Uso do laser de baixa potência para o tratamento de parestesia: uma revisão de literatura / Use of low-level laser to treat paresthesia: a literature review

Introdução: A parestesia é uma neuropatia que afeta a função sensorial. O Laser de Baixa Potência (LBP), por sua vez, apresenta propriedades analgésicas, bioestimuladoras e reparadoras. Objetivo: Realizar um levantamento na literatura científica sobre os aspectos gerais e benefícios do LBP no manejo terapêutico da parestesia, além de identificar a classificação e métodos de obtenção do diagnóstico desta condição. Materiais e Métodos: Tratou-se de uma revisão narrativa da literatura através da busca nas plataformas PubMed, SciELO, LILACS e Google Schoolar. Após o cruzamento dos descritores com os operadores booleanos e aplicação dos critérios de inclusão/exclusão, 26 estudos foram incluídos. Resultados: A parestesia pode ser classificada em neuropraxia, axonotmese e neurotmese, subdivididas em Grau I ao V. Seu diagnóstico pode ser executado através de testes subjetivos e objetivos. O LBP compreende em um dispositivo tecnológico com efeitos analgésico, anti-inflamatório e fotobiomodulador, que estimula o reparo neural. Os estudos mostram que a dosimetria nos comprimentos de onda vermelho e infravermelho, aplicação intra e extra oral, e com mais de uma sessão semanal exerce efeito modulatório positivo do reparo neural, com retorno progressivo da atividade sensitiva. Além disso, os estudos trazem uma ampla variação no número de pontos de aplicação, bem como no tempo de irradiação e quantidade de sessões, em virtude da extensão e tempo de diagnóstico da parestesia. Considerações finais: Apesar da alta complexidade da parestesia, o LBP exerce efeitos benéficos através do retorno da sensibilidade parcial ou total, além de ser um dispositivo bem tolerado pelo organismo e minimamente invasivo.

Introduction: Paresthesia is a neuropathy that affects sensory function. The Low-Level Laser (LLL), in turn, has analgesic, biostimulating and reparative properties. Purpose: Carry out a survey at the scientific literature on the general aspects and benefits of LLL in the therapeutic management of paresthesia in addition to identifying the classification and methods for obtaining a diagnosis of this condition. Materials and Methods: It was a narrative literature review through search in platforms PubMed, SciELO, LILACS and Google Schoolar. After crossing the descriptors with boolean operators and applying the inclusion/exclusion criteria, 26 articles were included in this study. Results: Paresthesia can be classified into neuropraxia, axonotmesis and neurotmesis, subdivided into Grades I to V. Its diagnostic can be carried out through subjective and objective tests. The LLL consists in a technological device with analgesic, anti-inflammatory and photobiomodulatory effects, which stimulates neural repair. Studies show that LLL in dosimetry at red and infrared wavelengths with intra and extra oral application and with more than one-week use exerts a positive modulatory effect on neural repair, with a progressive return of sensory activity. Furthermore, the studies show a wide variation in the number of application points, as well as the irradiation time and number of sessions, due to the extent and time of diagnosis of paresthesia. Final Considerations: Despite the high complexity of paresthesia, the LLL has beneficial effects through the return of partial or total sensitivity in addition being a device well tolerated by the body and minimally invasive.

Exodontia de supranumerário paramolar e de primeiro molar com destruição coronária em região de maxila: relato de caso / Extraction of a supernumerary paramolar and first molar with coronary destruction in the maxilla area: case report

Os dentes supranumerários são descritos como uma espécie de anomalia dentária, determinada pela formação de dentes além daqueles pertencentes à dentição convencional, que geralmente promovem complicações na cavidade oral. Diversos fatores etiológicos podem estar relacionados e de acordo com sua localização, são classificados em mesiodens, distomolar e paramolar. O presente estudo tem como objetivo apresentar e descrever a exodontia de um elemento supranumerário paramolar em região de maxila, bem como a remoção cirúrgica do primeiro molar com destruição coronária em região subjacente, através de um relato de caso. Paciente E.M.J., sexo feminino, 38 anos de idade, ASA 1, procurou atendimento odontológico devido à queixa principal de dor em região do 1° molar superior esquerdo. Ao exame físico e radiográfico, foi observada grande destruição coronária do elemento 26 associado a uma fístula intraoral, além da presença de dente supranumerário paramolar na região vestibular do dente 26. O tratamento preconizado foi a remoção cirúrgica de ambos elementos e a paciente evoluiu sem intercorrências no pós-operatório. Desta maneira, pode-se concluir que a remoção cirúrgica de dente supranumerário paramolar e de unidade dentária com grande destruição coronária por lesão cariosa, mostrou-se uma alternativa segura e eficaz no presente caso.

Supernumerary teeth are described as a kind of dental anomaly, determined by the teeth´s formation other than those belonging to the conventional dentition, which generally promote complications in the oral cavity. Several etiological factors may be related and, according to their location, they are classified into mesiodens, distomolar and paramolar. This study aims to present and describe the extraction of a paramolar supernumerary element in the maxillary region, as well as the surgical removal of the first molar with coronary destruction in the underlying region, through a case report. Patient E.M.J., female, 38 years old, ASA 1, sought dental care due to the main complaint of pain in the region of the upper left 1st molar. At the clinical and radiographic examination, a great coronal destruction of element 26 associated with a intraoral fistula was observed, in addition to the presence of a supernumerary paramolar tooth on the buccal side of tooth 26. The recommended treatment was the surgical removal of both elements and the patient evolved uneventfully in the post-operative. Thus, it can be concluded that the surgical removal of a supernumerary paramolar tooth and a dental unit with great coronary destruction due to a carious lesion proved to be a safe and effective alternative in the present case.

