Validação do conteúdo de um protocolo de avaliação da motricidade orofacial em lactentes / Content validation of an orofacial myofunctional assessment protocol for infants / Validación del contenido de un protocolo para la evaluación de la motricidad orofacial en bebés

Introdução: Muitos estudos têm se dedicado a compreender melhor a dinâmica da avaliação das estruturas e funções estomatognáticas de lactentes; até a presente pesquisa não foram encontrados estudos específicos para essa faixa etária, até recentemente. Objetivo: Validar o conteúdo de um instrumento fonoaudiológico de avaliação da motricidade orofacial para lactentes na faixa etária de um mês a dois anos. Metodologia: Foi elaborado o instrumento para "avaliação fonoaudiológica da motricidade orofacial de lactentes de um mês a dois anos" a partir dos dados obtidos na literatura. A validação do conteúdo do instrumento se deu por meio da avaliação de quatro juízes para clareza dos itens propostos no protocolo e da representatividade dos mesmos no processo de validação do conteúdo. Os juízes classificaram cada item quanto à clareza, a partir de uma escala tipo Likert de quatro pontos, sendo: (4) muito claro, (3) claro, (2) pouco claro, (1) sem clareza, com o propósito de realizar a validação do conteúdo por meio da aplicação da equação do Índice de Validação do Conteúdo (IVC). Resultados: O protocolo desenvolvido possui 8 itens e uma breve anamnese: Hábitos Orais; Avaliação Estrutural; Respiração; Voz; Avaliação Funcional; Alimentação e Deglutição - líquidos e alimentos em pedaços; Diagnóstico Fonoaudiológico. A etapa seguinte contou com a análise da representatividade e para clareza dos itens do protocolo pelos juízes, e após a segunda análise, a validação do conteúdo resultou na permanência dos 8 itens com Índice de Validade de Conteúdo total de 100%. Conclusão: O conteúdo do protocolo foi considerado válido para uso na avaliação do público-alvo, comprovado por profissionais com experiência na área. A versão final do Protocolo de avaliação fonoaudiológica da motricidade orofacial de bebês foi finalizada com 8 itens de avaliação. (AU)

Introduction: The instruments for evaluating the structures and functions of the stomatognathic system in babies have been lacking in studies. Objective: To validate the content of a speech-language instrument to assess orofacial motricity for babies aged between one month and two years old. Methodology: The instrument for "speech-language assessment of the orofacial motricity of babies from one month to two years old" was created based on the data obtained by the integrative review. The instrument's content was validated through the evaluation of four judges. The judges classified each item according to clarity, based on a four-point Likert scale, as follows: (4) very clear, (3) clear, (2) lightly clear, (1) unclear, to perform content validation by applying the Content Validation Index (CVI) equation. Results: The developed protocol has eight items and a brief anamnesis: Oral Habits; Structural Assessment; Breathing; Voice; Functional Assessment; Feeding and Swallowing - liquids and food in pieces; and Speech-Language Diagnosis. The next step included the analysis of the representativeness of the protocol items by the judges. After the second analysis, the validation of the content resulted in the permanence of the eight items with a total Content Validity Index of 100%. Conclusion: The content of the protocol was considered valid for use in the evaluation of the target audience, proven by people with experience in the area. The final version of the Protocol for the Speech-Language Pathology Assessment of Orofacial Motricity in Babies was completed with eight assessment items. (AU)

