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1.
Natal; s.n; 21 dez. 2022. 142 p. ilus.
Tese em Português | LILACS, BBO - Odontologia | ID: biblio-1532253

RESUMO

A primeira parte do trabalho avaliou, através de uma revisão sistemática de estudos in vitro, a aplicabilidade da fotobiomodulação como uma ferramenta auxiliar na engenharia de tecidos. De 8373 estudos inicialmente identificados a partir das estratégias de busca, dez artigos atingiram os critérios de inclusão para análise. Os dados obtidos na maioria dos estudos revisados indicaram que a laserterapia de baixa intensidade (LBI) pode aumentar a proliferação e diferenciação de células cultivadas na superfície dos biomateriais. Na segunda parte do trabalho foi avaliado o efeito da LBI na dose de 4 J/cm2 na proliferação de osteoblastos (OFCOL II) cultivados na superfície de arcabouços poliméricos tridimensionais (3D) de ácido polilático (PLA) e de PLA associado a quitosana (PLA/Q) produzidos pela técnica de fiação por sopro em solução. O ensaio do Alamar Blue demonstrou que as células OFCOL II cultivadas sobre os arcabouços 3D de PLA e irradiadas apresentaram uma maior atividade proliferativa quando comparadas aos grupos não irradiados no intervalo de 72 h. Além disso, as células OFCOL II cultivadas sobre arcabouços de PLA/Q também apresentaram uma maior atividade proliferativa em 24 h. A análise pela microscopia eletrônica de varredura (MEV) mostrou que os osteoblastos se encontravam ancorados em concavidades das fibras nos arcabouços examinados. Concluiu-se que o modelo proposto apresentou um potencial para estudos na área da engenharia tecidual óssea. Na terceira parte do trabalho foi avaliada a influência da LBI infravermelha (IV) e vermelha (V) em diferentes dosagens (1 J/cm², 4 J/cm² e 6 J/cm²) na proliferação e viabilidade das células OFCOL II. O ensaio do Alamar Blue mostrou diferenças significativas (p<0,05) na atividade mitocondrial do grupo IV utilizando a dose de 1 J/cm2 e 4 J/cm2, nos intervalos de 24 e 48 h. Já o ensaio do Live/Dead evidenciou que a LBI induziu aumento da viabilidade celular no grupo IV na dose de 4 J/cm2, quando comparada com os demais grupos. Em conjunto, os resultados sugerem que a LBI pode promover bioestimulação in vitro de osteoblastos, inclusive quando cultivados na superfície de arcabouços poliméricos 3D, representando assim uma ferramenta promissora nas técnicas de engenharia tecidual óssea (AU).


The first part of the work evaluated, through a systematic review of in vitro studies, the applicability of photobiomodulation as an auxiliary tool in tissue engineering. Of 8373 studies initially identified from the search strategies, ten articles met the inclusion criteria for analysis. Data obtained from most of the reviewed studies indicated that low-intensity laser therapy (LLLT) could increase the proliferation and differentiation of cells cultured on the surface of biomaterials. The second part of the work evaluated the effect of LLLT at a dose of 4 J/cm² on the proliferation of osteoblasts (OFCOL II) cultivated on the surface of threedimensional (3D) polymer scaffolds of polylactic acid (PLA) and PLA associated with chitosan (PLA/Q) produced by the solution blow spinning technique. The Alamar Blue assay demonstrated that OFCOL II cells cultured on 3D PLA scaffolds and irradiated showed more significant proliferative activity when compared to non-irradiated groups within 72 h. Furthermore, OFCOL II cells cultured on PLA/Q scaffolds showed higher proliferative activity at 24 h. Analysis by scanning electron microscopy (SEM) showed that the osteoblasts were anchored in the concavities of the fibers of the examined scaffolds. It was concluded that the proposed model showed potential for studies in the field of bone tissue engineering. The third part of the work evaluated the influence of infrared (IR) and red (R) laser therapy at different dosages (1 J/cm², 4 J/cm², and 6 J/cm²) on the proliferation and viability of OFCOL II cells. The Alamar Blue assay showed significant differences (p<0.05) in the mitochondrial activity of group IR using the dose of 1 J/cm² and 4 J/cm² at 24 and 48 h. The Live/Dead assay showed that LLLT induced an increase in cell viability in the IR group at a dose of 4 J/cm² compared to the other groups. Taken together, the results suggest that LLLT can promote in vitro biostimulation of osteoblasts, even when cultivated on the surface of 3D polymeric scaffolds, thus representing a promising tool in bone tissue engineering techniques (AU).


Assuntos
Materiais Biocompatíveis , Engenharia Tecidual , Técnicas In Vitro , Terapia com Luz de Baixa Intensidade , Quitosana
2.
Rev. Odontol. Araçatuba (Impr.) ; 43(2): 25-28, maio-ago. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1361992

RESUMO

Benign fibrous histiocytoma (BFH) is a common mesenchymal lesion on the skin where it is better known as dermatofibroma. It mainly affects areas of the integument exposed to the sun. It can occur in the mucous membranes, being quite unusual in the oral cavity. This article presents a rare case of benign oral fibrous histiocytoma in childhood. An eleven-year-old male patient sought the stomatology clinic of the dentistry course at a reference university in northeastern Brazil, complaining of an asymptomatic increase in volume on the cheek, with an evolution of approximately two years. On intraoral examination, a lesion in the cheek mucosa was observed, measuring approximately 4 cm. The lesion had a nodular, circumscribed, reddish appearance, showing ulcerated areas covered by a yellowish pseudomembrane on its surface. The clinical diagnostic hypothesis was pleomorphic adenoma. Excisional biopsy was performed and, after morphological and immunohistochemical evaluation, the diagnosis of BFH was reached. Although it is a lesion with an excellent prognosis, BFH must be carefully analyzed for the differential diagnosis with malignant neoplasms that may have a mild appearance, such as fibrosarcoma or dermatofibrosarcoma. In addition, other benign lesions such as desmoplastic fibroblastoma, myofibroma, myopericytoma and nodular fasciitis may, in some histological sections, mimic the microscopic appearance of benign fibrous histiocytoma. In this reported case, immunohistochemical evaluation was essential to conclude the diagnosis of BFH(AU)


