Rare case of gemination and fusion involving supernumerary teeth and second mandibular molar - Case report.

This article presents the rare case of a patient with gemination and fusion involving conical supernumerary teeth and the second mandibular molar, along with its treatment. The 13-year-old girl, without any associated syndromes and currently undergoing orthodontic treatment, was referred for evaluation due to the presence of a supernumerary tooth. Following a clinical examination and analysis of a panoramic radiograph, a cone beam computed tomography was requested for a more detailed assessment of the supernumerary tooth and its relationship with adjacent structures. The sagittal sections revealed the presence of two conical paramolar supernumerary teeth, which were geminated and fused to the mesial root of tooth 47. The suggested treatment was the surgical removal of the supernumerary teeth, which was successfully performed without complications and with good healing. After one-year post-procedure, the formation of periodontal ligament was verified at the site where the supernumerary teeth were extracted. The simultaneous occurrence of gemination of two supernumerary teeth and their fusion to a mandibular molar is extremely rare, and their surgical removal provided the patient with better plaque control in the region and contributed to the progress of orthodontic treatment. Key words:Gemination and fusion of supernumerary teeth and second mandibular molar.

Plant extracts used in Brazil for treatment of oral ulcers and mucositis: systematic review / Extratos vegetais utilizados no Brasil para tratamento de úlceras orais e mucosite: revisão sistemática

Objective: To identify and analyze plant extracts used in Brazil for the treatment of oral ulcers and oral mucositis. Material and Methods: A systematic review was registered in PROSPERO (CRD 42018102184) and performed following the PRISMA protocol. The databases searched were PubMed, Web of Science, Scopus, Lilacs, Scielo, the Brazilian Dentistry Library. Manual searches were also performed. Results: Initially, 440 studies were found, of which 392 were excluded after reading the titles and abstracts. A total of 29 articles were read in full and 11 studies were excluded, resulting in 18 articles included in the systematic review. Nine plant species were identified in five clinical trials and 13 in vivo studies, with Chamomila recutita being the most used (33.3% of the studies). Chamomila recutita showed more promising results for analgesic, anti-inflammatory, and healing properties. Calotropis procera latex significantly decreased (p<0.05) inflammatory mediators, such as TNF-α and IL-1ß in oral mucositis induced in rats. Eupatorium laevigatum showed anti-inflammatory activity and analgesic action on oral ulcers. Carapa guianensis Aubl. reduced the severity and painful symptoms of oral mucositis and exhibited better results compared to the use of low power laser. Curcuma longa L accelerated re-epithelialization and resolution of inflammatory processes. Spondias mombin reduced oxidative stress and inflammation caused by oral mucositis and helped on healing it. Extracts of Aloe barbadensis Miller or Aloe vera showed anti-inflammatory action but did not help in the healing process of oral ulcers. Copaifera reticulata Ducke oil did not induce improvement in the healing process, nor did it show an anti-inflammatory effect. Malva sylvestrisdid not show an anti-inflammatory action on oral lesions in humans or rats. The assessment of methodological heterogeneity showed the impossibility of performing a meta-analysis. Risk of bias varied from low to high. Conclusion: The plant species most used and with the best results for the treatment of oral ulcerations and oral mucositis was Chamomilla recutita. Spondias mombin L., Curcuma longa L., Carapa guianensis Aubl and Calotropis procera showed good results in the treatment of oral mucositis, while Eupatorium laevigatum was efficient in the treatment of ulcers of traumatic origin. Malva sylvestris, Copaifera reticulata Ducke, and Aloe barbadensis Miller did not exhibit significant results (AU)