Introducción: Los instrumentos para la evaluación de las estructuras y funciones del sistema estomatognático en los bebés han mostrado falta de estudios. Objetivo: Validar el contenido de un instrumento de fonoaudiología para la evaluación de la motricidad orofacial en bebés de un mes a dos años de edad. Metodología: Inicialmente, se llevó a cabo la elaboración del instrumento para la "evaluación logopédica de la motricidad orofacial de bebés de un mes a dos años de edad" propiamente dicho, a partir de los datos obtenidos por la revisión integradora. La validación del contenido del instrumento se realizó a través de la evaluación de cuatro jueces. Los jueces calificaron cada ítem en términos de claridad, utilizando una escala de Likert de cuatro puntos, de la siguiente manera: (4) muy claro, (3) claro, (2) poco claro, (1) poco claro, con el propósito de realizar la validación de contenido a través de la aplicación de la ecuación del Índice de Validación de Contenido (CVI). Resultados: después de la lectura y discusión de los artículos, fue posible desarrollar el protocolo que contiene 8 ítems y una breve anamnesis, que son: Hábitos Orales; Evaluación Estructural; Respiración; Voz; Evaluación Funcional; Alimentación y deglución: líquidos y alimentos en trozos; y; Diagnóstico de Patología del Habla-Lenguaje. El siguiente paso fue el análisis de la representatividad de los ítems del protocolo por parte de los jueces, y luego del segundo análisis, la validación de contenido resultó en la permanencia de 8 ítems con un Índice de Validez de Contenido total del 100%. Conclusión: El contenido del protocolo se consideró válido para su uso en la evaluación del público objetivo, confirmado por personas con experiencia en el área. La versión final del Protocolo de evaluación de la patología del habla y el lenguaje para la motricidad orofacial en bebés se completó con 8 ítems de evaluación. (AU)

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones con patrones de crecimientos y oclusión normal, se reportan diferencias estadísticamente significativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs, Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con dentición mixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales. Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido de Ricketts para los niños. Materiales y Métodos: investigación observacional, descriptiva en cuatro poblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas, Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 años de edad. La muestra 163 niños, seleccionados por el método estratificado por conglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalograma resumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos de confianza. Resultados: tres variables mostraron medias iguales a las normas de Ricketts: eje facial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantes fueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianza para cada una de las variables del cefalograma resumido de Ricketts. Conclusiones: solamente tres variables presentaron valores similares a los planteados por Ricketts, las restantes presentaron valores que difieren significativamente de los planteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en esta investigación en las variables del cefalograma resumido de Ricketts para diagnosticar las anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations with normal growing and occlusion patterns, significant statistic differences are reported in relation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak, and others. In Cuba there are not studies of these patterns in children with mixed dentition that might allow a better diagnosis of dental, maxilla-facial anomalies. Objective: to propose the improvement of the standards of the Ricketts abridge cephalogram for children. Materials and methods: descriptive, observational research in four populations belonging to different regions of the country: Matanzas, Cárdenas, Camagüey and Sancti Spíritus. The universe was formed by 1675 children aged 9 years old; the sample, 163 children with normal dental occlusion, was chosen by the stratified method per conglomerate. The analysis of the Ricketts summarized cephalogram and the mean T test were used to determine the values of the studied variables; punctual estimates and estimates by confidence interval were carried out. Results: three variables showed equal means than Ricketts' standards: facial axis (90o), facial depth (87o) and maxillary depth (90o). In the remaining variables there were found significant differences. A confidence interval was obtained for every one of the Ricketts' summarized cephalogram variable. Conclusions: only three variables showed values similar to those given by Ricketts. The remaining ones presented values significantly differing from those established by Ricketts. The proposition is using the confidence interval obtained in this research in the variables of the Ricketts' summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones conpatrones de crecimientos y oclusión normal, se reportan diferencias estadísticamentesignificativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs,Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con denticiónmixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales.Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido deRicketts para los niños.Materiales y Métodos: investigación observacional, descriptiva en cuatropoblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas,Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 añosde edad. La muestra 163 niños, seleccionados por el método estratificado porconglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalogramaresumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos deconfianza.Resultados: tres variables mostraron medias iguales a las normas de Ricketts: ejefacial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantesfueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianzapara cada una de las variables del cefalograma resumido de Ricketts.Conclusiones: solamente tres variables presentaron valores similares a los planteadospor Ricketts, las restantes presentaron valores que difieren significativamente de losplanteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en estainvestigación en las variables del cefalograma resumido de Ricketts para diagnosticarlas anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations withnormal growing and occlusion patterns, significant statistic differences are reported inrelation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak,and others. In Cuba there are not studies of these patterns in children with mixeddentition that might allow a better diagnosis of dental, maxilla-facial anomalies.Objective: to propose the improvement of the standards of the Ricketts abridgecephalogram for children.Materials and methods: descriptive, observational research in four populationsbelonging to different regions of the country: Matanzas, Cárdenas, Camagüey andSancti Spíritus. The universe was formed by 1675 children aged 9 years old; thesample, 163 children with normal dental occlusion, was chosen by the stratifiedmethod per conglomerate. The analysis of the Ricketts summarized cephalogram andthe mean T test were used to determine the values of the studied variables; punctualestimates and estimates by confidence interval were carried out.Results: three variables showed equal means than Ricketts standards: facial axis(90o), facial depth (87o) and maxillary depth (90o). In the remaining variables therewere found significant differences. A confidence interval was obtained for every one ofthe Ricketts summarized cephalogram variable.Conclusions: only three variables showed values similar to those given by Ricketts.The remaining ones presented values significantly differing from those established byRicketts. The proposition is using the confidence interval obtained in this research inthe variables of the Ricketts summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Analysis of the stomatognathic system of children according orthodontic treatment needs.

