A new model of classification of third molars development and its correlation with chronological age in a Brazilian subpopulation.

The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian's stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB-enamel mineralization; CD-crown dentin mineralization; EFG-root formation; and H-complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies.

Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction.

BACKGROUND: Anxiety symptoms are frequently observed in dental patients, whether they are undergoing simple or more invasive procedures such as surgery. This research aimed to compare the effects of Passiflora incarnata and midazolam for the control of anxiety in patients undergoing mandibular third molar extraction. MATERIAL AND METHODS: Forty volunteers underwent bilateral extraction of their mandibular third molars in a randomized, controlled, double-blind, crossover clinical trial. Passiflora incarnata (260 mg) or midazolam (15 mg) were orally administered 30 minutes before surgery. The anxiety level of participants was evaluated by questionnaires and measurement of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2). RESULTS: Considering each procedure independently, there were no significant differences between the protocols in BP, HR, and SpO2. Over 70% of the volunteers responded that they felt quiet or a little anxious under both protocols. With midazolam, 20% of the participants reported amnesia (not remembering anything at all), while Passiflora showed little or no ability to interfere with memory formation. CONCLUSIONS: Passiflora incarnata showed an anxiolytic effect similar to midazolam, and was safe and effective for conscious sedation in adult patients who underwent extraction of their mandibular third molars.

Full mouth periodontal debridement with or without adjunctive metronidazole gel in smoking patients with chronic periodontitis: A pilot study.

BACKGROUND AND OBJECTIVE: The evidence of effectiveness of metronidazole (Mtz) as an adjunct therapy to periodontal procedure in the treatment of patients with chronic periodontitis is not conclusive. The aim of this study was to compare the effect of Mtz (delivered locally as a gel or systemically as a tablet) as an adjunctive therapy with full mouth periodontal debridement (1 h of ultrasonic calculus/plaque removal) in smokers with chronic periodontitis. MATERIAL AND METHODS: This pilot study involved 30 smokers with at least six teeth with a clinical attachment loss of ≥ 5 mm and probing pocket depth (PPD) of ≥ 5 mm. They were randomly assigned into one of three groups (n = 10): (i) 3 g daily of placebo gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; (ii) 3 g daily of a 15% Mtz benzoate gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; and (iii) a daily single dose of 750 mg Mtz (Flagyl(®)) + periodontal debridement. Clinical parameters (visible plaque index, gingival bleeding index [GBI], relative attachment level and PPD) and quantitative analysis (by real-time polymerase chain reaction) of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia were assessed at baseline and at 1, 3 and 6 mo after periodontal debridement. RESULTS: There was no statistically significant difference in the average GBI and visible plaque index values at baseline between the groups (p ≥ 0.05). There was no significant difference between groups in all parameters evaluated (p ≥ 0.05). Significant reductions in GBI at 3 and 6 mo were observed in all groups (p < 0.05). Significant reductions in both PPD and relative attachment level at 1, 3 and 6 mo were observed in all groups (p < 0.05). Significant reductions in bacterial levels at 7 and 30 d were observed in all groups (p < 0.05). CONCLUSION: Adjunctive use of Mtz (gel or tablet) to periodontal debridement had similar clinical and microbiological improvement compared to treatment with placebo + periodontal debridement in smokers with chronic periodontitis up to 6 mo post-treatment. Further studies are necessary to confirm the clinical relevance of these findings.

4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for emergency root canal treatment in mandibular molars with irreversible pulpits: a randomized clinical study.

AIM: To compare the anaesthetic efficacy of inferior alveolar nerve blocks (IANB) with 1.8 mL of 2% lidocaine (LI) to a buccal infiltration (BI) with 1.8 mL of 4% articaine (AR), both with 1 : 100 000 epinephrine, in patients with symptomatic irreversible pulpits in a randomized controlled trial. METHODOLOGY: Volunteers presenting at the Emergency Centre (FOP-UNICAMP) were randomly divided into two groups (30 for AR and 20 for LI). Operator and patient were not blinded. Success was recorded when complete pain-free treatment was achieved after a single injection (IANB or BI) or when one supplemental injection was needed for emergency endodontic procedures. Success rate of supplemental injection was evaluated between and within groups using Fisher's exact test and chi-square test. RESULTS: A higher success rate (P = 0.03/Fisher's exact test) was observed with AR (40%) than with LI (10%). No significant difference was found when a single injection plus one supplemental injection was compared between groups (P = 1.0; AR = 70%; LI = 80%). However, supplemental injection increased the anaesthetic success rates (AR, P = 0.04; LI, P = 0.0001) within groups. CONCLUSIONS: Single anaesthesia techniques (IANB or BI) were not able to achieve pain-free emergency endodontic treatment. Supplemental anaesthetic techniques should be considered prior to treatment procedures in order to increase success rate (consort: registration number - NCT01912755/Fapesp: #2009/10834-4).

