Mindfulness Practice Reduces Hair Cortisol, Anxiety and Perceived Stress in University Workers: Randomized Clinical Trial.

BACKGROUND: Anxiety and stress are common mental health conditions reported by university workers. Practices of mindfulness represent one promising approach as an effective and feasible means to reduce stress, improve mental health and promote well-being; however, there are no clinical trials that have combined long-term stress biomarkers (hair cortisol) and psychometric assessments in a sample of university workers. OBJECTIVE: This study investigated the effectiveness of a mindfulness-based program on long-term stress, by measuring hair cortisol concentration and perceived stress and anxiety among workers who were undergoing high levels of stress. METHOD: We conducted a randomized clinical trial at work among the employees of a public university. We compared a group that received the eight-week mindfulness intervention with the wait list group who received no intervention. RESULTS: A total of 30 participants were included in the study, with n = 15 subjects in the intervention group and n = 15 in the control group. Hair cortisol, perceived stress and anxiety significantly reduced after the intervention compared to the control group, which had no appreciable decline in the measured variables. CONCLUSION: This clinical trial showed the effectiveness of a mindfulness program on mental health psychometric measures (perceived stress and anxiety) and on a long-term stress biomarker (hair cortisol). It can be concluded that an eight-week mindfulness program could be implemented as an effective strategy to reduce stress biomarkers (hair cortisol) as well as perceived stress and anxiety, improving the mental health of university workers.

The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic.

This quantitative, before-after study was developed to evaluate the usefulness of an online mindfulness practices program to help nursing professionals deal with stress in the challenging context of the COVID-19 pandemic through the assessment of perceived stress, anxiety and depression, levels of mindfulness, and participants' satisfaction with the program. Eligible participants were assessed at baseline to receive the online mindfulness training program for eight weeks and were appraised again at the end of the program. Standardized measures of perceived stress, depression, anxiety, and one-dimensional and multidimensional mindfulness were performed. Participant satisfaction was also studied. Adherence to treatment was 70.12%. The perceived stress, depression, and anxiety scores were significantly lower after the intervention. The mindfulness measure increased significantly, as well as the sense of well-being and satisfaction with life, study, and/or work. The participants showed high satisfaction with the program and would recommend it to other professionals. Our results indicate that mindfulness-based interventions represent an effective strategy for nurses in the face of the need for self-care with mental health and mechanisms that guarantee the sustainability of their capacities to continue exercising health care.

Auriculotherapy in a patient with Arnold Chiari malformation type II: Case report.

AIMS: Auriculotherapy is a therapeutic method of traditional Chinese Medicine in which a stimulus is exerted on the ear and activates energy channels throughout the body, helping to control anxiety, stress, pain, inflammation, illnesses chronic, and possibly can be used in patient with Arnold Chiari Malformation type II who have painful symptoms that are difficult to resolve. Thus, the aim of this article is to present a case in a patient with Chiari Malformation II where auriculotherapy and effect of laser therapy were performed, to relieve symptoms of agitation, anxiety and healing of self-mutilation injuries. CASE REPORT: Data from medical records were used to collect medical and dental history, complaints and treatments performed. Eight sessions of auriculotherapy and one of laser therapy were carried out in order to heal the lesions. The patient presented lower levels of anxiety, agitation and ceased the habit of self-mutilation and, consequently, the pain. CONCLUSIONS: The use of auriculotherapy led to a considerable improvement in the patient's painful condition and reduced anxiety, also benefiting the interaction with her family members and laser therapy promoted wound healing.

Knowledge, attitudes, and psychosocial impacts among Brazilian Pediatric Dentists during COVID-19 pandemic.

In this study, we evaluated the knowledge, attitudes, and psychosocial impacts among Brazilian pediatric dentists during the COVID-19 pandemic. A cross-sectional study with primary data collection was carried out using an online structured questionnaire. Data were submitted to descriptive analysis by using absolute and relative frequencies. A chi-square test was used for association analysis and log-linear regression models to estimate the prevalence ratio (5%). The population comprised mostly women and knowledge regarding COVID-19 was satisfactory (above 80% in most items). N95 masks and faceshields were used, albeit 64.22% reported difficulty in providing dental care to children due to the need for extra Personal Protective Equipment. Thirty eight percent provided urgency/emergency dental care, 59.78% performed invasive procedures, 59.56% used high speed handpieces, 8.44% started using cariostatics, and 6.22% introduced the use of chemomechanical caries removal agents. Fear for the future (PR = 1.21) and use of medications (for anxiety, depression, or insomnia) increased (PR = 1.16) among the ones who had wage losses. Brazilian pediatric dentists have knowledge about COVID-19, and attitudes in their clinical routines changed due the pandemic. Financial life was harmed and a negative impact of the pandemic in psychosocial aspects of workers was found.

