Treatment of gingival recession: Comparative study between subepithelial connective tissue graft and guided tissue regeneration

Background: Various procedures have been proposed to treat gingival recession, but few studies compare these procedures to each other. The purpose of this study was to evaluate a clinical comparison of subepithelial connective tissue graft (SCTG) and guided tissue regeneration (GTR) with a collagen membrane in the treatment of gingival recessions in humans. Methods: Twenty-four defects were treated in 12 patients who presented canine or pre-molar Miller Class I and/or II bilateral gingival recessions. Both treatments were performed in all patients, and clinical measurements were obtained at baseline and 18 months after surgery. These clinical measurements included gingival recession height (GR), root coverage (RC), probing depth (PD), keratinized tissue width (KT), and final esthetic result. Results: Both SCTG and GTR with a bioabsorbable membrane and bone graft demonstrated significant clinical and esthetic improvement for gingival recession coverage. The SCTG group was statistically significantly better than GTR for height of GR (SCTG = 0.2 mm, GTR = 1.12 mm, P = 0.02) and KT (SCTG = 4.58 mm, GTR = 2.5 mm, P <0.0001). However, PD was statistically significantly better for GTR than SCTG treatment (GTR = 1.66 mm, SCTG = 1.00, P = 0.01). The 2 procedures were statistically similar in root coverage (SCTG = 95.6%, GTR = 84.2%, P = 0.073). The esthetic condition after both treatments was satisfactory (P = 0.024). Conclusions: It was concluded that the gingival recessions treated with the SCTG group were superior for GR, RC, and KT clinical parameters, while GTR demonstrated better PD reduction. The final esthetic results were similar using both techniques.

Manifestações otorrinolaringológicas em crianças com AIDS

Introduction: The study of otolaryngologic manifestations in children HIV + can lead to early diagnosis of AIDS, allowing specific treatment, responsible by reduced morbidity and mortality. Objectives: Detect the otolaryngologic manifestations in children with AIDS and alert to the importance of the early diagnosis. Study design: Clinical prospective. Material and method: We evaluated 22 children with AIDS assisted at Faculdade de Medicina de Botucatu (São Paulo, Brasil). The medical records were reviewed and the children were submitted to otolaryngologic and hearing acuity exams. Results: We evaluated 12 boys and 10 girls, whose ages ranged from 8 months to 12 years. In B and C clinical classification were included 18 children who were using anti-retroviral medicaments. Physical examination mainly indicated cervical lymphadenopathy (18 cases), paleness of the nasal mucous membrane with abundant mucous secretion over the nasal epithelium (15 cases) and retraction of tympanic membranes (seven cases). The main otolaryngologic diagnoses were: rhinosinusitis (16 cases), oral candidiasis (13 cases), inadequate eustachian tube function (seven cases) and recurrent tonsillar infections (six cases). Conductive hearing loss were detected in 4 children. No child presented sensorineural hearing loss. Conclusions: The main otolaryngologic manifestations presented by the children with HIV virus were rhinosinusitis, oral candidiasis, inadequate eustachian tube function and recurrent tonsillar infections. The allergic aspect of the nasal mucous membrane and the cervical lymphadenopathy were frequent signs and could alert the otolaryngologyst to AIDS during the exam.

Seqüência de moebius: Manifestações clínicas e avaliação auditiva

Introduction: Children with Moebius syndrome may present paralysis of cranial nerves III, IV, V, VI, VII, VIII, IX, X and XII, compromising motor and sensorial functions. Hands and feet defects (syndactyly, equinovarus and arthrogryposis) are frequently associated. These manifestations can be attributed to the use of misoprostol during pregnancy to induce abortion. Study design: Clinical prospective. Aim: To evaluate the main clinical manifestations, hearing acuity and possible etiologic factors in children with Moebius syndrome. Material and method: The children were submitted to clinical, otolaryngological and hearing acuity assessment. Hearing acuity was evaluated through behavioral tests, pure tone audiometry, tympanometry and auditory brainstem response (ABR). We investigated possible etiologic factors. Results: Three boys and two girls were evaluated. The main manifestations were: facial paralysis, paralysis of masseter muscle, defects in dental occlusion, retraction of tympanic membrane, equinovarus, oblique palpebral fissure and tongue atrophy. Conductive hearing loss was detected in three children and sensorineural hearing loss in one child. The use of misoprostol during pregnancy was reported by four mothers. Conclusions: The children with Moebius syndrome evaluated in the present study manifested palsies of various cranial nerves, especially V, VII and XII nerves, responsible for motor and sensorial alterations. Inadequate eustachian tube function associated to conductive hearing loss was frequent. The use of misoprostol during pregnancy was reported by the mothers and it was considered a possible etiologic factor.

