Treatment of obstructive sleep apnea syndrome in patients from a teaching hospital in Brazil: is it possible?

The aim of this study was to evaluate the efficacy of a cost-effective intra-oral appliance for obstructive sleep apnea syndrome built into a large teaching hospital. Out of 20 evaluated and treated patients, 14 concluded the study: eight men and six women, with a mean age of 42-46 (mean + SD) years and mean body mass index of 27.66. Inclusion criteria were mild or moderate apnea-hypopnea index (AHI) according to a polysomnographic study. All patients were treated with the monobloco intra-oral appliance. They were then submitted to a follow-up polysomnographic study after 60 days using the appliance. An orofacial clinical evaluation was carried out with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and with clinical evaluation questionnaire devised by the Orofacial Pain Team before and 60 days after fitting the intra-oral appliance. The AHI showed a statistically meaningful (p = 0.002) reduction from 15.53 to 7.82 events per hour, a non-statistically significant oxygen saturation increase from 83.36 to 84.86 (p = 0.09), and Epworth`s sleepiness scale reduction from 9.14 to 6.36 (p = 0.001). Three patients did not show any improvement. The most common side effect during the use of the appliance/device was pain and facial discomfort (28.57%), without myofascial or temporomandibular joint pain as evaluated by the RDC/TMD questionnaire. The intra-oral device produced a significant reduction of the apnea-hypopnea index during the study period with the use of the monobloco intra-oral appliance. Patients did not show prior myofascial pain or 60 days after use of the intra-oral appliance.

Efeito da escovação na formação in situ de biofilme dentário inicial e na rugosidade superficial em cerâmica de y-tzp após vitrificação e polimento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Epos orale russo tra oralità e scrittura: problemi e proposte di traduzione

In the present thesis, I discuss the role of orality in translation, taking into account the problems arising while translating Russian folk epics. I investigate the meaning of orality in the context of folkloristic translation, trying to define a concept of oral poetry, and exploring its consequences for translation. In the first chapter, I try to identify the main differences between written literature and oral modes of expression, with special reference to folklore. Oral verbal art is performed, sung or recited, and based on a vital and dynamic interrelation between kinesics, sound, speech and gestures. According to Muhawi (2006), performance provides an interpretive frame enabling a correct interpretation of the message conveyed beyond the literal meaning. Transposing certain performance elements into print is one of the most controversial problems in folklore studies. However, formulas and formal stylistic devices may be rendered in transcription, building a bridge between oral and written elements. In the translation of oral poetry in transcription, this interconnection between orality and literacy might be emphasized, thus creating a hybrid dimension where oral and literary features coexist. In the second chapter, I introduce and describe the genre of Russian folk epics, transmitted orally, and transcribed between the 19th and 20th centuries, from a historical, linguistic and stylistic point of view. In the third and fourth chapters, I explore the issue of translation of Russian oral poetry. I first analyse existing Italian translations of Russian epics, and then present and discuss my own translation, based on a philological, scholarly approach. Thus, in my translation, which is followed by a rich commentary, I try to focus on the rendering of formulas as one of the most relevant aspects of Russian epics. At the same time, oral devices combine with literary features, thus creating a sort of frozen orality.

O papel do flúor como agente corrosivo dos fios ortodônticos

O tratamento ortodôntico insere-se numa área da medicina dentária que se dedica ao estudo das formas de prevenir, interceptar e corrigir as más posições dos dentes e dos maxilares. Durante este tratamento é importante que os pacientes consigam manter uma boa higiene oral dos dentes e do aparelho, o que requer precisão e tempo. Para ajudar a manter a higiene oral os pacientes recorrem frequentemente ao uso de produtos fluoretados, que apesar dos seus benefícios como agentes na prevenção da cárie têm consequências no tratamento ortodôntico nomeadamente na corrosão dos fios ortodônticos. Através de uma revisão da literatura pretende-se explorar a relação entre o uso de flúor durante o tratamento ortodôntico com a corrosão dos fios mais usados nesse mesmo tratamento. Materiais e Métodos: Nesta revisão de literatura realizou-se pesquisa nas bases de dados electrónicas “Medline/PubMed”, e “B-On”; referências bibliográficas de artigos; livros de Medicina Dentária e pesquisa narrativa. Conclusão: O uso de agentes fluoretados tópicos pode induzir uma diminuição das propriedades mecânicas dos fios ortodônticos nomeadamente do níquel-titânio, e consequentemente provocar o prolongamento do tratamento ortodôntico. Os Ortodontistas devem ter em consideração o tipo de fio usado no tratamento no momento da prescrição de colutórios e outros agentes fluoretados.

