Tratamiento de la transposición de incisivos inferiores / Treatment of transposition of lower incisors

La transposición es el intercambio de la posición de dos dientes adyacentes durante los primeros años de la dentición mixta. El objetivo de la investigación fue evaluar los cambios clínicos de un caso con transposición parcial bilateral de incisivos laterales mandibulares. Se atendió una paciente de 8 años de edad, femenina, de raza blanca, síndrome de Clase II división 1, con transposición de los incisivos laterales con caninos inferiores. Fue tratada con un arco lingual de cierre horizontal, de alambre 0,032 y dos muelles de NiTi comprimidos desde el cierre horizontal del arco hasta una armella soldada a la banda que se colocó en ambos incisivos laterales. Se recuperó el espacio necesario para la erupción de los caninos inferiores y así mejoró la estética dental y facial de la paciente.

Transposition is the exchange of the position of two adjacent teeth during the first years of the mixed dentition. The objective of this research is to evaluate the clinical changes of a case with partial bilateral transposition of mandibular lateral incisors. We present an 8-year-old white female patient with Class II Division 1 malocclusion and transposition of the lateral incisors with lower canines. She was treated with a 0.032 wire horizontal closure lingual arch and two NiTi springs compressed from the horizontal closure of the arch to an eyebolt welded to the band that was placed on both lateral incisors. The necessary space for the eruption of the lower canines was recovered, thus improving her dental and facial aesthetics.

Surgical rehabilitation of cleft lip and/or palate: evaluation of the Brazilian public health system

Abstract Objective: To evaluate the surgical rehabilitation of cleft lip and/or palate by the Brazilian public health system. Methods: Retrospective, analytical and comparative ecological study, with information on hospital procedures performed on individuals with cleft lip and/or palate in Centers authorized by the Brazilian public health system, between the years 2008 and 2020. The information was collected in databases Ministry of Health data. Results: Between 2008 and 2020, there was an increase of 8 (36.4%) qualified Centers in Brazil, currently having 30 Centers in 100% of the geographic regions. The surgical procedures performed totaled 68,716; with multiple surgeries being the most frequent. Complete cleft lip and palate was the most frequent type in hospital admissions. The public financial resources invested in the surgical rehabilitation of cleft lip and palate in the qualified Lip and Palate Malformation Treatment Centers were US$ 39,693 million, making an average value per procedure of US$ 577.64. Conclusions: In Brazil, public health system performed and financed, over the years 2008 and 2020, an important volume of surgical procedures for cleft lip and/or palate, which presented a polarization in the Southeast region but with a slight tendency expansion to other regions of the country. The most performed surgical procedures were multiple surgeries and mostly for individuals with cleft lip and palate. The amounts paid showed a heretogeneous distribution in the national territory. Level of evidence: Level 5: Report containing program evaluation data.

Alergias alimentarias en pacientes con glositis migratoria benigna / Food allergies in patients with benign migratory glossitis

Introducción: la glositis migratoria benigna, también conocida como lengua geográfica, es una variante normal, que presenta zonas superficiales circulares. Según la literatura revisada, dentro de sus causas figuran los procesos alérgicos, en los que están las alergias alimentarias. Se decidió realizar esta investigación para determinar la prevalencia de las alergias alimentarias frecuentes en estos pacientes mediante pruebas cutáneas. Materiales y métodos: se realizó un estudio descriptivo, longitudinal y prospectivo. La muestra estuvo compuesta por 27 pacientes en el período de enero hasta agosto de 2018 en portadores de glositis migratoria benigna, a los cuales se les realizaron pruebas alérgicas de tipo cutáneas para la determinación de alergias alimentarias. Resultados: el 59,3 % fue mujer y el antecedente alérgico más frecuente fue la rinitis alérgica. El antecedente de alergia alimentaria más frecuente fue los lácteos. Respecto a los resultados de las pruebas para la leche y los mariscos, estas dieron positivas en la mayoría de los pacientes, seguidos por el pescado, los huevos y los frutos secos. La prevalencia de positividad para por lo menos una prueba fue de 85,2%. Discusión: actualmente no existe suficiente literatura que hable sobre las posibles etiologías de la glositis migratoria benigna. Dentro de los antecedentes alérgicos, la rinitis alérgica fue la más frecuente, seguida de la alergia alimentaria. Hasta ahora existen pocas investigaciones que estudien esta prevalencia de alergias alimentarias en los pacientes de forma específica. Conclusión: la lengua geográfica no tiene factor epidemiológico predominante. El antecedente alérgico puede ser un factor predisponente, la alergia alimentaria puede ser desencadenante de la presentación de la lengua geográfica.