Expressão dos filamentos intermediários no diagnóstico dos tumores mamários de cadelas

Immunohistochemical evaluation was performed to study the histogenesis of canine mammary tumors and to contribute to a better understanding of their classification. Monoclonal antibodies specific for different types of intermediate filaments (cytokeratins, vimentin, α-actin) were used. Epithelial cells stained positively for cytokeratins and their expression was lost as the malignant transformation occurs. Myoepithelial cells stained positively for vimentin and α-actin. In contrast to vimentin, α-actin lost the expression as the cartilaginous or osseous metaplasia occurs. Immunohistochemical evaluation with monoclonal antibodies proved to be efficient for identification of tumor histogenesis.

The comparative efficacy of yohimbine and atipamezole to treat amitraz intoxication in dogs

This study compared the efficacy of yohimbine with atipamezole, a new α2-adrenergic antagonist, to treat canine amitraz intoxication. Thirty dogs were divided equally into 3 groups (A, AY, and AA). Group A received 2.5% amitraz iv at 1 mg/kg; Group AY received the same dose of amitraz followed 30 min later by 0.1 mg/kg (2 mg/mL) yohimbine iv; and Group AA received the same dose of amitraz followed 30 min later by 0.2 mg/kg (5 mg/mL) atipamezole iv. Temperature, heart rate, respiratory frequency, mean arterial pressure, degree of sedation, mean time of tranquilization and diameter of pupils were monitored for 360 min. Sedation, logs of reflexes, hypothermia bradycardia, hypotension, bradypnea and mydriasis were observed in Group A, with 3rd eyelid prolapse, increased diuresis and vomiting in some animals. Yohimbine reversed all alterations induced by amitraz, but induced significant cardiorespiratory effects such as tachycardia and tachypnea. Atipamezole was a useful antagonist for amitraz, with less cardiorespiratory effects, suggesting its potential role as an alternative treatment of amitraz intoxication in dogs.

Effect of the Clinical Application of the GaA1As Laser in the Treatment of Dentine Hypersensitivity

Objective: The aim of this study was to evaluate the effectiveness of the clinical use of the gallium-aluminum-arsenium (GaAlAs) laser at the maximum and minimum energies recommended by the manufacturer for the treatment of dentine hypersensitivity. Background Data: Dentine hypersensitivity (DH) is a response to a stimulus that would not usually cause pain in a healthy tooth. It is characterized by sharp pain of short duration from the denuded dentin. Its etiology is unknown. The dentin only begins to show sensitivity when exposed to the buccal environment. This exposure can result after removal of the enamel and/or dental cement, or after root denudation. Different treatments are proposed for this disorder. Materials and Methods: In this study, 25 patients, with a total number of 106 cases of DH, were treated with GaAlAs low-level laser therapy (LLLT). 65% of the teeth were premolars; 14% were incisors and molars; 6.6% were canines. The teeth were irradiated with 3 and 5 J/cm 2 for up to six sessions, with an interval of 72 h between each application, and they were evaluated initially, after each application, and at 15 and 60 days follow-up post-treatment. Results: The treatment was effective in 86.53% and 88.88% of the irradiated teeth, respectively, with the minimum and maximum energy recommended by the manufacturer. There was a statistically significant difference between DH and after a follow-up of 60 days for both groups. The difference among the energy maximum and minimum was not significant. Conclusion: The GaAlAs low-level laser was effective in reducing initial DH. A significant difference was found between initial values of hypersensitivity and after 60 days follow-up post-treatment. No significant difference was found between minimum (3 J/cm 2) and maximum (5 J/cm 2) applied energy.