"Música Paraense" e Terruá Pará: identidade regional, indústria cultural e psicologia das massas / "Pará Music" and Terruá Pará: regional identity, cultural industry and mass psychology / La «Musique Paraense¼ et le Terruá Pará: identité régionale, l'industrie culturelle et la psychologie des foules / "Música Paraense" y Terruá Pará: identidad regional, industria cultural y psicología de las masas

Desde a consolidação de emissoras de rádio e TV no Pará, a mídia local propaga a ideia de uma "música paraense", título utilizado com frequência em uma série de eventos recentemente produzidos dentro e fora do estado. Ao contestar essa singularização, a presente pesquisa apresenta uma análise psicossociológica dos mecanismos que operam na inter-relação entre indústria cultural e formação de massas, utilizando como objeto privilegiado de estudo o espetáculo Terruá Pará. Visando tal intento, além do recurso à revisão bibliográfica, realizou-se uma pesquisa documental sobre parte do material impresso produzido para a terceira edição do festival. Em termos conclusivos, defende-se que o Terruá Pará, embora pautado por um discurso pretensamente racional em prol da valorização da música regional, torna-se dialeticamente promotor de irracionalidades expressas na sugestão de modos de subjetivação específicos que, desconsiderando diversidades, acabam por reduzir o seu público consumidor à qualidade de multidão abstrata

Since the consolidation of radio and TV broadcasters in Pará, local media has propagated the idea of a "Pará music," moniker often used in a series of events produced in and outside the State. By contesting such singularization, this psychosociological analysis unveils the mechanisms that mediate cultural industry and mass formation by analyzing the spectacle Terruá Pará. For this purpose, a bibliographic review was conducted, as well as a documentary research concerning part of the printed material produced for the festival's third edition. In conclusion, although Terruá Pará appears based on an allegedly rational discourse to value regional music, it dialectically promotes irrationalities expressed in specific modes of subjectivation that, disregarding diversity, reduce its consuming public to the quality of abstract crowd

Depuis la consolidation des stations de radio et télévision à l'état du Pará, les médias locaux ont diffusé l'idée d'une «musique paraense¼, expression souvent utilisée dans une série d'événements récemment produits dans cet état autant que dehors. En contestant cette singularisation, cette recherche présente une analyse psychosociologique des mécanismes agissant dans l'interrelation entre l'industrie culturelle et la formation des foules, en prenant comme objet principal d'étude le spectacle Terruá Pará. Dans ce but, outre le recours à l'étude bibliographique, on a mené une recherche documentaire sur une partie du matériel imprimé produit pour la troisième édition du festival. En conclusion, on soutient que Terruá Pará, bien que guidé par un discours prétendument rationnel en faveur de la valorisation de la musique régionale, devient dialectiquement promoteur d'irrationalités exprimées par la suggestion de modes de subjectivation spécifiques qui, en ignorant les diversités, finissent par réduire son public consommateur à une foule abstraite

Desde la consolidación de las estaciones de radio y televisión en Pará, los medios locales han difundido la "musica paraense", título de uso frecuente en eventos producidos dentro y fuera del Estado. Al impugnar esta singularización, esta investigación presenta un análisis psicosociológico de los mecanismos que operan en la interrelación entre la industria cultural y la formación de masas, utilizando como objeto privilegiado de estudio el espectáculo Terruá Pará. Además del uso de la revisión bibliográfica, fue llevada a cabo una investigación documental sobre parte del material producido para la tercera edición del festival. En conclusión, se argumenta que Terruá Pará, aunque guiado por un discurso supuestamente racional a favor de la valorización de la música regional, se convierte dialécticamente en promotor de irracionalidades expresadas en la sugerencia de modos específicos de subjetivación que, sin tener en cuenta las diversidades, reducen su público consumidor a la calidad de multitud abstracta

Clinical Aspects and Etiopathogenesis of Recurrent Aphthous Ulcer: Narrative Literature Review / Aspectos Clínicos e Etiopatogenia da Úlcera Aftosa Recorrente: Revisão Narrativa da Literatura

Recurrent aphthous ulcer (RAU) is a common oral mucosal lesion with varied and etiopathogenesis. It presents with pain and clinically manifests as an oval-shaped lesion with regular borders surrounded by an erythematous halo and covered by pseudo membrane. Due to the uncertainty about the possible causative factors, there is a need for studies that seek a better understanding of its pathophysiology. In this context, this study aimed to discuss the etiopathogenesis and clinical aspects of RAU. It was a descriptive study characterized as a narrative literature review. The inclusion criteria were studies relevant to the topic, written in Portuguese and English, without a time limit. The search was conducted between December 2022 and July 2023, through active searching in the Pubmed, LILACS, and SciELO platforms, as well as grey literature from Google Scholar and secondary free search. The Health Sciences Descriptors (DeCS/MeSH) were crossed using a Boolean operator, namely "aphthous ulcers" AND "predisposing factors." RAU has a multifactorial etiopathogenesis and may be associated with immunological, hereditary, nutritional, dietary, psycho-emotional, hormonal, and local trauma factors, although its relationship with microorganisms is controversial. Clinically, it is classified based on its morphology and clinical course. Morphologically, it is classified into minor, major, and herpetiform types, with the minor form being the most common. Therefore, RAU is a frequent oral mucosal lesion, with the minor form being the most prevalent, and despite its uncertain etiopathogenesis, studies indicate that immunological, traumatic, hereditary, hormonal, nutritional, and psycho-social factors are directly related to its development. (AU)