Percepção do estado de saúde de doentes com anticoagulação oral

RESUMO - O aumento da incidência das doenças crónicas representa um desafio enorme para todos os Sistemas de Saúde, pelo que a assistência de Saúde a doentes crónicos se tornou num problema das sociedades ocidentais. Os países mais pobres são os que mais sofrem, embora nos países desenvolvidos também se verifique um aumento notável das doenças crónicas. Estima-se que estas representem mais de 60% do total das doenças mundiais no ano 2020 (WHO, 2001). A adaptação dos actuais modelos de saúde aos doentes crónicos não atingiu os objectivos, o que conduziu a que, de há alguns anos a esta parte, se procure alternativas mais eficazes e eficientes. Uma das pressões do mercado que se fazem sentir será caracterizada por uma maior aposta na Promoção da Saúde e Prevenção da doença. O conceito de “Saúde” migrou de “não existência de doença” para “Bem-estar Físico e Psicológico”. Desta forma, o foco dos cuidados de saúde teve que ser adaptado, o que conduziu a uma situação em que o âmbito da prestação de cuidados de saúde é um contínuo de serviços que vai desde a promoção da saúde, medicina preventiva e medicina curativa aos cuidados continuados e cuidados paliativos. As tecnologias de informação e comunicação desempenharão um importante papel nesta tendência, permitindo estabelecer ligações contínuas entre os consumidores e prestadores de cuidados de saúde. Por outro lado, as potencialidades da Internet, das comunicações móveis, dispositivos portáteis e do instrumental electrónico, tornam-se evidentes no desenvolvimento de serviços de e-Saúde: para monitorização, seguimento e controlo dos doentes extra hospitalar - serviços estes centrados no doente. O objectivo geral do presente estudo consiste no desenho de um projecto de investigação para posterior avaliação da percepção do estado de saúde dos doentes seguidos na consulta de hipocoagulação do Hospital de Santa Marta. Devido à escassez de investigação na temática deste trabalho em Portugal, procedeu-se a um trabalho exploratório, descritivo, de carácter comparativo e enquadrado na abordagem quantitativa. O campo de análise consiste em comparar doentes que fazem anticoagulação oral, seguidos na consulta de cardiologia (consulta convencional), com os doentes seguidos no programa Airmed (através das comunicações móveis). 4 Para avaliação da percepção do estado de saúde foi utilizado o questionário SF-36.----ABSTRACT - The increasing incidence of chronic diseases represents an enormous challenge to the Health Systems and on cause of that, the Health Assistance to chronic patients became a concern of the Occidental society. The Countries with lower economical resources are the ones that suffers the most, but also the Developed countries have a noticeable increase of chronic diseases. It is estimated these will represent over 60% of total diseases world wide in 2020 (WHO,2001). The adaptation of the actual Health Models to chronic patients did not achieved it’s goals, what leaded to look for more effective and efficient alternatives. One of the more sensitive market pressure factor is to look for a better Health Promotion and Disease Prevention. The concept of “Health” merged from “Disease absence” to “Physic and Psychic Wellness”. In this way the Health Care focus had to be adapted, what drove to a status where the scope of the Health care is a continuum of services that goes from the Health Promotion, Preventive and Curative to Continued and Palliative Medical Care. The Information and Communication Technologies will play a crucial role in this trend, allowing to establish continued connections between patients and Health Care providers. In parallel the potential of the Internet, mobile communications, portable devices and electronic instruments became evident to deploy e-Health services: to monitor, follow-up and control of patients outside the Hospital. The overall objective of the present study is an Investigation Project Design to further evaluate the health status perception of the patients followed in the consultation for Hypocoagulation in the “Hospital de Santa Marta”. Due to lack of investigation in this thematic, in Portugal, this study is developed in an exploratory way, descriptive, comparative, within a scope of a quantified approach. The analysis field consists on comparing patients prescribed with oral anticoagulants and followed-up at the