Introduction: The benign migratory glossitis, also known as geographic tongue, is a normal variant, which presents circular or irregular depapillated superficial areas. According to the literature reviewed, its causes include allergic processes, among these are food allergies. It was decided to carry out this investigation to determine the prevalence of frequent food allergies in these patients using skin tests. Materials and methods: A descriptive, longitudinal, prospective study was carried out. The sample consisted of 27 patients in the period January-August 2018, carriers of geographic tongue who underwent skin-type allergic tests to determine food allergies. Results: 59.3% were women without statistically significant predominance, the most frequent allergic history was allergic rhinitis. The most frequent history of food allergy was to dairy. Regarding the results of the tests for milk and shellfish, they were positive in 55.6%, followed by fish 14.8%, eggs and nuts with 11.1% respectively. The prevalence of positivity for at least one test was 85.2% with a statistically significant predominance over the negative result. Discussion: There is currently not enough literature that discusses the possible etiologies of benign migratory glossitis. Within the allergic history, allergic rhinitis was the most frequent, followed by food allergy. Until now there are few investigations that study this prevalence of food allergies in patients in a specific way. Conclusion: Geographic tongue does not have a predominant epidemiological factor, an allergic history can be a predisposing factor, food allergy can be a trigger for presentation of geographic language.

Atypical oral features of patient with neurofibromatosis type 1: case report / Características orais atípicas de paciente com neurofibromatose tipo 1: relato de caso

RESUMEN El propósito de este artículo es ayudar a los dentistas clínicos a identificar la neurofibromatosis tipo 1 y sus variantes. Presentamos un caso raro de un hombre de 68 años, afectado desde la infancia por la presencia de nódulos generalizados en todo el cuerpo, provocando deformaciones estéticas. Curiosamente, el impacto en la cavidad oral no fue significativo, con nódulos solo en la encía, un área de manifestación raro. La radiografía panorámica mostró un ligero agrandamiento del canal mandibular. Tras un año de seguimiento, el paciente falleció por complicaciones cardiovasculares provocadas por el síndrome.

Clinical Investigation of Congenital Factor Affecting Craniofacial Morphology of Unilateral Cleft Lip and Palate in Japanese Patients

Objective: To evaluate the craniofacial morphology of Japanese patients with unilateral cleft lip and palate and to evaluate the multiple congenital factors that affects craniofacial morphology in unilateral cleft lip and palate patients. Material and Methods: Lateral cephalograms of 140 subjects with unilateral cleft lip and palate were taken before any orthodontic treatment and alveolar bone graft. Subjects mean age was 6.85 ±1.56 years. Primary surgeries performed by surgeons from Hokkaido University Hospital. The craniofacial morphology of the 140 subjects was assessed by angular and linear cephalometric measurements. Gender, side of cleft, complete/incomplete type of cleft, presence/absence of lateral incisor in the affected side, family history of cleft and family history of skeletal Class III was chosen as congenital factors. To compare the assessments using congenital factors affecting craniofacial morphology in the unilateral cleft lip and palate subjects, angular and linear cephalometric measured values from each individual subject (control group) were converted into Z scores in relation to the means and standard deviation of the two parameters. Results: Twelve out of 13 craniofacial morphology outcomes were insignificant in 5 out of 6 dependent variables. Only 1 dependent variable showed 3/13 significant differences. Conclusion: Current study revealed the evidence that there were almost no significant differences in the craniofacial morphology outcome among various congenital factors. This will provide base line information and help determine the effectiveness of such factors.

Incidence of Egyptian Live Births of Cleft Lip and/or Palate in Cairo, Luxor, Aswan and New Valley Governorates: A Survey Study in 237,783 Children

Objective: To evaluate the prevalence, cleft types distribution and etiological risk factors among newly born babies with cleft lip and/or palate (CL±P) in four governorate of the Arab Republic of Egypt, beginning the 1st of January 2013 till the 31st of December 2013. Material and Methods: Total 237,783 newly born babies from Cairo (162174), Aswan (42880), Luxor (32729), and New Valley (877) governorate in the Arab Republic of Egypt were included in this study. Incidence of CL±P babies per 1000 births was calculated in each district for the four studied governorates. Percentage distribution of cleft types within each governorate. Chi-square test was used for determining significance of difference of incidence and percentages within and between the governorates. Results: The mean prevalence value of CL±P in the four Egyptian studied governorates was 0.40/1000. The highest percentage of cleft type was cleft lip and palate followed by cleft lip and isolated cleft palate. The highest etiological risk factor was maternal passive smoking in the four studied governorates followed by consanguineous marriage and medicine intake during pregnancy. Conclusion: These data provided a picture of the prevalence of CL±P in four different governorate of Egypt and also provided a useful reference for cleft types distribution and etiological risk factors of CL±P data in Egypt and internationally.