Catecholamines promote the expression of virulence and oxidative stress genes in Porphyromonas gingivalis.

BACKGROUND AND OBJECTIVE: Stress has been identified as an important risk factor in the development of many infectious diseases, including periodontitis. Porphyromonas gingivalis, a gram-negative oral anaerobic bacterium, is considered an important pathogen in chronic periodontitis. Microorganisms, including P. gingivalis, that participate in infectious diseases have been shown to respond to catecholamines released during stress processes by modifying their growth and virulence. Therefore, the purpose of this study was to evaluate the effects of adrenaline and noradrenaline on the growth, antimicrobial susceptibility and gene expression in P. gingivalis. MATERIAL AND METHODS: P. gingivalis was incubated in the presence of adrenaline and noradrenaline (100 µm) for different time-periods in rich (Tryptic soy broth supplemented with 0.2% yeast extract, 5 µg/mL of hemin and 1 µg/mL of menadione) and poor (serum-SAPI minimal medium and serum-SAPI minimal medium supplemented with 5 µg/mL of hemin and 1 µg/mL of menadione) media, and growth was evaluated based on absorbance at 660 nm. Bacterial susceptibility to metronidazole was examined after exposure to adrenaline and noradrenaline. The expression of genes involved in iron acquisition, stress oxidative protection and virulence were also evaluated using RT-quantitative PCR. RESULTS: Catecholamines did not interfere with the growth of P. gingivalis, regardless of nutritional or hemin conditions. In addition, bacterial susceptibility to metronidazole was not modified by exposure to adrenaline or noradrenaline. However, the expression of genes related to iron acquisition (hmuR), oxidative stress (tpx, oxyR, dps, sodB and aphC) and pathogenesis (hem, hagA and ragA) were stimulated upon exposure to adrenaline and/or noradrenaline. CONCLUSION: Adrenaline and noradrenaline can induce changes in gene expression related to oxidative stress and virulence factors in P. gingivalis. The present study is, in part, a step toward understanding the stress-pathogen interactions that may occur in periodontal disease.

Effect of particles of ashes produced from sugarcane burning on the respiratory system of rats.

The practice of burning sugarcane obtained by non-mechanized harvesting exposes workers and the people of neighboring towns to high concentrations of particulate matter (PM) that is harmful to health, and may trigger a series of cardiorespiratory diseases. The aim of this study was to analyze the chemical composition of the micro-particles coming from sugarcane burning residues and to verify the effects of this micro-particulate matter on lung and tracheal tissues. Micro-particulate matter (PM10) was obtained by dissolving filter paper containing burnt residues in NaCl solution. This material was instilled into the Wistar rats' nostrils. Histological analyses (hematoxylin and eosin - HE) of cardiac, lung and tracheal tissues were performed. Inflammatory mediators were measured in lung tissues by using ELISA. The chemical composition of the particulate material revealed a large quantity of the phthalic acid ester, high concentrations of phenolic compounds, anthracene and polycyclic aromatic hydrocarbons (PAH). Histological analysis showed a reduction in subjacent conjunctive tissue in the trachea, lung inflammation with inflammatory infiltrate formation and reduction of alveolar spaces and a significant increase (p<0.05) in the release of IL-1α, IL-1ß, IL-6, and INF-γ in the group treated with PM10 when compared to the control group. We concluded that the burning sugarcane residues release many particles, which have toxic chemical compounds. The micro-particulate matter can induce alterations in the respiratory system.

Proteomic analysis of Porphyromonas gingivalis exposed to nicotine and cotinine.

