Clinical and x-ray oral evaluation in patients with congenital Zika Virus.

OBJECTIVE: The aim of this study was to investigate possible malformations in the soft, bone and/or dental tissues in patients with congenital Zika Virus (ZIKV) by clinical and x-ray evaluation. METHODOLOGY: Thirty children born with ZIKV and 30 children born without ZIKV (control group) were included in the study. Patients were evaluated over 24 consecutive months according to the variables: sex, age, cleft palates, soft tissue lesions, alveolar ridge hyperplasia, short labial and lingual frenums, inadequate posture of the lingual and perioral muscles at rest, micrognathia, narrow palatine vaults, changes in the teeth shape and/or number, sequence eruption, spasms, seizures and eruption delay were evaluated. Chi-square test, Student's t-test and nominal logistic regression were used (p<0.05). RESULTS: Among the 30 babies examined, the mean age of the first dental eruption was 10.8±3.8 with almost two-thirds of the children (n=18, 60%) experiencing eruptions of their first tooth after 9 months of age, nine children (30%) had inadequate lingual posture at rest, more than half of the children (n=18, 60%) had short labial or lingual frenums. ZIKV babies showed a high prevalence of clef palate (p<0.001), inadequate lingual posture at rest (p=0.004), micrognathia (p=0.002), changes in the shape and/or number of teeth (p=0.006), alteration in sequence of dental eruption (p<0.001) and muscles spasms (p=0.002). The delay eruption was associated with inadequate lingual posture at rest (p=0.047), micrognathia (p=0.002) and changes in the shape and/or number of teeth (p=0.021). The delayed eruption (p=0.006) and narrow palatine vaults (p=0.008) were independently associated with ZIKV. Moreover, female patients showed the most narrow palatine vaults (p=0.010). CONCLUSIONS: The children with ZIKV showed a greater tendency to have delayed eruption of the first deciduous tooth, inadequate lingual posture and short labial and lingual frenums.

Clinical and x-ray oral evaluation in patients with congenital Zika Virus

Abstract Objective: The aim of this study was to investigate possible malformations in the soft, bone and/or dental tissues in patients with congenital Zika Virus (ZIKV) by clinical and x-ray evaluation. Methodology: Thirty children born with ZIKV and 30 children born without ZIKV (control group) were included in the study. Patients were evaluated over 24 consecutive months according to the variables: sex, age, cleft palates, soft tissue lesions, alveolar ridge hyperplasia, short labial and lingual frenums, inadequate posture of the lingual and perioral muscles at rest, micrognathia, narrow palatine vaults, changes in the teeth shape and/or number, sequence eruption, spasms, seizures and eruption delay were evaluated. Chi-square test, Student's t-test and nominal logistic regression were used (p<0.05). Results: Among the 30 babies examined, the mean age of the first dental eruption was 10.8±3.8 with almost two-thirds of the children (n=18, 60%) experiencing eruptions of their first tooth after 9 months of age, nine children (30%) had inadequate lingual posture at rest, more than half of the children (n=18, 60%) had short labial or lingual frenums. ZIKV babies showed a high prevalence of clef palate (p<0.001), inadequate lingual posture at rest (p=0.004), micrognathia (p=0.002), changes in the shape and/or number of teeth (p=0.006), alteration in sequence of dental eruption (p<0.001) and muscles spasms (p=0.002). The delay eruption was associated with inadequate lingual posture at rest (p=0.047), micrognathia (p=0.002) and changes in the shape and/or number of teeth (p=0.021). The delayed eruption (p=0.006) and narrow palatine vaults (p=0.008) were independently associated with ZIKV. Moreover, female patients showed the most narrow palatine vaults (p=0.010). Conclusions: The children with ZIKV showed a greater tendency to have delayed eruption of the first deciduous tooth, inadequate lingual posture and short labial and lingual frenums.

