Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Obtenção de triacetato de celulose a partir do bagaço de cana-deaçúcar para revestimento de micropartículas de goma gelana e avaliação do seu perfil de liberação in vitro e da mucoadesão ex vivo

Oral route of administration is considered to be the most comfortable, safe and greater adaptation for patients. But, oral route presents some disadvantages such as drugs bioavailability and side effects on the stomach. Some technologies are studied to soften and/or resolve these problems, such as coating with polymeric films, which are able to protect the pharmaceutical form of the acid stomachic environment and to act in the drug release, and mucoadhesive systems, which allow the pharmaceutical form remains a greater time interval in the intestine, increasing the effectiveness of the drug. Cellulose triacetate (CTA) films were produced from cellulose extracted from sugar cane bagasse. The films were prepared with different morphologies (with and without water, acting as non-solvent) and concentrations (3, 6.5 and 10%) of CTA and characterized using scanning electron microscopy (SEM), water vapor permeability (WVP), puncture resistance (PR), enzymatic digestion (DE), and mucoadhesive force evaluation (MF). Microscopy showed the formation of symmetric and asymmetric morphologies. WVP data showed that more concentrated films have higher values for WVP; moreover, asymmetric films had higher values than symmetric films. PR measurements showed that symmetric membranes are more resistant than asymmetric ones. More concentrated films were also more puncture resistant, except for symmetric membranes with CTA concentrations of 6.5 and 10% that did not show significant differences. All of the films presented large mucoadhesive capacities independent of their morphology and CTA concentration. From the results of WVP and RP, a symmetric filme with 6.5% CTA showed better ability and mechanical resistance, therefore, was selected to serve as coating of gellan gum (GG) particles incorporating ketoprofen (KET), which was confirmed by SEM. The selected film presented low values in measurements of the swelling index (SI) and in a dissolution test (DT). TGA analysis showed that the CTA coating does not influence the thermal stability of the particles and there is no incompatibility evidence between CTA, GG and KET. Coated particles released 100% of the ketoprofen in 24 h, while uncoated particles released the same amount in 4 h. The results of this study highlight the potential of CTA in the development of new controlled oral delivery systems.

Premotor Mechanisms for Orofacial Coordination

The mouth, throat, and face contain numerous muscles that participate in a large variety of orofacial behaviors. The jaw and tongue can move independently, and thus require a high degree of coordination among the muscles that move them to prevent self-injury. However, different orofacial behaviors require distinct patterns of coordination between these muscles. The method through which motor control circuitry might coordinate this activity has yet to be determined. Electrophysiological, immunohistochemical, and retrograde tracing studies have attempted to identify populations of premotor neurons which directly send information to orofacial motoneurons in an effort to identify sources of coordination. Yet these studies have not provided a complete picture of the population of neurons which monosynaptically connect to jaw and tongue motoneurons. Additionally, while many of these studies have suggested that premotor neurons projecting to multiple motor pools may play a role in coordination of orofacial muscles, no clear functional roles for these neurons in the coordination of natural orofacial movements has been identified.

In this dissertation, I took advantage of the recently developed monosynaptic rabies virus to trace the premotor circuits for the jaw-closing masseter muscle and tongue-protruding genioglossus muscle in the neonatal mouse, uncovering novel premotor inputs in the brainstem. Furthermore, these studies identified a set of neurons which form boutons onto motor neurons in multiple motor pools, providing a premotor substrate for orofacial coordination. I then combined a retrogradely traveling lentivirus with a split-intein mediated split-Cre recombinase system to isolate and manipulate a population of neurons which project to both left and right jaw-closing motor nuclei. I found that these bilaterally projecting neurons also innervate multiple other orofacial motor nuclei, premotor regions, and midbrain regions implicated in motor control. I anatomically and physiologically characterized these neurons and used optogenetic and chemicogenetic approaches to assess their role in natural jaw-closing behavior, specifically with reference to bilateral masseter muscle electromyogram (EMG) activity. These studies identified a population of bilaterally projecting neurons in the supratrigeminal nucleus as essential for maintenance of an appropriate level of masseter activation during natural chewing behavior in the freely moving mouse. Moreover, these studies uncovered two distinct roles of supratrigeminal bilaterally projecting neurons in bilaterally synchronized activation of masseter muscles, and active balancing of bilateral masseter muscle tone against an excitatory input. Together, these studies identify neurons which project to multiple motor nuclei as a mechanism by which the brain coordinates orofacial muscles during natural behavior.

