Association Between Hand Digit Ratio (2D:4D) and Nonsyndromic Orofacial Clefts.

OBJECTIVES: Digit ratio (2D:4D) has been considered to be a marker in studies evaluating an individual's susceptibility to diseases, especially those diseases that show sex differences in their occurrence. We aimed to assess whether 2D:4D ratios are associated with nonsyndromic cleft lip and/or palate (NSCL/P) and verify the existence of a specific pattern of 2D:4D ratio in individuals affected by orofacial clefts. DESIGN: This was a case-control study. METHODS: Digital measurements of index and ring finger lengths of both hands of patients with NSCL/P (n = 54) and age- and gender-matched controls (n = 54) were obtained using a digital vernier caliper. Mean ratios between the second and fourth digits were compared. Data were analyzed by Student's t test and Mann-Whitney test with a significance level of 5%. RESULTS: No significant difference was found between the mean digit ratios of the right and left hands between the groups for any analysis (P > .05), neither for the whole sample nor for the distributions by type of cleft and by gender. CONCLUSIONS: Although the development of the fingers and the occurrence of NSCL/P can be regulated by the actions of similar genes, our results are not consistent with an association between 2D:4D ratio and this craniofacial deformity. This suggests that intrauterine exposure to fetal androgens, assessed using this marker, is similar between patients with NSCL/P and healthy individuals. We highlight the need for further studies in populations with different ancestries.

Caries experience in a sample of adolescents and young adults with cleft lip and palate in Brazil.

Objective : To compare the caries experience of adolescents and young adults with cleft lip and/or palate (CL/P) with a noncleft control group. Design : Thirty CL/P subjects and 30 controls were clinically examined to obtain the decayed, missing and filled teeth (DMFT) and the decayed, missing and filled surfaces (DMFS) indices, gingival bleeding index, plaque index, and active caries lesions. Data concerning oral hygiene, access to fluoridated water, mother's education level, and family income were also collected. Setting : Pro-Smile Center, a reference center for the treatment of facial deformities, Alfenas, Minas Gerais, Brazil. Subjects : Subjects aged 12 to 21 years with CL/P and without associated syndromes were matched to noncleft controls by sex, age, living habits, and use of orthodontic devices. Null Hypothesis Formulated Prior to Data Collection : Caries experience in CL/P adolescents and young adults is similar to that observed in noncleft controls. Statistical Analysis : Data were analyzed using SPSS 17.0 software for Windows Data Editor. The CL/P and control groups were compared using the McNemar test, paired t test and Wilcoxon test. A significance level of 5% was adopted for all tests. Results : There were no significant differences between the groups for oral hygiene and contact with fluoride. Significant differences were found in per capita income, presence of active caries, decayed surfaces, plaque index, and gingival bleeding. Conclusions : The caries experience of CL/P subjects was higher than that of the noncleft individuals.

Prevalence of Dental Anomalies in Patients With Nonsyndromic Cleft Lip and/or Palate in a Brazilian Population.

Objective : Many studies have demonstrated a high frequency of dental anomalies in patients with cleft lip and/or palate. Because dental anomalies may complicate dental treatment, we investigated the prevalence of dental anomalies in a group of Brazilian patients with nonsyndromic cleft lip and/or palate. Design, Participants, Setting : Retrospective analysis was performed using clinical records of 296 patients aged between 12 and 30 years with repaired nonsyndromic cleft lip and/or palate without history of tooth extraction and orthodontic treatment. Associations between oral clefts and presence of dental anomalies outside the cleft area were investigated. Results : Dental anomalies were identified in 39.9% of the nonsyndromic cleft lip and/or palate patients, and tooth agenesis (47.5%), impacted tooth (13.1%), and microdontia (12.7%) were the most common anomalies. Cleft lip patients were less affected by dental anomalies compared with cleft palate or cleft lip and palate patients (p  =  .057). Specifically, patients with unilateral cleft lip and palate were significantly more affected by dental anomalies than those with bilateral cleft lip and palate (p  =  .00002), and individuals with unilateral complete cleft lip and palate (p  =  .002) and complete cleft palate (p  =  .01) were significantly more affected by tooth agenesis than other cleft types. Agenesis of the premolars (p  =  .043) and maxillary lateral incisors (p  =  .03) were significantly more frequent in patients with unilateral complete cleft lip and palate. Conclusions : The present study revealed a high frequency of dental anomalies in nonsyndromic cleft lip and/or palate patients and further demonstrated that patients with unilateral cleft lip and palate were frequently more affected by dental anomalies than those with bilateral cleft lip and palate. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning for individuals affected by nonsyndromic cleft lip and/or palate.

Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts.

OBJECTIVE: The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts. METHODS: This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy. RESULTS: Folic acid supplementation was observed in 116 (87.8%) of the case group (p < 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p = 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p = 0.13), while 247 (88.8%) reported consumption in the control group. CONCLUSIONS: The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.

Typing Candida albicans oral isolates from healthy brazilian schoolchildren using multilocus enzyme electrophoresis reveals two highly polymorphic taxa.

The genetic diversity of C. albicans oral isolates from 75 healthy schoolchildren from eight schools located in different geographic areas of Piracicaba city, São Paulo state, Brazil, was established using isoenzymes marker (Multilocus Enzyme Electrophoresis - MLEE) and cluster analysis. Patterns of monoclonal and polyclonal oral colonization by C. albicans within and between groups of schoolchildren were identified. However, significant divergence between the observed and the expected genotypic frequencies (Hardy-Weinberg equilibrium test) was not detected in the geographically adjacent groups, suggesting the hypothesis that populations of healthy schoolchildren do not correspond to the selection factor (differential survival) of strains. Two highly polymorphic and distantly genetically related taxa (A and B) were identified within the total population of yeasts, each contained subgroups (A1, A2, A3, A4, B1 and B2) and clusters of moderately related strains (from I to X), suggesting the existence of strains restricted or not to certain groups of geographically limited, healthy students. However, the coexistence of identical strains in healthy schoolchildren from the same school (geographically related) reinforces the hypothesis of oral transmission, where the sources of propagation could be explored. Furthermore, this could also be used in current and retrospective analyses of C. albicans isolated from immunocompetent and immunocompromised people, in order to detect commensal or potentially pathogenic yeast groups, predominantly in candidiasis, and in the development of strategies to prevent transmission or human propagation.

Orofacial features of Treacher Collins syndrome.

Treacher Collins syndrome (TCS) is a rare autosomal dominant disorder of craniofacial development. Major features include midface hypoplasia, micrognathia, microtia, conductive hearing loss, and cleft palate. The present study is on the orofacial features of 7 Brazilian patients with sporadic TCS aged 4 to 38 years. All patients presented the typical down-slanting palpebral fissures, colobomas, zygomatic and mandibular hypoplasia, partial absence of the lower eyelid cilia, and abnormalities of the ears. Malocclusion was present in all patients, and an anterior open bite was found in 3 patients. None of the patients had a cleft palate.

Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts

Abstract Objective The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts. Methods This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy. Results Folic acid supplementation was observed in 116 (87.8%) of the case group (p< 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p= 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p= 0.13), while 247 (88.8%) reported consumption in the control group. Conclusions The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.

Taurodontism in patients with nonsyndromic cleft lip and palate in a Brazilian population: a case control evaluation with panoramic radiographs.

OBJECTIVES: The purpose of this study was to evaluate the prevalence of taurodontism in patients with nonsyndromic cleft lip and palate (NSCLP) within a Brazilian population. STUDY DESIGN: The study was designed as an epidemiologic case-control single-center study. Three hundred eighty-eight patients were included: 88 had NSCLP, and 300 comprised the control group. The first and second permanent mandibular molars were included in this study. By using panoramic radiographs, taurodontism was categorized as mesotaurodontism, hypotaurodontism, and hypertaurodontism. RESULTS: Seventy patients (23.3%) from the control group and 36 patients (40.9%) from the case group presented taurodontism (P < .001). In the control group, 108 (9%) teeth showed taurodontism, whereas in the case group with cleft lip and palate (CLP), 64 (18.2%) teeth showed dental anomalies (P < .001). In both groups, most taurodontic teeth presented hypotaurodontism, followed by mesotaurodontism, while hypertaurodontism was found in only two teeth. The probability of taurodontism in patients with cleft lip (CL) was 2.36 (P = .010) times higher compared with those with CLP, whereas the occurrence of taurodontism in patients with cleft palate (CP) was 3.15 (P = .002) times greater than in patients with CLP. CONCLUSIONS: The results from this study indicate a close relationship between taurodontism and NSCLP and the possibility of different cleft subphenotypes.