Objetivo: Identificar e analisar extratos vegetais utilizados no Brasil para o tratamento de úlceras orais e mucosite oral. Material e Métodos: Uma revisão sistemática foi registrada no PROSPERO (CRD 42018102184) e realizada seguindo o protocolo PRISMA. As bases de dados pesquisadas foram PubMed, Web of Science, Scopus, Lilacs, Scielo, Biblioteca Brasileira de Odontologia. Buscas manuais também foram realizadas. Resultados: Inicialmente, foram encontrados 440 estudos, dos quais 392 foram excluídos após a leitura dos títulos e resumos. Um total de 29 artigos oram lidos na íntegra e 11 estudos foram excluídos, resultando em 18 artigos incluídos na revisão sistemática. Nove espécies vegetais foram identificadas em cinco ensaios clínicos e 13 estudos in vivo, sendo a Chamomila recutita a mais utilizada (33,3% dos estudos). A Chamomila recutita apresentou resultados mais promissores quanto às propriedades analgésicas, anti-inflamatórias e cicatrizantes. O látex de Calotropis procera diminuiu significativamente (p<0,05) os mediadores inflamatórios, como TNF-α e IL-1ß, na mucosite oral induzida em ratos. Eupatorium laevigatumapresentou atividade anti-inflamatória e ação analgésica em úlceras orais. Carapa guianensis Aubl. reduziu a gravidade e os sintomas dolorosos da mucosite oral e apresentou melhores resultados em comparação com o uso do laser de baixa potência. Curcuma longa L. acelerou a reepitelização e resolução de processos inflamatórios. Spondias mombinreduziu o estresse oxidativo e a inflamação causadas pela mucosite oral e ajudou na sua cicatrização. Extratos de Aloe barbadensis Miller ou Aloe vera apresentaram ação anti-inflamatória, mas não auxiliaram no processo de cicatrização de úlceras orais. O óleo de Copaifera reticulata Ducke não induziu melhora no processo cicatricial, nem apresentou efeito anti-inflamatório. Malva sylvestris não apresentou ação anti-inflamatória em lesões orais em humanos ou ratos. A avaliação da heterogeneidade metodológica mostrou a impossibilidade de realizar uma meta-análise. O risco de viés variou de baixo a alto. Conclusão: A espécie vegetal mais utilizada e com melhores resultados para o tratamento de ulcerações orais e mucosite oral foi a Chamomilla recutita. Spondias mombin L., Curcuma longa L., Carapa guianensis Aubl e Calotropis procera apresentaram bons resultados no tratamento da mucosite oral, enquanto Eupatorium laevigatum foi eficiente no tratamento de úlceras de origem traumática. Malva sylvestris, Copaifera reticulata Duckee Aloe barbadensis Miller não apresentaram resultados significativos(AU)

Combined nonsurgical and implant restoration after dental trauma: a case report.

Dentoalveolar trauma is an important etiologic factor for tooth loss. A multidisciplinary approach to treatment is necessary because the functional, esthetic, and psychosocial problems that result from dentoalveolar trauma can significantly influence the patient's quality of life. The objective of this article is to describe the multidisciplinary treatment of a 39-year-old man who experienced dentoalveolar trauma in a bicycle accident. Clinical and tomographic examinations revealed the avulsion of the maxillary left central incisor as well as coronal fractures of the other incisors and the maxillary right canine. The maxillary right central incisor had a subgingival fracture, and the treatment included endodontic treatment followed by orthodontic extrusion using a temporary intraradicular retention pin and an orthodontic elastic band attached to a provisional prosthesis for anchorage. A dental implant and a connective tissue graft were placed at the site of the avulsed tooth. Subsequently, 5 zirconia crowns were fabricated using a digital workflow. In some cases of dentoalveolar trauma, orthodontic extrusion accomplished with the aid of the provisional prosthesis can be a conservative, fast, and economical option to preserve periodontal tissues and restore the biologic width. In the present case, the combination of orthodontic extrusion, implant placement, and a digital workflow ensured the precision, comfort, and esthetics of the final restorations, improving the quality of life of the patient.

Removal of mandibular third molars displaced to deep fascial spaces: case reports.

This article reports the treatment of 2 cases of mandibular third molar displacement into deep fascial spaces during attempted extraction, 1 of which resulted in acute infection. In addition to treatment approaches, the article reviews the risk factors for tooth displacement and techniques that may be used for its prevention. In both of the reported cases, after tooth extraction procedures resulted in the displacement of a third molar, the correct location of the tooth was ascertained by 3-dimensional imaging. The displaced tooth was removed via intraoral access while the patient wasunder general anesthesia. Both patients healed without postsurgical complications, confirming the success of the treatment.

Orthognathic surgery associated with reconstruction of the temporomandibular joint with a customized prosthesis: a case report.

The objective of this case report is to describe the treatment of a dentofacial and temporomandibular joint (TMJ) deformity by means of reconstruction with a customized TMJ prosthesis and orthognathic surgery. The article discusses the therapeutic approach and the importance of functional and esthetic rehabilitation of the patient. A 22-year-old man displayed sequelae of osteomyelitis diagnosed at 6 years of age, including facial asymmetry, laterognathism, unsatisfactory occlusion, and mandibular retrognathism. Computed tomography revealed a deformity of the left mandibular condyle, ramus, and fossa. The patient underwent 1-stage surgery that involved bimaxillary orthognathic surgery and mentoplasty in conjunction with reconstruction of the left TMJ with a customized prosthesis. Postoperatively, substantial improvement was observed in the patient's facial pattern and masticatory function, and the beneficial changes have been maintained through 2 years of follow-up. The positive outcome in this patient suggests that TMJ reconstruction using a customized prosthesis in combination with computer-guided orthognathic surgery can be a satisfactory approach to correct a mandibular defect. The advantages of 1-stage surgery for the surgeon include shorter treatment time and more predictable results, while the benefits for the patient are good esthetic and functional results and improved quality of life.