Características morfológicas encontradas na cavidade oral de neonatos: revisão de literatura / Morphological characteristics found in the oral cavity of newborns: a literature review

Objetivo: revisar a literatura sobre as característicasmorfológicas da cavidade oral de recém-nascidos. Revisãode literatura: as profissões da área de saúde estãocada vez mais voltadas para um acompanhamentoprecoce do indivíduo, iniciando-se antes mesmo donascimento ou nos primeiros dias de vida da criança.Sendo assim, recém-nascidos apresentam na cavidadeoral características peculiares da sua fase de desenvolvimentoque podem trazer dúvidas para os pais e/ouresponsáveis. As principais variações da cavidade oralde recém-nascidos envolvem tecidos duros e tecidosmoles. Considerando o posicionamento dos maxilares,as alterações mais comuns são: mordida aberta anterior,sobremordida e mordida topo a topo. Em relação aos tecidosmoles, o contorno dos lábios dos recém-nascidosse apresenta triangular e, com a amamentação constante,forma-se um aumento de volume na linha média dolábio superior. Considerações finais: além de ser necessárioque os profissionais da área tenham conhecimentodas características morfológicas da cavidade oral dosrecém-nascidos, também é imprescindível que estessaibam diagnosticar possíveis anormalidades e, quandohouver necessidade, indicar tratamento adequado. (AU)

Objective: to review the literature on the morphological characteristics of the oral cavity of newborns. Literature review: health professions are increasingly focused on the early follow-up of individuals, starting even before birth or during the first days of life of the child. Therefore, the oral cavity of newborns presents characteristics particular to their development phase, which may cause doubts to parents and/or caregivers. The major variations of the oral cavity of newborns involve both hard and soft tissues. Considering the positioning of the jaws, the most common changes are anterior open bite, overbite, and edge-to-edge bite. Regarding the soft tissues, the contour of the lips of newborns is triangular and constant breastfeeding causes an increase of volume formed in the midline of the upper lip. Final considerations: therefore, health professionals are required not only to understand the morphological characteristics of the oral cavity of newborns, but it is also essential that they are able to diagnose potential abnormalities and to indicate appropriate treatment when necessary. (AU)

Frenectomia labial pela técnica de reposicionamento cirúrgico proposta por Chelotti / Labial frenum by chirurgic replacement technic proposed by Chelotti

O freio labial superior, localizado entre os incisivos centrais superiores, é uma estrutura anatômica fina e triangular com base voltada para apical e estendendo-se do tubérculo do lábio superior até o processo alveolar. Quando, ao se tracionar o lábio para frente, para baixo e lateralmente com o objetivo de manter o freio tenso, ocorre uma isquemia tecidual, a intervenção cirúrgica está indicada, obedecendo a princípios da necessidade e oportunidade cirúrgica, principalmente no paciente infantil. A proposta deste trabalho foi apresentar um caso clínico de paciente com oito anos de idade, gênero masculino, que apresentou ao exame clínico freio tetolabial persistente que, ao ser tracionado, produzia isquemia na papila palatina, além da presença de diastema interincisal. O tratamento proposto foi o reposicionamento cirúrgico do freio. Concluiu-se que a técnica proposta contribuiu para o fechamento espontâneo do diastema e preservou as características anatômicas, funcionais e estéticas do freio labial superior.(AU)

The upper labial frenum, between maxillary central incisors, is a thin and triangular anatomical structure which base is faced to the apex extending from the upper labial tubercle until the alveolar process. When the upper lip is pulled to keep its tense, and blanches through to the palatal papilla, this seems to be an indication for its removal, regarding the principles of surgery needs and opportunity, mainly in young patient. Patient with eight years old, male, had abnormal frenum that when was pulled, blanched through to the palatal papilla, besides the midline diastema. In the RX no alteration was observed and we confirmed that midline diastema theory it was a result of abnormal frenum. The proposed treatment was a frenum replacement surgery. This technic had cooperated to the diastema naturally closure and had preserved the anatomical, functional and aesthetics characteristics of the upper labial frenum.(AU)

