Influence of Parental Exposure to Risk Factors in the Occurrence of Oral Clefts.

STATEMENT OF THE PROBLEM: Non-syndromic cleft lip and palate are the most frequent craniofacial abnormalities in humans. The genetic, environmental and behavioral factors involved in this malformation must be clarified in different parts of the globe in the view of implementing preventive measures. PURPOSE: To analyze the influence of parental exposure to risk factors on the occurrence of oral clefts. MATERIALS AND METHOD: A case-control study was conducted with 150 mothers of oral cleft children paired by the children's gender to 300 mothers of children without congenital anomalies from Mato Grosso, Brazil, for the study of the variables: gender and race/color of the children; parental educational level; age; number of pregnancies; prenatal care; obesity; stress; diabetes; hypertension; use of medications, alcohol and illicit drugs; smoking and exposure to ionizing radiation during the first trimester of pregnancy. The results were analyzed in relation to the chances possibility of each variable for the occurrence of oral cleft through the bivariate and multivariate analysis by applying the model of logistic regression. RESULTS: Passive smoking, obesity, exposure to ionizing radiation and use of antibiotics were associated with the presence of clefts. The use of folic acid and analgesics were identified as preventive factors. The father's low educational level was found as a risk factor, while the black race/color was a preventive factor; nevertheless these variables were not associated in the multivariate analysis. CONCLUSION: The results reinforce the need to follow up the pregnant women, especially in the first trimester of pregnancy, in order to control the identified risk factors. Considering the factors associated with occurrence of oral clefts and those associated with its prevention, it is possible to apply specific health promotion measures during pregnancy, which can result in the reduction of oral clefts' occurrence.

Head and Neck Cancer Patients' Quality of Life: Analysis of Three Instruments.

STATEMENT OF THE PROBLEM: Head and neck cancer treatment has provided better cure and survival rates but the patient's quality of life is still an issue. PURPOSE: To verify the correlation between the three most used instruments for evaluating the quality of life of head and neck cancer patients. MATERIALS AND METHOD: This cross-sectional study evaluated patients treated for head and neck cancer at the Mato Grosso Cancer Hospital, Cuiabá, MT, Brazil. The variables age, gender, cohabitation status, education, religion, smoking, ethnicity, tumor location and histological type and treatment modality were collected. The patients quality of life was assessed by the Functional Assessment of Cancer Therapy Quality of Life Measurement System (FACT-H&N), University of Washington Quality of Life Questionnaire (UW-QOL), and EORTC QLQ-C30/EORTC QLQ-H&N35 of the European Organization for Research and Treatment of Cancer. RESULTS: The study population consisted of 33 individuals with a mean age of 63.42±11.25 years; 69.70% were males; 54.55% had no partner; 45.45% had only elementary education; 87.9% followed a religion; 84.38% were smokers and 87.50% alcoholics. Squamous cell carcinoma responded for 78.79% of the cases and palate/oropharynx and mouth floor (21.21% each) were the most affected sites. All patients underwent radiotherapy, 90.91% chemotherapy and 63.64% surgery. On the analysis of quality of life, shoulder (UW-QOL), social performance (EORTC QLQ-C30/QLQ-H&N35) and overall well-being (FACT-H&N) had the highest scores while saliva (UW-QOL), nausea and vomiting (EORTC QLQ-C30/QLQ-H&N35) and emotional well-being (FACT-H&N) had the lowest scores. A positive correlation was found between the questionnaires for the patient's overall quality of life and the domains Pain, Appearan-ce, Activity, Deglutition, Chewing, Speech, Taste, Saliva, Mood and Anxiety. CONCLUSION: Given the correlation between the questionnaires, the selection of the instrument for future research involving head and neck cancer patients' quality of life should consider the specific aspects to be evaluated.

Cytotoxicity of chelating agents used in endodontics and their influence on mmps of cell membranes

Abstract This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Resumo Este estudo avaliou o efeito citotóxico e a capacidade de inibição das metaloproteinases da matriz extracelular (MMP-2 e MMP-9) pela quitosana 0,2%(CH) e o ácido acético 1% (AA) em comparação com o ácido etilenodiaminotetracético 17% (EDTA). O ensaio de viabilidade celular foi realizado de acordo com a ISO 10993-5 com fibroblastos de camundongo (L929). A cultura foi exposta a CH 0,2%, AA 1% e EDTA 17%. Os agentes quelantes foram avaliados imediatamente após o contato com as células e após 6 h, 12 h e 24 h de incubação. A viabilidade celular foi analisada utilizando o ensaio de brometo de 3- (4,5-dimetitiazol-2-il) -2,5-difeniltetrazólio (MTT). A inibição da atividade gelatinolítica de MMP-2 e MMP-9 foi avaliada por zimografia de gelatina. Diferentes concentrações de CH foram avaliadas: 50 mM, 5 mM, 0,5 mM e 0,05 mM. EDTA (0,5 mM) foi usado como controlo positivo. Os resultados demonstraram que CH e AA apresentaram um efeito citotóxico inicial, que diminuiu após 6 h, 12 h e 24 h, sendo estatisticamente similar ao EDTA (P> 0,05). Adicionalmente, CH a concentrações de 50 mM, 5 mM e 0,5 mM tiveram um efeito inibidor sobre MMP-2 e MMP-9, semelhante ao controlo com EDTA. Os agentes quelantes apresentaram efeitos não citotóxicos após 24 h. MMP-2 e MMP-9 foram inibidas pelas soluções experimentais.