The Relation between Maxillary Sinuses and Cleft Lip and Palate / A Relação Entre os Seios Maxilares e a Fissura Labiopalatina

Cleft lip and palate are anomalies of craniofacial development that require reparative surgery to provide considerable improvement in the individual's quality of life, but which can also have a negative impact on the maxilla development. The aim of this study was to understand the influence of surgical repair of cleft lip and palate on the volume of the maxillary sinus of these individuals. A narrative review was carried out using the scientific databases Pubmed and Scielo, where the articles selected by the abstract were fully read, categorized and critically analyzed. There are reports of high frequency of chronic sinusitis in patients with cleft lip and palate, especially children, that may be related to hypoplasia of the maxilla and lower volume of the maxillary sinus related to the cleft. In addition, these individuals are submitted to several surgical corrections that can also negatively influence the maxilla development due to tissue fibrosis, with suggestions for surgical techniques to reduce this interference. Thus, the patient with cleft lip and palate may present maxillary underdevelopment, which may result in hypoplasia of the maxillary sinus, and reparative surgeries can aggravate this complication. This review suggests some surgical techniques to reduce this interference, although there are few articles with clinical trials found in the literature that can explore these alternatives and correlate the results with current surgical protocols. (AU)

As fissuras labiopalatinas são anomalias de desenvolvimento craniofacial que necessitam de cirurgias reparadoras para proporcionar melhora considerável à qualidade de vida do indivíduo, mas que também podem repercutir negativamente no desenvolvimento da maxila. O objetivo deste estudo foi compreender a influência das cirurgias reparadoras de fissuras labiopalatais no volume do seio maxilar desses indivíduos. Foi realizada uma revisão narrativa pelas bases de dados científicos Pubmed e Scielo, de onde os artigos selecionados pelo abstract foram lidos na íntegra, categorizados e analisados criticamente. Há relatos de alta frequência de sinusite crônica em pacientes com fissuras labiopalatais, principalmente crianças, que podem estar relacionada a hipoplasia de maxila e menor volume do seio maxilar relacionado à fissura. Além disso, esses indivíduos são submetidos a diversas correções cirúrgicas que também podem influenciar negativamente o desenvolvimento da maxila devido a fibrose tecidual, havendo sugestões de técnicas cirúrgicas para diminuir essa interferência. Então, o paciente com fissuras labiopalatais pode apresentar hipodesenvolvimento maxilar podendo ter como consequência a hipoplasia do seio maxilar e as cirurgias reparadoras podem agravar essa complicação. Essa revisão sugere algumas técnicas cirúrgicas para diminuir essa interferência, embora existam poucos artigos com ensaios clínicos encontrados na literatura que possam explorar essas alternativas e correlacionar os resultados com os protocolos cirúrgicos atuais. (AU)

Antimicrobial potential of plant extracts from the Brazilian Cerrado.

Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 µg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 µg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 µg/mL, Senna martiniana (73.28%) in the concentration of 40 µg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 µg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.

Paracoccidioidomicose afetando a mucosa bucal: relato de caso / Paracoccidioidomycosis affecting the buccal mucosa: case report / Paracoccidioidomicosis con afectación de la mucosa oral: relato de caso

Introdução: A paracoccidioidomicose é uma infecção micótica sistêmica com manifestações pulmonares primária que podem apresentar lesões cutâneas e orais. É mais comum no Brasil e em alguns outros países da América Latina, representando um importante problema de saúde pública devido às suas características potencialmente fatais. Relato de caso: Trabalhador rural de 53 anos, fumante e etilista, apresentando lesão ulcerada de aspecto moriforme em mucosa bucal direita. Realizou-se biópsia incisional cujo laudo histopatológico foi de paracoccidioidomicose. O paciente foi encaminhado ao médico infectologista para tratamento por meio de itraconazol (200mg por dia) por 18 meses. Após 03 meses de tratamento já apresentava regressão da lesão. Considerações Finais: Portanto, o objetivo deste trabalho é enfatizar a importância do cirurgião-dentista no reconhecimento das lesões oral e realização da biópsia para o correto diagnóstico e manejo desta doença por meio de um relato de caso clínico... (AU)

Paracoccidioidomycosis is a systemic mycotic infection with primary pulmonary manifestations that can present cutaneous and oral lesions. It is more common in Brazil and some other Latin American countries, representing an important public health problem due to its potentially fatal characteristics. Case report: 53-year-old rural worker, smoker and drinker, presenting an ulcerated lesion with a moriform aspect in the right oral mucosa. An incisional biopsy was performed, and the histopathological report was of paracoccidioidomycosis. The patient was referred to the infectious disease physician for treatment with itraconazole (200mg per day) for 18 months. After 03 months of treatment, he already had regression of the lesion. Final Considerations: Therefore, the objective of this paper is to emphasize the importance of the dentist in recognizing oral lesions and performing a biopsy for the correct diag... (AU)

