Seguimento nutricional de pacientes após episódios de lesão renal aguda e identificação de fatores de riscos nuricionais para o óbito tardio

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Tumor odontogênico queratocístico: relato de caso

Introduction: The odontogenic keratocyst tumor (OKT) derived from dental lamina rests with particularities and specific histological features, with high rates of relapse and aggressive clinical behavior. Presents certain predilection for males, affecting the mandible of 60% to 80% of cases may be related to impacted tooth 25 to 45% of cases. Objective: To highlight the clinical, histopathological and imaging procedures of the OKT, as well as discuss the treatment of this injury. Case Report: To report a case of 10 years of age to look for the orthodontist to correct anterior open bite was observed in panoramic radiography radiolucent area in the region of the body of the mandible associated with pathological inclusion of the lower premolar. It was performed an incisional biopsy of the lesion and the histopathologic diagnosis was odontogenic keratocyst tumor. It was performed a CT scan to assess the extent of the injury and its relation to anatomic structures. How to conduct, we opted for the extraction of the deciduous molar and enucleation of the lesion, preserving the premolar included. The same goes on clinical and radiographic control 18 months, after removal of OKT obtaining the eruption of premolar that was involved in the injury. Final Comments: It is necessary to adopt protocols that include dental care knowledge of oral diagnosis, medical history and careful clinical evaluation without forgetting the need for histopathological confirmation.

Enxerto de tecido conjuntivo para correção da margem peri-implantar

Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. The results of coverage in peri-implant sites, in comparison with soft tissue coverage around a tooth, is less predictable. This clinical report describes the correction of an esthetic problem with a single-tooth implant-supported using a subepithelial connective tissue graft (SCTG) combined with the re-establishment of a new limit of gingival margin, and emergence crown profile. After anamnese and clinical exam it was observed an implant in the region of tooth 22 in vestibular position to alveolar ridge with a recession of 5 mm in its vestibular face. In the first cirurgical procedure the crown and the abutment were removed and a SCTG associated with a coronally positioned flap was performed in order to re-establish the limit of gingival margin. After 90 days, it was observed that the tissue in the implant site showed no adequate volume or thickness. Because of that, another SCTG was performed. The reopening procedure to install the healing cap was performed after 4 weeks. Then the prosthesis was installed. At 180 and 360 days postoperative, the implant adjacent tissue presented regular contour, color compatible with health and absence of bleeding. The patient was satisfied with the esthetic result. According to the clinical results and favorable esthetics it was possible to conclude that the use of ETC to correct an esthetic deficiency may be a feasible approach to establish new and stable peri-implant soft tissue contours.

Halitose na geriatria: diagnóstico, causas e prevalência

Halitosis is the unpleasant odor of exhaust air through the mouth and lungs. There are over 50 causes, and approximately 90% of cases, is of oral origin. May have physiological origin (stress, breath of morning, fasting, and inappropriate diets), local reasons (bad oral hygiene, bacterial plaque retained on the tongue and/or tonsils, lower production of saliva, gum disease) or systemic reasons (diabetes, kidney or liver problems, constipation, etc.). In the Third Age, this problem tends to increase significantly. Thus, the aim of this study was to detect the presence of halitosis in the geriatric group attended in the dental clinic of UNIRP, identifying their incidence and principal causes. The sample consisted of 48 volunteer patients aged 60 years or older and included more than 90% of patients treated in this age group. It was performed a anamnesis and physical examination. The intra-oral halitosis was detected using a breath meter (halimeter). In the group studied, approximately 54.16% had halitosis, 84.61% of these were users of the prosthesis. The tongue coating was present in 80.76% of individuals with halitosis. After brushing the tongue, 88.46% of patients with halitosis have had the initial index oral malodor decreased. Based on the results of this study it was concluded that factors as dental prostheses and tongue coating are critical factors in causing halitosis.

Odontoma em pacientes odontopediátrico: diagnóstico e tratamento. Relato de caso clínico.

Odontoma is a term that refers to a benign tumor of odontogenic and mixed nature, composed of epithelial and mesenchymal components. Histologically, they are compounds of different configurations including dental enamel, dentin, cementum and in some cases the pulp tissue. A slow growing asymptomatic tumor, odontoma is usually discovered through routine radiographic examination. A 3-year old male patient sought care at the School of Dentistry’s Baby Clinic (UNESP-Araçatuba), complaining of “small ball close to the teeth.” During the interview, the mother reported that the lesion was observed soon after a trauma, and evolved in less than one month. An ulcerated lesion with a 0.8 cm diameter was found during intraoral clinical examination. It was located in the inferior and anterior region of the mouth, between teeth 81 and 82, and there was also crown distalization. A radiographic examination showed a radiolucent area and root distance. In the absence of clinical and radiographic characteristics suggesting a case of odontoma, the differential diagnosis was peripheral giant cell lesion and pyogenic granuloma. So the area was punctured. Nonetheless, due to the absence of liquid, the surgical removal of the lesion was performed, followed by histological examination, which showed the definite diagnosis of a suggestive case of emerging odontoma.