BACKGROUND AND OBJECTIVE: Smokers are more predisposed than nonsmokers to infection with Porphyromonas gingivalis, one of the most important pathogens involved in the onset and development of periodontitis. It has also been observed that tobacco, and tobacco derivatives such as nicotine and cotinine, can induce modifications to P. gingivalis virulence. However, the effect of the major compounds derived from cigarettes on expression of protein by P. gingivalis is poorly understood. Therefore, this study aimed to evaluate and compare the effects of nicotine and cotinine on the P. gingivalis proteomic profile. MATERIAL AND METHODS: Total proteins of P. gingivalis exposed to nicotine and cotinine were extracted and separated by two-dimensional electrophoresis. Proteins differentially expressed were successfully identified through liquid chromatography-mass spectrometry and primary sequence databases using MASCOT search engine, and gene ontology was carried out using DAVID tools. RESULTS: Of the approximately 410 protein spots that were reproducibly detected on each gel, 23 were differentially expressed in at least one of the treatments. A particular increase was seen in proteins involved in metabolism, virulence and acquisition of peptides, protein synthesis and folding, transcription and oxidative stress. Few proteins showed significant decreases in expression; those that did are involved in cell envelope biosynthesis and proteolysis and also in metabolism. CONCLUSION: Our results characterized the changes in the proteome of P. gingivalis following exposure to nicotine and cotinine, suggesting that these substances may modulate, with minor changes, protein expression. The present study is, in part, a step toward understanding the potential smoke-pathogen interaction that may occur in smokers with periodontitis.

Evaluation of the screw tent-pole technique for the repair of anterior maxilla width defects: a prospective, randomized, split-mouth study.

The aim of this prospective study was to compare horizontal bone augmentation in the anterior maxilla associated with two types of tenting screw used in the screw tent-pole technique. Ten patients with a premaxilla width deficiency underwent grafting with protein-free xenograft bone. A split-mouth design was used, with sides allocated randomly to receive standard and wide-head tenting screws. Implants were installed after 9 months. Patients underwent clinical, cone beam computed tomography (CBCT), and histomorphometric evaluations. The buccal aspect of the ridge was classified as flat or concave in shape. Clinical measurements showed width augmentation of 1.05mm, 2.45mm, and 2.70mm for standard screws and 1.50mm, 3.10mm, and 3.45mm for wide-head screws, at the ridge, 5mm, and 10mm, respectively. CBCT showed width augmentation of 0.74mm, 3.88mm, and 4.72mm for standard screws and 0.91mm, 4.05mm, and 4.37mm for wide-head screws, at the crest, 5mm, and 10mm, respectively. Histomorphometric analysis showed 30.99% ± 26.43% vital bone tissue, 11.32% ± 9.68% graft residue, and 57.66% ± 21.85% connective tissue for standard screws and 32.64% ± 20.28%, 9.73% ± 5.82%, and 57.61% ± 20.15%, respectively, for wide-head screws. Flat alveolar ridges showed the lowest percentage of vital bone. New bone formation seems to be optimized on concave ridges. There was no statistically significant difference in bone gain results between standard and wide-head tenting screws.

Effect of glucosamine sulphate on the temporomandibular joint of ovariectomised rats.

Glycosamine is an amino-monosaccharide present in connective and cartilage tissues that contribute to the maintenance, resistance, flexibility, and elasticity of these tissues. This study aimed to determine the in vivo effects of glucosamine sulphate (GS) on the temporomandibular joint (TMJ) of ovariectomised rats (OVX).Thirty-two rats were distributed into four groups as follows: G1, sham-OVX+saline solution; G2, sham-OVX+glucosamine sulphate (80mg/kg) - oral administration; G3, OVX+saline solution; G4, OVX+glucosamine sulphate (80mg/kg) - oral administration. Animals were treated for seven days. The TMJ was removed and stained with toluidine blue. The thickness of the cartilage layers and cytokines IL-1ß, IL-6, and TNF-α levels were determined by histomorphometry and immunoassay, respectively. The administration of GS to OVX females did not change the thickness of condylar cartilage when compared with the other groups (p>0.05). There was an increase in the total cartilage thickness in sham-OVX females. IL-1ß and TNF-α levels were significantly lower in sham-OVX females than in OVX females, indicating that ovariectomy acts as potent cytokine inducer. IL-6 levels were significantly higher in sham-OVX females. GS did not affect cytokine production in OVX females (p>0.05). In conclusion, the administration of GS did not affect cytokine levels, but did induce an increase in the total thickness of the TMJ condylar cartilage in sham-OVX rats.

Morphological changes in the position of the mandibular foramen in dentate and edentate Brazilian subjects.

