Innovation in pediatric surgery: the use of ultrasonic CVD tips: case report

The non-eruption of teeth due to highly keratinized gingival mucosa is a frequent event in the pediatric dentistry, which harms the oral aesthetics and function. A surgical excision of the involved area is indicated, exposing the non-erupted tooth. This procedure involves anesthesia and cutting instruments that may increase the fear and anxiety in young patients. The use of new technologies has avoided these instruments and has promoted more comfort to the patients. This study presents clinical cases in which gingivectomy was performed using the innovative method with an ultrasound-activated CVD tip. It was concluded that this method presented effectiveness, promoted more comfort, and less fear to the patients, making its use a viable alternative to pediatric surgery.

Tratamento multidisciplinar: relato de casos clínicos

Introduction: Adult patients are more prone to periodontal disease mainly caused by poor plaque control. In these patients, orthodontic movement is not contraindicated, but it is necessary to evaluate their periodontal status so that we can establish the appropriate treatment plan. Objective: The objective of this article is to describe and discuss the clinical cases of severely periodontally compromised individuals in need of oral rehabilitation. Methods: The study consisted of orthodontic treatment of two cases with periodontal involvement. After clinical and radiographic examinations, the cases were analyzed by a multidisciplinary team of Orthodontics, Periodontics and Prosthodontics, in order to provide the patient with the best possible esthetic, functional and stability outcomes. Periodontal treatment consisted of supra and subgingival scaling prior to orthodontic treatment, and regular maintenance performed on a quarterly basis throughout orthodontic movement. Activation was carried out every 45 to 50 days, with light forces. Retention remains to the present day, even after completion of the rehabilitation. Conclusion: Multidisciplinary oral rehabilitation treatment yields satisfactory results. The interaction between Orthodontics and Periodontics reveals that patients with reduced, but healthy periodontium, can receive orthodontic treatment as long as the forces applied do not exceed patient's biological limits.

Achados clínicos, genéticos e microbiológicos de uma família com periodontite agressiva de Maceió

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Clareamento interno em dentes despolpados como alternativa a procedimentos invasivos: relato de caso

The increasing interest of patients for a better aesthetic appearance of their smile, associated with the development of new materials and techniques, encouraged by media couverage of this concept of beauty, provided an important evolution of cosmetic dentistry. As the darkness of a single anterior tooth or a group of teeth, in most cases, impairs the appearance of the smile and there is growing appreciation of the less invasive procedures, the technique of tooth bleaching is an important option for aesthetic treatment. To have success in the bleaching treatment, it is important to have knowledge of the origin, nature and composition of the stain. Among the causes of color changes acquired post-eruptive, dental trauma, with or without pulp necrosis, is one of the most commonly encountered etiologies, characterized by a reddish-brown color. Current techniques of bleaching for teeth treated endodontically employ oxidative agent hydrogen peroxide. The objective of this paper is to describe the immediate technique of bleaching non-vital tooth by presenting a clinical case.

Repercussões endodônticas dos procedimentos clareadores

Tooth bleaching is a treatment modality that raises great interest, due to the important role played by aesthetics in current life style. To perform such procedure, nowadays, there are several bleaching substances at several concentrations, as well as, diverse clinical techniques. When suggesting this procedure, the dentist should take into consideration several factors related to the patient to determine which will be the most appropriate technique/material combination for solving the clinical problem. The procedure indication should not only be based on the expectations exhibited by the patient, but also on respecting the biological principles to maintain the integrity of both the endodontic and periodontal tissues.

Procedimentos conservadores para restabelecimento da estética anterior

A Odontologia atual está direcionada em executar procedimentos cada vez menos invasivos sem perder a objetividade, tais como função e estética. Como tais procedimentos, podemos citar o clareamento dentário e a utilização de resinas compostas diretas, que nos fazem praticar o conceito de uma Odontologia minimamente invasiva. Este artigo tem o objetivo de demonstrar, através de alguns procedimentos conservadores, a possibilidade de se obter resultados satisfatórios.

Dificuldades relatadas por estudantes de odontologia diante de procedimentos relacionados à periodontia

Objective: This study aimed at evaluating the difficulties reported by last-year dentistry course students regarding basic and surgical periodontal procedures. Methods: A proposed questionnaire with 24 questions, 14 related to basic periodontal procedures and 10 to surgical procedures, was applied to 45 undergraduate students with jobs involving these procedures, during the practical activities of the Integrated Clinic Discipline, a compulsory subject in the curriculum of the course, taught to last-year students. Students were asked about their own perceptions of the difficulties in implementing the various steps related to the treatments. The degree of individual difficulty was determined according to the Likert scale: 0 = none, 1 = mild, 2 = moderate, 3 = high, 4 = very high. Exploratory analysis of data was applied, and the difficulty level was also dichotomized into none to mild (scores 0 and 1) and moderate to very high (scores 2–4). Results: Regarding the basic periodontal treatment, bone level probing was the procedure with the highest number of student difficulties (57.5%). As for the difficulties reported by students regarding the stages of periodontal surgery, only the procedures related to anesthesia and suture removal had no report of doubts. Conclusion: Periodontal surgery was the procedure involving the most prevalent questions reported as moderate to very high, and the indication for the most suitable surgical technique was the stage with the highest percentage of questions (66.6%) among the undergraduates.