Oral findings and its association with prenatal and perinatal factors in newborns / 소아과

PURPOSE: This study aimed to determine the frequency of abnormalities in the newborn oral cavity and to evaluate the association with prenatal and perinatal factors. METHODS: This cross-sectional study evaluated 2,216 newborns. Oral findings were assessed in the first 24 hours of life using visual examination. Sex, weight, length, gestational age, and medical disorders at birth were recorded. Maternal demographic and medical information was also obtained. RESULTS: The most common oral findings were Bohn’s nodules, Epstein’s pearls, and dental lamina cysts. Other intraoral findings included odontogenic cysts, ankyloglossia, and natal teeth, among others. In logistic regression analyses, folic acid consumption during pregnancy was significantly associated with Bohn’s nodules (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.23–2.55; P=0.002), Epstein’s pearls (OR, 1.63; 95% CI, 1.14–2.33; P=0.007), and dental lamina cysts (OR, 1.45; 95% CI, 1.02–2.05; P=0.038). Moreover, preterm births were negatively associated with prevalence of Bohn’s nodules (OR, 0.63; 95% CI, 0.50–0.80; P≤0.0001). Comparison between newborns with and without oral inclusion cysts showed that maternal folic acid and iron intake were significantly different (P < 0.05). CONCLUSION: Maternal folic acid and iron intake were associated with the prevalence of oral inclusion cysts.

Tratamento primário da deformidade labial e nasal nas fissuras labiais e labiopalatinas unilaterais / Primary treatment of lip and nasal deformity in unilateral cleft lip or cleft lip and palate

Introdução: A fissura labiopalatina é a deformidade congênita mais frequente dentre as malformações craniofaciais, afetando principalmente o lábio superior, nariz e palato. A realização da queiloplastia associada à rinoplastia primária em tempo único é uma tendência. Avaliamos a correlação entre a gravidade da fissura, a idade cirúrgica e a qualidade estética do resultado pós-operatório. Métodos: Foram avaliados 26 pacientes com fissuras labiais ou labiopalatinas unilaterais, com idades entre 3 e 12 meses, operados pela técnica de queilorrinoplastia de Göteborg/McComb. Foi feita uma avaliação fotográfica do pré e pós-operatório por cinco cirurgiões plásticos separadamente e os dados analisados. Resultados: A idade média de realização do procedimento foi de 6,5 ± 3,15 meses, sendo que somente sete pacientes (26,9%) foram operados na idade de 3 meses preconizada pelo protocolo. Foi encontrada correlação entre a gravidade da fissura e a qualidade dos resultados, ao mesmo tempo em que não foi encontrada associação entre a idade da cirurgia e os resultados. Todos os casos do estudo foram considerados ótimos ou satisfatórios. Conclusões: A utilização de uma técnica de queiloplastia que seja de fácil reprodutibilidade, com bons resultados estéticos, e que possa ser utilizada em conjunto com outras técnicas de tratamento primário do nariz é uma boa opção a ser adotada por centros de tratamentos deste tipo de paciente. A gravidade da fissura é um fator importante na qualidade dos resultados. Quanto mais grave a fissura os resultados tendem ser piores. A idade da cirurgia, neste estudo, não teve correlação com a qualidade nos resultados.

Introduction: Cleft lip and palate, the most frequent congenital craniofacial deformity, mainly affects the upper lip, nose, and palate. One possible treatment is single-stage lip repair with primary rhinoplasty. Here we assessed the correlations among cleft severity, surgical age, and aesthetic results. Methods: A total of 26 patients with unilateral cleft lip or cleft lip and palate aged 3-12 months underwent surgical lip repair associated with the Göteborg/McComb rhinoplasty technique. Steps before and after surgery were separately evaluated by five plastic surgeons using pictures and the data were analyzed. Results: The average patient age at surgery was 6.5 ± 3.15 months, and only seven patients (26.9%) underwent surgery at 3 months of age as recommended by the protocol. Cleft severity and results quality were associated, whereas surgical age and aesthetic results were not correlated. Results in all cases were considered optimal or satisfactory. Conclusions: The lip repair technique, which presents good reproducibility and aesthetic results and can be used with other primary treatment techniques for the nose, should be adopted by treatment centers managing cleft lip and palate. Cleft severity is an important factor in results quality; the greater the severity, the worse the results. In the present study, surgical age was not correlated with results quality.

Analysis of factors related to psychological status for adolescent orthodontic patients in stomatology department and intervention strategies / 中国实用护理杂志

Objective To explore and analyze the risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and to develop intervention strategies according to the results. Methods A total of 186 cases of adolescent orthodontic patients in stomatology department from September 2012 to September 2015 were selected, and psychological status was investigated by Chinese Middle School Students Mental Health Scale (MMHI-60 scale) and Symptom Self-rating Scale (SCL-90).The patients were divided into observation group (with psychological problems) and control group (without psychological problems) according to the psychological status scale scores. Univariate descriptive analysis and multivariate Logistic regression analysis were used to determine related factors of the possible influencing factors, and the intervention strategies were developed. Results The factors such as social roles, living area, single parent, only child, internal and external tropism, neuroticism, being given health education, malocclusion severities of the deformities were closely related to psychological status of adolescent orthodontic patients in stomatology department (χ2=2.534-44.297, P<0.05 or 0.01). The independent risk factors were classified as high to low according to the degrees of danger: severe malocclusion (OR=3.578, P=0.000), instability emotional (OR=2.934,P=0.000), workers (OR=1.857, P=0.011) and rural life (OR=1.632, P=0.014), while the factors such as outgoing personality (OR=0.628, P=0.008) and being given health education (OR=0.746, P=0.010) were protective factors. Conclusions The factors such as severe malocclusion, instability emotional, workers,rural life,outgoing personality and health education are the related risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and psychological health intervention should be strengthened in the clinical practice to improve the psychological status and compliance.

Utilização de agente esclerosante no tratamento de hemangioma lingual: relato de caso / Use of sclerosing agent in the treatment of lingual hemangioma: a case report

O hemangioma é uma neoplasia benigna que se caracteriza por proliferação endotelial anormal. Acomete a região maxilofacial com predileção pelos lábios, língua e mucosa jugal. O tratamento pode ser realizado por diferentes formas terapêuticas, desde corticoterapia até a excisão cirúrgica. Neste trabalho, descrevemos um caso clínico de hemangioma lingual, no qual se optou pela utilização de oleato de monoetanolamina a 5% - ethamolin®, obtendo-se total involução da lesão em 3 aplicações, além de nenhum sinal de recidiva após 15 meses

The hemangioma is a benign neoplasm characterized by abnormal endothelial proliferation. It affects the maxillofacial region with predilection for the lips, tongue and buccal mucosa. The treatment can be performed by different therapeutics, since steroids to surgical excision. In this work we describe a case of lingual hemangioma, where we opted to use monoethanolamine oleate 5% - ethamolin® to get the total lesion regression in 3 applications, and no sign of recurrence after 15 months

Endodontic treatment of a mandibular hypertaurodontic second molar / Tratamento endodôntico de segundo molar inferior com hipertaurodontia

Taurodontism is the consequence of a developmental disorder in which the invagination of Hertwig's epithelial root sheath doesn't occur at a proper level. As a result, the pulp body and the chamber of a multi-root tooth, usually permanent molar teeth, are enlarged by the apical displacement of the pulp floor. Despite its clinically normal appearance, the morphological variation of this tooth can be diagnosed by a routine radiographic exam that shows enlarged apico-occlusal pulp chamber and short roots. Due to these anatomical variations, endodontic treatment of a taurodontic element is a clinical challenge given the complexity of localization and instrumentation of the root canal system. According to the degree of displacement of the pulp floor, taurodontism can be classified as: hypotaurodontism, mesotaurodontism and hypertaurodontism. This study objective is to report a clinical case of a patient who was submitted to endodontic treatment of the second inferior molar affected by hypertaurodontism.

A taurodontia é consequência de um distúrbio de desenvolvimento em que a bainha epitelial de Hertwig não invagina corretamente em um nível normal, repercutindo em um aumento do corpo e da câmara pulpar de um dente multiradicular, predominantemente molares permanentes, pelo deslocamento do assoalho pulpar no sentido apical. Apesar de clinicamente aparentar-se como um dente normal, esta variação morfológica pode ser diagnosticada por exame radiográfico de rotina evidenciando câmara pulpar aumentadas em tamanho no sentido ápico-oclusal e raízes curtas. Devido a estas alterações anatômicas, o tratamento endodôntico de um elemento com taurodontia se torna um desafio clínico, já que é necessário um cuidado especial na localização e manejo do sistema de canais radiculares. De acordo com o grau de deslocamento apical do assoalho pulpar, a taurodontia pode ser classificada em: hipotaurodontia, mesotaurodontia e hipertaurodontia. O objetivo deste trabalho é relatar o caso clínico de um paciente que necessitou de tratamento endodôntico em um segundo molar inferior com hipertaurodontia.

Histopatologia da forma labial cicatricial de Keith / Histopathology of Keith`s lip scar

O estudo da etiologia das formas congênitas ditas cicatriciais, que incluem bandas cicatriciais congênitas e formas cicatriciais das fissuras labiais, apresenta diversas teorias, que fundamentam seu aparecimento, porém não justificam todos os aspectos envolvidos nessas malformações. Neste artigo são apresentados 4 casos de pacientes portadores da forma cicatricial de Keith, submetidos à realização de queiloplastia pela técnica de Spina, comparados a 1 caso de paciente portador de cicatriz traumática. Todos os pacientes tiveram amostra de tecido enviada para estudo histopatológico, com coloração com hematoxilina-eosina. Os casos estudados apresentaram semelhanças entre a pele embrionária e a cicatriz comum.

Examinations of the etiology of congenital cicatricial presentations, which include congenital constriction bands and cicatricial presentations of cleft lip, have provided several theories that explain their development; however, they do not explain all the aspects involved in these malformations. In the present article, we present the cases of 4 patients with Keith's lip scar who underwent cheiloplasty using the spina technique. These cases were compared with 1 case of a patient with a traumatic scar. Tissue samples were obtained from all the patients for histopathological examination using hematoxylin-eosin staining. The cases under study exhibited similarities in embryonic skin and common scar tissue.