Tratamento tardio de traumatismo dentário anterior pela técnica de apicificação

Introdução: paciente do sexo masculino, 37 anos de idade. Após a anamnese, foi constatado que o dente 11 apresentava abertura coronária e presença de hidróxido de cálcio com histórico de trauma dentário nesse dente. Radiograficamente, o dente 11 apresentava formação radicular incompleta, paredes dentinárias finas e frágeis, com divergência foraminal associada a imagem radiolúcida periapical. Objetivo: relatar um caso clínico de apicificação, realizado com trocas de curativo de hidróxido de cálcio. Métodos: o tratamento de escolha foi a apicificação, a qual teve início na segunda sessão, após 15 dias, por meio de desbridamento químico-mecânico de todo o canal radicular, com limas tipo K e irrigação com uma solução de hipoclorito de sódio a 2,5%. Em seguida, pasta de hidróxido de cálcio (hidróxido de cálcio, iodofórmio e propilenoglicol) foi aplicada e trocada de 15 em 15 dias, durante 4 meses. O exame radiográfico foi novamente realizado e demonstrou o fechamento completo da abertura foraminal e regressão da radiolucência periapical. O canal radicular foi obturado utilizando-se um cone confeccionado a partir da união de três cones #60 e pela técnica de condensação lateral com Sealapex. Resultados: seis meses após a obturação, exames revelaram tecidos periapicais normais e ausência de sintomas. Conclusão: concluiu-se que o tratamento do traumatismo dentário associado à necrose do tecido pulpar e à lesão periapical, com trocas sucessivas de pasta de hidróxido de cálcio, foi adequado para se obter a regressão da lesão periapical, formação de barreira mineralizada e promoção de saúde ao paciente.

Diastemas: reestablishment of an attractive smile

A healthy and attractive smile is very valued in today s society. Yet this requires better aesthetic and cosmetic solutions from dental surgeons.The present paper presents a case report of diastema closure using an association of tooth movement induced by orthodontic elastics,dental cosmetics and resin-bonded prosthesis. The female patient L.B.A.J., aged 19 years, visited the Integrated Clinic of Araçatuba DentalSchool UNESP mainly complaining of missing teeth and poor esthetics. After anamnesis, clinical and radiographic examination revealedhypodontia of the maxillary right and left first premolars, abnormal maxillary right lateral incisor shape and diastema between the maxillaryright lateral incisor and canine and between the maxillary left lateral incisor and canine. Planning was done which included indication ofdiastema closure with composite resin restoration and metal-free resin-bonded prosthesis, with a structure made of Vectris (Ivoclar VivadentInc., Amherst, NT, USA). The option for dental cosmetics associated with resin-bonded prosthesis after movement with orthodontic elasticsresulted in an excellent aesthetic outcome of low cost and short treatment duration.Indexing terms: composite resins; diastema; fixed resin bonded partial denture.

Lichenoid reaction: case report

Lichenoid lesions are mucocutaneous disease of chronic inflammatory origin. Can produce side effects to drugs, dental materials, affecting 0.5 to 1% of the world population mainly in women in the fourth decade of life. The history and meticulous clinical servation may clarify the reactive nature, but the clinical diagnosis will only be conclusive when associated with tests such as histopathology. Therefore the objective of the study is to report a case of a woman of 55 years old, complaining of "white spots sore". Reported being allergic to metals, chocolate, acidic foods and certain types of clothes. From accurate intraoral clinical examination, white plaques were found in the dorsum of the tongue, hard palate and buccal mucosa, inaccurate and rough limits, and ulcerations throughout the labial edge and upper palate. Histopathology revealed a lichenoid reaction. Was instituted as pharmacological treatment, the use of systemic corticosteroids. Clinical follow-up of one year showed reduction of clinical symptoms, allowing to conclude that the clinical follow-up of this disease is necessary since its dubious malignant potential and diagnostic difficulty. Thus, early recognition of this disease allows instituting appropriate treatment with relief of anxiety of the patient and their family.

Condições de saúde de pacientes do gênero feminino com dependência química

This study evaluated the general and oral health conditions of female patients included in a program for recovering drug addiction and patients who did not use drugs. By means of anamnesis and medical history, as well as medical and dental assessments, the health conditions of 160 patients were assessed; 80 presented drug dependence and 80 do not use drugs. The most frequently used drugs were tobacco, alcohol, and crack, usually in associations. The patients presenting chemical dependence had increased frequency of behavioral changes, as well as several diseases involving the immune and cardiovascular systems, detaching infectious and inflammatory reactions and delay in the process of tissue repair. In the oral cavity, it was verified a high occurrence of periodontitis and gingivitis. Chemical dependence showed to be associated to a high frequency of infections, arthritis, hypertension and behavioral changes, which normally would not be noted by health professionals, but that could compromise the results of medical and dental treatments.