Síndrome da ardência bucal: avaliação e tratamento

The burning mouth syndrome (BMS) is a relevant pathology that has been defined as a chronic pain with difficult diagnosis and treatment. The prevalence of BMS is estimate to be 15% of the general population, being more common in the elderly and middle-aged. Characterized by a burning sensation in more than one area, more frequently on the two thirds of the tongue, on the anterior half of the hard palate and on the mucosa of the upper lip, the BMS is associated with clinical signs of normality and normal laboratory findings. For several studies the BMS etiology is controversial because it is multifactorial since it can be caused by local, neuropathic, psychological and/or systemic factors. These controversies make the diagnosis more difficult, especially if the dentist does not have knowledge about the syndrome. Thus, the aim of this paper is to present, by means of a literature review, the main features of BMS, indicating the procedures that may be useful for diagnosis, and also the available therapeutic modalities in order to increasing the knowledge of health professionals so that patients with BMS may benefit from appropriate treatment, support and professional confidence, always aiming to better quality of life.

Conhecimento de mães sobre os procedimentos de emergência nos casos de avulsão dentária

Introduction: Despite tooth avulsion following trauma being relatively common in children, the available studies show that adults have limited knowledge about it. Aim: The purpose of this study was to assess, by a questionnaire, the mothers’ general knowledge about the immediate management of tooth avulsion. Material and method: This descriptive study was carried out on a convenient sample of mothers (n= 65) who participated of the “Pastoral da Criança”, from Araraquara, SP, Brazil. The questionnaire comprised 15 questions about personal data and knowledge on tooth avulsion management. Results: Participants were, on average, 35 years old. A total of 30.8% of the mothers reported that their children suffered dental trauma. The majority had never received advice on this subject (76.9%); and did not know how teeth are kept in the dental arch (69.2%). Almost a half of the sample believed that an avulsed tooth can be replanted (49.2%). In relation to the management of tooth avulsion, 40% of them would clean the avulsed tooth with water, even if it was not dirty (38.5%). Most of them (69.2%) would take the tooth by hand for cleaning purposes, regardless the tooth region; and believed that brushing the tooth was important to take the dirty out (67.7%). Conclusion: The general knowledge of mothers about the immediate management of tooth avulsion was considered inadequate endangering the successful treatment of tooth avulsion.

Diagnóstico radiográfico diferencial das reabsorções radiculares internas e externas entre especialistas em endodontia e clínicos gerais

Objectives: The objective of this study was to evaluate the ability of endodontists and general practioners to perform the differential radiographic diagnosis between internal and external root resorptions, using digitized periapical radiographs. Methods: Thirty periapical radiographic images of external and internal resorption were selected. The evaluators were comprised of 15 endodontists and 29 general practitioners who answered a questionnaire with the following question: “What type of resorption in the following radiographics do you diagnose?” (1) Inflammatory external root resorption. (2) Internal root resorption. Statistical analysis was performed based on the Mann-Whitney test, with significance level of 5%. Results: There was no statistically significant difference in the percentage of correct answers from specialists in endodontics and general practitioners. Conclusions: Both groups demonstrated satisfactory skill in the radiographic interpretation of internal and external resorption and there was a higher percentage of correct diagnosis of internal resorption than the external.

Guia prático de medicina baseada em evidências

Neste livro são expostos, para uso de profissionais da área, os princípios básicos e conceitos fundamentais, além dos procedimentos necessários para a prática da Medicina Baseada em Evidências (MBE). A MBE é uma prática relativamente nova, criada em 1992, pelo cientista epidemiologista Gordon Guyatt, na canadense McMaster University. Trata-se da utilização e do desenvolvimento de métodos rigorosos que respondam a questões clinicas sobre efetividade, eficiência e segurança de determinado tratamento e prevenção, bem como sobre a sensibilidade e especificidade de testes diagnósticos de certa doença na área de saúde. A MBE propõe realizar pesquisas de boa qualidade metodológica e livres de vieses e conflitos de interesse, de forma que as respostas sejam adequadas para auxiliar na tomada de decisão clínica. Segundo a MBE, a melhor forma de saber se uma medicação específica é eficaz no tratamento de determinada doença é a revisão sistemática de ensaios clínicos randomizados, que mapeiam os estudos publicados e não publicados realizados mundialmente sobre o assunto. Tal revisão deve ainda contar com metodologia rigorosa que busque, por exemplo, explicar resultados contraditórios sobre a mesma questão e comparar estudos com diferentes amostras para detectar possível diferença estatística. De forma didática e detalhada, mas mantendo todo o rigor científico, esta obra tem caráter de manual. Ao longo dos capítulos, seus autores explicam conceitos e apresentam o passo a passo da utilização da MBE para os profissionais de saúde.

Utilização de procedimentos multivariados no consumo de água e energia elétrica em habitações sociais com sistema de aquecimento solar

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

(En)quadros estéticos (artísticos e clínicos) e seus efeitos sensíveis

Based on the aesthetic investigations of Freud, the work intends to bring joints between possible sensitive effects caused by contact / reception with works of art (having them here as “framed art”) and psychoanalytic clinical setting. The text is also concerned to show that the production of these striking effects, happens by the condition of these items (artistic and clinical) are under a frame and therefore conceptualized as aesthetic in this article arguments.

Enquadres clínicos, enquadramentos estéticos: arte e psicanálise

This paper aims at establishing a link between the psychoanalytic idea of a clinical setting and the notion of framing in the artistic image. To this end, the reading is based on issues related to clinical care, in the specific sense of a setting, casting itself in artistic creations that challenge the rigid status – when it’s the case – of this setting, and reflecting on the notion of transference, a basic phenomenon in this context. The conclusions refer to a direct approach between the aesthetic experience and psychoanalytic experience.