Single nucleotide polymorphisms in dopamine receptor D2 are associated with bruxism and its circadian phenotypes in children.

Objective: To evaluate the association of bruxism phenotypes with single nucleotide polymorphisms in FKBP5, DRD2, ANKK1, and COMT.Methods: Clinical oral examination was performed to diagnose bruxism phenotypes in 150 children. DNA was collected from saliva. Logistic univariate regression, Chi-square, and Fisher's exact tests were performed (p < 0.05).Results: Bruxism was associated with DRD2 (p = 0.02). Tooth grinding while awake was associated with ANKK1 (p < 0.001), and tooth grinding while asleep was associated with DRD2 in the additive (p = 0.030) and dominant (p = 0.008) model. Tooth clenching while awake was associated with ANKK1 in the additive (p = 0.005) and dominant (p = 0.008) models, whereas tooth clenching while asleep was associated with ANKK1 (p < 0.001) and with COMT in the additive (p = 0.001) and dominant (p = 0.003) models.Discussion: Polymorphisms in DRD2, ANKK1, and COMT are associated with bruxism phenotypes.

Knowledge, attitudes, and psychosocial impacts among Brazilian Pediatric Dentists during COVID-19 pandemic

Abstract: In this study, we evaluated the knowledge, attitudes, and psychosocial impacts among Brazilian pediatric dentists during the COVID-19 pandemic. A cross-sectional study with primary data collection was carried out using an online structured questionnaire. Data were submitted to descriptive analysis by using absolute and relative frequencies. A chi-square test was used for association analysis and log-linear regression models to estimate the prevalence ratio (5%). The population comprised mostly women and knowledge regarding COVID-19 was satisfactory (above 80% in most items). N95 masks and faceshields were used, albeit 64.22% reported difficulty in providing dental care to children due to the need for extra Personal Protective Equipment. Thirty eight percent provided urgency/emergency dental care, 59.78% performed invasive procedures, 59.56% used high speed handpieces, 8.44% started using cariostatics, and 6.22% introduced the use of chemomechanical caries removal agents. Fear for the future (PR = 1.21) and use of medications (for anxiety, depression, or insomnia) increased (PR = 1.16) among the ones who had wage losses. Brazilian pediatric dentists have knowledge about COVID-19, and attitudes in their clinical routines changed due the pandemic. Financial life was harmed and a negative impact of the pandemic in psychosocial aspects of workers was found.

Influência do autocuidado utilizando as práticas integrativas e complementares durante a pandemia da COVID-19 em crianças e adolescentes de 4 a 13 anos com bruxismo e disfunção temporomandibular / Influence of self-care using complementary and integrative therapies during the COVID-19 pandemic in children and adolescents aged 4 to 13 years with bruxism and temporomandibular disorders

O Bruxismo é um comportamento da musculatura mandibular, caracterizado pelo apertamento e/ou rangimento dental, tanto em estado de vigília quanto no sono, que pode acarretar na Disfunção Temporomandibular (DTM). Altamente prevalente em crianças e etiologia multifatorial, destacam-se os aspectos psicossociais, principalmente o estresse e ansiedade. A necessidade de distanciamento social durante a pandemia da COVID-19 trouxe consequências para as crianças e fez surgir novos formatos de ações na Odontologia. Esse estudo avaliou a influência do autocuidado nas manifestações do Bruxismo/DTM em crianças que estavam em tratamento, antes da pandemia, no Serviço de Atendimento de Bruxismo e DTM na Infância (SABDI) da FORP/USP, por meio de intervenções assistidas, implementadas remotamente, de Práticas Integrativas e Complementares (PICs). Previamente às intervenções (T0), os pais responderam o questionário (Q1) sobre a criança (no formato Google Forms, enviado por WhatsApp e e-mail). As práticas propostas foram explicadas em reuniões virtuais (Google Meet) e foram realizadas durante 21 dias, registradas em um "Diário de Controle". Um novo questionário (Q2) foi preenchido para análise comparativa após as intervenções (T1). Das 37 crianças que estavam em tratamento, a amostra final das 18 que concluíram todas as etapas propostas apresentou diferença quantitativa nos itens: "dor na boca/rosto quando mastiga"; "dor ou dificuldade de abrir e fechar a boca"; "acorda com dor no rosto ou dor de cabeça" e, "dor de cabeça durante o dia ou à noite", "range os dentes em vigília"; "frequência que range os dentes em vigília"; "range os dentes enquanto dorme" e, "frequência que range os dentes enquanto dorme", "sono agitado"; "pesadelo" e "insônia". Observou-se evidência de diferença estatística com valor P<0,05, no item "aperta os dentes em vigília" (p=0,0057). Conclui-se que as intervenções propostas influenciaram as manifestações do Bruxismo favorecendo o seu controle.