PURPOSE: The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS: A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS: EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS: Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.

Oro-dental findings in Bardet-Biedl syndrome.

The Bardet-Biedl syndrome (BBS) is a human genetic disorder with an array of clinical features affecting many body systems. BBS is a pleiotropic disorder with mostly monogenic causes. It is also considered a primary ciliopathy syndrome. It is characterised by obesity, pigmentary retinopathy, polydactyly, mental deficiency and hypogonadism and recently a sixth feature, renal disease, has also been described. Since none of the diverse symptoms of BBS by itself is diagnostic of the disorder and many of the symptoms only become apparent over time, diagnosis of the BBS is often delayed until about 9 years of age when visual problems first appear.

Distracción ósea: tratamiento de la apnea obstructiva en neonatos con micrognatia / Mandibular distraction: treatment of obstructive apnea in neonates with micrognathia

Las malformaciones craneofaciales (secuencia de Pierre Robin, síndrome de Threacher-Collins, síndrome de Nager, etc.) con frecuencia van asociadas a hipoplasia mandibular grave, que puede causar obstrucción de la vía aérea superior por retroposición de la base de la lengua dentro del espacio faríngeo posterior. La mayoría de los pacientes responden al tratamiento postural, en decúbito prono, puede ser necesario controlar la saturación de oxígeno, insertar un tubo nasofaríngeo e incluso intratraqueal. En casos más graves con pausas prolongadas y frecuentes de apnea, la traqueostomía puede ser necesaria, pero se asocia a una alta morbilidad y, ocasionalmente, mortalidad. En los últimos 2 años, en la Unidad Multidisciplinaria de Labio y Fisura Palatina del Hospital Virgen de las Nieves de Granada, se ha tratado a 4 niños con apnea obstructiva grave secundaria a hipoplasia mandibular grave mediante distracción mandibular osteogénica, y este procedimiento se ha mostrado eficaz en la resolución del problema. Ha evitado la traqueostomía y se ha elongado la mandíbula en el plazo de 3-4 semanas. En este tiempo han desaparecido los problemas respiratorios obstructivos, así como también de la deglución, y los resultados estéticos obtenidos han resultado excelentes y las complicaciones, por el momento, mínimas(AU)

Craniofacial malformations (Pierre-Robin sequence, Treacher-Collins syndrome, Nager syndrome, etc.) are frequently accompanied by severe mandibular hypoplasia, which can cause upper airway obstruction due to retroposition of the base of the tongue in the posterior pharyngeal space. The majority of patients respond to postural treatment in decubitus prono. It may be necessary to monitor oxygen saturation and insert a nasopharyngeal or even an endotracheal tube. Tracheostomy may be necessary in more serious cases with long and frequent apnea pauses, but it is associated with high morbidity and occasional mortality. In the last two years, four children with severe obstructive apnea secondary to mandibular hypoplasia were treated by means of "osteogenic mandibular distraction" in the multidisciplinary Cleft Palate Department of Virgin de las Nieves Hospital (Granada, Spain). This procedure effectively resolved the problem, making tracheostomy unnecessary and lengthening the jaw within 3-4 weeks; in this period, obstructive respiratory problems and swallowing difficulties disappeared. The aesthetic results were excellent and the complications so far have been minimal. Objective: To present the results of a patient series with several types of POP treated using the same approach and operation(AU)

