A internação da gestante pode afetar a condição bucal do filho no terceiro ano de vida? / Can a pregnant woman's hospitalization affect the child's oral condition in the third year of life?

Objetivo: Avaliar se a hospitalização na gestação pode influenciar na condição bucal do filho no terceiro ano de vida. Métodos: Estudo longitudinal com bebês de gestantes internadas e acompanhadas no setor da Obstetrícia de um Hospital Escola em Pelotas, RS, Brasil. Os dados referentes a hospitalização e ao parto foram coletados do prontuário hospitalar e no terceiro de vida do filho (a) de um questionário aplicado a mãe e do exame bucal da criança. Cada agravo bucal foi avaliado com critérios específicos, por uma examinadora calibrada e analisado no programa IBM SPSS Statistics com 5% de nível de significância. Resultados: Participaram 20 díades mãe-filho (a). Alterações da oclusão acometeram 95% das crianças, sendo a mordida aberta anterior (MAA) a principal. Ainda, 25% das crianças apresentaram opacidades demarcas e/ou hipoplasia do esmalte, sendo significativamente maior em filhos de mães mais jovens e 20% tinham cárie da primeira infância (CPI), estando relacionada à ausência de creme dental fluoretado e à qualidade da higiene bucal. Conclusão: O reflexo mais evidente da hospitalização na gestação na saúde bucal no terceiro ano de vida do filho (a) foi a oclusão alterada, especialmente a MAA.(AU)

Objective: To assess whether hospitalization during pregnancy can influence the child's oral condition in the third year of life. Methods: Longitudinal study with babies of pregnant women hospitalized and followed up in the Obstetrics sector of a Teaching Hospital in Pelotas, RS, Brazil. Data referring to hospitalization and childbirth were collected from the hospital records and in the child's third of life through a questionnaire applied to the mother and the child's oral examination. Each oral condition was evaluated with specific criteria, by a calibrated examiner and analyzed in the IBM SPSS Statistics program with a 5% minimum significance level. Results: 20 mother-child participated. Occlusion alterations affected 95% of the children, with anterior open bite (AOB) being the main. Still, 25% of the children had opacities and/or enamel hypoplasia, which was significantly higher in children of younger mothers, and 20% had early childhood caries, which is related to the absence of fluoride toothpaste and the quality of oral hygiene. Conclusion: The clearest reflection of hospitalization during pregnancy on oral health in the third year of the child's life was altered occlusion, especially the AOB.(AU)

Clinical, radiological, and auxological characteristics of patients with cleidocranial dysplasia followed in a pediatric referral hospital in Argentina. / Características clínicas, radiológicas y auxológicas de pacientes con displasia cleidocraneal seguidos en un hospital pediátrico de referencia en Argentina.

Cleidocranial dysplasia is an autosomal dominant skeletal dysplasia caused by mutations in the RUNX2 gene; its prevalence has been estimated at 1/1 000 000 newborn infants. This study presents 37 patients (22 girls) assessed between 1992 and 2016 at the Skeletal Dysplasias Multidisciplinary Clinics of Hospital Garrahan, Argentina. FINDINGS: 35% of positive family history; median age at the time of diagnosis: 2.61 years old; positive radiological findings in the skull and pubis: 95%; in the clavicles: 100%. Dental and hearing complications were common. Auxology: boys had a median height of -1.81 SD (-3.26 to 0.2) and girls had a median height of -1.36 SD (-4.28 to 1.36). Five out of 13 patients were short for parental height. Adult height (median): 162.8 cm in boys and 149.2 cm in girls. No evident alterations were observed in the sitting height/height ratio. One patient had true macrocephaly; 12 (32%), relative macrocephaly. Intrafamily variability was described in terms of height.

