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ABSTRACT Objective: To evaluate the correlation between religiosity and alcohol use among adolescents with orofacial clefts. Methods: Cross-sectional study, developed in a Brazilian public and tertiary hospital, between December 2021 and March 2022. Data collection was hybrid, and three instruments were used: Sociodemographic Questionnaire, Durel Religiosity Scale, and the Alcohol Use Disorders Identification Test. For statistical analysis, the following tests were used: χ2, Fisher's Exact, Mann-Whitney and Spearman's Correlation Coefficient, in addition to analyses of linear correlation strength and bivariate logistic regression. The significance level adopted for all tests was 5% (p≤0.05). Results: 370 adolescents participated, with a mean age of 15.2 years (±1.8). Among them, 23 (5.4%) used alcohol riskly or harmfully, being more frequent among male adolescents (p=0.001), those of mixed race (p=0.046), attending high school (p=0.011), with no religion (p<0.001), or who did not attend religious services (p<0.001). Levels of organizational, non-organizational and intrinsic religiosity were significantly lower among adolescents with risky or harmful alcohol use (p=0.005; p<0.001 and p=0.002, respectively). There was a moderate correlation between risky or harmful alcohol use and non-organizational (r=0.31; p=0.002) and intrinsic (r=0.36; p<0.001) religiosity. Male adolescents (p<0.001; OR=6.58), closest in age to 18 years (p<0.001; OR=1.37), and non-practitioners of religion (p<0.001; OR=6. 48) presented higher odds of risky or harmful alcohol use. Conclusions: Adolescents with higher levels of organizational and intrinsic religiosity used less alcohol, while males, closest in age to 18 years, and non-practitioners of religion presented higher odds of using alcohol riskly or harmfully.
RESUMO Objetivo: Avaliar a correlação entre a religiosidade e o uso de álcool em adolescentes com fissura orofacial. Métodos: Estudo transversal, desenvolvido em um hospital público e terciário brasileiro entre dezembro de 2021 e março de 2022. A coleta de dados foi híbrida, e foram utilizados três instrumentos: Questionário Sociodemográfico, Escala de Religiosidade de Durel e o Alcohol Use Disorders Identification Test. Para a análise estatística foram empregados os testes: qui-quadrado, exato de Fisher, Mann-Whitney e o coeficiente de correlação de Spearman, além das análises de forças de correlação linear e de regressão logística bivariada. O nível de significância adotado para todos os testes foi de 5% (p≤0,05). Resultados: Participaram 370 adolescentes, com média de idade de 15,2 anos (±1,8). Entre eles, 23 (5,4%) usavam o álcool de forma arriscada ou prejudicial. A religiosidade organizacional, não organizacional e a intrínseca foram significativamente menos frequentes entre adolescentes que utilizavam o álcool de forma arriscada ou prejudicial (p=0,005; p<0,001 e p=0,002, respectivamente). Evidenciou-se correlação moderada entre o uso arriscado ou prejudicial do álcool e a religiosidade não organizacional (r=0,31; p=0,002) e a intrínseca (r=0,36; p<0,001). Apresentaram maiores chances de usar o álcool adolescentes do sexo masculino (p<0,001; odds ratio — OR=6,58), com idade mais próxima aos 18 anos (p<0,001; OR=1,37) e que não praticavam a religião (p<0,001; OR=6,48). Conclusões: Adolescentes com maiores níveis de religiosidade organizacional e intrínseca utilizaram menos frequentemente álcool de forma arriscada ou prejudicial, enquanto ser homem, possuir idade mais próxima aos 18 anos e não praticar a religião aumentou a chance de utilizar álcool.
