Efficacy and safety of induction chemotherapy in oral cavity cancer: An eight-year experience at a Portuguese reference center.

BACKGROUND: Induction chemotherapy has been described as an option in locally advanced oral cavity squamous cell carcinoma when the surgical morbidity is expected to be high. This work aimed to evaluate the outcome and safety of induction chemotherapy in this setting. METHODS: We performed a retrospective and observational study including patients with oral cavity squamous cell carcinoma, treated with induction chemotherapy between January 2010 and December 2018. Outcomes included induction chemotherapy toxicity, treatment response, disease-free survival and overall survival. RESULTS: A total of 108 oral cavity squamous cell carcinoma patients were included. Ninety-six (88.9%) had stage IV disease, while 12 (11.1%) had stage III. Eighty-four patients (80.8%) achieved at least a partial response to induction chemotherapy at clinical evaluation, and 75 (72.1%) at radiological evaluation. Seventy-eight patients have been proposed for subsequent definitive treatments, with no differences obtained in prognosis, when comparing surgical to non-surgical approaches. In patients treated with definitive treatments, improved five-year disease-free survival was obtained if at least a clinical (56.3%; p=0.001) or radiological (52.9%; p=0.001) partial response was achieved after induction chemotherapy. Similarly, superior five-year overall survival was verified for those achieving at least clinical (51.1%; p<0.0001) or radiological (52.6%; p=0.001) partial response. Also, accomplishing a pathologic complete response (n=22.6%) significantly improved disease-free survival (p=0.039) and overall survival (p=0.005). Grade 3 and 4 toxicities were observed in 52 patients (41.8%). CONCLUSION: Responses to induction chemotherapy predicted prognosis in our population, however important toxicities were observed. Further studies are necessary to identify induction chemotherapy response predictors and subgroups who may benefit from this approach.

Use of information and communication technology (ICT) by medical students / O uso de tecnologias de informação e comunicação por estudantes de medicina

Abstract: Introduction: The central topic of the present study is the evaluation of Information and Communication Technology use by medical students, since this relationship has become inseparable from medical training and practice. Objective: To characterize the profile of Information and Communication Technology use among medical students, identifying which are the most frequently used, the possible stimuli and the main impediments to its use. Method: An observational and cross-sectional study was carried out by applying an electronic form on the Google Forms® platform, to students attending from the 1st to the 12th semester of undergraduate medical school. Results: Of the 216 participants, there was a predominance of females (60.6%), aged between 20-24 years (65.3%) and with a family income of less than 3 minimum wages (36.1%). The main device used by the participants was the smartphone (68.1%) and the most frequently used Information and Communication Technologies were text messaging apps (99.5%) and internet browsers (96.8%), while Medication Apps (48.1%) and Specialized Calculators (31%) were significantly less often used. The main benefit mentioned was the possibility of distance communication, while the main impediment was the issue of security. Conclusion: It was concluded that the use of technologies by medical students is quite frequent and varied, but purposeful training, by teachers and students, is necessary for better use of the available technologies.

Resumo: Introdução: O tema central deste estudo é a avaliação do uso de tecnologias de informação e comunicação (TIC) pelos discentes do curso de Medicina, uma vez que, nos dias atuais, tal relação tornou-se indissociável da formação e da prática médica. Objetivo: Este estudo teve como objetivo caracterizar o perfil de utilização de TIC entre os acadêmicos, de modo a identificar quais são as mais adotadas, os possíveis estímulos e as principais barreiras ao seu uso. Método: Foi realizado um estudo observacional e transversal por meio da aplicação de um formulário eletrônico, do qual participaram discentes do primeiro ao 12º período da graduação. Resultado: Entre os 216 participantes, notou-se uma predominância do sexo feminino (60,6%), na faixa etária entre 20 e 24 anos (65,3%) e com renda familiar inferior a três salários mínimos (36,1%). O principal dispositivo utilizado pelos participantes foi o smartphone (68,1%). Quanto às TIC, os estudantes apontaram preferência por aplicativos de mensagens de texto (99,5%) e navegadores de internet (96,8%), enquanto aplicativos de medicamentos (48,1%) e calculadoras especializadas (31%) foram significativamente menos utilizados. De acordo com participantes do estudo, a possibilidade de comunicação a distância é o principal benefício das TIC. Com relação aos possíveis problemas, predominou o quesito segurança. Conclusão: O uso das tecnologias pelos acadêmicos é bastante frequente e variado, porém há a necessidade de treinamento deliberado de docentes e discentes para maior aproveitamento das tecnologias disponíveis.