Bruxism is a behavior of the mandibular muscles, characterized by clenching and/or dental grinding, both in wakefulness and in sleep, which can lead to Temporomandibular Disorders (TMD). Highly prevalent in children and possessing a multifactorial etiology, psychosocial aspects stand out, especially stress and anxiety. The need for social distancing during the COVID-19 pandemic has had consequences for children and has given rise to new formats of actions in Dentistry. This study evaluated the influence of self-care on the manifestations of Bruxism/TMD in children who were undergoing treatment, before the pandemic, Care Center for children with Bruxism and TMD, whose acronyms in Portuguese is SABDI, located in Ribeirão Preto School of Dentistry (FORP-USP), through assisted interventions, implemented remotely, of Complementary and Integrative Therapies (CIT). Prior to the interventions (T0), the parents answered the questionnaire (Q1) about the child (in Google Forms, sent by WhatsApp and e-mail). The proposed practices were explained in virtual meetings (Google Meet) and performed for 21 days and recorded in a "Control Diary". A new questionnaire (Q2) was completed for comparative analysis after the interventions (T1). Of the 37 children who were undergoing treatment, the final sample of 18 who completed all the proposed steps showed a quantitative difference in the items: "pain in the mouth/face when chewing"; "pain or difficulty opening and closing the mouth"; "waking up with pain in the face or headache" and "headache during the day or night"; "grinding teeth while awake"; "frequency grinding teeth while awake"; "grinding teeth while sleeping"; "frequency grinding teeth while sleeping"; "restless sleep"; "nightmare"; and "insomnia". Evidence of statistical difference was observed with a P value <0.05, in the item "clenches teeth while awake" (p=0.0057). It is concluded that the proposed interventions influenced the manifestations of Bruxism, favoring its control.

Efetividade de uma intervenção baseada em Mindfulness para redução de estresse e melhora da qualidade de vida em estudantes de enfermagem: Effects on stress and quality of life / Mindfulness based intervention for nursing students / Efectividad de una intervencion basada en Mindfulness para reduccion de estres y mejora de la calidad de vida en estudiantes de enfermeria

OBJETIVO: avaliar a efetividade de uma intervenção para redução de estresse baseada em Mindfulness em aspectos relacionados à Qualidade de Vida, Atenção Plena e Estresse Percebido, em estudantes de graduação e pós-graduação em enfermagem. MÉTODO: aplicados instrumentos de avaliação para a construção de uma linha basal e posteriormente a amostra foi submetida a um Programa de Redução de Estresse e aumento da Qualidade de Vida baseado em Mindfulness, formatado em encontros semanais por oito semanas. RESULTADOS: após a intervenção, houve diminuição do nível de Estresse Percebido, aumento do nível de Atenção Plena e melhora da Qualidade de Vida em âmbito psicológico. CONCLUSÃO: intervenções baseadas em Mindfulness se mostram efetivas e podem constituir um importante recurso para o gerenciamento do estresse e melhora na Qualidade de Vida dos estudantes.

OBJECTIVE: to evaluate the effectiveness of an intervention to reduce stress based on Mindfulness in aspects related to Quality of Life, Mindfulness and Perceived Stress in undergraduate and postgraduate students of Nursing. METHOD: evaluation instruments were applied to establish baseline data, and the sample was subsequently submitted to a Mindfulness Based Stress Reduction and Quality of Life, formatted eight consecutive weeks. RESULTS: after the intervention, there was a decrease in the level of Perceived Stress, increase in the level of Mindfulness and improvement of the Quality of Life in the psychological area. CONCLUSION: interventions based in Mindfulness are effective and can offer important resources for managing stress and improving the Quality of Life of students.