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Abstract Objective The current study delves into the accessibility of genetic evaluations for individuals with orofacial clefts (OC), comparing data between genetics and treatment centers across Brazil. Methods This cross-sectional retrospective study analyzed primary data from 1463 OC individuals registered in the Brazilian Database of Craniofacial Anomalies (BDCA) between 2008 and 2018 without age or sex selection. Diagnostic exam results stemming from research projects until 2023 were considered. Results Of the 1463 individuals with typical OC, 987 were non-syndromic, 462 were syndromic (SOC), 10 presented atypical forms, and three were not specified OC cases. The average age for accessing laboratory diagnosis was 8.5 years among SOC individuals. Notably, more SOC cases were registered in genetics centers than treatment and rehabilitation centers (37.1 % vs. 29 %, p = 0.0015). Those originating from genetics centers accessed diagnosis at an average age of 7.3 years, while those from treatment and rehabilitation centers experienced delays with an average age of 10.7 years (p = 0.0581). Conclusions Irrespective of the center of origin, the data highlight delayed diagnosis and challenges in accessing genetic tests for the syndromic group. Given the widespread reliance on the public health system by most of the Brazilian population, disseminating this data can significantly contribute to shaping an informed perspective on healthcare access. These insights can improve public policies tailored to the unique needs of individuals with OC.
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Introdução: Fissuras Labiopalatinas são malformações congênitas que acometem os lábios e/ou o palato e, comprometem outras estruturas e funções orofaciais. As alterações miofuncionais orofaciais causadas pelas fissuras são particulares da malformação e requerem uma avaliação completa e específica do sistema estomatognático. Objetivo: verificar protocolos utilizados para avaliação miofuncional orofacial nas fissuras labiopalatinas e averiguar as variáveis específicas para avaliação junto a esta malformação. Métodos: Esta revisão sistemática seguiu as recomendações do "Preferred Reporting Items for Systematic Reviews and Meta-Analyses", aprovada pela COMPESQ da instituição de ensino e registrada na PROSPERO. A estratégia de busca da revisão foi guiada pela estratégia "PICO". As pesquisas foram realizadas nas seguintes bases de dados (entre 2010 e maio de 2020): MEDLINE (PubMed), LILACS, Web of Science, EMBASE, CINAHL e Scielo. Foram incluídos estudos observacionais transversais, estudos de coorte, de controle de casos e ensaios clínicos, com instrumentos para avaliação miofuncional orofacial para Fissuras Labiopalatinas e nos idiomas inglês, espanhol e português. Para avaliação da qualidade dos estudos observacionais foi utilizado o "Study Quality Assessment Tools". Resultados:Foram incluídos três artigos com protocolos de avaliação miofuncional orofacial junto à população com fissuras labiopalatinas. As variáveis consideradas como específicas na comparação dos protocolos, foram: os lábios, língua, dentes, bochechas, palato duro, mobilidade labial e lingual. Conclusão: Esta revisão sistemática identificou três protocolos de avaliação da Motricidade Orofacial para indivíduos com fissura labiopalatina, que focaram na avaliação das estruturas dos lábios, língua, palato mole e duro, bochechas, dentes, e na mobilidade labial e lingual. A comparação dos itens frequentes com o protocolo AMIOFE-A, indicou a ausência de variáveis essenciais, como: a classificação da FLP, características das cicatrizes, avaliação do frênulo lingual, quantidade de dentes, presença e aspecto da úvula e das tonsilas palatinas, mobilidade do palato mole e da faringe, além de aspectos específicos da fala e da função velofaríngea. Recomenda-se a criação de um instrumento abrangente que avalie funções, estruturas, mobilidade, tonicidade e sensibilidade orofacial. Isso auxiliaria na elaboração de planejamentos terapêuticos precisos e na melhoria da qualidade das pesquisas. Além disso, futuros estudos devem padronizar as faixas etárias das amostras para permitir comparações mais precisas e protocolos amplamente aplicáveis. (AU)
Introduction: Cleft Lip and Palate are congenital malformations that affect the lips and/or palate and compromise other orofacial structures and functions. The orofacial myofunctional alterations caused by clefts are specific to the malformation and require a comprehensive and specific evaluation of the stomatognathic system. Objective: The objective of this systematic review is to identify the orofacial myofunctional assessment protocols for cleft lip and palate and to verify the specific variables for the assessment of this malformation. Methods: This systematic review followed the recommendations of the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses", approved by the COMPESQ of the educational institution and registered in PROSPERO. The search strategy for the review was guided by the "PICO" strategy. Searches were conducted in the following databases (between 2010 and May 2020): MEDLINE (PubMed), LILACS, Web of Science, EMBASE, CINAHL, and Scielo. Cross-sectional observational studies, cohort studies, case-control studies, and clinical trials were included, with instruments for orofacial myofunctional evaluation for cleft lip and palate in English, Spanish, and Portuguese languages. The "Study Quality Assessment Tools" were used to assess the quality of observational studies. Results: Three articles