Assuntos
Humanos , Masculino , Criança , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno
3.
J Cosmet Dermatol ; 21(2): 473-481, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33786961

RESUMO

INTRODUCTION: Several treatments have been used to reduce inflammation and to reverse epithelial alterations in actinic cheilitis (AC). AIM: A systematic review was conducted to analyze the potential of topical treatments for remission and clinical improvement of AC as well as patient acceptability. METHODS: A systematic review of clinical trials was conducted following the PICO strategy to answer the following question: Are topical anti-inflammatory and antineoplastic agents effective in the treatment of actinic cheilitis? The quality of the studies was assessed by ROB-2, and the certainty of evidence was rated by GRADE guidelines. RESULTS: Eight clinical trials were selected, including four that investigated the use of anti-inflammatory drugs and four use of antineoplastic agents. The use of 3% diclofenac sodium was associated with partial remission of AC, while 5% imiquimod and ingenol mebutate promoted complete remission. Furthermore, 5% fluorouracil was the drug most associated with complications during treatment. Diclofenac sodium (3%) and fludroxycortide showed the best acceptance by the patients, especially in terms of symptom relief and comfort provided. CONCLUSION: The anti-inflammatory and antineoplastic agents analyzed largely provided good clinical outcomes, with evidence of remission of AC lesions, development of few local adverse reactions during treatment, and good patient adherence.


Assuntos
Antineoplásicos , Queilite , Idoso , Anti-Inflamatórios/efeitos adversos , Antineoplásicos/efeitos adversos , Queilite/tratamento farmacológico , Humanos , Resultado do Tratamento
4.
Head Neck Pathol ; 15(3): 955-966, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33394370

RESUMO

Odontomas and ameloblastic fibro-odontomas (AFOs) are the result of a developmental anomaly of odontogenic tissues. A literature review of proteins immunoexpressed in odontomas and AFOs was conducted in order to determine which proteins are involved in the pathogenesis of these lesions. AFO was changed to early odontoma in the 2017 WHO classification and will also be discussed in this article. A literature search was performed in the following electronic databases: PubMed/MEDLINE, Web of Science, Scopus, EMBASE, Lilacs, Cochrane Collaboration Library, and Science Direct. The research question was developed according to the population, intervention, comparison, and outcome (PICO) framework: Which proteins are related to the differentiation of odontomas and what is their interrelationship with AFOs? Thirty articles met all inclusion criteria and were selected for this systematic review, totaling 355 cases of odontomas and 43 cases of AFO. Similar immunoexpression was observed in odontomas and AFOs. Immunoexpression of proteins involved in cell differentiation was higher in compound odontomas than in complex odontomas. Proteins involved in histodifferentiation and enamel formation were more frequent in odontomas. The immunoexpression of enamel matrix proteins differs between odontomas and tooth germs, with their persistence being related to the development of odontomas. Compound odontomas exhibit the highest immunoexpression of proteins involved in cellular histodifferentiation and the Wnt/beta-catenin pathway is involved in tumor formation.


Assuntos
Odontoma/metabolismo , Odontoma/patologia , Animais , Humanos , Odontogênese/fisiologia , Proteômica
5.
Head Neck Pathol ; 15(2): 608-616, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33044723

RESUMO

Primary intraosseous oral squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that affects the jaws. Despite its aggressive biological behavior, there are no studies that evaluated the clinicopathological features of this tumor and parameters associated with its prognosis. The objective of the present study was to conduct a systematic review of the available data on oral and maxillofacial PIOSCC in order to determine its clinicopathological characteristics and biological behavior. We conducted a systematic review in May 2020 in multiple databases using a specific search strategy. Cases diagnosed as PIOSCC in the oral cavity and maxillofacial complex that had sufficient histopathological data, absence of ulceration in the oral mucosa, a negative result for a distant primary tumor, and radiographic evidence of an osteolytic lesion that was entirely or mostly surrounded by the jaw bones were included. A total of 109 published articles were included in our systematic review, corresponding to 257 cases. PIOSCC showed a male predilection (69.3%) and a preference for the mandible (7:1), with the posterior region being the most commonly affected site. The mean age at diagnosis was 57.3 years. Cortical expansion, pain, and lip/facial paresthesia were the most common clinical features. Regarding histopathological features, most PIOSCC were well-differentiated and the solid subtype was the most common. Statistical analysis showed that PIOSCC located in the mandible (p = 0.03) and recurrence (p < 0.01) were significantly associated with a higher mortality rate. PIOSCC has a poor prognosis, with high rates of mortality.


Assuntos
Neoplasias Maxilomandibulares/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Lasers Med Sci ; 36(2): 259-267, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32813260

RESUMO

Laser therapy has proved effective in the treatment of different tissue injuries but little is known about its effect on the testis. The aim of this review was to synthesize research on the in vivo effect of low-level laser therapy on the seminiferous epithelium. A search was performed in the PubMed/Medline, Scopus, Web of Science, and LILACS databases. The initial search retrieved 354 references, and five articles that met the eligibility criteria were selected. In general, the studies showed that laser therapy exerted a positive effect on the germ cell population; however, there was considerable variation in the laser parameters, as well as in the experimental models and methods of tissue analysis used. In conclusion, further studies determining the biostimulation parameters of laser therapy in the testis are necessary in order to provide a basis for the possible application of this technique to the restoration of the human seminiferous epithelium and consequent treatment of some male reproductive disorders.


