Evaluation of a mucoadhesive pilocarpine tablet for the treatment of xerostomia: a randomized, double-blind, crossover clinical trial.

The objectives of this study were to determine the effectiveness of a mucoadhesive tablet of pilocarpine, 5 mg, for the treatment of xerostomia and verify its pharmacokinetic profile. The randomized, double-blind, crossover clinical trial involved 25 older adults (60 to 80 years) with xerostomia and hyposalivation who were randomly divided into groups A and B. Once daily, for 7 days, group A used a mucoadhesive tablet containing pilocarpine, while group B used a mucoadhesive tablet without the active ingredient (first intervention). After 7 days of washout (no treatment), use of the medications resumed for 7 days, with a crossover between groups (second intervention). Xerostomia was evaluated through a shortened version of the Summated Xerostomia Inventory-Dutch Version, and the unstimulated salivary flow (USF) and stimulated salivary flow (SSF) of the patients were measured. The patients were evaluated at baseline and 7, 14, and 21 days. Then, the pharmacokinetic profiles of mucoadhesive and conventional oral pilocarpine tablets were compared using saliva obtained from 8 patients. Both of the interventions resulted in a significant reduction in Summated Xerostomia Inventory scores and a significant increase in the mean USF (P < 0.05). A statistically significant increase in the mean SSF only occurred when pilocarpine was administered (P < 0.05). No significant adverse effects were found. The mucoadhesive tablet resulted in much higher salivary concentrations of pilocarpine than did the conventional oral tablet. Both formulations of the mucoadhesive tablet, with or without pilocarpine, relieved patients' dry mouth symptoms. Trial registration: Registro Brasileiro de Ensaios Clinicos (ReBEC) No. RBR-9qdnws.

Percepção da atratividade mentual feminina por cirurgiões bucomaxilofaciais, ortodontistas e leigos / Perception of female chin attractiveness by maxillofacial surgeons, orthodontists and lay people

Resumo Objetivos ­ Avaliar a percepção da atratividade do mento feminino pelos cirurgiões bucomaxilofaciais, ortodontistas e leigos por meio de simulações de mentoplastia realizadas com auxílio de software. Materiais e métodos ­ A fotografia de perfil, juntamente com a telerradiografia de face lateral, foram manipuladas usando o software Dolphin Imaging versão 11.8 e diferentes situações clínicas foram projetadas. As alterações foram realizadas com movimentos ânteroposteriores, com imagens de mentoplastia de avanço (+2, +3 e +4) e recuo (-2, -3, -4). A referência do movimento foi dada em relação à Linha Vertical Verdadeira (LVV). Noventa pessoas foram entrevistadas, 30 ortodontistas, 30 cirurgiões maxilofaciais e 30 leigos. Eles observaram as fotos e classificaram o perfil em: extremamente agradável, agradável, desagradável e extremamente desagradável. Para avaliar a presença de diferença significativa entre os grupos em relação à análise de perfil, foi utilizado o teste Exato de Fisher. Resultados ­ A maioria dos leigos, cirurgiões e ortodontistas (46%) considerou o queixo no limite da LVV como um perfil extremamente atraente; 34,4% consideraram o queixo 2 mm antes da LVV como um perfil atrativo; queixo 3 mm além da LVV como pouco atrativo (45,5%) e os menos atraentes foram 4 mm além da LVV (75,6%). Conclusâo ­ Dessa forma, a maioria dos entrevistados demonstrou preferência pelo posicionamento do queixo no perfil LVV ou ligeiramente Classe II em pacientes do sexo feminino, o que pode orientar os profissionais num melhor planejamento (AU)