A úlcera aftosa recorrente (UAR) é uma lesão frequente da mucosa oral com etiopategia variada. Apresenta dor e clinicamente se manifesta com formato oval, bordas regulares circundada por halo eritematoso e coberta por pseudomembrana. Devido a incerteza sobre os possíveis fatores causais, há uma necessidade de estudos que busquem maior compreensão sobre sua patofisiologia. Diante desse contexto, o presente estudo teve como objetivo discorrer sobre a etiopatogenia e os aspectos clínicos da UAR. Tratou-se de um estudo descritivo, caracterizado como revisão narrativa da literatura. Os critérios de inclusão estabelecidos foram: estudos pertinentes à temática, redigidos em português e inglês, sem corte temporal. O levantamento ocorreu entre dezembro/2022 a julho/2023, através da busca ativa nas plataformas Pubmed, LILACS e SciELO, além da literatura cinzenta do Google Acadêmico e busca livre secundária. Os Descritores em Ciências da Saúde (DeCS/ MeSH) foram cruzados com operador booleano, a saber: "aphthous ulcers" AND "predisposing factors". A UAR apresenta etiopatogenia multifatorial, em que pode estar associada com fatores imunológicos, hereditários, nutricionais, alimentares, psico-emocionais, hormonais e traumas locais, todavia sua relação com microrganismos é controversa. Clinicamente, é classificada de acordo com sua morfologia e com sua evolução clínica. Morfologicamente, se classifica em menor, maior e herpetiformes, e a forma menor apresenta maior ocorrência. Portanto, a UAR trata-se de uma lesão frequente em mucosa oral, em que a forma menor tem maior frequência, e apesar de sua etiopatogenia incerta, estudos indicam que fatores imunológicos, traumáticos, hereditários, hormonais, nutricionais e psico-sociais apresentam relação direta com seu desenvolvimento. (AU)

A hora da estrela: desamparo e tragicidade na obra clariciana / L'heure de l'étoile: impuissance et tragédie dans l'œuvre de Clarice / The hour of the star: helplessness and tragicity in Clarice's work

O presente trabalho tem por objetivo abordar a noção freudiana de desamparo a partir da leitura do último romance da escritora Clarice Lispector, intitulado A Hora da Estrela. A metodologia adotada na presente pesquisa consiste em uma pesquisa bibliográfica, sendo privilegiado o referencial teórico freudiano. O intuito do trabalho consiste em realizar aproximações entre as noções de desamparo, literatura e tragicidade na teoria psicanalítica e no texto clariciano aqui abordado. Sabendo que a obra clariciana propicia que diversas leituras sejam efetivadas, optamos por realizar um recorte teórico e fincar nossas observações em trechos da obra que nos levem ao entendimento do conceito teórico freudiano de desamparo. Assim sendo, conclui-se que o desamparo é a expressão máxima da marca humana e que há maneiras de lidarmos com esta verdade tão avassaladora, inclusive por meio da arte poética. Ainda que as marcas deixadas por esta verdade, que são compostas de tragicidade e conflito, sejam demasiadamente rígidas, a psicanálise e a literatura nos fornecem subsídios para enfrentá-las

Le présent travail vise à aborder la notion freudienne d'impuissance à partir de la lecture du dernier roman de l'écrivain Clarice Lispector, intitulé L'heure de l'étoile. La méthodologie adoptée dans cette recherche consiste en une recherche bibliographique, en privilégiant la référence théorique freudienne. Le but du travail est de faire des rapprochements entre les notions d'impuissance, de littérature et de tragique dans la théorie psychanalytique et dans le texte lispectorien abordé ici. Sachant que l'œuvre de Clarice permet d'effectuer plusieurs lectures, nous avons choisi de faire une coupure théorique et de baser nos observations sur des extraits de l'œuvre qui nous amènent à la compréhension du concept théorique freudien d'impuissance. Nous en concluons donc que l'impuissance est l'expression ultime du manque humain et qu'il existe des moyens de faire face à cette vérité écrasante, y compris par le biais de l'art poétique. Bien que les marques laissées par cette vérité, qui sont composées de tragique et de conflit, soient trop rigides, la psychanalyse et la littérature nous fournissent des subventions pour y faire face.

The present work aims to address the Freudian notion of helplessness from the reading of the last novel by the writer Clarice Lispector, entitled The Hour of the Star. The methodology adopted in this research consists of a bibliographical research, being privileged the Freudian theoretical framework. The purpose of the work is to make approximations between the notions of helplessness, literature and tragicity in psychoanalytic theory and in the Clarice's text addressed here. Knowing that the author's work allows several readings to be carried out, we chose to make a theoretical cut and base ourobservations on excerpts from the work that lead us to the understanding of the Freudian theoretical concept of helplessness. Therefore, it is concluded that helplessness is the maximum expression of human mark and that there are ways to deal with this overwhelming truth, including through poetic art. Although the marks left by this truth, which are composed of tragicity and conflict, are too rigid, psychoanalysis and literature provide us with subsidies to face them

Aplicação da fotobiomodulação laser em úlceras traumáticas na cavidade oral: revisão integrativa da literatura / Laser photobiomodulation application in traumatic ulcers in the oral cavity: integrative literature review