La displasia cleidocraneal es una displasia esquelética autosómica dominante causada por mutaciones en el gen RUNX2, con una prevalencia estimada de 1/1 000 000 de recién nacidos. Se presentan 37 pacientes (22 mujeres) evaluados entre 1992 y 2016 en las clínicas de displasias esqueléticas, Hospital Garrahan, Argentina. Hallazgos: 35% de antecedentes familiares positivos; edad mediana al momento del diagnóstico: 2,61 años; características radiológicas positivas en el cráneo y el pubis: 95%; en las clavículas: 100%. Las complicaciones dentales y auditivas fueron comunes. Auxología: mediana de estatura de -1,81 (-3,26-0,2) DE en los varones, -1,36 (-4,28-1,36) DE en las mujeres. Cinco de trece pacientes fueron bajos para la estatura parental. Estatura adulta (mediana): 162,8 cm y 149,2 cm en los varones y las mujeres. No fueron evidentes alteraciones en la proporción estatura sentada/estatura. Un paciente presentó macrocefalia real; 12 (32%), macrocefalia relativa. Se describe variabilidad intrafamiliar de estatura.

Oral and dental health issues in people with mental disorders. / Problemáticas de salud bucodental en personas con trastornos mentales.

Patients with mental disorders are subject to a greater number of risk factors for oral and dental disease than the general population. This is mostly caused by the side effects of the medications that they receive, lack of self-care, difficulty to access health services, a negative attitude towards healthcare providers, and patients’ lack of cooperation in dental treatments. The most common psychiatric disorders in our population are depression, anxiety disorders, schizophrenia, bipolar disorder, and dementia. In disorders such as anxiety and depression, the main issue is the loss of interest in self-care, which results in a poor hygiene. The most frequent oral and dental diseases in these patients are dental cavities and periodontal disease. The purpose of this brief review is to provide up-to-date information about the management of oral and dental diseases of patients with mental disorders.

Los pacientes con trastornos mentales están sometidos a un mayor número de factores de riesgo de enfermedades bucodentales. Ello debido a los efectos secundarios de las medicaciones que consumen, la falta de autocuidado, la dificultad para acceder a atención, la actitud hacia los profesionales sanitarios y también la falta de cooperación en los tratamientos dentales. Los trastornos mentales más comunes en nuestra población incluyen a la depresión, la ansiedad, la esquizofrenia, el trastorno bipolar y la demencia. En trastornos como la ansiedad y la depresión, el mayor problema está en la pérdida del interés hacia la salud, lo que deriva en una mala higiene. Las patologías bucodentales más frecuentes en estos pacientes son las caries y las enfermedades periodontales. El objetivo de esta breve revisión narrativa, es proporcionar información actualizada sobre el manejo de las enfermedades bucodentales de pacientes con trastornos mentales.

Correlational study of impacted and non-functional lower third molar position with occurrence of pathologies.

BACKGROUND: Lower third molar (M3) eruption is unpredictable. The purpose of this study was to correlate radiographic position of M3 on a preexistent film with the current clinical, histopathological, and radiographic findings. METHODS: A retrospective cohort study was performed. The sample was collected from a database of patients covered by Medical Fund of Brazilian Army. Radiographs were obtained a minimum of 5 years prior to the presurgical visit and after their clinical exam. The primary outcome variables were the teeth positions using Pell and Gregory/Winter classifications on panoramic X-rays. Those variables were analyzed at both the beginning (T0) and end of the study (T1). Clinical assessments and histopathological study of the thirds that were extracted were performed only at T1. Correlation between the teeth positions were related to the clinical, histopathological, and radiographic parameters using statistical analysis tests with significance set at p < 0.05. RESULTS: Twenty-six patients with 49 M3 were assessed over 10 months. Mean age was 14.92 years at T0 and 21.87 years at T1. The average time between T0 and T1 was 6.77 years. A significant relationship (p = 0.024) was found between the presences of root resorption on the second molar if M3 presented in an IB horizontal position at T1. There was also a significant correlation (p = 0.039) between dental crowding of the anterior lower teeth with IIIB position at T0 and if the patient finished orthodontic treatment without lingual retainers. CONCLUSIONS: Lower M3 in position IIIB seen in a teenager and IB seen in an adult is more likely to have negative consequences and should be followed closely.

