Smoking in adolescents with cleft lip and/or palate: prevalence and associated factors.

OBJECTIVE: To assess the prevalence and factors associated with smoking in adolescents with cleft lip and/or palate. METHODS: This is a cross-sectional study, developed in a Brazilian public and tertiary hospital between November 2018 and August 2019. Adolescents aged between 12 and 19 years old, previously submitted to cheiloplasty and/or palatoplasty surgeries were included. Data collection was carried out through interviews, guided by questionnaires referring to sociodemographic issues, use and factors associated with smoking. For statistical analysis, Fisher's Exact Test, Chi-square, Student's t test and bivariate logistic regression were used, all with a significance level of 5% (p≤0.05). RESULTS: 102 adolescents participated. The prevalence of smoking was 20.6% (n=21). Having cleft lip and palate was associated with smoking (p=0.012). The bivariate analysis showed that not dating (p=0.001; OR=0.19) and owning a home (p=0.032; OR=0.33) were configured as protective factors for the act of being a smoker, while believing that smoking facilitates interaction with young people or with the group of friends (p=0.043; OR=2.95), having friends who use alcoholic beverages (p=0.002; OR=8.40), having friends who use drugs, except cigarettes (p=0.002; OR=5.33), use alcoholic beverages (p<0.001; OR=10.67) and sexual initiation (p<0.001; OR=7.00), were associated with being a smoker. CONCLUSIONS: From the knowledge of the profile of adolescents most vulnerable to tobacco use, it is possible to plan and implement educational and preventive actions.

Smoking in adolescents with cleft lip and/or palate: prevalence and associated factors / Tabagismo em adolescentes com fissura de lábio e/ou palato: prevalência e fatores associados

Abstract Objective: To assess the prevalence and factors associated with smoking in adolescents with cleft lip and/or palate. Methods: This is a cross-sectional study, developed in a Brazilian public and tertiary hospital between November 2018 and August 2019. Adolescents aged between 12 and 19 years old, previously submitted to cheiloplasty and/or palatoplasty surgeries were included. Data collection was carried out through interviews, guided by questionnaires referring to sociodemographic issues, use and factors associated with smoking. For statistical analysis, Fisher's Exact Test, Chi-square, Student's t test and bivariate logistic regression were used, all with a significance level of 5% (p≤0.05). Results: 102 adolescents participated. The prevalence of smoking was 20.6% (n=21). Having cleft lip and palate was associated with smoking (p=0.012). The bivariate analysis showed that not dating (p=0.001; OR=0.19) and owning a home (p=0.032; OR=0.33) were configured as protective factors for the act of being a smoker, while believing that smoking facilitates interaction with young people or with the group of friends (p=0.043; OR=2.95), having friends who use alcoholic beverages (p=0.002; OR=8.40), having friends who use drugs, except cigarettes (p=0.002; OR=5.33), use alcoholic beverages (p<0.001; OR=10.67) and sexual initiation (p<0.001; OR=7.00), were associated with being a smoker. Conclusions: From the knowledge of the profile of adolescents most vulnerable to tobacco use, it is possible to plan and implement educational and preventive actions.

RESUMO Objetivo: Avaliar a prevalência e os fatores associados ao tabagismo em adolescentes com fissura de lábio e/ou palato. Métodos: Estudo de corte transversal, desenvolvido em um hospital público e terciário brasileiro entre novembro de 2018 e agosto de 2019. Foram incluídos adolescentes com idade entre 12 e 19 anos, submetidos previamente às cirurgias de queiloplastia e/ou palatoplastia. A coleta de dados foi realizada por meio de entrevista, guiada por questionários referentes a questões sociodemográficas, uso e fatores associados ao tabagismo. Para a análise estatística, utilizaram-se os testes: exato de Fisher, qui-quadrado, t de Student e regressão logística bivariada, todos com nível de significância de 5% (p ≤ 0,05). Resultados: Participaram 102 adolescentes. A prevalência do tabagismo foi de 20,6% (n=21). Possuir fissura de lábio e palato associou-se ao tabagismo (p=0,012). A análise bivariada mostrou que não namorar (p=0,001; OR=0,19) e possuir habitação própria (p=0,032; OR=0,33) configuraram fatores de proteção para o ato de ser tabagista, enquanto acreditar que fumar facilita a interação com os jovens ou com o grupo de amigos (p=0,043; OR=2,95), ter amigos que usam bebida alcoólica (p=0,002; OR=8,40), ter amigos que usam drogas, exceto o cigarro (p=0,002; OR=5,33), usar bebida alcoólica (p<0,001; OR=10,67) e iniciação sexual (p<0,001; OR=7,00) associaram-se a ser tabagista. Conclusões: Pelo conhecimento do perfil dos adolescentes mais vulneráveis ao uso do tabaco, é possível planejar e programar ações educativas e preventivas.