This study assessed the mandibular foramen (MF) position variability in dentate and edentate Brazilian mandibles. Eighty dentate and 79 edentate mandibles of unknown sex were measured bilaterally using a digital caliper (0.1-mm precision). Horizontal linear measurements (HM) were done from the MF to the anterior border of the mandibular ramus (MF-A) and from the MF to the posterior border of the mandibular ramus (MF-B). Vertical linear measurements (VM) were done from the MF to the most inferior point of the mandibular notch (MF-C) and from the MF to the inferior border of the mandibular ramus (MF-D). Data were analyzed by two-way ANOVA (alpha = 5%). The HM means and standard deviations (+/-SD) for MF-A were, edentate right (ER): 17.5 (+/-3.2) mm, edentate left (EL): 17.4 (+/-3.4) mm, dentate right (DR): 19.2 (+/-3.6) mm, and dentate left (DL): 18.8 (+/-3.8) mm. The means (+/-SD) for the MF-B measurements were, respectively, ER: 12.8 (+/-2.4) mm, EL: 12.9 (+/-2.3) mm, DR: 14.2 (+/-2.4) mm, and DL: 13.9 (+/-2.6) mm. The VM values for the MF-C measurements were, ER: 23.4 (+/-3.8) mm, EL: 22.9 (+/-3.7) mm, DR: 23.6 (+/-3.1) mm, and DL: 23.1 (+/-3) mm, and for the MF-D measurements, ER: 26.4 (+/-4.2) mm, EL: 26.4 (+/-4) mm, DR 28.3 (+/-3.9) mm, and DL 28 (+/-3.8) mm. Side had no influence (p>0.05) on any edentate or dentate mandible measurement. Dentate mandible measurements showed statistically significant differences compared to the edentate mandibles, except for MF-C. The mandibular foramen position changes with loss of teeth and this variability may be responsible for occasional failure of inferior alveolar nerve block.

The effect of omega-3 in temporomandibular joint synovial tissues of rats with induced arthritis: pilot study.

This study evaluated the effect of systemic administration of omega-3 on the expression of interleukins IL-1ß and IL-10 and tumour necrosis factor alpha (TNF-α) and on the thickness of cartilage in the temporomandibular joint (TMJ) inflammatory model induced by complete Freund's adjuvant (CFA). Thirty-two adult rats were divided equally into four groups: control, CFA (induced arthritis), and induced arthritis animals treated with dexamethasone or omega-3. The TMJs were then removed and assigned to histomorphometric analysis or immunoassay. The Kruskal-Wallis test with Dunn post hoc test was applied to the data; the significance level was set at 5%. IL-1ß levels (median; interquartile range) were higher (P<0.0001) in the CFA group (46.4 ng/ml; 39.4-53.3) than in the control group (1.81 ng/ml; 1.5-5.4), but there were no differences between the control, omega-3, and dexamethasone groups. TNF-α levels were also higher (P<0.0001) in the CFA group (122.7 ng/ml; 92.9-284.7) than in the control group (29.1 ng/ml; 23.7-31.3). IL-10 levels were lowest (P<0.0001) in the CFA group (73.5 ng/ml; 52.8-90.5), and no differences were found amongst the other groups. In conclusion, omega-3 successfully reduced the damage in the TMJ of induced arthritis rats. Further investigations are warranted to confirm whether the administration of omega-3 has a comparable effect to glucocorticoids in rheumatoid arthritis patients.

A PK/PD approach on the effects of clarithromycin against oral and nasal microbiota of healthy volunteers.

OBJECTIVE: To assess the pharmacokinetics of clarithromycin (CLR) and its effects on oral and nasal microbiota in healthy volunteers in an open, randomized, two-period crossover design. METHODS: A single 500 mg oral dose of CLR (Group 1: Merck; Group 2: Klaricid) was administered observing a 1-week interval between doses. Blood samples were collected from pre-dose to 24 h. Plasmatic concentrations of CLR were quantified by the LC-MS-MS method. Saliva and nasal mucosa swabs were obtained previously and after 1.33, 2, 6 and 12 h of drug administration. Pharmacokinetics and PK/PD (t > MIC, %t > MIC and AUC0-24/MIC ratio) parameters were estimated. The microorganism counts were obtained on different culture media. RESULTS: No statistically significant differences were observed between the two formulations (p > 0.05) regarding the pharmacokinetic parameters. Total microorganisms, staphylococci and streptococci counts did not show statistical differences (p > 0.05) between the two groups during each sampling time. Considering the microorganisms of each group, no statistically significant differences were found after drug administration, but all differed from pre-dose counts (p < 0.05). The observed t > MIC ranged from 14.45 h (+/- 1.69) to 1.19 h (+/- 2.17) considering MICs of 0.25 microg/ml and 2.0 microg/ml, respectively. There was no correlation between any t > MIC, %t > MIC or AUC0-24 and bacterial reduction (between 0- and 12-h periods). However, the profile of reduction of microorganisms in both saliva and nasal samples were compatible with high values of t > MIC verified for both clarithromycin formulations. CONCLUSION: Both formulations of clarithromycin had similar pharmacokinetics and efficacy.

