Avaliação do nível de conhecimento de cirurgiões-dentistas e graduandos em Odontologia quanto ao manejo de indivíduos em uso de anticoagulantes orais / Assessment of dentists and dental students' level of knowledge in the management of individuals using oral anticoagulants

Introdução: Diante da alta incidência das doenças cardiovasculares, muitos são os pacientes que fazem uso de medicações para prevenção e tratamento dessas desordens. Consequentemente, o número de pessoas em uso de anticoagulantes orais a serem submetidas a tratamento odontológico é crescente e o manejo desses indivíduos requer criteriosa avaliação da condição clínica e do procedimento a ser realizado. Objetivo: Avaliar o nível de conhecimento de cirurgiões-dentistas e graduandos em Odontologia quanto ao manejo de indivíduos em uso de anticoagulantes orais a serem submetidos a tratamento odontológico. Material e método: Investigação descritiva, quantitativa, de corte transversal, com base em um questionário respondido por 100 indivíduos, sendo 70 cirurgiões-dentistas e 30 graduandos do curso de Odontologia, escolhidos por conveniência, para avaliar o conhecimento sobre o tema proposto. Para comparação das variáveis quantitativas, foi utilizado o Teste t de student, para comparação de duas amostras, e o Teste ANOVA, com pós-teste de Bonferroni, para comparação de três amostras. Resultado: Dentre os entrevistados, 74,5% dos cirurgiões-dentistas e 54,2% dos graduandos relataram já ter atendido um paciente que faz uso de anticoagulante oral. Não houve diferença estatística quanto ao desempenho entre profissionais e alunos acerca do manejo odontológico de pacientes em uso de anticoagulantes. Dentre o grupo de cirurgiões-dentistas, os profissionais da cirurgia bucomaxilofacial e os que fizeram residência multiprofissional apresentaram melhor desempenho quando comparados aos clínicos gerais. Conclusão: Pôde-se concluir que, para os grupos estudados, o manejo de pessoas em uso de anticoagulantes orais ainda é um desafio.

Introduction: Cardiovascular diseases have a high incidence and due to that there is a large amount of patients who take medications for prevention and treatment of these disorders. Consequently, the number of people to be submitted to dental treatment and also under oral anticoagulant therapy is increasing and the management of these individuals requires a careful evaluation of the clinical condition and the procedure to be performed. Objective: To evaluate the level of knowledge of dentists and undergraduate dental students in the management of individuals using oral anticoagulants to be submitted to dental treatment. Material and method: Descriptive, quantitative, cross-sectional study based on a questionnaire answered by 100 individuals (70 dentists and 30 undergraduate dental students), chosen for convenience to evaluate their knowledge about the proposed topic. To compare the quantitative variables, the Student's T test was used to compare two samples and the ANOVA test with Bonferroni's post test to compare three samples. Result: Among the interviewees, 74.5% of dental surgeons and 54.2% of undergraduates reported having attended a patient under oral anticoagulant therapy. There was no statistical difference regarding the performance between professionals and students in the dental management of patients taking anticoagulants. Among the group of dental surgeons, the professionals of the bucomaxillofacial surgery and those who had multiprofessional residency presented better performance when compared to the general practitioners. Conclusion: The management of patients using oral anticoagulants stills a challenge for the groups studied.

Demineralized bone matrix and calcium-phosphate cement in bone regeneration in rats.

PURPOSE: To compare bone regeneration in critical-sized defects in rat calvarium using demineralized bone matrix and calcium phosphate cement. METHODS: Thirty Wistar rats were divided into 3 groups of 10 animals each. Two defects of 5-mm were made in the parietal bones of each animal. Group I had calcium phosphate cement placed in the experimental defect, Group II had filled with demineralized bone matrix and Group III had with the combination of the matrix and cement in equal parts. All animals had one defect left unfilled to serve as controls. Five animals in each group were sacrificed at 4 and 8 weeks. Histomorphometric analysis was used to quantify the amount of new bone within the defects. RESULTS: The results showed that demineralized bone matrix-treated defects had significantly more new bone at 4 weeks compared to calcium phosphate cement-treated defects (p=0.03) and also had significantly more new bone at 8 weeks compared to unfilled defects (p=0.04). CONCLUSIONS: The demineralized bone matrix was superior to calcium phosphate cement in bone regeneration. It seems that calcium phosphate cement acted by inhibiting the osteogenesis when associated with a demineralized bone matrix and this combination should not be recommended.