Anthelmintic effect of Cassia fistula and Combretum leprosum protein fractions against goat gastrointestinal nematodes / Efeito antihelmíntico das frações proteicas de Cassia fistula e Combretum leprosum contra nematodeos gastrintestinais de caprinos

Abstract In this study, we evaluated the ovicidal and larvicidal activity of protein preparations obtained from Cassia fistula L. and Combretum leprosum Mart. leaves on the gastrointestinal parasites of goats. Protein preparations were obtained after the extraction of C. fistula L. and C. leprosum Mart. leaves, followed by protein fractionation (with ammonium sulfate saturation percentages of 30%, 30%-60%, and 60%-90%) and dialysis, which resulted in protein fractions (called F1, F2, and F3, respectively). The fractions were evaluated by egg hatching (the eggs were recovered in stool samples from naturally infected goats) and larval development tests. The results reveled that the inhibition of hatching of eggs caused by the protein fractions of C. fistula (38%) were similar to that of the control drug, thiabendazole. In addition, the fractions of C. fistula caused significant inhibition (61-69%) of larval development also. However, C. leprosum did not reveal significant inhibition of egg hatching and larval development. We conclude that C. fistula L. showed better ovicidal and larvicidal activity against endoparasites.

Resumo Neste estudo, foram avaliadas as atividades ovicida e larvicida de preparações proteicas de Cassia fistula L. e Combretum leprosum Mart. em parasitas gastrointestinais de caprinos. As preparações proteicas foram obtidas por extração das folhas de C. fistula L. e C. leprosum Mart. seguido pelo fracionamento proteico (com porcentagens de saturação de sulfato de amônio de 30%, 30-60%, 60-90%) e diálise, resultando nas frações proteicas (intituladas F1, F2 e F3, respectivamente). As frações foram avaliadas nos testes de eclosão de ovos (os ovos foram recuperados em amostras de fezes de cabras naturalmente infectadas) e de desenvolvimento larvar. Os resultados revelaram que a inibição da eclosão de ovos causada pelas frações proteicas de C. fistula (38%) foi semelhante à do fármaco controle, o tiabendazol. Além disso, as frações de C. fistula também causaram inibição significativa (61-69%) do desenvolvimento larvar. No entanto, C. leprosum não revelou inibição significativa na eclosão dos ovos e no desenvolvimento larvar. Concluiu-se que C. fistula L. mostrou uma melhor atividade ovicida e larvicida contra endoparasitas.

Fibroma odontogênico central em mandíbula: relato de caso com breve revisão da literatura / Central odontogenic fibroma in mandible: case report with short literature review

O fibroma odontogênico central é definido como uma neoplasia benigna dos maxilares caracterizada por apresentar uma quantidade variável de epitélio odontogênico inativo em meio a um estroma de tecido conjuntivo fibroso. É considerada uma neoplasia rara que representa de 0% a 5,5% de todos os tumores odontogênicos na maioria dos estudos retrospectivos encontrados na literatura. Acomete pacientes em uma ampla faixa etária com certa predominância em indivíduos do sexo feminino. Apresenta-se, na grande maioria dos casos, como uma lesão de crescimento lento e assintomático que pode promover abaulamento das corticais ósseas adjacentes. Do ponto de vista radiográfico, aparece, tipicamente, sob a forma de uma imagem radiolúcida uni ou multilocular com margens bem definidas, podendo apresentar focos de calcificação em seu interior. O fibroma odontogênico central é subdividido histologicamente em tipo simples (pobre em epitélio) e tipo OMS (rico em epitélio). A lesão responde bem ao tratamento cirúrgico conservador por enucleação associada à curetagem, sendo as recidivas muito incomuns. Esse trabalho tem o objetivo de fazer uma breve revisão de literatura a respeito das características epidemiológicas, clínico-imaginológicas e histopatológicas desta lesão e relatar um caso diagnosticado num paciente do sexo masculino, 13 anos, com queixa de aumento de volume em mento. Os exames de imagem evidenciaram a presença de defeito osteolítico bem delimitado em região de sínfise mandibular associado aos elementos dentários 33 e 43 que se apresentavam inclusos. A lesão foi submetida à enucleação e curetagem. O paciente encontra-se em proservação há dois anos sem sinais de recidiva da lesão.