with protocols for orofacial myofunctional evaluation among the population with cleft lip and palate were included. The variables considered specific in the comparison of protocols were lips, tongue, teeth, cheeks, hard palate, labial, and lingual mobility. Conclusion: This systematic review identified three orofacial myofunctional assessment protocols for individuals with cleft lip and palate, focusing on the evaluation of the structures of the lips, tongue, soft and hard palate, cheeks, teeth, and labial and lingual mobility. The comparison of frequent items with the AMIOFE-A protocol indicated the absence of essential variables such as: FLP classification, scar characteristics, evaluation of the lingual frenulum, number of teeth, presence and appearance of the uvula and palatine tonsils, mobility of the soft palate and pharynx, as well as specific aspects of speech and velopharyngeal function. It is recommended to create a comprehensive instrument that assesses orofacial functions, structures, mobility, tonicity, and sensitivity. This would aid in the development of precise therapeutic plans and improve the quality of research. Furthermore, future studies should standardize the age ranges of samples to allow for more accurate comparisons and widely applicable protocols. (AU)
Introducción: La fisura labiopalatina es una malformación congénita que afecta a los labios y/o paladar y compromete otras estructuras y funciones orofaciales. Las alteraciones miofuncionales orofaciales causadas por las fisuras son específicas de la malformación y requieren una evaluación integral y específica del sistema estomatognático. Objetivo: Examinar los protocolos utilizados para la evaluación miofuncional orofacial en la fisura labiopalatina e investigar variables específicas para la evaluación en esta malformación. Métodos: Esta revisión sistemática siguió las recomendaciones de los "Preferred Reporting Items for Systematic Reviews and Meta-Analyses", aprobadas por el COMPESQ de la institución educativa y registradas en PROSPERO. La estrategia de búsqueda para la revisión fue guiada por la estrategia "PICO". Las búsquedas se realizaron en las siguientes bases de datos (entre 2010 y mayo de 2020): MEDLINE (PubMed), LILACS, Web of Science, EMBASE, CINAHL y Scielo. Se incluyeron estudios observacionales transversales, estudios de cohortes, estudios de casos y controles, y ensayos clínicos, con instrumentos para la evaluación miofuncional orofacial para la fisura labiopalatina en inglés, español y portugués. Se utilizaron las "Herramientas de Evaluación de la Calidad del Estudio" para evaluar la calidad de los estudios observacionales. Resultados: Se incluyeron tres artículos con protocolos para la evaluación miofuncional orofacial entre la población con fisura labiopalatina. Las variables consideradas específicas en la comparación de los protocolos fueron: labios, lengua, dientes, mejillas, paladar duro, movilidad labial y lingual. Conclusión: Esta revisión sistemática identificó tres protocolos de evaluación miofuncional orofacial para individuos con fisura labiopalatina, que se centraron en la evaluación de las estructuras de los labios, la lengua, el paladar blando y duro, las mejillas, los dientes y la movilidad labial y lingual. La comparación de los ítems frecuentes con el protocolo AMIOFE-A indicó la ausencia de variables esenciales, tales como: clasificación de FLP, características de las cicatrices, evaluación del frenillo lingual, cantidad de dientes, presencia y aspecto de la úvula y las amígdalas palatinas, movilidad del paladar blando y la faringe, además de aspectos específicos del habla y de la función velofaríngea. Se recomienda la creación de un instrumento integral que evalúe funciones orofaciales, estructuras, movilidad, tonicidad y sensibilidad. Esto ayudaría en la elaboración de planes terapéuticos precisos y en la mejora de la calidad de la investigación. Además, los estudios futuros deben estandarizar los rangos de edad de las muestras para permitir comparaciones más precisas y protocolos ampliamente aplicables. (AU)
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Humans , Clinical Protocols , Cleft Palate , Stomatognathic SystemABSTRACT
Abstract Objective This study aimed to review literature from the past five years, focusing on the use of educational videos as a guidance tool for parents and guardians of children with lip and palate clefts. Source of data Conducted between April and July 2022, this integrative literature review was framed around the question: 'What is the evidence regarding the use of videos in health education for parents/guardians of children with cleft lip and palate? PICO strategy was used to develop the research. A literature search was undertaken across PubMed, Web of Science, Scopus, and the Virtual Health Library databases. Of the eight articles included in this review, four were sourced from the PubMed database, with three published in 2021. Summary of the findings The findings indicated that YouTube videos were moderately satisfactory and met the needs of parents or legal guardians to a partial extent. The majority of the videos analyzed in this review were characterized by a moderate level of informational content. One study particularly underscored that the content of these videos only partially satisfies the requirements of the parents or legal guardians of the children. Conclusions Nevertheless, such videos are considered viable alternatives for health education, offering numerous benefits yet facing challenges, primarily due to the scarcity of information on orofacial malformations.
