Beyond the mouth: Uncovering non-secretory multiple myeloma through oral symptoms.

Non-secretory multiple myeloma (NSMM) is a rare cancer of plasma cells characterized by the absence of detectable monoclonal M protein in the blood or urine. A 57-year-old woman presented with mandibular pain but without intraoral swelling. Imaging studies revealed multiple osteolytic lesions in her mandible and pronounced root resorption of the left mandibular second molar. Biopsy results showed atypical plasmacytoid cells positive for anti-kappa, CD138, MUM1, and CD79a antibodies, but negative for anti-lambda and CD20. These results were indicative of a malignant plasma cell neoplasm. No abnormalities were revealed by free light chain assay or by serum or urine protein electrophoresis, leading to a diagnosis of NSMM. The patient began chemotherapy in conjunction with bisphosphonate therapy and achieved remission following treatment. This case underscores the critical role of dentists in the early detection and prevention of NSMM complications, as the disease can initially present in the oral cavity.

Influence of design implant and apical depth in post-extraction sockets: an in vitro simulated study.

BACKGROUND: Implant design and apical stability are principal parameters involved in achieving successful primary stability. Using polyurethane models to simulate post-extraction sockets, we investigated the effects of using differing blade designs on the primary stability of tapered implants and the impact of apical depth. METHOD: Six polyurethane blocks were used to simulate post-extraction pockets. One of the implants presented self-tapping blades (Group A), while the other (Group B) did not. Seventy-two implants were placed at 3 different depths (5 mm, 7 mm, and 9 mm), and a torque wrench was used to measure the stability of the implants. RESULTS: When evaluating the implants (placed at 5 mm, 7 mm, and 9 mm apical to the socket), we observed that the torque of the Group B implants was higher than that of Group A implants (P < 0.01). At the 9-mm depth, there was no difference between the groups (Drive GM 34.92 Ncm and Helix GM 32.33 Ncm) (P > 0.001), and considering the same implant groups, those placed at 7-mm and 9-mm depths presented higher torques (p < 0.01) than those placed at 5-mm (p > 0.01). CONCLUSION: Considering both groups, we concluded that an insertion depth of greater than 7 mm is needed for initial stability, and in situations involving reduced supportive bone tissue or low bone density, a non-self-tapping thread design improves implant stability.

Avaliação de usuários sobre atributos da atenção primária à saúde bucal na Estratégia Saúde da Família / User evaluation on the attributes of primary care for oral health in the Family Health Strategy

Avaliação em saúde é uma importante ferramenta no processo de transformação e melhoria de um serviço de saúde. O PCATool (Instrumento de Avaliação da Atenção Primária) é um dos principais instrumentos usados para avaliar o primeiro nível de atenção à saúde. O objetivo do trabalho foi avaliar a Atenção Primária à Saúde Bucal em um Centro de Saúde da Família na perspectiva de usuários adultos. Trata-se de uma pesquisa transversal realizada em 2016 no Centro de Saúde da Família Francisco Moura Vieira em Sobral, Ceará. Para coleta dos dados foi usado o Instrumento de Avaliação da Atenção Primária - Saúde Bucal (PCATool-SB), versão usuário. Participaram do estudo 172 usuários. As análises dos resultados mostraram uma alta orientação à Atenção Primária à Saúde nos atributos de Primeiro Contato (Utilização) e Coordenação (Sistema de Informações), enquanto os demais atributos essenciais e derivados indicaram baixa orientação. Não houve associação entre os escores e as variáveis sociodemográficas. Conclui-se que há necessidade de restruturação da atenção prestada na unidade, principalmente na adequação da relação número de profissionais e demanda, a fim de melhorar o serviço de saúde ofertado aos usuários.

Health assessment is an important tool in the process of transformation and improvement of a health service. The PCATool (Primary Care Assessment Tool) is one of the main tools used to evaluate the first level of health care. The aim of the present paper is to evaluate the Primary Oral Health Care in a Family Health Center from the perspective of adult users. This is a cross-sectional study carried out in 2016 at the Francisco Moura Vieira Family Health Center in Sobral, Ceará. To collect the data, the Primary Care Assessment Tool - Oral Health (PCATool-SB), user version, was used. 172 users participated in the study. The analysis of the results showed a high orientation to Primary Health Care in the attributes of First Contact (Use) and Coordination (Information System), while the other essential and derivatives attributes indicated low orientation. There was no association between scores and sociodemographic variables. It is concluded that there is a need to restructure the care provided at the unit, mainly in the adequacy of the relationship between the number of professionals and demand, in order to improve the health service offered to users.