OBJETIVO: evaluar la efectividad de una intervención para reducción de estrés basada en Mindfulness en relación a la Calidad de Vida, Atención Plena y Estrés Percibido, en universitarios y estudiantes de postgrado de Enfermería. MÉTODO: previamente se aplicaron instrumentos de evaluación para la construcción de una línea basal y posteriormente la muestra fue sometida a un Programa de Reducción de Estrés y aumento de la Calidad de Vida basado en Mindfulness, constituído de encuentros semanales, durante ocho semanas consecutivas. RESULTADOS: se observó que después de la intervención, hubo disminución del nivel de Estrés Percibido, aumento del nivel de Atención Plena y mejora de la Calidad de Vida en ámbito psicológico. CONCLUSIÓN: intervencones basadas en Mindfulness se muestran efectivas y pueden constituir un importante recurso para manejar el estrés y mejorar la Calidad de Vida de los estudiantes.

Analysis of the stomatognathic system of children according orthodontic treatment needs.

PURPOSE: The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS: A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS: EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS: Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.

Development of an intraoral device for social inclusion of a physically disabled patient.

The aim of this study is to describe the use of an intraoral assistive technology for a patient with idiopathic generalized muscular dystonia, presenting temporomandibular disorder and severe anterior tooth mobility and diastema. A multidisciplinary team developed an intraoral device to provide typing and painting functions, and promote relaxation of masticatory muscles without compromising the teeth and supporting tissue structures. The occlusal splint associated with the device promoted muscle relaxation and relief of the signs and symptoms of temporomandibular dysfunction, in this case with generalized muscle dystonia, allowing typing and painting with her mouth without causing tooth mobility or occlusal alteration. This intraoral device has low cost, easy adaptation and was efficient in TMD symptoms. Furthermore, the patient returned to her rehabilitation allowing performance of her duties without compromising dental structures, facilitating the social and the digital inclusion.

Oral findings and dental treatment in a child with Williams-Beuren syndrome.

Williams-Beuren syndrome (WBS), also known as Williams syndrome, is a rare congenital disorder involving cardiovascular problems, mental retardation, distinctive facial features and tooth anomalies. It is caused by the submicroscopic deletion of 1.5 to 1.8 Mb on chromosome 7q11.23. This paper reports the dental care to a 7-year-old child with WBS syndrome. The interview also revealed visual impairment, sensorineural hearing loss, hyperacusis, photophobia and hoarse voice. The intraoral clinical examination showed anterior open bite, tongue thrusting, excessive interdental spacing, enamel hypomineralization of the incisors, hypoplasia and caries lesions. The dental treatment included: modulating sessions to control aversion to noises, the photophobia, and the dental fear and anxiety because of his reduced visual acuity; oral hygiene instructions, dietary and daily use of a 0.05% sodium fluoride mouthwash; the permanent mandibular left first molar was treated endodontically, and maxillary and mandibular first molars were restored with amalgam. Due to the patient's heart defect, a prophylactic antibiotic regimen was prescribed prior to the dental procedures. This patient has been followed up for 4 years and this case report underscores the importance of early dental evaluation and counseling for parents of WBS patients.

Oral Findings and Dental Treatment in a Child with Williams-Beuren Syndrome

Williams-Beuren syndrome (WBS), also known as Williams syndrome, is a rare congenital disorder involving cardiovascular problems, mental retardation, distinctive facial features and tooth anomalies. It is caused by the submicroscopic deletion of 1.5 to 1.8 Mb on chromosome 7q11.23. This paper reports the dental care to a 7-year-old child with WBS syndrome. The interview also revealed visual impairment, sensorineural hearing loss, hyperacusis, photophobia and hoarse voice. The intraoral clinical examination showed anterior open bite, tongue thrusting, excessive interdental spacing, enamel hypomineralization of the incisors, hypoplasia and caries lesions. The dental treatment included: modulating sessions to control aversion to noises, the photophobia, and the dental fear and anxiety because of his reduced visual acuity; oral hygiene instructions, dietary and daily use of a 0.05% sodium fluoride mouthwash; the permanent mandibular left first molar was treated endodontically, and maxillary and mandibular first molars were restored with amalgam. Due to the patient's heart defect, a prophylactic antibiotic regimen was prescribed prior to the dental procedures. This patient has been followed up for 4 years and this case report underscores the importance of early dental evaluation and counseling for parents of WBS patients.