Influence of saliva and mucin on the adhesion of Candida oral clinical isolates

Objectives: This research work intends to clarify the role of artificial saliva, in particularly the role of mucin, a salivary protein, on the surface properties and adhesion ability of Candida spp. oral clinical isolates to abiotic surfaces. Methods: Four oral clinical isolates of Candida spp. were used: two Candida albicans strains (AC; AM) and two Candida parapsilosis strains (AD; AM2). The strains were isolated from patients using oral prosthesis. The microorganisms were cultured in the absence or presence of mucin and artificial saliva, and their adhesion to an abiotic surface (coated with mucin and artificial saliva) was evaluated. Results: The presence of mucin per se onto the abiotic surface decreased the adhesion of all strains, although the combination of mucin with artificial saliva had reduced this effect. No direct correlation between adhesion and the surface free energies of adhesion of the microorganisms was found. Significance: Candida spp. were human commensal microorganisms that became pathogenic when the host immune defenses were compromised. Medical devices were colonized by Candida spp. particularly, oral prostheses, which might lead to the degradation of the prostheses and systemic infections. The salivary secretions that constantly cover the oral cavity influenced Candida spp. adhesion process. Therefore, it was important to understand the interactions between Candida spp., salivary proteins and the characteristic of oral prosthesis when developing materials for oral prostheses.

Laser treatment of 13 benign oral vascular lesions by three different surgical techniques

Objectives: Benign Oral Vascular Lesions (BOVLs) are a group of vascular diseases characterized by congenital, inflammatory or neoplastic vascular dilations clinically evidenced as more or less wide masses of commonly dark bluish color. If traumatized BOVLs are characterized by a great risk of hemorrhage and their treatment usually requires great caution to prevent massive bleeding. In the last decades lasers have dramatically changed the way of treatment of BOVLs permitting the application of even peculiar techniques that gave interesting advantages in their management reducing hemorrhage risks. The aim of this study was to evaluate the capabilities and disadvantages of three laser assisted techniques in the management of BOVLs. Study design: In this study 13 BOVLs were treated by three different laser techniques: the traditional excisional biopsy (EB), and two less invasive techniques, the transmucosal thermocoagulation (TMT) and the intralesional photocoagulation (ILP). Two different laser devices were adopted in the study: a KTP laser (DEKA, Florence, Italy, 532nm) and a GaAlAs laser (Laser Innovation, Castelgandolfo, Italy, 808nm) selected since their great effectiveness on hemoglobin. Results: In each case, lasers permitted safe treatments of BOVLs without hemorrhages, both during the intervention and in the post-operative period. The minimally invasive techniques (TMT and ILP) permitted even the safe resolution of big lesions without tissue loss. Conclusions: Laser devices confirm to be the gold standard in BOVLs treatment, permitting even the introduction of minimal invasive surgery principles and reducing the risks of hemorrhage typical of these neoplasms. As usual in laser surgery, it is necessary a clear knowledge of the devices and of the laser-tissue interaction to optimize the results reducing risks and disadvantages

Enrichment cultures should be performed in the detection of bacterial oral human pathogens in DUWLs

Water delivered by dental units during routine dental practice is densely contaminated by bacteria. The aim of this study was to determine actual isolation of the microorganisms sprayed from Dental Unit Water Lines (DUWLs) when enrichment cultures are performed and to compare frequencies with those obtained without enrichment cultures. Moreover, the antimicrobial susceptibilities of the microorganisms isolated were also studied. Water samples were collected from one hundred dental equipments in use at Dental Hospital of our University in order to evaluate the presence/absence of microorganisms and to perform their presumptive identification. Aliquots from all of the samples were inoculated in eight different media including both enrichment and selective media. Minimal inhibitory concentrations (MIC) were determined by the broth dilution method. The results herein reported demonstrate that most of the DUWLs were colonized by bacteria from human oral cavity; when enrichment procedures were applied the percentage of DUWLs with detectable human bacteria was one hundred percent. The results showed that in order to evaluate the actual risk of infections spread by DUWLs the inclusion of a step of pre-enrichment should be performed. The need for devices preventing bacterial contamination of DUWLs is a goal to be achieved in the near future that would contribute to maintain safety in dental medical assistance

Histological Outcomes on the Development of New Space-making Devices for Maxillary Sinus Floor Augmentation