Assuntos
Terapia com Luz de Baixa Intensidade , Epitélio Seminífero/efeitos da radiação , Animais , Masculino , Modelos Animais , Viés de Publicação , Risco , Resultado do Tratamento
7.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 29-32, set./dez. 2020.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1121740

RESUMO

Introdução: O SARS-CoV-2 apresenta-se como um tipo de coronavírus que teve seus primeiros relatos no fim do ano de 2019, sendo declarado como uma emergência de saúde pública internacional no início do ano 2020 pela Organização mundial de saúde. Trata-se de um vírus com alto potencial de transmissibilidade, dessa forma novas medidas e protocolos de biossegurança foram empregadas durante o atendimento odontológico, com a finalidade de minimizar os danos e riscos aos profissionais e pacientes. Objetivo: Relatar as principais medidas de proteção e recomendações que devem existir em ambientes que prestam atendimentos odontológicos durante a pandemia de Covid-19. Metodologia: Foi realizada revisão de artigos presentes nas bases de dados Pubmed e Scielo do ano de 2020, assim como nos manuais atuais de biossegurança em atendimentos odontológicos. Foram utilizados os descritores COVID-19 e Dentistry, e em adicional foram utilizados 14 documentos, sendo 8 artigos e 6 manuais oficiais sobre o tema. Conclusão: Medidas de proteção devem ser empregadas durante o atendimento odontológico, sendo importante que durante a pandemia do COVID-19 haja um reforço na biossegurança dos cirurgiões dentistas, para minimizar dessa forma o risco de contágio(AU)


Introduction: SARS-CoV-2 presents itself as a type of coronavirus that had its first reports at the end of 2019, being declared as an international public health emergency at the beginning of 2020 by the WHO. It is a virus with a high potential for transmissibility, so new biosafety measures and protocols were used during dental care, in order to minimize the damage and risks to professionals and patients. Objective: To report the main protection measures and recommendations that should exist in environments that provide dental care during the Covid-19 pandemic. Methodology: A review of articles in the Pubmed and Scielo databases for the year 2020 was carried out, as well as in the current biosafety manuals for dental care. The descriptors COVID-19 and Dentistry were used, and in addition 14 documents were used, 8 articles and 6 official manuals on the subject. Conclusion: Protective measures should be used during dental care, it is important that during the COVID-19 pandemic there is a reinforcement in the biosafety of dental surgeons, in order to minimize the risk of contagion(AU)


Assuntos
Assistência Odontológica , Infecções por Coronavirus , Coronavirus , Contenção de Riscos Biológicos
8.
J. Oral Investig ; 9(1): 97-105, jan.-jun. 2020.
Artigo em Português | BBO - Odontologia | ID: biblio-1342289

RESUMO

Introdução: O complexo zigomático é de grande importância no estudo da traumatologia devido a sua posição anatômica muito suscetível a traumas. Devido a sua interação direta com a órbita, o osso zigomático é uma importante proteção do globo ocular, assim como um dos responsáveis pela dissipação e transmissão de forças mastigatórias. Objetivo: O presente estudo objetiva revisar as formas de diagnóstico, exames complementares e as principais abordagens cirúrgicas bem como as possíveis complicações. Metodologia: Os dados selecionados foram obtidos através do acesso as bases de dados eletrônicos Medline, PubMed e Science direct. Foram selecionados 1 livro e 15 artigos publicados entre 2013 e 2019. Resultados: Diversas abordagens cirúrgicas podem ser utilizadas em fraturas do complexo zigomático dependendo da extensão e localização da fratura. As cirurgias são consideradas procedimentos seguros, com baixos níveis de complicações e sem problemas maiores no pósoperatório. Com a tecnologia 3D, o diagnóstico e planejamento dos casos se torna facilitado e mais preciso, levando a um procedimento mais seguro e previsível. Conclusão: O diagnóstico de fraturas no osso zigomático deve ser minucioso, envolvendo aspectos clínicos e exames complementares, o tratamento deve ser realizado de forma a preservar não só a função bem como a aparência, visto que erros no reposicionamento pós-trauma do processo zigomático pode causar simetria facial evidente no paciente, assim como o afundamento do globo ocular, diplopia, fissura orbital superior e hemorragia retrobulbar(AU)


Introduction: The zygomatic complex is of great importance in the study of traumatology due to its anatomical position very susceptible to trauma. Due to its direct interaction with the orbit, the zygomatic bone is an important protection of the eyeball, as well as one of those responsible for the dissipation and transmission of masticatory forces. Objective: This study aims to review the forms of diagnosis, complementary exams and the main surgical approaches as well as possible complications. Methodology: The selected data were obtained through access to the electronic databases Medline, PubMed and Science direct. One book and 15 articles published between 2013 and 2019 were selected. Results: Several surgical approaches can be used in fractures of the zygomatic complex depending on the extent and location of the fracture. The surgeries are considered safe procedures, with low levels of complications and without major problems in the postoperative period. With 3D technology, diagnosis and planning of cases becomes easier and more accurate, leading to a safer and more predictable procedure. Conclusion: The diagnosis of fractures in the zygomatic bone must be thorough, involving clinical aspects and complementary exams, the treatment must be carried out in order to preserve not only function but also appearance, since errors in the post-trauma repositioning of the zygomatic process can cause facial symmetry evident in the patient, as well as sinking of the eyeball, diplopia, upper orbital fissure and retrobulbar hemorrhage(AU)


Assuntos
Fraturas Zigomáticas , Fraturas Zigomáticas/cirurgia , Zigoma/cirurgia , Zigoma/lesões , Fraturas Zigomáticas/diagnóstico , Fraturas Zigomáticas/diagnóstico por imagem , Fraturas Ósseas
9.
Rev. Odontol. Araçatuba (Impr.) ; 41(1): 30-33, jan.-abr. 2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1102370