The central odontogenic fibroma is defined as a benign neoplasm of the jaws characterized by having a variable amount of inactive odontogenic epithelium in the midst of a fibrous connective tissue stroma. It is considered a rare neoplasm that is from 0% to 5.5% of all odontogenic tumors in most retrospective studies found in the literature. Affects patients in a wide age range with a certain predominance in females. , Is shown in most cases, as a slow-growing lesions and asymptomatic which can promote the bulging adjacent cortical bone. The radiographic point of view, appears typically in the form of an image radiolucent uni or multilocular with well-defined margins and may have foci of calcification inside. The central odontogenic fibroma is subdivided histologically in simple type (poor epithelium) and WHO type (rich in epithelium). The injury responds well to conservative treatment by surgical enucleation associated with curettage, and the very unusual relapses. This work aims to make a brief review of literature on the epidemiological, clinical and histopathological imaginological this injury and to report a case diagnosed in a male patient, 13, with volume up complaint ment. Imaging tests showed the presence of well-defined osteolytic defect in mandibular symphysis region associated with dental elements 33 and 43 who performed included. The lesion was submitted to enucleation and curettage. The patient is under observation for two years without signs of recurrence.

Preventive effect of toothpastes with MMP inhibitors on human dentine erosion and abrasion in vitro

ABSTRACT The use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro. Material and Methods Five groups each containing 12 specimens of human root dentine were prepared. The specimens were subjected to 1 min erosion by immersion in a cola drink, 4 times a day, for 5 d. Each day, after the first and last erosive challenges, the specimens were brushed for 15 s with a slurry of dentifrice and water (1:3) containing placebo, 1,100 ppm fluoride, 0.61% green tea extract, 0.12% chlorhexidine or 0.004% chlorhexidine (commercial toothpaste). Between the acid challenges, the specimens were stored in artificial saliva with remineralizing potential until the next treatment. Dentine loss was determined using profilometry. Data were analyzed using one-way ANOVA after log transform (p<0.05). Results The mean wear values (μm) were as follows: placebo 1.83±0.53; 0.61% green tea extract 1.00±0.21; fluoride 1.27±0.43; 0.12% chlorhexidine 1.19±0.30; and 0.004% chlorhexidine 1.22±0.46. There was a significant difference in wear between placebo and all the treatment toothpastes, which did not differ from each other. Conclusion The results suggest that toothpastes containing MMP inhibitors are as effective as those based on NaF in preventing dentine erosion and abrasion.

Dificuldades vivenciadas em um serviço de atendimento móvel de urgência: percepções da equipe de enfermagem / Difficulties lived in an urgency mobile service: the nurse team perception

Objetivou-se conhecer as principais dificuldades vivenciadas pela equipe de enfermagem que atua em um serviço deatendimento móvel de urgência na percepção da equipe de enfermagem. Trata-se de uma pesquisa exploratóriodescritivade abordagem qualitativa, realizada com quatro enfermeiros e 14 técnicos de enfermagem no período demarço a abril de 2013 na sede dos serviços de atendimento móvel de urgência em uma cidade da região central do RioGrande do Sul, Brasil. Os dados coletados por meio de entrevista semiestruturada, contendo questões mistas, foramsubmetidos à Análise de Conteúdo de Bardin, emergindo nas categorias: desconhecendo a função do SAMU;dificuldades com a central de regulação; estratégias que possibilitam a melhoria do serviço. O estudo permitiu aossujeitos (pesquisador e pesquisados) refletirem acerca da atuação com o Serviço de Urgência Móvel, instigando areflexão acerca de possíveis estratégias para melhoria da realidade investigada.

