Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.

Interação entre odontologia restauradora e periodontia - parte 1: planejamento e protocolo cirúrgico

Current dental treatments search for alternatives to achieve restablishment of esthetics and function. The increased demand for high esthetic patterns stimulates an interaction between the dental specialties towards a comprehensive treatment in order to solve slinical cases effectively. Knowing the components involved in the dental smile harmony is essential for treatment planning and implementation. It is also important to be aware of the changes that may impair suck harmony and become a patient's complaint. This article addresses a multidisciplinary treatment that involved the integration between Periodontics and Restorative Dentistry. After the surgical-restorative planning, periodontal procedures were performed to obtain an adequate balance between the teeth and soft tiessues.

Aplicação do enxerto conjuntivo subepitelial para recobrimento de recessões em dentes inferiores

Some regions of the oral cavity present anatomical conditions that seem to hinder the result of gingival recessions coverage. Thus, the aim of this case report was to present two surgeries for gingival recessions coverage in the mandibular teeth performed on the same patient with the follow-up of 24 months. Patient RP, 35 years old, male, Caucasian, nonsmoker, systemically healthy, sought care at the clinic of specialization course in Periodontics from the Araraquara Dental School (Foar-Unesp). His main complaint was the gingival recessions within the lower teeth 33, 34, 35, 43, 44 and 45. Besides the aesthetic nuisance, the patient reported occasional dentin sensitivity. For resolution of the case was referred to the technique of subepithelial connective tissue graft associated with a coronally advanced flap. After 2 years of surgery, it was observed an excellent root guards with significant aesthetic improvement of the case. It can be concluded that the subepithelial connective tissue graft technique was effective in covering of type class I gingival recessions of Miller, even in a region that provides a difficult procedure.

Recobrimento radicular para o tratamento de hipersensibilidade dentinária cervical persistente

Gingival recession has a high prevalence in the population. This alteration may promote several complications such as cervical dentinal hypersensitivity (HSDC), carious and non-carious cervical lesions, and cosmetic changes due to the increase of the clinical crown length. To treat HSDC there are several therapeutic possibilities that should aim to eliminate pain after external stimulus. Treatment of this alteration can be performed by a conventional or invasive procedure, depending on the clinical condition and patients' desires. In situations where aesthetics is not the main complaint and HSDC persists even after conservative procedures, it is possible to indicate a procedure to achieve root coverage in Miller's Class I and II recessions. The aim of this paper is to report a case where the HSDC was not eliminated by conventional methods, which was resolved only after performing a minimally invasive surgery that promoted total root coverage.

A identidade feminina em The Magic Toyshop: estudos de gênero no texto e na tela

Besides producing a vast literary work, Angela Carter (1940-1992) participated of the screenplay’s production for two movies based on her books, The Company of Wolves and The Magic Toyshop. Either through the influence that cinema had in her life or through the very own style of her writing, the relation of the British author with the seventh art is visible. Considering the importance of significations in literary works, this paper proposes a comparative study between Angela Carter’s The Magic Toyshop (1967) and the film of the same title, based on Carter’s novel, directed by David Wheatley and produced by Granada Television, in 1987. Based on Tania Carvalhal’s conception about intertextuality and film theories, the focus of this paper is the gender study, since its ideology is subscribed, represented and reproduced in every cultural practice, including literature and cinema. The characters construction in both cases, especially the female characters, is filled with symbols which are going to bring the film closer to the literary work and contribute to express the critics suggested in the work’s leading: the complaint to the patriarchal system. However, given the different nature of each work, it is necessary to stress that this present comparison doesn’t intend to establish a total identification between novel and film, but to set a dialogue between both, observing the approximation and distance of these two instances.

Conflitos no sul do Brasil e queixa pública contra Alvarenga Peixoto (São João del-Rei, Minas Gerais, 1776-1780)

The objective of this article is to analyze the accounts rendered of the provisions bought by the magistrate Inácio José de Alvarenga Peixoto to serve the soldiers of Minas Gerais state sent to fight in the war against the Spaniards in the south of Brazil.

Triagem interventiva: a caracterização de uma demanda

This paper analyzes the process of sorting through the intervening demand survey that reaches the Center for Research and Applied Psychology (CPPA) “Dr. Betti Katzenstein” UNESP Assis. The objective was to better understand the reality of conflicts that people face and, therefore, to characterize the patients who seek help in CPPA. With greater understanding of demand, it is possible to trace more consistent referrals and tailor the service to the school clinic profile of clients that demand. Recalling that the actual attendance of screening is already a form of interventional care, because it provides patient care from first contact. This was a documentary research, which had collected their data sheets of the CPPA trials conducted in 2011. 394 screenings were performed. We present the distribution of the demand for sex, age and complaint that motivated the search for care. It can be concluded that the characterization allows a customer routing more efficient services offered at the institution, as it contributes to a better understanding delineated in each case and a reduced number of dropouts in the screening process.