Características da cavidade oral de bebês recém-nascidos, Blumenau/SC / Characteristics of the oral cavity of the newborns of Blumenau - SC, Brazil

Objetivo: Descrever as características morfológicas da cavidade oral de bebês recém-nascidos a termo. Método: Esta investigação se caracterizou como um estudo descritivo do tipo transversal, mediante o levantamento de dados secundários. Foram avaliados os dados obtidos de 270 prontuários odontológicos de bebês recém-nascidos a termo no Hospital Santa Catarina de Blumenau, SC, no período de agosto de 2006 a maio de 2010. As variáveis estudadas foram as alterações bucais e a relação de rodetes gengivais. Foram consideradas as seguintes características: relação de rodetes gengivais, aspecto da mucosa oral, freios e bridas, presença de pérolas de Epstein, nódulos de Bohn, epúlide congênita, dentes natais, presença de cordão fibroso de Robin e Magitot e apoio para sucção. Os dados foram registrados e agrupados com auxílio do programa Microsoft Excel, sendo calculadas as frequências absolutas e relativas e apresentados de forma descritiva. Resultados: Observou-se que sobressaliência (66,7%), pérolas de Epstein (47,7%), sucção adequada (100%), freios e bridas normais (98,5%) foram os resultados mais prevalentes. Os menos prevalentes foram mordida topo a topo (1,1%), sobremordida (4,4%), epúlide congênita (1,0%), dente natal, mucocele, rânula e língua volumosa (0,5%). Conclusão: As características da cavidade oral foram semelhantes às encontradas na literatura. A prevalência de alterações e/ou anormalidades foi baixa. As relações de rodetes gengivais, consideradas normais para bebês recém-nascidos, foram as mais prevalentes. A tendência atual é o atendimento odontológico precoce, e além de ser cada vez mais importante a inserção do cirurgião-dentista no ambiente hospitalar.

Objective: The aim of this study was to describe the morphological characteristics of the oral cavity of full-term newborns. Methods: A descriptive cross-sectional study was developed by the collection of secondary data from 270 dental records of full-term newborns born between August, 2006 and May, 2010 at the Hospital Santa Catarina in Blumenau, SC, Brazil. The studied variables were oral anomalies gum pad relationships. The data were recorded, grouped in Windows Excel for calculating the absolute and relative frequencies, and then presented in a descriptive mode and tabulated. Results: It was observed that overjet (66.7%), Epstein pearls (47.7%), adequate suction (100%), normal frenums and bridles (98.5%) were the most prevalent results. The less prevalent were edge-to-edge anterior relationship (1.1%), overbite (4.4%), congenital epulis (1.0%), and natal tooth, mucocele, ranula, voluminous tongue, all with 0.5%. Conclusion: In view of the results obtained in this study, it may be concluded that the characteristics of the oral cavity of full-term newborns were similar to those found in the literature. Oral anomalies were not prevalent and frontal maxillomandibular relationships considered as normal for newborn babies were the most prevalent result. Early dental treatment is a current tendency and dentist's inclusion in the hospital staff is becoming ever more important.

Variações de normalidade e patologias bucais em crianças com deficiência, assistidas em um Centro Odontológico Especializado do Brasil / Variations of normality and oral pathologies in children with disabilities, assisted in a Specialized Dental Center in Brazil

O conhecimento epidemiológico regionalizado das doenças bucais nas populações é essencial para um planejamento efetivo na prevenção destas doenças. No Brasil são poucas as pesquisas sobre etiologia e prevalência das lesões bucais em crianças com deficiências. Portanto, a proposta deste estudo clínico epidemiológico descritivo foi analisar as principais variações de normalidade e patologias bucais em 293 crianças com deficiência na faixa etária de zero a 12 anos de idade, atendidas em primeira consulta no CEOPE - Centro Estadual de Odontologia para Pacientes Especiais do Mato Grosso - Brasil, no ano de 2010, cujo projeto foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Saúde Pública/ SES – MT (n°441/09). As variáveis dependentes analisadas foram cárie dentária, alterações gengivais, variações de normalidade da cavidade bucal, patologias bucais e anormalidades dentárias. As variáveis independentes foram: idade, sexo, raça, patologia de base, município de residência, perfil demográfico do cuidador (idade, renda familiar mensal, escolaridade). O estudo foi dividido em dois capítulos, no primeiro, avaliou-se as crianças com deficiência de zero a cinco anos (n=105 crianças). Dentre estas, 71,5% delas possuíam idade igual ou superior a 3 anos, 52,4% eram do sexo masculino e em relação à raça, 62,9% eram pardas. Quanto as variáveis idade, nível de escolaridade e renda familiar do cuidador, 52,4% eram maiores que 30 anos, possuíam ensino médio completo e 60% dos participantes relataram renda familiar entre 1 e 2 salários mínimos. Quanto a patologia de base, as mais frequentes foram as más-formações congênitas, deformidades e anomalias cromossômicas (34,3%). Das 105 crianças avaliadas, encontrou-se 81 variações de normalidade da cavidade bucal, sendo a mais comum a língua saburrosa (48,1%). Das 198 patologias bucais encontradas, a cárie dentária (28,3%) e as alterações gengivais (25,7%) foram as mais prevalentes. A análise bivariada para avaliação da...