This study aimed at learning the main difficulties lived by the health team in an urgency mobile service through theperception of the nursing team. It is an exploratory research, with a descriptive and qualitative approach, involvingfour nurses and fourteen nurse technicians, performed in March and April of 2013, in the head office of the urgencymobile services in a central city in Rio Grande do Sul, Brazil. Data were collected through semi-structured interviewcontaining mixed questions and submitted to Bardin’s content analysis, resulting in the following categories:unawareness in relation to the function of the SAMU; difficulties regarding the central of regulation; strategies thatprovide improvements in the service. The study allowed the subjects (researcher and interviewees) to reflect abouttheir performance together with the Urgency Mobile Service, fostering reflections about possible strategies to improve the reality investigated.

El estudio tuvo como objetivo identificar las principales dificultades experimentadas por el equipo de salud que trabaja en un servicio de atención móvil de urgencia en la percepción del equipo de enfermería. Es un estudioexploratorio, cualitativo y descriptivo realizado con cuatro enfermeros y 14 técnicos de enfermería en el período demarzo a abril de 2013 en la sede de los servicios de emergencia móvil en una ciudad central del Rio Grande del Sur.Los datos fueron colectados a través de entrevistas semiestructuradas, conteniendo preguntas mixtas y sometidos al análisis de contenido de Bardin, de donde emergieron las siguientes categorías: Desconocimiento de la función delSAMU, las dificultades con las centrales de regulación y estrategias que permitan mejorar el servicio. Así, el estudiopermitió a los participantes (investigados y encuestados) reflexionar sobre las acciones tomadas por el servicio móvil de urgencia para posibles estrategias de mejorías sobre la realidad investigada.

Procedimentos para lidar com o tabu da morte / Procedures for dealing with the taboo of death

A morte, por mais estudada que seja, continua sendo um mistério. Lidar com ela não é algo nada fácil e por essa razão ela assusta tanto. Todos os medos do ser humano estão, no fundo, relacionados com o da morte. Tudo isso por ela ser um mistério do qual pouco ou nada sabemos, embora seja natural. À vista disso, as religiões dão a este tema o seu principal enfoque. Assim sendo, procuro neste artigo tratar o tabu da morte, refletindo temas relacionados a ele. Temas que estão presentes na vida das pessoas, sobretudo quando passam pela experiência da perda de alguém do seu círculo familiar ou de amizade. Dentre eles, abordo a Unção dos Enfermos, as Exéquias, a Missa do Sétimo Dia e a tradição de rezar pelos mortos. Temas que ajudam a lidar com o tabu da morte ou a perda de um ente querido.

The more death is studied, the more it remains a mystery. Dealing with death is no easy matter and for that reason it is so frightening. All the fears of human beings are fundamentally related to the fear of death. This is because it is a mystery about which we know little or nothing, although it is natural to die. In view of this, religions give this topic a primary focus. Therefore, in this article an attempt is made to deal with the taboo surrounding death and reflect on issues associated with it. These themes are present in people's lives, especially when they have the experience of losing someone in their family or circle of friends. Among these subjects, the aspects of the Anointing of the Sick, the Funeral Mass, the Seventh Day Mass and the tradition of praying for the dead are all touched upon. These are all themes that help to deal with the taboo of death or losing a loved one.

Transient Willis-Ekbom's disease (restless legs syndrome) during pregnancy may be caused by estradiol-mediated dopamine overmodulation.

Willis-Ekbom's disease (WED), formerly called restless legs syndrome, is more common in pregnant than in non-pregnant women, implying that the physiological and biochemical changes during pregnancy influence its development. During pregnancy, many hormone levels undergo significant changes, and some hormones significantly increase in activity and can interfere with other hormones. For example, the steroid hormone estradiol interferes with the neuroendocrine hormone dopamine. During pregnancy, the activity of the thyroid axis is enhanced to meet the increased demand for thyroid hormones during this state. Dopamine is a neuroendocrine hormone that diminishes the levels of thyrotropin and consequently of thyroxine, and one of the roles of the dopaminergic system is to counteract the activity of thyroid hormones. When the activity of dopamine is not sufficient to modulate thyroid hormones, WED may occur. Robust evidence in the medical literature suggests that an imbalance between thyroid hormones and the dopaminergic system underpins WED pathophysiology. In this article, we present evidence that this imbalance may also mediate transient WED during pregnancy. It is possible that the main hormonal alteration responsible for transient WED of pregnancy is the excessive modulation of dopamine release in the pituitary stalk by estradiol. The reduced quantities of dopamine then cause decreased modulation of thyrotropin, leading to enhanced thyroid axis activity and subsequent WED symptoms. Iron deficiency may also be a predisposing factor for WED during pregnancy, as it can both diminish dopamine and increase thyroid hormone.

