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1.
J Spec Oper Med ; 20(3): 114-116, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969014

RESUMO

This is second of a two-part series on the history and effectiveness of mouthguards (MGs) for protection from orofacial injuries. MGs are hypothesized to reduce orofacial injuries by separating the upper and lower dentation, preventing tooth fractures, redistributing and absorbing the force of direct blows to the mouth, and separating teeth from soft tissue which helps prevent lacerations and bruises. The single study on MG use in military training found that when boil-and-bite MGs were required for four training activities, orofacial injury rates were reduced 56% compared with when MGs were required for just one training activity. A recent systematic review on the effectiveness of MGs for prevention of orofacial injuries included 23 studies involving MG users and nonusers and a wide variety of sports. For cohort studies that directly collected injury data, the risk of an orofacial injury was 2.33 times higher among MG nonusers (95% confidence interval, 1.59-3.44). More well-designed studies are needed on the effectiveness of MGs during military training. Despite some methodological limitations, the current data suggest that MGs can substantially reduce the risk of orofacial injuries in sport activities. MGs should be used in activities where there is a significant risk of orofacial injuries.


Assuntos
Militares , Protetores Bucais , Traumatismos em Atletas/prevenção & controle , Traumatismos Faciais/prevenção & controle , Humanos , Lacerações , Boca/lesões
2.
J Laryngol Otol ; 134(5): 458-459, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32493525

RESUMO

BACKGROUND: Rigid oesophagoscopy is a widely used therapeutic and diagnostic procedure. Smooth friction-free insertion of the rigid scope is important to prevent oral and oesophageal mucosal damage, as such damage can cause delays in oral intake or more serious complications such as perforation. Protection appliances such as gum guards are useful adjuncts to cushion the teeth in rigid oesophagoscopy; however, there are no specific adjuncts for the edentulous patient. METHODS: In order to investigate different adjuncts, the force required to pull a standard adult rigid oesophagoscope from a metal clamp whilst enclosed in dry gauze, wet gauze, a gum guard or sleek on gauze was recorded, and a prospective audit of post-procedural trauma was performed. RESULTS AND CONCLUSION: Less force was required to create movement of the scope against sleek on gauze, with a lower rate of oral trauma (8 per cent) compared to that reported in the literature. Sleek on gauze is recommended for the edentulous patient.


Assuntos
Esofagoscópios/efeitos adversos , Esofagoscopia/métodos , Complicações Intraoperatórias/prevenção & controle , Boca Edêntula/complicações , Boca/lesões , Fenômenos Biomecânicos , Desenho de Equipamento , Esofagoscopia/efeitos adversos , Humanos , Protetores Bucais , Padrões de Prática Médica , Estudos Prospectivos
3.
J Spec Oper Med ; 20(2): 139-143, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32573752

RESUMO

This is the first of a two-part series on the history and effectiveness of mouthguards (MGs) for orofacial injury protection. Military studies have shown that approximately 60% of orofacial injuries are associated with military training activities and 20% to 30% with sports. MGs are hypothesized to reduce orofacial injuries by separating the upper and lower dentation, preventing tooth fractures, redistributing and absorbing the force of direct blows to the mouth, and separating teeth from soft tissue, preventing lacerations and bruises. In 1975, CPT Leonard Barber was the first to advocate MGs for military sports activities. In 1998, Army health promotion campaigns promoted MG education and fabrication. A US Army basic training study in 2000-2003 showed that more MG use could reduce orofacial injuries and the Army Training and Doctrine Command subsequently required that basic trainees be issued and use MGs. Army Regulation 600-63 currently directs commanders to enforce MG use during training and sports activities that could involve orofacial injuries. In the civilian sector, MGs were first used by boxers and then were required for football. MGs are currently required nationally for high school and college football, field hockey, ice hockey, and lacrosse, and are recommended for 29 sport and exercise activities.