Taxas de prevalência de hanseníase nas macrorregiões do estado de Mato Grosso: Datasus-Brasil / Leprosy prevalence rates in Mato Grosso state macroregions: Datasus-Brazil / Tasas de prevalencia de lepra en macrorregiones del estado de Mato Grosso: Datasus-Brazil

Objetivo: analisar e comparar taxas de prevalência de hanseníase nas macrorregiões do estado de Mato Grosso a partir informações coletadas do Departamento de Informática do Sistema Único de Saúde (DATASUS) do Ministério da Saúde do Brasil. Método: estudo retrospectivo transversal onde analisou a taxa de prevalência no período de janeiro a dezembro de 2017. Os dados foram obtidos através do (DATASUS). Os valores foram comparados por análise de variância, testes de KolmogorovSmirnov e Levene, seguidos pelo teste post hoc de Tukey, com nível de significância em p<0,05. Resultados: Houve diferença estatisticamente significante entre as Macrorregiões do estado de Mato Grosso, Teles Pires, Vale do Peixoto, Vale do Arinos e Médio Araguaia, consideradas "hiperendêmicas". Conclusão: As taxas de prevalência de hanseníase encontradas neste estudo a partir da utilização da ferramenta DATASUS avaliando as macrorregiões do estado de Mato Grosso abrem perspectivas futuras para estudo epidemiológicos bem elaborados bem como a análise da qualidade dos serviços de saúde utilizados. A ferramenta DATASUS pode ser utilizada no planejamento de políticas públicas para a hanseníase.(AU)

Background: Objective: To analyze and compare leprosy prevalence rates in the macroregions of the state of Mato Grosso from information collected from the Department of Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. Method: a retrospective cross-sectional study analyzing the prevalence rate from January to December 2017. Data were obtained through (DATASUS). The values were compared by analysis of variance, Kolmogorov-Smirnov and Levene tests, followed by Tukey post hoc test, with significance level of p <0.05. Results: There was a statistically significant difference between the macroregions of the state of Mato Grosso, TelesPires, Peixoto Valley, Arinos Valley and Middle Araguaia, considered "hyperendemic". Conclusion: The prevalence rates of leprosy found in this study from the use of the DATASUS tool evaluating the macro-regions of the state of Mato Grosso open future perspectives for well-prepared epidemiological studies as well as the analysis of the quality of the health services used. DATASUS tool can be used in the planning of public policies for leprosy.(AU)

Objetivo: analizar y comparar las tasas de prevalencia de lepra en los macrorregiones del estado de Mato Grosso a partir de la información recopilada del Departamento de Informática del Sistema Único de Salud (DATASUS) del Ministerio de Salud de Brasil. Método: estudio retrospectivo transversal que analiza la tasa de prevalencia de enero a diciembre de 2017. Los datos se obtuvieron a través de (DATASUS). Los valores se compararon mediante análisis de varianza, pruebas de KolmogorovSmirnov y Levene, seguidas de la prueba post hoc de Tukey, con un nivel de significación de p <0,05. Resultados: Hubo una diferencia estadísticamente significativa entre los macrorregiones del estado de Mato Grosso, Teles Pires, Peixoto Valley, Arinos Valley y medio Araguaia, consideradas "hiperendémicas". Conclusión: Las tasas de prevalencia de lepra encontradas en este estudio a partir del uso de la herramienta DATASUS que evalúa las macro regiones del estado de Mato Grosso abren perspectivas futuras para estudios epidemiológicos bien preparados, así como el análisis de la calidad de los servicios de salud utilizados. La herramienta DATASUS se puede utilizar en la planificación de políticas públicas.(AU)

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure / A Influência do Uso de Vasoconstritor na Anestesia Local em Indivíduos com Insuficiência Renal Crônica

Individuals with chronic renal failure (CRD) undergo hemodialysis to compensate for systemic-based disease and often develop systemic arterial hypertension (SAH). Such individuals, when needing dental treatment, carry with them the consideration of which type of anesthetic to be used in clinical and surgical interventions. The objective of this study was to evaluate the action of anesthetics with vasoconstrictor (AwV) and without vasoconstrictor (AoV) in individuals with chronic renal failure. Research subjects needed dental treatment, with dental restorations, on the right and left lower dental arch in premolars and / or molars, thus receiving the model of a split-mouth clinical study. In a randomized study, each side of the mandible was subjected to an anesthetic infiltration with only one 1.8 mL tube in two different moments with a minimum interval of 7 days (for one moment with AwV and another AoV moment). The parameters of oxygen saturation (SaO2), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 5 minutes before anesthesia, 5, 15 and 30 minutes after anesthesia. The results found in this study showed statistical difference only in SaO2 in the time of 5 minutes after the anesthesia in comparison of the AwV and AoV group, this same result was obtained when only those individuals who, besides nephropathies, had a diagnosis of SAH, were evaluated. The findings of this study highlight the safety of the use of anesthetics, with or without vasoconstrictors since in small amounts, in individuals with CRF with or without associated SAH. (AU)