Water sorption of CH3- and CF3-Bis-GMA based resins with additives

OBJECTIVES: To evaluate the effect of additives on the water sorption characteristics of Bis-GMA based copolymers and composites containing TEGDMA, CH3Bis-GMA or CF3Bis-GMA. MATERIAL AND METHODS: Fifteen experimental copolymers and corresponding composites were prepared combining Bis-GMA and TEGDMA, CH3Bis-GMA or CF3Bis-GMA, with aldehyde or diketone (24 and 32 mol%) totaling 30 groups. For composites, barium aluminosilicate glass and pyrogenic silica was added to comonomer mixtures. Photopolymerization was effected by 0.2 wt% each of camphorquinone and N,N-dimethyl-p-toluidine. Specimen densities in dry and water saturated conditions were obtained by Archimedes' method. Water sorption and desorption were evaluated in a desorption-sorption-desorption cycle. Water uptake (%WU), water desorption (%WD), equilibrium solubility (ES; µg/mm³), swelling (f) and volume increase (%V) were calculated using appropriate equations. RESULTS: All resins with additives had increased %WU and ES. TEGDMA-containing systems presented higher %WU, %WD, ES, f and %V values, followed by resins based on CH3Bis-GMA and CF3Bis-GMA. CONCLUSIONS: Aldehyde and diketone led to increases in the water sorption characteristics of experimental resins.

Ansiedade frente ao tratamento odontológico: prevalência e fatores predictores em brasileiros / Anxiety regarding dental treatment: prevalence and predictors among Brazilians

Diante do impacto negativo que a ansiedade exerce sobre o atendimento odontológico, buscou-se conhecer sua prevalência e seus fatores predictores frente esse tratamento em brasileiros. Foi realizado um estudo de corte transversal, utilizando-se a escala de ansiedade de Corah para avaliar 3000 pacientes. Os resultados demonstram que 2 em cada 8 brasileiros avaliados apresentaram moderada ou severa ansiedade frente ao atendimento odontológico, verificando-se que a probabilidade de um paciente da população da qual a amostra foi extraída apresentar ansiedade é mais elevada se: for mulher (p = 0,007), da faixa etária superior a 20 anos (p = 0,006), se não possuir acesso a internet e/ou jornais (p = 0,016), se tiver baixa frequência de higiene oral (p = 0,001), se a visita dental for motivada por busca de tratamento curativo, por dor ou outro problema, ao invés de um check-up (p = 0,047), e experiência de odontalgia (p<0,001). O medo e a ansiedade a fatores odontológicos existem de fato na população brasileira e as conclusões do estudo sugerem que, além da falta de recursos econômicos, o descaso com a saúde bucal, o gênero e a idade podem aumentar o grau de ansiedade.

Considering the negative impact anxiety can exert over dental treatment, the scope of this study was to determine the prevalence of predictors of anxiety regarding dental treatment among Brazilians. A cross-sectional study was carried out using the Corah dental anxiety scale to assess the degree of anxiety regarding dental treatment among 3000 patients. The results reveal that two out of every eight Brazilian patients manifest moderate to severe anxiety regarding dental treatment. In this sample, the degree of anxiety was higher among females (p=0.007), over 20 years of age (p=0.006), without access to the Internet and/or newspapers (p=0.016), with a low frequency of oral hygiene (p=0.001), for whom the reason for the dental appointment was curative treatment, pain or another problem rather than a check up (p=0.047) and those suffering from toothache (p<0.001). Fear and anxiety regarding dental treatment indeed exist in the Brazilian population and the findings of this study suggest that, besides the lack of economic resources, negligence with respect to oral health, gender and age may increase the degree of anxiety.

Brain abscess of odontogenic origin.

