Estudo retrospectivo de lesões do complexo maxilomandibular nos laudos do Instituto Médico-Legal de Cascavel (PR) / Retrospective study of maxillomandibular complex injuries recorded in the reports at Medical Legal Institute of Cascavel (PR)

Estudos mostram que a cabeça é a região do corpo mais acometida por lesões corporais. Esses danos devem ser definidos através de perícia médica ou odontolegal. Este estudo verificou a incidência e distribuição das injúrias maxilomandibulares relatadas nos laudos de lesões corporais do Instituto Médico Legal de Cascavel-PR, entre 2002 a 2012. As lesões foram classificadas segundo a etiologia: agressão, acidente de trânsito ou trabalho, causa não revelada e localização. A localização das lesões foi dividida em: lesões superficiais; fraturas de mandíbula/maxila, de zigomático, nasal, ossos da órbita, dento-alveolares e perdas dentais. Dos 24.435 laudos avaliados, 6.443 continham lesões bucomaxilofaciais (26,36%). Neles estimou-se 8.344 lesões, sendo 89,3% de tecidos moles, 7,21% fraturas e 2,15% lesões dentais. Por ser a área de atuação do cirurgião-dentista, o odontolegista é o profissional capacitado para atuar nesses casos, apresentando laudos e descrições fidedignas e de melhor clareza de lesões do complexo maxilomandibular, sendo primordial nos institutos médicos legais.

Studies show that the body region most affected by injury is the head. Such damage must be defined by medical or dental-legal expertise. The aim of this study was to report the distribution of maxillomandibular injuries of bodily injuries of the Medical Legal Institute of Cascavel-PR from 2002-2012. These, the lesions were classified according to their etiology (violence, traffic collisions, occupational, and undisclosed) and according to the body location. The head injuries were classified in: soft tissues injuries; jaw fractures, maxilla, zygomatic, nasal, orbital bones, dentoalveolar and tooth loss. Of the 24,435 reports evaluated, 6,443 contained maxillofacial injuries (26.36%). In them was estimated 8.344 injuries, where 89.3% where soft tissue, 7.21% by fractures and 2.15% by dental lesions. With this, we see that the forensic dentist is a trained professional to act in these cases, being able to present reports and descriptions more clearly, being paramount in forensic institute.

Phytochemical screening, antioxidant, and antimicrobial activities of the crude leaves' extract from Ipomoea batatas (L.) Lam.

BACKGROUND: Ipomoea batatas (L.) Lam., popularly known as sweet potato (SP), has played an important role as an energy and a phytochemical source in human nutrition and animal feeding. Ethnopharmacological data show that SP leaves have been effectively used in herbal medicine to treat inflammatory and/or infectious oral diseases in Brazil. The aim of this research was to evaluate the phytochemical, antioxidant, and antimicrobial activities of the crude leaves' extract of SP leaves. MATERIALS AND METHODS: The screening was performed for triterpenes/steroids, alkaloids, anthraquinones, coumarins, flavonoids, saponins, tannins, and phenolic acids. The color intensity or the precipitate formation was used as analytical responses to these tests. The total antioxidant capacity was evaluated by the phosphomolybdenum complex method. Antimicrobial activity was made by agar disk and agar well diffusion tests. RESULTS: The phytochemical screening showed positive results for triterpenes/steroids, alkaloids, anthraquinones, coumarins, flavonoids, saponins, tannins, and phenolic acids. Total contents of 345.65, 328.44, and 662.02 mg were respectively obtained for alkaloids, anthraquinones, and phenolic compounds in 100 g of the dry sample. The total antioxidant capacity was 42.94% as compared to ascorbic acid. For antimicrobial studies, no concentration of the SP freeze dried extract was able to inhibit the growth of Streptococcus mutans, S. mitis, Staphylococcus aureus, and Candida albicans in both agar disk and agar well diffusion tests. CONCLUSIONS: SP leaves demonstrated the presence of secondary metabolites with potential biological activities. No antimicrobial activity was observed.