Indivíduos com insuficiência renal crônica (IRC) em geral são submetidos à hemodiálise para compensação da doença de base sistêmica e frequentemente desenvolvem a hipertensão arterial sistêmica (HAS). Tais indivíduos, ao necessitarem de tratamento odontológico, levam consigo a ponderação de qual tipo de anestésico a ser utilizado em intervenções clínicas e cirúrgicas. O objetivo deste estudo foi avaliar a ação de anestésicos com vasoconstritor (ACV) e sem vasoconstritor (ASV) em indivíduos com insuficiência renal crônica. Os indivíduos da pesquisa tinham necessidade de tratamento odontológico, com restaurações dentárias, no arco dentário inferior direito e esquerdo em pré-molares e/ou molares, recebendo assim o modelo de estudo clínico de boca dividida. De forma aleatória, os hemiarcos inferiores foram submetidos, em dois diferentes momentos com intervalo mínimo de 7 dias, a infiltração anestésica com apenas um tubete de 1,8 mL (para um momento com ACV e outro momento ASV). Foi feita aferição dos parâmetros de saturação de oxigênio (SaO2), frequência cardíaca (FC), pressão arterial sistólica (PAS) e diastólicas (PAD), 5 minutos antes da anestesia, 5, 15 e 30 minutos após a anestesia. Os resultados encontrados neste estudo demonstraram diferença estatística apenas na SaO2 no tempo de 5 minutos após a anestesia em comparação do grupo ACV e ASV, esse mesmo resultado foi obtido quando avaliados apenas os indivíduos que, além de nefropatas, apresentavam diagnóstico de HAS. Os achados deste estudo ressaltam a segurança do uso de anestésicos, com ou sem vasoconstritores desde que em pequenas quantidades, em indivíduos com IRC com ou sem HAS associada. (AU)

Correlation of periodontal and microbiological evaluations, with serum levels of estradiol and progesterone, during different trimesters of gestation.

Our purpouse was to identify quantitatively and qualitatively the subgingival flora in different gestational trimesters, compared to non-pregnant women; evaluating the correlations between epidemiological characteristics, clinical diagnosis, microbiological findings and levels of estradiol and progesterone. 52 pregnant women divided into 3 groups, according to the gestational trimester and 15 non-pregnant patients, without hormonal contraceptives, were evaluated. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were evaluated. Subgingival biofilm samples were processed by the qPCR technique and the serum levels of estradiol and progesterone quantified by chemiluminescence. Clinical diagnosis during gestation was correlated with the total bacterial count. A higher prevalence of Tannerella forsythia (Tf) was identified in first trimester of pregnancy and this periodontopathogen was correlated with the diagnosis of gingivitis among pregnant women. Porphyromonas gingivalis (Pg) showed a positive correlation with progesterone levels in the first trimester. High prevalence of periodontopathogens was noticed in this population. Clinical diagnosis in gestation was positively correlated with the total amount of bacteria, without influence of the hormonal levels or the epidemiological factors evaluated. The presence of Tf favored occurrence of gingivitis during pregnancy and the progesterone levels in the first trimester enhanced the growth of Pg.

Immediate Insertion of Dental Implants Immediate Insertion in Bilateral Traumatic Bone Cysts With or Without a Bone Grafting Material: A 5-Year Follow-Up Case Report.

This case report describes the rehabilitation of a patient who received dental implants in traumatic bone cyst areas (TBC). A 24-year-old male patient sought dental treatment for the bilateral absence of the mandibular second premolars. Radiographic examination revealed bilateral large radiolucent images in the mandible body. Surgical exploration confirmed the diagnosis of TBC. Rehabilitation with dental implants was performed using different approaches on each side. One cystic cavity was filled with blood clot and allogenic bone graft; the other was filled only with blood clot. After 5 years, the implants are osseointegrated and functioning. The filling of the traumatic bone cyst cavity with local blood clot in contact with the implant presented clinical and radiographic success similar to that obtained with filling with bone graft in the same patient. Thus, in this patient, the blood clot-only approach can be considered as a viable, safe-low cost alternative to blood clot and grafting material.

Surgical Treatment of Odontogenic Keratocyst with Application of Carnoy's Solution: Case Report / Tratamento Cirúrgico de Queratocisto Odontogênico com Aplicação de Solução de Carnoy: Relato de Caso

Odontogenic cysts are benign non-neoplastic lesions that originate from epithelial cells Arachnida-Araneae) community in the process of the teeth development. Among them, the odontogenic keratocyst is a developmental cyst characterized by its epithelium of parakeratinized stratified and aggressive squamous cells as well as infiltrative behavior. Thus, the objective of this study was to describe a clinical case of surgical treatment of odontogenic keratocysts in a 52-year-old female patient, who presented for the treatment of a large lesion in a region of the left mandibular body and angle. After incisional biopsy and installation of a decompression device, the histopathological diagnosis of odontogenic keratocyst was obtained. Subsequently to a period of 9 months with the decompression device in place, a decrease of the lesion was noticed, thus allowing intervention to be performed the excision of the lesion. Thus, the patient was subjected, under general anesthesia, to enucleation of the lesion as the main treatment, with complementary maneuvers of peripheral ostectomy and application of Carnoy solution over the remaining bone bed. After an outpatient follow-up of 16 months, no signs of recurrence of the lesion were observed. The proposed treatment was efficient in removing the keratocyst with minimal surgical morbidities. In conclusion, the treatment protocol was effective and conservative in the surgical management of the lesion, allowing rapid recovery and return of the function.(AU).