Dental anomalies in the deciduous dentition of non-syndromic oral clefts patients / Anomalias dentárias na dentição decídua de pacientes com fissuras orais não sindrômicas

Abstract Objectives: to investigate the prevalence of dental anomalies in complete deciduous dentition of children with NSCL/P. Methods: this study included 75 children with NSCL/P and 286 healthy control. In both groups the children had deciduous dentition with ages varying from 4 to 6 years. Clinical examination, panoramic and periapical radiographies were performed and dental anomalies of number and shape were considered. Results: there was a higher prevalence of dental anomalies in the case group, compared to the control group. In all, 42 dental anomalies were identified, 25.33% in the case group and 8.04% in control group (p<0.001). Therewas a higher frequency of dental anomalies in NSCL/P (47.36%), followed by non-syndromic cleft lip (31.57%) and non-syndromic cleft palate (21.05%). The occurrence of agenesis (p= 0.005) and twinning (p = 0.029) were higher in the case group. Conclusions: the occurrence of agenesis and dental twinning was more frequent in the case group and may contribute to the definition of oral cleft subphenotype.

Resumo Objetivos: investigar a prevalência de anomalias dentárias na dentição decídua completa de crianças com FL/PNS. Métodos: este estudo incluiu 75 crianças com FL/PNS e 286 controles saudáveis. Em ambos os grupos as crianças tinham dentição decídua com idade variando de 4 a 6 anos. Exame clínico, radiografias panorâmicas e periapicais foram realizadas e anomalias dentárias de número e forma foram consideradas. Resultados: houve maior prevalência de anomalias dentárias no grupo caso, comparado ao grupo controle. Ao todo 42 anomalias dentárias foram identificadas, 25,33% no grupo caso e 8,04% no grupo controle (p<0,001). Houve maior frequência de anomalias dentárias na FL/PNS (47,36%), seguida da fissura labial não sindrômica (31,57%) e da fissura palatina não sindrômica (21,05%). A ocorrência de agenesia (p= 0,005) e geminação (p=0,029) foram maiores no grupo caso. Conclusão: a ocorrência de agenesia e geminação dentária foram mais frequentes no grupo caso e pode contribuir para a definição de subfenótipos de fissuras orais.

Orofacial features of hypohidrotic ectodermal dysplasia.

Hypohidrotic ectodermal dysplasia (HED) is a type of genodermatosis characterized by the abnormal development of sweat glands, teeth, and hair. The most prevalent form of HED is X-linked hypohidrotic ectodermal dysplasia (XLHED), which is associated with mutations in the EDA gene. The aim of this case report was to describe a family with XLHED with emphasis on differences in orofacial features between members. Family members were systematically evaluated to characterize the pattern of inheritance and clinical features. Dental examination included evaluation of agenesis and abnormal teeth structure. The pedigree of the last seven generations of the family was constructed. Clinical examination and medical history revealed five males affected by HED and nine female as heterozygous carriers. The males exhibited the classic phenotype of XLHED, with dental abnormalities, hypohydrosis, and craniofacial dysmorphologies. The heterozygous carriers of the X-linked gene defect principally exhibited dental agenesis of the lateral maxillary incisors. Careful clinical examination, including dental evaluation, is an important way to detect heterozygous carriers of X-linked HED. Heterozygous parents of patients with HED may also show some features of the disorder. The identification of female carriers results in genetic counseling being offered to affected families, as well as providing adequate treatment as necessary and long-term follow-up of these patients.

[Study of patients with cleft lip and palate with consanguineous parents]. / Estudo de pacientes com fissuras lábio-palatinas com pais consanguíneos.

UNLABELLED: Cleft lip and/or palate (CL/P) are the most common congenital anomalies of the face. CL/P are non-syndromic (CL/PNS) in about 70% of subjects. AIM: To describe clinical cases of non-syndromic CL/P (CL/PNS) associated with consanguinity, diagnosed at a reference hospital in Minas Gerais, Brazil, and to correlate these alterations with possible risk factors. SERIES AND METHODS: A retrospective study at a reference hospital for craniofacial deformities in Minas Gerais, Brazil from 2006 to 2009 based on data in medical records. RESULTS: Of 246 CL/PNS cases diagnosed and treated at the institution, 15 (6.1%) were CL/PNS with reported first-degree consanguinity; 73.3% occurred in males. Four of 15 patients had complete right cleft palate and lip (CLP), 4 presented complete cleft palate and lip (right and left), 3 had complete unilateral left CLP, 3 had isolated cleft palate, and 1 presented cleft lip only. Among the risk factors, only three mothers reported smoking during pregnancy. CONCLUSIONS: CLP (unilateral or bilateral) were more frequent in the group with a history of first-degree consanguinity; males predominated. Among the risk factors, only smoking was observed in three cases.

