Lateral periodontal cyst: A rare clinicopathological presentation mimicking a residual cyst.

This article describes an unusual clinical-radiographic presentation of a lateral periodontal cyst, as a differential diagnosis of a residual cyst, following the 'CARE guidelines for case reports'. The radiolucent lesion was identified on the imaging exam of a 53-year-old male patient. Based on radiographic findings and aspiration puncture, the probable diagnosis was a residual cyst; however, histological analysis revealed a thin, non-inflamed fibrous capsule covered by some epithelial layers in most of the lesion. The definitive diagnosis was a lateral periodontal cyst with unusual clinical and radiographic features. The cyst was surgically enucleated and local bone neoformation was observed, with no signs of recurrence after 12 months. The results of this study suggest that a radiolucent lesion, suggestive of a residual cyst or keratocyst in the maxilla, may correspond to a lateral periodontal cyst. In this context, the histopathological analysis of the cyst is essential for the definitive diagnosis. Key words:Cysts, odontogenic cysts, periapical cysts, periodontal cysts.

Razões da escolha de fitoterapia por usuários da atenção primária no município do Rio de Janeiro / Purpose of choose of phytoterapy among users of basic health care in the city of Rio de Janeiro

O presente estudo,com abordagem descritiva de caráter exploratório, quantitativo e qualitativo,objetivou identificar razões da escolha de fitoterapia na cidade do Rio de Janeiro. A população de estudo foi composta por 50 usuários de uma unidade básica de saúde (UBS), que oferta fitoterapia, na área programática (AP 2.1). Participaram da pesquisa,com abordagem na Teoria de Análise de Redes Sociais,pessoas que declararam fazer uso de plantas medicinais e/ou fitoterápicos. Buscou-se,por meio de um breve roteiro, identificar o perfil sociodemográfico dos usuários, quem foram as pessoas que haviam indicado a fitoterapia e quais eram as razões para seu uso. Como resultado sobre as razões de uso para a fitoterapia evidenciamos neste estudo que 1-Ela está fortemente ligada à rede pessoal do usuário. A indicação na rede pessoal é maior do que na rede formal de saúde, aqui representada pela UBS; 2-Parece haver correlação entre sistema de crenças pessoais, como cientificidade e religiosidade/espiritualidade em certos casos; 3-Identificamos uma percepção da fitoterapia pelo usuário como sendo uma terapêutica menos agressiva em termos de efeitos colaterais e adversos.Para institucionalização da fitoterapia na atenção primária, os resultados sugerem que o acesso à informação e a indicação sobre a prática da fitoterapia é fortemente ligada aos contextos sociais. Portanto, estas evidências sugerem a importância de que sejam inseridos nos serviços de fitoterapia espaços de discussão concernentes ao paradigma das Práticas Integrativas e Complementares.

This descriptive, exploratory, quantitative and qualitative study aimed to identify reasons for the use of phytotherapy, in the city of Rio de Janeiro. The study population consisted of 50 users of a basic health unit (UBS), that offer phytotherapy in the program area (AP 2.1). Participants in this research based on the Theory of Social Network Analysis were people who declared that they made use of medicinal plants and/or herbal medicines. Through questions, we sought to identify the sociodemographic profile of users, who recommended and what were the reasons for using phytotherapy. As a result, on the reasons for using herbal medicine, 1 ­It seems to be strongly related to the personal network, more than the health service advice, here represented by the UBS; 2-There seems to be a correlation between the personal beliefs such as religion, science and spirituality in certain cases; 3-We identified a perception of herbal medicine as less aggressive in terms of collateral effects and adverse effects. In order to the institutionalization of phytotherapy in primary care, our results suggest that access to information and indication about the practice of phytotherapy is strongly linked to social contexts. Therefore, this evidence suggest the importance of being inserted into the phytotherapy services spaces of discussion concerning the paradigm of Integrative and Complementary Practices.

Periodontal profile and radiographic characterization of the jaws in a patient with autosomal dominant osteopetrosis.