Interference of conventional and orthodontic nipples in system stomatognatic: systematic review. / Interferência dos bicos ortodônticos e convencionais no sistema estomatognático: revisão sistemática.

PURPOSE: Check if the type of nozzle, orthodontic or conventional, of pacifier and bottle have any influence on the changes found in the stomatognathic system caused by the maintenance of the sucking habit. Research Strategies: Through a systematic literature review with meta-analysis, performed from the databases Lilacs, Medline and Embase and Scholar Google, with the following key words in Portuguese and English: "malocclusion" + "Pacifiers "; "Malocclusion" + "Bottle Feeding"; "Malocclusion" + "Bottle feeding" beyond words "Orthodontic Beak" + "Conventional Beak". SELECTION CRITERIA: We included studies that presented in their methods to compare groups who used pacifiers and/or bottle with conventional nozzle with groups using orthodontic nipple without temporal delimitation. DATA ANALYSIS: The analysis of the article in its entirety was performed systematically, ordering the relevant results in the following categories: objective, method-case studies and evaluation, results, and conclusion. RESULTS: Found 1,041 jobs, from the period 1969 to 2013, 848 jobs were excluded based on the exclusion criteria and another 174 that were repetitions. A total of 19 articles were read in full of which 4 articles met the proposed inclusion criteria, and three studies were included in the meta-analysis. These results show that there are no significant differences between the orthodontic and conventional nozzles on the implications of the stomatognathic system. CONCLUSION: There is no way to conclude that there are differences as to the consequences to the stomatognathic system caused by conventional nozzles and orthodontic pacifier/bottle.

Interferência dos bicos ortodônticos e convencionais no sistema estomatognático: revisão sistemática / Interference of conventional and orthodontic nipples in system stomatognatic: systematic review

RESUMO Objetivo: Verificar se o tipo de bico, ortodôntico ou convencional, de chupeta e mamadeira, tem alguma influência sobre as alterações encontradas no sistema estomatognático causadas pela manutenção do hábito de sucção. Estratégia de pesquisa: Por meio de uma revisão de literatura sistemática com metanálise, realizada a partir das bases de dados Lilacs, Medline e Embase e com a ferramenta de busca Google Acadêmico™, com os seguintes descritores em português e inglês: “Má oclusão” + “Chupetas”; “Má oclusão” + “Alimentação Artificial”; “Má oclusão” + “Mamadeira”, além das palavras “Bico Ortodôntico” + “Bico Convencional”. Critérios de seleção: Foram incluídos estudos que apresentassem em seus métodos a comparação de grupos que utilizaram chupeta e/ou mamadeira com bico convencional com grupos que utilizaram o bico ortodôntico, sem delimitação temporal. Análise dos dados: A análise do artigo na íntegra foi realizada de modo sistemático, com as seguintes categorias tabelando os resultados pertinentes: objetivo, método - casuística e avaliação, resultados e conclusão. Resultados: Foram encontrados 1.041 trabalhos, período de 1969 a 2013, desses foram excluídos 848 trabalhos, devido aos critérios de exclusão, e outros 174 que eram repetições. Foram lidos na íntegra 19 trabalhos, dos quais quatro artigos atenderam aos critérios de inclusão propostos, e três trabalhos foram incluídos na metanálise. Tais resultados expressaram que não há diferenças significantes entre os bicos ortodôntico e convencional quanto às implicações no sistema estomatognático. Conclusão: Não há possibilidade de concluir a existência de diferenças quanto às consequências no sistema estomatognático ocasionadas por bicos convencionais e ortodônticos de chupetas/mamadeiras.

