Ozone therapy effect in medication-related osteonecrosis of the jaw as prevention or treatment: microtomographic, confocal laser microscopy and histomorphometric analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS: Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS: Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS: Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE: Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.

Preclinical in vitro study of streptococcus mutans accumulation in three fixed retainer designs: Microbiological assay.

The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research was to evaluate, in vitro, the accumulation of Streptococcus mutans (S. mutans) in 3 designs of fixed retainers. Nine models were reproduced in heat-cured acrylic resin and divided into groups: straight retainer (SR), retainer with vertical strap (RVS), retainer with horizontal strap (RHS). The accumulation of S. mutans was assessed using the MTT assay (3-4,5-dimethyl-thiazol-2-yl-2,5-diphenyltetrazolium bromide) and then measured using an automated reader. The RHS group showed less biofilm accumulation compared to the other groups (p<0.05). The distance between the tooth surface and the retainer showed a strong negative correlation with biofilm accumulation (rs=-0.79, p=0.00037). The RHS showed significantly less accumulation of S. mutans due to the distance between the retainer and the tooth surface. This research provides relevant data for a future randomized clinical trial.

[At the forefront of the temporomandibular dysfunction: a study of experiences]. / Nas trincheiras da disfunção temporomandibular: estudo de vivências.

How does one address an ailment related to such unique experiences without dissociating it from relationships, living conditions and society? Temporomandibular Disorder (TMD) is one of a group of chronic disorders that are difficult to diagnose and provide treatment. As in other similar ailments, such difficulties may accentuate a negative impact on health. The study seeks to identify experiences of health service users with TMD, aiming to contribute to reflection and management practices for the issue. A qualitative otobiographical study was developed, using interviews with people undergoing TMD treatment. Based on the Nietzschean premise that the process of subjectivation is fed by experiences, the method seeks to identify traces of these experiences through the texts resulting from the interviews. Patients' experiences were grouped into five categories: recognition; frustrations; concealment; sadness, fear and death; and destinies. A variety of negative effects have been described in the first three stages, whereas the last one, namely destinies, elicits feelings of well-being. The value of the interactive (professional-user) space, which expresses itself as the power to create innovative and sensitive ways of dealing with health-disease processes, needs to be highlighted.

Como abordar uma doença que traz vivências tão singulares e fazê-lo sem dissociações com as relações, as condições de vida e sociedade? A Disfunção temporomandibular (DTM) é um grupo de desordens crônicas difíceis de diagnosticar e prover tratamento. Como em outras doenças similares, tais dificuldades podem agravar o impacto negativo sobre a saúde. O estudo busca identificar vivências de usuários de serviços de saúde com DTM, visando contribuir com as práticas de reflexão e manejo para a questão. Foi desenvolvido um estudo qualitativo, de caráter otobiográfico, a partir de entrevistas com pessoas em tratamento de DTM. Parte-se da premissa nietzschiana de que o processo de subjetivação é alimentado por vivências; portanto, o método busca a identificação de traços dessas vivências nos textos produzidos a partir da transcrição das entrevistas. As vivências dos pacientes foram agrupadas em cinco trincheiras: nomeação; frustrações; escondido; tristeza, medo e morte; e destinos. Uma variedade de efeitos negativos foi descrita através dos três primeiros estágios, enquanto em destinos, emergem as sensações de bem-estar. Destaca-se o valor do espaço profissional-usuário, que expressa a potência de criação de modos inovadores e sensíveis de lidar com os processos de saúde-doença.