Brain abscess is a rare and threatening infection, which is in a suppuration area, caused either by trauma, neurosurgical complication, or by a secondary infection of dental origin complication. The infectious process spread from the start focus can occur in 2 ways: hematogenous or by contiguity. The treatment should ideally be based on the etiological factor excision, combined with drainage and antibiotics as adjuvant; this philosophy is not observed in the reports described in the 1960s, 1970s, and 1980s. This study's goal was to report a case of brain abscess consequent of an odontogenic outbreak, where an adequate treatment was set up, but it was already in advanced stages and had as a result the lethal outcome. Complications from the odontogenic infections have a low incidence, but should never be disregarded, because they can lead to death, as described in this manuscript.

Restless legs syndrome in subjects with a knee prosthesis: evidence that symptoms are generated in the periphery.

OBJECTIVE: There are no data adressing the prevalence of restless legs syndrome in subjects who have knee prosthesis. Therefore, we conducted a cross-sectional survey of subjects who underwent knee prosthesis surgery. METHOD: A total of 107 subjects (30 male, 77 female) were interviewed over the telephone regarding restless legs syndrome symptoms. If the patients exhibited symptoms of the syndrome, we conducted face-to-face interviews. Lastly, a therapeutic test with pramipexole was proposed for each subject. RESULTS: In our cohort, 7 males (23%) and 30 females (39%) had restless legs syndrome. Of these, 6 males and 23 females were submitted to face-to-face-interview. Of the males, 5 (83%) had restless legs after the knee surgery-exclusively in the operated leg- and reported no family restless legs history. One man had a prior case of bilateral restless legs syndrome, a positive family history and claimed exacerbation of symptoms in the operated leg. Among the females, 16 (69%) had restless legs prior to surgery. A total of 10 female patients reported bilateral symptoms, with fewer symptoms in the operated leg, while 6 displayed a worse outcome in the operated leg. The 7 females (31%) without restless legs prior to surgery and without a family history experienced symptoms only in the operated leg. All subjects responded favorably to the pramipexole therapeutic test. CONCLUSION: Our results suggest that secondary unilateral restless legs syndrome may ensue from knee prosthesis surgery and that the symptoms are generated in the peripheral nervous system.

Restabelecimento estético e funcional de incisivo central superior traumatizado por meio de clareamento dentário e cimentação de pino intracanal: controle de 2 anos / Esthetic and functional reestablishment of traumatized upper incisive using dental bleaching and glass-fiber post: two years control

Paciente do sexo feminino, 25 anos de idade, procurou tratamento estético queixando-se do escurecimento do dente 21. Foram realizados exames clínicos e readiográficos, comprovando a alteração de cor e o tratamento endodôntico satisfatório. O plano de tratamento foi proposto para estabelkecer a função e a estética do dente 21 (técnica mediata), associado ao clareamento externo, em consultório, dos dentes #15 a #25 e #35 a #45 co peróxido de hidrogênio a 35 por cento, ativado com luz híbrida, a fim de que fossem uniformizadas as tonalidades de cor dos dentes. Posteriormente, um pino de fibra de vidro foi fixado no canal radicular, com cimento de ionômero de vidro convencional, seguido pela restauração da abertura coronária com resina composta. As etapas do tratamento revelaram que o planejamento correto combinado com o conhecimento das técnicas disponíveis e das propriedades dos materiais são essenciais para a obtenção da excelência estética e funcional dos dentes em questão.

A 25-year-old woman was seeking for aesthetic treatment for her #21 tooth. Clinical and radiographic examinations were done confirming color change and satisfactory endodontic treatment. Thus, a treatment was proposed to reestablish function and aesthetics to the compromised teeth. The #21 tooth received internal bleaching and #15 to #25 and #35 to #45 teeth received external bleaching with a 35% hydrogen peroxide gel activated by hybrid light. This was performed in order to standardize the tonalities of the color of the teeth. Subsequently, a glass-fiber post was fixed inside the radicular conduct with conventional glass-ionomer cement and the endodontic coronal aperture was restored with composite resin. Treatment steps showed that the correct planning associated with the knowledge of available techniques and material properties are essential for reaching functional and aesthetic excellence.