As úlceras traumáticas representam uma condição benigna e recorrente que acomete a cavidade oral, com variação de tamanho e dimensão. Existem inúmeras terapias que podem ser empregadas com o objetivo de promover analgesia e(ou) reparo tecidual. A fotobiomodulação laser (FBML) tem adquirido espaço no manejo dessas lesões, por se tratar de um dispositivo minimamente invasivo e bem tolerado pelo organismo, além de atuar na bioestimulação, o que confere efeito analgésico, anti-inflamatório e cicatricial. Dessa maneira, o estudo tem como objetivo avaliar a aplicação terapêutica da FBML em úlceras traumáticas na cavidade oral. Tratou-se de uma revisão integrativa da literatura, com base na pesquisa de artigos científicos dos últimos nove anos, realizada nas plataformas LILACS, BVS, SciELO, PubMed, e Google Acadêmico, utilizando o cruzamento de Descritores em Ciências da Saúde (DeCS) e empregando o uso dos operador booleano "AND". De forma adicional, a busca livre foi realizada com vistas à complementação da fundamentação teórica. Um total de sete artigos foram incluídos na presente revisão integrativa, o que incluiu estudos em humanos e em modelo animal. Todos os estudos incluídos apresentaram resultados positivos com a utilização da FBML, que demonstrou efeito benéfico através de uma ou duas sessões, com indução do processo de cicatrização, melhora da sintomatologia dolorosa e da inflamação. A FBML foi capaz de melhorar o quadro clínico e histológico das úlceras traumáticas em cavidade oral, através da modulação da percepção da dor e da inflamação, aceleração da cicatrização e consequente regressão das lesões.

Traumatic ulcers represent a benign and recurrent condition that affects the oral cavity, varying in size and dimension. There are numerous therapies that can be used to promote analgesia and/or tissue repair. Laser photobiomodulation (FBML) has gained space in the management of these lesions, as it is a minimally invasive device that is well tolerated by the body, in addition to acting in biostimulation, which confers analgesic, anti-inflammatory and healing effects. Thus, the study aims to evaluate the therapeutic application of FBML in traumatic ulcers in the oral cavity. This was an integrative literature review, based on the research of scientific articles from the last nine years, carried out on the LILACS, BVS, SciELO, PubMed, and Google Scholar platforms, using the intersection of Health Sciences Descriptors (DeCS) and employing the use of the Boolean operator "AND". Additionally, the free search was carried out with a view to complementing the theoretical foundation. A total of seven articles were included in this integrative review, which included studies in humans and in an animal model. All included studies showed positive results with the use of FBML, which demonstrated a beneficial effect through one or two sessions, inducing the healing process, improving pain symptoms and inflammation. FBML was able to improve the clinical and histological picture of traumatic ulcers in the oral cavity, by modulating the perception of pain and inflammation, accelerating healing and consequent regression of the lesions.

Understanding mucus modulation behavior of chitosan oligomers and dextran sulfate combining light scattering and calorimetric observations.

This study reports the fundamental understanding of mucus-modulatory strategies combining charged biopolymers with distinct molecular weights and surface charges. Here, key biophysical evidence supports that low-molecular-weight (Mw) polycation chitosan oligosaccharides (COSs) and high-Mw polyanion dextran sulfate (DS) exhibit distinct thermodynamic signatures upon interaction with mucin (MUC), the main protein of mucus. While the COS â†’ MUC microcalorimetric titrations released ~14 kcal/mol and ~60 kcal/mol, the DS â†’ MUC titrations released ~1200 and ~1450 kcal/mol at pH of 4.5 and 6.8, respectively. The MPT-2 titrations of COS â†’ MUC and DS â†’ MUC indicated a greater zeta potential variation at pH = 4.5 (relative variation = 815 % and 351 %, respectively) than at pH = 6.8 (relative variation = 282 % and 136 %, respectively). Further, the resultant binary (COS-MUC) and ternary (COS-DS-MUC) complexes showed opposite behavior (aggregation and charge inversion events) according to the pH environment. Most importantly, the results indicate that electrostatics could not be the driving force that governs COS-MUC interactions. To account for this finding, we proposed a two-level abstraction model. Macro features emerge collectively from individual interactions occurring at the molecular level. Therefore, to understand the outcomes of mucus modulatory strategy based on charged biopolymers it is necessary to integrate both visions into the same picture.

Falsa acusação de abuso sexual na alienação parental: luto ou melancolia? / False accusation of sexual abuse in parental alienation: mourning or melancholia? / Falsa acusación de abuso sexual en la alienación parental: ¿luto o melancolía?

Este artigo apresenta como principal objeto de estudo a falsa acusação de abuso sexual no contexto da alienação parental para, diante dela, estabelecer a seguinte problemática: será possível propor uma eventual correlação entre si e os processos psíquicos do luto e da melancolia? Neste sentido, a partir do recurso teórico ao referencial psicanalítico de Freud e de Laplanche, debate as circunstâncias que norteiam o discurso levado ao Judiciário pelo genitor alienante valorizando em tal movimento não apenas a realidade material da prova, tão importante no campo jurídico, mas também a realidade psíquica ditada pelo inconsciente, a qual se pauta em uma noção de verdade que, na sua vinculação direta com a particularidade de cada sujeito e com o dinamismo das relações específicas que ele estabelece consigo mesmo e com os outros, coloca em xeque as certezas positivistas da norma. Em termos conclusivos, destaca o quanto, a despeito da atual literatura existente sobre alienação parental no Brasil a correlacionar, em regra, a um luto mal elaborado por parte do alienante, é possível e mesmo desejável cogitar também a presença da melancolia - ou, mais especificamente, de traços melancólicos intermediários - na formação e desenvolvimento desse fenômeno.(AU)