Cistos odontogênicos são lesões benignas não-neoplásicas que tem por origem células remanescentes epiteliais do processo de formação do órgão dental. Dentre elas, o queratocisto odontogênico é um cisto de desenvolvimento caracterizado por seu epitélio de células escamosas estratificadas paraqueratinizadas, pelo comportamento agressivo e infiltrativo. Sendo assim, o objetivo desse estudo foi descrever um caso clínico de tratamento cirúrgico do queratocisto odontogênico em uma paciente do gênero feminino de 52 anos de idade, que compareceu para o tratamento de uma lesão de grande porte em região de corpo e ângulo mandibulares à esquerda. Após biópsia incisional e instalação de um dispositivo descompressivo, obteve-se o diagnóstico histopatológico de queratocisto odontogênico. Posteriormente a um período de 9 meses com o dispositivo de descompressão em posição, notou-se uma diminuição da lesão, permitindo assim a execução de intervenção para exérese da lesão. Assim, a paciente foi submetida, sob anestesia geral, à enucleação da lesão como tratamento principal, com manobras complementares de ostectomia periférica e aplicação de solução de Carnoy sobre o leito ósseo remanescente. Após um acompanhamento ambulatorial de 16 meses, não foi observado nenhum sinal de recorrência da lesão. O tratamento proposto foi eficiente em remover o queratocisto com as mínimas morbidades cirúrgicas. Concluindo, o protocolo de tratamento foi efetivo e conservador no manejo cirúrgico da lesão, permitindo rápida recuperação e retorno da função. (AU).

Maxillofacial Fractures in a University Hospital in Central Brazil / Fraturas Oralmaxilofaciais em um Hospital Universitário do Brasil Central

The objective of this study was to evaluate epidemiological aspects of maxillofacial fractures in 346 hospitalized patients treated at the Department of Oral and Maxillofacial Surgery of the University General Hospital, Mato Grosso, Brazil. The following information was collected from the patients' medical records: gender, age, etiologic factor, type of injury, patient origin, seasonal distribution and hospital stay period. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. The highest incidence of maxillofacial fractures was found among males (n=290; 83.8%), with 21-30 years-old (n=120; 34.5%) and from inner cities of Mato Grosso (n=169; 48.9%). The main etiologic factor were vehicle traffic accidents (n=169; 48.9%), violence (n=65; 18.8%) and falls (n=25; 7.2%). The seasonal distribution showed that most of the cases occurred in the fall (n=89; 25.8%), winter and spring (n=77; 22.2% each). The lower third of the face was the most commonly involved region (n=276; 54.3%). The most frequently observed fracture involved the zygomatic complex (n=146; 28.7%), followed by the mandible body (n=99; 19.4%). The epidemiological aspects of maxillofacial fractures in this study were similar to those observed in other studies, regarding the prevalence of the male, age group and traffic accidents as the main etiological factor. (AU).

Avaliou-se os aspectos epidemiológicos das fraturas oralmaxilofaciais em prontuários de pacientes atendidos em um Hospital Universitário do Brasil central. A amostra do estudo foi proveniente da revisão de prontuários de 346 pacientes atendidos no Serviço de Cirurgia e Traumatologia Oralmaxilofacial do Hospital Geral Universitário na cidade de Cuiabá, Mato Grosso, Brasil. Os seguintes dados foram coletados dos registros hospitalares de cada paciente: sexo, idade, fator etiológico, região anatômica afetada, procedência, distribuição sazonal e período de internação. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observouse elevada frequência de fraturas oralmaxilofaciais em indivíduos do sexo masculino (n=290; 83,8%), com idade variando entre 21-30 anos (n=120; 34,5%) e provenientes de cidades do interior do estado do Mato Grosso (n=169; 48,8%). Os principais fatores etiológicos foram os acidentes de trânsito motorizados (n=169; 48,9%), violência (n=65; 18,8%) e quedas (n=25; 7,2%). A distribuição sazonal evidenciou elevado número de lesões no outono (n=89; 25,8%), inverno e primavera (n=77; 22,2%, cada um). O terço inferior da face foi a região mais comumente envolvida (n=276; 54,3%). A injúria mais comum foi a fratura do complexo zigomático (n=146; 28,7%), seguida da fratura do corpo da mandíbula (n=99; 19,4%). Os dados obtidos se assemelham aos encontrados na literatura, no que diz respeito à prevalência do sexo masculino, da faixa etária e dos acidentes de trânsito como principal agente etiológico. (AU).