Comparison of the effects of pilocarpine and cevimeline on salivary flow.

OBJECTIVE: The aim of the present study was to compare the effect of low-dose pilocarpine and cevimeline as stimulants for salivary flow in healthy subjects. METHODS: In this cross-over clinical trial with a 1-week washout period, 40 male volunteers were submitted to an oral dose of pilocarpine 1% (Salagen) -60 microg kg(-1) body-weight (Group 1) or Cevimeline (Evoxac) -30 mg (Group 2). Saliva samples were collected and the salivary flow rate was measured (ml min(-1)) at baseline and 20, 40, 60, 80, 140 and 200 min after administration of drugs. In addition, salivary secretion was also measured under mechanical stimulation to observe salivary gland function. RESULTS: The data were analyzed by Friedman and Wilcoxon signed-rank tests (significance level = 5%). Pilocarpine and cevimeline significantly increased salivary flow 140 min after intake. There was a significant higher secretion with cevimeline 140 and 200 min after administration. There were no differences seen among subjects in the salivary glands function by mechanical stimulation. CONCLUSION: Both drugs showed efficacy in increasing the salivary flow in healthy volunteers, but cevimeline was more effective than pilocarpine.

The relationship between volatile sulphur compounds, tongue coating and periodontal disease.

The purpose of the present study was to observe the casual levels of volatile sulphur compounds (VSC) in volunteers with different clinical scores of tongue coating, periodontal pockets depth and Gingival Bleeding Index. Seventy-two subjects who attended for the first time at the dental clinic of the University were randomly selected for intra-oral and periodontal examinations. Systemic and dental histories were also obtained. The subjects were unaware of all procedures. The level of VSC was assessed by using a portable sulphide monitor (Halimeter; Interscan Co., Chatsworth, CA, USA). High tongue coating levels were related with more VSC counts (multivariate anova, P = 0.01). No statistically significant relation (multiple linear regression, P > 0.05) was observed among the VSC levels considering age, bleeding and periodontal pockets sites (depth > 4 mm). We concluded that the tongue coating was one of the main factors influencing the VSC levels.

Assessment of the bioavailability of an antibiotic prophylactic protocol in patients undergoing third molar surgery.

The aim of this prospective study was to determine the antibiotic bioavailability of a prophylactic protocol in patients undergoing third molar surgery. Samples from 25 patients were analysed (average age 21 ± 3.89 years, range 18-33 years; 14 female). The patients received single-dose prophylaxis of 2 g amoxicillin orally 1 hour prior to third molar surgery. Venous blood (1.5 ml) and blood from the third molar socket (1.50 ml) were obtained. The amoxicillin plasma concentration was determined in both samples by high performance liquid chromatography with a diode-array detector (HPLC/DAD). Their associations with demographic variables (age, height, weight, body mass index (BMI), sex) and antibiotic exposure time were analyzed using linear regression models. The mean amoxicillin plasma level detected in the venous blood was 1.21 ± 1.17 µg/ml (range 0.49-6.34 µg/ml) and in the third molar socket was 4.14 ± 2.24 µg/ml (range 0.86-7.46 µg/ml) (P < 0.001). No relationship was observed between the bioavailability of the drug and the patient biometric indices evaluated. The prophylactic administration of 2 g amoxicillin in third molar surgery showed greater bioavailability in the molar socket than the concentrations established as necessary to inhibit the growth of microorganisms that cause oral infections. The results show the need to review the current infection control protocols in oral surgery in light of the overestimated doses observed.

Effects of auriculotherapy and midazolam for anxiety control in patients submitted to third molar extraction.

