Falha no Tratamento da Avulsão Dentária Infantil: Relato de Caso / Failure in child tooth avulsion treatment: a case report

Objetivo: este artigo tem como objetivo demonstrar a abordagem de um trauma alveolar dentário no qual o reimplante dentário foi realizado no Sistema Único de Saúde (SUS) e encaminhado para acompanhamento a longo prazo em uma Clínica Odontológica da Universidade do Nordeste do Brasil. Relato de caso: paciente do sexo masculino, 7 anos, encaminhado à Clínica Odontológica da Universidade Tiradentes para acompanhamento em longo prazo de um reimplante dentário do elemento 11. Durante o exame clínico, observa-se um grau severo de mobilidade dentária, além da presença de fístula na linha do muco gengival do dente. Radiograficamente, observou-se espessamento do ligamento periodontal e áreas de extensa reabsorção externa. O acompanhamento do caso durou aproximadamente 1 ano. Conclusão: portanto, é essencial que o profissional cirurgião-dentista tenha conhecimento para o correto diagnóstico e agilidade neste tratamento urgente, a fim de preservar o órgão dentário na cavidade oral por mais tempo

Introduction: dental trauma is an injury that mainly affects children and adolescents. Tooth avulsion is one of the most common causes of trauma, which is the expulsion of the alveolar tooth. The prognosis is due to pulp and support tissue repair, however, it is associated with complications such as functional, aesthetic and psychological problems, and is doubtful and dependent on rapid behavior. Objective: this article aims to demonstrate the approach of a dental alveolar trauma in which dental reimplantation was performed in the Unified Health System (SUS) and referred for long-term follow-up in a University Dental Clinic of Northeast Brazil. Case report: a 7-year-old male patient, referred to the Dental Clinic of Universidade Tiradentes for long-term follow-up of a dental reimplantation of element 11. During the clinical examination, a severe degree of tooth mobility can be observed, in addition to presence of fistula in the gingival mucus line of the tooth. Radiographically, thickening of the periodontal ligament and areas of extensive external resorption were observed. The follow-up of the case lasted approximately 1 year. Conclusion: thus, it is essential that the dental surgeon professional has knowledge for the correct diagnosis and agility in this urgent treatment, in order to preserve the dental organ in the oral cavity for a longer time.

Bioactive glass added to autogenous bone graft in maxillary sinus augmentation: a prospective histomorphometric, immunohistochemical, and bone graft resorption assessment

Abstract Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.

In vitro evaluation of the anti-leishmanial activity and toxicity of PK11195

BACKGROUND Leishmaniasis, one of the most neglected diseases, is a serious public health problem in many countries, including Brazil. Currently available treatments require long-term use and have serious side effects, necessitating the development of new therapeutic interventions. Because translocator protein (TSPO) levels are reduced in Leishmania amazonensis-infected cells and because this protein participates in apoptosis and immunomodulation, TSPO represents a potential target for Leishmania chemotherapy. The present study evaluated PK11195, a ligand of this protein, as an anti-leishmanial agent. OBJECTIVE To evaluate the leishmanicidal activity of PK11195 against L. amazonensis in infected CBA mouse macrophages in vitro. METHODS The viability of axenic L. amazonensis, Leishmania major, and Leishmania braziliensis promastigotes was assessed after 48 h treatment with PK11195 (0.2-400 µM). Additionally, intracellular parasite viability was evaluated to determine IC50 values and the number of viable parasites in infected macrophages treated with PK11195 (50-100 µM). Infected macrophages were then treated with PK11195 (25-100 µM) to determine the percentage of L. amazonensis-infected cells and the number of parasites per infected cell. Electron microscopy was used to investigate morphological changes caused by PK11195. The production of free oxygen radicals, nitric oxide, and pro-inflammatory cytokines was also evaluated in infected macrophages treated with PK11195 and primed or not primed with IFN-γ. FINDINGS Median IC50 values for PK11195 were 14.2 µM for L. amazonensis, 8.2 µM for L. major, and 3.5 µM for L. braziliensis. The selective index value for L. amazonensis was 13.7, indicating the safety of PK11195 for future testing in mammals. Time- and dose-dependent reductions in the percentage of infected macrophages, the number of parasites per infected macrophage, and the number of viable intracellular parasites were observed. Electron microscopy revealed some morphological alterations suggestive of autophagy. Interestingly, MCP-1 and superoxide levels were reduced in L. amazonensis-infected macrophages treated with PK11195. MAIN CONCLUSIONS PK11195 causes the killing of amastigotes in vitro by mechanisms independent of inflammatory mediators and causes morphological alterations within Leishmania parasites, suggestive of autophagy, at doses that are non-toxic to macrophages. Thus, this molecule has demonstrated potential as an anti-leishmanial agent.