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Introduction: Nasoalveolar Moulding (NAM) is a pre-surgical technique designed to reshape the alveolus, lip, and nose in infants with cleft lip and palate. The objectives of NAM for bilateral cleft lip and palate include: retracting the premaxilla using extraoral traction via lip taping, preserving the arch form with a passive appliance, developing clinically significant columellar tissue, and achieving harmonious nasal tip projection. Aim and Objective: To access effectiveness of nasoalveolar moulding on alveolus and nose in bilateral cleft lip and palate. Study Design: Descriptive study. Place and Duration of Study: IGIMS, Patna. Between March 2022 and March 2024. Material and Method: This descriptive study comprised 10 infants with bilateral cleft lip and palate (BCLP), undergoing nasoalveolar moulding (NAM). The mean age of the infants at the start of the study was <6 weeks, impression was taken over which NAM appliance was fabricated and adjusted weekly depending upon progress of the treatment. Nasal stents were incorporated once the cleft width was reduced to 6 mm. Duration of treatment extends to 25 to 29 weeks. Post NAM impression was taken, alveolar and nasal measurements were recorded. Result: Right & left Alveolar cleft width, mid-palatal arch width decreases significantly. Columellar length, right & left nasal height increase due to tissue elongation. Right & left nasal width and bialar width decreases significantly. Conclusion: NAM therapy should be considered an integral part of the multidisciplinary approach to managing cleft lip and palate, improving not only the surgical outcomes but also the overall quality of life for affected infants.
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O sorriso gengival possui inúmeras causas, podendo acontecer por motivos esqueléticos, musculares ou por alteração no desenvolvimento dos tecidos de suporte. No entanto, na atualidade, a estética vermelha e a branca têm se apresentado completamente passíveis de transformações e com uma gama de procedimentos cirúrgicos ou não cirúrgicos para sanar as queixas dos pacientes. O objetivo geral deste trabalho é mostrar o poder que a odontologia tem frente às questões estéticas, como, por exemplo, a vergonha de sorrir por não se sentir confortável com os dentes curtos e com uma grande faixa de gengiva sendo exposta. O método utilizado foi um relato de caso. Que descreve todos os passos clínicos do tratamento de um paciente de 40 anos, que estava insatisfeita com o seu sorriso por apresentar erupção passiva alterada juntamente com hiperatividade do lábio superior. O plano de tratamento escolhido foi de realizar a cirurgia de aumento de coroa clínica estético, seguido de clareamento dentário e posteriormente um reposicionamento labial, com ajuda da toxina botulínica. Finalizando, para ajudar na cicatrização, o uso de laserterapia. O resultado de todo o processo cirúrgico envolvido neste trabalho, é satisfação do paciente, materializando o sonho deste, devolvendo segurança e espontaneidade ao sorrir. Pôde-se observar que através da combinação de técnicas cirúrgicas periodontais para tratar o sorriso gengival, obtém-se êxito tanto no sentido científico quanto no biológico, alcançando um sorriso esteticamente mais atrativo(AU)
Gummy smile has numerous causes, which can occur for skeletal or muscular reasons or due to changes in the development of supporting tissues. However, nowadays, the red and white aesthetics have been completely capable of transformation and with a range of surgical or non-surgical procedures to resolve patients' complaints. The general objective of this work is to show the power that dentistry has in the face of aesthetic issues, such as, for example, the shame of smiling due to not feeling comfortable with short teeth and a large strip of gum being exposed. The method used was a case report. Which describes all the clinical steps of the treatment of a 40-year-old patient, who was dissatisfied with her smile due to an altered passive eruption together with hyperactivity of the upper lip. The chosen treatment plan was to perform aesthetic clinical crown augmentation surgery, followed by tooth whitening and later lip repositioning, with the help of botulinum toxin. Finally, to help with healing, the use of laser therapy. The result of the entire surgical process involved in this work is patient satisfaction, materializing the patient's dream, restoring security and spontaneity when smiling. It was observed that through the combination of periodontal surgical techniques to treat gummy smile, success is achieved both in the scientific and biological sense, achieving a more aesthetically attractive smile(AU)