Effect of propolis gel on the in vitro reduction of dentin permeability

OBJECTIVE: The aim of this study was to evaluate the capacity of potassium oxalate, fluoride gel and two kinds of propolis gel to reduce the hydraulic conductance of dentin, in vitro. MATERIAL AND METHODS: The methodology used for the measurement of hydraulic conductance of dentin in the present study was based on a model proposed in literature. Thirty-six 1-mm-thick dentin discs, obtained from extracted human third molars were divided into 4 groups (n=9). The groups corresponded to the following experimental materials: GI-10 percent propolis gel, pH 4.1; GII-30 percent propolis gel; GIII-3 percent potassium oxalate gel, pH 4,1; and GIV-1.23 percent fluoride gel, pH 4.1, applied to the dentin under the following surface conditions: after 37 percent phosphoric acid and before 6 percent citric acid application. The occluding capacity of the dentin tubules was evaluated using scanning electron microscopy (SEM) at ×500, ×1,000 and ×2,000 magnifications. Data were analyzed statistically by two-way ANOVA and Tukey's test at 5 percent significance level. RESULTS: Groups I, II, III, IV did not differ significantly from the others in any conditions by reducing in hydraulic conductance. The active agents reduced dentin permeability; however they produced the smallest reduction in hydraulic conductance when compared to the presence of smear layer (P<0.05). The effectiveness in reducing dentin permeability did not differ significantly from 10 percent or 30 percent propolis gels. SEM micrographs revealed that dentin tubules were partially occluded after treatment with propolis. CONCLUSIONS: Under the conditions of this study, the application of 10 percent and 30 percent propolis gels did not seem to reduce the hydraulic conductance of dentin in vitro, but it showed capacity of partially obliterating the dentin tubules. Propolis is used in the treatment of different oral problems without causing significant great collateral effects, and can be a good option in the treatment of patients with dentin sensitivity.

Carcinoma mucoepidermoide de glândulas salivares menores / Mucoepidermoid carcinoma of minor salivary glands

Introdução: Os carcinomas mucoepidermoides (CME) representam cerca de 5% de todos os tumores das glândulas salivares. Trata-se de uma lesão agressiva e deve ser considerada como hipótese de diagnóstico em lesões proliferativas da mucosa oral. O diagnóstico precoce e o correto manejo dessa neoplasia são fatores determinantes do prognóstico. Ressecção local ampla e eventualmente a radioterapia pós-operatória são o tratamento de escolha. Objetivo: Relatar o caso de uma paciente com carcinoma mucoepidermoide de cavidade oral, exteriorando-se pela boca, sendo submetida a exérese cirúrgica e radioterapia, evoluindo para óbito no quarto mês do início do tratamento. Relato do Caso: CT, 47anos, branca, foi encaminhada ao serviço de ORL do HSJA após episódio de sangramento importante em cavidade oral. Relatou o surgimento de uma massa com crescimento rápido e expansivo em topografia de fossa canina há +/- 06 meses, associado a emagrecimento de 10 kg. Paciente desidratada, hipocorada, apresentando tumoração pediculada de +/- 06 cm, consistência firme, indolor à palpação, sangrante. Etilista e tabagista crônica. Linfonodos cervicais não palpáveis. Diante do caso optou por fazer a ressecção cirúrgica do tumor e realizar o exame histopatológico que confirmou carcinoma mucoepidermoide de glândulas salivares menores. A paciente foi encaminhada ao serviço de radioterapia; porém, abandonou o tratamento e evoluiu com óbito 4 meses após. Comentários Finais: Neste caso, o crescimento rápido e agressivo da lesão, o tamanho do tumor e o abandono do tratamento proposto foi determinante no prognóstico da paciente.

Introduction: The Mucoepidermoid Carcinomas (MEC) represent about 5% of all tumors in the salivary glands. It is an aggressive lesion and must be considered as a diagnosis hypothesis in the oral mucosa proliferative lesions. The early diagnosis and the correct management of this neoplasm are key factors for the prognosis. Wide local resection and eventually postoperative radiotherapy is the choice treatment. Objective: To report the case of a patient with mucoepidermoid carcinoma of oral cavity, exteriorizing through the mouth and being submitted to surgical exeresis and radiotherapy that evolved to death on the fourth month from beginning of the treatment. Case Report: CT, 47 years old, white woman was forwarded to the ORL service of the HSJA after a critical bleeding episode in oral cavity. She reported the appearing of a mass with fast and expansive growth in a topography of canine fossa for +/- 06 months, associated to the loss of 10 kg. Patient dehydrated, pale with pediculated tumoration of +/- 06 cm, firm consistency, painless upon palpation and bleeding. Chronic alcoholic and smoker. Non-palpable cervical lymph nodes. Faced with the case we opted for a surgical resection of the tumor and the performance of histopathological exam that confirmed mucoepidermoid carcinoma of minor salivary glands. The patient was sent to the radiotherapy service; but she abandoned the treatment and evolved with death 4 months after. Final Comments: In this case, the fast and aggressive growth of the lesion, the size of the tumor and the abandonment of the proposed treatment was determinant for the patient's prognosis.