Background: Previous studies have pointed out that the mere elevation of the maxillary sinus membrane promotes bone formation without the use of augmentation materials. Purpose: This experimental study aimed at evaluating if the two-stage procedure for sinus floor augmentation could benefit from the use of a space-making device in order to increase the bone volume to enable later implant installation with good primary stability. Materials and Methods: Six male tufted capuchin primates (Cebus apella) were subjected to extraction of the three premolars and the first molar on both sides of the maxilla to create an edentulous area. The sinuses were opened using the lateral bone-wall window technique, and the membrane was elevated. One resorbable space-making device was inserted in each maxillary sinus, and the bone window was returned in place. The animals were euthanatized after 6 months, and biopsy blocks containing the whole maxillary sinus and surrounding soft tissues were prepared for ground sections. Results: The histological examination of the specimens showed bone formation in contact with both the schneiderian membrane and the device in most cases even when the device was displaced. The process of bone formation indicates that this technique is potentially useful for two-stage sinus floor augmentation. The lack of stabilization of the device within the sinus demands further improvement of space-makers for predictable bone augmentation. Conclusions: It is concluded that (1) the device used in this study did not trigger any important inflammatory reaction; (2) when the sinus membrane was elevated, bone formation was a constant finding; and (3) an ideal space-making device should be stable and elevate the membrane to ensure a maintained connection between the membrane and the secluded space.

Slow-release fluoride devices: a literature review

Although the prevalence of caries has decreased dramatically over the past decades, it has become a polarised disease, with most of subjects presenting low caries levels and few individuals accounting for most of the caries affected surfaces. Thus it become evident for the need of clinical approaches directed at these high-risk patients, in order to overcome problems related to compliance and low attendance at dental care centres. Slow-release fluoride devices were developed based on the inverse relationship existing between intra-oral fluoride levels and dental caries experience. The two main types of slow-release devices - copolymer membrane type and glass bead - are addressed in the present review. A substantial number of studies have demonstrated that these devices are effective in raising intra-oral F concentrations at levels able to reduce enamel solubility, resulting in a caries-protective effect. Studies in animals and humans demonstrated that the use of these devices was able to also protect the occlusal surfaces, not normally protected by conventional fluoride regimens. However, retention rates have been shown to be the main problem related to these devices and still requires further improvements. Although the results of these studies are very promising, further randomised clinical trials are needed in order to validate the use of these devices in clinical practice. The concept of continuously providing low levels of intra-oral fluoride has great potential for caries prevention in high caries-risk groups.

Deep venous thrombosis prophylaxis in oral and maxillofacial surgery: a Brazilian survey

Background : Deep venous thrombosis (DVP) is a frequent disease. Prophylaxis is the best means to reduce its incidence, for lowering morbidity and mortality rates and treatment costs caused by its complications. Objective : To evaluate the knowledge and use of any kind of DVT prophylaxis by Brazilian Oral and Maxillofacial surgeons. Materials and Methods : A questionnaire was sent to all Oral and Maxillofacial surgeons associated to the Brazilian College of Oral and Maxillofacial Surgeons that have a valid e-mail address. The data retrieved was evaluated and tabulated. Results : Of the 1100 questionnaires sent, only 4% were retrieved. The 42 retrieved were included in the study. Twenty six of the surgeons do not use any kind of deep venous thrombosis (DVT) prophylaxis, 11 use mechanical means as elastic compressive stockings or pneumatic compressive devices for prophylaxis, and 5 uses low-molecular weight heparins (LMWH) as the choice for prophylaxis. Conclusion : The data collected, despite the low rate of participation (4%) by the surgeons, shows that this subject still does not receive proper attention. Whereas other medical specialties make routine use of prophylactic means maybe the maxillofacial surgeons lack concern on that matter.

Desenvolvimento de um paralelizador intra-oral e verificação de sua precisão como método de transferência de planos de guia: Estudo laboratorial

Pós-graduação em Odontologia Restauradora - ICT

Candida spp. adherence to oral epithelial cells and levels of IgA in children with orthodontic appliances

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity

Nanotechnology-based drug delivery systems for treatment of oral cancer: a review

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

Effects of probiotic fermented milk on biofilms, oral microbiota, and enamel

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)