ABSTRACT Purpose: Check if the type of nozzle, orthodontic or conventional, of pacifier and bottle have any influence on the changes found in the stomatognathic system caused by the maintenance of the sucking habit. Research Strategies: Through a systematic literature review with meta-analysis, performed from the databases Lilacs, Medline and Embase and Scholar Google, with the following key words in Portuguese and English: “malocclusion” + “Pacifiers “; “Malocclusion” + “Bottle Feeding”; “Malocclusion” + “Bottle feeding” beyond words “Orthodontic Beak” + “Conventional Beak”. Selection Criteria: We included studies that presented in their methods to compare groups who used pacifiers and/or bottle with conventional nozzle with groups using orthodontic nipple without temporal delimitation. Data Analysis: The analysis of the article in its entirety was performed systematically, ordering the relevant results in the following categories: objective, method—case studies and evaluation, results, and conclusion. Results: Found 1,041 jobs, from the period 1969 to 2013, 848 jobs were excluded based on the exclusion criteria and another 174 that were repetitions. A total of 19 articles were read in full of which 4 articles met the proposed inclusion criteria, and three studies were included in the meta-analysis. These results show that there are no significant differences between the orthodontic and conventional nozzles on the implications of the stomatognathic system. Conclusion: There is no way to conclude that there are differences as to the consequences to the stomatognathic system caused by conventional nozzles and orthodontic pacifier/bottle.

Pacifier-sucking habit duration and frequency on occlusal and myofunctional alterations in preschool children.

The objective of this study was to evaluate the association of pacifier-sucking habit with occlusal and oral myofunctional alterations in preschool children. Eighty-four 2- to 5-year-old children participated in the study. Data on duration and frequency of pacifier use were collected from parents or guardians. Occlusal and oral myofunctional characteristics were examined by a dentist and a speech therapist, respectively. Chi-square tests and Poisson regression were used to analyze the data. The occlusal characteristics that were significantly associated with a pacifier-sucking habit were anterior open bite, altered canine relation, posterior crossbite, increased overjet, and malocclusion. The oral myofunctional characteristics that were significantly associated with a pacifier-sucking habit were resting lip position, resting tongue position, shape of the hard palate, and swallowing pattern. The strongest associations were for anterior open bite (prevalence ratio [PR] = 11.33), malocclusion ( PR = 2 .33), altered shape of the hard palate ( PR = 1.29), and altered swallowing pattern (PR = 1.27). Both duration and frequency of pacifier-sucking habit were associated with occlusal and oral myofunctional alterations. These results emphasize the need for pediatric dentists to advise parents and caregivers about the risks of prolonged pacifier use and refer children to professionals for multidisciplinary assistance to minimize these risks whenever necessary.

Pacifier-sucking habit duration and frequency on occlusal and myofunctional alterations in preschool children

The objective of this study was to evaluate the association of pacifier-sucking habit with occlusal and oral myofunctional alterations in preschool children. Eighty-four 2- to 5-year-old children participated in the study. Data on duration and frequency of pacifier use were collected from parents or guardians. Occlusal and oral myofunctional characteristics were examined by a dentist and a speech therapist, respectively. Chi-square tests and Poisson regression were used to analyze the data. The occlusal characteristics that were significantly associated with a pacifier-sucking habit were anterior open bite, altered canine relation, posterior crossbite, increased overjet, and malocclusion. The oral myofunctional characteristics that were significantly associated with a pacifier-sucking habit were resting lip position, resting tongue position, shape of the hard palate, and swallowing pattern. The strongest associations were for anterior open bite (prevalence ratio [PR] = 11.33), malocclusion (PR = 2.33), altered shape of the hard palate (PR = 1.29), and altered swallowing pattern (PR = 1.27). Both duration and frequency of pacifier-sucking habit were associated with occlusal and oral myofunctional alterations. These results emphasize the need for pediatric dentists to advise parents and caregivers about the risks of prolonged pacifier use and refer children to professionals for multidisciplinary assistance to minimize these risks whenever necessary.

