Microstomia: Aplicação da fotogrametria para mensurar a eficiência da órtese oral associada à terapia fonoaudiológica / Microstomy: Application of photogrammetry to measure the efficiency of oral orthosis associated with speech therapy

OBJETIVO: Esse estudo teve como propósito verificar, por meio da fotogrametria computadorizada, a eficácia do uso da órtese oral como auxiliar na terapia fonoaudiológica. MÉTODO: Após a documentação fotográfica, cada paciente foi submetido a terapia fonoaudiológica, por meio da terapia miofuncional orofacial, associada ao uso da órtese oral, confeccionada segundo Borges et al. (2011). Ao término do tratamento, foi realizado novo registro fotográfico, em seguida, a mensuração da dimensão vertical (distância entre lábio superior/inferior) e horizontal (distância entre comissuras direita/esquerda), com o uso do programa Corel Draw X3. RESULTADOS: As médias da abertura bucal aumentaram da avaliação inicial para a avaliação final, tendo aumentado 5,1 mm no sentido horizontal (67,3 mm para 72,4 mm) e 13,9 mm no sentido vertical (de 32,7 mm para 46,6 mm). Essas diferenças se revelam significativas para as avaliações (p <0,05). CONCLUSÃO: O uso da órtese oral associado a terapia fonoaudiológica demonstrou ser eficaz como mais um instrumento na prevenção da microstomia.

OBJECTIVES: The aim of this study was to through computerized photogrammetry, the efficacy of oral orthosis as an aid in speech therapy. METHODS: After the photographic documentation, each patient underwent speech therapy, through orofacial myofunctional therapy, associated with the use of an oral orthosis, made according to Borges et al. (2011). At the end of the treatment, a new photographic record was taken, then the vertical dimension measurement (distance between upper lip) and horizontal (distance between corners right/left), using the program Corel Draw X3. RESULTS: The mean mouth opening increased from the initial evaluation to the final evaluation, increasing 5.1 mm in the horizontal direction (67.3 mm to 72.4 mm) and 13.9 mm in the vertical direction (from 32.7 mm to 46.6 mm). These differences are significant for the evaluations (p<0.05). CONCLUSION: The use of oral orthosis associated with speech therapy proved to be effective as another tool in the prevention of microstomia.

Comprehensive Risk-Based Diagnostically Driven Treatment Planning: Developing Sequentially Generated Treatment.

The clinical example presented in this article demonstrates a risk-based, diagnostically driven treatment planning approach by focusing on 4 key categories: periodontal, biomechanical, functional, dentofacial. In addition, our unique approach allowed the comprehensive clinical management of a patient with complex restorative needs. A full-mouth rehabilitation was completed sequentially without sacrificing the amount of dentistry necessary to restore health, comfort, function, and esthetics. The result exceeded the patient's expectation and was made financially possible by extending treatment over numerous years.

Treatment planning and dental rehabilitation of a periodontally compromised partially edentulous patient: a case report - Part I.

When planning a prosthetic rehabilitation of a periodontally compromised case, the clinician is often confronted with difficulties and dilemmas related to selecting the appropriate treatment modality that would provide a long-term longevity in terms of function and esthetics. In such cases, a correct diagnosis and prognosis of the intraoral situation supported by evidence-based dentistry is the basis for the establishment of a proper treatment strategy. In this two-part treatment planning series, a systematic approach of patient examination and prognosis of each tooth is presented. Furthermore, different removable and fixed treatment possibilities are described and the rationale governing the decision-making process is revealed. The execution of the final treatment plan as specified by the concept of comprehensive dental care is outlined and the final outcome is discussed according to the literature.

Atención odontopediátrica del niño con fisura labio alveolo palatina / Pediatric dental care for children with cleft lip, alveolous and palate

La intervención del odontopediatra es fundamental en los primeros días de vida del niño, debido al problema de falta de succión y los trastornos que causan en la alimentación. El logro de un tratamiento eficaz en elniño fisurado dependerá del trabajo multidisciplinario y de lograr instruir y concientizar a los padres en la importancia de la permanente atención del niño, cumpliendo todos los pasos indicados por el equipo de trabajo para lograr el correcto tratamiento interdisciplinario, teniendo en cuenta además que son tratamientos muy largos con control y atención del niño afectado, prácticamente hasta la adolescencia, por parte de cada uno de los integrantes de este equipo de trabajo...

Effect of a multi-faceted intervention on gingival health among adults with systemic sclerosis.

OBJECTIVES: To evaluate the effect of adaptive oral hygiene devices and orofacial exercise to improve gingival health among adults with systemic sclerosis (SSc). METHODS: Forty-eight patients with SSc were assigned randomly to the multifaceted oral health intervention or usual dental care control group. Participants in the intervention group received a rechargeable, powered Oral-B® oscillating-rotating-pulsating toothbrush and a Reach® Access™ Flosser that has a toothbrush-like handle. For those with an oral aperture of less than 40 mm, orofacial exercises were taught. Participants in the control group were each given a manual toothbrush and dental floss. Participants in both groups received instructions and demonstration on the use of the devices, and were requested to perform the respective intervention twice a day for 6 months. Evaluations were at baseline, 3-, and 6-months. The main outcome was gingival index (GI), an indicator of gingival inflammation. RESULTS: Both groups showed significant reduction in GI scores at 6 months (ps<0.005). Reduction in GI scores of the intervention group at 6 months was 20.8% which is considered to be clinically significant. Compared to the control group, the intervention group showed a significant and larger reduction in GI score by 8% at 6 months (p=0.0007). CONCLUSIONS: Results support the use of adaptive devices and orofacial exercise to improve gingival health in adults with SSc when compared to use of manual toothbrushing and finger-held flossing. Recommending and educating patients with SSc to use adaptive devices to clean the tooth surfaces looks promising for long-term oral health improvement.

