Avaliação clínica dos fatores de risco sistêmicos relacionado ao ardor bucal secundário / Clinical assessment of systemic risk factors related to secondary burning mouth

O Ardor Bucal Secundário (ABS) pode estar relacionado a diferentes doenças e condições que afetam a mucosa oral, ou representar uma manifestação oral de um quadro sistêmico. O propósito deste estudo foi investigar se existe associação entre o ABS queixa de Ardor Bucal e condições sistêmicas presentes na história médica do paciente. Foi realizado um estudo retrospectivo, constituído por 102 pacientes com ABS apresentando HAS ou DM tipo II, e o grupo controle constituído por 102 pacientes pareados por idade e sexo, com HAS ou DM tipo II e sem ABS. Na comparação entre os grupos, foram empregados os testes Qui-Quadrado de Pearson (χ2) e Exato de Fisher, além da obtenção da razão de chances (Odds ratio, OR) e seu respectivo intervalo de confiança (IC) de 95%. Foi aplicado, ainda, o modelo de regressão logística multivariada, para obtenção dos Odds ratio ajustados (ORa). Após análise multivariada, a gastrite foi identificada como fator de risco para ABS (ORa=2,50; IC 95% = 1,32­4,74; p=0,005). O uso de subclasses de anti-hipertensivos, tais como betabloqueadores (ORa = 0,36; IC 95% = 0,16-0,80; p=0,012), inibidores da enzima conversora de angiotensina (ECA) (ORa = 0,19; IC 95% = 0,06-0,56; p=0,003) e bloqueadores dos receptores da angiotensina (BRA) (ORa = 0,26; IC 95% = 0,14-0,49; p<0,001), revelou-se menos associado para o ABS. O presente estudo demonstrou que os pacientes com HAS e DM tipo II não obtiveram associação com o ABS. Todavia, nos pacientes portadores de gastrite foi observado 2,5 vezes mais chances de desenvolver a ABS. Além disso, os medicamentos antihipertensivos, inibidores da ECA, BRA e betabloqueadores, foram menos associados ao ABS (AU).

Secondary Burning Mouth (SBM) can be related to different diseases that affect the oral mucosa or represent an oral manifestation of a systemic condition presented by the patient. This study aimed to investigate whether there is an association between the complaint of SBM Complaint of Burning Mouth and Systemic Conditions presents in the patient's medical history. It was a retrospective case-control study of 102 patients with BMS and SAH or type II DM and a control group of 102 patients matched by age and sex, with SAH or type II DM and without ABS. Pearson's Chi-Square (χ2) and Fisher's Exact tests were applied to compare the groups, in addition to obtaining the odds ratio (OR) and its respective confidence interval (CI) of 95%. The multivariate logistic regression model was also applied to obtain the adjusted odds ratio (ORa). After multivariate analysis, gastritis was identified as a risk factor for SBM (ORa=2.50; 95% CI = 1.32­4.74; p=0.005). The use of antihypertensive subclasses, such as beta-blockers (ORa = 0.36; 95% CI = 0.16-0.80; p=0.012), angiotensin-converting enzyme (ACE) inhibitors (ORa = 0.19; 95% CI = 0.06- 0.56; p=0.003) and angiotensin receptor blockers (ARB) (ORa = 0.26; 95% CI = 0.14-0.49; p<0.001), proved to be less associated for ABS. The present study demonstrated that SAH and type II DM were not associated with SBM. A 2.5-fold greater chance of developing SBM was observed in patients with gastritis. In addition, antihypertensive drugs from the groups of ACE inhibitors, ARBs, and beta-blockers were shown to be less associated for SBM (AU).

Use of topical anti-inflammatory and antineoplastic agents in the treatment of young-aged actinic cheilitis: A systematic review.

INTRODUCTION: Several treatments have been used to reduce inflammation and to reverse epithelial alterations in actinic cheilitis (AC). AIM: A systematic review was conducted to analyze the potential of topical treatments for remission and clinical improvement of AC as well as patient acceptability. METHODS: A systematic review of clinical trials was conducted following the PICO strategy to answer the following question: Are topical anti-inflammatory and antineoplastic agents effective in the treatment of actinic cheilitis? The quality of the studies was assessed by ROB-2, and the certainty of evidence was rated by GRADE guidelines. RESULTS: Eight clinical trials were selected, including four that investigated the use of anti-inflammatory drugs and four use of antineoplastic agents. The use of 3% diclofenac sodium was associated with partial remission of AC, while 5% imiquimod and ingenol mebutate promoted complete remission. Furthermore, 5% fluorouracil was the drug most associated with complications during treatment. Diclofenac sodium (3%) and fludroxycortide showed the best acceptance by the patients, especially in terms of symptom relief and comfort provided. CONCLUSION: The anti-inflammatory and antineoplastic agents analyzed largely provided good clinical outcomes, with evidence of remission of AC lesions, development of few local adverse reactions during treatment, and good patient adherence.