Functional application of lactic acid bacteria exopolysaccharide in complex food systems

Lactic acid bacteria expolysaccharides (LAB-EPS), in particular those formed from sucrose have the potential to improve food and beverage rheology and enhance their sensory properties potentially replacing or reducing expensive hydrocolloids currently used as improvers in food and beverage industries. Addition of sucrose not only enables EPS formation but also affects organic acid formation, thus influencing the sensory properties of the resulting food/beverage products. The first part of the study the organoleptic modulation of barley malt derived wort fermented using in situ produced bacterial polysaccharides has been investigated. Weisella cibaria MG1 was capable to produce exopolysaccharides during sucrosesupplemented barley malt derived wort fermentation. Even though the strain dominated the (sucrose-supplemented) wort fermentation, it was found to produce EPS (14.4 g l-1) with lower efficiency than in SucMRS (34.6 g l-1). Higher maltose concentration in wort led to the increased formation of oligosaccharide (OS) at the expense of EPS. Additionally, small amounts of organic acids were formed and ethanol remained below 0.5% (v/v). W. cibaria MG1 fermented worts supplemented with 5 or 10% sucrose displayed a shear-thinning behaviour indicating the formation of polymers. This report showed how novel and nutritious LAB fermented wort-base beverage with prospects for further advancements can be formulated using tailored microbial cultures. In the next step, the impact of exopolysaccharide-producing Weissella cibaria MG1 on the ability to improve rheological properties of fermented plant-based milk substitute plant based soy and quinoa grain was evaluated. W. cibaria MG1 grew well in soy milk, exceeding a cell count of log 8 cfu/g within 6 h of fermentation. The presence of W. cibaria MG1 led to a decrease in gelation and fermentation time. EPS isolated from soy yoghurts supplemented with sucrose were higher in molecular weight (1.1 x 108 g/mol vs 6.6 x 107 g/mol), and resulted in reduced gel stiffness (190 ± 2.89 Pa vs 244 ± 15.9 Pa). Soy yoghurts showed typical biopolymer gels structure and the network structure changed to larger pores and less cross-linking in the presence of sucrose and increasing molecular weight of the EPS. In situ investigation of Weissella cibaria MG1 producing EPS on quinoa-based milk was performed. The production of quinoa milk, starting from wholemeal quinoa flour, was optimised to maximise EPS production. On doing that, enzymatic destructuration of protein and carbohydrate components of quinoa milk was successfully achieved applying alpha-amylase and proteases treatments. Fermented wholemeal quinoa milk using Weissella cibaria MG1 showed high viable cell counts (>109 cfu/mL), a pH of 5.16, and significantly higher water holding capacity (WHC, 100 %), viscosity (> 0. 5 Pa s) and exopolysaccharide (EPS) amount (40 mg/L) than the chemically acidified control. High EPS (dextran) concentration in quinoa milk caused earlier aggregation because more EPS occupy more space, and the chenopodin were forced to interact with each other. Direct observation of microstructure in fermented quinoa milk indicated that the network structures of EPS-protein could improve the texture of fermented quinoa milk. Overall, Weissella cibaria MG1 showed favorable technology properties and great potential for further possible application in the development of high viscosity fermented quinoa milk. The last part of the study investigate the ex-situ LAB-EPS (dextran) application compared to other hydrocolloids as a novel food ingredient to compensate for low protein in biscuit and wholemeal wheat flour. Three hydrocolloids, xanthan gum, dextran and hydroxypropyl methylcellulose, were incorporated into bread recipes based on high-protein flours, low-protein flours and coarse wholemeal flour. Hydrocolloid levels of 0–5 % (flour basis) were used in bread recipes to test the water absorption. The quality parameters of dough (farinograph, extensograph, rheofermentometre) and bread (specific volume, crumb structure and staling profile) were determined. Results showed that xanthan had negative impact on the dough and bread quality characteristics. HPMC and dextran generally improved dough and bread quality and showed dosage dependence. Volume of low-protein flour breads were significantly improved by incorporation of 0.5 % of the latter two hydrocolloids. However, dextran outperformed HPMC regarding initial bread hardness and staling shelf life regardless the flour applied in the formulation.

