Effect of preemptive photobiomodulation associated with nimesulide on the postsurgical outcomes, oxidative stress, and quality of life after third molar surgery: a randomized, split-mouth, controlled clinical trial.

OBJECTIVE: The aim of this study is to compare the effect of photobiomodulation with low-level laser therapy (LLLT) and nimesulide on inflammatory parameters, biomarkers of oxidative stress and inflammation, and quality of life after lower third molar (L3M) surgery. MATERIAL AND METHODS: A randomized, two-factor, triple-blind, controlled, split-mouth clinical trial was performed with 40 volunteers who required bilateral L3M removal. Patients were allocated depending on the use or not of 100 mg nimesulide 1 hbefore surgery, as well as the use or not of LLLT in the preoperative period. RESULTS: Pain peaks occurred after 6 h (nimesulide-placebo [N-P] group) and 8 h (nimesulide group). In the N-P group, LLLT resulted in significantly lower mean pain scores than the subgroup without LLLT after 4 h (p = 0.009) and 6 h (p = 0.048). As for edema, a shorter distance between the mandibular angle and the outer canthus of the eyes after 7 days (p = 0.037) and a smaller cumulative effect (p = 0.036) were observed in the N-P group associated with LLLT. A direct effect between LLLT (p = 0.047) and a reduction in the mean scores of overall dissatisfaction with quality of life was detected. CONCLUSIONS: Preemptive use of nimesulide only delayed peak pain. LLLT reduced edema, trismus, and contributed to a better perception of quality of life. Nimesulide inhibits peroxidation by increasing GSH and stopping neutrophil migration. The benefit of the association of both strategies was not superior to the use of LLLT alone. CLINICAL RELEVANCE: Translational study with impact on clinical-surgical protocols involving L3M surgery related to pharmacological and non-pharmacological methods.

Reconstruction of Frontal Bone With Custom-Made Prosthesis Using Rapid Prototyping.

Frontal bone fracture treatment is still an issue of research in craniofacial surgery and neurosurgery. The aims of the treatment are to reduce the complication risks and to keep the aesthetic of the face. Before the management of this fracture type, it is necessary to consider the permanence or not of the frontal sinus function. Rapid prototyping has been an aid tool on planning and simulation of the surgical procedure, improving the diagnostic quality and the implant manufacture, beyond reducing the operative time. Among the used materials on treatment of these fractures, titanium mesh shows large versatility and ease of handling. Poly(methyl methacrylate) has been used in defects of partial thickness or irregularities on cranial surface. The aim of this study is to report a case of a patient presenting sequelae of large fracture of anterior wall of frontal bone, treated by a titanium mesh associated with the customized poly(methyl methacrylate) implant from the rapid prototyping. It could be concluded that the use of this technique showed itself effective on patient treatment, and rapid prototyping demonstrated being a valuable tool showing predictable and satisfactory results.

Radiomorphometric indices for sex estimation in edentulous individuals: A receiver operating characteristic curve and discriminant function analysis-based study.

This study aimed to evaluate sexual dimorphism in Brazilian edentulous individuals using a formula based on mandible-related linear radiomorphometric measurements. A cross-sectional observational study was conducted with 390 panoramic radiographs (PRs) distributed into three age groups (51-60, 61-70, and 71-80 years). PRs were used to obtain linear measurements of the mandible and derived indices (superior and inferior panoramic mandibular indices [s-PMI and i-PMI, respectively], alveolar bone resorption [ABR] index), and the mandibular cortical index (MCI). Sex-related differences (and sex classifications) increased in the oldest cohort. Both s-PMI and i-PMI were shown to be significant in predicting sex in the age group from 71 to 80 years (p = 0.001 and p = 0.003, respectively) and, when considering the mean of the sides, only the s-PMI was significant (p = 0.037). The ABR index was significantly associated with sex (p = 0.004) and not influenced by MCI, and was used to construct a formula for sex estimation, which demonstrated 69.0% accuracy in the age group of 71-80 years. Sexual dimorphism was evidenced by the formula based on the s-PMI, i-PMI, and ABR indices.

Sensitive nerve function measurement in facial trauma: An observational study.