La paracoccidioidomicosis es una infección micótica sistémica con manifestaciones pulmonares primarias que pueden presentar lesiones cutáneas y bucales. Es más común en Brasil y algunos otros países de América Latina, lo que representa un importante problema de salud pública debido a sus características potencialmente fatales. Caso clínico: trabajador rural de 53 años, fumador y bebedor, con lesión ulcerada de aspecto moriforme en mucosa oral derecha. Se realizó biopsia incisional y el informe histopatológico fue de paracoccidioidomicosis. El paciente fue remitido al médico de enfermedades infecciosas para tratamiento con itraconazol (200 mg al día) durante 18 meses. Después de 03 meses de tratamiento, ya tenía regresión de la lesión. Consideraciones finales: Por lo tanto, el objetivo de este trabajo es enfatizar la importancia del odontólogo en el reconocimiento de las lesiones bucales y la realización de una biopsia para el correcto diagnóstico y manejo de esta enfermedad a través de la presentación de un caso clínico... (AU)

Antimicrobial potential of plant extracts from the Brazilian Cerrado

Abstract Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 μg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 μg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 μg/mL, Senna martiniana (73.28%) in the concentration of 40 μg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 μg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.

Resumo Bactérias estão relacionadas a diferentes doenças bucais, como a cárie dentária e a doença periodontal. Assim, o controle e/ou erradicação de microrganismos e seus subprodutos é primordial para o sucesso dos tratamentos. Uma alternativa para diminuir a carga bacteriana é a utilização de extratos vegetais utilizados na medicina popular. A citotoxicidade e ação antimicrobiana de extratos de Cariniana rubra Gardinerex Miers, Senna martiniana H.S. Irwin & Barneby, Anadenanthera colubrina (Vell.) Brenan e Spiranthera odoratissima St. Hil. contra cepas de Streptococcus mutans, Enterococcusfaecalis, Staphylococcus aureus, Escherichia coli, Agartibacter actinomycetencomitans e Candida albicans foram investigados. A citotoxicidade foi avaliada nas concentrações de 1, 10, 40, 80, 100 e 1000 μg/mL por meio do teste MTT. Aqueles com citotoxicidade aceitável tiveram a ação antimicrobiana medida pelo teste XTT. Cariniana rubra Gardinerex Miers apresentou os maiores resultados de citototoxicidade, enquanto Spiranthera odoratissima St. Hil. obteve os melhores resultados, mas todos os extratos apresentaram citotoxicidade aceitável em diferentes concentrações. Os extratos vegetais apresentaram maior atividade contra A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80,52%) a 40 μg/mL, Spiranthera odoratissima St. Hil (78,48%) em 1 μg/mL, Senna martiniana H.S. Irwin & Barneby (73,28%) na concentração de 40 μg/mL e Cariniana rubra Gardinerex Miers (70,50%) em 10 μg/mL. Todos os extratos analisados apresentaram citotoxicidade aceitável em diferentes concentrações e foram promissores na inibição dos microrganismos patogênicos estudados.

Epidermoid cyst mimicking a thyroglossal duct cyst in a pediatric patient: a case report.

This article presents a case of an epidermoid cyst that mimicked a thyroglossal duct cyst in a pediatric patient. An 8-year-old boy was referred for evaluation of a volumetric increase in the median cervical region with an evolution of about 4 years. The skin in the submental region was healthy and normal colored. Palpation revealed a mobile, well-circumscribed nodular lesion of soft consistency. Computed tomography of the neck showed an expansive hypodense formation extending from the base of the tongue to the upper portion of the hyoid bone, suggesting a thyroglossal duct cyst. Considering the diagnostic hypothesis, cystic enucleation via the Sistrunk procedure was planned. However, no ductal structure was identified during the surgical procedure, and the lesion was only near, but not attached to, the hyoid bone. Simple excision of the lesion was therefore performed. At the most recent follow-up examination, about 3 months postoperatively, the patient demonstrated satisfactory clinical progress. The epidermoid cyst close to the hyoid bone presented diagnostic difficulty due to its similarity to a thyroglossal duct cyst. Computed tomography provides limited information for diagnosing this type of lesion, and ultrasonography is the preferred test. In view of the uncertain diagnosis in this case, the extent of the excision was determined during the surgery, and simple excision was a satisfactory treatment associated with a good prognosis.