Epidemiological studies regionalized of oral diseases in populations is essential for effective planning in preventing these diseases. In Brazil there is few research on the etiology and prevalence of oral lesions in children with disabilities. Therefore, the purpose of this clinical descriptive epidemiological study was to analyze the main buccal variations of normality and oral pathologies in 293 disabled children aged zero to 12 years of age, attending the first appointment at CEOPE - State Center of Dentistry for Special Patients of Mato Grosso - Brazil, in 2010, whose project was approved by the Ethics Committee of the School of Public Health / SES - MT (no. 441/09). The dependent variables analyzed were dental caries, gingival alterations, normal variations of the oral cavity, oral pathologies and dental anomalies. The independent variables were age, sex, race, underlying pathology, city of residence, caregiver demographic profile (age, family income, education). The study was divided into two chapters, in the first, we evaluated children with disabilities aged zero to five years (n = 105 children). Among these, 71.5% of them were aged less than 3 years, 52.4% were male and in relation to race, 62.9% were brown. From the variables age, education level and family income of the caregiver, 52.4% were older than 30 years had high school and 60% reported family income between 1 and 2 minimum wages. As the underlying pathology, the most frequent were congenital malformations, deformations and chromosomal abnormalities (34.3%). From these 105 children assessed, it was found 81 buccal variations of normality, the most common being a coated tongue (48.1%). From the 198 oral pathologies encountered, dental caries (28.3%) and gingival alterations (25.7%) were the most prevalent. The bivariate analysis to assess the association between dental caries and sociodemographic indicators showed significant association between dental caries and the age of the children...

Variações de normalidade e patologias bucais em crianças com deficiência, assistidas em um Centro Odontológico Especializado do Brasil / Variations of normality and oral pathologies in children with disabilities, assisted in a Specialized Dental Center in Brazil

O conhecimento epidemiológico regionalizado das doenças bucais nas populações é essencial para um planejamento efetivo na prevenção destas doenças. No Brasil são poucas as pesquisas sobre etiologia e prevalência das lesões bucais em crianças com deficiências. Portanto, a proposta deste estudo clínico epidemiológico descritivo foi analisar as principais variações de normalidade e patologias bucais em 293 crianças com deficiência na faixa etária de zero a 12 anos de idade, atendidas em primeira consulta no CEOPE - Centro Estadual de Odontologia para Pacientes Especiais do Mato Grosso - Brasil, no ano de 2010, cujo projeto foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Saúde Pública/ SES – MT (n°441/09). As variáveis dependentes analisadas foram cárie dentária, alterações gengivais, variações de normalidade da cavidade bucal, patologias bucais e anormalidades dentárias. As variáveis independentes foram: idade, sexo, raça, patologia de base, município de residência, perfil demográfico do cuidador (idade, renda familiar mensal, escolaridade). O estudo foi dividido em dois capítulos, no primeiro, avaliou-se as crianças com deficiência de zero a cinco anos (n=105 crianças). Dentre estas, 71,5% delas possuíam idade igual ou superior a 3 anos, 52,4% eram do sexo masculino e em relação à raça, 62,9% eram pardas. Quanto as variáveis idade, nível de escolaridade e renda familiar do cuidador, 52,4% eram maiores que 30 anos, possuíam ensino médio completo e 60% dos participantes relataram renda familiar entre 1 e 2 salários mínimos. Quanto a patologia de base, as mais frequentes foram as más-formações congênitas, deformidades e anomalias cromossômicas (34,3%). Das 105 crianças avaliadas, encontrou-se 81 variações de normalidade da cavidade bucal, sendo a mais comum a língua saburrosa (48,1%). Das 198 patologias bucais encontradas, a cárie dentária (28,3%) e as alterações gengivais (25,7%) foram as mais prevalentes. A análise bivariada para avaliação da...

Epidemiological studies regionalized of oral diseases in populations is essential for effective planning in preventing these diseases. In Brazil there is few research on the etiology and prevalence of oral lesions in children with disabilities. Therefore, the purpose of this clinical descriptive epidemiological study was to analyze the main buccal variations of normality and oral pathologies in 293 disabled children aged zero to 12 years of age, attending the first appointment at CEOPE - State Center of Dentistry for Special Patients of Mato Grosso - Brazil, in 2010, whose project was approved by the Ethics Committee of the School of Public Health / SES - MT (no. 441/09). The dependent variables analyzed were dental caries, gingival alterations, normal variations of the oral cavity, oral pathologies and dental anomalies. The independent variables were age, sex, race, underlying pathology, city of residence, caregiver demographic profile (age, family income, education). The study was divided into two chapters, in the first, we evaluated children with disabilities aged zero to five years (n = 105 children). Among these, 71.5% of them were aged less than 3 years, 52.4% were male and in relation to race, 62.9% were brown. From the variables age, education level and family income of the caregiver, 52.4% were older than 30 years had high school and 60% reported family income between 1 and 2 minimum wages. As the underlying pathology, the most frequent were congenital malformations, deformations and chromosomal abnormalities (34.3%). From these 105 children assessed, it was found 81 buccal variations of normality, the most common being a coated tongue (48.1%). From the 198 oral pathologies encountered, dental caries (28.3%) and gingival alterations (25.7%) were the most prevalent. The bivariate analysis to assess the association between dental caries and sociodemographic indicators showed significant association between dental caries and the age of the children...