[Study of alternating magnetic field influence on rates of rehabilitation of patients after dental implantation].

New way of using alternating magnetic field is described. Basic functional description of new treatment and diagnostic offered (patents of RF No75294 and 75314), which included digital plethysmograph and regulation of angiotonic microcirculation channel device. Comparative estimation of clinical and functional indiced of regional blood flow of patients in the main group and in the control group showed a positive correlation. Expressed influence of alternating magnetic field on frequency of oscillations pulse vessels microcircution channel and acceleration of leveling disorder of blood circulation in tissue after surgical treatment was proved.

Microsistema de dientes: un método novedoso en el alivio del dolor lumbar agudo / Teeth microsystem: a novel method in the relief of the acute lumbar pain

Para evaluar la eficacia del tratamiento estomatológico con el uso del microsistema de dientes en la remisión del dolor lumbar agudo se realizó un ensayo clínico terapéutico fase II tardía en la Clínica Estomatológica Docente Provincial Ismael Clark y Mascaró desde junio de 2004 a febrero de 2006. El tamaño de la muestra estuvo constituido por 64 pacientes conformados en dos grupos homogéneos: control (tratamiento acupuntural) y el estudio (tratamiento acupuntural más estomatológico) cada uno con 32 pacientes. Se evaluó examen estomatológico clínico y radiológico en ambos grupos al inicio del estudio y se concluyó que los problemas bucales que más incidieron fueron la caries dental, las enfermedades periodontales y las obturaciones de amalgamas responsables de la intensidad del dolor e impotencia funcional. Los resultados fueron sorprendentes a la séptima sesión en el grupo estudio donde fue más eficaz la combinación del tratamiento estomatológico y la terapia acupuntural. No se precisaron reacciones adversas severas(AU)

To evaluate the stomatological treatment effectiveness with the use of teeth microsystem in the remission of the acute lumbar pain, a late stage II therapeutic clinical trial was performed at Ismael Clark y Mascaró" Provincial Teaching Odontology Clinic from June 2004 to February 2006. The size of the sample was constituted by 64 patients conformed in two homogenous groups: control (acupuncture treatment) and study (acupuncture and stomatological treatment) with 32 patients each. The clinical stomatological and radiological examination in both groups at the beginning of the study was evaluated and dental caries, periodontal diseases and amalgam fillings responsible for the intensity of pain and functional impotence were the oral problems with more incidence was concluded. Results were surprising to the seventh session in the study group where it was most effective the combination of the stomatological treatment and acupuncture therapy. No severe adverse reactions were required(AU)

Esthetic alumina and zirconia rehabilitation: a team approach to treatment planning and material selection.

To meet the ever-increasing demands of well-informed patients, an interdisciplinary team approach is imperative to achieve optimal esthetics and function in complex rehabilitations. Orthodontic pretreatment is one viable option to improve a clinical situation prior to restorative treatment. An individual diagnostic waxup can be used to educate patients about treatment options, lower unrealistic expectations, and serve the technician as a blueprint for ideal framework design. Newly developed dental materials and computer technology have led to new restorative treatment options for both conventional and implant-retained restorations. With the increased processing power of computers over the past decade, computer-aided design/computer-assisted manufacture (CAD/ CAM) copings, frameworks, and abutments for conventional and implant-supported restorations have significantly altered treatment protocols for dentists and dental technicians. CAD/CAM-generated oxide ceramic components can be used to achieve optimal esthetics in any area of the mouth.

Reabilitação oral anterior: alternativas de tratamento em odontopediatria / Anterior oral rehabilitation: treatment alternatives in pediatric dentistry

Este trabalho relata o caso clínico de um paciente de 2 anos de idade, que apresentava dentes anteriores com lesões de cárie extensas. O tratamento inclui exodontia, endodontia, restauração de resina composta direta sobre o núcleo de preenchimento, reforçado com fio ortodôntico, confecção de coroa de resina acrílica prensada, coroa unitária e com pôntico suspenso, cimentadas sobre pinos confeccionados em dentina. O resultado estético e funcional, mostrou-se bastante satisfatório

[Complex oral rehabilitation of children with cleft lip-jaw-palate]. / Komplexe orale Rehabilitation von Kindern mit Lippen-Kiefer-Gaumensegel-Spalten.

The prerequisite for the full oral rehabilitation and social adaptation of cleft palate patients is a consistent, comprehensive care system, providing a well organised integration of preventive and interceptive measures, as well as close cooperation between the various specialised disciplines. Preventive stomatological care should begin in infancy.

Indications for orthodontic-prosthodontic collaboration in dental treatment.

In dental practice, combined plans of orthodontic and prosthodontic treatment are underused. Indications for a collaborative effort include preservation of integrity of the dental arch, biomechanical factors, limitations in design of prostheses, esthetic appearance, periodontal considerations, prevention of malocclusion, and better retention of position of teeth.