RESUMO

As próteses removíveis são consideradas facilitadoras em potencial da estomatite protética, caracterizada por aspectos hiperplásicos e eritematosos na mucosa de suporte. Este trabalho tem como objetivo relatar as principais manifestações orais da estomatite protética em um paciente geriátrico associada a candidíase oral pseudomembranosa. Paciente do gênero masculino, setenta e quatro anos, apresentava uma lesão exofítica, na região de palato com dois centímetros de extensão, além da presença de candidíase pseudomembranosa, fazia o uso de uma prótese parcial superior removível há aproximadamente dez anos. Foi levantada a hipótese diagnóstica de estomatite protética associada a candidíase pseudomembranosa. A terapêutica instituída consistiu no uso de antifúngico por um período de quinze dias e biópsia incisional. O exame histopatológico confirmou o diagnóstico de hiperplasia fibrosa inflamatória. Foi recomendado a confecção de uma nova prótese para que fosse evitado a recorrência da lesão, e o paciente também foi instruído quanto a sua higiene oral evitando-se desta forma a recorrência da candidíase. O cirurgião-dentista deve ser capaz de reconhecer e diagnosticar a estomatite protética em sua prática diária e tratar o paciente de acordo com a sua etiologia, oferecendo desta forma para o paciente um maior conforto e melhores condições de vida(AU)


Removable total dentures are considered potential facilitators of prosthetic stomatitis, characterized by hyperplastic and erythematous aspects in the supporting mucosa. This paper aims to report the main oral manifestations of prosthetic stomatitis in an elderly patient associated with pseudomembranous oral candidiasis. A seventyseven-year-old male patient presented with an exophytic lesion in the palate region of two centimeters in length, in addition to the presence of pseudomembranous candidiasis, and had been using a removable upper partial denture for approximately ten years. The diagnostic hypothesis of prosthetic stomatitis associated with pseudomembranous candidiasis was raised. The therapy instituted consisted of the use of antifungal for a period of fifteen days and incisional biopsy. Histopathological examination confirmed the diagnosis of inflammatory fibrous hyperplasia. It was recommended to make a new prosthesis to avoid recurrence of the lesion, and the patient was also instructed as to its oral hygiene, thus avoiding the recurrence of candidiasis. The dentist should be able to recognize and diagnose prosthetic stomatitis in his daily practice and treat the patient according to its etiology, thus offering the patient greater comfort and better living conditions(AU)


Assuntos
Humanos , Masculino , Idoso , Estomatite sob Prótese , Prótese Dentária , Estomatite , Estomatite sob Prótese/diagnóstico , Estomatite sob Prótese/terapia , Candidíase Bucal
10.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e205-e216, mar. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196250

RESUMO

BACKGROUND: Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations that are frequently characterized as architectural and cytological derangements upon histological analysis. Epithelial-mesenchymal transition (EMT) has been proposed as a critical mechanism for the acquisition of the malignant phenotype in neoplastic epithelial processes. This study aims to systematically review the current findings on the immunohistochemical expression of epithelial-mesenchymal transition markers in oral potentially malignant disorders and to evaluate their possible application as biomarkers associated with the progression of oral epithelial dysplasias. MATERIAL AND METHODS: A systematic search was performed in the following databases: PubMed, EMBASE, Chinese BioMedical Literature Database, and Cochrane Library. Articles that evaluated the relationship between the expression of EMT markers and the degree of oral epithelial dysplasia were selected for the systematic review. The quality of each eligible study was evaluated by independent reviewers that used operationalized prognostic biomarker reporting guidelines (REMARK). RESULTS: Seventeen articles met all inclusion criteria and were selected. The EMT markers analyzed exhibited an important association with the prognosis of the cases evaluated. The results showed a progressive increase in the expression of nuclear transcription factors and markers of mesenchymal differentiation, as well as negative regulation of epithelial and cell adhesion markers, according to the stage of oral epithelial dysplasia. CONCLUSIONS: The dysregulation of expression of important EMT components in oral dysplastic epithelium is a potential prognostic marker in OPMDs


No disponible


Assuntos
Humanos , Transição Epitelial-Mesenquimal , Doenças da Boca/patologia , Leucoplasia Oral/patologia , Biomarcadores Tumorais/análise , Mucosa Bucal/patologia , Imuno-Histoquímica , Valor Preditivo dos Testes , Prognóstico , Lesões Pré-Cancerosas/patologia , Progressão da Doença
11.
Clin Oral Investig ; 24(1): 181-191, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31069539

RESUMO

OBJECTIVE: This study aimed to evaluate tryptase and E-cadherin protein expression in odontogenic keratocysts (OKCs) and radicular cysts (RCs) and their relationship with lesion size. MATERIALS AND METHODS: Thirty OKC and 30 RC cases were analyzed by immunohistochemistry. Tryptase expression was quantitatively assessed using the quantification of mast cells, and expression of E-cadherin was semi-quantitatively analyzed estimating the proportion of positive cells: 1 = less than 25% of immunopositive cells; 2 = 26 to 50% of immunopositive cells; 3 = 51 to 75% of immunopositive cells; 4 = more than 75% of immunopositive cells. Data on cystic lesion sizes were obtained from patients' clinical files, based on previous radiographic exams, and the lesions were categorized into three groups: group 1 (< 2 to 2 cm); group 2 (> 2 to 4 cm), and group 3 (> 4 cm). RESULTS: Higher mast cell means were found for RCs, with the predominance of degranulated mast cells in both OKCs and RCs (p = 0.082). Concerning the epithelial component, a higher concentration of degranulated mast cells was detected in RCs (p = 0.000). Regarding connective tissue, degranulated mast cells were more evident in OKCs (p = 0.762). A negative correlation was observed between E-cadherin expression and total number of mast cells (p = 0.011), degranulated mast cells (p = 0.040), and degranulated mast cells in both superficial (p = 0.035) and deep connective tissues (p = 0.009). Concerning lesion size, a negative correlation with total number of mast cells (p = 0.016) and number of degranulated mast cells (p = 0.049) was observed, both in the epithelial components. Herein, the larger the lesion size, the lower the number of degranulated mast cells in the epithelium (r = - 0.271; p = 0.49), suggesting that these cells play a role in the initial cystic expansion phase. CONCLUSION: The higher expression of tryptase in degranulated mast cells was linked to a lower expression of E-cadherin, which may be related to a change in the epithelial permeability in these lesions, contributing to increased cystic content and lesion growth. CLINICAL RELEVANCE: Evidence of the relationship between mast cells and E-cadherin in the growth of odontogenic cysts was studied.