Afectación de la salud oral en niños que padecen maltrato infantil: reporte de caso / Impact of oral health in children with child abuse: a case report

El maltrato infantil es una patología de la cual se tienen registros desde las civilizaciones antiguas como la griega y egipcia; pero es hasta 1924 que se firma la declaración de Ginebra: Derechos de la infancia, siendo el IX derecho: No al Maltrato. En México se tiene registro de maltrato infantil desde hace 20 años. Se ha tipificado el maltrato infantil en dos grandes rubros: activo y pasivo, la negligencia odontológica es clasificado como maltrato pasivo, por lo tanto el odontólogo (en especial el Odontopediatra) debe prestar atención al hacer la inspección clínica y elaboración de historia clínica del paciente, para encontrar indicios de maltrato infantil y llevar a cabo la atención de estos pacientes con adecuado manejo de su conducta, la cual puede ser variable dependiendo el tipo de maltrato que ha sufrido. Las consecuencias del maltrato en cavidad oral son múltiples y pueden manifestarse a corto, largo y mediano plazo. En este artículo se presenta un caso clínico de maltrato por abandono, negligencia odontológica y las consecuencias que éste tuvo en la salud oral y general de la paciente.

Child abuse is a disease for which there are records from ancient civilizations like the Greek and Egyptian, but until 1924 when the Geneva Declaration was signed: Children's rights: No to Abuse. In Mexico records of child abuse have been kept for the last 20 years. It has classified child abuse into two major categories: active and passive, dental malpractice liability is classified as child abuse therefore the dentist (especially the pediatric dentist) should pay attention to realize a clinical inspection and preparation of patient history, for signs of child abuse, and carry out the care of these patients with adequate management of their behavior, which can vary depending on the type of abuse the child has suffered. The consequences of abuse in oral cavity are multiple and can occur at short, medium and long term. This article presents a case of abuse by dental neglect and the consequences that this has on oral health, and therefore on the general health of the patient.

National survey of oral/dental conditions related to tobacco and alcohol use in Mexican adults.

Oral diseases are a major burden on individuals and health systems. The aim of this study was to determine whether consumption of tobacco and alcohol were associated with the prevalence of oral/dental problems in Mexican adults. Using data from the National Performance Evaluation Survey 2003, a cross-sectional study part of the World Health Survey, dental information from a representative sample of Mexico (n = 22,229, N = 51,155,740) was used to document self-reported oral/dental problems in the 12 months prior to the survey. Questionnaires were used to collect information related to sociodemographic, socioeconomic, and other risk factors. Three models were generated for each age group (18-30, 31-45 and 46-98 years). The prevalence of oral/dental conditions was 25.7%. Adjusting for sex, schooling, socioeconomic position, diabetes, and self-reported health, those who used tobacco (sometimes or daily) (OR = 1.15, p = 0.070; OR = 1.24, p < 0.01; and OR = 1.16, p < 0.05, for each age group respectively) or alcohol (moderate or high) (OR = 1.26, p < 0.001; OR = 1.18, p < 0.01 and OR = 1.30, p < 0.001, for each age group respectively) had a higher risk of reporting oral/dental problems. Because tobacco and alcohol use were associated with self-reported oral/dental problems in one out of four adults, it appears advisable to ascertain how direct is such link; more direct effects would lend greater weight to adopting measures to reduce consumption of tobacco and alcohol for the specific purpose of improving oral health.

