obtained using Sealapex cement, which differed significantly from AH26, Tubli-Seal and Diaket; there was no significant difference between the latter. The poorest results were obtained with Endomethasone and CRCS; there was a significant difference between these and the previous three sealing cements.