Assuntos
Caderinas , Cistos Odontogênicos , Cisto Radicular , Humanos , Mastócitos , Triptases
12.
Rev. Ciênc. Plur ; 6(2): 113-124, 2020. tab
Artigo em Português | BBO - Odontologia, LILACS | ID: biblio-1100316

RESUMO

Introdução:A utilização de fitoterápicos para os tratamentos de prevenção e de suporte de patologias situadas nos diversos órgãos e tecidos, caracteriza-se como uma prática amplamente disseminada no Brasil.Objetivo:Avaliar a ação antimicrobiana de 09 substâncias fitoterápicas utilizadas costumeiramentepara o tratamento de suporte em algumas afecções bucais no nordeste brasileiro. Materiais:O experimento in vitrofoi realizado no Laboratório de Microbiologia do Centro de Biociências da Universidade Federal do Rio Grande do Norte, e o preparo foi realizado por decocção em por um período de 10 minutos e para cada espécie de bactérias, foram utilizadas duas Placas dePetri com meio de cultura Agar Muller Hinton.Métodos:Para a realização da decocção, foi utilizadauma quantidade de 10 gramas eesperou-se os preparos atingir a temperatura ambiente (37º),aatividade antimicrobiana foi avaliada frente à duas cepas de bactérias,através de uma técnica de observação em laboratório, para cada espécie de bactéria.Foram utilizadas duas Placas de Petri com meio de cultura Agar Muller Hinton, onde a inoculação foi realizada por meio de Swabs, e sobre os quais foram realizadoscinco poços de aproximadamente 6 mm de diâmetro. Resultados:Os extratos da semente de manuscada, óleo de coco, casca de cajueiro, semente de sucupira, raiz de urtiga branca e gengibre, foram ineficazes contra o Streptococcus mutans,e Streptococcus mitis,por outro lado o extrato de româ exibiu eficácia para o Streptococcus mutanse a pedra hume exibiu eficácia parao Streptococcus mitis.Conclusões:Os extratos de casca de cajueiro, casca de romã, gengibre e de pedra hume foram eficazes antibacterianos sobre Streptococcus mutansquando comparado com o Periogard®, considerado padrão ouro nos estudos sobre os agentes antibacterianos na odontologia (AU).


Introduction:The use of herbal medicines for the prevention and support treatments of pathologies located in the various organs and tissues is characterized as a widespread practice in Brazil.Objective:To analyze, from the elaboration of antibiogramsof the species Streptococcus mutans and Streptococcus mitis, the antimicrobial activity of phytotherapeutic species in oral disorders.Materials:The in vitro experiment was carried out at the Microbiology Laboratory of the Biosciences Center of the Federal University of Rio Grande do Norte, and the preparation was carried out by decoction in a period of 10 minutes and for each species of bacteria, two plates were used Petri dish with Agar Muller Hinton culture medium.Methods:For the decoction, a quantity of 10 grams was used and the preparations were expected to reach room temperature (37º), the antimicrobial activity was evaluated against two strains of bacteria, using a laboratory observation technique, for each species of bacteria, two Petri dishes with Agar Muller Hinton culture medium were used, where the inoculation was performed by means of Swabs, and on which five wells of approximately 6 mm in diameter were made.Results:The extracts of the mamuscada seed, coconut oil, cashew bark, sucupira seed, white nettle root and ginger, were ineffective against Streptococcus mutans, and Streptococcus mitis, on the other hand, pomegranate extract showed efficacy for Streptococcus mutans and the hume stone showed efficacy for Streptococcus mitis. Conclusions:Cashew bark, pomegranate, ginger and hume stone extracts were effective antibacterials against Streptococcus mutans when compared to Periogard®, considered the gold standard in studies on antibacterial agents in dentistry (AU).


Introducción: El uso de hierbas medicinales para la prevención y el tratamiento de apoyo de patologías localizadas en los diversos órganos y tejidos se caracteriza como una práctica generalizada en Brasil. Objetivo:analizar, a partir de la elaboración de antibiogramas de las especies Streptococcus mutans y Streptococcus mitis, la actividad antimicrobiana de las especies fitoterapéuticas en los trastornos orales.Materiales:Elexperimento in vitro se realizó en el Laboratorio de Microbiología del Centro de Biociencias de la Universidad Federal de Rio Grande do Norte, y la preparación se realizó por decocción en un período de 10 minutos y para cada especie de bacteria, se utilizaron dos placas. Placa de Petri con medio de cultivo Agar Muller Hinton. Resultados:los extractos de semilla de mamuscada, aceite de coco, corteza de anacardo, semilla de sucupira, raíz de ortiga blanca y jengibre, no fueron efectivos contra Streptococcus mutans y Streptococcus mitis, por otrolado, el extracto de granada mostró eficacia para Streptococcus mutans y el cálculo de húmero mostraron eficacia para Streptococcus mitis.Métodos:Para la decocción, se utilizó una cantidad de 10 gramos y se esperaba que las preparaciones alcanzaran la temperatura ambiente (37º), se evaluó la actividad antimicrobiana contra dos cepas de bacterias, utilizando una técnica de observación de laboratorio. Para cada especie de bacteria, se utilizaron dos placas de Petri con medio de cultivo Agar Muller Hinton, donde la inoculación se realizó por medio de hisopos, y en la cual se hicieron cinco pozos de aproximadamente 6 mm de diámetro.Conclusiones:los extractos de corteza de anacardo, granada, jengibre y cálculos de húmero fueron antibacterianos efectivos contra Streptococcus mutans en comparación con Periogard®, considerado el estándar de oro en estudios sobre agentes antibacterianos en odontología (AU).