Frenillo labial superior doble / Double frenulum of the superior lip

El frenillo labial superior doble no sindrómico es una anomalía del desarrollo que no hemos encontrado reportada en la revisión bibliográfica realizada. Se presenta una niña de 11 años de edad que fue remitida al servicio de Cirugía Maxilofacial del Hospital Eduardo Agramonte Piña , de Camagüey, por presentar un frenillo labial superior doble de baja inserción. Se describen los síntomas clínicos asociados a esta anomalía y el tratamiento quirúrgico utilizado para su solución: una frenectomía y plastia sobre la banda muscular frénica anormal que provocaba exceso de tejido en la mucosa labial. Consideramos muy interesante la descripción de este caso, por no haber encontrado reporte similar en la literatura revisada

Non-syndromic double frenulum of the superior lip is a developmental anomaly that was not found as reported in our literature review. This is the case of an eleven-years old girl who was referred to the maxillofacial surgery service of Eduardo Agramonte Pina hospital in Camaguey, with a diagnosis of double frenulum of the superior lip of low insertion. The clinical symptoms linked to this anomaly and the surgical treatment applied to this case were described in this paper: frenectomy and frenoplasty upon the abnormal muscular band of the frenulum that brought excessive amount of tissue in the lip mucosa. The description of this case was considered to be very interesting since no similar report had been found in the reviewed literature

Conservative approach for a patient with extreme delay in maxillary lateral incisor development.

The purpose of this article is to report the orthodontic treatment of a patient with extremely delayed development of the maxillary lateral incisors. At 7 years of age, the boy's permanent maxillary lateral incisors had not erupted. A radiograph showed no tooth germs in place, although well-defined radiolucent areas were evident. Removal of the radiolucent areas was contemplated, but it was rejected in favor of a conservative approach. At age 13, peg-shaped maxillary lateral incisors erupted; they were positioned during orthodontic treatment and reshaped with composite restorations, providing good esthetics and function.

Focal dermal hypoplasia: a case report and literature review.

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

The importance of oral-clinical findings for the correct diagnosis of Ellis-van Creveld syndrome.

Ellis-van Creveld syndrome (EVC), also known as chondroectodermal dysplasia, is a rare autosomal recessive disorder. It is characterized by a variable spectrum of clinical findings, and the most common tetrad is chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac defects. Among the oral findings, number anomalies, peg-shaped teeth, and alterations in soft tissues are noteworthy. The aim of this paper is to report a case in which the diagnosis of EVC was possible only with the oral findings of a dentist and to relate the dental treatment performed. A 2-year-old girl was brought for dental care due to a lack of teeth. Her condition was initially diagnosed as thanatophoric dysplasia by her pediatrician. After evaluation of the oral manifestations, the dentist referred her to a geneticist, with the suggestion of EVC. The dental report, together with the systemic manifestations, allowed the geneticist to confirm the EVC diagnosis. The necessary dental procedures were performed, and the patient, now age 5, is still monitored by a multidisciplinary team.

Oral-facial-digital syndrome type 1: oral features in 12 patients submitted to clinical and radiographic examination.

OBJECTIVE: To evaluate the oral features in individuals with oral-facial-digital syndrome type 1 (OFD 1), previously diagnosed by the Genetic Sector of the Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC-USP). DESIGN: Twelve patients with OFD 1 were examined clinically and radiographically; their medical files were also evaluated. RESULTS: Associated oral malformations were observed in all patients (100%). The most frequent findings were tongue hamartomas, multiple buccal frena, asymmetric lips, asymmetric tongue, and bilateral maxillary gingival swelling. Interestingly, atrophy of the maxillary midline frenum was also observed in all the individuals examined. CONCLUSIONS: Several extra and intraoral alterations were observed in patients with OFD 1. The authors suggest the inclusion of atrophy of the maxillary midline frenum as a commonly found characteristic of OFD 1.

The applications of diode and Er:YAG lasers in labial frenectomy in infant patients.