Demineralized bone matrix and calcium-phosphate cement in bone regeneration in rats

Abstract Purpose: To compare bone regeneration in critical-sized defects in rat calvarium using demineralized bone matrix and calcium phosphate cement. Methods: Thirty Wistar rats were divided into 3 groups of 10 animals each. Two defects of 5-mm were made in the parietal bones of each animal. Group I had calcium phosphate cement placed in the experimental defect, Group II had filled with demineralized bone matrix and Group III had with the combination of the matrix and cement in equal parts. All animals had one defect left unfilled to serve as controls. Five animals in each group were sacrificed at 4 and 8 weeks. Histomorphometric analysis was used to quantify the amount of new bone within the defects. Results: The results showed that demineralized bone matrix-treated defects had significantly more new bone at 4 weeks compared to calcium phosphate cement-treated defects (p=0.03) and also had significantly more new bone at 8 weeks compared to unfilled defects (p=0.04). Conclusions: The demineralized bone matrix was superior to calcium phosphate cement in bone regeneration. It seems that calcium phosphate cement acted by inhibiting the osteogenesis when associated with a demineralized bone matrix and this combination should not be recommended.

Oral cancer in Brazil: a secular history of Public Health Policies / Prevenção e controle do câncer bucal no Brasil: uma história secular de Políticas Públicas de Saúde

The oral cancer in Brazil is considered an important public health issue. Despite almost a century of combat disease, with oncological assistance programs and prevention campaigns based public policies, the incidence of oral cancer in several regions is still high. The major goal of cancer prevention and control is a reduction in both the incidence of the disease and the associated morbidity and mortality, as well as improved life for cancer patients and their families. Low-income and disadvantage groups are generally more exposed to avoidable risk factors such as tobacco and alcohol consumption. These groups have less access to the health services and education that would empower them to make decisions to protect and improve their own health. Thus, cancer control programs are the most effective instrument to bridge the gap between knowledge and practice and achieve this goal. The authors report some key historical facts concerning the fight against oral cancer in Brazil, in addition to addressing the epidemiological aspects of disease.

O câncer de boca no Brasil é considerado um importante problema de saúde pública. Apesar de quase um século de combate à doença, com políticas públicas baseadas em programas de assistência oncológica e campanhas de prevenção, ainda é alta a incidência do câncer de boca em diversas regiões do país. O objetivo principal da prevenção e controle do câncer é a redução na incidência da doença, como também, da morbidade e mortalidade associadas, além da melhoria da qualidade de vida para pacientes e suas famílias. Populações com baixa renda e grupos desfavorecidos são geralmente mais expostos a fatores de risco evitáveis, como o tabaco e o consumo de álcool. Estes grupos têm menos acesso aos serviços de saúde e educação que lhes permitam tomar decisões para proteger e melhorar a sua própria saúde. Assim, os programas de controle do câncer são o instrumento mais eficaz para diminuir a distância entre conhecimento e prática e alcançar esta meta. Os autores relatam alguns dos principais fatos históricos relativos à luta contra o câncer de boca no Brasil, além de abordar aspectos epidemiológicos da doença. .

Quantificação volumétrica de fenda alveolar em pacientes fissurados / Volumetric Measurement of Alveolar Cleft

Objetivos: O propósito deste estudo foi avaliar a fenda alveolar de indivíduos portadores de fissura labiopalatal, além de mensurar as suas dimensões volumétricas, descrever a topografia do defeito e avaliar o suporte ósseo periodontal dos dentes adjacentes à fenda. Metodologia: 16 pacientes entre 11 e 30 anos de idade foram selecionados para avaliação volumétrica da fenda alveolar. Todas as mensurações foram realizadas da junção cemento-esmalte à estrutura óssea local. A espessura do corte das imagens da tomografia computadorizada de feixe cônico foi de 0.25mm. O delineamento do defeito foi feito por um único operador. Resultados: O volume médio das fendas foi de 1,13cm3±0,35cm3. Não houve relevância estatística entre o volume da fenda e a idade dos pacientes, tampouco entre o volume da fenda e a presença/ausência do incisivo lateral. Conclusão: Através da tomografia computadorizada de feixe cônico e suas reconstruções em 3D, é possível visualizar toda a extensão e profundidade da fenda, facilitando o planejamento cirúrgico de enxerto ósseo.