Abstract Objectives- Evaluate the perception of the female chin attractiveness by maxillofacial surgeons, orthodontists and lay people through simulations of mentoplasty performed with the aid of a software. Profile photography along with lateral face teleradiography were manipulated using Dolphin Imaging Software version 11.8, and different clinical situations were designed. Methods: The alterations were performed with anteroposterior movements, with images of mentoplasty of advancement (+2, +3 and +4), and recoil (-2, -3, -4). The reference of the movement was given in relation to the True Vertical Line (TVL). Ninety people were interviewed. 30 orthodontists, 30 maxillofacial surgeons and 30 lay people. They observed the photos and classified the profile according to extremely pleasant, pleasant, unpleasant and extremely pleasant. To evaluate the presence of significant difference between the groups in relation to the profile analysis, the Fisher Exact test was used. Results: Most lay people, surgeons and orthodontists (46%) considered the chin at the limit of the TVL as an extremely attractive profile. 34.4% considered the chin 2 mm before the TVL as an attractive profile; chin 3 mm beyond the TVL as unattractive (45.5%), and the most unattractive ones were 4 mm beyond the TVL (75.6%). Conclusion: So the great majority of the people interviewed showed a preference for the positioning of the chin in the TVL or slightly Class II profile in female patients, which can guide professionals in a better planning. (AU)

Application of Dexamethasone in the Masseter Muscle During the Surgical Removal of Lower Third Molars.

PURPOSE: The aim of the present study was to analyze the effect of the application of dexamethasone in the masseter muscle during third molar surgery. METHODS: This randomized, clinical trial used dependent samples and the split-mouth method. A sample of 30 patients, with impacted or semi-impacted third molars, as well as vertical and mesioangular positions of a similar surgical difficulty (on both sides), was subjected to 2 operations: an experimental operation and a control procedure, with a 30-day wash-out. The choice of which group would be experimental or control was random. The experimental group received 8 mg of dexamethasone, which was applied directly to the masseter muscle immediately after surgery. The control group did not receive corticosteroids. Seven and 15 days after the surgery, the patients were assessed in relation to their levels of pain, trismus, and edema. RESULTS: Concerning edema and trismus, there was a significant difference (P <0.05) between the control and experimental groups. As for the pain scale, no significant differences were found between the presence or absence of corticoids. CONCLUSION: The present study concluded that the application of dexamethasone in the masseter muscle effectively reduces edema and trismus, but does not affect pain.

Osteoma em mandíbula: quando tratá-lo cirurgicamente / Osteoma of the mandible: when to treat it surgically

Osteomas são tumores benignos, que se desenvolvem a partir do osso maduro compacto ou esponjoso. São normalmente detectados na região bucomaxilofacial e raramente, em outros ossos. Os locais de ocorrência mais frequentes são a mandíbula e os seios paranasais. Afetam igualmente ambos os sexos, e sua prevalência é mais comum em adultos jovens, tendo sua origem associada a anomalias congênitas, à inflamação crônica, atividade muscular, aos distúrbios embrionários e ao trauma. No presente artigo,é relatado o caso de um jovem que se queixava de aumento de volume em região submandibular direita, com evolução de 9 meses. Apresentava queixa álgica ao realizar movimentos de flexão lateral e rotação da cabeça para ambos os lados. Ao exame tomográfico da face, apresentaram uma imagem hiperdensa, de formato oval e superfície irregular adjacente à cortical óssea de corpo mandibular direito. Com hipótese diagnóstica de osteoma, o paciente foi submetido à cirurgia sob anestesia geral, para a excisão da lesão. Após a peça cirúrgica ser enviada para análise, o laudo histopatológico confirmou diagnóstico de osteoma compacto. Já no décimo quarto dia pós-operatório, o paciente não mais apresentava dor, ao realizar movimentação cervical.

Osteomas are benign tumours which develop from mature compact or cancellous bone. They are normally detected in the maxillofacial region and rarely in other bones. The most common sites of occurrence are the mandible (angle, condyle and inferior edge region) and the paranasal sinuses. They affect both sexes equally and their prevalence is greater in young adults, their origin being associated with congenital anomalies, chronic inflammation, muscle activity, embryonic disorders and trauma. This paper reports the case of a young man who complained of swelling in the right submandibular region with nine months' progression. He complained of pain when performing lateral flexion and rotation of the head to both sides. A CT scan of the face showed an oval-shaped hyperdense image and an uneven surface adjacent to the cortical bone of the right mandibular body. With a hypothetical diagnosis of osteoma, the patient underwent surgery under general anesthesia for the excision of the lesion. After the specimen was sent for analysis, the histopathological report confirmed the diagnosis of a compact osteoma. By the fourteenth postoperative day the patient no longer felt any pain on cervical spine movement.