Tratamento cirúrgico de sequela de lábio leporino bilateral com emprego de retalho de Abbé / Surgical treatment of sequel of cleft lip using Abbé flap

Relato de caso de paciente do sexo feminino, 15 anos, que após ser submetida à correção de lábio leporino bilateral há 8 anos, evoluiu com sequela ocasionada pela diminuição do comprimento horizontal do lábio superior. Essa desproporção do lábio superior acarretou alterações estéticas e funcionais relativas a fonação, alimentação e sorriso. Essas alterações foram acentuando-se com o passar dos anos, comprometendo o convívio social. No presente relato de caso, os autores demonstram uma opção cirúrgica – o retalho de Abbé – para correção de tal sequela, que consiste na reconstrução de defeitos do lábio superior utilizando retalho de lábio inferior, apresentando resultado funcional adequado, com preservação da estética facial.

Case report of female patient, 15 years, after that be subjected to correction of bilateral cleft lip 8 years ago, developed with sequel called lip tight. The disproportion of the up perlip resulted in functional and cosmetic changes, such as speech, food and smile. These changes have been emphasizing over the years compromising social coexistence. In this case report, the authors demonstrate a surgical option – Abbé flap – to correct this sequel, which is the reconstruction of defects of the upper lip using flap of lower lip, giving appropriate functional outcome with preservation of facial esthetics.

Modificação na rinoqueiloplastia primária do paciente com fissura labial unilateral / Primary rhinocheiloplasty modification for unilateral cleft lip patients

Introdução: Desde 1957, quando Millard introduziu o conceito de reparo tipo avanço e rotação, este se tornou o procedimento de escolha para o reparo da fissura labial unilateral em todo o mundo. Mais recentemente, modificações descritas por Noordhoof, Mohler, Skoog e McComb passaram a ser realizadas em associação para que melhores resultados pudessem ser obtidos. Neste trabalho, os resultados estéticos e o padrão de crescimento ósseo facial do reparo primário da fissura labial unilateral através de técnica modificada são sistematicamente apresentados. Método: Quarenta e cinco pacientes portadores de fissura labial unilateral foram submetidos ao reparo cirúrgico primário por meio da técnica proposta. Para a análise dos resultados, foi estabelecido um sistema de pontuação dos resultados estéticos e a avaliação do padrão de crescimento ósseo facial foi realizada com emprego do índicede Atack. Resultados: Verificamos que 17,8% dos pacientes apresentaram bons resultados estéticos e 82,2%, resultados considerados excelentes. Entre os aspectos considerados negativos, houve predomínio da deformidade tardia da cartilagem lateral inferior (37,8%). Quanto ao índice de Atack, 83,4% dos pacientes apresentaram índice 1 e 16,6% índice 2 de Atack. Conclusões: Por meio da abordagem para rinoqueiloplastia primária apresentada, independentemente do tipo de fenda, é possível a obtenção de bons resultados estéticos e funcionais. Para que melhores resultados possam ser obtidos ao longo do tempo, refinamentos técnicos e a análise criteriosa dos resultados devem ser rotineiramente buscados.

Introduction: Since 1957, when Millard introduced the concept of rotation-advancement repair, this technique has become the procedure of choice for unilateral cleft lip worldwide. More recently, modifications described by Noordhoof, Mohler, Skoog, and McComb started being jointly performed so that better results could be obtained. In this study, the aesthetic results and the facial growth pattern after primary unilateral cleft lip repair through a modified technique are presented. Methods: Forty-five patients with unilateral cleft lip underwent primary surgical repair through this technique. For results analysis, a scoring system for aesthetic results was established and to evaluate the facial bone growth pattern the Atack’ Index was used. Results: By means of the established technique, 17.8% presented good aesthetic results and 82.2% were considered excellent results. Among aspects considered negative, late deformity of the lower lateral cartilage prevailed (37.8%). We observed that 83.4% had Atack’ Index 1 and 16.6% had Atack’ Index 2. Conclusions: Through the presented primary rhinocheiloplasty approach, regardless of cleft type, it is possible to obtain good aesthetic and functional results. In order to obtain better results along time, technical refinements and the criterial analysis of results must be performed on a routinely basis.

Tratamento de microstomia grave: relato de caso / Treatment of severe microstomia: case report

O tratamento da microstomia é frequentemente um desafio no dia-a-dia do tratamento das sequelas de queimaduras. De maneira geral, as técnicas utilizadas são complexas, com resultados muitas vezes insatisfatórios e com alta taxa de recidiva. O presente trabalho teve como objetivo apresentar um caso grave de microstomia em uma criança de 2 anos, que teve sua resolução alcançada de forma simples, prática e econômica em contrapartida aos métodos tradicionais que muitas vezes são caros, complexos e pouco práticos.