Assuntos
Traumatismos em Atletas/prevenção & controle , Traumatismos Faciais/prevenção & controle , Militares , Protetores Bucais/história , Boca/lesões , História do Século XX , Humanos , Esportes , Ferimentos e Lesões/prevenção & controle
4.
J Craniofac Surg ; 31(5): e517-e520, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569059

RESUMO

PURPOSE: Maxillofacial trauma represents a serious public health problem and their epidemiology is extremely variable.The objective of the present study was to analyze and discuss the epidemiological characteristics of 2492 patients with oral and maxillofacial trauma over a 5-year period. PATIENTS AND METHODS: This retrospective study was conducted at different hospitals of Xinjiang from 2012 to 2016. Data were collected for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, presence of associated injuries, nerve injury, different treatment protocols. All the data were analyzed using statistical analysis that is chi squared test.Statistical analyses performed included descriptive analysis, chi square test, and logistic regression analyses. RESULTS: A total of 2492 maxillofacial trauma patients were seen in 1981 patients with a male to female ratio of 3.88:1. The age group 21 to 30 years accounted for the largest subgroup in both sexes. The most common etiology of the trauma was traffic accident, accounted for 41.8%. The mandible (31.97%) was the most common site of fracture followed by the zygoma (25.3%). The common type associated injuries was limb injury (27.5%), it was followed by brain (24.5%) and eye (21.4%) injuries. The common nerve injury was the facial nerve injury, accounting for 62.9%. CONCLUSION: The incidence of oral and maxillofacial trauma is related to gender, age, and the cause of trauma. Young adults are the most likely group (P < 0.05). Maxillofacial trauma is often associated with limb, craniocerebral, and eye injuries. Traffic accident is the main cause of maxillofacial injury (P < 0.5).


Assuntos
Traumatismos Maxilofaciais/epidemiologia , Boca/lesões , Acidentes de Trânsito , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas Cranianas/epidemiologia , Lesões dos Tecidos Moles/epidemiologia , Adulto Jovem
5.
Medicina (Kaunas) ; 56(5)2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32456057

RESUMO

Vascular malformations (VMs) are a wide vascular or lymphatic group of lesions common on the head and neck. The objective of this study was to assess the efficacy and morbidity of sclerotherapy for the treatment of VMs in the oral and perioral area. Special attention was given to factors that may contribute to minimizing postoperative morbidity. Data from 25 patients (32 lesions) with oral VMs submitted to sclerotherapy with monoethanolamine oleate (EAO) were included. A structured form was used to collect data. An arbitrary score was determined to evaluate postoperative morbidity. Each of the following signs or symptoms received one point: pain, swelling, hematoma, ulceration, erythema, transient numbness, and transient itching. Pain and swelling were further divided into mild to moderate (1 point) and severe (2 points). Theoretically, the score was in the range of 0-9. Calculated scores ranged 0-4. The patients were further divided into two groups with scores of 0-1 denoting minimal morbidity (MIN) and 2-4 denoting significant morbidity (SIG). The number of lesions in each morbidity-score group were comparable (MIN 17and SIG 15). There were no statistically significant differences between the groups regarding age, number of applications, or average injection volume per mm lesion. Statistically significant differences were noted regarding gender (p = 0.05), lesion diameter (p = 0.030), total volume of first (p = 0.007) and second application (p = 0.05), and total injected volume (p = 0.03). Factors contributing to the risk for significant morbidity included being male, lesion diameter > 5 mm, volume > 0.3 mL per application, and total injected volume > 0.3 mL. A waiting time of 12 weeks prior to additional EAO application was required in 12 out of 29 lesions for clinical observation of complete regression. It was concluded that sclerotherapy with EAO as monotherapy is easy to apply, safe, and effective within a small number of sessions. Application of <0.3 mL EAO per session, and a waiting time of 12 weeks prior to the second application, would significantly minimize morbidity.