Objectives: The purpose of this study was to evaluate the alveolar cleft in individuals with cleft lip and palate,and measure its volumetric dimensions, describe the topography of the defect and assess periodontal bone support of teeth adjacent to the cleft. Methods: 16 patients between 11 and 30 years old were selected for volumetric evaluation of alveolar cleft. All measurements were made of cement-enamel junction to the bone structure location. The slice thickness of the images of cone beam computed tomography was 0.25mm. The delineation of the defect was done by a single operator. Results: The mean volume of the clefts was 1.13 cm3 ± 0.35 cm3. There were no statistical significance between the volume of the cleft and the ages of the patients, nor between the volume of the cleft and the presence/absence of the lateral incisor. Conclusion: Through the cone beam computed tomography and its 3D reconstructions is possible to visualize the entire length and depth of the cleft, facilitating surgical planning of bone transplantation.

Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables

Objective: This paper investigates the relationship between preoperative findings and short-term outcome in third molar surgery. Study design: A prospective study was carried out involving 80 patients who required 160 surgical extractions of impacted mandibular third molars between January 2009 and December 2010. All extractions were performed under local anesthesia by the same dental surgeon. Swelling and maximal inter-incisor distance were measured at 48 h and on the 7th day postoperatively. Mean visual analogue pain scores were determined at four different time periods. Results: One-hundred eight (67.5%) of the 160 extractions were performed on male subjects and 52 (32.5%) were performed on female subjects. Median age was 22.46 years. The amount of facial swelling varied depending on gender and operating time. Trismus varied depending on gender, operating time and tooth sectioning. The influence of age, gender and operating time varied depending on the pain evaluation period (p < 0.05). Conclusions: Short-term outcomes of third molar operations (swelling, trismus and pain) differ depending on the patients' characteristics (age, gender and body mass index). Moreover, surgery characteristics such as operating time and tooth sectioning were also associated with postoperative variables (AU)

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A Descriptive Epidemiology Study of Oral Cleft in Sergipe, Brazil

The nonsyndromic orofacial cleft is the fourth most common birth defect, but in Brazil, data about the cleft epidemiology are not accurate. Objective: This study aimed to describe the epidemiologic characteristics of oral cleft cases at Specialized Society Attending Cleft Patient in Sergipe State. Methods  Data were obtained from patients' medical records in relation to the following characteristics: age; gender; race; origin; cleft type; additional malformations and/or complications; prenatal accomplishment; treatment applied. For diagnosis analysis, it was noted if mothers had received prenatal care and if they had ultrasonography performed and if the cleft was viewed in it. Results: We observed a prevalence of male gender (54%). Age between 0 and 4 years old was most prevalent (53%), and pheoderma race was observed in 47%. Transincisive foramen cleft was found in 52.3% of the individuals. The prevalence of pre- and transincisive foramen cleft was higher in men (66.3 and 55.7%), women accounted for 65.0% of postincisive foramen, and atypical facial cleft (0.3%) occurred in one case. Associated malformations and complications were present in 12% of patients. Prenatal care was reported by 48% of the mothers. Conclusion: In this study male gender was the most affected, and 0 to 4 years was the most frequent age group. Transincisive foramen cleft type was most frequently encountered. Prenatal care was reported by most mothers. So, this study found that early treatment is a reality in SEAFESE (Service Specializing in Cleft Care of Sergipe), and consequently the chances of successful integration of the child to society will be better...

Traumatic bone cyst of the mandible: a review of 26 cases.

UNLABELLED: The traumatic bone cyst is characterized by the presence of an asymptomatic sinus devoid of epithelial lining, which is rarely found in the jaws. OBJECTIVE: To describe the clinical, surgical and radiographic findings of traumatic bone cysts. MATERIAL AND METHOD: A retrospective study was made of patients diagnosed with traumatic bone cysts at an oral pathology department from 1992 to 2007. Data on the clinical, radiographic and surgical complications were gathered. RESULTS: Twenty-six cases of traumatic bone cyst were diagnosed in 15 years; 17 were male and 09 were female. Most patients were within first two decades of life and had no pain or history of trauma in the affected area. The multilocular pattern was observed in only seven cases, its radiographic appearance suggests a tumor. Air was found inside the lesion in about 70% of cases; serous fluid with blood and blood only were uncommon within the lesions. CONCLUSION: A higher prevalence in young patients, absence of a history of trauma, and a small number of lesions containing serous fluid with blood reflects the need to discuss the true pathogenesis of traumatic bone cysts.