Eficácia do propionato de clobetasol 0, 05 nas lesões ulceradas da cavidade bucal / Efficacy of 0.05% clobetasol propionate in ulcerated lesions of the oral cavity

O uso tópico de Propionato de Clobetasol 0,05% em solução aquosa para lesões ulceradas na cavidade bucal é pouco divulgado nacionalmente e tem sido pouco citado em traba-lhos científicos a respeito de sua eficácia, tempo de regressão da lesão e efeitos adversos. Portanto, o objetivo deste estudo foi avaliar retrospectivamente prontuários de pacientes que foram tratados de lesões ulceradas através do uso do Propionato de Clobetasol 0,05%, no ambulatório de estomatopatologia de uma Instituição, a fim de investigar sua eficácia. Foram selecionados prontuários de pacientes que apresentaram a alteração fundamental ulcerada ou erosiva e que fizeram o uso tópico de Propionato de Clobetasol 0,05%. A aná-lise retrospectiva foi feita por um examinador, que fez a seleção da amostra seguindo os critérios de inclusão e exclusão. Foram coletadas as informações: Idade, gênero, diagnós-tico da alteração; quantidade de lesão, tempo de uso, evolução da lesão, tempo exato de regressão e presença de reações adversas. Foram incluídos 17 prontuários, dos quais cinco eram de pacientes com lesões erosivas de líquen plano, três úlceras traumáticas, três lesões liquenóides, dois eritemas multiformes, uma alergia a lactose, uma afta e uma gengivite descamativa. Todos os casos apresentaram resolução da sintomatologia, porém as altera-ções clínicas permaneceram em seis casos, embora mais leves e assintomáticas. Não foi ob-servada nenhuma reação adversa registrada no prontuário. A análise estatística não apontou associação em relação ao sexo (teste Exato de Fisher; p=0,49; p>0,05). Não foi observada diferença estatística significativa na frequência das lesões (teste exato de Fisher; p= 0,85; p>0,05). O uso do Propionato de Clobetasol 0,05% prescrito por até cinco dias se mostrou eficaz no tratamento de lesões ulceradas da mucosa bucal, principalmente para o alívio sintomático, além disso, não revelou efeitos adversos.

The treatment of ulcerated lesions of the oral cavity is usually carried out using topical analgesic drugs, anti-inflammatory corticosteroids, and alcohol-free oral antiseptics. The topical use of 0.05% Clobetasol Propionate in aqueous solution for ulcerated lesions in the oral cavity is little publicized nationally and little mentioned in scientific studies regarding its effectiveness, lesion regression time, and adverse effects. Therefore, the objective of this study was to retrospectively evaluate the medical records of patients who were treated for ulcerated or erosive lesions, using Clobetasol Propionate 0.05%, in the stomatology clinic of an institution to investigate its effectiveness. Medical records of patients who presented the fundamental ulcerated alteration and made topical use of 0.05% Clobetasol Propionate were selected. An examiner selected the sample following the inclusion and exclusion cri-teria and performed the retrospective analysis. The types of information collected were age, gender, diagnosis of the disorder, amount of injury, time of use, the evolution of the injury, exact time of regression, and presence of adverse reactions. A total of 17 medical records were included, of which five were from patients with erosive lichen planus lesions, three traumatic ulcers, three lichenoid lesions, two multiform erythema, one lactose allergy, one cold sore, and one scaly gingivitis. All cases had their symptoms solved, but, in six cases, the clinical changes remained, although milder and asymptomatic. No adverse reaction was noted in the medical record. The statistical analysis showed no association in relation to gender (Fisher's exact test; p = 0.49; p> 0.05). There was no statistically significant diffe-rence in the frequency of injuries (Fisher's exact test; p = 0.85; p> 0.05). The use of 0.05% Clobetasol Propionate, prescribed for up to five days, proved effective in treating ulcerated lesions of the oral mucosa, mainly for symptomatic relief. Furthermore, it revealed no ad-verse effects.

Treatment of bisphosphonate-related osteonecrosis using platelet-rich plasma: microtomographic, microscopic, and immunohistochemical analyses.