A Síndrome de Williams-Beuren (SWB), também conhecida como síndrome de Williams, consiste em uma desordem congêntica rara a qual apresenta problemas cardiovasculares, retardo mental, alterações faciais e anomalias dentárias. É causada pela microdeleção de 1,5 a 1,8 Mb no cromossomo 7q11.23. Este trabalho relata o tratamento odontológico de uma criança de 7 anos com a síndrome. Durante a anamnese constatou-se deficiência visual, perda auditiva neurossensorial, hiperacusia, fotofobia e voz rouca. O exame clínico intra-oral revelou mordida aberta anterior, deglutição atípica, espaçamento interdental excessivo, hipomineralização dos incisivos, hipoplasia e lesões de cárie. O tratamento dentário incluiu: sessões de condicionamento comportamental afim de controlar a aversão a ruídos, a fotofobia e o medo e a ansiedade frente ao tratamento odontológico, provocadas principalmente por sua reduzida acuidade visual; instruções de higiene oral, dieta e uso diário de bochechos de fluoreto de sódio a 0,05%; endodontia do primeiro molar permanente inferior esquerdo e restaurações de amálgama nos primeiros molares superiores e inferiores. Devido ao defeito cardíaco do paciente, antibioticoterapia profilática foi realizada antes dos atendimentos odontológicos. Este paciente está em acompanhamento há 4 anos e este relato ressalta a importância da avaliação odontológica precoce e do aconselhamento aos pais dos pacientes com SWB.

Behavioral problems and emotional stress in children with bruxism.

Bruxism has a multifactorial etiology, and psychosocial factors have been considered to increase the risk of occurrence of this parafunction. The aim of this study was to evaluate the behavior profile of a group of children diagnosed with bruxism. Eighty 7-11-year-old children of both genders (mean age 8.8 years) first recruited as eligible participants. Twenty-nine children (18 males and 11 females) whose parents/guardians reported to present frequent episodes of tooth grinding/clenching while awake or during sleep (at least 3 nights a week) in the previous 3 months were enrolled in the study. The diagnosis of bruxism was established based on the parents/guardians' report about the children's behavior, habits and possible discomforts in the components of the stomatognathic system allied to the presence of signs and symptoms such as pain on the masticatory muscles, masseter muscle hypertrophy, wear facets, fractures of restorations, dental impressions on the cheek mucosa and tongue. As part of the psychological evaluation, the Rutter's Child Behavior Scale-A2 was applied to the parents/caregivers (one for each child) and the Child Stress Scale was applied to the children. Data were analyzed descriptively based on the frequency of each studied variable. Twenty-four (82.76%) children needed psychological or psychiatric intervention; 17 of them presented neurotic disorders and 7 children presented antisocial disorders. Six (20.70%) children presented significant physical and psychological manifestations of stress. The findings of the present study suggest that behavioral problems and potential emotional problems can be risk factors to bruxism in children.

Behavioral problems and emotional stress in children with bruxism

Bruxism has a multifactorial etiology, and psychosocial factors have been considered to increase the risk of occurrence of this parafunction. The aim of this study was to evaluate the behavior profile of a group of children diagnosed with bruxism. Eighty 7-11-year-old children of both genders (mean age 8.8 years) first recruited as eligible participants. Twenty-nine children (18 males and 11 females) whose parents/guardians reported to present frequent episodes of tooth grinding/clenching while awake or during sleep (at least 3 nights a week) in the previous 3 months were enrolled in the study. The diagnosis of bruxism was established based on the parents/guardians' report about the children's behavior, habits and possible discomforts in the components of the stomatognathic system allied to the presence of signs and symptoms such as pain on the masticatory muscles, masseter muscle hypertrophy, wear facets, fractures of restorations, dental impressions on the cheek mucosa and tongue. As part of the psychological evaluation, the Rutter's Child Behavior Scale-A2 was applied to the parents/caregivers (one for each child) and the Child Stress Scale was applied to the children. Data were analyzed descriptively based on the frequency of each studied variable. Twenty-four (82.76%) children needed psychological or psychiatric intervention; 17 of them presented neurotic disorders and 7 children presented antisocial disorders. Six (20.70%) children presented significant physical and psychological manifestations of stress. The findings of the present study suggest that behavioral problems and potential emotional problems can be risk factors to bruxism in children.