Epidemiological Profile of Patients with Hematological Neoplasms in an Oncological Hospital of Mato Grosso / Perfil Epidemiológico de Pacientes com Neoplasia Hematológica em um Hospital Oncológico de Mato Grosso

O objetivo do estudo foi analisar os aspectos epidemiológicos de pacientes adultos com diagnóstico de neoplasia hematológica, no período de 2004 a 2014, em um Hospital Oncológico em Mato Grosso. A coleta de dados foi realizada através de busca e análise de 590 prontuários. Entre os pacientes, 335 (56,8%) eram do sexo masculino (p<0,05). A maioria possuía mais de 50 anos (p<0,05), com idade média de 53,97±16,55 anos. Quanto ao local de procedência, 257 pacientes eram provenientes da região metropolitana de Cuiabá (43,6%) e 333 (56,4%) de outros locais (p<0,05). A maioria eram pacientes não brancos (p<0,05) e solteiros 342 (58%) (p<0,05). Em relação ao tratamento, 537 (91%) pacientes utilizavam quimioterapia (p<0,05), 57 (9,7%) fizeram uso da radioterapia (p<0,05). Cinquenta e quatro (9,2%) pacientes fizeram uso de ambas as terapias de forma associada (p<0,05) e 50 pacientes (8,4%) não fizeram uso de radioterapia e nem de quimioterapia. Referente aos tipos de neoplasia, os diagnósticos mais encontrados na análise foram de: leucemia mielóide crônica 131 (22,2%); linfoma não Hodking 119 (20,2%); mieloma múltiplo 93 (15,8%); trombocitemia essencial 49 (8,3%); linfoma de Hodking 39 (6,6%); leucemia linfocítica crônica 38 (6,4%); policetemia vera 34 (5,8%); leucemia mielóide aguda 27 (4,6%); síndrome mielodisplasica 21 (3,6); leucemia linfocítica aguda 13 (2,2%) e síndrome mieloproliferativa 10 (1,7%) (p<0,05). A partir dos resultados deste estudo, pode-se concluir que, em geral, os pacientes mais acometidos pelas neoplasias hematológicas tinham mais de 50 anos, eram homens, provenientes do interior do Estado, não brancos e solteiros.(AU).

The objective of this study was to analyze the epidemiological aspects of adult patients diagnosed with hematologic neoplasia, from 2004 to 2014, at a Cancer Hospital in Mato Grosso. Data collection was performed through the search and analysis of 590 patient records. Among the patients, 335 (56.8%) were male (p <0.05). The majority was older than 50 years (p <0.05), with a mean age of 53.97 ± 14.95 years. Regarding origin, 257 patients came from the metropolitan region of Cuiabá (43.6%) and 333 (56.4%) from other sites (p <0.05). The majority was non-white patients (p <0.05) and unmarried 342 (58%) (p <0.05). About treatment, 537 (91%) patients used chemotherapy (p <0.05), 57 (9.7%) used radiotherapy (p <0.05). Fifty-four (9.2%) patients used both therapies in an associated way (p <0.05) and 50 patients (8.4%) did not use either radiotherapy or chemotherapy at any time of their treatment. Regarding the types of neoplasia, the diagnoses most found in the analysis were: chronic myelogenous leukemia 131 (22.2%); non Hodking lymphoma 119 (20.2%); multiple myeloma 93 (15.8%); essential thrombocythemia 49 (8.3%); Hodgkin's lymphoma 39 (6.6%); chronic lymphocytic leukemia 38 (6.4%); policetemia vera 34 (5.8%); acute myeloid leukemia 27 (4.6%); myelodysplastic syndrome 21 (3,6); acute lymphocytic leukemia 13 (2.2%) and myeloproliferative syndrome 10 (1.7%) (p <0.05). From the results of this study, it can be concluded that, in general, the most affected patients by hematological malignancies were older than 50 years, were men from the interior of the State, non-white and unmarried.(AU)

Effectiveness of different endodontic irrigants against Enterococcus faecalis: an ex vivo study

Aim: To evaluate the effectiveness of different endodontic irrigants against Enterococcus faecalis (ATCC 29212). Methods: Seventy bovine mandibular incisors were prepared, inoculated with a bacterial strain for 60 days and divided into the following groups: positive control; negative control; 2.5% NaOCl; 17% EDTA; 0.2% chitosan; 2.5% NaOCl + 0.2% chitosan; and 2.5% NaOCl + 17% EDTA. The irrigation protocol was performed using an experimental peristaltic pump device, with the irrigating solutions circulating within the apparatus at a constant flow for 10 min. Paper-point samples were then collected from the root canals and immersed in 7 mL of brain heart infusion broth, followed by incubation at 37°C for 48 h. Bacterial growth was assessed by turbidity of the culture medium. Results: E. faecalis was present in all samples after the use of different irrigants. Conclusion: The different irrigants tested were not effective in completely eliminating dentin bacterial contamination with E. faecalis.

Immediate Rehabilitation of Elderly Patient with Large Proportion Residual Cyst / Reabilitação Imediata de Paciente Idoso com Cisto Residual de Grande Proporção

Residual cyst is consequence of a radicular cyst incomplete removal. This paper presents the case of a patient with residual cyst of unusual size located in the pre-maxilla causing large bone defect rehabilitated by titanium mesh. A 78-year-old male patient with good general health sought treatment reporting maladjustment of the upper dental prosthesis due to a volumetric increase with one year of evolution. Patient history and clinical and complementary exams led to diagnosis of residual cyst. Due to the cyst size and bone resorption, after the lesionremoval, a titanium mesh was fixed and a membrane positioned, in an attempt to reduce bone deformity and induce tissue repair to avoid functional and aesthetic sequelae. The treatment restored maxillary sinus health and provided satisfactory aesthetic contours to the patient's face, enabling a proper prosthetic rehabilitation and proved to be a viable alternative for the treatment of similar cases. (AU).