Respiración bucal: alteraciones dentomaxilofaciales asociadas a trastornos nasorespiratorios yortopédicos / Oral breathing: dentomaxillofacial irregularities associated with nasorespiratory and orthopedic dysfunctions

Fundamento: El hombre nace condicionado para respirar por la nariz y alimentarse por la boca. Al romperse ese mecanismo fisiológico se afecta elcrecimiento y desarrollo, no sólo facial, sino general. Objetivo: Caracterizar las maloclusiones de clase II de Angle de los respiradores bucales entre las edades de 5 a 11 años y su asociación con alteraciones nasorespiratorias y ortopédicas. Método: Se realizó unestudio observacional, descriptivo y correlacional, durante el período de diciembre de 2004 a noviembre de2005. Se realizó el examen clínico a un total de 833 niños, de los cuales se seleccionaron 60 que reunieronlas condiciones para el estudio. Luego se analizó cada caso en las consultas de Ortodoncia, Otorrinolaringología y Ortopedia. Las variables del estudio fueron la edad, el sexo, alteraciones nasorespiratorias, alteraciones ortopédicas y anomalías dentomalixofaciales. Resultados: Las anomalías dentomaxilofaciales másfrecuentes fueron: incompetencia bilabial, vestibuloversión, resalte aumentado, micrognatismo transversal y sobrepase aumentado. Las alteraciones nasorespiratorias que más afectaron los niños fueron la adenoiditis y la hipertrofia de amígdalas. La alteración ortopédica que más predominó fue la cifosis. Conclusiones: Existe una alta relación entre lasanomalías dentomaxilofaciales y las alteraciones nasorespiratorias y ortopédicas, las cuales en generalprovocan grandes daños en los diferentes componentes del aparato estomatognático(AU)

Background: Human beings are conditioned to breathe through the nose and feed through the mouth, when this physiological mechanism is interrupted facial and general growth is also affected. Objective: To characterize Angle´s Class II malocclusions in oralbreathers with nasorespiratory and orthopedic dysfunctions. Method: A correlational, observational and descriptive study was developed from December 2004 to November 2005 including clinical examination of833 children out of which 60 were selected to take part in this study. Each case was analyzed in Orthodontia,Orthopedics and Otolaryngology consultations. The studied variables were: age, sex, nasorespiratory disorders, orthopedic dysfunctions, dental-maxillofacialirregularities. Results: The mot frequent dentalmaxillofacial irregularities were: bilabial incompetence, transversal micrognathism, vestibular version, overjet and overbite. The most important nasorespiratory dysfunctions found in these children were adenoiditis,and tonsil hypertrophy. The most outstanding orthopedic dysfunction was ciphosis. Conclusion: It is conclusiveto state that there is a high relationship between dentomaxillofacial anomalies and nasorespiratory and orthopedic dysfunctions(AU)

[The suitability of orthodontical groups of indications (OGI) for preventive dental examinations of the public health service]. / Die Eignung der "Kieferorthopädischen Indikationsgruppen" (KIG) für die zahnärztliche Vorsorgeuntersuchung des Offentlichen Gesundheitsdienstes (OGD).