Nas trincheiras da disfunção temporomandibular: estudo de vivências / At the forefront of the temporomandibular dysfunction: a study of experiences

Resumo Como abordar uma doença que traz vivências tão singulares e fazê-lo sem dissociações com as relações, as condições de vida e sociedade? A Disfunção temporomandibular (DTM) é um grupo de desordens crônicas difíceis de diagnosticar e prover tratamento. Como em outras doenças similares, tais dificuldades podem agravar o impacto negativo sobre a saúde. O estudo busca identificar vivências de usuários de serviços de saúde com DTM, visando contribuir com as práticas de reflexão e manejo para a questão. Foi desenvolvido um estudo qualitativo, de caráter otobiográfico, a partir de entrevistas com pessoas em tratamento de DTM. Parte-se da premissa nietzschiana de que o processo de subjetivação é alimentado por vivências; portanto, o método busca a identificação de traços dessas vivências nos textos produzidos a partir da transcrição das entrevistas. As vivências dos pacientes foram agrupadas em cinco trincheiras: nomeação; frustrações; escondido; tristeza, medo e morte; e destinos. Uma variedade de efeitos negativos foi descrita através dos três primeiros estágios, enquanto em destinos, emergem as sensações de bem-estar. Destaca-se o valor do espaço profissional-usuário, que expressa a potência de criação de modos inovadores e sensíveis de lidar com os processos de saúde-doença.

Abstract How does one address an ailment related to such unique experiences without dissociating it from relationships, living conditions and society? Temporomandibular Disorder (TMD) is one of a group of chronic disorders that are difficult to diagnose and provide treatment. As in other similar ailments, such difficulties may accentuate a negative impact on health. The study seeks to identify experiences of health service users with TMD, aiming to contribute to reflection and management practices for the issue. A qualitative otobiographical study was developed, using interviews with people undergoing TMD treatment. Based on the Nietzschean premise that the process of subjectivation is fed by experiences, the method seeks to identify traces of these experiences through the texts resulting from the interviews. Patients' experiences were grouped into five categories: recognition; frustrations; concealment; sadness, fear and death; and destinies. A variety of negative effects have been described in the first three stages, whereas the last one, namely destinies, elicits feelings of well-being. The value of the interactive (professional-user) space, which expresses itself as the power to create innovative and sensitive ways of dealing with health-disease processes, needs to be highlighted.

Bisphosphonate-associated osteonecrosis of the jaw.

INTRODUCTION: The purpose of this systematic review was to determine the possible risk factors related to pathophysiology of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and identify adequate treatment strategies available and success rates. EVIDENCE ACQUISITION: We performed a search for publications about the treatment of BRONJ, published between 2003 and 2018 in the PubMed/Medline data base using the key words: "Bisphosphonate-Associated Osteonecrosis of the Jaw" OR "Bisphosphonate Osteonecrosis" OR "BRONJ", based on the list of MeSH and DeCS. EVIDENCE SYNTHESIS: According to pre-established criteria for data collection concerning the treatment of BRONJ, we found 19 articles covering a total of 400 patients. Treatments that showed good outcomes were Ozone, PRF, PRP/Debridement/Laser bio-stimulation, Laser surgery and Laser surgery/Laser bio-stimulation. HBO did not achieve good results and was used in only 10 patients. BRONJ is a rare condition in patients with osteoporosis/other pathologies using BP orally. These patients had long exposure time and cumulative doses of BPs until onset of the lesion. The oncological patients were exposed to more potent intravenously administered BPs such as pamidronate and zoledronate. These patients had a shorter exposure time until onset of the lesion. CONCLUSIONS: The treatment of BRONJ is still under debate and there are promising treatments that need randomized trials with larger numbers of patients to confirm their results. Patients receiving BPs or those who will start treatment should be encouraged to perform preventive dental treatment and maintain good oral hygiene.

The impact of impending / onset of vision loss on depression, anxiety, and vision-related quality of life in Birdshot-Retinochoroiditis and Serpiginous Choroiditis.

To evaluate the impact of Birdshot-Retinochoroidopathy (BSRC) and Serpiginous Choroiditis (SC) on depression, anxiety, and vision-related quality of life. 72 individuals (BSRC: n = 28, SC: n = 8; healthy control group (HC): n = 36) completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Visual Function Questionnaire (VFQ-25). Multivariate linear regression models were used to analyze different subscales of the PHQ-9, the GAD-7 and the VFQ-25. The results showed that the mean of PHQ-9 was significantly higher while the mean of the VFQ-25 and its´ subscales were consistently lower in the disease group compared to HC. The mean of GAD-7 was not significantly lower in the disease group compared to HC. Stratification for different disease severity stages and duration of disease did not reveal any differences in sum scores of PHQ-9, GAD-7, and VFQ-25, whereas there were significant differences in some subscales of the VFQ-25. We conclude that BSRC and SC patients show higher levels of depression and a reduced visual quality of life due to imminent loss of vision. Because depression and quality of life are adversely affected by lack of social contacts and functioning, psychological treatment should enable patients to maintain their independence and ability to social interaction. Psychosomatic care should be taken in account for the treatment of BSRC and SC.

Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis.

BACKGROUND: To describe changes in the retina/choroid in patients with Serpiginous Choroiditis (SC) by Optical Coherence Tomography Angiography (OCTA) in a multimodal imaging approach. METHODS: Prospective, monocentric study of 24 eyes of 12 consenting patients diagnosed with SC, who underwent OCTA, which was analyzed and compared to other methods such as enhanced depth imaging-OCT, fluorescein angiography, indocyanine green angiography, and fundus autofluorescence. RESULTS: The study group consisted of 9 patients with peripapillary SC, 1 macular SC, and 2 atypical cases. All eyes presented an inactive SC confirmed by standard imaging. OCTA demonstrated the lesions tridimensionally in great detail. There was no difference in the angioarchitecture among the 3 forms of SC. A loss of the choriocapillaris/retinal pigment epithelium left a "window-defect", where the vessels of larger caliber of the choroid became recognizable and their appearance inverted ("white-on-black"). A relationship between the presence of segmentation errors (SE) in the slabs and low visual acuity was established with a one-way ANOVA. CONCLUSIONS: OCTA was able to non-invasively assess vascular lesions of the choroid/retina in patients with SC with a high degree of correlation to other diagnostic modalities. Consequent long-term assessments could lead to a better understanding of disease progression.

TRPA1 mediates the antinociceptive properties of the constituent of Crocus sativus L., safranal.

Safranal, contained in Crocus sativus L., exerts anti-inflammatory and analgesic effects. However, the underlying mechanisms for such effects are poorly understood. We explored whether safranal targets the transient receptor potential ankyrin 1 (TRPA1) channel, which in nociceptors mediates pain signals. Safranal by binding to specific cysteine/lysine residues, stimulates TRPA1, but not the TRP vanilloid 1 and 4 channels (TRPV1 and TRPV4), evoking calcium responses and currents in human cells and rat and mouse dorsal root ganglion (DRG) neurons. Genetic deletion or pharmacological blockade of TRPA1 attenuated safranal-evoked release of calcitonin gene-related peptide (CGRP) from rat and mouse dorsal spinal cord, and acute nociception in mice. Safranal contracted rat urinary bladder isolated strips in a TRPA1-dependent manner, behaving as a partial agonist. After exposure to safranal the ability of allyl isothiocyanate (TRPA1 agonist), but not that of capsaicin (TRPV1 agonist) or GSK1016790A (TRPV4 agonist), to evoke currents in DRG neurons, contraction of urinary bladder strips and CGRP release from spinal cord slices in rats, and acute nociception in mice underwent desensitization. As previously shown for other herbal extracts, including petasites or parthenolide, safranal might exert analgesic properties by partial agonism and selective desensitization of the TRPA1 channel.

Multimodal Imaging in Birdshot Retinochoroiditis.

PURPOSE: To describe retinal vascular changes in Birdshot Retinochoroiditis (BSRC) with multimodal imaging techniques and functional values. METHODS: In this single-center study, 64 eyes of 32 subjects with BSRC were classified according to disease activity and duration and underwent imaging with spectral domain optical coherence tomography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography angiography (OCTA). RESULTS: Mean age of the patients was 60 years (range, 38-74). OCTA revealed capillary loops (58%), telangiectatic vessels (44%), increased intercapillary spaces (52%), altered vascular architecture (53%), and rarefication of C-scans (63%) in retinal layers. Increased rarefications of C-scans (p = 0.0056; p = 0.0046) and altered vascular architecture (p = 0.0120; p = 0.0243) in superficial and deep capillary layers were significantly correlated with disease activity. CONCLUSION: OCTA adds new insights in a multimodal imaging approach of retinal vascular layer visualization in BSRC and may contribute to existing methods for diagnosing severity and potentially progression of the disease.