Cisto ósseo traumático da mandíbula: revisão de 26 casos / Traumatic bone cyst of the mandible: a review of 26 cases

O cisto ósseo traumático é uma entidade patológica caracterizada pela presença de uma cavidade óssea assintomática desprovida de revestimento epitelial, sendo raramente encontrado nos maxilares. OBJETIVO: Descrever as características clínico-cirúrgicas e radiográficas dos cistos ósseos traumáticos. MATERIAL E MÉTODO: Estudo de caráter retrospectivo dos pacientes diagnosticados com cisto ósseo traumático em um serviço de patologia oral no período de 1992 a 2007. Informações referentes às características clínicas, radiográficas e cirúrgicas foram coletadas. RESULTADOS: Vinte e seis casos de cisto ósseo traumático foram diagnosticados no período de 15 anos, 17 pertencentes ao sexo masculino e 09 ao sexo feminino. A maioria dos pacientes afetados pertencia às duas primeiras décadas de vida, não relatava sintomatologia dolorosa, bem como história de trauma na região da lesão. O padrão multilocular foi observado em apenas sete casos, dando às lesões uma aparência radiográfica tumoral. A presença de ar no interior da cavidade patológica foi relatada em aproximadamente 70% dos casos, sendo rara a presença de conteúdo serossanguíneo e seroso. CONCLUSÃO: A maior prevalência de casos em pacientes jovens, a infrequente história de trauma e o pequeno número de lesões com conteúdo serossanguíneo refletem a necessidade de se discutir a real patogênese do cisto ósseo traumático.

The traumatic bone cyst is characterized by the presence of an asymptomatic sinus devoid of epithelial lining, which is rarely found in the jaws. OBJECTIVE: To describe the clinical, surgical and radiographic findings of traumatic bone cysts. MATERIAL AND METHOD: A retrospective study was made of patients diagnosed with traumatic bone cysts at an oral pathology department from 1992 to 2007. Data on the clinical, radiographic and surgical complications were gathered. RESULTS: Twenty-six cases of traumatic bone cyst were diagnosed in 15 years; 17 were male and 09 were female. Most patients were within first two decades of life and had no pain or history of trauma in the affected area. The multilocular pattern was observed in only seven cases, its radiographic appearance suggests a tumor. Air was found inside the lesion in about 70% of cases; serous fluid with blood and blood only were uncommon within the lesions. CONCLUSION: A higher prevalence in young patients, absence of a history of trauma, and a small number of lesions containing serous fluid with blood reflects the need to discuss the true pathogenesis of traumatic bone cysts.

Inverted papilloma (Schneiderian papilloma) with involvement of the oral cavity: report of an unusual case.

Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an unusual case of this pathology with involvement of the oral cavity in a 61-year-old white man. Clinical evaluation revealed a vegetating mass in the alveolar ridge of the right maxilla that had been present for approximately 4 months. After radiographic evaluation, involvement of the maxillary sinus was detected. Microscopic evaluation, in situ hybridization and immunohistochemical analysis of the specimen led to a diagnosis of ISP moderate dysplasia associated with HPV infection.

Evaluation of the muscle relaxant cyclobenzaprine after third-molar extraction.

BACKGROUND: Pain, swelling and trismus are undesirable effects of extraction of impacted mandibular third molars. The authors conducted a study to evaluate the effectiveness of the muscle relaxant cyclobenzaprine when used as a supplement to cryotherapeutic, antibiotic and steroidal anti-inflammatory treatment with the aim of reducing undesirable consequences after third-molar extraction. METHODS: The authors conducted a prospective, randomized, double-masked, placebo-controlled clinical trial involving 50 participants aged 18 to 29 years randomly assigned to receive cyclobenzaprine or the placebo. The authors used a split-mouth design, so each participant acted as his or her own control. For each participant, the authors extracted one impacted mandibular third molar on each side of the mouth at different times. Participants received 10 milligrams of cyclobenzaprine or a placebo once per day the day before surgery, the day of surgery and the first day after surgery. The authors assessed the participants' postoperative pain by means of a visual analog scale at four, six, eight, 12, 24 and 48 hours. They measured the participants' swelling and maximal interincisor distance at 48 hours and seven days. RESULTS: The authors assessed both sides of each participant's mouth for differences in pain, swelling and trismus. They found no statistically significant differences between sides of the mouth regarding these three variables. CONCLUSIONS: The results of this trial indicate that the influence of cyclobenzaprine over pain, swelling and trismus does not justify prescribing additional medication for patients undergoing third-molar extraction. CLINICAL IMPLICATIONS: The muscle relaxant cyclobenzaprine was ineffective in reducing pain, swelling and trismus after third-molar extraction.