Avaliação dos impactos financeiros gerados pela pandemia da Covid-19 aos técnicos de prótese dentária no Brasil / Assessing the financial impacts of the COVID-19 pandemic on denture technicians in Brazil

Resumo Introdução a pandemia da Covid-19 e medidas de controle da sua expansão impactaram diferentes segmentos da economia, dentre eles os profissionais da Odontologia. Objetivo este trabalho analisou o impacto financeiro gerado pela pandemia da Covid-19 aos técnicos de prótese dentária (TPDs) no Brasil. Material e método por meio de um estudo transversal descritivo, aplicou-se aos TPDs do Brasil um questionário relacionado ao perfil sociodemográfico e profissional, impacto financeiro e medidas adotadas para minimizar seus efeitos. O questionário foi aplicado de forma on-line em redes sociais entre 27 de janeiro e 15 de fevereiro de 2021. Resultado demonstrou-se que 59,8% dos participantes eram do sexo masculino; 47,5% até 30 anos de idade e 57,3% com menos de 10 anos de prática. As medidas para contenção da propagação do coronavírus impactaram financeiramente 89,6% dos participantes; 72,0% interromperam totalmente seus trabalhos; 97,7% tiveram redução no faturamento; 98,2% tiveram mudança na rotina de trabalho; 94,8% tiveram aumento das despesas do laboratório no período; houve queda do faturamento para 41,2% entre 0% e 25,0% e para 36,3% entre 25,0% e 50,0%; 66,6% continuaram trabalhando durante a pandemia devido à sua situação financeira. Não pensaram em fechar seu laboratório de forma definitiva 71,8% dos participantes; 92,2% seguiram rotineiramente os cuidados de higienização e 21,6% fizeram uso das reservas financeiras. Conclusão os TPDs tiveram impacto financeiro durante o período da pandemia da Covid-19 causado principalmente pela diminuição da carga horária de trabalho, redução do faturamento e aumento do custo operacional devido à mudança na rotina de biossegurança.

Abstract Introduction the COVID-19 pandemic and measures to control its expansion impacted different segments of the economy, including dentistry professionals. Objective this study analyzed the financial impact of the COVID-19 pandemic on dental technicians in Brazil. Material and method this is a descriptive cross-sectional study with the application of a questionnaire of sociodemographic and professional profile, financial impact, and effect containment measures to dental technicians in Brazil. The questionnaire was applied online on social networks between January 27 and February 15, 2021. Result 59.8% of the participants were male, with 47.5% aged up to 30 years, and 57.3% with less than 10 years of practice. The measures to contain the spread of the coronavirus had a financial impact on 89.6% of the participants: 72.0% had their work completely interrupted, 97.7% had their billing reduced, 98.2% changed their work routine, and 94.8% had higher laboratory expenses in the period. Revenue decreased between 0% and 25.0% for 41.2% and between 25.0% and 50.0% for 36.3%. In addition, 66.6% continued working during the pandemic due to their financial situation. 71.8% of the participants did not consider closing their laboratory permanently, whereas 92.2% followed hygiene protocols routinely and 21.6% made use of their financial reserves. Conclusion dental technicians were financially impacted by the COVID-19 pandemic, mainly caused by fewer working hours, revenue reduction, and higher operating costs due to the change in the biosafety routine.

Relationship between Oral Parafunctions and Signs and Symptoms of Craniomandibular Dysfunction in Children with Cleft Lip and Palate / Relação Entre Parafunções Orais e Sinais e Sintomas de Disfunção Craniomandibular em Crianças com Fissura Labiopalatina

The aim of this study was to evaluate the association of oral parafunctions with the presence of signs and symptoms of craniomandibular disorder in children with cleft lip and palate (CLP). A cross-sectional study was performed in which one hundred and eighty-eight children with CLP and absence of associated syndromes or malformations were investigated. During clinical examination, the presence of wear facets and dental occlusion were observed and palpation was performed in the temporomandibular joint region (TMJ) and orofacial musculature . The children and their guardians were interviewed regarding the presence of oral parafunctional habits (bruxism, the act of biting the lips and/or cheeks, nail biting, sucking of fingers and pacifiers) and signs and symptoms of craniomandibular dysfunction (headache, ear and/or neckache, tiredness or crack in the TMJ during mouth opening and chewing movements). The data were analyzed by means of absolute and relative frequency measurements, and bivariate analysis using Pearson's chi-square test and likelihood ratio test were performed, considering the significance level of 5%. A higher prevalence of cleft lip and palate type (76.0%) and the presence of malocclusion (61.7%) was observed, highlighting the anterior crossbite (58.7%) and midline deviation (48.9%). There was a higher occurrence of teeth grinding (40.4%), onychophagy (28.7%) and biting lips and/or cheeks (28.7%). Onychophagia was associated with headache (p <0.05) and with pain or cracking during mouth opening (p <0.05). It was concluded that parafunctional oral habits may be associated with signs and symptoms of craniomandibular disorder in children with cleft lip and palate.