The microstomia treatment is still a challenge in the day by day of the burn sequelae treatment. Usually, the techniques are complex, with poor results and high incidence of recurrence. This study presents a severe case of microstomia in a 2 years old child. The solution was simple, and cheap, in comparison to the traditional surgical methods, usually expensive, complex and low acessibility in a small Center.

Efeito do tratamento combinado com tretinóina e ácido glicólico na abertura bucal de pacientes com sequela de queimadura / Combined tretinoin and glycolic acid treatment for improvement of the mouth opening in burned patients

O processo de reparação tecidual evolui tardiamente com alteração das propriedades físicas da pele, cuja gravidade varia, entre outros fatores, em função da profundidade original da lesão. Clinicamente a pele é seca, descamativa, discrômica e com diminuição da elasticidade, especialmente em cicatrizes hipertróficas. As características do tegumento pós-queimadura podem ser melhoradas com agentes de uso tópico normalmente utilizados em patologias como acne e fotoenvelhecimento. Foram avaliados 77 pacientes portadores de sequela de queimadura peri-oral, entre seis e 46 anos de idade. O tipo de tegumento foi classificado como restaurado, quando epitelizado espontaneamente, ou enxertado. O tratamento tópico consistiu de tretinoína (0,01-0,05%) e ácido glicólico (5-7%) durante três meses. Duas distâncias foram medidas com paquímetro digital em abertura bucal máxima, a inter-dentária (D) e a inter-labial (L). Houve aumento significativo (p£0,01) de D e L nos grupos tratados quando comparados aos respectivos controles, tanto nos pacientes com tegumento restaurado como nos enxertados. O aumento de L foi significativamente maior que D. Sugerimos a utilização da medida inter-labial como parâmetro complementar à medida inter-incisal como método de avaliação indireta da elasticidade cutânea no tegumento pós-queimadura.

Tissue repair processes evolve with alterations of the cutaneous physical properties, which are proportional, among other factors, to the original depth of the lesion. At examination, the skin is dry, dyschromic and less elastic, specially in hypertrophic scars. Post-burn skin characteristics can be improved by topical agents regularly used in pathologies like acne or photodamage. We evaluated 77 patients who had peri-oral burn sequela. The ages ranged from six to 46 years old. The tegument was classified as restored, when spontaneously healed, or skin grafted. The topical treatment consisted of tretinoin (0,01-0,05%) and glycolic acid (5-7%) for three months. Inter-incisal (D) and inter-labial (L) distances were measured at maximal mouth opening with a digital pachymeter. Both inter-incisal and inter-labial distances increased significantly in the groups treated when compared to respective controls (p£0,01). This fact was similar in both types of tegument. Inter-labial distance (L) increased significantly more than D. We suggest its use as a complementary measure to inter-incisal distance for indirect evaluation of skin elasticity in the post-burn tegument.

Structural analysis of the edge of the cleft lip in individuals with cleft lip with or without cleft palate

Three hundred and thirty six specimens of lateral and medial cleft margins from 168 infants with different types of cleft lips were studied histologically and compared with the normal. The structure and distribution of epithelial tissues and their appendages were compatible with the normal lip. However in some cleft lip specimens there was keratinisation of the mucous membrane. Occasionally sebaceous glands were present in the submucosa. The structure of the blood vessels was compatible with the normal and no inflammatory changes were seen in them. Disorganization of muscle tissue increased with the severity of the cleft. There was an increased amount of connective tissue and significantly less muscle tissue in the cleft lip than in the normal. There was no evidence of degeneration, regeneration, necrosis or phagocytosis in the cleft lip muscle. The arrangement of muscle tissue in different types of clefts was studied. The importance of identifying the intrinsic and extrinsic muscle bundles in the cleft lip and repairing them separately was discussed. Histochemical studies showed a reduction in the mean diameter of both type 1 and type 2 muscle fibres in the cleft lip. Electron microscopy confirmed that these fibres were hypotrophic. The cleft lip had a significantly higher percentage of type 2 muscle fibres than the normal. This could possibly be due to delay or arrest in the transformation of type 2 fibres to type l. On ATPase staining fibre type differentiation was normal. On NADH and SDH stained specimens fibre type differentiation was impaired. The majority of fibres showed an intense reaction with these stains with focal darkly stained areas. Electron microscopy showed these to be mitochondrial aggregates. Some of these mitochondria showed abnormalities in the Crystal arrangement. Reduction in the muscle quantity and increase in the connecti ve tissue in the muscle layer suggest tissue damage. Reduction in the diameter of the fibres with ultrastructural features of hypotrophy implies Possible arrest or retardation of growth of muscle fibres. Mitochondrial abnormalities seen in the cleft lip muscle were similar to that of ischaemic muscle. The possibility that hypoxia may have an association with the pathogenesis of clefting was discussed. Experimental animal studies and human foetal studies are needed to clarify the Possible relationship between hypoxia and clefting.