Urgencias estomatológicas en pacientes con VIH/SIDA de la Clínica Estomatológica Docente Yuri Gómez Reinoso / Stomatology urgencies in HIV/AIDS patients in Yuri Gómez Reinoso Stomatology Teaching Clinic

Se realizó un estudio observacional descriptivo transversal con el objetivo de identificar la edad, el sexo y la frecuencia de urgencias estomatológicas y su relación con el tiempo de infección por el virus de inmunodeficiencia humana y el consumo de antirretrovirales. El universo lo constituyeron 32 pacientes mayores de edad, con infección por el virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida, que se presentaron con urgencias estomatológicas en la clínica Yuri Gómez Reinoso, en La Habana, Cuba, entre el mes de enero de 2008 e igual mes de 2010. Resultó que el 68,75 por ciento correspondieron al sexo masculino, el 31,25 por ciento con edades de 31 a 40 años, el 25 por ciento presentaron estomatitis aftosa recurrente, el 21,8 por ciento absceso dentoalveolar agudo, el 15,62 por ciento pulpitis irreversible aguda y candidiasis eritematosa y el 37,5 por ciento xerostomía. El 46,87 por ciento de los pacientes con infección por el virus de 6 a 10 años de diagnóstico presentaron urgencias. El 46,9 por ciento de los pacientes, no consumían medicamentos antirretrovirales y el 53,1 por ciento sí lo consumían. Estas diferencias no fueron estadísticamente significativas (p= 0,8026). Se concluyó que en los pacientes estudiados, predominó el sexo masculino y los mayores de 31 años. Los tipos de urgencias mayormente tratadas fueron: estomatitis aftosa recurrente, absceso dentoalveolar agudo, pulpitis irreversible y candidiasis eritematosa. En la investigación no se constaron diferencias entre la presencia de urgencias y el consumo de antirretrovirales(AU)

A cross-sectional, descriptive and observational study was conducted to identify age, sex and frequency of Stomatology urgencies and its relation to time of infection from HIV and of antiretroviral consumption drugs. Universe included 32 HIV/AIDS adult patients came with Stomatology urgencies in the Yuri Gómez Reinoso Teaching Clinic between January, 2008 and January, 2010. The 68,75 percent corresponded to male sex, the 31,25 percent aged from 31 to 40, the 125 percent had recurrent aphthous stomatitis, the 21,8 percent had acute dentoalveolar abscess and the 15,62 percent had acute irreversible pulpitis and erythematous candidiasis, the 37,5 percent had Xerostomia. The 46,87 percent of patients with HIV from 6 to 10 years of diagnosed had urgencies. The 46,9 percent had no of antiretroviral drugs consumption but the 53,1 percent yes; these differences were not statistically significant (p= 0.8026). We conclude that in study patients there was predominance of male sex and age over 31 years; the urgency types: recurrent aphthous stomatitis, acute dentoalveolar abscess, irreversible pulpitis and erythematous candidiasis in decreasing order without differences between the urgency presence and antiretroviral drugs consumptio(AU)

Dental approach in the pediatric oncology patient: characteristics of the population treated at the dentistry unit in a pediatric oncology brazilian teaching hospital.

OBJECTIVES: The objective of this paper was to characterize the population seen at the dentistry unit of the hematology-oncology service of the Oncology-Hematology Service, Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Oral problems resulting from cancer therapy increase the risk of infection, length of hospital stay, treatment cost and negative impact on the course and prognosis of the disease. METHOD: Of the 367 medical records of cancer patients seen from November 2007 until December 2008: 186 with a cancer diagnosis and complete clinical data were selected, while 20 with a cancer diagnosis and incomplete records were excluded; 161 medical records with only hematological diagnosis were also excluded. The following characteristics were assessed: ethnicity, gender, age, diagnosis and characteristics of the neoplasm, cancer therapy status and performed dental procedures. RESULTS: Review of 1,236 visits indicated that 54% (n=100) of the patients had blood cancers, 46% (n=86) had solid tumors and 63% were undergoing anticancer therapy. The proportion of males (52.7%) in the study population was slightly greater. The most common cancer was acute lymphocytic leukemia (32.2%). Cancer occurred more often among those patients aged 5 to 9 years. The most common dental procedures were restorative treatment, preventive treatment and removal of infectious foci. CONCLUSION: The characteristics of the studied population were similar to those of the general Brazilian and global populations, especially regarding gender and diagnosis distributions. The aim of implementation of the dentistry unit was to maintain good oral health and patients' quality of life, which is critical to provide oral care and prevent future oral problems.