Particle flux characterisation and sedimentation patterns of protistan plankton during the iron fertilisation experiment LOHAFEX in the Southern Ocean

The taxonomic composition and types of particles comprising the downward particle flux were examined during the mesoscale artificial iron fertilisation experiment LOHAFEX. The experiment was conducted in low-silicate waters of the Atlantic Sector of the Southern Ocean during austral summer (January-March 2009), and induced a bloom dominated by small flagellates. Downward particle flux was low throughout the experiment, and not enhanced by addition of iron; neutrally buoyant sediment traps contained mostly faecal pellets and faecal material apparently reprocessed by mesozooplankton. TEP fluxes were low, <5 mg GX eq/m**2/day, and a few phytodetrital aggregates were found in the sediment traps. Only a few per cent of the POC flux was found in the traps consisting of intact protist plankton, although remains of taxa with hard body parts (diatoms, tintinnids, thecate dinoflagellates and foraminifera) were numerous, far more so than intact specimens of these taxa. Nevertheless, many small flagellates and coccoid cells, belonging to the pico- and nanoplankton, were found in the traps, and these small, soft-bodied cells probably contributed the majority of downward POC flux via mesozooplankton grazing and faecal pellet export. TEP likely played an important role by aggregating these small cells, and making them more readily available to mesozooplankton grazers.

Effect of enhanced pCO2 levels on the production of dissolved organic carbon and transparent exopolymer particles in short-term bioassay experiments

It has been proposed that increasing levels of pCO2 in the surface ocean will lead to more partitioning of the organic carbon fixed by marine primary production into the dissolved rather than the particulate fraction. This process may result in enhanced accumulation of dissolved organic carbon (DOC) in the surface ocean and/or concurrent accumulation of transparent exopolymer particles (TEPs), with important implications for the functioning of the marine carbon cycle. We investigated this in shipboard bioassay experiments that considered the effect of four different pCO2 scenarios (ambient, 550, 750 and 1000 µatm) on unamended natural phytoplankton communities from a range of locations in the northwest European shelf seas. The environmental settings, in terms of nutrient availability, phytoplankton community structure and growth conditions, varied considerably between locations. We did not observe any strong or consistent effect of pCO2 on DOC production. There was a significant but highly variable effect of pCO2 on the production of TEPs. In three of the five experiments, variation of TEP production between pCO2 treatments was caused by the effect of pCO2 on phytoplankton growth rather than a direct effect on TEP production. In one of the five experiments, there was evidence of enhanced TEP production at high pCO2 (twice as much production over the 96 h incubation period in the 750 ?atm treatment compared with the ambient treatment) independent of indirect effects, as hypothesised by previous studies. Our results suggest that the environmental setting of experiments (community structure, nutrient availability and occurrence of phytoplankton growth) is a key factor determining the TEP response to pCO2 perturbations.

Experiment: Response of Nodularia spumigena to pCO2

The filamentous and diazotrophic cyanobacterium Nodularia spumigena plays a major role in the productivity of the Baltic Sea as it forms extensive blooms regularly. Under phosphorus limiting conditions Nodularia spumigena has a high enzyme affinity for dissolved organic phosphorus (DOP) by production and release of alkaline phosphatase. Additionally, it is able to degrade proteinaceous compounds by expressing the extracellular enzyme leucine aminopeptidase. As atmospheric CO2 concentrations are increasing, we expect marine phytoplankton to experience changes in several environmental parameters including pH, temperature, and nutrient availability. The aim of this study was to investigate the combined effect of CO2-induced changes in seawater carbonate chemistry and of phosphate deficiency on the exudation of organic matter, and its subsequent recycling by extracellular enzymes in a Nodularia spumigena culture. Batch cultures of Nodularia spumigena were grown for 15 days aerated with three different pCO2 levels corresponding to values from glacial periods to future values projected for the year 2100. Extracellular enzyme activities as well as changes in organic and inorganic compound concentrations were monitored. CO2 treatment-related effects were identified for cyanobacterial growth, which in turn was influencing exudation and recycling of organic matter by extracellular enzymes. Biomass production was increased by 56.5% and 90.7% in the medium and high pCO2 treatment, respectively, compared to the low pCO2 treatment and simultaneously increasing exudation. During the growth phase significantly more mucinous substances accumulated in the high pCO2 treatment reaching 363 µg Gum Xanthan eq /l compared to 269 µg Gum Xanthan eq /l in the low pCO2 treatment. However, cell-specific rates did not change. After phosphate depletion, the acquisition of P from DOP by alkaline phosphatase was significantly enhanced. Alkaline phosphatase activities were increased by factor 1.64 and 2.25, respectively, in the medium and high compared to the low pCO2 treatment. In conclusion, our results suggest that Nodularia spumigena can grow faster under elevated pCO2 by enhancing the recycling of organic matter to acquire nutrients.