Ocorrência de doença periodontal, cárie e perda dentária em tabagistas pacientes de uma clínica-escola de Odontologia no sul do estado de Minas Gerais: estudo caso-controle

Comparar a ocorrência de doença periodontal, cárie e perda dentária em tabagistas de ambos os gêneros, adultos, admitidos para tratamento odontoló- gico integrado em uma escola de odontologia, comparados a um grupo-controle não tabagista. Métodos: foram avaliados exames clínicos dentários e periodontais em prontuários de 31 pacientes fumantes e de 46 não fumantes, quanto à ocorrência de: sangramento e/ ou supuração gengival; perda de suporte periodontal por bolsa ou retração gengival; hipermobilidade dentária; dentes cariados, restaurados e dentes perdidos. Para comparar as médias entre os grupos, foi utilizado o teste t de Student (p≤ 0,005) e a correlação entre as variáveis foi obtida por análise multivariada. Resultados: os tabagistas relataram fumar, em média, 11,32 ± 8,599 cigarros/dia, sendo que 54,83% deles fumavam mais de 10 cigarros/dia. Observou-se que as variáveis: número de dentes com perda de inserção, bolsa periodontal, retração gengival, hipermobilidade, sangramento/supuração, perda média de inserção (em mm) e idade estão altamente correlacionadas e são diretamente proporcionais. O número de dentes hígidos foi inversamente proporcional à idade e o índice de placa correlacionou-se com o número de dentes cariados, perdidos e com cálculo. Entretanto, não foi observada diferença estatisticamente significativa entre os grupos para nenhum parâmetro, exceto quanto à perda dentária, com os fumantes apresentando, em média, mais dentes perdidos do que os não fumantes (p=0,0171). Conclusão: o tabagismo não influenciou significativamente na ocorrência de cárie ou de doença periodontal na população estudada, porém os fumantes têm maior perda dentária do que os não fumantes, e deveriam ser aconselhados a abandonar o tabaco.

Ophthalmic changes in cleft lip and palate / Alterações oftalmológicas na fissura lábio palatina

ABSTRACT The current study aimed to analyze through a literature review evidence of association between ocular changes and non-syndromic cleft lip and/or palate (NSCL/P). A literature review was carried out in accordance with the Cochrane Collaboration Group protocol. PubMed, Scopus, Academic Google and ISI Web of Science databases were systematically searched. A total of 16 studies were accessed, and three made up the final sample.All three studied ocular abnormalities in patients with NSCL/P.The articles found ocular abnormalities in 6.21%, 17.54% and 1.03% of patients respectively.The presence of ocular abnormalities in patients with NSCL/P was significant in this systematic review, but the articles all agreed that future studies should explore the possibility of a greater occurrence of ocular changes in individuals with NSCL/P.

RESUMO O presente estudo teve como objetivo analisar evidências de associação entre as alterações oculares e fissuras lábio palatinas não sindrômicas (FL/PNS), através de uma revisão da literatura. Foi realizada a revisão da literatura com pesquisa sistemática, observando o protocolo de colaboração com o Grupo Cochrane. PubMed, Scopus, Google Acadêmico e ISI-Web of Science. A partir de16 estudos acessados, 3 compuseram a amostra final. Todos os trabalhos da amostra final relataram alterações oculares em pacientes com FL/PNS. Os artigos relataram respectivamente alterações oculares em 6,21%, 17,54% e 1,03% dos pacientes. A presença de alterações oculares em pacientes com FL /PNS foi significativa nesta revisão sistemática, mas todos os três artigos sugerem que futuros estudos deverão explorar a possibilidade de que haja um aumento de alterações oculares em indivíduos com FL/PNS.

Maternal and paternal age, birth order and interpregnancy interval evaluation for cleft lip-palate.