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Humans , Female , Adult , Crown Lengthening , Oral Surgical Procedures , Esthetics, Dental , GingivoplastyABSTRACT
Introduction: Cheiloscopy, the study of lip prints, offers a novel approach in genetic research, particularly in understanding the inheritance of cleft lip and palate (CL/P). Lip prints, unique like fingerprints, are influenced by genetic factors and may provide critical insights into the hereditary components of CL/P. Materials and Methods: This study, conducted in the Dept. of Public Health Dentistry, SPDC, Sawangi, Wardha, India, included parents of children with confirmed CL/P. Using the cellophane method, lip prints were collected non-invasively. The patterns were analyzed according to Suzuki and Tsuchihashi’s classification. Data analysis was performed using SPSS with chi-square and logistic regression methods, focusing on significance levels below 0.05. Results: The study revealed significant insights into the genetic correlations of CL/P. The average age of participants was 32.28 years, with a balanced gender distribution. The prevalence of cleft types showed both cleft lip and palate as most common. Analysis indicated Type II lip pattern as the most prevalent across genders and quadrants. Notably, gender-specific variations in lip patterns were observed. A significant prevalence of whorl patterns was noted, suggesting their potential as a genetic marker for CL/P, although no gender-based differences were statistically significant. Conclusion: The study underscores the potential of lip print analysis as a non-invasive tool for understanding CL/P genetics. The significant prevalence of certain lip patterns, especially Type II and whorl patterns, suggests their relevance as genetic markers, highlighting the need for further research in this promising field.
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Introduction: The histopathological variant of lipoma identified as spindle cell lipoma invariably begins to develop deep within the skin in the back of the neck, upper back, or shoulder region. It develops seldomly in the oral cavity yet extremely frequently on the lip. Predominantly, these lesions manifest mostly as painless or slowly gaining masses. Case report: A 75-year-old woman had single swelling in the left lower lip which had existed there for four months. On a microscopic level, these tumors are well structured and represented in varied amounts of mature adipocytes, spindle cells, and irregular bundles of thick collagen fibres. The spindle cells are S-100 protein, desmin, and smooth muscle actin-negative whilst immunopositive to CD34. Treatment primarily involves local excision, and no reports of recurrence have been made. Conclusion: With a study of the available literature on diverse histological variants, differential diagnosis, and the adoption of IHC for diagnostic purposes, we present a rare case of spindle cell lipoma of the lip.
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Cleft lip (CL) with or without cleft palate is a common condition in newborns, leading to significant anatomical defects and psychosocial problems. Surgical correction is crucial for improving aesthetic appearance and psychological well-being. Medical records of patients with cleft lip and palate were reviewed at a public hospital in Mexico City from March 2022 to April 2024. Preoperative and postoperative photographs were analyzed to assess aesthetic outcomes. Nine patients (5 males, 4 females) with unilateral cleft lip underwent definitive rhinoplasty, with a mean age of 17 years. Three approaches were identified: without prior secondary cheiloplasty (2 patients), with simultaneous cheiloplasty (1 patient), and following previous secondary cheiloplasty (6 patients). Costal cartilage grafts were used in 5 patients for structural support. Our study underscores the importance of combining lip and nasal corrections to enhance facial harmony. Personalized surgical plans based on the specific sequelae of primary cheiloplasty are essential for optimal results in cleft lip nasal deformity management.