This paper describes a clinical case of labial frenectomy using different high power lasers: diode (810 nm) and Er:YAG (2940 nm). Considerations are made about specific indications, surgery techniques, and advantages of labial frenectomy using these laser wavelengths. The diode laser has high absorbance by pigmented tissues with hemoglobin, melanin, and collagen chromophores. For this reason, this wavelength is well indicated for surgery in soft tissue (vaporization, incision, coagulation, hemostasis). It is not properly absorbed, however, and should never be used in contact with hard tissues (bone). The Er:YAG laser has high absorbance to water and mineral apatite, making this wavelength useful and safe for the ablation of hard tissues. In the labial frenectomy clinical procedure, a combined technique is suggested: using the diode laser in soft tissues and the Er:YAG laser in periosteal bone tissues and for removal of final collagen fibers. It is important for the professional to understand the physical characteristics of the different laser wavelengths and their interaction with biological tissues to assure that they are used in a safe way, and that the benefits of this technology can be provided to infant patients.

Freio teto-labial persistente: diagnóstico e tratamento cirúrgico / The abnormal maxillary anterior frenum: diagnosis and surgical treatment

A cirurgia em Odontopediatria obedece aos mesmos princípios que regem a cirurgia geral. Porém, no caso da criança, alguns fatores adicionais precisam ser considerados. O presente trabalho revisa os aspectos relevantes do crescimento e desenvolvimento que têm influência no diagnóstico do freio teto-labial persistente. Com base na literatura e na experiência clínica dos autores, são discutidas também a necessidade, oportunidade e técnica cirúrgica

Hypoplastic or absent mandibular frenulum: a new predictive sign of infantile hypertrophic pyloric stenosis.

Among 25 patients with hypertrophic pyloric stenosis, a hypoplastic or absent mandibular frenulum was noted in 92%, compared with 1.6% of 319 control infants (P <.001). This previously unrecognized sign may prove helpful in identifying newborns at risk of developing the disorder.

Absence of the superior labial frenulum in holoprosencephaly: a new diagnostic sign.

The upper lip of 17 consecutive individuals with various forms of holoprosencephaly were examined either at autopsy or during clinical evaluation. A total of 88% of cases were missing the superior labial frenulum regardless of the severity of holoprosencephaly or other associated craniofacial defects. Because the frenulum was found to be missing across a complete clinical spectrum of holoprosencephaly including cases exhibiting only minimal craniofacial features, it should be inspected as part of the craniofacial examination, and its absence should be prompt imaging studies of the brain. Absence of the frenulum in holoprosencephaly also provides evidence that its embryonic origin is that of the medial nasal process.

Síndrome de Ellis-Van Creveld: relato de caso / Ellis-Van Creveld syndrome: case report

A síndrome de Ellis-Van Creved apresenta-se com váriss alteraçöes bucais, para as quais os cirurgiöes-dentistas, clínicos gerais, devem atentar na elaboraçäo de uma diagnóstico diferencial. Dentre essas, nota-se a presença de freios labiais múltiplos, diminuiçäo do sulco vestibular, fendas nos processos alveolares, anomalias dentais de números, forma e estrutura entre outras. Descreve-se o caso de um casal de irmäos portadores dessa síndrome, enfatizando as características por eles apresentadas. Assim, possibilita-se que os cirurgiöes-dentistas obtenham conhecimento sobre essa síndrome, facilitando seu diagnóstico e tomando as providências necessárias no âmbito odontológico

Remoção de brida lateral com finalidade ortodôntica / High buccal frenectomy for orthodontic finality

A presença de freios ou bridas é motivo do surgimento de alguns problemas à nível periodontal, protético bem como ortodôntico. Acarreta entre outras coisas, o mau posicionamento dentário, dificuldade de fala, de higienização, e dificuldade de instalação de próteses entre outras alterações. A técnica cirúrgica mais adequada para remoção de freios e/ou bridas ainda é motivo de muita discussão. Neste trabalho é apresentado um caso de bridectomia com finalidade ortodôntica discutindo as técnicas para sua realização