Assuntos
Técnicas In Vitro/métodos , Odontologia , Tratamento Farmacológico , Medicamento Fitoterápico , Antibacterianos , Plantas Medicinais , Brasil
13.
Rev. Ciênc. Plur ; 6(2): 192-204, 2020.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1100328

RESUMO

Introdução:Os projetos de extensão universitáriaapresentam grande importância para os estudantes e para a sociedadecomo um todo, uma vez que possibilitamuma reflexão crítica nos indivíduos, a fim de integrar os conhecimentos acadêmicos à sociedade.O projeto Formando Sorrisosda Universidade Federal do Rio Grande do Norte(UFRN), promove atendimento odontológico aos estudantes da instituição que sejam caracterizados como vulneráveis socioeconomicamente; durante as atividades os pacientes são constantemente instruídos sobre cuidados orais e incentivados a levar as práticas às suas residências, configurando-se um vetor inicial para prevenção de agravos orais.Objetivo:Relatar a contribuição do projeto na formação do estudante de Odontologia.Metodologia:Trata-se de um estudo descritivo do tipo relato de experiência com base na rotina clínica dos alunos de odontologia do segundo ao décimoperíodo de um projeto de extensão daUFRN. Os dados se referem ao período de 2018 a 2019, avaliando desde a recepção dos pacientes até a finalização de seus tratamentos odontológicos.Resultados:A experiência nas diferentes atividades doprojeto possibilitaaosestudantesum olhar mais integraldo paciente. A vivência clínica desde cedo na graduação auxiliaao aluno um maior entendimento sobre a Odontologia, motivando-oem relação ao curso, facilitando o aprendizado e contribuindo para a formação profissional.Conclusões:As atividades desenvolvidas pelo projeto contribuempara a formação acadêmica do estudante de Odontologiae proporciona aos estudantes universitários atendimento odontológico de qualidade e em horários flexíveis (AU).


Introduction:University extension projects are of great importance for students and society as a whole since they allow critical reflection on individuals, to integrate academic knowledge into society. The Formando Sorrisos project of the Federal University of Rio Grande do Norte (UFRN) promotes dental care to the institution's students who are characterized as socioeconomically vulnerable; during activities, patients are constantly instructed about oral care and encouraged to take the practices to their homes, setting up an initial vector for preventing oral diseases.Objective:To report the project's contribution to the training of dentistry students.Methodology:This is a descriptive study of the type of experience report based on the clinical routine of dentistry students from the second to the tenth period of an extension project at UFRN. The data refer to the period from 2018 to 2019, evaluating from the reception of patients to the completion of their dental treatments. Results:Experience in the different activities of the project allows students to have a more comprehensive view of the patient. The clinical experience from an early stage in graduation helps students to gain a better understanding of Dentistry, motivating them concerning the course, facilitating learning, and contributing to professional training.Conclusions:The activities developed by the project contribute to the academic education of dentistry students and provide university students with quality dental care and flexible hours (AU).


Introducción: Los proyectos de extensión universitaria son de gran importancia para los estudiantes y para la sociedad en general, ya que permiten la reflexión crítica sobre las personas, para integrar el conocimiento académico en la sociedad. El proyecto Formando Sorrisos de la Universidad Federal de Río Grande del Norte(UFRN), promueve la atención dental a los estudiantes de la institución que se caracterizan por ser socioeconómicamente vulnerables; Durante las actividades, los pacientes reciben constantemente instrucciones sobre el cuidado bucal y se les alienta a llevar las prácticas a sus hogares, estableciendo un vector inicial para laprevención de enfermedades orales.Objetivo: Informar la contribución del proyecto a la formación de estudiantes de odontología. Metodología: Este es un estudio descriptivo del tipo de informe de experiencia basado en la rutina clínica de los estudiantes de odontología del segundo al décimo período de un proyecto de extensión en la UFRN. Los datos se refieren al período de 2018 a 2019, evaluando desde la recepción de pacientes hasta la finalización de sus tratamientos dentales.Resultados: La experiencia en las diferentes actividades del proyecto permite a los estudiantes tener una visión más completa del paciente. La experiencia clínica desde una etapa temprana de la graduación ayuda a los estudiantes a comprender mejor la odontología, motivándolos en relación con el curso, facilitando el aprendizaje y contribuyendo a la formación profesional.Conclusiones: Las actividades desarrolladas por el proyecto contribuyen a la educación académica de los estudiantes de odontología y brindan a los estudiantes universitarios atención dental de calidad y horarios flexibles (AU).


Assuntos
Humanos , Masculino , Feminino , Estudantes de Odontologia , Relações Comunidade-Instituição , Aprendizagem Baseada em Problemas/métodos , Serviços de Saúde Bucal , Educação em Odontologia , Escovação Dentária/métodos , Brasil , Epidemiologia Descritiva
14.
Rev. Ciênc. Plur ; 5(2): 161-170, ago. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021784

RESUMO

Introdução:A intrusão resulta no deslocamento do dente no sentido axial para o interior do osso alveolar, podendo causar injúrias à estrutura periodontal e ao tecido pulpar através do esmagamento e ruptura das fibras do ligamento periodontal e do aporte vascular.Objetivo:abordar a ocorrência de um traumatismo dentário do tipo intrusivo, na dentição decídua, descrevendo aspectos relacionados ao diagnóstico, tratamento e proservação da unidade dentária. Relato de caso:Paciente, quatro anos de idade, gênero feminino, apresentou traumatismo dentário condizente com o diagnóstico de luxação intrusiva, foi estabelecido um tratamento conservador, preservando o elemento dentário no arco até que ocorresse a esfoliação do mesmo. No presente caso, obteve-se um bom prognóstico, visto que foi percebida a reerupção do elemento dentário no período de dois meses.Conclusões:O conhecimento das técnicas de manipulação dos traumatismos dento-alveolares e dos tecidos moles é imprescindível para a realização de um tratamento adequado dessas condições. Desta maneira, é importante o cirurgião-dentista ter habilidades no manejo da criança para um correto diagnóstico, estabelecendo um adequado tratamento, para melhor prognostico da unidade dentária (AU).