Early bony changes associated with bisphosphonate-related osteonecrosis of the jaws in rats: A longitudinal in vivo study.

OBJECTIVE: To evaluate early bony changes in an animal model of Medication-Related Osteonecrosis of the Jaw (MRONJ) at the side of the local trauma and at the contralateral side, comparing with a control group. Bony changes were evaluated by Microcomputed Tomography (MicroCT) at three times points: at baseline (T0), after drug administration (T1) and after dental extraction (T2). DESIGN: Two groups were compared: the experimental group in which zoledronic acid (ZA) was administered (17 rats) and the control group (13 rats). Dental extractions of the lower left first molars were performed in all animals. The left side was considered as the supposed affected area in the ZA group, and the right side was considered as the unaffected area. In these areas, the following structural microtomographic bone parameters were calculated: Bone Mineral Density (BMD), Trabecular Thickness (Tb.Th), and Bone Volume Proportion (BV/TV). The comparison of quantitative bone parameters among the different sides and experimental phases of both studied groups were performed by ANOVA-factorial. RESULTS: None of the animals of the control group developed MRONJ. In the ZA group, 76% presented bone exposure. From T0 to T1, Tb.Th and BV/TV increased, and in T2, the mean values were higher in ZA group than in the control group. BMD increased throughout the different phases of both groups. CONCLUSIONS: Structural bony changes occurred in the ZA group at both mandibular sides before the dental extraction (T1). Tb.Th and BV/TV should be further investigated as potential early bone markers of MRONJ.

Study of the kinematic variables of unilateral and habitual mastication of healthy individuals. / Estudo das variáveis cinemáticas da mastigação unilateral e habitual de indivíduos saudáveis.

PURPOSE: To describe and compare the temporal-spatial kinematic variables of mandibular movement during deliberate unilateral and habitual mastication in healthy young-adult individuals. METHODS: The study sample was composed of eight male healthy volunteers aged 19 to 24 years. The kinematic data were obtained using a motion analysis system - Qualisys Track Manager (QTM) ProReflex MCU. Recordings were performed during deliberate unilateral mastication (UM) and habitual mastication (HM) of firm-consistency gummy candy. The following variables were analyzed: (1) masticatory sequence: duration, number of masticatory cycles, and chewing rate; (2) masticatory cycle: duration, vertical and medial-lateral mandibular range of motion in relation to the skull, and maximum velocity during the opening and closing phases. Data of the variables were compared during UM and HM by the paired t test, and the effect sizes ('d' Cohen) were calculated. RESULTS: Regarding the variables of the masticatory sequence, smaller chewing rate was observed for UM compared with that for HM (1.19±0.21Hz and 1.29±0.16Hz, respectively, p=0.004, d=0.53). Smaller values of maximum velocity during the opening (MU=67.4 mm/s and MH=80.02, p=0.053, d=0.80) and closing (MU=71.77±9.35mm/s and MH=3.51±7mm/s, p=0.014, d=0.79) phases of the masticatory cycle were observed in deliberate unilateral mastication compared with those in habitual mastication. CONCLUSION: Kinematic variables associated with the sequence and cycle of mastication are influenced by the chewing pattern adopted - deliberate unilateral or habitual.

In vitro evaluation of wound healing and antimicrobial potential of ozone therapy.