Recubrimiento pulpar directo e idirecto: mantenimiento de vitalidad pulpar / Direct and indirect pulp capping: maintaining pulp vitality

El recubrimiento pulpar directo e indirecto, desde el punto de vista biológico y clínico, representa importantes mecanismos para el mantenimiento de la vitalidad pulpar; sin embargo aún es considerado un tema controversial en la clínica odontológica, debido a la complejidad del diagnóstico y a la delicada conducta terapéutica necesaria para obtener éxito en el tratamiento clínico. En tal sentido, este artículo realizará un abordaje biológico y clínico del Recubrimiento Pulpar Directo e Indirecto con la intención de resaltar la importancia fundamental del diagnóstico clínico y radiográfico de la condición pulpar, enfatizando las indicaciones y contra indicaciones de ambos tratamientos. Adicionalmente serán materia de discusión los materiales comúnmente utilizados para la protección del complejo dentinopulpar y las nuevas perspectivas en esta área

Direct and indirect pulp capping represents important mechanisms, from the point of clinical and biological aspects to maintain the pulp vitality. However, it still a controversy issue at dental field, once the complexity diagnosis and the accurately therapeutics are need to achieve the success of clinical treatment. Seeing that, this article outlines the broad of the biological and clinical approach of the direct and indirect pulp capping. Emphasizing fundamentally the importance of the corrected diagnose of clinical and radiographic pulp condition, further the indications and contra-indications of both treatments. Furthermore, it will be discussed regarding the classical dental materials used to dentin-pulp protection and contemporary perspectives in this area

Atresia coanal bilateral em paciente de 34 anos / Bilateral choanal atresia in 34 year-old patients

Introdução: A atresia de coanas (AC) pode ser definida como a falha no desenvolvimento da comunicação entre a cavidade nasal e a nasofaringe. Pode ocorrer como uma placa ósteo-membranosa, óssea ou membranosa. O diagnóstico depende de alto grau de suspeição clínica e exames complementares, o tratamento é cirúrgico. Objetivo: Relatar um caso de uma paciente adulta com diagnóstico de atresia coanal bilateral e que foi submetida a tratamento cirúrgico. Relato do Caso: MLSM, 34 anos,sexo feminino, com história de obstrução nasal bilateral, rinorreia hialina desde a infância. Na endoscopia nasal e Tomografia Computadorizada de seios da face evidenciou atresia ósteo-membranosa bilateral. Paciente foi submetida a tratamento cirúrgico endoscópico via transnasal, com confecção de retalho mucoso cobrindo a área cruenta, sem colocação de stent. Foi feito Tomografia de controle que evidenciou coanas abertas e amplas. Paciente evoluiu bem e apresenta respiração nasal normal. Comentários Finais: A AC bilateral, embora rara, pode ocorrer em pacientes adultos...

Introduction: Choanal atresia (CA) can be defined as a failure to develop the communication between the nasal cavity and nasopharynx. May occur as a plate osteo-membranous, bony or membranous. Diagnosis depends on high clinical suspicion and laboratory tests, treatment is surgical. Objective: To report a case of an adult patient diagnosed with bilateral choanal atresia and underwent surgery. Case Report: MLSM, 34 years old female with a history of bilateral nasal obstruction, rhinorrhea hyaline since childhood. On nasal endoscopy and CT scan of the sinuses showed bilateral membranous atresia osteo. Patient underwent endoscopic transnasal route, with production of mucosal flap covering the wound, without stent placement. Tomography was performed which showed control choanae open and broad. The patient progressed well and has normal nasal breathing. Conclusion: AC bilateral, although rare, can occur in adult patients...