Resolution of a titanium implant fracture after a recurrent trauma

Post-traumatic complications occasionally lead to tooth loss as well as the need for future implants. However, rehabilitation with endosseous osseointegrated implants does not protect the patient from the risk of suffering a new trauma. Implant fracture and the damage of the hexagon are post-traumatic complications that guide the clinician to preparing a more intricate treatment plan. The authors present a clinical case of a recurrent trauma of maxillary implant fracture. The treatment plan was to remove the implants followed by autogenous bone grafting to correct the defect. Two titanium implants were replaced, followed by connective tissue graft after allowing complete the healing process of the bone graft to occur. In the postoperative period of 6 months, satisfactory results have been shown as regards soft and hard tissues wound healing.

Radiographic assessment of photodynamic therapy as an adjunctive treatment on induced periodontitis in immunosuppressed rats

Objective: The aim of this study was to assess radiographically the effect of photodynamic therapy (PDT) as an adjunctive treatment to scaling and root planing (SRP) on induced periodontitis in dexamethasone-induced immunosuppressed rats. Material and Methods: The animals were divided into 2 groups: ND group (n=60): saline treatment; D group (n=60): dexamethasone treatment. In both ND and D groups, periodontal disease was induced by the placement of a ligature in the left first mandibular molar. After 7 days, ligature was removed and all animals received SRP, being divided according to the following treatments: SRP: saline and PDT: phenothiazinium dye (TBO) plus laser irradiation. Ten animals per treatment were killed at 7, 15 and 30 days. The distance between the cementoenamel junction and the height of the alveolar bone crest in the mesial surface of the mandibular left first molars was determined in millimeters in each radiograph. The radiographic values were analyzed statistically by ANOVA and Tukey's test at a p value <0.05. Results: Intragroup radiographic assessment (ND and D groups) showed that there was statistically significant less bone loss in the animals treated with PDT in all experimental periods compared to those submitted to SRP. Intergroup radiographic analysis (ND and D groups) demonstrated that there was greater bone loss in the ND group treated with SRP compared to the D group treated with PDT at 7 and 30 days. Conclusion: PDT was an effective adjunctive treatment to SRP on induced periodontitis in dexamethasone-induced immunosuppressed rats.

Recession Defects Associated With Scraped Roots Treated With Subepithelial Connective Tissue Graft

The objective of the current study was to assess histo-morphometrically the healing process of recession defects associated with scraped roots treated with subepithelial connective tissue graft (SCTG). Six dogs were used. Bone dehiscence defects (6 x 8 mm) and root planing were carried out on maxillary canine teeth. Following a split-mouth model, according to the treatment, left canines (control) were covered with coronally positioned flap (CPF). Right canines were submitted to treatments with SCTG. After a 3-month postoperative period, the animals were killed, and the blocks processed for the histomorphometric assessment. Data assessment demonstrated that the CPF group showed parameters of a new connective tissue attachment, length of new cement (NC), length of new bone (mean +/- SD: 0.95 +/- 0.53, 2.44 +/- 1.97, and 1.96 +/- 2.29 mm, respectively), which were higher than those of SCTG group (mean +/- SD: 0.71 +/- 0.36, 2.21 +/- 1.28, and 1.52 +/- 1.31 mm, respectively), although not significantly (P > 0.05). The length of both epithelial tissue and connective tissue apposition in the SCTG group (mean +/- SD: 1.70 +/- 0.53 and 2.62 +/- 1.52 mm, respectively) were higher than those of the CPF group (mean +/- SD: 1.18 +/- 0.49 and 2.03 +/- 1.03 mm, respectively), although showing no significant differences (P > 0.05). Within the limits of the current study, it was possible to conclude that there were no significant differences between the groups according to the histologic parameters assessed.

Effect of photodynamic therapy on the healing of cutaneous third-degree-burn: histological study in rats

The aim of this study was to conduct a histological assessment of the effect of photodynamic therapy (PDT) on the repairing of third-degree-burn wounds made on the backs of rats with a heated scalpel. Ninety-six rats were divided into groups: G1, control (n = 24), cold scalpel; G2, burned, heated scalpel (n = 24); G3, low-level laser therapy (LLLT) (n = 24), on burns; and G4, photodynamic therapy (PDT) (n = 24), toluidine-O blue (100 A mu g/ml) and LLLT treatment on burns. The laser (685 nm) was applied in continuous mode, 50 mW, 4.5 J/cm(2), contact mode at nine points (9 s/point). Eight animals in each group were killed at 3 days, 7 days or 14 days after surgery, and tissue specimens containing the whole wounded area were removed and processed for histological analysis; the results were statistically analyzed with Kruskal-Wallis and Dunn's tests (P < 0.05). The results demonstrated significant differences between G2 and G3, and between G2 and G4, at both 3 days and 7 days, with regard to acute inflammation scores; G1 and G2 showed significant differences when compared with G4 at 3 days, with regard to neo-angiogenesis scores; G1 and G2 were statistically different from G3 and G4 at both 3 days and 7 days, with regard to re-epithelization scores; G2 showed statistically significant differences when compared with G3 and G4 with regard to collagen fiber scores at 7 days. LLLT and PDT acted as a biostimulating coadjuvant agent, balancing the undesirable effect of the burn on the wound healing process, acting mainly in the early healing stages, hastening inflammation and increasing collagen deposition.

Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.

Surgical and Prosthetic Rehabilitation of Patients With Hemimandibular Defect

Purpose: This work intended to investigate, by means of a literature revision, the techniques and materials used for the rehabilitation of hemimandibular defect patients, prosthetic and occlusal aspects of these patients, and chewing and swallowing.Materials and Methods: For the confection of this revision, we consulted the database indexers Google Scholar, PubMed, and SciELO and found studies published between the periods 1972 and 2008. The terms used for the search had been "to hemimandibular defects," "to temporomandibular joint protheses," and "vascularized cap grafts," which had been searched separately and combined.Conclusions: Diverse techniques and materials used for the reconstruction of hemimandibular defects exist; however, great bone resorption is still observed, which will compromise the prosthetic rehabilitation of these patients. More prospective works and stories of clinical cases duly registered will be able to elucidate in a clearer form the anatomic and functional devolutions of the verbal socket of hemimandibular defect patients.

A importância da saúde bucal na ótica de pacientes hospitalizados

A percepção da condição bucal é um importante indicador de saúde, pois sintetiza a condição real de saúde, as respostas subjetivas, os valores e as expectativas culturais. O estudo avaliou a importância da saúde bucal segundo a percepção de pacientes internados em um hospital da cidade de Araçatuba (SP). Foi aplicado um questionário semi-estruturado para a coleta de dados e utilizado para análise estatística o programa Epi Info 2000. Os resultados mostraram que metade dos pacientes haviam realizado a última visita ao cirurgião-dentista em um período compreendido entre seis a doze meses devido a problemas periodontais (35%) e cárie dentária (20%). Observou-se que, embora todos os pacientes considerassem ter uma boa higiene bucal, o tratamento periodontal foi identificado como o de maior necessidade entre os pacientes (67,93%). A presença do cirurgião-dentista no corpo clínico hospitalar foi considerada por todos os entrevistados como fundamental para contribuir no cuidado integral à saúde dos pacientes hospitalizados. Quanto ao papel do dentista em um hospital, a grande maioria dos pacientes (90,63%) afirmou ser o cuidar dos dentes. Assim, conclui-se que todos os pacientes têm conhecimento do quão é importante a manutenção das condições adequadas de saúde bucal, principalmente em pacientes hospitalizados.

Treatment of experimental periodontal disease with antimicrobial photodynamic therapy in nicotine-modified rats

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

Incidence of Maxillary Sinusitis Following Le Fort I Osteotomy: Clinical, Radiographic, and Endoscopic Study

Purpose: The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities.Patients and Methods: Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery.Results: Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population.Conclusion: Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up. 0 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:346351, 2011

Níveis de sedação determinados pela clonidina e midazolam na medicação pré-anestésica: avaliação clínica e eletroencefalográfica bispectral

JUSTIFICATIVA E OBJETIVOS: Verificar o efeito sedativo da clonidina, um a2-agonista, e do midazolam, um benzodiazepínico, quando utilizados na medicação pré-anestésica, empregando-se avaliação clínica e eletroencefalográfica bispectral. MÉTODO: Após aprovação institucional e consentimento escrito fornecido, 45 pacientes de 18 a 65 anos, estado físico ASA I, foram aleatoriamente distribuídos nos grupos placebo (P), clonidina (C) ou midazolam (M), em que receberam, respectivamente placebo, 150 µg de clonidina ou 15 mg de midazolam por via oral, 60 minutos antes da indução da anestesia (n = 15 por grupo). A monitorização constituiu-se de eletrocardiograma (D II), pressão arterial não invasiva, freqüência cardíaca, saturação de pulso de oxigênio, freqüência respiratória, temperatura axilar e da sala de cirurgia e eletroencefalograma bispectral para determinação do índice bispectral (BIS). Esses atributos e a escala de sedações (1 - ansioso, 2 - calmo, 3 - sonolento, 4 - dormindo com reflexo, 5 - dormindo sem reflexo) foram obtidos aos 0 (M0), 15 (M15), 30 (M30), 40 (M40), 50 (M50) e 60 (M60) minutos após a medicação. RESULTADOS: Nos grupos não houve alteração significante dos parâmetros respiratórios, hemodinâmicos e de temperatura. Houve diferença significante entre os grupos na ES (M60: M=C>P) e no BIS (M50 e M60: M=C>P). CONCLUSÕES: Nas condições utilizadas, a clonidina e o midazolam determinaram níveis de sedação adequados e semelhantes na medicação pré-anestésica de pacientes estado físico ASA I, quando avaliados pela escala de sedação e pelo índice bispectral, sem determinarem alterações hemodinâmicas e respiratórias.