Assuntos
Boca/fisiopatologia , Complicações Pós-Operatórias/etiologia , Escleroterapia/métodos , Malformações Vasculares/cirurgia , Adolescente , Adulto , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Boca/lesões , Complicações Pós-Operatórias/epidemiologia , Melhoria de Qualidade , Estudos Retrospectivos , Escleroterapia/normas , Escleroterapia/estatística & dados numéricos , Resultado do Tratamento
6.
J Forensic Leg Med ; 72: 101958, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32452448

RESUMO

The body of a 53-year-old man was found in a burning car. The ignition key was in start position and the accelerator pedal was held down by his right foot. Autopsy revealed a gunshot entrance wound in the hard palate, a bullet track through the anterior cranial fossa and a projectile lodged in the left frontal lobe. The brain stem was free of lesions and any signs of secondary brain injury, such as brain oedema and intracranial haemorrhage, were not significant. Soot deposits and thermal injury to the mucosa were observed in the airways below the glottis and carboxyhaemoglobin (COHb) saturation was 40%. A single bullet case and a handgun were recovered next to the driver's seat. Fire investigators identified the motor as the beginning of the burning: therefore, the conclusion was that the car had caught fire due to overheating of the engine. Differential diagnosis between complex and complicated suicide was essential. The cause of death was identified as carbon monoxide intoxication, and the injuries to the brain were not felt to be immediately fatal. The case has been classified as a complicated suicide. There are no other published cases of a complicated suicide involving exposure to fire or the use of firearms.


Assuntos
Queimaduras/patologia , Intoxicação por Monóxido de Carbono/diagnóstico , Fogo , Boca/lesões , Suicídio Consumado , Ferimentos por Arma de Fogo/patologia , Automóveis , Carboxihemoglobina/análise , Correspondência como Assunto , Medicina Legal , Traumatismos Cranianos Penetrantes/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Boca/patologia , Mucosa Respiratória/lesões , Mucosa Respiratória/patologia , Fuligem
8.
Dent Traumatol ; 36(1): 19-24, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31162805

RESUMO

BACKGROUND/AIMS: Ketamine sedation has not been reported to be widely used as a pharmacological behavioural management strategy to facilitate the treatment of acute paediatric oro-dental trauma. The aim of this study was to investigate the safety and effectiveness of intramuscular ketamine sedation for managing paediatric oro-dental trauma in a paediatric Emergency Department (ED). METHODS: The database of all paediatric procedural sedations performed in the hospital ED from 01 January 2014 to 31 December 2016 was reviewed to identify cases where intramuscular ketamine sedation was administered for dentists' treatment of oro-dental trauma. Patient demographics and epidemiological data, the type and number of sedation-related adverse events, and interventions performed were extracted from the database. Clinical notes were reviewed to verify the dental diagnoses and dental treatment performed. Adverse events were further risk stratified using the World SIVA adverse event reporting tool. RESULTS: In the study period, 167 intramuscular ketamine sedations were administered by ED doctors for dental treatment of oro-dental trauma. The patients' median age was 3.6 years (range 1.1 to 12 years). All dental procedures were successfully completed. Nineteen adverse events were reported (11.4%, n = 19) with the most common being emesis (9.0%) followed by transient desaturation (1.8%) and hypersalivation (0.6%). The lowest oxygen saturation level was 90%. None of the patients aspirated, and none required assisted ventilation or chest compression. The most common dental diagnosis was primary tooth luxation (49.1%). The most common dental treatment was primary teeth extraction (70.7%). When adverse events were stratified using the World SIVA tool, there were only 17 (10.2%) minor risk outcomes. CONCLUSIONS: The data support the safety and effectiveness of intramuscular ketamine sedation administered by trained ED doctors to facilitate the management of paediatric oro-dental trauma emergencies.