Osteopetrosis (OP) comprehends a rare group of conditions, presenting on radiographs increased bone density, deriving from irregularities in osteoclast differentiation or function. In the autosomal dominant osteopetrosis (ADO), some patients stay asymptomatic for some time, or only develop mild symptoms. The dental surgeon is often the first to presuppose the disease during routine imaging examinations, referring the patient to a specialized medical group. Furthermore, osteomyelitis is one of the major OP complications, and should be refrained through frequent dental monitoring. Signals of cortical interruption, sclerotic sequestra or periosteal new bone formation, should be looked for in these patients. Their dental management is complex and procedures encompassing bone tissue, such as implant procedures, tissue regenerations, tooth extractions, maxillofacial surgeries and orthodontic treatments, when elected, should be avoided. This case report describes a case of ADO with a diagnosis of moderate generalized chronic periodontitis, not statistically related to plaque index. This is the first case to describe such a condition, in which the systemic component and the altered bone metabolism seem to be related to the loss of periodontal apparatus, independent of the biofilm. Concerning prevention, we can reinforce the need for frequent dental monitoring to avoid further interventions in those cases. LEARNING POINTS: This paper reports a case in which the systemic component and the altered bone metabolism seem to have been related to the loss of periodontal attachment apparatus, independent of the biofilm.The periodontal damage observed in the OP patient was not related to the dental plaque, which leads us to suggest that the cases of periodontitis in OP patients should be diagnosed as periodontitis as a manifestation of systemic diseases.The periodontitis prevention should be longed for in OP patients thus, we propose that doctors responsible for patients with OP refer them to a dental service as soon as possible and that dentists should be aware of the preventive dentistry value as well as the most appropriate dental management for those cases.

Caracterização da saúde de idosos numa perspectiva fonoaudiológica / Characterization of the elderly health in a speech and language therapy perspective

RESUMO Objetivo: estimar a prevalência de problemas da comunicação oral, memória, leitura, escrita, voz, audição e motricidade orofacial em idosos. Métodos: estudo transversal, com 75 idosos cadastrados em uma Clínica da Família carioca. Foram estimadas as prevalências por sexos e conjuntamente. Verificou-se a presença de diferenças entre os sexos por meio dos testes t e qui-quadrado. Resultados: os principais problemas de comunicação oral e memória foram "evita se comunicar" (20,5%) e "dificuldades em lembrar fatos recentes e passados" (34,7% e 26,4%, respectivamente). Observou-se elevada prevalência de dificuldade na leitura e escrita. Em relação à audição, 43,1% relataram "ver televisão e ouvir rádio muito alto". Quanto à voz, 71,2% referiam "falar alto ou gritando" e 23,6% "ficar roucos com frequência". Na motricidade orofacial, 24,7% apresentavam "dificuldades na mastigação em geral" e 54,8% "roncavam ao dormir". Conclusão: neste estudo, observou-se uma grande parcela de idosos que referia dificuldades relacionadas às habilidades de linguagem, audição, fonação e mastigação, que são funções relacionadas à socialização, bem-estar e manutenção da autonomia funcional, podendo interferir diretamente na sua qualidade de vida e saúde.

ABSTRACT Purpose: to estimate the prevalence of oral communication, memory, reading and writing, voice and oral motor skills problems in elderly people. Methods: cross-sectional study with 75 older people registered in a Family Clinic of Rio de Janeiro. It was estimated the prevalence, in all cases and by sex. The presence of differences between the sexes was verified by statistical tests t and chi-square. Results: the problems most frequently related to oral communication and memory were the avoidance to communicate (20.5%), difficulty in remembering recent and past events (34.7% and 26.4% respectively). There was a high prevalence of difficulty in reading and writing. According to hearing, 43.10% reported "watching television and listening to radio too loud." Related to voice perception, 71.2% referred "speak loudly or shouting" and 23.6% to "get hoarse frequently." As far as Myofunctional oral motor skill, 24.7% had "difficulties in chewing in general" and 54.8% "snoring while sleeping." Conclusion: in this study, there was a large proportion of elderly people who referred difficulties related to language, hearing, speech and chewing skills, which are functions related to socialization, welfare and maintenance of functional autonomy and can directly interfere with their quality of life and health.

Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature.

The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: "temporomandibular joint laser therapy" and "TMJ laser treatment". [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD.

Efeito da terapia anti-hipertensiva com inibidores da enzima conversora da angiotensina sobre a prevalência e gravidade da periodontite crônica / The effect of antihypertensive therapy with angiotensin converting enzyme inhibitors on the prevalence and severity of chronic periodontitis

Objetivo: Testar a hipótese de que drogas anti-hipertensivas inibidoras da enzima conversora da angiotensina (iECA) causam aumento de prevalência e gravidade da periodontite crônica. Metodologia: Sessenta e cinco pacientes hipertensos (trinta no grupo teste e trinta e cinco no controle) que fazem uso regular de anti-hipertensivos participaram desse estudo. Dados clínicos periodontais, incluindo nível clínico de inserção (NCI), profundidade de bolsa à sondagem (PBS) e índices de sangramento à sondagem (ISS), de placa visível (IPV), de cálculo (IC) e de sangramento marginal (ISM), obtidos de 6 sítios/dente, foram submetidos a testes estatísticos paramétricos e não-paramétricos, incluindo o Modelamento Linear Generalizado com Equações de Estimação Generalizada (GLM/GEE). Resultados: Ambos os grupos apresentaram médias de idade e de tempo de terapia anti-hipertensiva semelhantes, porém diferiram na renda média e no IPV. Os pacientes que fazem uso dos iECA tiveram condições periodontais piores e chances até 4 vezes maiores de apresentar PBS e NCI ≥ 5mm. Além disso, observou-se que a prevalência de periodontite crônica neste grupo foi o dobro da apresentada pelo grupo controle (63,4 % vs. 31,5 %, P < 0,001). Conclusão: Pacientes sob terapia anti-hipertensiva com iECA apresentam prevalência e gravidade aumentadas de periodontite crônica. (AU)

Aim: The objective of this study was to test the hypothesis that angiotensin-convertingenzyme inhibitor (ACEi) drugs lead to higher prevalence and severity of chronic periodontitis. Methodology: Sixty-five individuals with high blood pressure who make regular use of antihypertensive drugs (thirty patients who used ACEi and thirty-five controls using a different antihypertensive treatment), were selected to participate. Periodontal clinical data, including clinical attachment loss (CAL), probing pocket depth (PPD), and the presence of bleeding on probing (BOP), visible plaque (VP), calculus (CI) and marginal gingival bleeding (MGB) obtained from 6 sites per tooth, were submitted to parametric or non-parametric statistical tests, including the General Linear Model with Generalized Estimated Equations (GLM/GEE) to compare the odds ratio between groups for presenting PPD and CAL ≥ 5 mm. Results: Both groups showed similar mean age and mean length of anti-hypertensive therapy, although mean income and VP differed between groups. Patients under ACEi therapy showed worsened periodontal conditions as well as an odds ratio around four for presenting PPD and CAL ≥ 5mm. Furthermore, chronic periodontitis was two times more prevalent in patients taking ACEi drugs compared to controls (63.4 % vs. 31.5 %, P < 0,001). Conclusion: Patients under antihypertensive therapy with ACEi drugs show increased prevalence and severity of chronic periodontitis. (AU)

Effects of phototherapy on muscle activity and pain in individuals with temporomandibular disorder: a study protocol for a randomized controlled trial.

BACKGROUND: According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session. METHODS/DESIGN: A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles. DISCUSSION: The study will contribute to the practice of the evidence-based use of phototherapy in individuals with a myogenous TMD. Data will be published after the study is completed. TRIAL REGISTRATION: This study is registered with the Brazilian Registry of Clinical Trials, NCT02018770, date of registration: 7 December 2013.