This article presents as the main object of study the false accusation of sexual abuse in the context of parental alienation, to establish the following problem: would it be possible to propose a probable correlation between parental alienation and the psychic processes of mourning and melancholia? In this sense, based on the psychoanalytic theoretical framework of Freud and Laplanche, the article discusses the circumstances that guide the discourse taken to the judiciary branch by the alienating parent, valuing in such action not only the material reality of the evidence, which is very important in the legal field, but also the psychic reality dictated by the unconscious, which is guided by a notion of truth that, in its direct connection with the particularity of each subject and with the dynamism of the specific relations that they establish with themselves and others, threatens the positivist certainties of the norm. In conclusive terms, it highlights how, despite the current existing literature on parental alienation in Brazil generally correlates it to a poorly elaborated mourning by the alienating person, it is possible and even desirable to also consider the presence of melancholia-or, more specifically, of intermediate melancholic traits-in the formation and development of this phenomenon.(AU)

Este artículo presenta como principal objeto de estudio la falsa acusación de abuso sexual en el contexto de alienación parental, con el fin de responder al siguiente planteamiento: ¿Es posible proponer una posible correlación entre la alienación parental y los procesos psíquicos de duelo y melancolía? Para ello, desde el marco psicoanalítico de Freud y de Laplanche, se discuten las circunstancias del discurso llevado al Poder Judicial por el padre alienante, que valora en tal movimiento no solo la realidad material de la prueba, tan importante en el campo jurídico, sino también la realidad psíquica dictada por el inconsciente, el cual se guía por una noción de verdad que, en su conexión directa con la particularidad de cada sujeto y con el dinamismo de las relaciones específicas que establece consigo mismo y con otros, pone en jaque las certezas positivistas de la norma. En la conclusión, destaca cómo, a pesar de la literatura actual existente sobre la alienación parental en Brasil, en general, la correlaciona con un duelo mal diseñado por parte de la persona alienante, es posible e incluso deseable considerar la presencia de la melancolía -más específicamente, de rasgos melancólicos intermediarios- en la formación y desarrollo de este fenómeno.(AU)

Tratamento de ceratocistos na síndrome de Gorlin Goltz / Diagnosis and treatment of oral keratocysts in Gorlin Goltz Syndrome / Tratamento de ceratocistos na Síndrome de Gorlin Goltz

A Síndrome de Gorlin Goltz apresenta características com comprometimento craniofaciais que incluem carcinomas basocelulares, ceratocístos odontogênicos e fenda labial e/ou palatina. Ceratocísticos odontogênico aparecem durante as primeiras décadas de vida, mais comumente na mandíbula, associados a dentes impactados. O diagnóstico precoce possibilita a cura da lesão, minimiza as deformidades ósseas e pode ser concluído com exames como radiográfico e histopatológico. Relato de caso: Com o objetivo descrever o diagnóstico e analisar as possibilidades de tratamento das manifestações faciais da Síndrome de Gorlin Goltz será relatado um caso clínico de uma paciente infantil. A paciente tem um acompanhamento clínico multidisciplinar com geneticista, oncologista e cirurgião-dentista de 6 anos. Apresentou 5 ceratocisticos odontogênicos, carcinomas basocelulares na região do pescoço, calcificação da foice cerebral, ceratose palmo-plantar e macrocefalia. O tratamento para as lesões císticas foi a enucleação, seguida de osteotomia periférica. O defeito ósseo produzido pela enucleação de cisto mandibular foi enxertado com bloco de osso alógeno do banco de tecidos do INTO-RJ. Conclusão: Constata-se que o Cirurgião-dentista é capacitado para fazer o diagnóstico desta síndrome e encaminhar para o tratamento multidisciplinar. O enxerto alógeno é uma opção adequada de reconstrução de cavidades císticas, beneficiando pacientes do Sistema Único de Saúde... (AU)

Gorlin Goltz Syndrome has features with craniofacial involvement that include basal cell carcinomas, odontogenic keratocysts, and cleft lip and/or palate. Odontogenic keratocysts appear during the first decades of life, most commonly in the mandible, associated with impacted teeth. Early diagnosis enables healing of the lesion, minimizes bone deformities and can be completed with exams such as radiographic and histopathological exams. Case report: In order to describe the diagnosis and analyze the treatment possibilities of the facial manifestations of Gorlin Goltz Syndrome, a clinical case of a child patient will be reported.The patient has a multidisciplinary clinical follow-up with a 6-year geneticist, oncologist and dental surgeon. She had 5 odontogenic keratocystic keratocysts, basal cell carcinomas in the neck region, sickle cerebral calcification, palmoplantar keratosis and macrocephaly. The treatment for cystic lesions was enucleation, followed by peripheral osteotomy. The bone defect produced by the enucleation of a mandibular cyst was grafted with an allogeneic bone block from the tissue bank of INTO-RJ. Conclusion: It is concluded that the dentist is trained to make the diagnosis of this syndrome and refer to multidisciplinary treatment. Allogeneic graft is an appropriate option for the reconstruction of cystic cavities, benefiting patients from the Unified Health System... (AU)