Tolerância de perdas de solo na bacia do rio Itiquira, Mato Grosso, Brasil

The geographic area of the present study corresponds to the basin of the Itiquira river high course (Figure 1), in the portion that extends from the tributaries of its source, in the east of the plateau Correntes/Itiquira, in the neighbourhoods the city of Alto Garç as, to the scarp of the São Jerônimo mountain range, toward the west of Itiquira, in the state of Mato Grosso, totalizing 5,361 km 2. The area is placed in the eastern part of the Alto Paraguai basin, in the western portion of the Paraná Sedimentary Basin plateau. Through GIS techniques, it was possible to asses total soil losses from the Itiquira river basin, considering the years of 1966, 1985 and 1996, being based on the Universal Soil Loss Equation. Thus, in 1966 the basin lost 201,546.94 ton of soil, with an average loss of 0.37 ton/ha/year. Considering that the total area of the Itiquira river basin is of 536,100 ha, while in 1985 the soil losses had passed to 1,760,833.40 ton, with an increase of approximately 8.5 times. The average of soil losses in 1985 was of 3.28 ton/ha/year. In 1996 the basin lost 1,662,043.24 ton, with a reduction of only 9.4% in relation to 1985 but, in relation the 1966, the increase continued in the order of 8 times. The average losses per hectare in this year was in the order of 3.10 ton/ha/year (Chart 1). The map of potential of the laminar erosion for 1966 (Figure 3), shows to the highest values in small areas, situated in the northeast of the area, in Alto Garças, with values between 10 the 20 ton/ha/year and some spots in sources of the Itiquira and Ariranha rivers, with values between 1 the 5 ton/ha/year. In a general way, however, the area presents low soil loss for laminar erosion in this year, with inferior values to 1 ton/ha/year. The higher class of erosion, over 10 ton/ha/year, occupied 2,947 ha in 1966. In the year of 1985 (Figure 4), the erosive process spread over the entire studied area, and the class of erosion over of 10 ton/ha/year, already started to occupy 78,437 ha, implying an increase of approximately 27 times in 19 years. A strong increment in the erosive process was noticed in the western part of the area, to along the BR-163 road, exactly where great areas of natural vegetation (open pasture) had been transformed in culture and pasture areas. In the north-eastern part of the area it was also noticed an increment in the erosive process in agreement with the increase of culture areas and reduction of the natural areas, but it was not of so intense form as in the western portion of the area. In the year of 1996 (Figure 5), the class of erosion over of 10 ton/ha/year had diminished for a total of 53.499 ha noticing a retraction of the erosive process in the western part of the area, alongside the BR-163 road. On the other hand, it occurred a strong increment in the northern part of the area, in the neighbourhoods of the city of Alto Garças, alongside the BR-364 road and part of the MT-040 road. In a general way, in the outskirts of the city of Itiquira, in the central part of the area, it was verified an increase of the amount of zones with erosion between 0-1 ton/ha/year, passing to the immediately superior class, of 1-3 ton/ha/year; scarce data of hydrosedimentology in the UHE Itiquira (1999), shows good agreement with the values gotten for the EUPS (Chart 2). Based on the hydric classification proposal for FAO (1967) (Chart 3), it is noticed that areas with high degree of erosion (> 50) in the analysed area are very restricted, occupying 493 ha in 1985 and 332 ha in 1996 (Chart 4). In 1996 appeared as isolated spots in the north of Itiquira and Alto Garças, however beyond limits of the Itiquira river basin. These areas require special cares in its use as agricultural areas. Aiming at identifying and indicating the areas of potential risk of erosion and that need implementation of conservation practices, it was elaborated the map of limit of tolerance to the soil losses. In 1966 (Figure 6), areas with soil losses over of the tolerable were restricted to small spots located in the eastern part of the area, occupying 0.43% of the total of the area; already in 1985 (Figure 7), this percentage passed to 5.86%, spreading for all the area; in 1996 (Figure 8) it is observed a fast reduction of the areas with soil losses over of the tolerance limit, passing 5.43% of the total of the area. All the areas with losses over of the tolerable value must be considered as risk areas and were done in these areas studies for implementation of conservation practices.