Dental approach in the pediatric oncology patient: characteristics of the population treated at the dentistry unit in a pediatric oncology brazilian teaching hospital

OBJECTIVES: The objective of this paper was to characterize the population seen at the dentistry unit of the hematology-oncology service of the Oncology-Hematology Service, Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Oral problems resulting from cancer therapy increase the risk of infection, length of hospital stay, treatment cost and negative impact on the course and prognosis of the disease. METHOD: Of the 367 medical records of cancer patients seen from November 2007 until December 2008: 186 with a cancer diagnosis and complete clinical data were selected, while 20 with a cancer diagnosis and incomplete records were excluded; 161 medical records with only hematological diagnosis were also excluded. The following characteristics were assessed: ethnicity, gender, age, diagnosis and characteristics of the neoplasm, cancer therapy status and performed dental procedures. RESULTS: Review of 1,236 visits indicated that 54 percent (n=100) of the patients had blood cancers, 46 percent (n=86) had solid tumors and 63 percent were undergoing anticancer therapy. The proportion of males (52.7 percent) in the study population was slightly greater. The most common cancer was acute lymphocytic leukemia (32.2 percent). Cancer occurred more often among those patients aged 5 to 9 years. The most common dental procedures were restorative treatment, preventive treatment and removal of infectious foci. CONCLUSION: The characteristics of the studied population were similar to those of the general Brazilian and global populations, especially regarding gender and diagnosis distributions. The aim of implementation of the dentistry unit was to maintain good oral health and patients' quality of life, which is critical to provide oral care and prevent future oral problems.

Oral manifestations of Albright hereditary osteodystrophy: a case report.

Albright hereditary osteodystrophy is a hereditary metabolic disorder of dominant autosomal etiology that is commonly characterized by short stature, round face, small metacarpus and metatarsus, mental retardation, osteoporosis, subcutaneous calcification, variable hypocalcemia, and hyperphosphatemia. In this study, we report a clinical case of a 17-year-old woman with Albright hereditary osteodystrophy, and we discuss her clinical, radiographic, and laboratory test characteristics together with the oral manifestations, and we correlate them with the characteristics found in the literature. We also discuss the odontological management of treatment of related periodontal disease and planning for corrections of related malocclusions.

Manifestaçöes estomatológicas da paracoccidioidomicose / Stomatological manifestations of paracoccidioidomycosis

Forma de estudo: Retrospectivo clínico. Material e método: Para elaboração da presente pesquisa, foi realizada a revisão de 187 prontuários médicos de pacientes provenientes do Serviço de Infectologia do Ambulatório de Micoses Profundas do Hospital de Clínicas da Universidade Federal do Paraná em Curitiba-PR, no período de maio de 1985 a março de 1998. Os objetivos foram traçar o perfil epidemiológico, descrevendo as manifestações estomatológicas encontradas na amostra, discutir sobre os achados encontrados estabelecendo comparações com a literatura pertinente, observar possíveis mudanças e se estas são significativas, bem como observar a sensibilidade dos corantes que foram usados na histopatologia (HE, PAS e GROCOTT) em 20 lâminas. Foi estabelecido um protocolo prévio, para obtenção de dados, referentes à epidemiologia da doença, como as manifestações orais, descrevendo o tipo e localização destas lesões. Nos resultados encontrados, o sexo, a idade, a naturalidade, a procedência e a profissão dos pacientes foram fatores determinantes na descrição do perfil epidemiológico e demográfico da amostra estudada (187 casos), comparada com a literatura pertinente. Resultado: A avaliação dos resultados evidenciou mudanças pouco significativas em relação à epidemiologia da doença. E ficou bem evidenciada, também, a exuberância nas manifestações orais da doença, que são muito comuns e com freqüência levam à piora do estado geral do paciente ou mesmo à manutenção da doença, pela dificuldade de alimentação que aumenta a "imunossupressão. Da amostragem dos 187 pacientes revista por este estudo, 167 (89,3 por cento) eram do sexo masculino e 20 (10,7 por cento) do feminino. Em relação à idade, 75 (40,1 por cento) estão entre 41 e 50 anos, destacando-se alguns aspectos: 81 pacientes (43,3 por cento eram agricultores, sendo que 93 (49,7 por cento) eram oriundos do interior do Paraná. A perda de peso foi relatada em 72 (17,22 por cento) das 418 queixas, seguidas de dispnéia. Em relação à forma da lesão, 85 (41,46 por cento) dos pacientes não apresentavam lesões visíveis. Naqueles em que as lesões eram visíveis, a mais comuns foram a ulcerada e a granulomatosa, seguida esta da moriforme. O local com maior incidência de lesões foi a região de lábios, seguida de orofaringe e de palato duro; foi também observado o aparecimento de mais de um tipo de lesão em um mesmo paciente...