BACKGROUND: Facial trauma is responsible for various types of health damage and may be functional or aesthetic. Depending on the degree of energy released in this type of trauma, sometimes an irreversibility degree is obtained. This study aimed to perform an objective evaluation of traumatic peripheral nerve injuries resulting from mandibular fractures and midface, using silicon monofilaments. MATERIAL AND METHODS: This was an observational, cross-sectional study. All patients with maxillofacial fractures, who were hospitalized by the department of Oral and Maxillofacial Surgery of Instituto Dr. José Frota Hospital, were randomly recruited and screened for inclusion in the present study. Sixty patients, victims of automobile accidents or firearms, were evaluated using Semmes Weinstein monofilaments in the regions corresponding to the mental and infraorbital nerves, right and left. RESULTS: The highest frequencies mandibular nerve changes were those that there was a loss protective sensation, but in which, the patient can feel deep pressure and pain; In which the worst sensory alterations occurred in patients' victims of firearm. In the middle third of the face, the worst alterations were those that there was a loss of the protective and discriminating sensation for hot and cold. CONCLUSIONS: The use of monofilaments is a support tool in oral and maxillofacial traumatology for the diagnosis and monitoring of peripheral sensory alterations. Key words:Peripheral nerve injuries, facial trauma, wounds and injuries, accidents, traffic, violence.

Development and validation of a new formula for sex estimation based on multislice computed tomographic measurements of maxillary and frontal sinuses among Brazilian adults.

OBJECTIVES: To evaluate the accuracy of the measurements of the maxillary sinus (MS) and frontal sinus (FS) in sex estimation among Brazilian adults using multislice computed tomography (MCT) and to develop and cross-validate a new formula for sex estimation. METHODS: The present cross-sectional research was conducted in two phases: (1) development of a formula on the basis of the measurements of both the sinuses (50 males and 50 females); and (2) validation study (20 males and 20 females). The linear measurements (height, width and diameter) were assessed using the RadiAnt DICOM software. A new formula for sex estimation was developed (multivariate statistical approach) and validated. Receiver operating characteristic curves, area under the curve, sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratio were estimated. RESULTS: Males displayed higher mean values (width, height and diameter) of the FS and MS (p < 0.05). The MS was a better predictor in sex estimation (males vs females), compared to the FS (accuracy between 61-74% and 58-69%, respectively). The distance between the right and left MS displayed the highest accuracy (74%). The sensitivity, specificity and accuracy of the new formula were 80%, 95.5% and 87.5%, respectively. 63.1% reduction was observed in the number of predictive values for sex estimation (individuals older than 30 years). CONCLUSIONS: The present MCT measurements showed a higher accuracy in the estimation of sex in males. The highest accuracy was associated with the distance between the right and left MS. The new formula displayed high precision for sex estimation.

Influence of Educational Level, Stage, and Histological Type on Survival of Oral Cancer in a Brazilian Population: A Retrospective Study of 10 Years Observation.

The mortality rate associated with oral cancer is estimated at approximately 12,300 deaths per year, and the survival rate is only 40% to 50% for diagnosed patients and is closely related to the duration of time between disease perception and its diagnosis and treatment. Socioeconomic risk factors are determinants of the incidence and mortality related to oral cancer. We conducted a retrospective, cross-sectional study of 573 records of patients with oral cancer at Haroldo Juaçaba Hospital - Cancer Institute of Ceará from 2000 to 2009 to evaluate the influence of socioeconomic factors on survival and epidemiological behavior of this neoplasia in a Brazilian population. In this study, patients with oral cancer were males greater than 60 years of age, presented squamous cell carcinoma in the floor of mouth and were characterized by low education levels. A total of 573 lesions were found in oral cavities. Cox proportional hazards regression model showed that the histological type, tumor stage, and low degree of education significantly influenced survival. A lower patient survival rate was correlated with a more advanced stage of disease and a worse prognosis. Squamous cell carcinoma is associated with a higher mortality when compared with other histological types of malign neoplasia.

Prevalence of Oral and Maxillofacial Trauma in Elders Admitted to a Reference Hospital in Northeastern Brazil.