Introduction:Intrusion results in axial displacement of the tooth into the alveolar bone and may cause damage to the periodontal structure and pulp tissue by crushing and rupturing the periodontal ligament fibers and vascular input.Objective:To address the occurrence of intrusive dental trauma in the deciduous dentition, describing aspects related to the diagnosis, treatment and proservation of the dental unit. Case report:Patient, four years old, female, had dental trauma consistent with the diagnosis of intrusive dislocation, a conservative treatment was established, preserving the dental element in the arch until exfoliation occurred. In the present case, a good prognosis was obtained, since it was noticed the re-erection of the dental element in the period of two months. Conclusions:The knowledge of the techniques of manipulation of dento-alveolar and soft tissue trauma is essential for the adequate treatment of these conditions. In this way, it is important for the dental surgeon to have skills in the management of the child for a correct diagnosis, establishing an appropriate treatment, for a better prognosis of the dental unit (AU).


Assuntos
Humanos , Feminino , Pré-Escolar , Prognóstico , Dente Decíduo , Radiografia Dentária/instrumentação , Traumatismos Dentários/etiologia , Brasil
15.
J Biosci ; 44(4)2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31502556

RESUMO

Foreign bodies can penetrate the interior of soft and, sometimes, hard, tissues in various ways, including through open wounds, lacerations and traumatic accidents. However over the years, evidence of links between the use of dental materials and lately, significant involvement of aesthetic filler materials as foreign bodies in the oral and perioral region have been reported. Foreign body granulomas (FBGs) may develop from this exogenous material, histopathologically characterized by the presence of chronic inflammation and a high amount of macrophages. This study presents nine FBG cases affecting the oral and perioral regions, and carries out a literature review on the main clinical, histopathological and material characteristics used in dental and dermatological procedures related to the appearance of this type of granuloma.


Assuntos
Materiais Dentários/efeitos adversos , Restauração Dentária Permanente/efeitos adversos , Granuloma de Corpo Estranho/patologia , Inflamação/patologia , Adolescente , Adulto , Feminino , Corpos Estranhos/induzido quimicamente , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/patologia , Granuloma de Corpo Estranho/induzido quimicamente , Granuloma de Corpo Estranho/diagnóstico por imagem , Humanos , Inflamação/induzido quimicamente , Inflamação/diagnóstico por imagem , Macrófagos/efeitos dos fármacos , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
Rev. Ciênc. Plur ; 5(1): 102-112, jun. 2019. ilus
Artigo em Português | BBO - Odontologia, LILACS | ID: biblio-1007362

RESUMO

Introdução:A queilite granulomatosa (QG) é uma lesão oral rara, apresentando clinicamente inchaço de aspecto granulomatoso no lábio.Objetivo:O presente estudo, tem como objetivo apresentar um relato de caso de QG, tendo em vista, a dificuldade do diagnóstico e tratamento de condições inflamatórias com etiologias desconhecidas que acometem a cavidade oral.Relato de caso:Paciente do sexo feminino, apresentou aumento de volume no lábio superior exibindo sintomatologia dolorosa, porém, sem relatar associações com alterações sistêmicas. Durante o exame clínico notou-se que o lábio superior apresentava fissuras profundas, observando tambémedema que se estendia da comissura labial, atravessando a linha média. Levantou-se então, a hipótese diagnóstica de QG. Foi realizada uma biópsia incisional para confirmação do diagnóstico. A análise histopatológica evidenciou, presença de granulomas não caseosos e infiltrado inflamatório linfoplasmocitário perivascular. De acordo com os dados clínicos e análise histopatológica foi dado o diagnóstico inicial de QG. Após o diagnóstico inicial de QG, a paciente foi encaminhada para uma avaliação médica, a fim de avaliar possíveis alterações intestinais que pudessem caracterizar a síndrome de Melkersson-Rosenthal ou Cronh, como também possível reação de hipersensibilidade tardia. Conclusões:O cirurgião-dentista deve estar preparado para diagnosticar aumentos de volume significativos nos lábios, a fim de manejar corretamente o tratamento do paciente, estabelecendo desta forma, prognósticos favoráveis para essas condições (AU).


Introduction:Granulomatous cheilitis (HQ) is a rare oral lesion, presenting clinically granulomatous swelling on the lip. Objective: This study aims to present a case report of HG, considering the difficulty of diagnosis and treatment of inflammatory conditions with unknown etiologies that affect the oral cavity.Objective:This study aims to present a case report of HG, considering the difficulty of diagnosis and treatment of inflammatory conditions with unknown etiologies that affect the oral cavity.Case report:A female patient presented increased volume in the upper lip showing painful symptoms, but without reporting associations with systemic alterations. During the clinical examination it was observed that the upper lip presented deep fissures, also observing edema that extended from the labial commissure, crossing the middle line. The diagnostic hypothesis of GQ was then raised. An incisional biopsy was performed to confirm the diagnosis. Histopathological analysis revealed the presence of non-caseous granulomas and perivascular lymphoplasmacytic inflammatory infiltrate. According to the clinical data and histopathological analysis the initial diagnosis of GH was given. After initial diagnosis of HG, the patient was referred for medical evaluation to evaluate possible intestinal changes that could characterize Melkersson-Rosenthal syndrome or Cronh, as well as possible late hypersensitivity reactions.Conclusions:The dentist should be prepared to diagnose significant volume increases in the lips in order to correctly manage the patient's treatment, thus establishing favorable prognoses for these conditions (AU).


