Fechamento de fístula buco-sinusal usando tecido adiposo bucal

The Oro-antral Fistula is a common pathologic event, which occurs an opening or communication of the maxillary sinus with the oral cavity through dental extractions of upper posterior elements whose roots have close relationship with the maxillary sinus. This study aims to clarify the Surgeon Dentist about the possible etiological factors responsible for Oro-antral Communication, to identify its clinical and radiographic signs, to explain the Buccal Fat Pad’s anatomy and functioning and to describe the surgical technique adopted front of these cases. For this, the authors present a case of a patient who had a fistula in the region where there was a dental extraction of the upper posterior element. The treatment of Oro-antral Fistula using the buccal fat pad provides to be a safe and effective surgical method, because this element presents a rich blood supply and easy access. Many authors have found that this method have a broad application, large index of success, lower risk of infection, provides a comfortable post-operative for the patient. However, it needs to be done properly so that you have minimum incidence of failures, and this requires some caution on the part of professional.

Oroantral communication closure using a pedicled buccal fat pad graft

OBJETIVO: O objetivo desde artigo foi relatar um caso clínico de fechamento de fístula buco-sinusal tardia utilizando rotação de enxerto de tecido adiposo pediculado do corpo adiposo da bochecha. DESCRIÇÃO do CASO: Paciente do sexo masculino, 66 anos, leucoderma, em boas condições de saúde geral, foi encaminhado para fechamento de extensa comunicação buco-sinusal. Ao exame clínico, observou-se uma fístula de aproximadamente 10 mm de diâmetro comunicando a cavidade oral com o seio maxilar. A cirurgia foi realizada em nível ambulatorial, sob anestesia local, para fechar a fístula buco-sinusal com um enxerto de tecido adiposo pediculado do corpo adiposo da bochecha. A reparação da ferida e o fechamento do defeito foram observados no pós-operatório de 30 dias, com completa epitelização. CONCLUSÃO: O enxerto pediculado de tecido do corpo adiposo da bochecha mostrou-se uma alternativa simples, eficaz e segura no fechamento mediato da fístula buco-sinusal apresentada neste caso clínico.

Sinusite odontogénica

Monografia apresentada à Universidade Fernando Pessoa para obtenção do grau de Licenciada em Medicina Dentária.

Higiene buco-dental en los alumnos con Necesidades Educativas Especiales.

Incluye material elaborado por los alumnos y un programa de contenidos y actividades de salud buco-dental

Programa de atención buco-dental en alumnos discapacitados psíquicos con epilepsia.

El proyecto pretende cubrir las necesidades de atención sanitaria en salud buco-dental y desarrollar hábitos y costumbres sanas de higiene buco-dental en los alumnos. El objetivo es que los discapacitados psíquicos alarguen sus períodos de bienestar y disminuyan las enfermedades buco-dentales, que aparecen por el tipo de vida, la conducta y los efectos de la medicación en los alumnos con epilepsia. Otros objetivos son reconocer y apreciar el propio cuerpo y contribuir a su desarrollo; reconocer principales patologías buco-dentales; establecer medidas preventivas para impedir enfermedades; y realizar estrategias ante un problema de salud individual y los pasos del protocolo de actuación de higiene buco-dental. En cuanto a la metodología, una vez diseñadas las programaciones, se elabora el material para mejorar la práctica y adaptarlo a las necesidades de los alumnos, de forma normalizada, integradora y atendiendo a la diversidad. Las actividades se realizan en las aulas, después en la consulta de odontología y finalmente en los departamentos de Terapia Ocupacional y Centro de Día, manteniendo así una estrecha colaboración entre auxiliares, terapeuta ocupacional, educadores y maestros. La evaluación es continua y se realiza a través de registros de observación individual, cuestionarios para las familias, datos clínicos, consulta odontológica y materiales. Se elaboran fichas de actividades; registros de evaluación; cuestionarios como el de datos demográficos, datos clínicos, y hábitos de alimentación sana; guías informativas sobre las actividades buco-dentales, fichero de consulta para enfermedades, alimentación sana y hábitos de higiene oral; vídeos formativos; pictogramas de exploración dental; guías fotográficas; y protocolo de actuación. Se incluye el cuestionario de exploración buco-dental y los resultados, el cuestionario para las familias, el programa guía para alumnos y profesionales de atención buco-dental, y la guía para alumnos y profesionales de anatomía buco-dental..