O objetivo do estudo foi avaliar a associação de parafunções orais com sinais e sintomas da disfunção craniomandibular em crianças com fissuras labiopalatinas (FLP). Um estudo transversal foi realizado, no qual cento e oitenta e oito crianças com FLP e ausência de síndromes ou malformações associadas, foram investigadas. Durante exame clínico, a presença de facetas de desgaste e a oclusão dentária foram observadas e foi realizada a palpação na região da articulação temporomandibular (ATM) e musculatura orofacial. As crianças e seus responsáveis foram entrevistados com relação à presença de hábitos orais parafuncionais (bruxismo, ato de morder os lábios e/ou bochechas, onicofagia, sucção de dedos e de chupeta) e sinais e sintomas de disfunção craniomandibular (cefaléia, ouvido, dor, cansaço ou estalo na ATM durante movimentos de abertura bucal e de mastigação). Os dados foram analisados por meio de medidas de frequência absoluta e relativa e a análise bivariada foi realizada por meio dos testes do Qui-quadrado de Pearson (χ2) e a Razão de verossimilhança, considerando o nível de significância de 5%. Uma maior prevalência das fissuras envolvendo lábio e palato (76,0%) e presença de maloclusão (61,7%) foi observada, com destaque para mordida cruzada anterior (58,7%) e desvio de linha média (48,9%). Houve uma maior ocorrência do ato de ranger os dentes (40,4%), da onicofagia (28,7%) e do hábito de morder lábios e/ou bochechas (28,7%). A onicofagia foi associada à cefaléia (p<0,05) e à dor ou estalo durante abertura bucal (p<0,05). Conclui-se que hábitos orais parafuncionais podem estar associados a presença de sinais e sintomas da disfunção craniomandibular em crianças com FLP.

Migratory Glossitis Associated with Cleft Tongue: Case Report / Glossite Migratória Associada a Língua Fissurada: Relato de Caso

Benign migratory glossitis, also known as geographic tongue, is characterized by the tongue inflammation and is associated with pain and difficulty eating due to the lingual papillae atrophy. It may appear in association with the fissured tongue. This paper reports the case of a 47-year-old male patient who sought dental care with the main complaint of burning, discomfort, increased sensitivity and a burning sensation on the tongue. He was diagnosed with migratory glossitis associated with a fissured tongue. The patient treatment was performed with an ointment based on triamcinolone acetonide (Omcilon- A Orabase®), which showed improvement in the clinical signs after seven days. The therapy used in this patient was effective in restoring the tongue papillae and improving signs and symptoms.

A glossite migratória benigna, também conhecida como língua geográfica, caracteriza-se por inflamação da língua e está associada a dor e dificuldade na alimentação devido a atrofia das papilas linguais. Pode aparecer em associação à língua fissurada. Este trabalho relata o caso de um paciente do sexo masculino com idade de 47 anos que buscou atendimento odontológico com queixa principal de ardência, desconforto, sensibilidade aumentada e sensação de queimação na língua. Foi diagnosticado com glossite migratória associada a língua fissurada. O tratamento do paciente foi realizado com pomada à base de triancinolona acetonida (Omcilon- A Orabase®) demonstrou melhora no quadro clinico após sete dias. A terapêutica usada neste paciente foi eficaz no restabelecimento das papilas da língua e melhora dos sinais e sintomas.

Medicinal plants used for the treatment of mucositis induced by oncotherapy: a systematic review.

PURPOSE: This systematic review aimed to identify effective medicinal plants for the treatment of mucositis induced by oncotherapy. METHODS: The clinical question was the following: "Which medicinal plants are effective in the treatment of oral mucositis induced by cancer treatment?" (PubMed, Medline, Web of Science, Scopus, Lilacs, and SciELO). The keywords were the following: phytotherapy OR "herbal drug" OR "plant extract" OR plant OR "medicinal plant" OR pharmacognosy OR ethnobotany OR ethnomedicine OR ethnopharmacology OR "flower essences" OR "natural product" AND mucositis OR mucositides OR stomatitis OR stomatitides OR "oral ulcer" AND chemotherapy OR radiotherapy OR immunotherapy OR cancer OR neoplasm OR neoplasm OR tumor OR tumor. The inclusion criteria for the selection of articles were the type of study design (clinical trials) and the studied population (cancer patients presenting lesions of oral mucositis having undergone treatment with medicinal plants). RESULTS: After evaluation of the works, 24 of 893 articles were selected. Matricaria chamomilla (chamomilla) presented promising results, such as a reduction in severity and lesion incidence with improved pain symptomatology. The plant extracts Isatis indigótica, Olea europaea, Calendula officinalis, A. digitatae, and M. sylvestris improved the lesions. Mucotrol™ and QRLYD herbal products improved the degree of severity of the lesions, while SAMITAL® and MUCOSYTE allowed for greater pain control. CONCLUSION: The complementary treatment of oral mucositis in cancer patients, with analgesic and anti-inflammatory actions with lower side effects, is an alternative for healthcare professionals.