PPE tube filled with autologous fat in the repair of peripheral nerve: a new proposal / Tubo PPE relleno con grasa autóloga en la reparación de los nervios periféricos: una nueva propuesta

This study proposes the use of a porous polyethylene (PPE) tube as the conductive element in the regeneration in the sciatic nerve sectioning and evaluates the use of fill with autologous fat. The subject was divided randomly into five groups, 3 control and 2 experimental (PPE tube graft with/ without autologous fat). Each group was selected for functional, histological and morphometric evaluation of the sciatic nerve. Functional analysis of the sciatic nerve occurred through the "footprint" values near -100 refer sectioned sciatic nerve, near 0 (zero) refer to control group. On histological analysis of the experimental groups lots of dense connective tissue replacing nerve tissue was observed. In morphometric analysis the group EGPGf got higher performance in all of variables. The use of PPE has shown promise in nerve regeneration with favorable results when associate with fat as a trophic factor in the regeneration.

Este estudio propone el uso de un tubo de polietileno poroso (PPE) como elemento conductor en la regeneración del nervio ciático seccionado y evaluar el uso de relleno con grasa autóloga. Al azar se formaron cinco grupos, 3 y 2 de control experimental (PPE prótesis tubular con / sin grasa autóloga). Cada grupo fue seleccionado para estudiar la forma funcional, histológica y evaluación morfométrica del nervio ciático. Un análisis funcional del nervio ciático se produjo a través de los valores de "huella", cerca de -100 se refiere al nervio ciático seccionado; cerca de 0 (cero) se refiere al grupo control. En el análisis histológico de los grupos experimentales se observó una gran cantidad de tejido conjuntivo denso que sustituye el tejido nervioso. En el análisis morfométrico, el grupo experimental de injerto de polietileno lleno de grasa (EGPGf) obtuvo un mayor rendimiento en todas las variables. El uso de PPE ha mostrado ser prometedor en la regeneración del nervio, con resultados favorables cuando se asocia con la grasa como un factor trófico en la regeneración.

PREVALENCE OF THE HEPATITIS C VIRUS AMONG UNIVERSITY EMPLOYEES IN SÃO PAULO, SOUTHEASTERN BRAZIL: predictive factors and geoprocessing spatial analysis / Prevalência do vírus da hepatite C em funcionários universitários do Estado de São Paulo, Brasil: fatores preditivos e análise espacial por geoprocessamento

Background There are limited studies on the prevalence and risk factors associated with hepatitis C virus (HCV) infection. Objective Identify the prevalence and risk factors for HCV infection in university employees of the state of São Paulo, Brazil. Methods Digital serological tests for anti-HCV have been performed in 3153 volunteers. For the application of digital testing was necessary to withdraw a drop of blood through a needlestick. The positive cases were performed for genotyping and RNA. Chi-square and Fisher’s exact test were used, with P-value <0.05 indicating statistical significance. Univariate and multivariate logistic regression were also used. Results Prevalence of anti-HCV was 0.7%. The risk factors associated with HCV infection were: age >40 years, blood transfusion, injectable drugs, inhalable drugs (InDU), injectable Gluconergam®, glass syringes, tattoos, hemodialysis and sexual promiscuity. Age (P=0.01, OR 5.6, CI 1.4 to 22.8), InDU (P<0.0001, OR=96.8, CI 24.1 to 388.2), Gluconergam® (P=0.0009, OR=44.4, CI 4.7 to 412.7) and hemodialysis (P=0.0004, OR=90.1, CI 7.5 – 407.1) were independent predictors. Spatial analysis of the prevalence with socioeconomic indices, Gross Domestic Product and Human Development Index by the geoprocessing technique showed no positive correlation. Conclusions The prevalence of HCV infection was 0.7%. The independent risk factors for HCV infection were age, InDU, Gluconergan® and hemodialysis. There was no spatial correlation of HCV prevalence with local economic factors. .

