Diretrizes para o tratamento e acompanhamento periodontal durante o tratamento ortodôntico

The aim of this paper was to search though a revision of the literature the cares before, during and after the orthodontic treatment in patients with a periodontal disease. The literature shows that the orthodontical treatment in healthy patients brings no risk to the periodontium, although the presence of an active periodontal disease counter indicates the dental movement. Thus, it is extremely important to execute a correct diagnosis of any periodontal alteration and treat them before the beginning of the orthodontical treatment. Besides, during the whole orthodontical treatment is also important to have a periodontal control with periodic reevaluations and at the end of the orthodontical treatment, a new oral hygiene orientation may be needed to finally establish the follow-up of the patient according to the risk of periodontal disease.

Instrumentation of dental implants: a literature review

The aim of this study was to review the literature on the systems used to decontaminate the implant's surface. Different instruments have been proposed, but there is no agreement in the literature about which methods would be more efficient with no damage to the implant surface. It was reported the use of plastic, carbon fiber, stainless-steel and titanium curettes and also the use of other systems such as ultrasonic points with different tips, rubber cups and air abrasion. Literature review: In most of the studies, the injury caused on the titanium surface at the time of instrumentation was examined. In others, the cell adhesion on the titanium dental implants following instrumentation of the implant surface was observed. Moreover, to enhance cleaning around implants, ultrasonic systems were recently tested. Conclusion: Metal instruments can lead to major damage to implant surface, therefore, they are not indicated for decontamination of dental implants surfaces. Furthermore, non-metallic instruments, such as plastic curettes, rubber cups, air abrasion and some ultrasonic systems seem to be better choices to remove calculus and plaque of the sub- and supra-gingival peri-implant area. It is noteworthy that more studies evaluating the effects of these systems are required to establish best practices to be used in the treatment of patients with dental implants.

Displasia ectodérmica hipohidrótica: un síndrome de interés para la odontología

Hypohidrotic ectodermal dysplasia (HED) is a rare disease of genetic etiology. The most frequent form is of recessive linked to X-chromosome inheritance with affected male and female carriers. It can occur through autosomal mutations, of the gene EDA1 gene being responsible for the majority of the cases. It is characterized by the triad: hypohidrosis, oligodontia and hypotrichosis. We present two cases of patients with HED in which we observed characteristic signs of this syndrome: delicate skin, sparce hair, eyebrows and eyelashes, periorbital wrinkles, perioral and periorbital hyperpigmentation, prominent lips, in addition the patient in case 2 also present the depressed nasal bridge. We also found decreased salivary and lacrimal secretion and maxillary hypoplasia in both cases. At the oral examination in case 1 the upper right and left deciduous canines and lower right deciduous canine were present, and in case 2 the upper and lower (right and left) deciduous canines and two upper (one right and other left) permanent incisors were present with altered morphology, all of these dental elements were healthy. The early dental treatment of patients with HED, especially in the presence of oligodontia, as observed in our cases, is important not only to provide a better quality of life for these patients in the short term, but also an attempt to minimize the changes in facial growth to which these patients are subject.

Placement of dental implants in the maxillary tuberosity: a systematic review

The aim of this systematic review was to identify clinical studies on implants placed in the tuberosity region to determine the survival rate of these implants when compared to implants placed in other regions of the maxilla. A search for data published up until March 2014 was undertaken using the PubMed, Cochrane Library, Embase, and ScienceDirect databases. Eligible studies were selected according to inclusion and exclusion criteria. The first database search revealed 310 titles. After inclusion and exclusion criteria were applied, five studies remained for the detailed analysis. A total of 113 patients were followed for a period of 6-144 months; 289 implants were placed in the patients evaluated. There were eight failures/losses of dental implants in the tuberosity region; the overall survival rate was 94.63% for these implants. In controlled studies, the cumulative survival rates for implants placed in the maxillary tuberosity and other maxillary regions were 96.1% and 95%, respectively. In conclusion, implants placed into the maxillary tuberosity are a predictable alternative for the treatment of patients with insufficient bone volume in the maxillary region. However, randomized trials are needed to assess the effectiveness of this treatment.

Extensão do modelo hipercubo para análise de sistemas de atendimento médico emergencial com prioridade na fila

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Analysis of the feasibility of early hospital discharge after autologous hematopoietic stem cell transplantation and the implications to nursing care