A etiologia do bruxismo é multifatorial, e fatores psicossociais têm sido apontados como notáveis potencializadores do risco para a ocorrência dessa parafunção. O presente estudo teve como objetivo avaliar o perfil comportamental de um grupo de crianças com bruxismo. Oitenta crianças de ambos os sexos, com idade entre 7 e 11 anos (idade media de 8,8 anos) foram recrutadas como possíveis participantes. Vinte e nove crianças, 18 do sexo masculino e 11 do feminino, cujos pais ou responsáveis relataram que as mesmas apresentavam rangimento dental freqüente (3 noites por semana) ou apertamento/rangimento dental em vigília, nos últimos 3 meses, foram selecionadas para o estudo. O diagnóstico de bruxismo foi estabelecido com base no relato dos pais ou responsáveis sobre os hábitos cotidianos das crianças e possíveis desordens do sistema estomatognático aliados à presença de sinais e sintomas tais como dor à palpação da musculatura mastigatória, hipertrofia do músculo masseter, facetas de desgaste, fratura de restaurações, impressões dentais na bochecha e lingual. Como parte da avaliação psicológica, a Escala Comportamental Infantil A2 de Rutter foi aplicada aos pais ou responsáveis (um por criança) e a Escala de Stress Infantil foi aplicada às crianças. Os dados foram tabelados e analisados descritivamente com base na freqüência de cada variável estudada. Vinte e quatro (82,76%) crianças necessitavam de intervenção psicológica ou psiquiátrica, sendo que 17 crianças apresentavam desordens neuróticas e 7 apresentavam desordens anti-sociais. Seis (20,70%) crianças apresentaram manifestações físicas e psicológicas de stress. Os resultados do presente trabalho sugerem que problemas comportamentais e potencialidades para o desenvolvimento de desequilíbrios emocionais podem ser fatores de risco para o bruxismo em crianças.

Reação inflamatória periapical - repercussões sistêmicas / Apical periondontitis - systemic repercussions

A correlação entre as reações inflamatórias periapicais e a saúde orgânica ainda é um assunto polêmico no meio médico e odontológico. Diversos estudos têm aventado a possibilidade de as reações inflamatórias na região periapical ocasionarem alterações cardiovasculares, doenças respiratórias, diabetes, osteoporose, uveíte, abscesso intracraniano, bacteriospermia e subfertilidade, fascite necrosante, mediastinite e endocardite bacteriana pela disseminação por difusão, planos anatômicos, bactérias via corrente sanguínea, moléculas advindas de microrganismos e mediadores da resposta imune ou inflamatória. Entretanto, uma vez que esses estudos se baseiam em relatos de casos, pesquisas futuras se fazem necessárias para estabelecer os reais mecanismos de disseminação e em que intensidade os microrganismos presentes no biofilme apical, a resposta imuno-inflamatória periapical e as interações antígeno anticorpo são capazes de levar a reações sistêmicas.

The relationship between apical periodontitis and general health is a controversial subject in medical and dental . Several papers have suggested that chronic periapical inflammation may lead to cardiovascular events, respiratory diseases, diabetes, osteoporosis, uveitis, intracranial abscess, mediastinitis, and bacterial endocarditis. These alterations can occur due to dissemination throughout anatomic planes, blood stream bacterial spread, or due to host response against products and by-products from microorganisms. However these pieces of evidence are based on case reports and determination of the mechanisms by which bacteria present in the apical biofilm can reach other parts of the body and elicit systemic disturbances should shed light on this theory.

Inter-relação padrão de aleitamento e hábitos de sucção não nutritivos / Interrelalation between feeding and non nutritive habits

Pesquisas recentes mostram que a relação padrão de aleitamento e a presença de hábitos de sucção não nutritivos em crianças é um assunto relevante e controverso. Dessa maneira, o objetivo deste trabalho é o de relatar as publicações mais recentes acerca deste tópico e discutir os aspectos positivos e negativos desta inter-relação.

Current researches have been focused on the relationship between feeding and presence of non nutritive habits in children. The aim of this literature review is to describe the most relevant published papers in this and discuss about the positive and negative aspects of this interrelation.

Is there an association between bruxism and intestinal parasitic infestation in children?