The present study aimed to investigate the use of platelet-rich plasma (PRP) on tooth extraction sites in rats treated with bisphosphonates. Thirty Albinus Wistar male rats were administered 0.035 mg/kg zoledronic acid intravenously for 8 weeks, divided into four administrations with a 2-week interval between each application, after which their upper right central incisors were extracted to induce the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The samples were divided into the following two groups: Group 1 (G1) underwent marginal resection of BRONJ followed by the use of PRP, while Group 2 (G2) underwent resection of BRONJ but without the use of PRP. The treatment groups were evaluated after 14, 28, and 42 days. Clinical, microtomographic, microscopic, and immunohistochemical (IHC) evaluations were performed. Microtomography results revealed no significant difference between the groups (p <0.05) in any time period. Histomorphometric analysis showed increased bone formation over time for both groups (p < 0.001). G1 demonstrated a greater amount of new bone formation than G2 at 28 and 42 days (p < 0.001), with G1 presenting greater vascularization and a slightly higher VEGF expression. For both groups, RANKL/OPG expression levels were sufficient as a parameter for indicating the rate of bone remodeling in a previously treated area of osteonecrosis groups. Taken together, our findings indicated that the use of PRP improves the resolution process of BRONJ.

Explanation for the signs and symptoms of tooth eruption: mast cells.

This study contributes to the understanding of the mechanisms associated with signs and symptoms of tooth eruption, by investigating the presence of mast cells in pericoronal tissues during the intraosseous (Group 1) and submucosal (Group 2) phases of eruption. We compared findings for these two groups with each other and with those for the oral mucosa (Group 3). In each group, 14 specimens were analyzed microscopically after hematoxylin and eosin staining and immunohistochemical analysis of c-Kit and tryptase expression. Results revealed that the number and density of mast cells is different in follicular tissues according to the eruption phase, which may mean that: 1) masticatory trauma of the oral mucosa and dental follicles in the submucosa may explain why reduced enamel epithelium exposes enamel to the cells of the connective tissue; 2) exposure of antigenic enamel proteins might correspond to the release of sequestered antigens, which may lead to the interaction of IgE and a greater number of mast cells in the region; and 3) the consequent degranulation and the local release of mediators, such as histamine, leukotrienes, prostaglandins, proteases, cytokines and growth factors, contribute to the understanding of signs and symptoms associated with tooth eruption.

A new technique for tongue brushing and halitosis reduction: the X technique.

The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. OBJECTIVE: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. MATERIAL AND METHODS: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. RESULTS: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. CONCLUSION: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.

Explanation for the signs and symptoms of tooth eruption: mast cells

Abstract This study contributes to the understanding of the mechanisms associated with signs and symptoms of tooth eruption, by investigating the presence of mast cells in pericoronal tissues during the intraosseous (Group 1) and submucosal (Group 2) phases of eruption. We compared findings for these two groups with each other and with those for the oral mucosa (Group 3). In each group, 14 specimens were analyzed microscopically after hematoxylin and eosin staining and immunohistochemical analysis of c-Kit and tryptase expression. Results revealed that the number and density of mast cells is different in follicular tissues according to the eruption phase, which may mean that: 1) masticatory trauma of the oral mucosa and dental follicles in the submucosa may explain why reduced enamel epithelium exposes enamel to the cells of the connective tissue; 2) exposure of antigenic enamel proteins might correspond to the release of sequestered antigens, which may lead to the interaction of IgE and a greater number of mast cells in the region; and 3) the consequent degranulation and the local release of mediators, such as histamine, leukotrienes, prostaglandins, proteases, cytokines and growth factors, contribute to the understanding of signs and symptoms associated with tooth eruption.

Resumo Para contribuir com a compreensão dos mecanismos relacionados à sintomatologia e aos sinais associados à erupção dentária, investigou-se a presença de mastócitos nos tecidos pericoronários na fase intraóssea (Grupo 1) e submucosa (Grupo 2), comparando-os entre si e com a mucosa bucal (Grupo 3). Em cada grupo, 14 espécimes foram analisados microscopicamente em cortes corados com hematoxilina e eosina, e imunocitoquimicamente marcados com Ckit e Triptase. Pelos resultados obtidos, concluiu-se que a quantidade/densidade dos mastócitos é diferente nos tecidos foliculares de acordo com a fase de erupção, o que permite inferir que: 1) O traumatismo decorrente da mastigação sobre o conjunto "mucosa bucal com o folículo pericoronário na submucosa" pode explicar porque o epitélio reduzido exporia o esmalte às células do tecido conjuntivo; 2) A exposição das proteínas do esmalte com propriedades antigênicas corresponderia à liberação de antígenos sequestrados que levariam à interação de IgE e mastócitos em número aumentado na região; e 3) A consequente degranulação e liberação de mediadores no local, como histamina, leucotrienes, prostaglandinas, proteases, citocinas e fatores de crescimento, contribuem para a compreensão dos sinais e sintomatologia atribuídos à erupção dentária.