El Síndrome de Gorlin Goltz tiene características con compromiso craneofacial que incluyen carcinomas de células basales, queratoquistes odontogénicos y labio leporino o paladar hendido. Los queratoquistes odontogénicos aparecen durante las primeras décadas de vida, más comúnmente en la mandíbula, asociados con dientes retenidos. El diagnóstico precoz permite la curación de la lesión, minimiza las deformidades óseas y se puede concluir con exámenes como exámenes radiográficos e histopatológicos. Reporte de caso: Con el fin de describir el diagnóstico y analizar las posibilidades de tratamiento de las manifestaciones faciales del Síndrome de Gorlin Goltz, se reportará un caso clínico de un paciente infantil. El paciente tiene un seguimiento clínico multidisciplinario con un genetista, oncólogo y cirujano dentista de 6 años. Presentó 5 queratocísticos odontogénicos, carcinomas basocelulares en la región del cuello, calcificación de la hoz cerebral, queratosis palmoplantar y macrocefalia. El tratamiento de las lesiones quísticas fue la enucleación, seguida de una osteotomía periférica. El defecto óseo producido por la enucleación de un quiste mandibular se injertó con un bloque óseo alogénico del banco de tejidos de INTO-RJ. Conclusión: Parece que el odontólogo está capacitado para realizar el diagnóstico de este síndrome y derivar al tratamiento multidisciplinario. El injerto alogénico es una opción adecuada para la reconstrucción de cavidades quísticas, beneficiando a los pacientes del Sistema Único de Salud... (AU)

Color and surface gloss stability of bis-acryl and resin composite after exposure to cigarette smoke / Estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas após exposição por fumaça de cigarro

Objective: To evaluate color and surface gloss stability of bis-acryl resins and resin composites, submitted to artificial staining with cigarette smoke. Material and Methods: Specimens of each material were prepared (n=15). Two resin composites (GrandioSO [RCG], Filtek Supreme [RCZ]) and five bis-acryl resins (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] and Yprov [BisYPR]) were tested. Initial color was assessed using a spectrophotometer and surface gloss with a glossmeter. Samples were submitted to smoke exposure (10 cigarettes under 8 minutes per cycle). After 3 and 6 cycles, color and gloss were reassessed. Final readings were performed after brush prophylaxis. Data were analyzed using two-way repeated ANOVA and Tukey's test (p<0.05). Results: Differences and interaction of factors (p<0.01) were detected for both color and gloss readings. Resin composites were the least affected by aging, with gloss reduction after prophylaxis. Differences were detected among bis-acryl resins, with better results for BisLUX and BisPRO. BisPRO and BisSTR, showed reduction in gloss after 60 cigarettes, while BisYPR gloss decreased at all evaluated periods. Conclusion: Resin composites are less susceptible to changes after smoke exposure, while bis-acryl resins results are brand-dependent. Prophylaxis negatively influenced the surface gloss of most of the tested materials (AU)

Objetivo: Avaliar a estabilidade de cor e brilho superficial de resinas compostas e bisacrílicas, submetidos ao manchamento artificial por fumaça de cigarro. Material e Métodos: Foram preparados espécimes de cada material (n=15). Duas resinas compostas (GrandioSO [RCG], Filtek Supreme [RCZ]) e cinco resinas bisacrílicas (Luxatemp Star [BisLUX], Protemp4 [BisPRO], Structor3 [BisSTR], Visalys Temp [BisVIS] e Yprov [BisYPR]) foram testados. A cor inicial foi avaliada usando um espectrofotômetro e o brilho de superfície com um medidor de brilho. As amostras foram submetidas à exposição de fumaça de cigarro (10 cigarros com até 8 minutos por ciclo). Após 3 e 6 ciclos, a cor e o brilho foram reavaliados. As leituras finais foram realizadas após a profilaxia escova de robinson. Os dados foram analisados usando de medidas repetidas e teste de Tukey (p<0,05). Resultados: Foram detectadas diferenças e interação de fatores (p<0,01) tanto para leituras de cor quanto para leituras de brilho. As resinas compostas foram as menos afetados pelo envelhecimento, com redução do brilho após a profilaxia. Foram detectadas diferenças entre as resinas bisacrílicas, com melhores resultados para BisLUX e BisPRO. BisPRO e BisSTR, mostraram redução de brilho após 60 cigarros, enquanto que o brilho da BisYPR diminuiu em todos os períodos avaliados. Conclusão: As resinas compostas são as menos suscetíveis a mudanças após a exposição à fumaça, enquanto os resultados das resinas bisacrílicas são dependentes da marca. A profilaxia influenciou negativamente o brilho de superfície da maioria dos materiais testados.(AU)

Cellulose Nanofibers Improve the Performance of Retrograded Starch/Pectin Microparticles for Colon-Specific Delivery of 5-ASA.

Cellulose nanofibers (CNF) were employed as the nanoreinforcement of a retrograded starch/pectin (RS/P) excipient to optimize its colon-specific properties. Although starch retrogradation ranged from 32 to 73%, CNF addition discretely disfavored the RS yield. This result agrees with the finding that in situ CNF reduces the presence of the RS crystallinity pattern. A thermal analysis revealed that the contribution of pectin improves the thermal stability of the RS/CNF mixture. Through a complete factorial design, it was possible to optimize the spray-drying conditions to obtain powders with high yield (57%) and low moisture content (1.2%). The powders observed by Field Emission Gum Scanning Electron Microscopy (FEG-SEM) had 1-10 µm and a circular shape. The developed methodology allowed us to obtain 5-aminosalicilic acid-loaded microparticles with high encapsulation efficiency (16-98%) and drug loading (1.97-26.63%). The presence of CNF in RS/P samples was responsible for decreasing the burst effect of release in simulated gastric and duodenal media, allowing the greatest mass of drug to be targeted to the colon. Considering that spray-drying is a scalable process, widely used by the pharmaceutical industry, the results obtained indicate the potential of these microparticles as raw material for obtaining other dosage forms to deliver 5-ASA to the distal parts of gastrointestinal tract, affected by inflammatory bowel disease.