Assuntos
Analgésicos , Anestesia , Sedação Consciente , Traumatismos Craniocerebrais , Ketamina , Traumatismos Dentários , Analgésicos/administração & dosagem , Criança , Pré-Escolar , Sedação Consciente/métodos , Serviço Hospitalar de Emergência , Humanos , Lactente , Ketamina/administração & dosagem , Boca/lesões
9.
BMC Gastroenterol ; 19(1): 222, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864290

RESUMO

BACKGROUND: Endoscopic nasobiliary drainage (ENBD) is widely used for biliary decompression in patients with biliary disease. However, it is difficult to reposition a nasobiliary catheter from the mouth to nostril. We developed a new device, which has a curved flexible loop and bar-handle, for repositioning of ENBD catheter. The aim of this study was to evaluate the usefulness of the new loop-device for facilitating the repositioning of an ENBD catheter from the mouth to nostril. METHODS: Between January 2015 and December 2017, a comparative observational study was performed to evaluate the time taken for repositioning a nasobiliary catheter during endoscopic retrograde cholangiopancreatography (ERCP) and compare the results of ENBD procedure between the new loop-device and conventional techniques. In the subgroup analysis, we evaluated the occurrence of oral cavity injury and the time taken to transfer ENBD catheter from the mouth to nostril. RESULTS: In all, 145 ENBD procedures were performed using these two techniques. The procedure time was significantly shorter in the new technique group than in the conventional group. (44 s vs. 194 s, p < 0.001). The total success rate of new device technique was 97.3%. No complication, including oral cavity injury, was observed. CONCLUSIONS: The technique using our new loop-device was useful for repositioning a nasobiliary catheter from the mouth to nostril in ERCP. The new device does not require the removal of the mouthpiece before ENBD positioning, which can help perform the ENBD procedure rapidly and avoid the finger injury of endoscopists.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Remoção de Dispositivo/instrumentação , Drenagem/instrumentação , Intubação/instrumentação , Nariz , Idoso , Bile , Distribuição de Qui-Quadrado , Remoção de Dispositivo/métodos , Remoção de Dispositivo/estatística & dados numéricos , Drenagem/métodos , Desenho de Equipamento , Feminino , Humanos , Intubação/métodos , Intubação/estatística & dados numéricos , Masculino , Ilustração Médica , Pessoa de Meia-Idade , Boca/lesões , Orofaringe/anatomia & histologia , Estatísticas não Paramétricas , Fatores de Tempo
10.
Rev. Odontol. Araçatuba (Impr.) ; 40(3): 24-27, set.-dez. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1102216

RESUMO

O lipoma é uma neoplasia benigna mesenquimal de rara ocorrência em cavidade bucal, com maior predileção, principalmente pela mucosa bucal, em indivíduos acima da quarta década de vida. Clinicamente o lipoma se caracteriza por um aumento de volume flácido à palpação, de coloração amarelada ou normal de mucosa, com crescimento lento e geralmente assintomático. Histologicamente o lipoma apresenta presença de tecido adiposo maduro com células adiposas de aparência semelhante à gordura normal adjacente, bem circunscrito e podendo apresentar uma fina cápsula fibrosa. O tratamento do lipoma é cirúrgico e consiste na excisão da lesão. Assim, o objetivo do presente trabalho é relatar dois casos de lipoma em cavidade oral localizados em região de mucosa bucal tratado cirurgicamente. Paciente de 50 anos, sexo feminino, melanoderma, cursando com aumento de volume em região de mucosa bucal esquerda com 05 meses de evolução. Ao exame clínico foi possível avaliar lesão em região de mucosa bucal esquerda de aproximadamente 02 cm de diâmetro, flácido à palpação e coloração normal de mucosa. Foi realizada biopsia excisional sob anestesia local e posterior enucleação da lesão. A paciente evolui com 06 meses de pós-operatório sem evidências clínicas de recidiva da lesão ou complicações associadas. O lipoma é de difícil ocorrência em região intra-oral e mesmo quando tratada de maneira conservadora através da enucleação lesão possui baixas taxas de recidiva(AU)