Higiene personal i salut buco-dentària : guia metodològica dïeducació per a la salut a lïescola. 'Higiene personal y salud buco-dental : guía metodológica de educación para la salud en la escuela'.

El Programa de higiene personal y salud buco-dental ha sido elaborado por un equipo de sanitarios y docentes y se ha experimentado en clases de preescolar y ciclo inicial. Esta programación no pretende ser una recopilación exhaustiva de información sobre el tema, sino más bien ser una guía, que más que dar soluciones sugiera vías de acción a seguir y promueva el interés en este campo. Se combina el material didáctico junto con actividades prácticas para los alumnos.

Saúde buco-dental na poboación escolar. 'Salud buco-dental en la población escolar'.

Estudio sobre la salud buco-dental en los escolares, analizando las principales patologías buco-dentales de la población infantil.

Endocrine regulation of ovarian antral follicle development in cattle

Antral follicle growth in cattle occurs in two distinct phases; the first 'slow' growth phase spans the time from antrum acquisition to a size of approximately 3 mm detectable by transrectal ultrasound, and the second 'fast' phase is gondadotrophin-dependent and includes cohort growth, dominant follicle (DF) selection, and DF growth. This review summarises current concepts of the relative roles FSH and LH, ovarian and metabolic hormones play mainly in the second phase of antral follicle growth in animals of different reproductive and nutritional states. It is proposed that differential FSH response may enable one cohort follicle to become selected, and that follicular secretions, particularly inhibin, suppress FSH and thus are responsible for DF selection and dominance. Acute dependence of the DF on LH pulses will determine DF lifespan, and the LH pulse profile can be influenced by metabolic hormones such as leptin, providing one possible link for nutritional state and reproduction. Direct ovarian effects of acute and chronic changes in growth hormone, insulin and insulin-like growth factor (IGF)-I have been described on cohort follicles, DF oestrogen activity and on DF growth. Influences of metabolic hormones on early antral follicles undergoing their first 'slow' growth phase are less well described, yet metabolic hormones appear to enhance growth into the cohort available for FSH-induced emergence, and may influence subsequent developmental competence of oocytes. (C) 2003 Elsevier Science B.V. All rights reserved.

Numbers of antral follicles during follicular waves in cattle: Evidence for high variation among animals, very high repeatability in individuals, and an inverse association with serum follicle-stimulating hormone concentrations

The extent, causes, and physiological significance of the variation in number of follicles growing during ovarian follicular waves in human beings and cattle are unknown. Therefore, the present study examined the variability and repeatability in numbers of follicles 3 mm or greater in diameter during the follicular waves in bovine estrous cycles, and we determined if the variation in number of follicles during waves was associated with alterations in secretion of FSH, estradiol, inhibin, and insulin-like growth factor I (IGF-I). Dairy cattle were subjected to twice-daily ultrasound analysis to count total number of antral follicles 3 mm or greater in diameter throughout 138 different follicular waves. In another study, blood samples were taken at frequent intervals from cows that consistently had low or very high numbers of follicles during waves and were subjected to immunoassays. Results indicate the following: First, despite an approximately sevenfold variation in number of follicles during waves among animals and marked differences in age, stage of lactation, and season of the year, a very highly repeatable (0.95) number of follicles 3 mm or greater in diameter is maintained during the ovulatory and nonovulatory follicular waves of individuals. Second, variation in number of follicles 3 mm or greater in diameter during waves and the inverse association of number of follicles during waves with FSH are not directly explained by alterations in the patterns of secretion of estradiol, inhibin, or IGF-I. Third, ovarian ultrasound analysis can be used reliably by investigators to identify cattle that consistently have low or high numbers of follicles during waves, thus providing a novel experimental model to determine the causes and physiological significance of the high variation in antral follicle number during follicular waves among single-ovulating species, such as cattle or humans.