Aplicações médicas das abordagens complexas não lineares: a geometria fractal do EEG

Pós-graduação em Saúde Coletiva - FMB

Carcinoma de células escamosas de grandes proporções

The oral and oropharyngeal cancer is aggressive and, in Brazil, the incidence is considered one of the world’s tallest, the most common of head and neck. It affects males more intensively and 70% of cases are in adults over 50 years of age. It is located usually on the floor of the mouth and tongue. Therefore, the purpose of this study is to report a case of male patient, 78 years of age, leukoderma who sought hospital care. Reported frequent smoking and alcoholism. On physical examination headgear, there was the presence of lymph node fixed, painless 1.5 to 2 cm in diameter in the submandibular region. Physical examination intraoral ulcer was found at about 5 cm at its greatest extent, localized to the left oral floor region of the oropharynx, reddish, hardened edges, surface and bottom corrugated carton. The differential diagnosis suggested was traumatic ulcer, paracoccidioidomycosis and squamous cell carcinoma. The approach employed was obtained by incisional biopsy and the piece sent to histopathological analysis, confirming the case of squamous cell carcinoma. The treatment consisted in clarifying the patient about the disease and the need to search for an oncology center. It is concluded that the oral clinical examination is accurate in all major injuries to mouth, even if the chief complaint does not focus on this. In individuals at high risk examination should be systematic and individuals with suspicious lesions should be referred to specialist consultation.

Saúde do trabalhador na odontologia: o cirurgião-dentista em foco

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Emprego de ma teriais rest auradores adesivos direto no ângulo incisal de incisivos centrais fra turados

A case report of a patient who presents as chief complaint presence of stained restorations in the anterior teeth. After analysis and discussion of the clinical therapeutic approaches to be adopted, it was observed the presence of type class IV restorations on teeth 11 and 21, due to an oblique coronal fracture in the past. But the patient was not satisfied with the aesthetic result, then where was planned the realization of the removal of the restorations, for subsequently be used direct restorative materials for the correction of form, function and esthetics. The final result showed that the restorations were able to return the form, function and aesthetic dental, thereby evidencing the proven development of restorative dentistry in the solution of aesthetic problems.

Emprego de técnica cirúrgica e materiais adesivos diretos no fechamento de diastema

The following is a clinical case report of a patient whose main complaint was the presence of a generalized spacing in the anterior maxillary segment. After meticulous clinical analysis and discussions of the clinical procedures to be adopted, a labial frenectomy was our first choice, so that we could reduce the diastemas directly using composite resin. It was observed that the association of clinical and restorative procedures was capable of giving back shape, function and dental aesthetics, allowing to the young patient the satisfaction of smiling without any fear.

Considerações atuais da sialolitíase de ducto de glândula submandibular

The sialolithiasis is characterized by the formation of calcified structure called sialolith within the salivary ductal system. Although its etiology is unknown, it is believed that is from the deposition of calcium salts around an accumulation of organic leftovers in the lumen of the duct or be resulted by chronic sialadenitis and partial obstruction. In this study, the authors describe a case of a male patient, 46 years old, brown, who presented the complaint “pain under the tongue.” The presence of a hardened nodule located in the left sublingual fold was observed through intra-oral exam. Current considerations about treatment, clinical and radiographic characteristics were addressed in this work.

Resolution of tremor fluoxetine-induced in an elderly patient

Aim: To report a possible case of tremor fluoxetine-induced treated as Parkinson’s disease in an elderly female patient noncompliant with the pharmacotherapy, with uncontrolled hypertension and using fluoxetine to treat depression. Presentation of Case: Patient complained of sleepiness in the morning, agitation, anxiety, insomnia and mental confusion. Her greatest concern was about bilateral hand tremors which, in her view became, worse after biperiden was prescribed. Therefore, she stopped taking it. The initial medication was: omeprazole, losartan, biperiden, fluoxetine, atenolol + chlorthalidone, acetylsalicylic acid, atorvastatin and diazepam. Pharmacotherapeutic follow up was performed in order to check the necessity, safety and effectiveness of treatment. Discussion: During the analysis of pharmacotherapy, the patient showed uncontrolled blood pressure and had difficulty complying with the treatment. Thus, in view of the complaints expressed by the patient, our first hypothesis was a possible serotonin syndrome related to fluoxetine use. We proposed a change in the fluoxetine regime and discontinuation of biperiden. As tremors persisted, we suggested the replacement of fluoxetine by sertraline, since a possible tremor fluoxetine-induced could explain the complaint. This approach solved the drug-related problem identified. Conclusion: Tremors reported by the patient was identified as an iatrogenic event related to fluoxetine, which was solved by management of serotonin-reuptake inhibitors.

Characterization of the patellofemoral pain syndrome by frequency parameters of EMG signal

Patellofemoral pain syndrome (PFPS) is the most frequent complaint in orthopedic clinics; although, its etiology remains unclear [Bolgla, 2010; Felicio, 2011]. Trying to understand its causes has been used time analysis of electromyography (EMG), but this method shows controversies. The aim of this study was to apply a method of processing the EMG signal in the frequency domain of the vastus lateralis (VL) and vastus medialis (VM) muscles for the characterization of PFPS.