Anxiety is common and still represents a barrier to appropriate professional care for patients requiring dental treatment. The aim of this study was to compare the effects of auriculotherapy and midazolam for the control of anxiety in patients submitted to third molar extractions. This was a randomized, double-blind, controlled, crossover clinical trial. Thirty healthy volunteers requiring bilateral third molar extraction received midazolam 15mg (oral) and sham auriculotherapy during one session, and a placebo tablet (oral) and auriculotherapy during the other; the sessions were randomized. The level of anxiety was assessed through questionnaires and physical parameters (blood pressure, heart rate, and oxygen saturation (SpO2)) at three time points: baseline, on the day of surgery, and at follow-up. No significant differences between the protocols were observed for blood pressure and SpO2. Auriculotherapy induced a lower heart rate than midazolam during some periods. Auriculotherapy induced more events remembered after surgery than midazolam (P<0.0001). More undesirable effects were observed with midazolam (P<0.0001). However, patient preference for auriculotherapy (53.3%) was not higher than preference for midazolam (46.7%). Auriculotherapy showed an anxiolytic effect equivalent to the midazolam effect, without the undesirable effects usually attributed to the benzodiazepine.

Evaluation of volume of the sphenoid sinus according to sex, facial type, skeletal class, and presence of a septum: a cone-beam computed tomographic study.

We have used cone-beam computed tomographic (CT) images to retrospectivelyevaluate the influence of sex, skeletal class, facial type, and the presence of septa on the volume of the sphenoid sinus in 172 images from 85 men (mean (SD) age 28 (2) years) and 87 women (mean (SD) age 30 (1) years). Skeletal class and facial type were calculated for each patient from multiplanar reconstructions using NemoCeph® software. Volumetric analysis of the sphenoid sinus was made with the help of the ITK-SNAP® 3.4.0 segmentation software, while the presence or absence of septa in the sphenoid sinus was evaluated with the Carestream 3D Imaging® software 3.4.3. We analysed the results using two-way ANOVA, Student's independent sample t test, and Fisher's exact test, as appropriate, and probabilities of <0.05 were accepted as significant. Sex (p=0.0946), facial type (p=0.790), and skeletal class (p=0.120) had no significant influence on the volume of the sphenoid sinus, and nor did the volumes of the right and left sphenoid sinuses (p=0.0923), or the presence of a septum within the sinus (p=0.330) in its volume.

The effect of Cecropia glazioui SNETHLAGE on the physical and neurobehavioral development of rats.

This study aimed to determine the LD50, toxic effects on organogenesis/fetal-development, physical aspects, and developmental/neurobehavioral reflexes of litters previously exposed to Cecropia glazioui SNETHL (Cg) extract during the entire gestational period. Swiss mice were submitted to doses of 0.5, 1.0, 2.5 and 5.0 g/Kg/p.o. Female rats received 1.0 g/Kg/day of Cg extract (G1, n = 10) or 1.0 mL/Kg/day of deionized water (G2, n = 10) during pregnancy. The number of successful gestations, pregnant females weight and born/dead-born offsprings were evaluated. Physical development (offspring weight; fluff and hair appearing; ear unsticking and opening; incisor teeth eruption; eyes opening; testis descent; vagina opening; rearing frequency; uprightness latency and negative geotaxis) and the sleeping time (30 mg/Kg/i.p. sodium pentobarbital assay) were also observed. Open field assay evaluated the developmental/neurobehavioral reflexes of pups. LD50 was higher than 5.0 g/Kg. The extract did not affect the gestation number, born/dead-born offspring number and the female weight during pregnancy. The weight and the physical development of both genders pups were not affected (p > 0.05), but the uprightness latency and the negative geotaxis reflexes were enhanced and the rearing frequency decreased (p < 0.05). Ambulation, cleaning activity, sleeping time, and immobility were not affected (p > 0.05). We concluded that Cg extract showed low toxicity to pregnant rats and their litters.

Modified surgical approach for removal of an ivory osteoma in the paranasal sinus. A case report.

Osteomas are benign tumors that consist mainly of mature compact or cancellous bone. The most common site in maxillofacial complex is the mandible, particularly the angle, followed by sinuses. The authors report a case of an ivory osteoma of the paranasal sinus in a 16 year-old male patient. The lesion was located in the left paranasal sinus (frontal, ethmoidal and maxillary), obstructing the nasolacrimal duct, resulting in dacryocystitis and frontal mucocele. The ethmoid and orbital portions were approached and excised through a Weber-Ferguson incision and maxillary osteotomy was carried out to remove the ivory osteoma, considering its location in the central and deep region of the face. After tumor removal and drainage of frontal and ethmoidal sinuses, the bone flap was repositioned using titanium microplates and screws. Soft tissue was then sutured. The patient was seen again at 3 weeks, 3 months and 2 years after surgery. Overall, he showed a good recovery and wound healing. A multispeciality team approach is advisable in such cases if radical excision is necessary. A craniofacial approach made radical single stage excision of this multicompartmental ivory osteoma possible with an uneventful postoperative period.