O uso do plasma rico em plaquetas para correção de defeitos ósseos maxilares em Implantodontia / Use of platelet-rich-plasma for correction of maxillary bone defects in Implantology

O sucesso da reabilitação com implantes dentários está associado diretamente à quantidade e qualidade do tecido ósseo presente, favorecendo ou não o tratamento. A atrofia óssea dos maxilares, principalmente quando localizada nos rebordos alveolares, dificulta ou impede a reabilitação do aparelho estomatognático com o uso de implantes osseointegráveis. Na Odontologia, o plasma rico em plaquetas tem sido bastante estudado, sendo utilizado principalmente em cirurgias periodontais, cirurgias maxilofaciais e em pequenos enxertos ósseos em região alveolar para posterior colocação de implantes dentários. Diante disso, o objetivo do presente estudo foi realizar uma revisão de literatura sobre o plasma rico em plaquetas, abordando sua importância na Implantodontia, assim como sua obtenção e manipulação, características do material e indicações de aplicação. Muitos estudos demonstram as vantagens biológicas do plasma rico em plaquetas na reparação óssea em aplicações na clínica médica e odontológica. Esse biomaterial é uma alternativa viável, eficaz e de baixo custo relativo útil para acelerar os processos cicatriciais em tecidos moles e duros, podendo ser utilizado de forma isolada ou associado a outro biomaterial (AU).

The success of rehabilitation with dental implants is directly associated to the quantity and quality of bone tissue, favoring the treatment or not. The maxillary bone atrophy, especially when located in the alveolar ridges, obstructs or impedes the rehabilitation of the stomatognathic system with the use of dental implants. In Dentistry, the platelet-rich plasma has been studied extensively, being used especially in periodontal surgery, maxillofacial surgery, and small bone grafts in alveolar region for later placement of dental implants. Therefore, the aim of this study was to review the literature about the platelet-rich plasma, addressing its importance in Implantology, as well as obtaining and handling, characteristics of the material and directions for applying it. Many studies demonstrate the biological benefits of plateletrich plasma on bone healing in applications in medical and dental clinic. This biomaterial is a viable, effective and relatively low-cost useful alternative for speeding up the healing process in soft and hard tissues, and may be used alone or associated with another biomaterial (AU).

Reconstrução de dente anterior fraturado com restauração direta associada a pino de fibra de vidro ­ relato de caso / Fractured anterior tooth reconstruction with direct restoration associated with glass fiber pin ­ case report

O relato de caso tem por objetivo descrever as etapas de planejamento e o protocolo restaurador para um caso de reconstrução de dente anterior fraturado por meio de restauração direta com resina composta associada a pino de fibra de vidro, além de discutir os procedimentos necessários para a obtenção de restaurações satisfatórias nessa região. Paciente GLA, leucoderma, 14 anos de idade, vítima de acidente doméstico, com fratura coronária nos dentes 11 e 21. Após anamnese, exame clínico e radiográfico, constatou-se fratura coronária do tipo VI no dente 11, com tratamento endodôntico já realizado, e do tipo III no dente 21. Em virtude da idade do paciente, para o plano de tratamento optou-se pela utilização de um retentor intrarradicular estético, pino de fibra de vidro, associado à restauração direta em resina composta, dada às condições clínicas do remanescente dentário, e para o dente 21, optou-se pela restauração direta em resina composta. Dentes fraturados e submetidos ao tratamento endodôntico devem ser reconstruídos tendo por base um planejamento criterioso. Com a evolução das resinas compostas e dos sistemas adesivos, associados à técnica de condicionamento ácido de esmalte e dentina, tornou-se possível a execução de tratamentos restauradores estéticos mais conservadores (AU).

The objective of this case report was to describe the planning stages and the restorative protocol for a fractured anterior tooth reconstruction by means of direct restoration with composite resin associated with fiberglass pin, in addition to discussing the procedures necessary for obtaining satisfactory restorations in this region. The patient, GLA, leucoderma, 14 years old, was victim of a domestic accident, resulting on a coronary fracture in teeth 11 and 21. After anamnesis, clinical and radiographic examination, a type VI coronary fracture was found in tooth 11 with endodontic treatment and type III in tooth 21. Due to the age of the patient, the treatment plan included the use of an aesthetic intra-radicular retainer, fiberglass pin, associated to direct restoration in composite resin given the clinical conditions of the dental remnant, while the direct restoration in composite resin was chosen for element 21. Fractured teeth as those submitted to endodontic treatment should be reconstructed based on careful planning. With the evolution of composite resins and adhesive systems, associated with the acid etching technique of enamel and dentin, it became possible to perform more conservative esthetic restorative treatments (AU).