UNLABELLED: Cleft lip and palate (CL/P) are the most common congenital craniofacial anomalies. AIM: To evaluate environmental risk factors for non-syndromic CL/P in a reference care center in Minas Gerais. MATERIALS AND METHODS: we carried out a case-controlled study, assessing 100 children with clefts and 100 children without clinical alterations. The analysis dimensions (age, skin color, gender, fissure classification, maternal and paternal age, birth order and interpregnancy interval), obtained from a questionnaire; and later we build a data base and the analyses were carried out by the SPSS 17.0 software. The results were analyzed with the relative risk for each variable, in order to estimate the odds ratio with a 95% confidence interval, followed by a bivariate and multivariate analysis. RESULTS: among 200 children, 54% were males and 46% were females. As far as skin color is concerned most were brown, white and black, respectively. Cleft palates were the most common fissures found (54%), followed by lip cleft (30%) and palate cleft (16%). CONCLUSION: although with a limited sample, we noticed an association between maternal age and an increased risk for cleft lip and palate; however, paternal age, pregnancy order and interpregnancy interval were not significant.

Current surgical techniques for cleft lip-palate in Minas Gerais, Brazil.

UNLABELLED: Cleft lip and palate (CL/P) are the most common congenital anomalies of the craniofacial region. AIM: to evaluate the surgical techniques used in CL/P treatment in a craniofacial deformities ward, in Minas Gerais. MATERIALS AND METHODS: In this retrospective study, carried out between 2002 and 2007, we studied 109 individuals with non-syndromic CL/P submitted to treatment. The aspects analyzed (personal identification, classification of CL/P and surgical treatment performed) were obtained from patient charts, and then we built a database and ran statistical analyses through the SPSS 13.0 software. Followed by descriptive analysis of the surgical procedures depending on the type of CL/P found. RESULTS: Among the 109 patients, 65.1% were males and 34.8% females. We found that 45% of patients had cleft lip and palate, 37.6% cleft lip only and 17.4% cleft palate only. The surgical techniques employed were predominantly those from Millard and Spina for cheiloplasty, McComb for rhinoplasty and, Veau and Van Langenbeeck for palatoplasty. CONCLUSIONS: This study is the first to address treatment procedures for individuals with CL/P in the state of Minas Gerais. For unilateral CL/P we predominantly used the association of McComb, Veau and Millard techniques, respectively, for rhinoplasty, palatoplasty and cheiloplasty, in 76.9% of the patients.

[Biopsychosocial profile of patients with anophthalmia in the south of Minas Gerais - Brazil]. / Perfil biopsicossocial de portadores de anoftalmia no sul de Minas Gerais - Brasil.

PURPOSE: To evaluate the biopsychosocial profile of patients with anophthalmia, with emphasis on the psychological and functional impact of eye loss and the social reintegration of this population. METHODS: Prospective analyses of 84 patients (50 males and 34 females), rehabilitated or in the rehabilitation process with ocular prostheses were interviewed by means of a questionnaire with dimensions involving the etiology of the ocular defect, degree of adaptation to the ocular prosthesis, and impact on professional, family and social activities. RESULT: The right eye was affected in 45.2% of the patients, the left eye in 51.2%, and the rest of the patients had bilateral anophthalmia. Difficulty in adapting to monocular vision was reported by 47.6% of the patients. The main causes of anophthalmia in males were eye injuries due to accidents (54%), and, in females, acquired diseases (38.2%). For the total studied population, the eye loss occurred at a mean of 20.5 +/- 18.41 years, and the elapsed time until the first rehabilitation with ocular prosthesis was of 8.6 +/- 13.10 years. Most patients (66.1%) reported satisfaction and good adaptation to the prosthesis. Feelings of sadness, shame and shyness were frequently reported. CONCLUSION: Anophtalmic patients often exhibit psychic and/or functional disorders which hinder their social, professional and family readaptation, and this is aggravated by both economic factors and lack of public services that provide rehabilitative treatment. Public information campaigns could also be useful to prevent causes that lead to ocular loss.

Uso de dentes humanos extraídos e os bancos de dentes nas instituições brasileiras de ensino de odontologia / Use of extracted human teeth and the human tooth bank in brazilian dental schools