Assuntos
Humanos , Feminino , Adulto , Biópsia/métodos , Neoplasias Labiais/diagnóstico , Diagnóstico Bucal/métodos , Síndrome de Melkersson-Rosenthal/diagnóstico , Síndrome de Melkersson-Rosenthal/patologia , Brasil
17.
RFO UPF ; 24(1): 89-95, 29/03/2019. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1048456

RESUMO

Objetivo: identificar e descrever o perfil clínico e epidemiológico do carcinoma epidermoide bucal (CEB) em pacientes adultos jovens. Revisão da literatura: realizou-se uma revisão sistemática, utilizando-se como fontes de buscas as bases de dados eletrônicas Lilacs, SciELO, PubMed e Portal de Periódicos Capes, por meio dos descritores: câncer bucal, carcinoma de células escamosas oral, epidemiologia e paciente jovem, nos idiomas português, inglês e espanhol, no período de janeiro de 2003 a janeiro de 2016. Foram identificados 348 artigos, sendo 171 no Portal de Periódicos Capes, 126 no PubMed, 26 no Lilacs e 2 no SciELO. Após análise dos estudos localizados, oito artigos foram selecionados para a presente revisão sistemática. Considerações finais: são necessários mais estudos para a identificação das características clínicas e epidemiológicas do tumor na população em questão, bem como a padronização da faixa etária referente ao termo adulto jovem, visto que esses esclarecimentos podem refletir no seu controle e possibilitar o desenvolvimento de um programa de prevenção primária para o CEB em pacientes jovens. (AU)


Objective: to identify and describe the clinical and epidemiological profile of oral squamous cell carcinoma in young adult patients. Literature Review: a systematic review was performed using the Lilacs, SciELO, PubMed, and Periódicos Capes electronic databases as search sources, through the following descriptors: oral cancer, oral squamous cell carcinoma, epidemiology, and young patient, in English, Spanish, and Portuguese, from January 2003 to January 2016. A total 348 articles were identified, from which 171 were found in Periódicos Capes, 126 in PubMed, 26 in Lilacs, and 2 in SciELO. After analyzing the studies found, eight articles were selected for the present systematic review. Final considerations: further studies are required to identify the clinical and epidemiological characteristics of the tumor in this population and to standardize the age regarding the term young adult, considering these explanations may reflect in its control and allow developing of a primary prevention program for oral squamous cell carcinoma in young patients. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas/patologia , Fatores de Risco , Fatores Etários
18.
J Oral Pathol Med ; 48(6): 433-440, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30756461

RESUMO

BACKGROUND: The aim of the present study was to integrate available data published in the literature on extracapsular invasion in cases of CXPA that correlated findings with the prognosis of analysed patients. METHODS: An electronic search was carried out at the MEDLINE/PubMed, EMBASE and Cochrane Collaboration Library databases. Articles that assessed the relationship between extracapsular invasion and survival of patients diagnosed with CXPA were selected for the systematic review. Quality assessment was performed, in duplicate, for each eligible study by independent reviewers who used the operationalized prognostic biomarker reporting the REMARK guidelines. RESULTS: Eight published articles met all the inclusion criteria and were selected. Extracapsular invasion was evaluated in all selected studies and was correlated with clinical and pathological parameters. Recurrence and death due to the neoplastic process became a frequent finding in cases of tumours with extracapsular invasion >1.5 mm, being an important cut-off point in the prognostic analysis of cases diagnosed as CXPA. CONCLUSIONS: This systematic review demonstrates the importance of evaluating extracapsular invasion in cases diagnosed as CXPA, considering that tumours with invasion >1.5 mm, regardless of histopathological subtype, are associated with a worse prognosis. It is important to analyse the extracapsular invasion, especially as an auxiliary method to assess the prognosis of cases diagnosed in the initial clinical stages, thus identifying the possible biological behaviour of the neoplastic process and guiding the most appropriate patient management.


Assuntos
Adenoma Pleomorfo/diagnóstico , Invasividade Neoplásica , Neoplasias das Glândulas Salivares/diagnóstico , Adenoma Pleomorfo/patologia , Humanos , Recidiva Local de Neoplasia , Prognóstico , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia
19.
Med Mol Morphol ; 52(3): 123-134, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30382358

RESUMO

We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior.


Assuntos
Doenças Linfáticas/epidemiologia , Doenças Estomatognáticas/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Criança , Feminino , Humanos , Doenças Linfáticas/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Doenças Estomatognáticas/patologia , Doenças da Língua/epidemiologia , Doenças da Língua/patologia , Adulto Jovem
20.
Arch Oral Biol ; 87: 43-51, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29248700

RESUMO

OBJECTIVES: The objective of this systematic review was to evaluate information on the levels of MMP-8 in patients diagnosed with prediabetes or type 2 diabetes mellitus with periodontal disease, analyzing its validity as a possible biomarker for the diagnosis and progression of periodontal disease (PD). METHODS: A systematic search of the following databases was performed: PubMed/Medline, CENTRAL (The Cochrane Library), EMBASE and Web of Science. Studies involving the evaluation of MMP-8 in patients with prediabetes or patients presenting type 2 diabetes mellitus concomitantly with PD were selected. The evaluation of the methodological quality of the selected studies was based on the methodological bias risk analysis (QUADAS-2). RESULTS: Eight of the initially identified 2683 articles were selected. In all the selected studies, evaluator calibration and the use of clear methods for patient diagnosis with periodontal disease were present. Studies have demonstrated significantly higher MMP-8 concentrations in PD patients compared to controls, as well as in patients presenting more advanced stages of PD. However, controversies regarding MMP-8 levels in prediabetes/diabetes type 2 patients with PD. CONCLUSIONS: Higher MMP-8 levels in patients with PD compared to controls imply the potential use of MMP-8 in the diagnosis of PD. The influence of patient glycemic state, as well as medications these patients make use of, are factors that possibly contribute to the modulation of MMP-8 concentrations in patients with diabetes and should be analyzed, aiming at a better understanding of the relationship between glycemic state and MMP-8 levels in patients with PD.


Assuntos
Biomarcadores/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Metaloproteinase 8 da Matriz/metabolismo , Doenças Periodontais/metabolismo , Estado Pré-Diabético/metabolismo , Humanos
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