Contexto Existem escassos estudos sobre a prevalência e fatores de risco associados à infecção pelo vírus da hepatite C. Objetivos Identificar a prevalência e os fatores de risco para a infecção pelo vírus da hepatite C em funcionários de uma Universidade do Estado de São Paulo, Brasil. Métodos Testes sorológicos digitais para anti vírus da hepatite C foram realizados em 3.153 voluntários. Para a aplicação do teste digital foi necessário retirar uma gota de sangue através de uma picada de agulha. Nos casos positivos foram realizados genotipagem e RNA. Os testes Qui-quadrado e exato de Fisher foram utilizados, com valor de P<0,05 sendo considerado como estatisticamente significante. Regressão logística univariada e multivariada também foram aplicadas. Resultados A prevalência de anti vírus da hepatite C foi de 0,7%. Os fatores de risco associados com a infecção pelo vírus da hepatite C foram idade >40 anos, transfusão de sangue, uso de drogas injetáveis, uso de drogas inalatórias, Gluconergam® injetável, uso de seringas de vidro, tatuagens, hemodiálise e promiscuidade sexual. Idade (P=0,01, OR 5,6, IC 1,4-22,8), uso de drogas inalatórias (P<0,0001, OR=96,8, IC 24,1-388,2), Gluconergam® injetável (P=0,0009, OR=44,4, IC 4,7-412,7) e hemodiálise (P=0,0004, OR=90,1, IC 7,5-407,1) foram preditores independentes. A análise espacial da prevalência com índices socioeconômicos, produto interno bruto e índice de desenvolvimento humano, por meio da técnica de geoprocessamento, não mostrou correlação positiva. Conclusões A prevalência da infecção pelo vírus da hepatite C foi de 0,7%. Os fatores de risco independentes para a infecção pelo vírus da hepatite C foram idade, uso de drogas inalatórias, Gluconergan® injetável e hemodiálise. Não houve correlação espacial da prevalência de vírus da hepatite C com fatores econômicos locais. .

Determinação da Atividade Antimicrobiana do Extrato Hidroalcoólico da PlantaPlectranthus ornatus Codd (Boldo Chinês) / Determination of the antimicrobial activity in the hydroalcoholic extract of the plant Plectranthus ornatus Codd (Bilberry Chinese)

A planta Plectranthus ornatus Codd é originária dos países do Mediterrâneo e Oriente Próximo. Na medicina popular é indicada para males do fígado e problemas de digestão. É utilizada no tratamento para o controle da gastrite, na dispepsia, azia, mal-estar gástrico e ressaca. Este trabalho objetiva a avaliação antimicrobiana do extrato de P. ornatus, utilizando-se 15 microrganismos padronizados. Os testes antimicrobianos foram realizados em ágar Mueller Hinton pela técnica de poços. Foram utilizados os testes de microdiluição em caldo, para a determinação da concentração inibitória mínima (CIM) e semeadura, em placas contendo ágar Mueller Hinton para a concentração microbicida mínima (CMM). Os testes de microdiluição em caldo demonstraram que o extrato nas concentrações de 20,31; 325 e 650 mg/mL inibiu o crescimento bacterianode Bacillus cereus, Streptococcus pyogenes e Enterococcus faecalis, respectivamente. Para o fungo Saccharomyces cerevisiae os testes de microdiluição demonstraram inibi- ção do crescimento na concentração de 1.300 mg/mL. Para as demais cepas testadas, o extrato não demonstrou atividade. Em decorrência da crescente resistência múltipla microbiana aos antibióticos, pesquisas para o desenvolvimento de novos medicamentosque sejam economicamente viáveis e com margem de segurança efetiva têm ganhado espaço na comunidade científica.

Plectranthus ornatus Codd is a plant from Mediterranean and Near East countries. It is indicated for liver illnesses and digestion problems in popular medicine. It is used in the treatment for the control of gastritis, dyspepsia, heartburn, gastric discomfort, and hangover. This study aims to evaluate the antimicrobial activity in extracts of P. ornatus using 15 standardized micro-organisms. Antimicrobial tests were performed on Mueller Hinton agar through the technique of wells. Broth microdilution tests were used for the determination of the minimum inhibitory concentration (MIC), and seeding on plates containing Mueller Hinton agar for the determination of the minimum microbicide concentration (MMC). The broth microdilution tests demonstrated that the extract inhibited the growth of Bacillus cereus, Streptococcus pyogenes, and Enterococcus faecalis at the concentrations of 20.31, 325, and 650 mg/mL, respectively. The microdilution tests showed growth inhibition of Saccharomyces cerevisiae at a concentration of 1,300 mg/mL. The extract did not show inhibitory activity on the other tested strains. As a result of increased multiple resistances to antibiotics,microbial research in the development of new drugs that are economically viable and offer an effective safety margin have won space in the scientific community.