Papiloma invertido (Papiloma Schneideriano) com envolvimento da cavidade oral: relato de caso incomum / Inverted papilloma (Schneiderian papilloma) with involvement of the oral cavity: report of an unusual case

O papiloma invertido schneideriano é uma neoplasia de origem no epitélio de revestimento que surge da mucosa respiratória revestindo a cavidade nasal e os seios paranasais. Frequentemente, surge como uma lesão unilateral no septo nasal e estende-se secundariamente para o nariz e os seios paranasais. Este trabalho relata um caso incomum desta patologia, com o envolvimento da cavidade oral em um homem branco, de 61 anos de idade, cuja avaliação clínica revelou uma massa vegetante no rebordo alveolar direito da maxila, com duração de aproximadamente 4 meses. Após avaliação radiográfica, constatouse o envolvimento do seio maxilar. A análise microscópica, hibridização in situ e análise imunoistoquímica da peça cirúrgica levaram a um diagnóstico de displasia moderada em PIS associado à infecção por HPV.

Inverted Schneiderian papilloma (ISP) is a neoplasm of epithelial lining origin which arises in the respiratory mucosa that lines the nasal cavity and paranasal sinuses. The inverted Schneiderian papilloma frequently appears as a unilateral lesion in the nasal septum and extends secondarily to the nasal and paranasal sinuses. This paper reports an unusual case of this pathology with involvement of the oral cavity in a 61-year-old white man. Clinical evaluation revealed a vegetating mass in the alveolar ridge of the right maxilla that had been present for approximately 4 months. After radiographic evaluation, involvement of the maxillary sinus was detected. Microscopic evaluation, in situ hybridization and immunohistochemical analysis of the specimen led to a diagnosis of ISP moderate dysplasia associated with HPV infection.

Tumores de nervios periféricos de la cavidad bucal: esudio epidemiológico / peripheral nerve tumors of the oral cavity: epidemiological study

Los tumores neurales son lesiones oriundas de los nervios periféricos, siendo raros en la cavidad bucal. Estas lesiones incluyen el neurofibroma, neuroma traumático, schwanoma tumor de células granulares y el neuroma encapsulado. Objetivo: El presente trabajo se propuso a estudiar la prevalencia de estos tumores en dos servicios de diagnostico oral. Material y Método: fue realizado, a través de análisis de informes histopatológicos, un estudio retrospectivo de los casos de tumores neurales solitarios en la cavidad bucal diagnosticados en el laboratorio de Patología de la Universidad de Pernambuco, en el período de 1.992 a 2.007, y en el servicio de Patología de la Universidad Federal de Sergipe, en el periodo de 2.000 a 2.007. Resultados: Fueron encontrados 28 tumores neurales benignos, de un total de 4,485 informes analizados. De una manera general, el género femenino fue el más afectado y la lengua el sitio de mayor predilección. Hubo una discreta tendencia del surgimiento de las lesiones en la 1ª, 2ª e 3ª Décadas de vida. Conclusión: el conocimiento de estas lesiones, aunque raras en la cavidad bucal, se torna imprescindible para los profesionales del área odontológica, visto que las estrategias de diagnostico y tratamiento son dependientes de los datos epidemiológicos encontrados en la literatura especializada

Peripheral nerve sheath tumors rarely occur in the oral cavity and include neurofibroma, traumatic neuroma, schwannoma, granular cell tumor and palisaded encapsulated neuroma. Aim: The purpose of the present study was to determine the prevalence of these tumors in patients referred in two oral diagnostic services. Material and Method: Specimens diagnosed as oral peripheral nerve sheath tumors archived in the oral pathology services of Universidade de Pernambuco, from 1992 to 2007, and Universidade Federal de Sergipe, from 2000 to 2007, were evaluated. Results: Twentyeight peripheral nerve sheath tumors were diagnosed. Neurofibroma was the tumor more prevalent, including 40% of the cases. In general, females were more affected than males and the most frequent oral site was the tongue. Children and young people were more prevalent. Conclusion: The knowledge of these lesions, even though rare in oral cavity, it is essential for dentistry professionals, since that diagnosis and treatment strategies are dependents to epidemiological data founded in the literature

Perfil dos pacientes portadores de neoplasias malignas orais em uma população brasileira / Profile of oral malignant neoplasms patients in a Brazilian population