In the context of the dental preventive medical examinations of the public health service, the orthodontical data-gathering in children's day-care centre and schools, in contrast to the diagnoses of caries disease, was made was based so far on a non-uniform methodology. In order to provide in future, also in the orthodontical sector, data material that is usable for comparative national and local health reporting, a uniform methodology should form the basis for the data acquisition. The present study makes a contribution to this objective. A goal of the work was to test two different collection instruments for their suitability as objective tools in the context of the preventive dental medical examinations. The occurrence and the severity level of dentofacial anomalies as well as the orthodontic treatment status of Thuringian school children of defined age groups (9 to 11 years old, 12 to 13 years old) were recorded and the orthodontic treatment need was determined. In the younger age group valid the orthodontical groups of indications (OGI) were found for the first time in Germany; in the older group we tested the already long established Dental Aesthetic Index (DAI) and equipment application recommended by the World Health Organization (WHO). The work was a component of the task spectrum of the WHO Collaboration Centre "Prevention of Oral disease" of the Health Centre for Preventive Dentistry at the Centre for Tooth, Mouth and Jaw Dentistry of the Friedrich Schiller University of Jena in Thuringia. As investigation region, a rural area ("Landkreis Eichsfeld") of Thuringia was choosen. The study was arranged into a sociological and a clinical-epidemiological part. Altogether 1845 pupils were recruited from national schools. The questionnaire was based on the WHO-initiated "International Collaborative Study of Oral Health Outcomes" (ICS II study). The investigations took place in the context of the preventive medical examinations of the public health service. The results were based on the answers and findings of 691 probants of the group of the 9-11 years old (AG 1) and 774 probants of the group of the 12-13 years old (AG 2). The sociological results of both age groups reflected social restrictions regarding the presence of dentofacial anomalies in an order of magnitude of 20% in the AG 1 and 7.3% in the AG 2. In the AG 1 11.4% confirmed an orthodontical treatment and 47.9% of the probants examined indicated a desire for treatment. On the other hand, the proportion of orthodontically treated in AG 2 amounted to 31.1% and 37.8% expressed a desire for treatment. Dentofacial anomalies determined with the help of the OGI in the AG 1 as the most frequent were in the form of a distal bite (sagittal stage/group of D) with 55.5% of the examined pupils being documented. However here severity development stages 1 and 2 outweighed. Proportionally followed: confining (group E) with 21% and the vertical stage/deep bite (group T) with 7.8%. All other groups were represented by only small proportions, craniofacial anomalies (group A) were not diagnosed. Anomalies with severity development 1 and 2 were determined in 64.1% of the examined children. In the AG 2 examined with the DAI, the anomalies of space conditions with 58% exceeded anomalies of occlusion conditions with 38.9% and anomalies of dentition with 9.8%. An urgent orthodontical treatment need was determined in the AG 1 with 35.9% of the probants (severity development 3 to 5) and in the AG 2 with 16.8% (DAI values over 32). In the AG 2 too, over 60% DAI values from 13 to 25 were determined, 26% exhibited DAI values between 26 and 31. During the statistic evaluation the "Statistical Package found for Social Sciences (SPSS)" version 11.51 S with a significant level of 5% was used. Derived from the results of our analysis, the recommendation can be made that the methodology of the Orthodontical Groups of Indications for the employment is to be regarded as a possibility with dental preventive medical examinations in the public health service as a suitable equipment and so far allows the subjective estimate of the orthodontical treatment necessity to be made.

Novel oral findings in Schimmelpenning syndrome.

We report a patient with Schimmelpenning syndrome with two previously unreported oral manifestations: multiple pigmented malformed teeth and an adenomatoid odontogenic tumor of the anterior mandible. Also found were multiple complex odontomas, bilateral maxillary fibro-osseous lesions and recurrent central giant cell granulomas of the jaws.

Masticator space masses and pseudomasses.

We review the anatomy of the masticator space and the localization of masticator space lesions on cross-sectional imaging. The magnetic resonance imaging and computed tomography appearances of inflammatory, neoplastic, developmental and vascular masticator space lesions are discussed and illustrated. Benign processes and normal variations, which mimic masticator space pathology, are also considered.

Oropharyngeal fetus in fetu.

Fetus in fetu is an extremely rare entity and refers to the growth of a "parasitic" twin within a more mature fetus due to its inclusion within cells of the blastocyst. The presence of a vertebral column is considered essential for the diagnosis of a fetus in fetu. The retroperitoneum is the most common location for a fetus in fetu and its location in the mouth is rare. We report a case of oropharyngeal mass detected on antenatal sonography with imaging features consistent with a fetus in fetu. Complete surgical removal of the mass was aided by imaging. Follow-up of these patients is recommended to detect the rare incidence of malignant degeneration.