Changes in expression of bone morphogenetic proteins (BMPs), their receptors and inhibin co-receptor betaglycan during bovine antral follicle development: inhibin can antagonize the suppressive effect of BMPs on thecal androgen production

We reported previously that bone morphogenetic proteins (BMPs) potently suppress CYP17 expression and androgen production by bovine theca interna cells (TC) in vitro. In this study, real-time PCR was used to analyse gene expression in TC and granulosa cell (GC) layers from developing bovine antral follicles (1-18 mm). Abundance of mRNA transcripts for four BMPs (BMP2, BMP4, BMP6, and BMP7) and associated type I (BMPR1A, BMPR1B, ACVR1 and ACVR1B) and type II (BMPR2, ACVR2A and ACVR2B) receptors showed relatively modest, though significant, changes during follicle development. BMP2 was selectively expressed in GC, while BMP6, BMP7 and betaglycan (TGFBR3) were more abundant in TC. Abundance of betaglycan mRNA (inhibin co-receptor) in TC increased progressively (fivefold; P<0.001) as follicles grew from 1-2 to 9-10 mm. This suggests a shift in thecal responsiveness to GC-derived inhibin, produced in increasing amounts as follicles achieve dominance. This prompted us to investigate whether inhibin can function as a physiological antagonist of BMP action on bovine TC in vitro, in a manner comparable to that for activin signalling. BMP4, BMP6 and BMP7 abolished LH-induced androstenedione secretion and suppressed CYP17 mRNA >200-fold (P<0.001), while co-treatment with inhibin-A reversed the suppressive action of BMP in each case (P<0.001). Results support a physiological role for granulosa-derived inhibin as an antagonist of BMP action on thecal androgen synthesis. A shift in intrafollicular balance between thecal BMP signalling (inhibitory for androgen synthesis) and betaglycan-dependent inhibin signalling (stimulatory for androgen synthesis) accords with the physiological requirement to deliver an adequate supply of aromatase substrate to GC of developing follicles.

Ovarian expression of insulin-like peptide 3 (INSL3) and its receptor (RXFP2) during development of bovine antral follicles and corpora lutea and measurement of circulating INSL3 levels during synchronized estrous cycles

Insulin-like peptide 3 (INSL3), a major product of testicular Leydig cells, is also expressed by the ovary but its functional role remains poorly understood. Here, we quantified expression of INSL3 and its receptor RXFP2 in theca interna (TIC) and granulosa (GC) compartments of developing bovine antral follicles and in corpora lutea (CL). INSL3 and RXFP2 mRNA levels were much higher in TIC than GC and increased progressively during follicle maturation with INSL3 peaking in large (11-18mm) estrogen-active follicles and RXFP2 peaking in 9-10mm follicles before declining in larger (11-18mm) follicles. Expression of both INSL3 and RXFP2 in CL was much lower than in TIC. In situ hybridization and immunohistochemistry confirmed abundant expression of INSL3 mRNA and protein in TIC. These observations indicate follicular TIC rather than CL as the primary site of both INSL3 production and action, implying a predominantly auto-/paracrine role in TIC. To corroborate the above findings, we showed that in vitro exposure of TIC to a luteinizing concentration of LH greatly attenuated expression of both INSL3 and its receptor while increasing progesterone secretion and expression of STAR and CYP11A1. Moreover, in vivo, a significant cyclic variation in plasma INSL3 was observed during synchronized estrous cycles. INSL3 and estradiol-17β followed a similar pattern, both increasing after luteolysis, before falling sharply after the LH surge. Thus, theca-derived INSL3, likely from the dominant pre-ovulatory follicle, is detectable in peripheral blood of cattle and expression is down-regulated during luteinisation induced by the pre-ovulatory LH surge. Collectively, these findings underscore the likely role of INSL3 as an important intrafollicular modulator of TIC function/steroidogenesis, whilst raising doubts about its potential contribution to CL function.