INTRODUÇÃO: O conhecimento do perfil dos pacientes portadores de câncer de boca, nos diversos serviços de saúde, é imprescindível sob o ponto de vista epidemiológico. OBJETIVO: Realizar uma revisão dos tumores malignos orais diagnosticados no Serviço de Anatomia Patológica do Hospital Universitário da Universidade Federal de Sergipe, Brasil, no período de janeiro de 2000 a junho de 2009. METODOLOGIA: Dados clínicos de 39 pacientes foram estudados, incluindo sexo e idade bem como o tipo, diferenciação histológica e localização dos tumores. Resultados. Os tumores malignos orais compreenderam 7,5% (n = 39) das biópsias realizadas no serviço neste período. As formas espinocelulares foram as mais comuns, totalizando 87,2% dos casos. A maioria dos casos ocorreu em pacientes do sexo masculino, entre 50-79 anos de idade. Para este grupo de tumores, a língua foi o local de maior ocorrência, com a maioria dos casos classificados como de grau II, seguida do assoalho, gengiva e mucosa jugal. Os 12,8% restantes compreenderam os tumores de glândulas salivares menores (5,12%), sarcomas (5,12%) e carcinoma basocelular (2,56%). CONCLUSÃO: Apesar da baixa prevalência de tumores espinocelulares de lábio, o perfil dos pacientes portadores de neoplasias malignas é semelhante ao de vários estudos encontrados na literatura.

INTRODUCTION: Knowledge of the profile of patients with this disease, in many health services, it is essential from the epidemiological point of view. OBJECTIVE: To conduct a review of oral malignant tumors diagnosed at the Anatomy Pathology Service of University Hospital, Federal University of Sergipe, Brazil, from January 2000 to June 2009. METHOD: Clinical records of 39 patients were retrieved and analyzed for gender, age, site, neoplastic type and histologic differentiation. Results. Oral malignant tumors constituted 7.5% (n = 39) of the biopsies accomplished at the service during this period. Spindle cell tumors were the most common malignant tumors, with 87,2% of the cases. There was a male predominance, with lesions being most common in the 50-79 year age group. Tongue was the site more prevalent, with most cases being classified as grade II, followed by floor of mouth, buccal mucosa and gingival. The remaining oral malignancies, 12,8%, comprised minor salivary gland tumors (5,12%), sarcomas (5,12%) and basal cell carcinoma (2,56%). CONCLUSION: Despite the low prevalence of squamous cell carcinomas of the lip, the profile of patients with oral cancer is similar to several in the literature.

Fatores de risco em radioterapia de cabeça e pescoço / Risk factors in head and neck radioterapy

Objetivo: Avaliar os fatores de risco dentais e de malignidade relacionados com o aparecimento de complicações pós-radioterapia de cabeça e pescoço de pacientes tratados em um Centro de Radioterapia em Aracaju, Sergipe. Método: Foi realizada a avaliação clínica de 30 pacientes que estavam sendo irradiados na região de cabeça e pescoço no Centro de Radioterapia. Essa avaliação foi feita utilizando como parâmetros os critérios clínicos: doença periodontal, cárie extensa, dentes não funcionais, higiene oral deficiente, doses de radiação e combinação de tratamentos. Cada critério foi avaliado para definir o nível do fator de risco (alto, médio ou baixo) em que se enquadrava. Resultados: Com relação aos fatores de risco dentais, foram encontrados 25 com alto, 5 com baixo e nenhum com médio. Referente aos fatores de risco relacionados à malignidade, foram encontrados 27 com altos fatores de risco, 3 com baixo e nenhum médio. Conclusão: Portanto, devido ao grande número de pacientes examinados com altos fatores de risco dentais e relacionados a malignidade, conclui-se que esses apresentava uma alta predisposição para sofrer complicações secundárias advindas da radioterapia.

Objective: The objective of this study was to assess the dental and malignant risk factors associated with head and neck radiotherapy complications in patients treated at the Radiotherapy Center in Aracaju, Sergipe. Method: A clinical assessment was done of 30 patients who were receiving head and neck radiotherapy at the Radiotherapy Center. This assessment was done using the following clinical criteria as parameters: periodontal disease, extensive caries, non-functional teeth, poor oral hygiene, radiation doses and treatment combinations. Each criterion was assessed to define the risk factor level (high, intermediate, low). Results: Most (25) of the dental risk factors were high, none were intermediate and 5 was low. As for the malignant risk factors, 27 had high, none had intermediate and 3 had low risk factors. Conclusion: In conclusion, due to the great number of patients with high dental and malignant risk factors, these patients are very susceptible to complications of radiotherapy.