Fenda cervical mediana

The midline cervical cleft is an unusual congenital anomaly of the ventral neck and fewer than 100 cases have been reported overall and the first described by Bailey in 1924. This anomaly is report in association with median cleft of lower lip, cleft mandible and tongue, and hypoplasia of other midline neck structures. Its considered an anomaly originated from the two first branchial arches. The treatment of this cleft is a vertical complete excision and a closure with multiple Z-plasty. Many authors recommend avoid linear closure and prefer multiple Z-plasty for evicted fibrosis and local retraction. In this paper we report 2 case of this anomaly and the literature is reviewed.

Temperature analysis during bonding of brackets using LED or halogen light base units

The purpose of our investigation is to compare the intrapulpal temperature changes following blue LED system and halogen lamp irradiation at the enamel surface of permanent teeth. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Several light sources can be used: halogens, arc plasma, lasers, and recently blue LED systems. An important aspect to be observed during such a procedures is the temperature change. In this study, we have used nine human extracted permanent teeth: three central incisors, three lateral incisors, and three canines. Teeth were exposed to two light sources: blue LED system (preliminary commercial model LEC 470-II) and halogen lamp (conventional photo-cure equipment). The surface of teeth was exposed for 20, 40, and 60 sec at the buccal and lingual enamel surface with an angle of 45 degrees. Temperature values measured by a thermistor placed at pulpar chamber were read in time intervals of 1 sec. We obtained plots showing the temperature evolution as a function of time for each experiment. There is a correlation between heating quantity and exposition time of light source: with increasing exposition time, heating increases into the pulpal chamber. The halogen lamp showed higher heating than the LED system, which showed a shorter time of cooling than halogen lamp. The blue LED system seems like the indicated light source for photo-cure of composite resin during the bonding of brackets. The fixation of brackets using composite resin is more comfortable and faster when using a photo-curable composite. Blue LED equipment did not heat during its use. This could permit a shorter clinical time of operation and better performance. © Mary Ann Liebert, Inc.

Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits

The purpose of this study was to compare by qualitative histology the efficacy of rigid internal fixation with titanium system and the Lacto Sorb® system in mandibular fractures in rabbits. Thirty male adult rabbits Oryctolagus cuniculus were used. Unilateral mandibular osteotomies were performed between the canine and first premolar. The animals were divided into two groups: for Group I - rigid internal fixation was performed with titanium system 1.5 mm (Synthes, Oberdorf, Switzerland), with two screws of 6 mm (bicortical) on each side of the osteotomy. For Group II-rigid internal fixation was performed with PLLA/PGA system 1.5 mm (Lacto Sorb®, WLorenz, Jacksonville, FL, USA). The histological analysis evaluated the presence of inflammatory reaction, degree of bone healing and degree of resorption of the Lacto Sorb® screws. The results of both fixation systems were similar, only with a small difference after 15 and 30 days. In Group I a faster bony healing was noted. But after 60 days, bony healing was similar in both groups. It is concluded that both PLLA/PGA and titanium plates and screws provide sufficient strength to permit mandibular bone healing. The resorption process of PLLA/PGA osteosynthesis material did not cause acute or chronic inflammatory reaction or foreign body reaction during the studied period. © 2004 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The role of the oblique ligament in the mechanical behavior of the medial collateral ligament of the mongrel dog elbow joint - Some biomechanical aspects

This study investigated the oblique ligament mechanical contribution to the medial collateral ligament of the canine elbow joint. Fifteen dogs were used for the study of the failure load, displacement, and energy absorption of the medial collateral and oblique ligaments of the canine elbow joint, associate and separately in the joint. Medial collateral ligament failure load and energy absorption were significantly higher in relation to the isolated oblique ligament. When the ligaments were associated in the joint, they presented an increment in failure load, displacement and energy absorption in relation to the ligaments analyzed separately. It was concluded, therefore, that the oblique ligament could have an important paper in the stability of the canine elbow joint, as it favors the medial collateral ligament resistance to the tensile load, one of the main stabilizer of the elbow joint.