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Introdução: A fenda labial e a fissura palatina, apresentam elevada prevalência na população brasileira, sendo necessária uma formação acadêmica de cirurgiões que gere saberes que transformem a realidade. Diante do exposto, o presente manuscrito objetivou descrever o desenvolvimento, a aplicação e a avaliação de uma sequência didática sobre fissuras labiais, palatinas e labiopalatais com enfoque em aprendizagem significativa em que houve a associação de duas metodologias ativas, a construção de modelos didáticos e a sala de aula invertida. Metodologia: A sequência didática foi realizada na educação superior, com equipes de discentes de Odontologia, seguindo três etapas: planejamento; confecção do modelo didático semiplano de fissuras labiais, palatinas e labiopalatais; apresentação em roda de conversa. O desempenho dos acadêmicos foi avaliado em cada etapa. Resultados: Inicialmente, os discentes possuíam pouco conhecimento sobre o tema. Os modelos didáticos foram construídos com facilidade e durante a roda de conversa foram utilizados os modelos didáticos e compartilhados os conhecimentos sobre Embriologia, Teratologia, aspectos clínicos e tratamento odontológico para cada fenda representada, evidenciando a eficácia do método. Conclusões: As metodologias ativas adotadas utilizadas no processo de planejamento, confecção e debate sobre fissuras labiais, palatinas e labiopalatais foram ferramentas valiosas no processo ensino-aprendizagem na educação em Odontologia... (AU)
Introduction: Cleft lip and cleft palate showed prevalence in the Brazilian population, being an academic training of surgeries that generates knowledge that transforms reality. Given the above, this manuscript aimed to describe the development, application and evaluation of a didactic sequence on cleft lip, palate and lip and palate with a focus on meaningful learning with the association of two active methodologies, the construction of didactic models and the inverted classroom. Methodology: The didactic sequence was carried out in Higher Education with teams of Dentistry students following three stages: planning; making the semiplane didactic model of cleft lip, palate and lip and palate; presentation in conversation circle. Academic performance was assessed at each stage. Results: Initially, the students had little knowledge on the topic. Didactic models were easily built. During the conversation, didactic models were used and knowledge about Embryology, Teratology, clinical aspects and dental treatment was shared for each gap represented, showing the effectiveness of the method. Conclusions: The active methodologies adopted used in the process of planning, making and debating cleft lip, palate and lip and palate were valuable tools in the teaching-learning process in Dentistry Education... (AU)
Introducción: Labio leporino y paladar hendido, presentan elevada prevalencia en la población brasileña, es necesária una formación académica de los cirujanos para generar conocimientos que transformen la realidad, dado lo anterior, este manuscrito tuvo como objetivo describir el desarrollo, la aplicación y la evaluación de una secuencia didáctica sobre el lábio leporino, fisura palatina y paladar hendido con un enfoque de aprendizaje significativo en el que hubo la asociación de dos metodologias activas, la construcción de modelos didácticos y el aula invertida. Metodología: La secuencia didáctica se realizo en la enseñanza superior, con equipos de estudiantes de odontologia, siguiendo tres etapas: Planificación; realización de um modelo didáctico semiplano de lábio leporino y paladar hendido; presentación del circulo de conversación. Se evaluo el desempeño de los académicos en cada etapa. Resultados: Inicialmente, los estudiantes tenían poco conocimiento sobre el tema. Los modelos didácticos se construyeron facilmente y durante la conversación se utilizaron los modelos didácticos y se compartieron sobre Embriologia, Teratología, aspectos clínicos y tratamiento odontológico de cada fisura representada, evidenciando la efectividad del método. Conclusiones: Las metodologias activas adoptadas y utilizadas en el proceso de planificación, realización y debate sobre lábio leporino, paladar hendido y fisura palatina fueron herramientas valiosas en el proceso de enseñanza-aprendizaje en la formación odontológica... (AU)
Subject(s)
Humans , Male , Female , Palate/surgery , Practice Guidelines as Topic , Lip/abnormalitiesABSTRACT