Although ozone therapy is extensively applied when wound repair and antimicrobial effect are necessary, little is known about cellular mechanisms regarding this process. Thus, this study aimed to evaluate ozone cytotoxicity in fibroblasts (L929) and keratinocytes (HaCaT) cell lines, its effects on cell migration and its antimicrobial activity. Cells were treated with ozonated phosphate-buffered saline (8, 4, 2, 1, 0.5 and 0.25 µg/mL ozone), chlorhexidine 0.2% or buffered-solution, and cell viability was determined through MTT assay. The effect of ozone on cell migration was evaluated through scratch wound healing and transwell migration assays. The minimum inhibitory concentrations for Candida albicans and Staphylococcus aureus were determined. Ozone showed no cytotoxicity for the cell lines, while chlorhexidine markedly reduced cell viability. Although no significant difference between control and ozone-treated cells was observed in the scratch assay, a considerable increase in fibroblasts migration was noticed on cells treated with 8 µg/mL ozonated solution. Ozone alone did not inhibit growth of microorganisms; however, its association with chlorhexidine resulted in antimicrobial activity. This study confirms the wound healing and antimicrobial potential of ozone therapy and presents the need for studies to elucidate the molecular mechanisms through which it exerts such biological effects.

Estudo das variáveis cinemáticas da mastigação unilateral e habitual de indivíduos saudáveis / Study of the kinematic variables of unilateral and habitual mastication of healthy individuals

RESUMO Objetivo Descrever e comparar as variáveis cinemáticas temporoespaciais do movimento mandibular durante a mastigação unilateral deliberada e habitual de indivíduos saudáveis. Método Participaram do estudo 8 voluntários saudáveis, do gênero masculino, com faixa etária entre 19 e 24 anos. Os dados cinemáticos foram obtidos através do sistema de análise de movimento Qualysis (QTM - Qualisys Track Manager). Foram realizados registros de mastigação unilateral direita (MU) e habitual (MH) de bala de goma de gelatina de consistência firme. Foram analisadas variáveis relacionadas à (1) sequência mastigatória (duração, número de ciclos e frequência mastigatória); (2) ciclo mastigatório: duração do ciclo mastigatório, amplitude de movimento mandibular vertical e médio-lateral durante o ciclo mastigatório, velocidade máxima durante as fases de abertura e fechamento. A comparação das variáveis durante a MU e MH foi realizada por meio do teste t pareado (p<0,05) e os tamanhos de efeito (‘d’ de Cohen) foram calculados. Resultados Em relação à sequência mastigatória, observou-se menor frequência mastigatória durante MU comparada à MH (1,19±0,21 e 1,29±0,16Hz, respectivamente, p=0,004, d=0,53) e menores velocidades máximas de abertura (MU=67,4 mm/s e MH=80,02; p=0,053; d=0,80) e fechamento (MU=71,77±9,35mm/s e MH=83,51±17 mm/s, p=0,014, d=0,79) do ciclo mastigatório. Conclusão As variáveis cinemáticas relacionadas à sequência e ao ciclo mastigatório foram influenciadas pelo padrão mastigatório adotado – unilateral ou habitual.

ABSTRACT Purpose To describe and compare the temporal-spatial kinematic variables of mandibular movement during deliberate unilateral and habitual mastication in healthy young-adult individuals. Methods The study sample was composed of eight male healthy volunteers aged 19 to 24 years. The kinematic data were obtained using a motion analysis system - Qualisys Track Manager (QTM) ProReflex MCU. Recordings were performed during deliberate unilateral mastication (UM) and habitual mastication (HM) of firm-consistency gummy candy. The following variables were analyzed: (1) masticatory sequence: duration, number of masticatory cycles, and chewing rate; (2) masticatory cycle: duration, vertical and medial-lateral mandibular range of motion in relation to the skull, and maximum velocity during the opening and closing phases. Data of the variables were compared during UM and HM by the paired t test, and the effect sizes ('d' Cohen) were calculated. Results Regarding the variables of the masticatory sequence, smaller chewing rate was observed for UM compared with that for HM (1.19±0.21Hz and 1.29±0.16Hz, respectively, p=0.004, d=0.53). Smaller values of maximum velocity during the opening (MU=67.4 mm/s and MH=80.02, p=0.053, d=0.80) and closing (MU=71.77±9.35mm/s and MH=3.51±7mm/s, p=0.014, d=0.79) phases of the masticatory cycle were observed in deliberate unilateral mastication compared with those in habitual mastication. Conclusion Kinematic variables associated with the sequence and cycle of mastication are influenced by the chewing pattern adopted - deliberate unilateral or habitual.