Papiloma escamoso em lábio inferior após excisão de mucocele / Squamous cell papilloma in inferior lip after mucocele excision

O papilomavírus humano (HPV) constitui um grupo de vírus DNA oncogênico e está envolvido na indução de inúmeras lesões hiperplásicas, papilomatosas e verrucosas no epitélio, que reveste a pele e mucosa em vários locais, como região anogenital, uretra, laringe, região traqueobrônquica, cavidade nasal e oral. São vírus epiteliotrópicos, e mais de 120 tipos de HPV têm sido identificados em várias lesões. O presente artigo relata o caso de uma paciente de 13 anos de idade que desenvolveu um papiloma escamoso em lábio inferior, dias após ter sido removida uma mucocele, cujo epitélio de recobrimento revelou a presença de alterações citopáticas sugestivas da presença de HPV.

The human papillomavirus (HPV) consists in a group of AND oncogenic virus involved with the induction of innumerous hyperplasic, papillomatosis and verrucosus lesions in epithelium that cover the skin and mucosa in any locations as anus-genital, urethra, larynges, trachea-bronchus region, oral and nasal cavity. This paper objectives report a case of a patient with 13 years old that developed a squamous cell papilloma in lower lip few days after the excision of a mucocele, which overlay epithelium showed a significant cytological alteration suggestive of HPV presence.

Papiloma de células escamosas da cavidade oral / Squamous cell papillomas of the oral cavity

O Papilomavírus Humano (HPV) é um vírus DNA, que replica no núcleo das células epiteliais da pele, mucosa anogenital e orofaríngea. Na mucosa bucal, o HPV está fortemente relacionado à patogênese de lesões verrucosas benignas, como o papiloma escamoso, a verruga vulgar, o condiloma acuminado e a hiperplasia epitelial focal (Doença de Heck). O objetivo deste estudo foi o de realizar um estudo clínico-patológico de papilomas de células escamosas presentes na cavidade oral, diagnosticados em dois serviços de patologia oral do Nordeste brasileiro. Foi um estudo de caráter retrospectivo de lesões diagnosticadas, como papiloma de células escamosas nos serviços de Patologia Oral da Universidade Federal de Sergipe, no período de 2000 a 2008, e da Universidade de Pernambuco, no período de 1992 a 2008. Foram estudados 83 papilomas, sendo as mulheres mais afetadas do que homens numa proporção de 3:1. A maioria dos casos (35%) ocorreu na 4ª e 5ª décadas de vida, com predileção pela língua (40%), lábios (23%), palato (17%). As 20 lâminas estudadas mostraram a presença de um epitélio de revestimento do tipo pavimentoso estratificado paraqueratinizado bem como alterações do tipo acantose e papilomatose. A coilocitose também foi um achado frequente. Exocitose, espongiose, bi/multinucleação e displasia epitelial foram achados ocasionais. A maioria dos casos de papiloma de células escamosas da cavidade oral ocorre em adultos jovens, com predileção pela língua. Histologicamente, é comum a presença de alterações epiteliais, como a acantose e a papilomatose. A coilocitose é um achado frequente e sugere fortemente a presença do vírus, embora sua tipificação seja realizada somente através de técnicas de biologia molecular.

The human papilloma virus (HPV) is a DNA virus that replicates in the nucleus of epithelial cells of the skin and of the anogenital and oropharyngeal mucosa. In the oral mucosa, HPV is strongly related to the pathogenesis of verrucous lesions, such as benign squamous papilloma, verruca vulgaris in the condyloma acuminatum and focal epithelial hyperplasia (Heck?s disease). This study set out to conduct a clinical and pathological study of squamous cell papillomas in the oral cavity diagnosed in two departments of oral pathology in northeast Brazil. A retrospective study was made of lesions diagnosed as squamous cell papilloma in the Departments of Oral Pathology, Federal University of Sergipe, in the period 2000 to 2008, and University of Pernambuco, in the period 1992 to 2008. 83 papillomas were studied, women being more affected than men in a ratio of 3:1. Most cases (35%) occurred in the 4th and 5th decades of life, with a predilection for the tongue (40%), lips (23%) and palate (17%). The 20 slides showed the presence of an epithelial lining of the parakeratinized stratified pavement-type and changes characteristic of acanthosis and papillomatosis. Koilocytosis was also a frequent finding. Exocytosis, spongiosis, bi/multinucleation and epithelial dysplasia were occasional findings. Most cases of squamous cell papilloma of the oral cavity occur in young adults, with a predilection for the tongue. Histologically, it is common to find epithelial changes such as acanthosis and papillomatosis. Koilocytosis is a frequent finding and strongly suggests the presence of the virus, although its typification is made only by means of molecular biology techniques.