Avaliação de hábitos de higiene bucal e satisfação em usuários de prótese parcial removível / Assessment of mouth hygiene habits and the satisfaction of removable partial denture

A prótese parcial removível a grampo (PPRG) possibilita reabilitar áreas parcialmente edêntulas, restaurando a função mastigatória, estética e fonética. Apesar dos avanços da Odontologia observados nas últimas décadas, estudos indicam que a higiene bucal dos pacientes usuários de PPRG ainda é precária. Desse modo, o objetivo desse estudo foi verificar os hábitos de higienização das próteses e cavidade bucal, bem como o nível de satisfação dos pacientes usuários de PPRG atendidos na Universidade Federal do Ceará (UFC). Trata-se de um estudo descritivo, quantitativo onde foi aplicado um questionário a 31 pacientes usuários de PPRG. Os dados foram analisados através do teste qui-quadrado e expressos na forma de frequência absoluta e percentual considerando uma confiança de 95%. Da amostra, a maioria (77,4%) era do gênero feminino, com idade entre 40 a 60 anos, (64,5%) possuíam ensino médio completo e haviam recebido orientações de higiene após a instalação da prótese (96,8%). O método de higienização mais utilizado foi a escovação mecânica com dentifrício. Quanto à frequência de higienização, 71% responderam realizá-la 3 ou mais vezes ao dia. A cárie foi apontada como o principal fator etiológico das perdas dentárias, apresentando uma diferença significativa em relação ao grau de satisfação dos pacientes com a prótese. Verificou-se que a maior parte dos indivíduos está muito satisfeita com o tratamento, embora ainda apresentem falhas na execução dos métodos de higiene bucal e da prótese.

Removable partial denture with clasps (RPDC) restores partially toothless areas, coupled to the chewing, aesthetic and phonetic functions. In spite of progress in dentistry during the last decades, several studies indicate that mouth hygiene of RPDC patients is rather low. Current analysis verifies the hygiene of dentures and mouth cavity and the satisfaction level of patients with RPDC attended by the dentistry school of the Universidade Federal do Ceará, Brazil. Methods: The descriptive and quantitative study comprised a questionnaire to 31 RPDC users. Data were analyzed by χ2 test and expressed in absolute frequency at 95% confidence level. Most subjects (77.4%) were female, aged between 40 and 60 years (64.5%), with complete college. They had received hygiene directions after the installation of the denture (96.8%). The hygiene method most employed was mechanical brushing with dentifrice, three or more times a day, for 71.0% of the interviewed. Caries was the main etiological factor in teeth loss with a significant difference related to the satisfaction degree of patients with the prosthesis. Most subjects were highly satisfied with the treatment even though there were flaws in the execution of mouth and denture hygiene.

Aplicação da técnica da muralha de silicona em paciente pediátrico û relato de caso / Application of the silicon guide technique in pediatric patient û case report

Para a reconstrução de dentes anteriores que sofreram fraturas ou restaurações envolvendo o ângulo incisal, a Dentística dispõe de um tratamento que oferece a cópia ideal da estrutura palatina, a técnica de restauração usando a muralha de silicona. Esta técnica permite recuperar a estética de forma rápida, conservadora e oferece uma grande vantagem para a Odontopediatria como a redução do tempo de cadeira do paciente infantil. O objetivo do presente trabalho foi relatar um caso em que foi aplicada a técnica da muralha de silicona em paciente pediátrico. Paciente CIG, gênero masculino, 8 anos de idade, apresentando fratura oblíqua das coroas dos dentes 11 e 21. Após procedimentos emergenciais, o paciente teve suas arcadas moldadas e posterior moldagem de gesso, reconstrução em cera, confecção da muralha e restauração dos dentes fraturados. O caso foi solucionado apenas com recursos de Dentística, técnica da muralha, utilização de ceroplastia e resinas compostas fotopolimerizáveis, alcançando-se um bom resultado estético. Portanto, conclui-se que a confecção da técnica da muralha de silicona para restauração direta em dentes anteriores traz vantagens no tempo gasto para realização do procedimento clínico, além de resultado satisfatório e estético.