Lipoma is a benign mesenchymal neoplasm of rare occurrence in the oral cavity, with a higher predilection, mainly by the buccal mucosa, in individuals above the fourth decade of life. Clinically lipoma is characterized by an increase in flaccid volume at palpation, yellowing or normal mucosa, with slow and usually asymptomatic growth. Histologically, lipoma has the presence of mature adipose tissue with adipose cells similar in appearance to adjacent normal fat, well circumscribed and may have a thin fibrous capsule. The treatment of lipoma is surgical and involves the excision of the lesion. Thus, the objective of the present study is to report two cases of lipoma in the oral cavity located in a region of buccal mucosa treated surgically. A 50-year-old female patient, melanoderma, with an increase in volume in the region of the left buccal mucosa with 05 months of evolution. At the clinical examination it was possible to evaluate lesion in the region of the left buccal mucosa of approximately 02 cm in diameter, flaccid to palpation and normal mucosa staining. An excisional biopsy was performed under local anesthesia and subsequent enucleation of the lesion. The patient ev olves at 06 months postoperatively without clinical evidence of recurrence of the lesion or associated complications. Lipoma is difficult to perform in the intra-oral region and even when treated conservatively through the enucleation lesion has low rates of relapse(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Lipoma , Lipoma/cirurgia , Lipoma/diagnóstico , Neoplasias Bucais , Lipoma/patologia , Boca/lesões , Boca/patologia , Mucosa Bucal
11.
Pesqui. vet. bras ; 39(12): 983-988, Dec. 2019. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1056930

RESUMO

A retrospective study of oral trichomoniasis cases in raptors was carried out at "Laboratório Regional de Diagnóstico" of "Faculdade de Veterinária" of "Universidade Federal de Pelotas" (LRD-UFPel) from December 2014 to August 2017. Seven necropsy reports were reviewed. All raptors including Falconiformes and Strigiformes orders were from periurban zones. Four birds were adults, and there was no apparent sex predisposition. Clinical signs included dysphagia, regurgitation, and anorexia. Gross lesions were characterized by multifocal yellow to coalescent caseous nodules adhered to the oral cavity, which extended to the entrance of the esophagus. Microscopically, the lesions were characterized by severe focally extensive heterophilic granulomatous stomatitis. Trichomonas gallinae was isolated in modified Diamond medium of all samples collected from birds. It is believed the transmission occurred by the predation of domestic pigeons (Columbia livia domestica) contaminated with T. gallinae that agglomerate in patios of grain processing complexes.(AU)


Foi realizado um estudo retrospectivo de casos de tricomoníase oral em rapinantes recebidos no Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD-UFPel) no período de dezembro de 2014 a agosto de 2017. Foram revisados os protocolos de necropsia encontrando-se sete casos. Os animais eram todos de zonas periurbanas e foram afetadas a ordem Falconiformes e a ordem Strigiformes. Das aves afetadas 4/7 eram adultas e não houve aparente predisposição por sexo. Os sinais clínicos incluíram disfagia, regurgitação e anorexia. As lesões se caracterizaram por nódulos amarelados multifocais a coalescentes aderidos a cavidade oral, que se estendiam até a entrada do esôfago. Histologicamente as lesões caracterizaram-se por estomatite heterofílica granulomatosa focalmente extensiva acentuada. Foi isolado em meio Diamond modificado Trichomonas gallinae de todas as amostras coletadas das aves. Acredita-se que a fonte de transmissão tenha ocorrido a partir da predação por estes rapinantes de pombas domésticas (Columbia livia domestica) portadoras com T. gallinae que se aglomeram em pátios de complexos de beneficiamento de grãos.(AU)


Assuntos
Animais , Tricomoníase/patologia , Tricomoníase/veterinária , Tricomoníase/epidemiologia , Aves Predatórias/parasitologia , Brasil/epidemiologia , Boca/lesões
12.
Rev. cuba. estomatol ; 56(4): e2010, oct.-dez. 2019. graf
Artigo em Português | LILACS | ID: biblio-1093257