Avaliação dos índices de perfurações em luvas de látex após procedimentos odontológicos / Evaluation of perforation index from latex gloves after dental procedures

O presente trabalho tem como objetivo a avaliação dos índices de perfurações em luvas de látex, cirúrgicas e de procedimentos, após atendimentos rotineiros cirúrgicos e periodontais na Faculdade de Odontologia da Universidade Federal de Sergipe - UFS. A amostra foi constituída por 304 luvas utilizadas nos procedimentos realizados entre agosto de 2006 e julho 2007. Em 30 luvas não utilizadas, foram verificadas possíveis ocorrências de perfurações provenientes deprocessos de manufatura. Das 304 luvas examinadas, 180 foram luvas de procedimentos, não estéreis, usadas em terapia periodontal não cirúrgica, e as outras 124 foram luvas cirúrgicas estéreis, usadas em 62 cirurgias dentoalveolares. As coletas das luvas ocorriam imediatamenteapós os procedimentos e logo eram submetidas à análise por meio do método de enchimento com água e ligeira compressão. Posteriormente, as seguintes informações foram documentadas: clínica pesquisada, o tipo de procedimento e sua duração, a localização da perfuração e se o operadoré destro ou canhoto. No total, 65 luvas (21,3%) tiveram pelo menos uma perfuração. A análise dos índices relativos às clínicas revelou que Periodontia II obteve o maior índice (30%), seguida de Cirurgia I (29%), Cirurgia II (16,6%) e Periodontia I (15%). Nas 30 luvas não utilizadas, nãoforam observadas perfurações. Em relação à literatura pesquisada, a média geral de perfurações encontrada neste estudo se mostrou elevada.

The aim of this study was to evaluate the incidence of perforations in sterile and not sterile latex gloves, after surgical and periodontal routine procedures developed at the Dental School of the Federal University of Sergipe. The sample was constituted by 304 gloves, used byundergraduate students from August 2006 to July 2007, and 30 unused gloves that were checked for perforations proceeding from manufacture processes. From the amount of used gloves, 180 of those had been not barren gloves (90 periodontal procedures) and the others 124 had been barren gloves (62 surgical procedures). The gloves were collected immediately after the procedures and were submitted to analyses with the water wadding method and mild compression. Thereafter, the following points were registered: clinic researched, type of procedure and its long, site of perforation and operator skill. Considering the totality of perforations, Periodontics II had the highest index (30%), followed by Surgery I (29%), Surgery II (16.6%) and Periodontics I (15%).In total, 65 gloves (21,3%) had at least one perforation and considering the literature researched, this is a high index.

Reconstrução orbitária com tela de titânio: relato de dois casos / Orbital reconstrction with titanium mesh: two cases report

Os traumas na região do complexo zigomático-maxilar (CZM) podem acarretar diversas deformidades estéticas e incapacidades funcionais que vão desde depressões faciais a deficiências na movimentação do globo ocular. As fraturas do assoalho de órbita geralmente estão associadas ao deslocamento ósseo, ocasionado pelas fraturas na região zigomático-maxilar, cujas forças comprometem as delgadas paredes órbitárias. Entretanto, fraturas que acometem exclusivamente o assoalho orbitário também acontecem, e a este tipo de lesão dá-se o nome de fraturas do tipo blow out. O tratamento para fraturas de órbita pode ser instituído sob diversas formas que serão eleitas mediante o tamanho do defeito e da escolha do material reconstituinte. Este trabalho apresenta dois casos de fratura do CZM com fraturas de assoalho e parede medial da órbita que foram satisfatoriamente reconstituídos com tela de titânio.

Trauma in the zygomaticomaxillary complex may produce various esthetic deformities and functional defects ranging from facial depression to impairment of eye movements. Orbital floor fractures are generally associated with zygomatic fractures, the bone displacement undermining the thin walls of the orbital cavity. However, fractures that affect only the orbital floor also occur, and this type of injury is known as a blow-out fracture. The treatment of orbital fractures depends on the size of the defect and the choice of reconstructive material. The pathogenesis of these fractures is explained by the pressure of direct trauma on the eyeball, whose force is hydraulically transmitted to the thin walls that make up the orbit. This paper reports two cases of fracture of the medial floor and wall of the orbit successfully reconstructed with titanium mesh.