Behaviour and Prevention of 5'Fluorouracil and Doxorubicin-induced Oral Mucositis in Immunocompetent Patients with Solid Tumors: A Randomised Trial.

PURPOSE: This study evaluated the efficacy of four methods to prevent chemotherapy-induced oral mucositis (OM) in patients with solid tumors (ST). In addition, the behaviour of OM was investigated in these oncological patients. MATERIALS AND METHODS: Forty-eight patients, aged 27-84, were randomly allocated to different groups from the first day of chemotherapy (CT), in the following sequence: group 1: intensive oral care programme (IOCP); group 2: 0.12% chlorhexidine mouthrinse; group 3: 0.03% triclosan mouthrinse; group 4: low-level laser therapy (LLLT). Oral mucositis was evaluated on the 7th and 14th days by means of the Oral Mucositis Assessment Scale (OMAS). RESULTS: Thirty-one (64.5%) patients developed OM in the first cycle of CT and the pain was significantly associated with OM severity (p < 0.0001). The statistically significantly worst OMAS score was found for the lips and buccal mucosa (p < 0.0001). Despite a lack of statistical significance, IOCP and LLLT notably demonstrated potential effects to prevent OM in patients who presented with only oral erythema (75%) and lower peak of severity during the follow up, respectively. CONCLUSIONS: Improved oral care awareness is needed in patients undergoing 5'fluorouracil and doxorubicin, mainly to avoid pain caused by oral mucositis. Oral mucositis was more prevalent and aggressive in oral sites exposed to chronic trauma. The IOCP and LLLT approaches showed positive results to prevent oral mucositis and should be further investigated in similar and larger samples.

The Radiographic Management for Surgical Planning and Implant Placement: a Case of Atypical Antral Artery Position / Avaliação Radiográfica no Planejamento Cirúrgico para Instalaçào de Implante Dentário: um Caso de Posição Atípica da Artéria Antral

O conhecimento do suprimento sanguíneo do seio maxilar, em particular da parede lateral, é de considerável importância devido à possibilidade de rompimento acidental de uma artéria durante os procedimento de elevação do assoalho do seio maxilar. Paciente do sexo feminino, 65 anos de idade, com histórico de complicação pós-operatória, após procedimento de elevação do seio maxilar realizado há três anos. Após avaliação tomográfica, foi observada a presença da artéria antral em posição atípica. Identificar e reconhecer essa estrutura anatômica pelo exame radiográfico pré-operatório, evita possíveis complicações hemorrágicas, durante e após o procedimento cirúrgico.(AU).

It is very important the knowledge of the maxillary sinus blood supply, in particular of the lateral maxillary wall, due to the possibility of accidental rupture of a vessel during the sinus floor augmentation. A case report is described of a 65-year-old female, who reported a postoperative complication after a sinus augmentation that she had had 3 years before. After radiographic evaluation, it was observed the presence of antral artery in atypical position. The identification of this anatomical structure is very important, by preoperative radiographic examination, avoiding possible bleeding complications, during and after the surgical procedures.(AU).

Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles.

The present study aimed to assess the accuracy of linear measurements performed with two software packages in multislice (MSCT) and cone beam (CBCT) computed tomography (CT) images. The sample consisted of 10 human mandibles marked standardly 8 times with metallic orthodontic wires. The mandibles underwent both MSCT and CBCT scanning and were measured linearly and digitally with two software packages, namely Studio 3.1® (Anne Solutions®, SP, Brazil) (ST) and Implant Viewer 2.817® (Anne Solutions®, SP, Brazil) (IV). The linear measurements were the mandibular height (MH) and width (MW), and the distance from the alveolar ridge to the mandibular canal (AC). To validate the measurements, the mandibles were sectioned in the marked regions and measured with a digital caliper. Statistically significant differences were not observed between the measurements (MH, MW, and AC) taken digitally with the two software packages from images obtained from the two scanning modalities (MSCT and CBCT) and the measurements taken manually with a digital caliper (p>0.05). MSCT and CBCT images measured digitally with ST and IV software packages resulted in reliable outcomes when compared to measurements obtained manually. Both software and imaging modalities are reliably useful for planning surgical procedure in the dental practice.

Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles

ABSTRACT The present study aimed to assess the accuracy of linear measurements performed with two software packages in multislice (MSCT) and cone beam (CBCT) computed tomography (CT) images. The sample consisted of 10 human mandibles marked standardly 8 times with metallic orthodontic wires. The mandibles underwent both MSCT and CBCT scanning and were measured linearly and digitally with two software packages, namely Studio 3.1® (Anne Solutions®, SP, Brazil) (ST) and Implant Viewer 2.817® (Anne Solutions®, SP, Brazil) (IV). The linear measurements were the mandibular height (MH) and width (MW), and the distance from the alveolar ridge to the mandibular canal (AC). To validate the measurements, the mandibles were sectioned in the marked regions and measured with a digital caliper. Statistically significant differences were not observed between the measurements (MH, MW, and AC) taken digitally with the two software packages from images obtained from the two scanning modalities (MSCT and CBCT) and the measurements taken manually with a digital caliper (p>0.05). MSCT and CBCT images measured digitally with ST and IV software packages resulted in reliable outcomes when compared to measurements obtained manually. Both software and imaging modalities are reliably useful for planning surgical procedure in the dental practice.

Relationship between extra-alveolar time and atopy in the prognosis of the replantation of avulsed teeth.

BACKGROUND: The aim of this in vivo study was to evaluate the correlation between the occurrence of root resorption in avulsed and replanted teeth, extra-alveolar time, and the possible influence of Th2 immunologic profile, represented by patient's atopy and its influence in the prognosis of the tooth. METHODS: This study evaluated the presence or absence of root resorption in 57 avulsed and replanted teeth. The replantation technique and endodontic treatments were performed following the International Association of Dental Trauma guidelines. Follow-up of the replanted teeth included monthly clinical and radiographic examinations during 1 year. The patient's medical examination, including the personal and family allergic history, in conjunction with the skin prick test based the evaluation of patient's atopy. RESULTS: Of the 37 teeth of atopic patients, 33 (89.2%) teeth did not present root resorption. Of these, 27 (72.9%) had an extra-alveolar time of <1 hour and 6 (16.2%) had an extra-alveolar time >1 hour. Four (10.8%) teeth presented root resorption and an extra-alveolar period of time >1 hour. CONCLUSION: These results showed the importance of the extra-alveolar time and the predominantly Th2 immunologic profile, represented by atopic patients, that suffered replantation after dental avulsion in a 1-year follow-up.

The influence of atopy in the prognosis of the replantation of avulsed teeth.

BACKGROUND: Replantation is the most indicated procedure for traumatic dental avulsion, but it invariably results in a greater or lower degree of root resorption. The outcomes of these cases can be affected by some well-known factors. Because studies have shown the importance of the innate and acquired immune response in the mechanisms involved in the resorption of bone tissues, an endeavor was made to verify if such an influence applies to dental resorption. METHODS: Fifty-seven avulsed, endodontically treated teeth were assessed in the Endodontics Clinic, Pontifical Catholic University of Paraná. Follow-up of the replanted teeth included periodical clinical examinations and radiographs, in accordance with the control rules of the International Association of Dental Traumatology. The evaluation of atopy was based on the patient's personal and family history in conjunction with the skin-prick test for five allergen extracts. RESULTS: Of the 46 teeth with a favorable outcome, 33 (71.74%) were in atopic patients, and 13 (28.26%) were in non-atopic patients. Of the 11 teeth with an unfavorable outcome, four (36.36%) were in atopic patients, and seven (63.64%) were in non-atopic patients; a greater prevalence of unfavorable prognoses occurred in non-atopic patients. CONCLUSION: The outcome after 1 year for avulsed and replanted teeth is more favorable in atopic patients.

Treatment of painful post-traumatic peripheral neuropathy with capsaicin in an edentulous patient with extreme resorption in the mental region: a case report.

AIM: The aim of this report is to present a clinical case of extensive alveolar resorption in the mental region of the mandible of a complete denture wearer for which capsaicin was used for alleviation and remission of post-traumatic painful peripheral neuropathy. BACKGROUND: Resorption of the residual ridge occurs in a chronic and progressive manner, altering the configuration of the ridge and the mucosa covering it and subsequently compromising the stability of the complete denture prosthesis. Individual variability associated with such factors as gender, age, edentulous period, nutrition, excessive load and compression on the ridge, parafunctional habits, occlusal instability, and maladaptation of the prosthesis may have a role in the rate and manner of bone loss. REPORT: A 62-year-old woman, edentulous at the age of 30, presented with complaints of pain and spontaneous "electrical shocks" in the mucosa under her mandibular complete denture. The pain increased while chewing approximately two years ago due to the pressure of this denture on her supporting tissues. The patient indicated the level of pain corresponded to a score of ten out of ten on the Visual Analogical Scale (VAS). Treatment included denture replacement and topical application of capsaicin gel using a custom tray technique. SUMMARY: The review of the literature and the results obtained from the management of this case have served to emphasize how much neuropathic pain research has demonstrated the complexity of its neurophysiologic mechanism due to the lack of association with any somatic manifestation. During the fabrication of a new lower denture the topical application of capsaicin was shown to be effective in the relief and remission of the painful symptoms of the neuropathy as of this writing.