OBJECTIVE: To know the prevalence and etiology of oral and maxillofacial trauma in elders. METHODS: Analytical quantitative cross-sectional study conducted at a public trauma hospital located in Fortaleza-Ceará, Brazil. The study population comprised patients with trauma who were hospitalized from April to August 2014. Of these patients, patients with oral and maxillofacial trauma were chosen to be included in the research. A questionnaire was administered in order to obtain information on socio-demographics, systemic comorbidities, use of medication, deleterious habits (smoking and alcohol consumption), etiology of oral and maxillofacial trauma and type of pre-hospital care. RESULTS: Of the 280 elderly hospitalized with trauma, 47 had oral and maxillofacial trauma, with a prevalence of 16.8%. In this group, the age ranged from 60 to 88 years, with a mean age of 72.4 years (SD± 8.38). The elderly were mostly women (55.3%), self-declared pardos (53.2%), who presented with cardiovascular disorders (48.9%), and who received formal pre-hospital care (70.2%). Elderly who were in the 60-69 years age group, spent 6-9 years at school and drank alcohol were 2.64, 3.75, and 1.97, respectively, more likely to suffer oral and maxillofacial trauma. The main causes of trauma were physical aggression, traffic accidents, falls and domestic accidents. All of the physical aggressions resulted in oral and maxillofacial traumas, and the elderly who suffered traffic accidents were four times more likely to have oral and maxillofacial trauma. CONCLUSION: The prevalence of 16.8% and the lack of research on oral and maxillofacial traumas in the elderly is worrisome and should be included in the oral health indicators for the elderly population to support the importance of oral health.

Antimicrobial activity of the synthetic peptide Lys-a1 against oral streptococci.

The peptide LYS-[TRP(6)]-Hy-A1 (Lys-a1) is a synthetic derivative of the peptide Hy-A1, initially isolated from the frog species Hypsiboas albopunctatus. According to previous research, it is a molecule with broad antimicrobial activity. The objective of this study was to evaluate the antimicrobial activity of the synthetic peptide Lys-a1 (KIFGAIWPLALGALKNLIK-NH2) on the planktonic and biofilm growth of oral bacteria. The methods used to evaluate antimicrobial activity include the following: determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) in microtiter plates for growth in suspension and quantification of biomass by crystal violet staining and counting of colony forming units for biofilm growth. The microorganisms Streptococcus oralis, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus salivarius, Streptococcus mutans and Streptococcus sobrinus were grown in Brain Heart Infusion broth at 37°C under atmospheric pressure with 10% CO2. The peptide was solubilized in 0.1% acetic acid (v/v) at various concentrations (500-1.9 µg mL(-1)). Chlorhexidine gluconate 0.12% was used as the positive control, and BHI culture medium was used as the negative control. The tested peptide demonstrated a remarkable antimicrobial effect, inhibiting the planktonic and biofilm growth of all strains tested, even at low concentrations. Thus, the peptide Lys-a1 is an important source for potential antimicrobial agents, especially for the control and prevention of microbial biofilms, which is one of the most important factors in cariogenic processes.

Antimicrobial peptide control of pathogenic microorganisms of the oral cavity: a review of the literature.

Antimicrobial peptides, molecules produced in many different organisms, have high biocidal activity against several microorganisms. However, several questions about these molecules remain unclear. Therefore, this report details a systematic survey of the literature on the use of antimicrobial peptides against oral pathogens and indicates which peptides and microorganisms are most extensively studied. Articles were located using the PubMed and Science Direct databases with the following inclusion criteria: publication date between 2002 and 2011; keywords "biofilm OR biological film OR biological layer OR bacterial growth" AND "peptide" AND "oral cavity OR mouth OR buccal mucosa OR oral mucosa OR mouth mucosa"; and abstract in English. A total of 73 articles were selected after refinement of the data. An increase in publications focusing on the use of antimicrobial peptides against oral microorganisms was observed. In addition, the peptides produced by cells of the oral mucosa (defensins, LL-37 and histatins) as well as Streptococcus mutans (among cariogenic bacteria) and Porphyromonas gingivalis (among periodontal bacteria) were the most studied subjects. It was concluded that the use of antimicrobial peptides as a tool for microbial control is of increasing importance, likely due to its widespread use, mechanism of action, and low rates of bacterial resistance.