Propuesta de un modelo experimental in vitro para evaluar alteraciones morfológicas de eritrocitos expuestos a NaOCl 5.25% / Proposal for experimental in vitro model to assess morphological alterations in erythrocytes exposed to 5.25% NaOCl

Introducción: El hipoclorito de sodio (NaOCl) es el agente químico más utilizado como solución irrigadora durante la terapia endodóntica. Es altamente tóxico cuando se extruye a tejido periapicales. En endodoncia la hemolisis causada por el NaOCl ha quedado demostrada utilizando diferentes modelos, sin embargo poca o ninguna evidencia se tiene de las alteraciones morfológicas en la membrana celular de los eritrocitos. Objetivo: Proponer un modelo experimental que permita evaluar las alteraciones morfológicas que sufren los eritrocitos cuando son expuestos a NaOCl utilizado en la práctica odontológica mediante microscopia electrónica de barrido de alta resolución (MEB). Material y métodos: Se obtuvieron 20 mL de sangre periférica y se depositaron en tubos con anticoagulante EDTA (ácido etilendiaminotetraacético). Se realizaron lavados con solución amortiguadora de fosfatos (solución Evan's). Se prepararon diferentes diluciones de la muestra de eritrocitos (1:1, 1:2, 1:4, 1:8 y 1:16). Se obtuvieron 100 μL de cada una de estas diluciones y se confrontaron con 100 μL de NaOCl 5.25% de uso odontológico (Viarzoni-T, Medental®). Se tomaron 0.5 μL de estas muestras para depositarse en un portamuestra de aleación Zn-Cu, el cual se sometió a un proceso de metalización de baño de iones de Cu por el método antiguo llamado Sputtering. Obteniendo microfotografías por MEB. Resultados: Se lograron observar eritrocitos con alteración de tipo anisocitosis y poiquilocitosis (estomatocitos, eliptocitos, esferocitos y discocitos). También se observaron algunas características estructurales de cristales de NaOCl. Conclusión: Este modelo experimental permitió evaluar los cambios morfológicos que sufren los eritrocitos cuando son expuestos a NaOCl 5.25%.

Introduction: Sodium hypochlorite (NaOCl) is the chemical agent most frequently used as irrigation solution during endodontic therapy. When extruded to periapical tissue, it is highly toxic. In endodontics, hemolysis caused by NaCOl has been proven using different models, nevertheless, there is little or no evidence of morphological alterations in the cellular membrane of erythrocytes. Objective: To propose an experimental model which might allow to assess morphological alterations suffered by erythrocytes when they are exposed to NaOCl used in the dental practice by means of high resolution scanning electron microscopy (SEM). Materials and methods: In the present study, 20 mL of peripheral blood were obtained and deposited in tubes with EDTA (ethylenediaminetetraacetic acid) anticoagulant. Rinses were conducted with a phosphate buffer solution (Evan's solution). Several dilutions of the erythrocyte sample were prepared (1:1, 1:2, 1:4, 1:8 and 1:16); 100 μL of each of these dilutions was obtained to be then confronted with 100 μL of dental use 5.25% NaOCl (Viarzoni-T, Medental®); 0.5 μL of these samples were taken to then be deposited in a sample holder made of Zn-Cu alloy which was subjected to a process of Cu ion metallization bath, following the old Spluttering method. Microphotographs were obtained with SEM. Results: Erythrocytes with alteration type anisocytosis and poikilocytosis (stomatocytes, elliptocytes and discocytes) were observed. Some structural characteristics of NaOCl crystals were equally observed. Conclusion: This experimental model allowed assessment of morphological changes experienced by erythrocytes when exposed to 5.25% NaOCl.

Experimentally induced masseter-pain changes masseter but not sternocleidomastoid muscle-related activity during mastication.