Abordagens cirúrgicas em fraturas do complexo zigomático: revisão de literatura / Surgical approaches in fractures of the zygomatic complex: literature review

Introdução: O complexo zigomático é de grande importância no estudo da traumatologia devido a sua posição anatômica muito suscetível a traumas. Devido a sua interação direta com a órbita, o osso zigomático é uma importante proteção do globo ocular, assim como um dos responsáveis pela dissipação e transmissão de forças mastigatórias. Objetivo: O presente estudo objetiva revisar as formas de diagnóstico, exames complementares e as principais abordagens cirúrgicas bem como as possíveis complicações. Metodologia: Os dados selecionados foram obtidos através do acesso as bases de dados eletrônicos Medline, PubMed e Science direct. Foram selecionados 1 livro e 15 artigos publicados entre 2013 e 2019. Resultados: Diversas abordagens cirúrgicas podem ser utilizadas em fraturas do complexo zigomático dependendo da extensão e localização da fratura. As cirurgias são consideradas procedimentos seguros, com baixos níveis de complicações e sem problemas maiores no pósoperatório. Com a tecnologia 3D, o diagnóstico e planejamento dos casos se torna facilitado e mais preciso, levando a um procedimento mais seguro e previsível. Conclusão: O diagnóstico de fraturas no osso zigomático deve ser minucioso, envolvendo aspectos clínicos e exames complementares, o tratamento deve ser realizado de forma a preservar não só a função bem como a aparência, visto que erros no reposicionamento pós-trauma do processo zigomático pode causar simetria facial evidente no paciente, assim como o afundamento do globo ocular, diplopia, fissura orbital superior e hemorragia retrobulbar(AU)

Introduction: The zygomatic complex is of great importance in the study of traumatology due to its anatomical position very susceptible to trauma. Due to its direct interaction with the orbit, the zygomatic bone is an important protection of the eyeball, as well as one of those responsible for the dissipation and transmission of masticatory forces. Objective: This study aims to review the forms of diagnosis, complementary exams and the main surgical approaches as well as possible complications. Methodology: The selected data were obtained through access to the electronic databases Medline, PubMed and Science direct. One book and 15 articles published between 2013 and 2019 were selected. Results: Several surgical approaches can be used in fractures of the zygomatic complex depending on the extent and location of the fracture. The surgeries are considered safe procedures, with low levels of complications and without major problems in the postoperative period. With 3D technology, diagnosis and planning of cases becomes easier and more accurate, leading to a safer and more predictable procedure. Conclusion: The diagnosis of fractures in the zygomatic bone must be thorough, involving clinical aspects and complementary exams, the treatment must be carried out in order to preserve not only function but also appearance, since errors in the post-trauma repositioning of the zygomatic process can cause facial symmetry evident in the patient, as well as sinking of the eyeball, diplopia, upper orbital fissure and retrobulbar hemorrhage(AU)

Sialólito Gigante em Ducto de Wharton: um caso incomum / Giant Sialolith in the Wharton Duct: An Unusual Case

A obstrução das glândulas salivares por cálculos acomete 90% dessas estruturas, apresentando geralmente tamanho menor que 1 cm. É encontrada, principalmente, nas glândulas submandibulares. Clinicamente, o paciente apresenta um aumento de volume na região referente à glândula salivar envolvida, podendo apresentar sintomatologia dolorosa e drenagem purulenta. O presente artigo relata um caso de sialólito gigante com 2,5 cm de diâmetro, em glândula submandibular, removido cirurgicamente, com preservação funcional da glândula submandibular. O tratamento pode variar de acordo com o tamanho, a forma e localização do cálculo... (AU)

The obstruction of the salivary glands by calculations affects 90% of these structures, usually exhibiting a size smaller than 1 cm. It is mainly found in the submandibular glands. Clinically, the patient presents an increase in volume in the region related to the salivary gland involved and may present painful symptoms and purulent drainage. The present article reports a case of giant sialolith with a diameter of 2.5 cm in the submandibular gland, which was removed surgically with functional preservation of the submandibular gland. The treatment may vary according to the size, shape and location of the calculus... (AU)