Osteonecrosis severa de los maxilares asociada al uso de bifosfonatos / Severe osteonecrosis of the jaws in a compromised patient subjected to bisphosphonate therapy

Bisphosphonate-related osteonecrosis of the jaws is characterized by alveolar bone exposure, especially after mucosal trauma or after surgical procedures, in patients who have previously received or who are currently receiving bisphosphonates without a history of radiation therapy in the maxillofacial region. The condition is refractory to treatment, and attempts at debridement are not completely effective in eradicating the necrotic bone. We report here a case of a severe osteonecrosis of the jaws in a 77-year-old male patient, who had been subjected to chemotherapy and treatment with zoledronic acid and corticosteroid. The patient also had comorbidities such as diabetes and periodontal disease, which might have contributed to the lesion development. Bisphosphonate-related osteonecrosis of the jaws has become a reality in dental clinical practice. Although palliative treatment aiming at controlling pain, infection and injury progression is indicated, the therapeutic strategy is still challenging. So far, the best approach available is prevention, based on oral care before, during, and after bisphosphonate therapy(AU)

La osteonecrosis de los maxilares asociada al uso de bifosfonatos se traduce en la aparición de hueso alveolar expuesto y necrótico, especialmente después de un trauma de la mucosa o después de procedimientos quirúrgicos, en pacientes que han recibido previamente o que están recibiendo bifosfonatos pero sin historia de radioterapia a región máxilofacial. La afección es refractaria al tratamiento, y los intentos de desbridamiento no son totalmente eficaces en la erradicación del hueso necrótico. Se presenta aquí un caso de una grave osteonecrosis de los maxilares en un paciente masculino de 77 años de edad, que había sido sometido a quimioterapia y tratamiento con ácido zoledrónico y corticosteroides. El paciente también tenía comorbilidades como diabetes y enfermedad periodontal, que pueden haber contribuido al desarrollo de la lesión. El creciente número de casos de esta enfermedad en la literatura ha llamado la atención. Dado que el enfoque terapéutico sigue siendo difícil, la prevención es la mejor estrategia disponible(AU)

Mandibular metastasis of adenocarcinoma from prostate cancer: case report according to epidemiology and current therapeutical trends of the advanced prostate cancer

Prostate cancer represents the most frequent non-cutaneous neoplasia in males. This type of neoplasia can develop peculiar patterns of evolution, presenting, in many cases, precocious relapses and metastasis. Bone metastasis in the mouth is extremely rare, and represents 1% of all malignant mouth neoplasias. The aim of the present study is to report a clinical case of bone metastasis in the mandibular region associated with a tumoral prostate adenocarcinoma, as well as to discuss connected aspects about diagnosis, prognosis and integrated treatment of this condition.

Immunohistochemical assessment of the MIB, CK-14, p63, p16, Cal A, and Cys A markers in spindle cell squamous cell carcinomas of the lip / Avaliação imuno-histoquímica dos marcadores MIB, CK-14, p63, p16, Cal A e Cys em carcinomas espinocelulares de lábio

Objective: with the objective of testing the expression of the protein markers MIB, CK14, p63, p16, Cal A, and Cys A in the pathogenesis of oral spindle cell carcinoma, we conducted an immunohistochemical study of the expression of the protein markers MIB, CK14, p63, p16, Cal A, and Cys A in human biopsy specimens of these lesions. Methods: fifteen histological specimens of spindle cell squamous cell carcinoma of the lower lip were obtained from the Department of Oral Pathology, Bahia Federal University. Immunohistochemical analyses were performed at the Molecular Biology Laboratory of the Department of Otorhinolaryngology, Heidelberg University, Germany. Results: statistical analysis revealed no association between markers. There was strong positive staining for Ck14, MIB, and Cal A in 93.3% of cases, thus establishing a strong association. Conclusion: p63, p16, MIB, Cal A, Cys A are markedly expressed and p16 is strongly suppressed in oral cavity tumors, which suggests that the latter protein may play a role in negative regulation of cell cycle progression.