Gerodontology teaching amongst European dental schools – A European College of Gerodontology survey.

Introduction: In 2009, the European College of Gerodontology (ECG) published the Gerodontology undergraduate teaching guidelines. Seven years later it conducted a survey to explore the current status of Gerodontology teaching amongst the European dental schools.
Methods: The ECG Education Committee developed an electronic questionnaire that was emailed to the Deans or other contact persons in 185 dental schools in 40 European countries. The questionnaire recorded the prevalence, contents and methodology of Gerodontology education. Two weeks later a reminder was sent to non-respondents.
Results: The first wave of responses included 70 dental schools from 28 European countries. Gerodontology was included in the undergraduate curricula of 77% of the respondents and was compulsory in 61% of them. The course was usually offered in senior students and was interdisciplinary; the educators included dentists, physicians, nurses and other care providers. Lecturing was the most common educational technique (75%), and the most common topics included medical problems in old age, pharmacology and polypharmacy, the association between general and oral health, nutritional and chewing problems, xerostomia and prosthodontic management. Clinical training was usually offered within the dental school clinics (50%) and less often in remote locations (nursing homes, geriatric hospitals, day centers).
Key Conclusions: An increasing number of European dental schools teach Gerodontology at the undergraduate curriculum. The study is still ongoing, but a "worst case scenario" has to be born in mind, where dental schools, who failed to participate in the survey, may not be teaching in Gerodontology.

Seasonal changes in broodstock spawning performance and egg quality in ballan wrasse (Labrus bergylta)

Sea lice continue to be one of the largest issues for the salmon farming industry and the use of ballan wrasse (Labrus bergylta) as a biological control is considered to be one of the most sustainable solutions in development. Broodstock management has proved challenging in the initial phases due to the significant lack of understanding of basic reproductive physiology and behaviour in the species. The aim of the study was to monitor captive breeding populations throughout a spawning season to examine timing and duration of spawning,quantify egg production, and look at seasonal changes in egg quality parameters as well as investigate the parental contribution to spawning events. A clear spawning rhythm was shown with 3-5 spawning periods inclusive of spawning windows lasting 1-9 days followed by inter spawning intervals of 8-12 days. Fertilization rate remained consistently high (> 87.5%) over the spawning season and did not differ significantly between spawning populations. Hatch rate was variable (0-97.5 %), but peaked in the middle of the spawning season. Meanoocyte diameter and gum layer thickness decreased slightly over the spawning season with no significant differences between spawning populations. Fatty acid (FA) profile of eggs remained consistent throughout the season and with the exception of high levels of ARA (3.8 ± 0.5 % of total FA) the FA profile was similar to that observed in other marine fish species. Parental contribution analysis showed 3 out of 6 spawning events to be single paired mating while the remaining 3 had contributions from multiple parents. Furthermore, the proposed multiple batch spawning nature of this species was confirmed with proof of a single femalecontributing to two separate spawning events. Overall this work represents the first comprehensive data set of spawning activity of captive ballan wrasse, and as such and will be helpful in formulating sustainable broodstock management plans for the species.