RESUMO

RESUMO Introdução: a psoríase é uma doença inflamatória crônica e recorrente da pele que raramente ocorre apenas e primariamente na mucosa bucal. Objetivo: A descrever um caso de psoríase primária na mucosa bucal. Apresentação do caso: Um paciente de 16 anos de idade relatou uma "mancha que fez com que se sentisse desconfortável". O paciente apresentava uma placa leucoplásica, exofítica e uma úlcera. Na histopatologia e com as características clínicas, a suspeita de mucosite psoriasiforme foi confirmada. O tratamento escolhido para as lesões da psoríase foi a aplicação tópica de valerato de betametasona 1 mg/g por três semanas. Após duas semanas de tratamento, o paciente retornou para reavaliação clínica e foi observado sucesso na terapêutica. Conclusões: A presença de psoríase exclusiva na cavidade bucal é uma entidade rara. A apresentação clínica variada e a ausência de alterações locais ou sistêmicas associadas foram elementos-chave na suspeição diagnóstica. A abordagem por meio de cirurgia para remoção da lesão exofítica e o uso de betametasona tópica permitiram o controle locorregional(AU)


RESUMEN Introducción: La psoriasis es una enfermedad inflamatoria crónica y recurrente de la piel y que en rara ocasión ocurre única y por primaria vez en mucosa bucal. Objetivo: Describir un caso de psoriasis primaria en mucosa bucal. Presentación de caso: Paciente de 16 años de edad consultada que refirió una "mancha que incomodaba al comer". La paciente presentaba una placa leucoplásica, exofítica y una úlcera. En la histopatología y con las características clínicas, se confirmó la sospechosa de mucositis psoriasiforme. El tratamiento elegido para las lesiones de psoriasis fue la aplicación tópica de valerato de betametasona 1 mg/g durante tres semanas. Después de dos semanas de tratamiento la paciente retornó para reevaluación clínica y se constató éxito en la terapéutica escogida. Conclusiones: la presencia de psoriasis exclusiva en la cavidad bucal es una entidad poco frecuente. La presentación clínica variada y la ausencia de alteraciones locales o sistémicas asociadas fueron elementos clave en la sospecha diagnóstica. El abordaje por medio de cirugía para remoción de la lesión exofítica y utilización de betametasona tópica posibilitó el control locorregional(AU)


ABSTRACT Introduction: Psoriasis is a chronic inflammatory and recurrent skin disease that rarely occurs solely and primarily in the oral mucosa. Objective: Describe a case of primary psoriasis of the oral mucosa. Case presentation: A 16-year-old female patient attends consultation and reports "a spot that hurts when eating." Clinical observation revealed the presence of leukoplastic, exophytic plaque and an ulcer. Histopathological examination confirmed the suspicion of psoriasiform mucositis. The treatment chosen for the psoriatic lesions was topical application of betamethasone valerate 1 mg/g for three weeks. After two weeks of treatment, the patient returned for clinical reassessment and the treatment applied was found to have been successful. Conclusions: Exclusively oral psoriasis is an uncommon condition. Multi-faceted clinical presentation and the absence of local or systemic associated alterations were key elements in the diagnostic suspicion. Surgical removal of the exophytic lesion and application of topical betamethasone led to locoregional control(AU)


Assuntos
Humanos , Feminino , Adolescente , Psoríase/tratamento farmacológico , Estomatite/diagnóstico , Betametasona/uso terapêutico , Boca/lesões
13.
J Endod ; 45(12S): S28-S38, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31623907

RESUMO

Trauma or injury to the dentition and supporting tissues is associated with pain and discomfort, as expected, that may present immediately, shortly afterwards, or within a few days. Pain is an essential response to injury because it allows the organism to develop avoidance behavior to potential threats and helps the organism to avoid usage of the injured organ during the healing process. Not only does external trauma induce pain, but also essential invasive dental procedures such as extractions, dental implant insertions, root canal treatments, and oral surgeries are accompanied by similar post-surgical (post-traumatic) pain. The pain intensity after trauma varies and does not always correlate with the extent of injury. Trauma to the orofacial region or the teeth may also indirectly affect and induce pain in other orofacial structures such as the masticatory muscles, the temporomandibular joint, and even the cervical spine. In most cases, the pain will resolve as soon as healing of the affected tissue occurs or after dental and routine palliative treatment. In a limited number of cases, the pain persists beyond healing and evolves into a chronic pain state. Chronic pain in the orofacial region presents diagnostic and management challenges. Misdiagnosis or delayed diagnosis of the oral chronic pain condition may lead to unnecessary dental treatment. This article will discuss diagnosis and treatment for acute and chronic pain as well as potential mechanisms involved in the undesirable transition from acute to chronic pain.