Autologous hematopoietic stem cell transplantation is a conduct used to treat some hematologic diseases and to consolidate the treatment of others. In the field of nursing, the few published scientific studies on nursing care and early hospital discharge of transplant patients are deficient. Knowledge about the diseases treated using hematopoietic stem cell transplantation, providing guidance to patients and caregivers and patient monitoring are important nursing activities in this process. Guidance may contribute to long-term goals through patients' short-term needs. To analyze the results of early hospital discharge on the treatment of patients submitted to autologous transplantation and the influence of nursing care on this conduct. A retrospective, quantitative, descriptive and transversal study was conducted. The hospital records of 112 consecutive patients submitted to autologous transplantation in the period from January to December 2009 were revisited. Of these, 12 patients, who remained in hospital for more than ten days after transplantation, were excluded from the study. The medical records of 100 patients with a median age of 48.5 years (19-69 years) were analyzed. All patients were mobilized and hematopoietic stem cells were collected by leukapheresis. The most common conditioning regimes were BU12Mel100 and BEAM 400. Toxicity during conditioning was easily managed in the outpatient clinic. Gastrointestinal toxicity, mostly Grades I and II, was seen in 69% of the patients, 62% of patients had diarrhea, 61% of the patients had nausea and vomiting and 58% had Grade I and II mucositis. Ten patients required hospitalization due to the conditioning regimen. Febrile neutropenia was seen in 58% of patients. Two patients died before Day +60 due to infections, one with aplasia. The median times to granulocyte and platelet engraftment were 12 days and 15 days, respectively, with median red blood cell and platelet transfusions until discharge of three and four units, respectively. Twenty-three patients required rehospitalization before being discharged from the outpatient clinic. The median time to granulocyte engraftment was 12 days and during the aplasia phase few patients were hospitalized or suffered infections. The toxicity of the conditioning was the leading cause of rehospitalization. The nursing staff participated by providing guidance to patients and during the mobilization, transplant and outpatient follow-up phases, thus helping to successfully manage toxicity.

Análise do exercício físico e eletroestimulção do músculo tibial cranial após neurorrafia término-lateral do nervo fibular em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Claritromicina como adjuvante ao debridamento periodontal no tratamento de periodontite agressiva generalizada: estudo controlado randomizado

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Assistência cirúrgico-odontológica a pacientes com história de infarto do miocárdio

The execution of a appropriate odontological surgical treatment for patients with Myocardial Infarction has been based in established protocols for important works in world wide literature during the sixty’s and seventy’s decade, established with a minimum of six months before the noncardiac surgery. The recent advancements in the medical assessment of surgical risk based on the individual analysis of each case with availability of new therapeutic tools in reference to medical or dental treatment, allowing for new procedures that can be used in the execution of safer odontological surgery for each patients. This review of the literature shows the actual tendencies of the treatment of patients with Myocardial Infarction concerning specific care before, during and after surgery based on laboratory evaluation and drug therapy as well as the possibility of surgical treatment before six months post-infarction.

Effect of smoking on the survival of dental implants

Background. Although the long-term success of implant treatment has been well- established, failures can still occur and the smoking habit has been reported as a risk factor for implant loss. A literature review on the effects of smoking on the survival of dental implants was undertaken. Methods and Results. Medline database was used to carry out the review with the keywords “osseointegration”, “smoking” and “bone healing”. The cigarette has more than 4,000 bioactive chemical components with potential toxic effects to human tissues including bone. Nicotine is the main component of the cigarette and it is frequently associated with bone healing failures. Since smoking negatively affects the osseointegration of dental implants, the main target is to quit the consumption of cigarettes. Conclusion. Nevertheless, the smoking habit should not be an absolute contraindication for implant treatment, but, patients should be advised that they are at a greater risk of implant failure.

O tratamento da apneia obstrutiva do sono e a utilização de implantes osseointegráveis: revisão da literatura

The obstructive sleep apnea syndrome affects millions of people around the world. The mandibular repositioning devices have been indicated in cases of mild/moderate syndrome; however in edentulous patients its use is deficient since there is no retention. Therefore the objective of this study was to conduct a review on the use of this treatment method combined to osseointegrated implants. A search on the theme: Dental implant and sleep apnea syndromewas performed in the Medline/PubMed, ISI, Cochrane, Dentistry Oral Science, Clinical Trials, Controlled Trials, and Bireme-BvS, databases, and 22 articles were found. After anevaluation 2 studies were selected and the review was complemented with an analysis of randomized controlled trials in the previous seven bases using the key-words: Sleep apnea syndrome, Oral appliance and Randomized controlled trial. The search returned 37 articles, and after they were submitted to inclusion criteria 17 studies were selected. There are a small number of studies presenting the use of dental implants as a mean to assist the stabilization of the mandibular repositioning appliances; those that are available are case reports that focusing on the effectiveness of the technique. Studies examining the effect these appliances in dentate patients indicate improvement in the levels of apnea and snoring. The use of mandibular repositioning appliances in dentate patients is an effective technique in treatment of patients with obstructive sleep apnea syndrome mild/moderate. Randomized controlled trialsare required in order to enable an analysis of the use of mandibular repositioning devices with the aid of dental implants .

Evaluation in situ of tag formation in dental enamel submitted to microabrasion technique: effect of two etching times

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação das alterações cardiopulmonares precoces e tardias resultantes da secção da cadeia simpática realizada por videotoracoscopia em pacientes com hiperidrose

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Purification of coagulation factor VIII using chromatographic methods. Direct chromatography of plasma in anion exchange resins

Coagulation factor VIII (FVIII) concentrates are used in the treatment of patients with Hemophilia A. Human FVIII was purified directly from plasma using anion exchange chromatography followed by gel filtration. Three Q-Sepharose resins were tested, resulting in 40% recovery of FVIII activity using Q-Sepharose XL resin, about 80% using Q-Sepharose Fast Flow and 70% using the Q-Sepharose Big Beads. The vitamin K-dependent coagulation factors co-eluted with FVIII from the anion exchange columns. In the second step of purification, when Sepharose 6FF was used, 70% of FVIII activity was recovered free from vitamin K-dependent factors.

Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences

Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1) to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2) to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3) to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate.