Failures in the rehabilitation treatment with removable partial dentures

Background. Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. Methods and results. For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. Conclusions. This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas

The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.

Nanotechnology-based drug delivery systems for treatment of oral cancer: a review

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

Desenvolvimento da microbiota oral de bebês: análise longitudinal por pirosequenciamento da microbiota de bebês e suas mães dentro de um Programa de Saúde Bucal para Primeira Infância

Pós-graduação em Biopatologia Bucal - ICT

Alternativa de tratamento simplificado e integrado da retenção intraóssea de incisivo central superior, associada a odontoma: relato de caso

Permanent teeth impaction is highly prevalent among brazilian people. Its etiology is related to local and general factors association. Permanent teeth retention compromises dental occlusion and when anterior teeth are involved, it also brings esthetics impairments which lead to psychological disturbance. Early diagnosis and adequate treatment are extremely important to solve not only occlusal problems but also psychological aspects. Orthodontic traction of impacted teeth can be conducted by using fixed or removable appliances. Although it depends on patient compliance the use of removable appliances provides an anchorage based on the teeth and the palate reducing undesirable side effects. This paper describes the case of a fourteen years old female patient whose right maxillary central incisor was adequately tractioned with a removable orthodontic appliance. Removable orthodontic devices were used at first to reposition teeth in maxillary anterior area what provided adequate space to allow the placement of the impacted incisor and after were also used to traction and position this tooth. The procedure described seemed to be effective, non expensive and a viable treatment to be performed even on the scope of public health services, extending orthodontic treatment to a higher number of patients.

Próteses parciais removíveis associadas a encaixes: implicações clínicas e laboratoriais

Nowadays, the fixed partial dentures and/or dental implants is the most requested treatmentby the majority of partially edentulous patients. However, depending on the periodontal condition of the remaining teeth, as well as the bone condition of the prosthetic space, the oral rehabilitation with these treatments may be limited or even contraindicated. In such cases, the use of removable partial dentures associated to attachments becomes an important alternative for aesthetic and functional rehabilitation. Attachments are mechanical devices consisted of two parts (patrix-matrix), one placed inside another, which act as direct retainer, providing retention, support and stability to the dentures. These devices can be classified as intra or extracoronal attachments, considering their position in relation to the abutment tooth. However, regardless the type of attachment, the association between fixed and removable partial dentures should be performed respecting the biomechanical principles of both. Therefore, the purpose of this study was to review and discuss the literature about the clinical and laboratory implications of the association between fixed and removable partial dentures by means of attachments.

Emotional assessment of patients with oral lichen planus

Background Oral lichen planus is a chronic immune-mediated disease with an estimated prevalence of 0.5-2.5% in the general population. Patients with oral lichen planus are often emotionally unstable and anxious and may develop concomitant systemic disorders. The objective of this study was to evaluate emotional characteristics of patients with oral lichen planus.Methods Two groups were studied: the first group consisted of 48 patients with a diagnosis of oral lichen planus, and the second group consisted of controls without the disease matched for age and gender at a proportion of 1 : 1. The emotional state of the patients was evaluated using the State-Trait Anxiety Inventory, SF-36 generic quality of life questionnaire, and the Self Reporting Questionnaire-20.Results and conclusions The present investigation demonstrated the presence of anxiety and depression in patients with oral lichen planus and a negative impact of the disorder on the patient's quality of life as indicated by impairment of the physical aspect, vitality, mental health, and social aspect domains. This could indicate that associated psychological treatment may be important in the follow-up of these patients.

Highlights in peptide nanoparticle carriers intended to oral diseases

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

Evaluation of dentists' knowledge of the use of oral exfoliative cytology in clinical practice

Oral exfoliative cytology (EC) is a rapid and practical complementary test that can be used in the diagnosis of various diseases. The objectives of this study were to assess dentists'knowledge of EC and to disseminate information on the technique. The study included 240 dentists from the city of Anapolis (Goias, Brazil) who answered a questionnaire regarding demographic data and data relating to EC and who then received information on the technique. The data revealed that 26.92% of the dentists did not know about EC. Among those who reported knowledge of EC, 33.91% did not know the procedures for performing the technique, and 85.38% had no experience with EC. In addition, 54.09% of the answers regarding the instrument used to collect the material and 56.82% of the answers concerning suitable fixatives were inappropriate. Although 73.02% of the dentists adequately identified the pathologies for which EC is recommended, it was concluded that the respondents had poor knowledge of EC. There is a need to increase dentists'awareness of this subject and of EC's use in diagnostic practices.