Análise da transformação do uso da terra, vegetação e impactos ambientais por meio de sensoriamento remoto e geoprocessamento

The mapping of the land use, vegetation and environmental impacts using remote sensing and geoprocessing allows detection, spatial representation and quantifying all alterations due to the human action in the nature, contributing to the monitoring and planning of those activities that cause damages to the environment. The aim of this research is analyze the transformation ocurred with the land use and vegetation in order to detect environmental impacts during the period from 1962 to 1995, considering a test area in the district of Assistência and surroundings, in the Rio Claro (SP) region. In order to archieve such aim the authors used boolean operations available in the Geographical Information System (GIS) - Idrisi. The maps were obtained through the ordinary (conventional) interpretation of aerial photos, later digitized in the software CAD Overlay and georeferenced in AutoCAD Map. It's observed that operations such as crossing digitized maps of one specific area in two differents dates, using GIS, produce overall results that might point out expansion or retraction's trends of the mapped classes, as well as quantify the intensity of the phenomena.

Comparação entre técnicas coproparasitológicas no diagnóstico de ovos de helmintos e oocistos de protozoários em cães.

In this study we evaluated the frequency of enteroparasites in pet dogs and their association with age, sex and breed, as well as the efficiency of the Willis-Mollay, Faust, Sedimentation and Direct exam methods. By these methods we processed 401 fecal samples. The samples were positive in the following percentages: Ancylostoma spp. (53.1%), Toxocara canis (20.7%), Cystoisospora ohioensis (15.7%), Trichuris vulpis (3.7%), Dipylidium caninum (2.5%) and Taenia spp. (1.0%). Toxocara canis (67.3%) and C. ohioensis (47.3%) showed higher positivity in the puppies. The Willis-Mollay technique was more efficient in the diagnosis of Ancylostoma spp. and T. canis eggs. The Direct method was the least efficient. It was found that the majority of the cases of D. caninum were diagnosed by the Sedimentation method (8=2.0%), while for T. vulpis Willis-Mollay (12=3.0%) and Sedimentation (13=3.2%) were more efficient. In view of these results, we can recommend the association of Willis-Mollay and Sedimentation methods for the diagnosis of gastrointestinal helminths. Due to the elevated occurrence of Ancylostoma spp. and T. canis, which are involved in zoonotic diseases, it becomes necessary to apply more efficient prophylaxis of canine intestinal parasitosis at the City of Araçatuba, state of São Paulo.

Interdisciplinary approach to treat dyskeratosis congenita associated with severe aplastic anemia: A case report

This paper reports on a 4-year-old male who had dyskeratosis congenita and who acquired severe aplastic anemia. The patient developed hyperpigmentation of the face, neck and chest region, arms, shoulders and legs. In addition, he had dry skin, deformed fingernails and toenails, sparse hair and eyebrows and hyperkeratosis of the dorsum of the hands and feet. Laboratory and histological analysis revealed severe pancytopenia and dyserythropoiesis of red blood cells, hypocellularity of white blood cells and decreased megakaryocytes with dysplasia. The intraoral examination identified bleeding gums; petechiae of the palate, tongue and cheek mucosa; and an atrophic, smooth and shining dorsal surface of the tongue. There were deep carious lesions in the deciduous mandibular molars and maxillary anterior teeth; as well as mobility of mandibular left canine, which had bone loss. The treatment for oral lesions included diet changes, improved oral hygiene, and extraction of the deciduous teeth destroyed by caries.

Serological profile of anti-Toxoplasma gondii antibodies in apparently healthy dogs of the city of Botucatu, São Paulo state, Brazil

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a coccidian protozoan of worldwide distribution. The seroprevalence in canine population can be an alternative for measuring T. gondii urban spreading. A total of 780 blood samples from dogs were collected, during the yearly anti-rabies campaign, carried out by the Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Husbandry (FMVZ), São Paulo State University, UNESP, together with the county health authorities, in August 1999. Using Indirect Fluorescent Antibody Test (IFAT) for detecting antibodies anti-T. gondii in the sera samples, we observed that 258 dogs (33.1%) were positive. The associations between the serological results and the epidemiological variables were studied. Statistically significant differences were not found regarding sex (32.2% male and 34.3% female reactors). Dogs without a defined breed showed seropositivity statistically higher than the pedigreed group. The occurrence of infection was considered higher with age.