Evaluation of Select Food Additive Exposures in Children with Crohn's Disease

Thesis (Master's)--University of Washington, 2016-09

Preparos dentários de dentes pilares em prótese parcial removível

A perda de dentes além de afectar a mastigação e a estética, altera também o equilíbrio do sistema estomatognático, observando-se de imediato alterações na posição dos dentes adjacentes e dos dentes oponentes. Torna-se, portanto, imprescindível para a reposição da saúde oral do paciente a reabilitação com recurso a próteses fixas ou removíveis. No que diz respeito às próteses parciais removíveis (PPR´s) estas visam a substituição dos dentes perdidos, sendo facilmente removidas e inseridas pelo paciente, sem qualquer intervenção do médico dentista e, apoiam-se directamente na mucosa e nos dentes. Enquanto as PPR´s acrílicas são suportadas pela mucosa, mediante uma ampla área de contacto, as próteses esqueléticas são suportadas pelos dentes pilares através da colocação de retentores. No caso específico das PPR´s, é fundamental que o profissional de saúde tenha em consideração a importância do planeamento correcto e adequado da reabilitação oral. Para isso, pode e deve utilizar o paralelómetro, determinando assim correctamente a localização dos planos-guia, dos apoios e retentores necessários. Guiando-se por estes princípios fundamentais, qualquer reabilitação com recurso às PPR´s pode ser bem sucedida quer a nível estético quer a nível funcional.

Aumento de coroa clínica

O sorriso não se baseia apenas em factores dentários relacionados com a cor, a forma ou o alinhamento dos dentes na arcada, mas implica também a presença de tecidos periodontais saudáveis e com um contorno gengival harmónico. Este trabalho tem como objectivo abordar as diversas técnicas de aumento de coroa clínica, enunciar as vantagens e indicações das mesmas, bem como comparar as técnicas cirúrgicas com as ortodônticas. Para tal foi realizada uma pesquisa bibliográfica recorrendo aos motores de busca da Pubmed e b-on, utilizando como palavras-chave: crown lengthening, biological width, crown lengthening AND surgery e crown lengthening AND orthodontic extrusion. Dos 539 artigos encontrados, foram seleccionados 28 que correspondiam aos critérios de inclusão por nós estabelecidos. Critérios de inclusão: meta-análises, ensaios clínicos randomizados e revisões sistemáticas publicadas em Português, Inglês e Espanhol nos últimos 12 anos. De acordo com a literatura, podemos verificar que o aumento de coroa clínica está indicado em várias situações clínicas tais como: cáries infra-gengivais, fracturas radiculares, resolução de alguns problemas estéticos, como o sorriso gengival, principalmente em casos de erupção passiva alterada e assimetrias das margens gengivais. Este aumento pode ser realizado por técnicas cirúrgicas (gengivectomia e retalho de reposicionamento apical), técnicas ortodônticas (extrusão ortodôntica com ou sem fibrotomia) ou através da combinação de ambas.

O paciente com trissomia 21

A Síndrome de Down, também conhecida como Trissomia 21, representa a anomalia cromossómica mais comum da espécie humana. Caracteriza-se por um conjunto clássico de sinais e sintomas que afetam o desenvolvimento neuromotor e cognitivo. O diagnóstico da Síndrome de Down baseia-se numa série de sinais e sintomas, sendo a sua confirmação estabelecida através do estudo cromossómico. Nem toda a população afetada apresenta as mesmas características, sendo necessário uma identificação do cariótipo para um diagnóstico definitivo. Embora apresentando diferentes graus de severidade assim como inicio de manifestação dos primeiros sintomas em diferentes alturas, toda a população com SD apresenta morfismo característico da face e do sistema esquelético, alterações do SNC e início precoce da doença de Alzheimer. As características dento-maxilo-faciais afetam o normal funcionamento do sistema estomatognático. A maioria possui um padrão braquifacial com um desenvolvimento mandibular no sentido anti-horário e manifesta má-oclusão sob uma vasta etiologia. Consequentemente ocorrem alterações a nível da estética, postura, mastigação, respiração e fonação. Apresentam inclusive um controlo de placa ineficaz e pobre higienização oral, sendo os procedimentos de prevenção importantes. A Ortodontia tem um papel de relevo no tratamento das má-oclusões que contribuem para as limitações do paciente. Ressalte-se a importância da sensibilização dos familiares para a necessidade de higienização bucal destes pacientes, bem como o conhecimento pelo médico dentista acerca das principais manifestações bucais que acometem os pacientes portadores, para que o tratamento adequado seja oferecido e a qualidade de vida desses indivíduos preservada.