Aim- Methodology-To assess competence of oral stoma after reconstruction using digastric sling. Data was collected prospectively from patients of carcinoma oral cavity involving oral commissure operated in our institute. Patients who underwent reconstruction using digastric muscle sling along with ?ap and those without sling were chosen. Data was collected from patient records and on follow up visits at 1 month and 3 months by physical examination using standard grading system. There were 14 patients in each group with mean age of 61.5 in sling with ?ap groupResults- (A) and 61.8 in ?ap only group(B). Most common location was the angle of mouth and the clinical stage was T4a in both the groups. Nasolabial ?ap was used in 12 patient and 2 patients underwent pectoralis major myocutaneous ?ap in sling and ?ap group. Whereas 8 patients underwent PMMC ?ap reconstruction and 6 nasolabial ?ap reconstruction in the ?ap only group. There was signi?cant improvement in drooling frequency and severity with p value of 0.016 and 0.076 respectively using unpaired student t test. There was no statistically signi?cant difference in stoma size in both the groups with p value of 0.223. Digastric sling when used with ?ap for reconstruction of oral commissure defect signi?cantlyConclusion- decreases severity and frequency of drooling with no effect on size of the stoma.
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Objetivo: comprender las percepciones sobre calidad de vida (CV) y sus factores condicionantes en personas con Labio Fisurado y Paladar Hendido No Sindrómico (LPHNs), desde la experiencia de las personas con esta condición, y desde sus familias y equipo de salud. Métodos: estudio cualitativo con perspectiva fenomenológica. Se realizaron entrevistas semiestructuradas a seis individuos que cumplían los criterios de participación (4 mujeres) y seis familiares (esposos, hermanos, padre/madre) mediante un guion estructurado. Esta información se complementó con una entrevista a un ortodoncista con experiencia en atención a estos individuos y un grupo focal con laparticipación de profesionales de la salud. Se realizó análisis de contenido cualitativo y estrategias de reducción fenomenológica desde los discursos experienciales de la población participante. Se contó con aprobación ética e institucional. Resultados: se encontraron cuatro categorías principales desde la experiencia de las personas con LPHNs que involucran diferentes perspectivas de los participantes del estudio: 1) concepto de CV y sus factores condicionantes, 2) experiencia de vida con la condición de LPHNs; 3) experiencia durante el tratamiento integral para la condición de LPHNs; y 4) expectativas generales. Todas estas categorías reflejan la historia de vida, los elementos individuales y sociales, y las dificultades propias de su condición. Conclusiones: existen factores individuales, sociales y contextuales que inciden en la CV de los pacientes con LPHNs. Esto implica un abordaje intersectorial y multidisciplinario que permita la generación de políticas en salud y estrategias de tratamiento acordes a las necesidades individuales y colectivas de estas personas.
Objective: Understand the perceptions and experiences about quality of life (QOL) and their conditionants in people with Non-syndromic Cleft Lip and Palate (NSCLP), from the experience of people living with this condition, and from their families and health personnel. Methods: A qualitative study with phenomenological perspective was conducted. Six individuals and relatives (partner, siblings, parents) were interviewed. This information was complemented by an interview with an orthodontist who works with people with NSCLP and a Focus Group with the participation of health personnel working in a Specialized Foundation focused on these individuals. Qualitative content analysis and phenomenological reduction strategies were carried out to address the main themes extracted from the discourses of the participating population. Ethical and institutional approval was obtained. Results: Four main categories of the experience of people with NSCLP were found that involve the different perspectives of the study participants: 1) concept of QOL and its conditioning factors, 2) life experience with the condition of NSCLP; 3) experience during comprehensive treatment for NSCLP condition; and 4) general expectations. All these categories reflect the life history, the individual and social elements, and the difficulties inherent to their condition. Conclusions: there are individual, social, and contextual factors that affect the QOL of people living with NSCLP. This situation implies an intersectoral and multidisciplinary approach that allows the generation of health policies and treatment strategies according to the individual and collective people's needs.