Objetivo: Avaliar aspectos relacionados ao uso de dentes humanos extraídos nos cursos de graduação e pós-graduação do Brasil e a existência de Banco de Dentes Humanos (BDH) nas Instituições de Ensino Superior (IES) em Odontologia. Método: Foi realizado um estudo transversal, por meio de um questionário semiestruturado enviado, via endereço eletrônico, aos Coordenadores e/ou Diretores dos Cursos de Odontologia cadastrados no Ministério da Educação (MEC). Após envio do questionário, no caso da não-resposta após três tentativas, o instrumento impresso foi enviado às IES pelo correio. O instrumento foi testado por um coordenador de um curso de Odontologia de uma instituição diferente daquela na qual o projeto foi desenvolvido, para verificação de problemas de entendimento e formatação. Os dados foram analisados por meio da estatística descritiva (distribuições absolutas e percentuais). Resultados: Das 187 instituições localizadas junto ao MEC, 57 (30,48%) responderam. Os dentes humanos são utilizados para treinamento em 55 IES (96,5%): (87,70% em Endodontia; 63,20% em Dentística; 56,10% em Prótese, 47,40% em Anatomia Dental e 5,30% em Periodontia). A Endodontia é a disciplina que utiliza maior número de dentes (1.299 dentes/semestre). Em 42% das IES, os dentes foram fornecidos pelo BDH; em 44% pelos alunos; em 12% por ambos. O BDH foi também a principal fonte de dentes humanos para pesquisa para 64,3% de 46 IES (19.570 dentes/ano). Das 50 IES com cursos de Pós-graduação, 21 relataram utilizar dentes extraídos. Declararam conhecer a origem dos dentes 44 instituições e oito utilizam termo de doação, quando o dente não é proveniente do BDH. Possuem BDH 37 (64,91%) IES com 3,1±2,5 anos de existência. O BDH foi considerado autossuficiente em 16 delas. Conclusão: Embora o uso de dentes extraídos seja frequente no ensino e na pesquisa, nas diferentes áreas da Odontologia, a existência de BDH é fenômeno recente e incompletamente difundido nas IES.

Objective: The purpose of this study was to evaluate aspects related to the use of extracted human teeth in Brazilian undergraduate and graduate dental courses and the existence of a Human Tooth Bank (HTB) at the higher education institutions. Method: A semi-structured questionnaire was sent by e-mail to the coordinators and/or directors of dental courses registered with the Ministry of Education (MEC). In case of no response after three attempts, the questionnaire was sent to the institutions by mail. To check if there were understanding and formatting problems, the questionnaire was tested by a coordinator from a different institution from the one where it was designed. The data were analyzed and reported descriptively. Results: Out of the 187 institutions listed by MEC, 57 (30.48%) responded. Human teeth are used for training in 55 (96.5%) institutions (87.70% in endodontics; 63.20% in dentistry, in prosthodontics 56.10%, 47.40% in dental anatomy and 5.30% in periodontics). Endodontics is the discipline that uses the largest number of teeth (1,299 teeth/semester). In 42% of the institutions, the teeth were supplied by HTB, 44% by students; 12% by both. The HTB was also the main source for 64.3% of the 46 institutions that conduct research with human teeth (19,570 teeth/year). Out of the 50 institutions with graduate courses, 21 reported using extracted teeth. Forty-four institutions affirmed to know the origin of the teeth and 8 use a donation form, when the tooth is not coming from HTB. Thirty-seven institutions (64.91%) have HTB that are 3.1 ± 2.5 years old. The HTB was considered to be self-sufficient by 16 of them. Conclusion: Although the use of extracted teeth is common in teaching and research activities in the different s of dentistry, the existence of HTB is a new phenomenon, but yet not sufficiently disseminated among the higher education institutions.

Fatores de risco associados a fissuras orais não sindrômicas numapopulação brasileira: estudo caso-controle / Risk factors associated with nonsyndromic oral clefts in a Brazilian population: a case-control study

Introdução: Fissuras do lábio e/ou palato representam as anomalias congênitas mais comuns da face e, em 70% dos casos, tais anomalias congênitas ocorrem de forma não-sindrômica. Objetivo: Conduzir um estudo caso-controle para detectar fatores de risco associados às fissuras labiais e/ou palatinas não sindrômicas em um grupo de pacientes brasileiros. Material e método: Um questionário foi respondido por 60 mães com filhos apresentando fissuras labiais e/ou palatinas não sindrômicas (grupo caso) e por 51 mães com crianças saudáveis (grupo controle). As seguintes variáveis foram avaliadas: idade materna e paterna, distúrbios maternos, tabagismo e consumo de álcool durante a gravidez, história reprodutiva (aborto espontâneo, gravidez ectópica e natimorto), e uso de medicamentos e de multivitaminas durante a gravidez. Os resultados foram analisados em relação ao risco relativo de cada variável para estimar o odds ratio, com intervalo de confiança de 95%, e em seguida as análises bivariada e multivariada foram realizadas. Resultado: As análises revelaram que o único fator de risco mais relacionado às fissuras labiais e/ou palatinas não sindrômicas foi a variável história de natimorto, com odds ratio = 7,67 (p = 0,05). O uso de drogas lícitas não se correlacionou com as fissuras labiais e/ou palatinas não sindrômicas. Conclusão: Dos principais fatores de risco associados às fissuras labiais e/ou palatinas não sindrômicas descritas na literatura, apenas a história de natimorto mostrou significância estatística na população avaliada.