O cisto residual é consequência da remoção incompleta de um cisto radicular. Este artigo apresenta o caso de um paciente com cisto residual de tamanho incomum localizado na região pré-maxilar causando grande defeito ósseo reabilitado com uso de tela de titânio. Paciente do sexo masculino, 78 anos, com boa saúde geral procurou tratamento com desajuste da prótese dentária superior, devido a um aumento volumétrico com um ano de evolução. A história do paciente e exames clínicos e complementares levaram ao diagnóstico de cisto residual. Devido ao tamanho do cisto e à reabsorção óssea, após a remoção da lesão, uma tela de titânio foi fixada e uma membrana posicionada, na tentativa de reduzir a deformidade óssea e induzir a reparação tecidual para evitar sequelas funcionais e estéticas. O tratamento restaurou a saúde do seio maxilar e forneceu contornos estéticos satisfatórios para a face do paciente, permitindo uma reabilitação protética adequada e provou ser uma alternativa viável para o tratamento de casos semelhantes. (AU).

Sextuple Tumors in Head and Neck Area: Evidence of Field Cancerization.

BACKGROUND: Field cancerization is a phenomenon in which prolonged exposure to carcinogens induces changes throughout the epithelium leaving the field ready for the appearance of premalignant or malignant lesions. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors. The objective of this study was to report the case of a patient who developed six oral cavity tumors in five years of treatment and, also, demonstrate the immunohistochemical changes for p53 and Ki-67, routinely used to assess dysplasic regions. CASE REPORT: When altered, p53 and Ki-67 suggest the presence of field cancers, an area with genetically altered cells, presenting a high risk of developing premalignant and malignant lesions. This phenomenon explains the recurrence of malignant neoplasms after tumor resections. CONCLUSION: In addition, early identification of potentially malignant lesions in cases of second primary tumors is essential for effective treatment and patient survival, which usually have an unwelcoming prognosis.

Reconstruction of the Parotid Duct.

The most common causes of parotid duct lesions are injuries with sharp instruments. Late alterations after such lesions lead to esthetic defects and complicates the treatment. This case report presents an alternative surgical technique for late reparation of the parotid duct. A 31-year-old male patient was admitted with a history of physical aggression by a glass bottle, resulting in cutting injuries in face and drainage of extraoral transparent fluid from the buccinatory region lesion Antibiotic therapy was initiated immediately, and the surgery was performed nine days after the incident. The repair of the parotid duct lesion was achieved adapting a venous catheter that was passed through the distal portion of the duct from the oral orifice. The proximal segment of the duct was cannulated, the lacerated ends of the duct were approximated on the device and sutured with prolipopylene thread. At the 14-day post-operative return, the saliva was draining through the catheter, and then it was removed. Patients with cutaneous lesions in the buccinatory region require a thorough examination to identify injuries to the parotid duct. The surgical treatment using the presented alternative surgical technique was an effective and cheaper option when compared to other alternatives and showed no complications.

Perfil das mães com filhos diagnosticados com fissura labiopalatal / Profile of mothers with children diagnosed with cleft lip and palate

Objetivo: Avaliar o perfil das mães com filhos diagnosticados com fissura lábiopalatal e verificar as orientações recebidas acerca desta patologia e sobre o aleitamento materno. Material e método: Foram entrevistadas 50 mães de crianças com fissuras labiopalatinas, de ambos os sexos e sem outras anomalias congênitas associadas. As mães foram entrevistadas utilizando um questionário modificado, aplicado logo após a triagem no Ambulatório de Anomalias Craniofaciais do Hospital Geral Universitário de Cuiabá, Mato Grosso - Brasil. Os dados foram analisados utilizando os testes estatísticos ANOVA (análise de variância) e Tukey para nível de significância de 5% (p < 0,05). Resultados: A maioria das mães pertencia à faixa etária de 20-30 anos, 64% delas não possuíam o ensino médio completo. De todas as mães que realizaram consultas de pré-natal, 74% receberam o diagnóstico da fissura ainda na gestação, sendo que essas realizaram número maior de consultas de pré-natal em relação àquelas que receberam o diagnóstico no pós-natal. Sobre o aleitamento materno 62% delas receberam orientações no pré-natal, sendo este índice elevado a 70% na maternidade, após o diagnóstico da fissura. Os sentimentos de preocupação e aceitação foram os mais relatados pelas mães. O uso de mamadeira como forma de aleitamento foi observado em 54% dos casos após a alta da maternidade. Conclusão: Foi verificado que as mães eram jovens, com baixo nível escolar e um número expressivo delas recebeu a informação do diagnóstico da fissura durante a gestação e informações sobre o aleitamento materno. Medo e preocupação foram sentimentos comumente relatados.