Assuntos
Dor Crônica , Traumatismos Faciais , Boca/lesões , Procedimentos Cirúrgicos Bucais , Traumatismos Dentários , Traumatismos Faciais/complicações , Dor Facial , Humanos , Tratamento do Canal Radicular , Traumatismos Dentários/complicações
14.
Adv Dent Res ; 30(2): 50-56, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31633385

RESUMO

Tissue injuries in the oral and maxillofacial structures secondary to trauma, warfare, ablative cancer, and benign tumor surgery result in significant losses of speech, masticatory and swallowing functions, aesthetic deformities, and overall psychological stressors and compromise. Optimal oral rehabilitation remains a formidable challenge and an unmet clinical need due to the influence of multiple factors related to the physiologic limitations of tissue repair, the lack of site and function-specific donor tissues and constructs, and an integrated team of multidisciplinary professionals. The advancements in stem cell biology, biomaterial science, and tissue engineering technologies, particularly the 3-dimensional bioprinting technology, together with digital imaging and computer-aided design and manufacturing technologies, have paved the path for personalized/precision regenerative medicine. At the University of Pennsylvania, we have launched the initiative to integrate multidisciplinary health professionals and translational/clinical scientists in medicine, dentistry, stem cell biology, tissue engineering, and regenerative medicine to develop a comprehensive, patient-centered approach for precision and personalized reconstruction, as well as oral rehabilitation of patients sustaining orofacial tissue injuries and defects, especially oral cancer patients.


Assuntos
Bioimpressão , Boca , Impressão Tridimensional , Engenharia Tecidual , Estética Dentária , Humanos , Boca/lesões , Medicina Regenerativa
15.
Clin Sports Med ; 38(4): 513-535, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472763

RESUMO

The athletic training room is filled with a multitude of conditions encompassing many different specialties of medicine. When it comes to traumatic injuries in the training room, many of them are not musculoskeletal in nature. Ultrasound in the training room can help identify serious and subtle solid-organ injury and small pneumothoraces. The discussion of these conditions follows a simple outline that helps identify injury/conditions through a proper history and physical. Evidence-based treatment/management/return to play guidelines are discussed.


Assuntos
Traumatismos Abdominais/diagnóstico , Traumatismos em Atletas/diagnóstico , Traumatismos Faciais/diagnóstico , Traumatismos Torácicos/diagnóstico , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/terapia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/terapia , Traumatismos Faciais/etiologia , Traumatismos Faciais/terapia , Humanos , Boca/lesões , Lesões do Pescoço/diagnóstico , Lesões do Pescoço/etiologia , Lesões do Pescoço/terapia , Nariz/lesões , Exame Físico , Volta ao Esporte , Traumatismos Torácicos/etiologia , Traumatismos Torácicos/terapia
17.
Sports Med ; 49(8): 1217-1232, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31148073

RESUMO

BACKGROUND: Sport activities can account for up to one-third of all orofacial injuries. Mouthguards (MGs) have been proposed as a way to reduce these injuries. OBJECTIVES: To present a systematic review and meta-analysis of the effectiveness of MGs for the prevention of sports-related orofacial injuries and concussions. METHODS: Using specific search terms, PubMed, Ovid Embase, and the Cumulative Index to Nursing and Allied Health Literature were searched to find studies that (1) contained original quantitative data on MGs and orofacial injuries and/or concussions, (2) included groups involved in sports or exercise activities, (3) included MG users and non-MG users, and (4) provided either risk ratios (RRs) and 95% confidence intervals (95% CIs) comparing injuries among MG users and non-MG users, or data that could be used to calculate RRs and 95% CIs. RESULTS: Twenty-six studies met the review criteria. Investigations employed a variety of study designs, utilized different types of MGs, used widely varying injury case definitions, and had multiple methodological weaknesses. Despite these limitations, meta-analyses indicated that the use of MGs reduced the overall risk of orofacial injuries in 12 cohort trials (summary RR [nonusers/users] = 2.33, 95% CI 1.59-3.44), and 11 trials involving self-report questionnaires (summary RR [nonusers/users] = 2.32, 95% CI 1.04-5.13). The influence of MGs on concussion incidence in five cohort studies was modest (summary RR [nonusers/users] = 1.25, 95% CI 0.90-1.74). CONCLUSION: These data indicate that MGs should be used in sports activities where there is significant orofacial injury risk.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Traumatismos Faciais/prevenção & controle , Protetores Bucais , Boca/lesões , Humanos , Incidência
18.
Int J Pediatr Otorhinolaryngol ; 124: 6-13, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31151032