Manifestaçöes estomatológicas da Paracoccidioidomicose (Paracoccidioide Brasiliensis ou Enfermidade de Lutz-Splendore-Almeida): consideraçöes gerais e apresentaçäo de casos / Stomatological manifestations of the Paracoccidiodomycosis (Paracoccidioides Brasiliensis or Lutz-Splendore-Almeida disease): general considerations and cases presentation

Foram estudados 45 pacientes provenientes do Serviço de Doenças Infecto-Parasitárias e de Semiologia Aplicada da Universidade Federal do Paraná, que apresentavam manifestaçöes estomatológicas decorrentes da infecçäo fúngica causada pelo Paracoccidioides brasiliensis, no período compreendido entre 1992 a 1994. Da amostragem estudada, 39 pacientes do sexo masculino (86,67 por cento) e 6 do sexo feminino (13,33 por cento), com média de idade de 51 ñ 10 anos (faixa de 34 - 75), destacando-se alguns aspectos: 26 pacientes (57,80 por cento) eram agricultores, 19 (42,22 por cento) eram oriundos do interior do Paraná, 22 pacientes (48,89 por cento) eram tabagistas, sendo encontradas lesöes de orofaringe em 42 pacientes (93,33 por cento), sendo o local mais comumente o palato, bem como comum o aparecimento de vários tipos de lesöes num mesmo paciente. Näo houve comprometimento de linfonodos em 34 pacientes (75,56 por cento); 30 pacientes (66,67 por cento) apresentavam doença periodontal; 7 (15,56 por cento) exibiam dentes em péssimo estado de conservaçäo, e 10 pacientes (22,22 por cento) tinham comprometimento ósseo. Lesöes sistêmicas estavam ausentes em 35 pacientes (77,80 por cento), uma vez que já havia sido iniciada a terapêutica em muitos pacientes, e a lesäo mais comumente encontrada foi a fibrose pulpomar. Vinte e nove (29) pacientes (64,45 por cento) foram submetidos a tratamento com Sulfametoxazol + trimetropin, tendo sido também utilizado o Ketoconazol e o Itracoanazol nos casos resistentes ao tratamento convencional padronizado. Quarenta e dois (42) pacientes (93,33 por cento) mostraram remissäo das lesöes estomatológicas. Dois (02) pacientes (4,44 por cento) foram a óbito. Além da observaçäo clínica foram realizadas biópsias para o exame microscópico, micológico e sorologia para PCM, para acompanhar a evoluçäo do tratamento e proservaçäo

[Orodental occupational risks]. / Riesgos bucodentales de los trabajadores.

An approach to the origin of those diseases of the stomatognathic system which occur within the laboring media and may thus pose an occupational hazard to workers, is hereby attempted with the aim of creating consciousness in dentists as to the importance of occupational stomatology within the odontological field, in the hope of motivating them to explore and research further in the study of these pathologies.