Background: Cleft lip and/or palate are the most common congenital anomalies of the face. In 70% of cases, such congenital anomalies occur in a nonsyndromic form. Purpose: To conduct a case-control study in order to detect possible risk factors for nonsyndromic cleft lip and/or cleft palate in a group of Brazilian patients. Material and method: A questionnaire was answered by 60 mothers of children with nonsyndromic cleft lip and/or cleft palate (case group), and by 51 mothers of healthy children (control group). The following variables were assessed: maternal and paternal ages, maternal disorders, smoking and alcohol consumption during pregnancy, reproductive history (miscarriage, ectopic pregnancy and stillbirth), medication and multivitamin usage during pregnancy. The results were analyzed in relation to the relative risk of each variable in order to estimate the odds ratio with a confidence interval of 95%. This was followed by bivariate and multivariate analysis. Result: The analyses revealed that the only significantly increased risk factor was a history of stillbirth, with an odds ratio = 7.67 (p = 0.05). The use of licit drugs was not correlated with nonsyndromic oral clefts. Conclusion: Of the main risk factors associated with nonsyndromic oral clefts described in the literature, only a history of stillbirth showed a statistical significance in the population studied.

Frequency of congenital craniofacial malformations in a Brazilian reference center / Frequência de malformações congênitas craniofaciais em um centro de referência brasileiro

OBJETIVO: Avaliar a frequência de anomalias craniofaciais em pacientes assistidos em um Centro de Referência Brasileiro para deformidades craniofaciais. MÉTODO: Estudo retrospectivo epidemiológico avaliando os prontuários clínicos de 1.142 pacientes, sendo 656 (57,4 por cento) do gênero masculino e 486 (42,6 por cento) do feminino, entre os anos de 1992 e 2008. RESULTADOS: Entre os defeitos congênitos, fissura labial e/ou palatina não-sindrômica foi o mais frequente (778 casos; 68,1 por cento), seguido por anomalias congênitas simples ou múltiplas sem fissura labial e/ou palatina (240 casos; 21 por cento), síndromes ou sequências reconhecidas (56 casos; 5 por cento), síndromes com fissura orofacial como um componente do quadro sindrômico (41 casos; 3,5 por cento), e fissuras orofaciais em associação com malformações sistêmicas (27 casos; 2,4 por cento). CONCLUSÕES: Observou-se que o defeito congênito identificado mais frequente foi a fissura labial e/ou palatina não-sindrômica, no entanto, anomalias isoladas e síndromes envolvendo as estruturas craniofaciais foram bastante encontradas. Além disso, ressalta-se a necessidade de estudos que identifiquem a frequência e os fatores de riscos associados às anomalias craniofaciais na população brasileira, a fim de que se planejem estratégias e ações integradas para o desenvolvimento de programas preventivos e de tratamento adequado.

OBJECTIVE: To evaluate the frequency of craniofacial anomalies in patients treated at a Brazilian Reference Center for craniofacial deformities. METHOD: Retrospective epidemiological study evaluating the clinical records of 1,142 patients: 656 (57.4%) male and 486 (42.6%) female, between 1992 and 2008. RESULTS: Among birth defects, non-syndromic cleft lip and/or palate were the most frequent ones (778 cases; 68.1%), followed by single or multiple congenital anomalies without cleft lip and/or palate (240 cases; 21%), recognized syndromes or sequences (56 cases; 5%), syndromes with orofacial cleft as a component (41 cases; 3.5%), and orofacial clefts in association with systemic malformations (27 cases; 2.4%). CONCLUSIONS: Non-syndromic cleft lip and/or palate was the congenital defect most frequently identified, although, isolated anomalies and syndromes involving craniofacial structures were quite frequent. Furthermore, the need for studies to identify the frequency and risk factors associated with craniofacial anomalies in the Brazilian population is emphasized in order to plan comprehensive strategies and integrated actions for the development of preventive programs and treatment.