The aim of this study was to verify the effects of induced masseter-muscle pain on the amplitude of muscle activation, symmetry and coactivation of jaw- and neck-muscles during mastication. Twenty-eight male volunteers, mean age±SD 20.6±2.0years, participated in this study. Surface electromyography of the masseter and sternocleidomastoid (SCM) muscles was performed bilaterally during mastication of a gummy candy before and after injections of monosodium glutamate solution and isotonic saline solution. As a result, we observed a decrease in the amplitude of activation of the masseter muscle on the working side (p=0.009; d=0.34) and a reduction in the asymmetry between the working and the balancing side during mastication (p=0.007; d=0.38). No changes were observed either on the craniocervical electromyographic variables. In conclusion, experimentally induced pain reduced the masseter muscle activation on the working side, thereby reducing the physiological masseters' recruitment asymmetry between the two sides during mastication. No effects on SCM activity were detected. These results may partly explain the initial maladaptative changes underlying TMD conditions.

In situ carcinoma developed over oral lichen planus: a case report with analysis of BUB3, p16, p53, Ki67 and SOX4 expression.

Oral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.

In situ carcinoma developed over oral lichen planus: a case report with analysis of BUB3, p16, p53, Ki67 and SOX4 expression

AbstractOral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.

Frey's syndrome: diagnosis in geriatric dentistry.

Frey's syndrome, is characterized by warmth, flushing and sweating of the face, most of time in the preauricular region, initiated by any gustatory stimulus. It is frequently related to parotid surgery. A case of Frey's syndrome in a 81-year-old female whose long-delayed clinical onset post-parotidectomy is presented.

Dental autotransplant: case report

Introduction : The autogenous transplantation or dental autotransplantation is defined as the replacement of an absent or impaired tooth by another transplanted one, usually the third molar. The tooth is transplanted to a prepared or existing tooth socket occupied by the lost tooth, in a same person. This technique is considered a viable method due to its high success rate when properly indicated combined with a relatively low cost.Objective and case report:To report a clinical case study conducted in the Integrated Clinics of the Catholic University of Brasilia in a young melanoderm male patient, 13 years-old, who underwent late tooth transplantation technique, i.e., in two steps: the right upper third molar was transplanted to the socket of the right lower first molar. The case described showed incomplete root formation and radiographic following-up for eight consecutive months. Conclusion:This type of oral rehabilitation contributed to bone formation stimulation at the transplanted site, the maintenance of the masticatory function and the financial costs reduction for the patient, representing a further possible therapy in the dentist's armamentarium.

Paciente com angina e anomalia tipo óstio único de artéria coronária com origem no seio de valsalva direito / Patiente with angina and single coronary artery ostium originating from the right sinus of valsalva

A anomalia cardíaca tipo óstio único de artéria coronária é uma entidade congênita rara, de causa desconhecida. Clinicamente apresenta-se desde a forma assintomática até casos de morte súbita, podendo associar-se a doença arterial coronária aterosclerótica. Apresentamos o caso de uma paciente de 68 anos de idade, com quadro de angina estável desde 2007, que, após três anos de seguimento, em decorrência de piora da angina, foi submetida a cinecoronariografia eletiva. A cateterização seletiva da coronária direita demonstrou anomalia tipo óstio único de artéria coronária, lesão significativa na artéria circunflexa e artéria descendente anterior ocluída no terço médio. A angiotomografia das coronárias demonstrou trajeto benigno da coronária anômala e a paciente evoluiu favoravelmente com o tratamento clínico.

Patient with Angina and Single Coronary Artery Ostium Originating from the Right Sinus of Valsalva Single coronary artery ostium is a rare congenital disease of unknown origin. Clinical manifestations range from asymptomatic disease to sudden death and it may be associated to atherosclerotic coronary artery disease. We report the case of a 68-year-old woman with stable angina since 2007, who was submitted to elective coronary angiography due to worsening of angina after three years of follow-up. Selective right coronary artery catheterization indicated the presence of single coronary artery ostium, significant lesion of the left circumflex artery, and mid left anterior descending artery occlusion. CT coronary angiography showed a benign course of the anomalous coronary artery and the patient had a favorable outcome with medical treatment.