Uso de inhibidores de metaloproteinasas en la terapia periodontal / Use of metaloproteinasas inhibitors in periodontal therapy

Las metaloproteinasas de la matriz (MMPs) son una familia de enzimas proteolíticas metalodependientes que promueven la degradación de los componentes de la matriz extracelular,siendo una de las principales responsables por la degradación de colágeno durante la destrucción de los tejidos periodontales. El desequilibrio entre la degradación y la producción de colágeno debido a los altos niveles de MMPs en los tejidos periodontales inflamados, promueve la pérdida de inserción periodontal. Las enzimas liberadas degradan el colágeno que forma la base estructuraldel periodonto, promoviendo así la destrucción tisular. La actividad de las MMPs en el substrato de la matriz extracelular es regulada por la transcripción y activación de las proenzimas inactivas, la interacción con componentes específicos de la matriz extracelular y principalmente por los inhibidores tisulares endógenos de metaloproteinasas (TIMPs). En la terapia periodontal han sido administradas dosis subantimicrobianas de doxiciclina como coadyuvante al raspaje y alisado radicular, debido a sus propiedades de inhibición en la actividad de las MMPs. En este estudio,fueron revisados aspectos importantes de las MMPs, discutiéndose el papel de los TIMPs y de los inhibidores sintéticos de metaloproteinasas, el uso de dosis subantimicrobianas de doxiciclina,así como de antiinflamatorios no esteroideos (AINES) en la terapia periodontal. Ya que las MMPs participan activamente del proceso destructivo de la enfermedad periodontal, es importante el uso de inhibidores sintéticos de estas enzimas en la terapia periodontal con la finalidad de minimizar la destrucción del periodonto.

Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that promote degradation of extracellular matrix components, one of the main responsible for the degradation of collagen during the destruction of periodontal tissues. A disturbed balance between degradation and production of collagen, due to high levels of MMPs in periodontal tissues, promotes periodontal attachment loss. Released enzymes degrade collagen that forms the structural basis of the periodontium, thereby promoting tissue destruction. The activity of MMPs in the substrate of the extracellular matrix is regulated by the transcription and activation of inactive pro-enzymes, interaction with specific components of the extracellular matrix and especially by endogenous tissue inhibitors of MMPs (TIMPs). In periodontal therapy have been administered low-dose doxycycline (LDD) therapy as an adjunct to scaling and root planning, because for the properties of inhibiting the activity of MMPs. In this study, important aspectsof the MMPs were reviewed, discussing the role of TIMPs and synthetic inhibitors of metalloproteinases, the use of LDD, as well as non-steroidal anti-inflammatory drugs in periodontal therapy. Since the MMPs are actively involved in the destructive process of periodontal disease, it is important the use of synthetic inhibitors of these enzymes in periodontal therapy with the aim of minimizing the destruction of the periodontium.

Efeito da própolis no crescimento in vitro de microrganismos associados à periodontite em pacientes HIV-positivo / Effect of propolis on in vitro growth of microrganisms associated with periodontitis in HIV positive patients

A própolis tem demonstrado ser um bom antimicrobiano frente a diferentes microrganismos. O objetivo deste estudo foi avaliar in vitro a eficácia da própolis no controle de microrganismos que podem estar associados à periodontite em pacientes HIV-positivo. Para isto, foram utilizadas soluções de própolis marrom aquosa e alcoólica a 12%, própolis verde alcoólica a 12% e controle positivo com clorexidina 0,12%. Avaliaram-se o halo de inibição e as unidades formadoras de colônia eliminadas na presença da própolis que demonstrou resultados estatisticamente semelhantes à clorexidina sobre os microrganismos testados, sendo que a própolis verde apresentou ação antimicrobianas maior que a própolis marrom. A própolis apresentou poder antimicrobiano sobre P. aeruginosa e S.aureus semelhantes à clorexidina (p>0,05). Em relação a C. albicans, o poder antifúngico da própolis, apesar de inferior ao da clorexidina, não deve ser desconsiderado. Os dados obtidos indicam que a própolis pode ser usada como coadjuvante no controle do biofilme dental em pacientes HIV-positivo, evitando os efeitos adversos da clorexidina.

It has been demonstrated that propolis is a good antibiotic against different microorganisms. The purpose of this study was to evaluate in vitro the efficiency of propolis against microorganisms that can be related to periodontitis in HIV-positive patients. 12% alcoholic and aqueous brown propolis solutions, 12% alcoholic green propolis solution and 0.12% chlorhexidine were used. The halos of microbial growth inhibition and CFU eliminated in contact with propolis were determined. The results demonstrated differences not statistically significant between propolis and the clorhexidine on the microorganisms tested. Green propolis was more effective than brown propolis. Propolis, showed an antimicrobial effect against P. aeruginosa and S. aureus similar to clorhexidine (p>0,05). In relation to C. albicans, the antifungal effect, although inferior to clorhexidine, should not disregarded. The data obtained suggest that propolis may be used as a good substitute for chlorhexidine without its adverse effects in controlling microorganisms from HIV positive patients.