For the reconstruction of fractured anterior teeth or restorations involving the incisal angle, the silicone guide technique offers an ideal copy of the palatal structure. This technique allows a fast and conservative aesthetics restoration, as well as reduces chair time, an important advantage at odontopediatric procedures. The aim of this study was to report a case in which the silicone guide technique was applied at the treatment of a pediatric patient. CIG, male patient 8 years old, presenting oblique fracture on crowns of teeth #11 #21. After emergency procedures, dental impressions from the patient were taken and a cast model was made, followed by the wax-up. Then silicone wall was manufactured and teeth were restored. The case was solved using just dentistry resources such as the guide technique, wax-up, and light cured composite resins and has achieved satisfactory results. Therefore, it was concluded that the silicone guide technique applied to direct restoration in anterior teeth has the advantage of reduced chair time obtaining satisfactory aesthetic results.

Associação entre o uso da chupeta e a diminuição do risco de morte súbita em bebês / Relation between the use of pacifier and the reduction of cot death

Objetiva-se nesse artigo realizar um levantamento na literatura sobre a associação entre o uso de chupetas na prevenção de morte súbita em crianças. Foi realizada uma revisão de literatura e escolhidos 34 artigos publicados entre os anos de 1978 e 2012 em bancos de dados como PubMed e Scielo, usando os descritores: "morte súbita", "chupetas" e "SIDS". À medida que a mortalidade infantil vem sendo reduzida devido às melhorias socioeconômicas, ambientais e na assistência médica, as mortes súbitas na infância (MSI) tendem a assumir papel relativamente mais importante. Concluiu-se que, de acordo com a literatura, o uso de chupeta por lactentes vem reduzindo consideravelmente a incidência de morte súbita dos mesmos (AU)

The aim of this study was to present a literature review about the use of pacifiers use in the prevention of sudden infant death. A search was conducted in PubMed and SciELO, for studies published between 1978 and 2012 using the key words: "sudden death", "pacifiers", and "SIDS". Thirty four studies were selected. As infant mortality has been reduced due to socioeconomics and environmental improvements, as well as to better medical care, there is a tendency to dedicate greater attention to the sudden infant death syndrome (SIDS). It was concluded that according to the literature the use of pacifiers may reduce considerably the incidence of sudden death of them (AU)

Application of BMP-2 for bone graft in Dentistry

Introduction:The global increase life expectancy and the resulting tooth loss has required searching for new rehabilitation alternatives in Dentistry. Biomaterials can be defined as any material that acts replacing a lost bone defect and its function. In Dentistry, many studies have aimed to improve bone regeneration through the use of BMPs for bone replacement. Objective: To review the literature on the use and clinical viability of human morphogenetic protein for the jaws reconstruction. Material and methods: The following databases were searched: Pubmed, Bireme, Lilacs, and Scielo and 30 articles published between 1965 and 2013 were found using the following descriptors: "dental implants", "maxillary sinus", and "biocompatible materials". Results: Several studies demonstrate the biological advantages of rhBMP-2 on bone regeneration of the jaws. In recent years, morphogenetic protein has presented a large clinical use. Conclusion: Despite being a high-cost biomaterial, rhBMP-2 is a viable and very effective alternative for reconstruction of defects of the face.

Perfil epidemiológico de usuários intensivos de um centro de atenção psicossocial / Epidemiological profile of intensive users of a psychosocial care center / Perfil epidemiológico de los usuarios intensivos de un centro de cuidados psicosocial

Objetivo: avaliar o perfil epidemiológico dos usuários intensivos de um Centro de Atenção Psicossocial. Método: estudo descritivo quantitativo, de base documental, nos prontuários de pessoas atendidas de forma intensiva no período de maio a julho de 2010 no Centro de Assistência Psicossocial da Secretaria Executiva Regional VI do município de Fortaleza-Ceará. Os dados foram analisados no Programa IBM SPSS Statistics 20 apresentados em tabelas. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Parecer de nº 10029576-2. Resultados: foram analisados 35 prontuários de pacientes intensivos, observou-se que o gênero feminino predominou, principalmente de escolaridade e renda baixas. Entre as queixas de sintomatologia predominaram as alucinações auditivas, quanto às patologias predominou o transtorno de humor. Conclusão: as políticas públicas de saúde mental de Fortaleza devem atuar no sentido de atender as necessidades de mudanças no CAPS. (AU)

