Oral health evaluation of cardiac patients admitted to cardiovascular pre-surgery intervention / Saúde bucal de pacientes cardiopatas internados em pré- intervenção de cirurgia cardiovascular

ABSTRACT Objective: To assess the oral health status of patients admitted to pre-intervention heart surgery, observing the need index concerning invasive treatment. Methods: hospitalized volunteers in number of 75 were evaluated in order to be investigated concerning which systemic changes were occurring, the patients' oral health conditions as well as the need for invasive dental procedures. Results: Volunteers analyzed in the study were: 69.3% male and 30.7% female. As for the reason for hospitalization were: valvuloplasty (41.3%), coronary artery bypass surgery (24%), pacemaker implantation (16%), cardiac catheterization (8%), placement of stent (6.6%), congenital heart disease (4%). The associated systemic changes were: hypertension (54.6%), diabetes mellitus (20.0%), hypertension and diabetes mellitus (13.3%). Most patients presented the need to undergo invasive dental treatment procedures such as: Periodontal (58.6%), Restorative Dentistry (26.6%), surgical (18.6%), endodontic (12%), dental pain source (2, 6%), abscess presence (1.3%). Conclusion: The oral health status of the patients was considered poor, a significant number of patients at the time of the oral examination, needed some type of invasive dental treatment and the oral environment adequacy indicated dental condition which may cause the formation of infectious sites which in turn can trigger complications both in the oral cavity and general health, as well.

RESUMO Objetivo: Avaliar a condição de saúde bucal dos pacientes internados em pré- intervenção de cirurgia cardíaca, observando o índice de necessidade de tratamento invasivo. Métodos: Foram avaliados 75 voluntários hospitalizados, investigando quais as alterações sistêmicas, as condições de saúde bucal e avaliando a necessidades de procedimentos odontológicos invasivos. Resultados: Os voluntários analisados no estudo foram: 69,3% do gênero masculino e 30,7% do gênero feminino. Quanto ao motivo de internação foram: valvuloplastia (41,3%), cirurgia de revascularização do miocárdio (24%), implante de marcapasso (16%), cateterismo cardíaco (8%), colocação de Stent (6,6%), cardiopatia congênita (4%). As alterações sistêmicas associadas: hipertensão arterial (54,6%), diabetes mellitus (20,0%), hipertensão arterial e diabetes mellitus (13,3%). A maioria dos pacientes apresentaram necessidade de realização de tratamento odontológico invasivo: periodontal (58,6%), restaurador (26,6%), cirúrgico (18,6%), endodôntico (12%), dor de origem odontológica (2,6%), presença abcesso (1,3%). Conclusão: A condição de saúde bucal dos pacientes avaliados foi considerada deficiente, um número significativo de pacientes, no ato do exame bucal, necessitava de algum tipo de tratamento odontológico invasivo e de adequação do meio bucal indicado condição dentária com possibilidade de formação de focos infecciosos, podendo levar a complicações na cavidade bucal e saúde geral.

Evaluation of the genotoxicity and mutagenicity of Ca3SiO5-based cement

Abstract Ca3SiO5 is new cement based on the composition of Portland that has been developed to have superior physicochemical and biological properties. In a clinical evaluation, the cement did not appear to have cytotoxic properties and allowed for the proliferation of pulp cells and gingival fibroblasts. However, no previous studies have evaluated the genotoxicity or the mutagenicity of Ca3SiO5in vivo. Therefore, the goal of this study is to evaluate the genotoxic and mutagenic potential of Ca3SiO5-based cement in vivo. Twenty-four male Wistar rats were divided into 3 groups (n = 8). Group A rats received subcutaneous implantation of Ca3SiO5 in the dorsum. Group B rats received a single dose of cyclophosphamide (positive control). Group C rats received subcutaneous implantation of empty tubes in the dorsum (negative control). After 24 hours, all animals were euthanized and the bone marrow of the femurs was collected for use in the comet assay and the micronucleus test. The comet assay revealed that the Ca3SiO5 group had a tail intensity of 23.57 ± 7.70%, the cyclophosphamide group had a tail intensity of 27.43 ± 7.40%, and the negative control group had a tail intensity of 24.75 ± 5.55%. The average number of micronuclei was 6.25 (standard deviation, SD = 3.53) in the Ca3SiO5 group, 9.75 (SD = 2.49) in the cyclophosphamide group, and 0.75 (SD = 1.03) in the negative control group. There was an increase in the micronuclei frequency in the Ca3SiO5 group compared to that of the negative control group (p < 0.05). Our data showed that exposure to the Ca3SiO5-based cement resulted in an increase in the frequency of micronuclei, but no genotoxicity was detected according to the comet assay.

Estudo das características estomatológicas e sistêmicas em pacientes com lúpus eritematoso sistêmico / Study of characteristics and systemic stomatological in patients with lupus erythematosus

Introdução: O lúpus eritematoso sistêmico (LES) é uma doença inflamatória crônica, de causa desconhecida e de natureza autoimune. O uso de diversos medicamentos e a presença das múltiplas alterações sistêmicas podem comprometer o atendimento odontológico desses pacientes principal­ mente quando se encontram descompensados e debilitados. Objetivos: Avaliar a condição de saúde bucal e geral dos pacientes com LES, verificando: frequência e os tipos de danos sistêmicos perma­nentes e uso de medicamentos utilizados para o tratamento dessa enfermidade que comprometem o tratamento odontológico. Material e método: Foram analisados 34 pacientes portadores de LES, estes foram submetidos a uma entrevista estruturada sobre condição sistêmica e a um exame físico buco dental, avaliando: índice CPO-D, condição de saúde gengival e dor na articulação tem poro mandi­bular. Resultados: CPO-D média 15,3; Condição gengival: 65% com gengivite; artrite: 94%; envolvi­mento hematológico: 41%; envolvimento renal: 29%, envolvimento cardiovascular e pulmonar:18%. Medicamentos mais utilizados: glucocorticosteróides: 88%; anti-inflamatórios não esteróides 52%; hidroxicloroquina: 41%; antidepressivo: 32%. Conclusão: A condição de saúde bucal dos pacientes avaliados é deficiente; existe grande variabilidade de doenças sistêmicas; uso de diversos medica­mentos, com efeitos colaterais negativos e imunossupressores para a condição geral dos pacientes com LES. Esses pacientes se tornam de alto risco para o tratamento odontológico. Os Cirurgiôes-Den­tistas devem estar atentos e preparados para tratar as necessidades especiais do paciente com LES.

Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unkno­ wn cause and autoimmune nature. The use of multiple medications and the presence of multiple systemic changes may compromise the dental care of these patients especially when they are un­ compensated and debilitated. Objectives: The aim of this study was to analyze the condition of oral and general health of patients with SLE. The frequency, types of systemic damage, use of controlled medications used to treat this disease that undertake dental treatment. Methods: 34 patients were analyzed with SLE that were submitted a structured interview about systemic condition and dental exam: DMFT index, gingival health condition and temporo mandibular joint pain. Results: DMFT average 15.3%; gingival condition: 65 % with gingivitis; arthritis: 94%; hematologic involvement: 41%, renal involvement: 29%, cardiovascular and pulmonary involvement: 18%. Most widely used drugs: glucocorticosteroids: 88%, anti - inflammatory drugs 52%; hydroxychloroquine: 410f0; an­ tidepressant: 32 Ofo. Conclusion: The oral health of the patients is poor, there is great variability in systemic diseases, use of various drugs with negative side effects and immunosuppressants for the general condition of patients with SLE. These patients becomes an high risk for dental care and the dentists may be vigilant and prepared to apply special needs of patients with SLE.