Treatment of bisphosphonate-related osteonecrosis using platelet-rich plasma: microtomographic, microscopic, and immunohistochemical analyses

Abstract The present study aimed to investigate the use of platelet-rich plasma (PRP) on tooth extraction sites in rats treated with bisphosphonates. Thirty Albinus Wistar male rats were administered 0.035 mg/kg zoledronic acid intravenously for 8 weeks, divided into four administrations with a 2-week interval between each application, after which their upper right central incisors were extracted to induce the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The samples were divided into the following two groups: Group 1 (G1) underwent marginal resection of BRONJ followed by the use of PRP, while Group 2 (G2) underwent resection of BRONJ but without the use of PRP. The treatment groups were evaluated after 14, 28, and 42 days. Clinical, microtomographic, microscopic, and immunohistochemical (IHC) evaluations were performed. Microtomography results revealed no significant difference between the groups (p <0.05) in any time period. Histomorphometric analysis showed increased bone formation over time for both groups (p < 0.001). G1 demonstrated a greater amount of new bone formation than G2 at 28 and 42 days (p < 0.001), with G1 presenting greater vascularization and a slightly higher VEGF expression. For both groups, RANKL/OPG expression levels were sufficient as a parameter for indicating the rate of bone remodeling in a previously treated area of osteonecrosis groups. Taken together, our findings indicated that the use of PRP improves the resolution process of BRONJ.

Qualidade de vida dos cuidadores de crianças de 0 a 12 anos atendidas na clínica de terapia ocupacional / Quality of Life of Caregivers of Children from 0 to 12 Years Attended in the Occupational Therapy Clinic

Introdução: Atualmente a definição de qualidade de vida mais utilizada é a descrita pela Organização Mundial da Saúde (OMS) em 1998, que relaciona o termo com a "percepção do indivíduo de sua posição na vida no contexto cultural e sistema de valores em que vivem e sobre os seus objetivos, expectativas, padrões e preocupações". Já o cuidador, é todo aquele que se responsabiliza pelo ato de cuidar de um indivíduo suprindo suas necessidades. Objetivo: avaliar a qualidade de vida dos cuidadores de crianças de 0 a 12 anos atendidas na Clínica de Terapia Ocupacional da Universidade do Sagrado Coração. Métodos: tratou-se de uma pesquisa descritiva-exploratória com caráter quantitativo que utilizou para a coleta de dados um questionário sociodemográfico construído pela autora e o Questionário de Qualidade de Vida ­ SF ­ 36. Resultados: Observou-se prevalência de cuidadores do sexo feminino entre 31 a 40 anos e crianças do sexo masculino entre 7 a 9 anos, sem hipótese diagnóstica definida. Além disso, observouse que a soma dos resultados de todos os cuidadores na avaliação por meio do Questionário de Qualidade de Vida ­ SF 36 atingiu escores acima de 50, podendo considerar como "muito boa", com destaque para o domínio Capacidade Funcional com o melhor escore e Vitalidade com o pior. Conclusão: Apesar disso, nenhum escore atingiu 100, deixando transparecer que mesmo o resultado tendo sido significativo, existem intercorrências que afetam de alguma maneira a qualidade de vida desses cuidadores.

Introduction: Currently the adopted definition of quality is that provided by the World Health Organization (WHO) in 1998 that express it as "the individual´s perception to its life position in the cultural content and value system in which they live and on their goals, expectations, standards and concerns. In its turn, the definition of caregiver means every one that is liable for the act of taking care of an individual attending to your needs. Objectives: to evaluate the quality of life of caregivers of children 0 to 12 met in the Clinic of Occupational Therapy the University Sagrado Coração. Methods: This was a descriptive-exploratory quantitative study using for data collection a sociodemographic questionnaire constructed by the author and the Questionnaire of Quality of Life - SF 36. Results: it was observed a prevalence of female caregivers between 31 to 40 years and male children between 7 to 9 years without a defined diagnostic hypothesis. In addition, it was observed that the sum of the results of all the caregivers in the assessment through the Questionnaire of Quality of life - SF 36 has reached scores above 50 what can be considered "very good", with the featured pair to domain Functional Capacity with the best score, and Vitality with the worst. Conclusion: Despite some good findings, no score has reached 100, revealing that , despite the significant results, there are still aspects that may affect the quality of life these caregivers.

A new technique for tongue brushing and halitosis reduction: the X technique

Abstract The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users' perceptions of their breath.