Objective: evaluating the epidemiological profile of intensive users of a Psychosocial Care Center. Method: a quantitative descriptive study, of a document basis, in the records of people seen intensively in the period from May to July 2010 in the Psychosocial Assistance Center in Regional Executive Secretary VI in FortalezaCeara. Data were analyzed in IBM SPSS Statistics 20 presented in tables. The research project was approved by the Research Ethics Committee, Opinion nº 10029576-2. Results: there were analyzed 35 medical records of intensive patients, observing that females predominated, with low education and income. Among the complaints of symptoms predominated auditory hallucinations, regarding the diseases predominated mood disorder. Conclusion: the public policies of mental health in Fortaleza should act to meeting the needs of changes in CAPS. (AU)

Objetivo: evaluar el perfil epidemiológico de los usuarios intensivos de un Centro de Atención Psicosocial. Método: un estudio descriptivo cuantitativo, de base de documental, en los registros de personas atendidas intensamente en el período mayo-julio, 2010, en el Centro de Asistencia Psicosocial de la Secretaria Ejecutiva Regional VI en Fortaleza-Ceará. Se analizaron los datos en IBM SPSS Statistics 20 presentados en tablas. El proyecto de investigación fue aprobado por el Comité de Ética en la Investigación, Opinión nº 10029576-2. Resultados: eran analizados 35 prontuarios de pacientes intensivos, se observó que las mujeres predominaban, principalmente de baja educación y bajos ingresos. Entre los síntomas de quejas predominan las alucinaciones auditivas, para las enfermedades predominó el trastorno de humor. Conclusión: las políticas públicas de salud mental de Fortaleza deben actuar para satisfacer las necesidades de cambios en el CAPS. (AU)

Profile of temporomandibular disorder patients submitted to dental and physiotherapeutic treatment at a private clinic

Introduction: Temporomandibular disorder (TMD) is the term used in Dentistry to define the structural and disorder changes affect the physiology of the masticatory system composed of TMJ and related to musculoskeletal structures. Objective: To conduct a descriptive, transversal and documentary study aiming to determine the profile of 14 TMD patients undergoing simultaneous dental and physiotherapeutic treatment at a private practice of the city of Fortaleza-Ce. Material and methods: The following instruments for the collection of the data were employed: files registering the evaluation and evolution, findings of the radiographic examinations and forms. Data were statistically analyzed through SPSS software, version 10.0. Results: Most of the sample was composed by females aged 32 years (+/-10.60) in average, mainly complaining about chronic headache, masticatory myalgia , TMJ pain, cervicalgy, otalgia, among others. The complete sample presented, at least, one pathology associated to and/or concomitant to TMD. The radiographic findings showed TMJ alterations and tooth losses. Analgesics were the most used drugs. Conclusion: TMD is a complex syndrome, with many etiologies and symptoms, aggravating and perpetuating factors, requiring multiple and even more specialized therapeutic management attempting treatment success.

The efficacy of three formulations of Lippia sidoides Cham. essential oil in the reduction of salivary Streptococcus mutans in children with caries: a randomized, double-blind, controlled study.

Essential oils of many plants have been previously tested in the treatment of oral diseases and other infections. This study was a randomized, double-blind, in parallel with an active control study, which aimed to evaluate the efficacy of three formulations of the Lippia sidoides Cham. essential oil (LSO) in the reduction of salivary Streptococcus mutans in children with caries. 81 volunteers, aged 6-12 years, both genders, with caries, were recruited to participate in this study, and randomly assigned to either one of five different groups. Each group received topical treatment with either 1.4% LSO toothpaste, 1.4% LSO gel, 0.8% LSO mouthwash, 1% chlorhexidine gel, or 0.12% chlorhexidine mouthwash. A 5-ml volume of each gel was placed inside disposable trays, and applied for 1 min, every 24h, for 5 consecutive days. The mouthwash groups used 5-ml volume of a mouthwash inside disposable syringes. In the toothpaste group, children brushed their teeth for 1 min, once a day for 5 days. Saliva was collected before and after treatment. MS colonies were counted, isolated and confirmed through biochemical tests. Differences in MS levels measured in different days within the same treatment group was only verified with LSO toothpaste, chlorhexidine gel and chlorhexidine mouthwash. Comparison between groups of LSO mouthwash, toothpaste and gel showed that the toothpaste group expressed significantly lower MS levels than the mouthwash and gel groups at day-30. Chlorhexidine significantly reduced MS levels after 5 days of treatment, but these levels returned to baseline in other periods of the study. LSO toothpaste reduced MS levels after 5 days of treatment, and MS levels remained low and did not return to baseline during subsequent analysis. Hence, LSO toothpaste demonstrated the most long-lasting MS reduction in saliva, whereas other LSO formulations did not effectively reduce MS levels in children with dental caries.