Estresse e zumbido: o relaxamento como uma possibilidade de intervenção

The aim of this study was verify the stress on people with tinnitus and the effect of progressive relaxation to modify the perception of tinnitus and reduce the stress. The stress was tested in 50 patients and the intervention was done with 12 people in the sample. In this interview was used the history, symptom inventory stress and progressive relaxation. The results demonstrate that the tinnitus affects the patient’s life in physical and emotional aspects. The intervention with the progressive relaxation showed satisfactory answers such as modification in the perception of tinnitus and stress symptoms. The psychological intervention contributed with how the patients will deal with tinnitus, leading them to learning strategies and coping with the stress and the symptoms.

Avaliação do desempenho escolar de crianças contaminadas por chumbo

The lead contamination in children has been the subject of research in the field of public health. This study evaluated the academic performance of 102 children from first to fourth grade. The subjects were divided into two groups. The first group was composed of 34 children without lead poisoning or with poison at levels lower than 5 µg/dl. The second group was composed of 68 children with blood lead levels between 10 and 40 µg/ dl. The instruments used to evaluate the academic performance were anamnesis and a scholarly performance test called Teste de Desempenho Escolar, TDE. The results indicated better academic performances from the second group with significant differences in arithmetic, reading and general scores. In a comparison between genders, the girls had better performances than the boys. These results were consistent with the parents’ perception in anamnesis. Although other variables were present, the data showed great academic damage for children with higher leadpoison. These outcomes require political policies to control contamination and intervention in this population.

Avaliação radiográfica do sucesso e da qualidade do tratamento endodôntico em uma população brasileira

Objetivo: esta investigação tem como objetivo avaliar a prevalência de periodontite apical detectada na radiografia periapical e a relação entre a doença e a qualidade da obturação de canais radiculares realizada por estudantes de graduação. Métodos: foi investigada uma amostra aleatória de 131 prontuários de pacientes que haviam recebido tratamento do canal radicular na Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista. Realizou-se anamnese, radiografias e exame clínico quanto à sintomatologia dolorosa, presença e qualidade da restauração, bolsa periodontal, mobilidade dentária e trauma oclusal. Resultados: a porcentagem de sucesso obtido com o tratamento realizado pelos estudantes de graduação foi de 87,7%. Quando o tratamento foi adequado (43 casos), o percentual de sucesso foi de 90,69% (39 casos), enquanto para os tratamentos inadequados (14 casos), o percentual de sucesso foi de 78,57% (11 casos), sem diferença estatisticamente significativa (p>0,05). Não foi observada diferença estatisticamente significativa na taxa de sucesso relacionada ao sexo (p>0,05). A condição pulpar também não interferiu na taxa de sucesso (p>0,05). Conclusão: concluiu-se que o tratamento endodôntico foi satisfatório e alcançou uma taxa de sucesso adequada, em torno de 90% dos casos.

Efeito do tabagismo, atividade física e obesidade sobre os valores de proteína C reativa em adultos jovens de ambos os sexos: coorte de 12 meses

Pós-graduação em Fisioterapia - FCT

Avaliação da ingestão protéica e do balanço e do balanço nitrogenado em universitários praticantes de musculação

The alimentation of fitness people is fundamental by health. This study it has for objective to evaluate of quali-quantitative form the proteic-caloric ingestion, the nitrogen balance and its relation caloric ingestion/estimated metabolic rate, in colleges student practicing of body-building. Eleven body-builders student (18 until 30 years old), both sex, had been analyzed. The attainment of data used an alimentary register, and the gotten information were analyzed together with the nitrogen balance from 24 hours of piss collection. We observed that the nitrogen balance of individuals that make use of some protein supplement is significantly bigger than individuals that do not consume no type of it. This because, the percentile caloric obtained from protein ingestion is significantly raised, and this associate to the caloric ingestion in this group also is raised, determines the obtained results.

O brincar para conhecer o desenvolvimento de crianças com implante coclear

This research analyses the development of children presented with profound deafness and benefited by the cochlear implant, discovery of great significance in hearing health. The work is based, theoretically, on Winnicott, and methodologically, in anamnesis data and playing on a set of ludic scenes, systematically organized. Ten pre-school children with implants, selected by hospital and homogenization eligibility criteria participate in this study encompassing interviews with parents and playful observation sessions with the children, besides Lynn´s Dolls Structured Game. In the children, the results show immaturity, regression to earlier stages of their development, dependency and behavioral disorders, in particular, those related to language, interrelationship and anxiety. In the parents, family disorientation, partly overcome. The children and family participating are assisted by a multidisciplinary health team, at the hospital where they are attended.