Objective: To evaluate the profile of mothers with children with cleft lip and palate and to verify the guidelines received about this pathology and about breastfeeding. Material and method: Fifty mothers of children with cleft lip and palate of both sexes and without other associated congenital anomalies. Mothers were interviewed using a modified questionnaire, which was applied soon after screening at the Craniofacial Anomalies Outpatient Clinic of the General University Hospital of Cuiabá, Mato Grosso - Brazil. The data were analyzed using the ANOVA and Tukey tests for significance level of 5% (p <0.05). Results: The results showed a higher prevalence of mothers with mean age of 20-30 yearsold, and 64% of them did not have completed high school. Of all the mothers who underwent prenatal consultations, 74% of the fissure were diagnosed during pregnancy, and they performed a larger number of prenatal consultations in comparison to those who received the diagnosis in the postnatal period. Regarding breastfeeding, 62% of them received prenatal guidance, which was 70% in the maternity ward, after diagnosis of the fissure. The feelings of concern and acceptance were the most reported by the mothers. The use of bottle feeding as a form of breastfeeding was observed in 54% of cases after discharge from maternity. Conclusion: It was verified that the mothers were young, with low school level and a significant number of them received the information of the diagnosis of fissure during pregnancy and about breastfeeding. Fear and worry were commonly reported feelings.

Oral Changes in Patients with Sickle Cell Anemia of Dentistry Interest / Alterações Bucais em Pacientes com Anemia Falciforme de Interesse para o CirurgiãoDentista

Sickle cell anemia is determined by the presence of S hemoglobin in homozygous, autosomal recessive and characterized by the presence of red cells with abnormal shape (sickle shape). The clinical manifestations may vary from one individual to another, and it may appear in the first year of the patient's life, which emphasizes the importance of early diagnosis as the main measure of positive effect in the care of people with the disease. The aim of this study was to conduct a review of the literature on oral alterations of dental surgeon's interest in patients with sickle cell anemia. The search for the key words "sickle cell anemia" and "oral manifestations" was carried out in the Scientific Electronic Library Online database (SciELO), linked to the Virtual Health Library (VHL). The oral manifestations described in the literature were: paleness of the oral mucosa, smooth, bleached and despapilated tongue or jaundice, delays in dental eruption, periodontal disease, hypo mineralization of the enamel, pulp calcifications, hypercementose, aseptic pulp necrosis, mandibular nerve neuropathy, osteomyelitis and orofacial pain. People with the disease may also exhibit mouth ulcers, particularly in the gums. Anemia causes a high degree of suffering for patients, who deserve special attention from all the multiprofessional team that attends them. Therefore, it is important that the dental surgeon understands and knows the symptoms of the disease, as well as its implications for oral health, as well as the best treatment. The adoption of constant care, with prevention measures in oral care and health, is important to inhibit the occurrence of dental infections.(AU).

A anemia falciforme é determinada pela presença da hemoglobina S em homozigose, de caráter autossômico recessivo e caracterizada pela presença de células vermelhas com formato anormal (forma de foice). As manifestações clínicas variam de acordo com o indivíduo e ao longo do percurso da doença, pois pode surgir no primeiro ano de vida do paciente, o que enfatiza a importância do diagnóstico precoce como principal medida de efeito positivo na assistência às pessoas com a doença. O objetivo deste trabalho foi realizar uma revisão de literatura sobre as alterações bucais de interesse do cirurgião-dentista em pacientes com anemia falciforme. A busca pelas palavras chaves "anemia falciforme" e "manifestações bucais" foi realizada na base de dados Scientific Electronic Library Online - SciELO, vinculada à Biblioteca Virtual em Saúde - BVS. As manifestações bucais descritas na literatura foram: palidez da mucosa oral, língua lisa, descorada e despapilada ou icterícia, atrasos na erupção dentária, doença periodontal, hipomineralização do esmalte, calcificações pulpares, hipercementose, necrose pulpar asséptica, neuropatia do nervo mandibular, osteomielite e dor orofacial. Os portadores também podem exibir úlceras bucais, particularmente na gengiva. A anemia provoca alto grau de sofrimento aos pacientes que merecem atenção especial de toda a equipe multiprofissional que os assiste. Desta forma, é importante que o cirurgião-dentista conheça a doença, assim como suas implicações para a saúde bucal e a condução do melhor tratamento. A adoção de cuidados, com medidas de promoção e prevenção em saúde bucal, é importante para evitar a ocorrência de infecções dentárias.(AU).

Multidimensional Analysis of Curved Root Canal Preparation Using Continuous or Reciprocating Nickel-titanium Instruments.

Objective: To evaluate transportation (T) and centering ability (CA) of root canal preparations using continuous or reciprocating nickel-titanium endodontic files. Materials and Methods: Ninety-six mesiobuccal root canals of mandibular first and second molars were randomly divided into 6 groups (n=16) according to the rotary file used: 1. ProTaper Next; 2. ProTaper Gold; 3. Mtwo; 4. BioRaCe; 5. WaveOne Gold; 6. Reciproc. Root canals were prepared according to manufacturer's instructions. Cone beam computed tomography scans were obtained before and after root canal preparation. Measurements were made at six different reference points: 2, 3 and 4 mm from the apex and 2, 3 and 4 mm below furcation in different directions. Results: The greatest Mesiodistal (MD) Transportation (T) was found for Reciproc files (p<0.05), and the greatest buccolingual (BL) T, for Reciproc, ProTaper Gold and ProTaper Next files (p<0.05). The greatest Mesiodistal (MD) Centering Ability (CA) was found for BioRaCe files (p<0.05), and the greatest Buccolingual (BL) CA, for BioRaCe and Mtwo files (p<0.05). Conclusion: All systems produced root canal transportation. No file system achieved perfect CA of root preparation. Reciproc files had the greatest MD T and BL T. BioRaCe files had the greatest MD CA, whereas BL CA was similar for BioRaCe and Mtwo files.