RESUMO

OBJECTIVES: This study aims to identify specific patterns of risk in order to contribute to the prevention of Foreign Body (FB) injuries by assessing FB injury characteristics in Indian children. METHODS: Single center case series are included in the worldwide registry on Foreign Bodies Injuries www.susysafe.org. Statistical analysis performed on FB injury data (age, medical information, FB anatomical location (ICD) and characteristics, and situational data) from 252 Indian children (0-14 years) was used to identify FB risk patterns. RESULTS: The study included 252 FB injury cases, out of which 110 occurred in females (43.7%). Most of the reported FB injuries (N = 252) were located in the mouth, esophagus and stomach, or intestines and colon (34.5%), and in the nose (31.3%). The analysis of the median duration of all injuries (i.e., the difference between the reported injury time/date and the reported time/date of arrival at hospital) showed that children with a FB in the airways were those referred to the hospital latest (median of 332.50 min, p-value <0.001). With regards to FB type, the majority of FB objects were non-food items and ingestion of coins accounted for 25% of all FB injuries. CONCLUSIONS: Cultural differences may exist with regards to the Indian diet being conducive to lower choking food risk for children, and to acceptability and accessibility to objects such as coins and stationery. Such findings should be taken into account when developing primary and secondary prevention strategies aimed at reducing the burden of such injuries in India.


Assuntos
Corpos Estranhos/complicações , Corpos Estranhos/epidemiologia , Trato Gastrointestinal/lesões , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Adolescente , Obstrução das Vias Respiratórias/etiologia , Criança , Pré-Escolar , Colo/lesões , Ingestão de Alimentos , Esôfago/lesões , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Intestino Delgado/lesões , Masculino , Boca/lesões , Nariz/lesões , Sistema de Registros , Fatores de Risco , Estômago/lesões
20.
J Oral Pathol Med ; 48(5): 421-423, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30849196

RESUMO

Chronic mucosal trauma is suggested as an additional etiologic risk factor for oral squamous cell carcinoma (OSCC), but there is a lack of experimental-molecular data. If chronic trauma of the oral mucosa is carcinogenic, it should be associated with early genetic alterations seen during typical progression of OSCC, like loss of heterozygosity (LOH). We investigated LOH in the key chromosomal arms 3p, 9p and 17p in inflammatory fibrous hyperplasia associated with removable dental prosthesis and also in normal oral mucosa, by using the polymorphic microsatellite markers D3S1300 at 3p14.2, D9S1748 at 9p21, D17S1289 at 17p12 and D17S974 at 17p13 and capillary electrophoresis. LOH was detected in 2/15 (13%) fibrous hyperplasia samples similarly to other reactive and inflammatory lesions. None of the normal mucosa samples presented LOH. Our experimental-molecular results do not support the hypothesis that trauma associated with dental prosthesis has an important role in oral carcinogenesis.


Assuntos
Carcinoma de Células Escamosas/complicações , Dentaduras/efeitos adversos , Perda de Heterozigosidade , Neoplasias Bucais/complicações , Boca/lesões , Adulto , Idoso , Carcinogênese , Cromossomos Humanos Par 17 , Cromossomos Humanos Par 3 , Cromossomos Humanos Par 9 , Feminino , Humanos , Masculino , Repetições de Microssatélites , Pessoa de Meia-Idade
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