Bulk-fill versus layering pure ormocer posterior restorations: A randomized split-mouth clinical trial.

PURPOSE: To evaluate the clinical performance of Class II restorations made with bulk-fill or layering pure ormocer materials, as well as the time necessary to fill the preparations. METHODS: After ethics approval, a randomized controlled split-mouth clinical trial was performed. 30 subjects were selected according to the inclusion/exclusion criteria, and two restorations were randomly performed in each first or second molar that presented caries, fracture, or cosmetic needs. One restoration was done with the bulk-fill material Admira Fusion x-tra, applied with increments up to 4 mm (intervention group), while the second was performed with the regular Admira Fusion, applied by a 2 mm layering technique (control group). The universal adhesive system Futurabond U was used for both groups. The subjects and examiners were blinded, and the examiners were previously calibrated. The restorations were evaluated according to FDI criteria, after 7 days, 6, 12 and 24 months, and the outcome was success rate based on esthetic, functional and biological properties. The time necessary for application of both materials into the preparations was also measured. RESULTS: After 24 months, 26 patients attended the recall and 52 restorations were evaluated. The Fisher's statistical analysis (α= 5%) showed non-significant differences between techniques for esthetic, biological and functional properties in all evaluations (P> 0.05). After 2 years, 96% of the subjects for both groups did not show any sign of post-operative sensitivity and 100% of the teeth were vital and without secondary caries. Around 70% of the restorations received score excellent for surface luster, more than 83% for surface staining and 63% for color match. In relation to marginal adaptation and marginal staining, more than 80% for the layering material and 63% for the bulk showed excellent scores. Only three restorations of the 60 performed showed small fractures, although not affecting the esthetics or function. The time for composite application was significantly shorter for the bulk material (P= 0.0454). After 24 months of intraoral service, the restorations made with both materials presented similar and excellent clinical performance for all parameters analyzed. The bulk-fill material required significantly less chair time to apply than the layering one, simplifying and accelerating the restorative technique. CLINICAL SIGNIFICANCE: The bulk-fill ormocer-based composite was an appropriate alternative to the conventional layering material, since similar clinical performance was observed after 2 years, with the advantage of shorter chair time, due to simplified operative procedures.

Conservative approach to treating severe tetracycline staining: a 12-month follow-up.

Severe tetracycline staining may affect the esthetics of teeth and the self-esteem of patients. This case report describes minimally invasive treatment with dental bleaching and direct restorations to improve the esthetics of tetracycline-stained teeth in a 44-year-old woman. All of the patient's teeth were affected by grayish brown staining, and the maxillary central incisors demonstrated incisal wear. The buccal angulation of the anterior teeth and the patient's Class II skeletal profile hindered the use of direct or indirect veneer restorations. The proposed treatment was home bleaching with 10% carbamide peroxide applied in a soft vinyl tray, which was worn overnight for the first 3 months and 2 hours daily for the next 3 months (total treatment time of 6 months). Afterward, a single session of in-office bleaching with 37% hydrogen peroxide was performed over resistant bands of staining observed at the cervical thirds of the teeth. Fourteen days after the in-office bleaching treatment, composite resin restorations were placed at the incisal areas of the maxillary central incisors and the cervical areas of the central incisors, lateral incisors, and canines to treat the incisal wear and mask the remaining dental discoloration. In some cases, minimally invasive treatment with tooth bleaching might be indicated for the esthetic treatment of teeth severely stained by tetracycline, although this approach presents limitations. In the present case, the patient was satisfied with her smile after the treatment protocol was completed, and the results remained stable after 12 months. The patient reported an improved quality of life after treatment.

Narcisismo e Melancolia em Psicologia das Massas e Análise do Eu: aproximações / Narcissism and Melancholy in Group Psychology and the Analysis of the Ego: approximations / Narcisismo y Melancolía en Psicología de las Masas y Análisis del Yo: aproximaciones

Ao levar em conta a sua importância tanto metapsicológica quanto social, este artigo traça um itinerário das noções de narcisismo e melancolia no escopo de "Psicologia das Massas e Análise do Eu". Neste sentido, ao promover uma reconstituição do caminho que se inicia em "Introdução ao Narcisismo" e "Luto e Melancolia" até a reaparição desses conceitos no texto sobre a psicologia das massas, pretende lançar luz sobre os processos de idealização, identificação e introjeção que, de acordo com Freud, ladrilham uma continuidade entre sujeito e sociedade. Conclusivamente, aponta possíveis conexões entre a cisão do Eu, a servidão melancólica e as tentativas de reaver um narcisismo mediante a imersão nas massas hodiernas.

Taking into account both its metapsychological and social importance, this article traces an itinerary of the notions of narcissism and melancholy within the scope of Freud's "Group Psychology and the Analysis of the Ego". Therefore, through a reconstitution of the path that begins in "On Narcissism: an introduction" and "Mourning and Melancholia" until the reappearance of these concepts in the text about the psychology of the masses, it intends to shed some light on the processes of idealization, identification and introjection that, according to Freud, tile a continuous line between subject and society. In conclusive terms, the present work points out some possible connections between the splitting of the Ego, the melancholic servitude and the attempts to recover a narcissism upon the immersion in the contemporary masses.