Salivary Flow Analysis of Head and Neck Irradiated Patients / Análise do Fluxo Salivar de Pacientes Irradiados em Cabeça e Pescoço

This study aimed to analyze the salivary flow of irradiated patients for the head and neck cancer treatment after the conclusion of their treatment, and to compare it to the salivary flow of a group of non-irradiated patients. The salivary flow measurement was performed using the stimulated saliva analysis technique by masticatory action. The data collected were organized in planning using the Microsoft Excel program and then analyzed through the program IBM SPSS 20.0. The independent T-test was used to compare the median values between the groups that had normal distribution. 54 patients were evaluated, 18 from Group 1, of irradiated patients with an average time of ending radiotherapy of 11 months; and 36 patients from Group 2, with non-cancerous and non-irradiated patients. The mean salivary flow of Group 1 patients was 0.39 (± 0.85) and 100% of the patients expelled less than 3.5mL of saliva after stimulation for five minutes. Among the patients from Group 2, the mean salivary flow was 3.22 (± 2.65), and 77.78% of the patients had a salivary stimulation of less than 3.5 mL. This difference was statistically significant (p = 0.004). Through the methodology used, a high prevalence of hyposalivation was observed in patients irradiated in head and neck for cancer treatment even after months of the treatment conclusion and among patients without cancer and not submitted to radiotherapy. However, a deficiency in saliva production was statistically higher among patients irradiated in the head and neck. (AU)

Este estudo teve como objetivo analisar o fluxo salivar de pacientes irradiados no tratamento do câncer de cabeça e pescoço após a conclusão de seu tratamento, e compará-lo com o fluxo salivar de um grupo de pacientes não irradiados. A medição do fluxo salivar foi realizada utilizando a técnica de análise de saliva estimulada por ação masticatória. Os dados coletados foram organizados no planejamento utilizando o programa Microsoft Excel e, em seguida, analisados através do programa IBM SPSS 20.0. O teste T independente foi utilizado para comparar os valores medianos entre os grupos que apresentaram distribuição normal. Foram avaliados 54 pacientes, 18 do Grupo 1, de pacientes irradiados com tempo médio de término da radioterapia de 11 meses; e 36 pacientes do Grupo 2, com pacientes não cancerosos e não irradiados. O fluxo salivar médio dos pacientes do Grupo 1 foi de 0,39 (± 0,85) e 100% dos pacientes expeliram menos de 3,5 mL de saliva após estimulação por cinco minutos. Entre os pacientes do Grupo 2, o fluxo salivar médio foi de 3,22 (± 2,65), e 77,78% dos pacientes apresentaram estimulação salivar inferior a 3,5 mL. Essa diferença foi estatisticamente significante (p = 0,004). Por meio da metodologia utilizada, observou-se alta prevalência de hiposalivação em pacientes irradiados na cabeça e pescoço para tratamento de câncer mesmo após meses da conclusão do tratamento e entre pacientes sem câncer e não submetidos à radioterapia. No entanto, a deficiência na produção de saliva foi estatisticamente maior entre os pacientes irradiados na cabeça e pescoço. (AU)

Evaluation of the Light Intensity Emitted by the Light-curing Devices of a Dental School Clinic in the North of Brazil: a Pilot Study / Avaliação da Intensidade de Luz Emitida Pelos Fotopolimerizadores de uma Clínica-Escola da Região Norte do Brasil: um Estudo-Piloto

Photoactivated composite resins are among the most widespread restorative materials in dentistry, particularly in cosmetic dentistry. To obtain the best properties of the material, the resins must have their polymerization reaction initiated by means of the light-curing device, which activates the photoinitiators present in the composites. For this process to occur in the desired way, it is essential that the light-curing device emits light at the intensity necessary to properly activate the photoinitiators. Thus, a pilot study was carried out to assess the light intensity emitted by the light-curing devices used in a school clinic. To assess the light intensity emitted by the devices, a radiometer was used. Twentyfour light-curing devices were evaluated, 13 Optilight Max devices, 8 Optilight LD MAX 440 devices, 3 Emitter C. devices. All the devices had an emitted light below 400 mW / cm² and 67% of the devices had intensity above 300 mW/cm². The average light emission values of the light-curing devices were Optilight Max 334mW/cm², Emitter C 275mW/cm², Optilight LD MAX 440 296mW/cm². It was concluded that no light-curing device emitted light at the recommended intensity (400 mW/cm²), two thirds of the devices emitted light in intensity above the minimum required for photopolymerization of composite resin increments of up to 2mm and one third emitted light in intensity below the required minimum. There was no difference among the light-curing device models tested in this study. (AU)