Efeitos de reguladores vegetais no enraizamento de estacas caulinares de Poncirus trifoliata var. monstrosa (T. Ito)

O trabalho objetivou estudar os efeitos de reguladores vegetais no enraizamento de estacas caulinares de Flying Dragon [Poncirus trifoliata var. monstrosa (T. Ito)]. Na metade de cada estação do ano, ramos de citros foram coletados (4 experimentos), a partir dos quais foram retiradas estacas com 10 cm de comprimento com uma folha cortada ao meio. As bases das estacas foram tratadas com os seguintes reguladores vegetais na forma de talco: Testemunha (H2O); IBA 0,5%; NAA a 0,5%; IBA + ácido caféico a 0,5%, e NAA + ácido caféico 0,5%. As estacas foram plantadas em bandejas de isopor contendo fibra de coco e mantidas por três meses em câmara de nebulização. Os resultados mostraram que para a propagação desta espécie por estaquia, a coleta dos ramos deve ser no outono e que as mesmas sejam tratadas com a mistura de NAA + ácido caféico, ambos a 0,5%.

Efeitos do treinamento físico sobre a resistência mecânica do terço proximal do fêmur de ratos

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

The Effects of Nectar-Robbing on Fruit Production in Sparattosperma leucanthum (Bignoniaceae)

Many animals behave as robbers or thieves of floral resources, causing damage to floral tissues or consuming resources used to attract pollinators, or producing effects similar to emasculation by reducing the pollen load in the anthers (which generally results in losses in terms of sexual reproduction). The present work examined the direct and indirect impacts caused by nectar-robbing on the reproductive success of Sparattosperma leucanthum. Different manipulations of the flowers were tested to determine if fruit production was influenced by the perforations made in the floral tissues (direct damage), and if there were changes in visitation frequencies or in the behaviors of effective pollinators (indirect damage). Perforations made by nectar robbers did not lower the reproductive success of the plant species studied. The bee Trigona spinipes was the most frequent visitor and caused the largest perforations in the calyx and corolla of S. leucanthum. Additionally, we noted the occurrence of pollen theft by this same bee in flowers that had been protected against nectar-robbing. These results suggest that if S. leucanthum had developed a mechanism of resistance to robbery by T spinipes it would probably have experienced even lower pollination levels as a result of reductions in the quantities of pollen available for transfer by effective pollinators. We were not able to evaluate if nectar depletion through robbery modified the behavior of the effective pollinators (bumblebees of the genus Bombus).

Bee Visitors of Quaresmeira Flowers (Tibouchina granulosa Cogn.) in the Region of Dourados (MS-Brasil)

This research was developed in the center-urban area at the city of Dourados (MS), in Tibouchina granulosa trees, a plant popularly known as quaresmeira in Brazil. The floral visitors of this species were recorded in three daily periods: 7 - 8 a.m., 1 - 2 p.m. and 4 - 5 p. m. Bee visitors of those plants were collected with an entomological net when they landed on the flowers. The bees were anesthetized in a closed camera containing etila acetate, conserved in Dietrich ' s fixative and, soon afterwards, transferred to 70% ethyl alcohol for subsequent identification. Almost 300 specimens of Africanized Apis mellifera, Trigona spinipes and Tetragonisca angustula were collected. The presence of these three species of bees in the flowers of T. granulosa suggests that they can be considered the main floral visitors of that vegetal species. T. angustula workers did not visit the flowers of T. granulosa between 7 and 8 a.m., but they were the main floral visitors from 4 to 5 p.m. The workers of T. spinipes presented a very aggressive behavior against the Africanized A. mellifera workers on the quaresmeira flowers, defending the food sources with strength and efficiency and provoking a drastic reduction in the number of honeybee visits between 1 and 2 p.m. Nevertheless, they did not interfere in the opportunistic activity of foraging by T. angustula workers, mainly between 4 and 5 p.m. The most important result of this research was the detection of the Competitive Exclusion Principle between A. mellifera and T. spinipes species in relation to the foraging behavior, when they exploit the floral resources of T. granulosa.

Pollination of Adenocalymma bracteatum (Bignoniaceae): Floral Biology and Visitors

Adenocalymma bracteatum is a shrub of dense foliage and yellow flowers, easily found on grasslands areas in Central Brazil. The aim of this study was to determine the reproductive biology and the flower visitors of A. bracteatum in a pasture area nearby Ivinhema city, MS (Brazil). The flowering peak occurs in winter. The flower reflects ultraviolet light. Anthesis begins at 6:30h, and pollen and nectar are the resources to visitors. We captured 1,038 floral visitors. The bees Apis mellifera (L.), Trigona sp., Trigona spinipes (Fabricius), (Hymenoptera: Apoidea) and the ant Cephalotes sp. (Hymenoptera: Formicidae) were the main visitors. The reproductive tests indicate that A. bracteatum is self compatible, justifying its expansion in altered environments; however, the largest reproductive success was dependant on cross-pollination and self-pollination, evidencing the pollinators importance. Adenocalymma bracteatum presents melittophilous syndrome and bumblebees were the main pollinators in the area. The correlations observed between the climatic variables and the main pollinator species were low or medium.