Erupção passiva alterada

Introdução: Nos últimos anos, a estética tem vindo a desempenhar um papel cada vez mais importante na Medicina Dentária. Um sorriso considerado agradável é uma parte indispensável relativamente à harmonia facial e consequentemente à autoestima das pessoas. Quando durante o sorriso há exposição de mais de 3mm de gengiva, este é designado por “sorriso gengival”. Considerado como um sorriso inestético, representa uma queixa muito comum por parte dos pacientes e à qual se tem vindo a dar cada vez mais importância. De entre as várias causas, no âmbito deste trabalho, destaca-se a Erupção Passiva Alterada (EPA). Com uma prevalência de 12% na população geral, a EPA é uma condição de difícil diagnóstico devido aos seus sinais pouco específicos e, por isso, muitas vezes ignorada ao longo dos últimos anos. É um fenómeno que não é previsível e a sua etiologia ainda não é muito clara, mas parece tratar-se de um anormal desenvolvimento a nível dentário, em que uma grande porção da coroa dentária fica coberta por gengiva, dando a aparência de coroas clínicas curtas. Apesar de estar hoje em dia propriamente classificada, não dispensa um cuidadoso diagnóstico para que venha a ser tratada adequadamente. O objetivo deste trabalho é efetuar uma revisão bibliográfica dos principais conceitos relativos à etiologia deste fenómeno e à sua classificação, assim como fazer uma abordagem ao seu diagnóstico e tratamento. Materiais e métodos: Foi realizada uma pesquisa na base de dados da PubMed e Research Gate, utilizando como palavras/expressões-chave: “altered passive eruption” e “delayed passive eruption”. A pesquisa resultou num total de 23 artigos, tendo sido complementada com duas obras literárias de interesse. Resultados/conclusões: Foi possível verificar que, apesar de não haver muitos estudos relativos à EPA, é cada vez mais importante realizar um diagnóstico correto para que o tratamento seja o adequado e irmos de encontro às expectativas do paciente, já que muitas vezes este é um fenómeno não identificado devido às suas características inespecíficas. O tratamento da EPA é feito de acordo com a sua classificação e os seus resultados melhoram bastante a estética do sorriso.

A cocaína e suas manifestações orofaciais

A cocaína é uma droga com ação estimulante no sistema nervoso central, extraída e refinada a partir da planta de coca (Erythroxylum coca). É característica por induzir o consumidor a um estado de hipervigilância reduzindo ao mesmo tempo, o cansaço e a fadiga. Este pó branco, cristalino, de sabor amargo, possui também um efeito anestésico local e vasoconstritor. As formas de apresentação mais comuns da droga são o cloridrato de cocaína e a cocaína crack. Esta droga destaca-se por ser o estimulante mais consumido na Europa com cerca de 3,4 milhões de consumidores estimados no ano de 2014. A prevalência do consumo desta droga em Portugal aumentou 0,3% de 2001, para 2012 na população geral (15-64 anos). Os estudos mais recentes em populações escolares (entre 2010 e 2011) evidenciaram, de um modo geral, o aumento da prevalência de consumo nesta população. Os efeitos adversos resultantes, tanto a nível físico como psíquico, são vários, sendo as manifestações orofaciais as que mais interferem na Qualidade de vida do toxicómano. As manifestações mais frequentes são as perfurações do septo nasal e palatino, bruxismo, gengivite, erosão dentária, xerostomia, cárie, lesões brancas atípicas e cefaleias em salva, tendo o Médico Dentista um papel importante no diagnóstico e tratamento destas lesões. A legislação, ao nível Europeu, sobre drogas procura uma uniformização das medidas aplicadas nos países membros, baseando-se no equilíbrio entre as sanções e o tratamento. Apesar das convenções das Nações Unidas sobre drogas limitarem o consumo de estupefacientes e substâncias psicotrópicas exclusivamente para fins médicos e científicos, cabe aos países signatários a liberdade de decisão das políticas a adoptar em matérias de infrações penais como a posse e o consumo ilegal.