As resinas compostas fotoativadas estão entre os materiais restauradores mais difundidos em odontologia, particularmente na odontologia estética. Para obtenção das melhores propriedades do material, as resinas precisam ter sua reação de polimerização iniciada por meio do fotopolimerizador, que ativa os fotoiniciadores presentes nos compósitos. Para que esse processo ocorra da forma desejada, é fundamental que o fotopolimerizador emita a luz na intensidade necessária para ativar adequadamente os fotoiniciadores. Assim, foi realizado um estudo piloto para avaliadar a intensidade da luz emitida pelo fotopolimerizadores utilizados em uma clínica-escola. Para avaliar a intensidade da luz emitida pelos dispositivos, foi utilizado um radiômetro. Vinte e quatro fotopolimerizadores foram avaliados, 13 aparelhos Optilight Max, 8 aparelhos Optilight LD MAX 440, 3 aparelhos Emitter C. Todos os dispositivos tiveram a luz emitida em intensidade inferior a 400 mW/ cm² e 67% dos dispositivos apresentaram intensidade acima de 300 mW/cm². As médias de valores de emissão de luz dos fotopolimerizadores foram, Optilight Max 334mW/cm², Emitter C 275mW/cm², Optilight LD MAX 440 296mW/cm²Concluiu-se que nenhum fotopolimerizador emitiu luz na intensidade recomendada (400 mW/cm²), dois terços dos aparelhos emitiram luz em intensidade acima da mínima necessária para fotopolimerização de incrementos de resina composta de até 2mm e um terço emitiu luz em intensidade abaixo da mínima necessária. Não houve diferença entre os modelos de fotopolimerizador testados neste estudo.(AU)

Influence of Parental Exposure to Risk Factors in the Occurrence of Oral Clefts.

STATEMENT OF THE PROBLEM: Non-syndromic cleft lip and palate are the most frequent craniofacial abnormalities in humans. The genetic, environmental and behavioral factors involved in this malformation must be clarified in different parts of the globe in the view of implementing preventive measures. PURPOSE: To analyze the influence of parental exposure to risk factors on the occurrence of oral clefts. MATERIALS AND METHOD: A case-control study was conducted with 150 mothers of oral cleft children paired by the children's gender to 300 mothers of children without congenital anomalies from Mato Grosso, Brazil, for the study of the variables: gender and race/color of the children; parental educational level; age; number of pregnancies; prenatal care; obesity; stress; diabetes; hypertension; use of medications, alcohol and illicit drugs; smoking and exposure to ionizing radiation during the first trimester of pregnancy. The results were analyzed in relation to the chances possibility of each variable for the occurrence of oral cleft through the bivariate and multivariate analysis by applying the model of logistic regression. RESULTS: Passive smoking, obesity, exposure to ionizing radiation and use of antibiotics were associated with the presence of clefts. The use of folic acid and analgesics were identified as preventive factors. The father's low educational level was found as a risk factor, while the black race/color was a preventive factor; nevertheless these variables were not associated in the multivariate analysis. CONCLUSION: The results reinforce the need to follow up the pregnant women, especially in the first trimester of pregnancy, in order to control the identified risk factors. Considering the factors associated with occurrence of oral clefts and those associated with its prevention, it is possible to apply specific health promotion measures during pregnancy, which can result in the reduction of oral clefts' occurrence.

Extensive hard palate hyperpigmentation associated with chloroquine use.

A 66-year-old woman diagnosed clinical manifestation of extensive hard palate hyperpigmentation is presented. Due to historic of rheumatoid arthritis and use of chloroquine phosphate for 3 years, exogenous hyperpigmentation associated with the drug was included among the possible diagnoses. Incisional biopsy was performed and the histopathological exam confirmed exogenous hyperpigmentation compatible with chloroquine use. The patient was referred to the rheumatologist and the ophthalmologist for evaluation of the continuity of the chloroquine use. After one year of follow-up, no changes were seen in the hyperpigmentation nor other clinical changes. Hyperpigmentation of the hard palate by the use of chloroquine is one of the adverse effects of the chronic use of this drug and does not require specific treatment. The adequate anamnesis and the knowledge about the adverse effects of the drug allowed an adequate therapeutic approach in the case.