Restauração de dente posterior com resina Bulk Fill: relato de caso clínico / Posterior tooth restoration with a bulk fill composite: a case report

Objetivo: Demonstrar o uso da resina Bulk Fill como material de preenchimento em restaurações posteriores. Material e métodos: Paciente do sexo feminino, 28 anos, compareceu a clínica privada relatando incômodo nos dentes da região postero inferior esquerda. Após realização dos exames clínicos e radiográficos foi observada que havia restauração ocluso distal (OD) em resina composta com fratura da margem estendendo para face proximal e ausência de cárie no dente 35. Presença de cárie secundária sob a restauração de amálgama mesio ocluso distal (MOD) no dente 36 e restauração satisfatória em resina composta no dente 37. Como plano de tratamento foi proposta a substituição das restaurações dos dentes 35 e 36. Resultados: As restaurações dos dentes 35 e 36 foram removidas e após limpeza da cavidade, foi realizado tratamento dentinário com sistema adesivo autocondicionante e adaptação de matriz metálica. Inicialmente, o dente 35 foi restaurado com resina micro-híbrida e em seguida a restauração do dente 36 com a inserção da resina Bulk Fill com auxílio de um dispensador. A ponta do compule foi posicionada na parte mais profunda da cavidade e a resina injetada até o preenchimento de 4 mm. A restauração foi finalizada com incrementos de 2 mm da resina micro-híbrida na oclusal e polida após o período de 24 horas. Conclusões: A resina Bulk Fill pode ser utilizada como material de preenchimento em restaurações de dentes posteriores, permitindo a confecção de restaurações com maior praticidade e menor tempo clínico.

Objective: To demonstrate the use of a Bulk Fill composite as a fill material in posterior restoration. Material and Methods: Female patient, 28 years old, was presented to a private clinic with complaints of her lower left teeth region. Clinical and radiographic examination revealed: (i) an occlusal-distal composite resin restoration on tooth 35 (lower left second premolar) with fractured margin extending to the proximal face, but no signs of carie; (ii) presence of secondary caries under a mesialocclusal- distal (MOD) amalgam restoration on tooth 36 (lower left first molar), and (iii) satisfactory composite resin restoration on tooth 37 (lower left second molar). As a treatment plan it was proposed the replacement of the restoration on teeth 35 and 36. Results: The restoration on the teeth 35 and 36 were removed and after cleaning the cavity, dentin treatment with a self-etching adhesive system and metal matrix adaptation were performed. The tooth 35 was initially restored with a micro-hybrid resin and then restoration of the tooth 36 was carried out using a Bulk fill resin with the aid of a dispenser. The tip of the dispenser was placed in the deepest part of the cavity and the resin injected to a 4-mm filling. The restoration was completed by adding 2-mm increments of micro-hybrid resin on the occlusal face of the tooth, followed by polishing after 24h. Conclusion: Bulk Fill resin can be used as a fill material in posterior tooth restoration, thereby allowing restoration to be made with greater convenience and shorter clinical time.

Recovering Breathing and Feeding of a Newborn with Pierre Robin Sequence.

Pierre Robin sequence (PRS) is characterized by the triad micrognathia, glossoptosis, and airway obstruction, commonly associated with cleft palate. This study reports the case of a patient with characteristics consistent with the diagnosis of PRS in the 1st week of life. To stabilize the airway, oro-tracheal intubation was performed without success, followed by tracheostomy and glossopexy and after a small improvement in symptoms, it was decided to perform the mandibular distraction osteogenesis (MDO). At the age of 6, her maxillofacial development was within expectations, with patent airway, the presence of deciduous teeth, and without neurological impairment. The MDO described in this case allowed patient's respiratory and feeding improvement, thus avoiding episodes of cyanosis, allowing timely removal of the tracheostomy and glossopexy, and execution of palatoplasty at the right time. While it is uncertain whether MDO will replace the possible need for future orthognathic surgery, treatment greatly improved the quality of life of the patient.

Removal of Multiple Keratocystic Odontogenic Tumors in a Nonsyndromic Patient.

Multiple keratocystic odontogenic tumors are one of the key features of Gorlin-Goltz syndrome. A 15-year-old nonsyndromic female child presented with multiple keratocystic odontogenic tumors. The presence of the tumors was observed in immunological examinations. The images led to the suspicion of Gorlin-Goltz syndrome which was discarded after analyzing the patient's medical history and complementary examinations. Le Fort I osteotomy was opted to access the maxillary tumors favoring visibility and allowing simultaneous bilateral accesses. A sagittal vestibular incision in the lower rim was performed to access the mandibular lesions. After 3 months, the patient underwent a bilateral myotomy to reduce the volume of the masseter muscles. The occurrence of nonsyndromic multiple keratocystic odontogenic tumors is rare. Clinicians facing this situation shall seek for other known features of the Gorlin-Goltz syndrome and follow up closely these patients for the possibility of occurrence of basal cell carcinoma.