PURPOSE: Multiple factors have been considered in the etiology of bruxism in pediatric patients, among which are infestations by intestinal parasites suggested by some authors. No empirical evidence exists, however, of such association. Therefore, this study's purpose was to investigate the existence of an association between bruxism and intestinal parasitic infestation in children. METHODS: Fifty-seven 6- to 11-year-olds (30 cases and 27 controls) who had not used anthelminthics 2 months before the baseline examination were enrolled in the study. A diagnosis of bruxism was based on an intraoral clinical examination performed by a single trained examiner and on the parent/guardian's report of any perceived parafunctional habits (questionnaire-based interview). Bruxism cases were defined as those children with a report of currently perceived habits of eccentric or centric bruxism (tooth-grinding and tooth-clenching, respectively) combined with clinical evidence of nonphysiologic wear facets. The volunteers were required to collect 3 fecal samples (1 every 2 to 3 days). Parasitologic analysis was performed using the spontaneous sedimentation method. Data gathered from the intraoral clinical examination, questionnaire, and parasitologic analysis were tabulated and submitted to statistical analysis using the chi-square test and student's t test. RESULTS: Intestinal parasitic infestation was observed in 30% (N=9) of cases and 41% (N=11) of controls, but no statistically significant association was observed (P=.40). CONCLUSION: This study's findings do not support the existence of an association between intestinal parasitic infestation and bruxism among the evaluated pediatric population.

Gingival overgrowth in a renal transplant recipient using cyclosporine A.

Unsightly gingival enlargement is a frequent side effect in organ transplant recipients under immunosuppressive therapy with cyclosporin A (CsA). The purpose of this article was to report the treatment management of cyclosporin A-induced gingival overgrowth in a 9-year-old renal transplant recipient. Surgical reduction of the overgrown gingival tissue associated with an intensive biofilm control program and conversion from CsA to tacrolimus provided good clinical outcome with improvement of mastication, feeding, and phonetics. Gingival overgrowth stabilized with the change of medication. After approximately 3 months of follow-up, a regression of gingival enlargement was observed.

Aspectos odontológicos en paciente portador del síndrome de Mobius: relato de caso / Dental aspects of a patient with Mobius syndrome: case report

El síndrome de Mobius se caracteriza por la parálisis congénita y no progresiva de los nervios craneanos facial y abducentes cuyas manifestaciones clínicas principales son la apariencia facial estática y poco expresiva, el estrabismo bilateral convergente y la hipoplasia de miembros, entre otras. En la cavidad bucal puede observarse micrognacia, implantación heterotrófica de la lengua, anquiloglosia, úvula bífida, fisura palatina y anomalías dentales. La etiología del síndrome de Mobius es poco conocida y algunos relatos de la literatura señalan, como la hipótesis más probable, una isquemia fetal transitoria, durante el período de formación de los núcleos craneanos. Los posibles factores causales de esta isquemia serian los de orden ambiental, los disturbios fisiopatológicos y genéticos, o el uso ilícito de drogas como el Misoprostol, durante la gestación. El presente trabajo relata el tratamiento odontológico realizado en una paciente portadora de este síndrome enfatizando las particularidades observadas durante la atención, en función de las características propias de esa entidad clínica

Mobius syndrome is characterized by congenital and non-progressive paralysis of the facial and abducent cranial nerves. The principal manifestations of this syndrome are lack of facial expression, convergent bilateral strabismus and hypoplastic members. The oral findings include micrognatia, heterotrophic implantation of the tongue, ankyloglossia, bifid uvula, cleft palate and dental anomalies. The etiology of Mobius syndrome is unknown and some reports relate, as a main cause, the transitory fetal ischemia during the formation of cranial nucleus. The factors that lead to this ischemia are from ambient, physiopathological or genetic disturbs and use of drugs like Misoprostol during the pregnancy. This paper reports the dental treatment of a female patient with Mobius syndrome, emphasizing the peculiarities observed due to the characteristics of this clinical entity

Ojal quirúrgico (ulectomía) ¿cuando y como realizarlo?: reporte de 3 casos clínicos / Ulectomy: when and how to apply?: three case reports

En este trabajo es descrita la técnica de la ulectomía en pacientes con erupción dental retardada debido a fibrosis de la mucosa gingival. Son relatados aspectos relacionados al diagnóstico e indicación precisa de la técnica, a los exámenes clínico y radiográfico de la región, y presentados tres casos con resultados exitosos, después de la realización deste procedimento quirúrgico

In this study we describe the ulectomy in patients with retarded dental eruption due the fibrosis of the encíal mucosa. After clinical and radiographic exams of the area, and the presentation of three successful cases obtained after that surgical procedure, aspects relation with diagnosis and precise indication of that technique were related