Protocolo de observación de la respiración para detectar alteraciones que pueden desencadenar o favorecer trastornos orofaciales o de la voz / Observation protocol of breathing designed in order to detect mechanisms disabilities wich can be reason or the consequence of orofacial or voice disorder

Es manifiesta la importancia de los factores respiratorios para el correcto desarrollo de las estructuras y funciones orofaciales implicadas en el acto de hablar, así como para la emisión vocal. En el presente artículo, se presenta un protocolo de observación de la respiración elaborado para detectar alteraciones de sus mecanismos que pueden ser causa o consecuencia de trastornos orofaciales o de la voz. Se describen, también, las disfunciones más frecuentes observadas por las autoras entre la población escolar, después de utilizar dicho protocolo en su intervención práctica. Paralelamente, se intenta transmitir a los lectores algunas reflexiones sobre la utilidad de los datos obtenidos con este instrumento, para abordar la reeducación (AU)

Nevoid basal cell carcinoma syndrome. Clinical findings in 37 Italian affected individuals.

Nevoid basal cell carcinoma syndrome (NBCCS) is a hereditary condition transmitted as an autosomal dominant trait with complete penetrance and variable expressivity. The syndrome is characterised by numerous basal cell carcinomas (BCCs), odontogenic keratocysts of the jaws, palmar and/or plantar pits, skeletal abnormalities and intracranial calcifications. In this paper, the clinical features of 37 Italian patients are reviewed. Jaw cysts and calcification of falx cerebri were the most frequently observed anomalies, followed by BCCs and palmar/plantar pits. Similar to the case of African Americans, the relatively low frequency of BCCs in the Italian population is probably due to protective skin pigmentation. A future search based on mutation screening might establish a possible genotype phenotype correlation in Italian patients.

Síndrome de Rubinstein Taybi / Rubinstein Taybi syndrome: report of case

A patient of 25 years old girl bearing Rubinstein Taybi syndrome (RST) is presented. Broad thumbs and great toes, peculiar facial features and mental retardation characterize the syndrome. The oral and physical findings of the patient are reported, and she was subjected to orthodontic, phonoaudiologic and kinesiologic studies in order to give her a consistent oral rehabilitahon and preventive treatment

Paralelas funcionais e ângula crânio-escapular: novos métodos de diagnóstico para disfunçäo do sistema estomagnático / Functional parallels and skul-escapulae angle: new diagnostic's methods of estomatognatic system's disfunction

Apresentaçäo de novos métodos de diagnóstico para disfunçäo do Sistema Mastigatório e sua importância nas áreas de saúde

Estudo clínico sobre a relação da psoríase com alterações da mucosa bucal / Clinical study on relation of the psoriasis with oral mucosa alterations

Foram examinados clinicamente 306 pacientes, sendo 118 psoriásico, 88 portadores de língua geográfica e 100 pacientes com outras doenças. Os pacientes foram submetidos a exame clínico geral, dermatológico e estomatológico completos. Todas as alterações cutâneas e mucosas encontradas foram anotadas. Após o tratamento estatístico dos dados obtidos, constatamos que: a) a prevalência da língua geográfica é maior no grupo psoriásico (13,6%) do que no grupo controle (3%), bem como a língua fissurada (36,4% e 12%, respectivamente); b) existe uma inversão na prevalência da psoríase e língua geográfica com relação a idade; nas faixas etárias mais avançadas, a psoríase; nas faixas etárias mais precoces, a língua geográfica; c) os antecedentes familiares positivos e o estresse emocional apresentam uma frequência aumentada nos pacientes com psoríase e língua geográfica; d) a sintomatologia na psoríase esta representada pelo prurido em 86,4% e pelo ardor em 55%; na língua geográfica, pelo ardor em 53,4%; e) a pesquisa de doenças anteriores, tabagismo e etilismo, mostra uma prevalência aumentada no grupo com psoríase em relação ao grupo com língua geográfica; f) a análise microscópica realizada em 31 biópsias cutâneas psoriásicas revela alterações classicamente descritas, exceto o adelgaçamento das porções suprapapilares da epiderme; g) a prevalência da atopia (34%) é maior no grupo portador de língua geográfica do que nos pacientes do grupo psoriásico (16,1%) e controle (18,0%). Diante destas constatações, pudemos concluir que a língua geográfica pode ser uma forma frusta da psoríase que a precederia com ou sem simultaneidade posterior. O traço clínico comum entre as duas condições são os fatores etiológicos envolvidos, especialmente o estresse emocional e a hereditariedade, bem como a forma de estabelecimento de suas lesões. (AU)