Al tener en cuenta su importancia metapsicológica como social, este artículo traza un itinerario de las nociones de narcisismo y melancolía en "Psicología de las Masas y el Análisis del Yo". En este sentido, a través de una reconstitución del camino que comienza en "Introducción al Narcisismo" y "Luto y Melancolía" hasta la reaparición de estos conceptos en el texto sobre Psicología de las masas, se pretende discutir los procesos de idealización, identificación e introyección que, según Freud, enmarca una continuidad entre el sujeto y la sociedad. En conclusión, el presente trabajo señala algunas posibles conexiones entre la división del Yo, la servidumbre melancólica y los intentos de recuperar un narcisismo que se expande por la inmersión en las masas contemporáneas.

Highlights in poloxamer-based drug delivery systems as strategy at local application for vaginal infections.

Infectious diseases related to the vagina include diseases caused by the imbalance of the vaginal flora and by sexually transmitted infections. Some of these present themselves as a public health problem due to the lack of efficient treatment that leads to their complete cure, and others due to the growing resistance to drugs used in therapy. In this sense, new treatment strategies are desirable, with vaginal administration rout being a great choice since can bypass first-pass metabolism and decrease drug interactions and adverse effects. However, it is worth highlighting limitations related to patient's discomfort at application time. Thereby, the use of poloxamer-based drug delivery systems is desirable due its stimuli-sensitive characteristic. Therefore, the present review reports a brief overview of poloxamer properties, biological behavior and advances in poloxamer applications in controlled drug release systems for infectious diseases related to the vagina treatment and prevention.

Highlighting the use of micro and nanoparticles based-drug delivery systems for the treatment of Helicobacter pylori infections.

Due to the high adaptability of Helicobacter pylori and the low targeting specificity of the drugs normally used in pharmacological therapy, the strains are becoming increasingly resistant to these drugs, making it difficult to eradicate the infection. Thus, the search for new therapeutic approaches has been considered urgent. The incorporation of drugs in advanced drug delivery systems, such as nano and microparticles, would allow the improvement of the retention time in the stomach and the prolongation of drug release rates at the target site. Because of this, the present review article aims to highlight the use of micro and nanoparticles as important technological tools for the treatment of H. pylori infections, focussing on the main nanotechnological systems, including nanostructured lipid carriers, liposomes, nanoemulsion, metallic nanoparticles, and polymeric nanoparticles, as well as microtechnological systems such as gastroretentive dosage forms, among them mucoadhesive, magnetic and floating systems were highlighted.

Chitosan-based systems aimed at local application for vaginal infections.

Vaginal administration is a promising route for the local treatment of infectious vaginal diseases since it can bypass the first-pass metabolism, drug interactions, and adverse effects. However, the commercial products currently available for topical vulvovaginal treatment have low acceptability and do not adequately explore this route. Mucoadhesive systems can optimize the efficacy of drugs administered by this route to increase the retention time of the drug in the vaginal environment. Several polymers are used to develop mucoadhesive systems, among them chitosan, a natural polymer that is highly biocompatible and technologically versatile. Thus, the present review aimed to analyze the studies that used chitosan to develop mucoadhesive systems for the treatment of local vaginal infections. These studies demonstrated that chitosan as a component of mucoadhesive drug delivery systems (DDS) is a promising device for the treatment of vaginal infectious diseases, due to the intrinsic antimicrobial activity of this biopolymer and because it does not interfere with the effectiveness of the drugs used for the treatment.

Exploiting drug delivery systems for oral route in the peptic ulcer disease treatment.

Peptic ulcer disease (PUD) is a common condition that is induced by acid and pepsin causing lesions in the mucosa of the duodenum and stomach. The pathogenesis of PUD is a many-sided scenario, which involves an imbalance between protective factors, such as prostaglandins, blood flow, and cell renewal, and aggressive ones, like alcohol abuse, smoking, Helicobacter pylori colonisation, and the use of non-steroidal anti-inflammatory drugs. The standard oral treatment is well established; however, several problems can decrease the success of this therapy, such as drug degradation in the gastric environment, low oral bioavailability, and lack of vectorisation to the target site. In this way, the use of strategies to improve the effectiveness of these conventional drugs becomes interesting. Currently, the use of drug delivery systems is being explored as an option to improve the drug therapy limitations, such as antimicrobial resistance, low bioavailability, molecule degradation in an acid environment, and low concentration of the drug at the site of action. This article provides a review of oral drug delivery systems looking for improving the treatment of PUD.

The role of polysaccharides from natural resources to design oral insulin micro- and nanoparticles intended for the treatment of Diabetes mellitus: A review.

Oral administration of insulin (INS) would represent a revolution in the treatment of diabetes, considering that this route mimics the physiological dynamics of endogenous INS. Nano- and microencapsulation exploiting the advantageous polysaccharides properties has been considered an important technological strategy to protect INS against harsh conditions of gastrointestinal tract, in the same time that improve the permeability via transcellular and/or paracellular pathways, safety and in some cases even selectivity for targeting delivery of INS. In fact, some polysaccharides also give to the systems functional properties such as pH-responsiveness, mucoadhesiveness under specific physiological conditions and increased intestinal permeability. In general, all polysaccharides can be functionalized with specific molecules becoming more selective to the cells to which INS is delivered. The present review highlights the advances in the past 10 years on micro- and nanoencapsulation of INS exploiting the unique natural properties of polysaccharides, including chitosan, starch, alginate, pectin, and dextran, among others.

Ultra-processed foods and early childhood caries in 0-3-year-olds enrolled at Primary Healthcare Centers in Southern Brazil.

OBJECTIVE: To investigate the relationship between ultra-processed food consumption and early childhood caries. DESIGN: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. SETTING: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. PARTICIPANTS: Children aged 0-3 years (n 309). RESULTS: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. CONCLUSIONS: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children's oral health.