Gingival squamous cell carcinoma: a case report

Squamous cell carcinoma is a malignant epithelial neoplasm characterized by variable clinical manifestations. When located in the gingiva, this neoplasm may mimic common inflammatory lesions. The aim of this study was to report a case of atypical squamous cell carcinoma, in which the patient had no risk factors for the development of this neoplasm. A 61 year old Caucasian female was seen with a 3 month history of a rapidly growing, painful nodule in the gingiva adjacent to tooth #11. Clinical examination revealed a proliferative lesion in the vestibular marginal gingiva of teeth #11 and #12, presenting with purulent exudation. Thus, in view of the clinical symptoms and differential diagnosis of an infectious granulomatous process and malignant neoplasm, an incisional biopsy was obtained from the lesion. The diagnosis of squamous cell carcinoma was made and fourteen days after incisional biopsy, healing was found to be unsatisfactory. The patient was referred for treatment consisting of surgical excision of the tumour. A removable partial denture was fabricated for rehabilitation, one month after surgery of the maxilla; the patient was submitted to dissection of the regional lymph nodes and radiotherapy for an additional 3 months. Three years after the end of treatment, the patient continues to be followed-up and does not show any sign of recurrence. Gingival squamous cell carcinoma is a condition which chance of cure is higher when carcinomatous lesions are diagnosed and treated early. In this instance dentists play an important role in early detection of gingival squamous cell carcinoma.

Patients from the Oral Oncology Center, UNESP, Araçatuba with an indication for prosthesis

Head and neck tumors are a major health concern worldwide, due to their high incidence and mortality rates, particularly in developing countries. In Brazil, this type of cancer is commonly diagnosed and studies suggested that it may be the leading cause of mortality in the country. The increase in life expectancy worldwide, as well as environmental and behavioral factors, are related to carcinogenesis. Therefore, an understanding of basic epidemiology and statistical methods is critical, in order to promote early diagnosis and cancer prevention. Cancer patients with an indication for prosthesis were selected from the medical records of the Oral Oncology Center, School of Dentistry, São Paulo State University (UNESP), Araçatuba, between 1991 and 2010. The following variables were recorded: gender, age, type and location of the lesion, radiation dose and dental prosthesis. The majority of the patients were male (74.15%) and >60 years of age (53.37%). Tumors were most commonly located in the floor of the mouth (11.1%) and squamous cell carcinoma was the most prevalent type (72.8%). This study provides the profiles of patients who attended the Oral Oncology Center and the results may aid in the creation of cancer prevention programs.

Prosthetic rehabilitation of a patient after a partial mandibulectomy

The treatment of orofacial tumors may cause facial deformities by losses of structures that affect basic functions, i.e. feeding, speech, and the reduction of patient self-steam. A white male patient was diagnosed with epidermoid cancer on the mandibular alveolar ridge with infiltration staging IV A. The patient was submitted to a mandibulectomy associated with a complete extraction of mandibular teeth. For rehabilitation, a conventional denture for the mandibular arch and a removable partial denture for the maxillary arch were fabricated. A correct occlusal adjustment and a satisfactory amount of alveolar bone was favorable for conventional dentures of the prostheses bases improve their retention and stability. After one year of follow-up, the patient was adapted to the prostheses, satisfied with their retention, and reported an improvement on his feeding. The prosthetic rehabilitation of patients after a partial mandibulectomy is essential for their self-steam. Conventional dentures may have their retention and stability improved if they are well fabricated, recorded and have a balanced occlusion. A correct occlusal adjustment and an adequate retention of the prostheses bases may improve their retention and stability. Patients without xerostomy and with a satisfactory amount of alveolar bone may have a favorable prognosis for conventional dentures.

Oral syphilis: report of three cases and characterization of the inflammatory cells

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.