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Las fisuras labio-máxilo-palatinas (FLMP) son malformaciones congénitas que requieren de un manejo quirúrgico complejo para devolver un correcto funcionamiento del sistema estomatognático. Sin embargo, aún no existe un consenso sobre qué modalidad quirúrgica representa los mejores resultados y sus efectos a largo plazo en el desarrollo esqueletal y funcional de los individuos. El objetivo de este trabajo fue describir mediante la información científica disponible; el efecto de los diferentes protocolos quirúrgicos para el cierre de la FLMP sobre el crecimiento y desarrollo esqueletal de los pacientes. Se realizó una búsqueda de la literatura en bases de datos Pubmed, Cochrane y Epistemonikos, contemplando estudios desde el año 2013 hasta la actualidad. Se obtuvieron un total de 999 estudios encontrados. Una vez aplicados los criterios de inclusión y exclusión, se seleccionaron 13 estudios. El tratamiento quirúrgico de las FLMP consiste en procedimientos complejos que implican alteraciones en el desarrollo esqueletal de los individuos intervenidos a largo plazo. Las discrepancias en el desarrollo esqueletal de los pacientes empiezan a detectarse durante la dentición mixta. Es recomendable extender el seguimiento hasta la etapa de la pubertad y adultez, ya que podría demostrar diferencias significativas entre las diferentes cronologías quirúrgicas empleadas.
Cleft Lip and Palate (CLP) belong to a group of congenital anomalies that require complex surgical management, in order to restore the normal function of the stomatognathic system. However, there is no consensus that determines which surgical technique is better according to its outcomes and long- term effects on the skeletal and functional development of treated individuals. The objectives of this study are To describe, using the available scientific information, the effect of the different surgical protocols regarding CLP closure, on the skeletal and functional development patients undergoing surgery. A research of the available information was made in three different databases: PubMed, Cochrane and Epistemonikos. This research included articles released since the year 2013 onwards. A total of 999 studies were found. Once exclusion and inclusion criteria were applied, 13 studies were selected. Surgical treatment of CLP consists of complex procedures which imply long-term skeletal alterations in undergoing patients. These skeletal discrepancies are first detected during the mixed dentition phase. It is recommended to extend patient follow-up up until puberty and adulthood, as it might demonstrate significant differences among the different surgical approaches.
Subject(s)
Humans , Palate/surgery , Cleft Lip/surgery , Cleft Palate/surgery , Palate/pathology , Cephalometry/methods , Cleft Lip/pathology , Cleft Palate/pathology , Plastic Surgery Procedures/methods , Face/anatomy & histology , Maxilla/pathology , Maxillofacial Development/physiologyABSTRACT
Introdução: A fissura labiopalatina é a malformação congênita craniofacial mais comum. Dificuldades na alimentação, fala e audição são comuns nestes pacientes, necessitando de tratamento multidisciplinar, o que dificulta a criação e manutenção de serviços especializados. A diversidade de classificações e o grande número de técnicas cirúrgicas utilizadas nas cirurgias primárias (queiloplastia e palatoplastia) dificultam a comparação de dados epidemiológicos e de complicações entre os serviços, existindo carência de estudos avaliando centros especializados em fissuras labiopalatinas recém-criados. Método: Foi realizado estudo do tipo coorte prospectiva com pacientes com diagnóstico de fissura labiopalatina submetidos a procedimentos cirúrgicos primários, no Hospital de Clínicas da Universidade Federal de Uberlândia, entre julho de 2017 e fevereiro de 2023. Foram incluídos pacientes menores de 18 anos com acompanhamento pós-operatório de pelo menos 3 meses. Resultados: Participaram do estudo 79 pacientes, que foram submetidos a 115 cirurgias primárias (54 queiloplastias e 61 palatoplastias). Foram relatadas 11 complicações neste período: 2 deiscências em queiloplastia (3,70%), 1 cicatriz hipertrófica em queiloplastia (1,85%), 6 fístulas em palatoplastia (9,83%) e 2 deiscências em palatoplastia (3,28%). A incidência de complicações foi de 9,56% quando analisado o total de cirurgias, sendo 5,55% nos pacientes submetidos a queiloplastia e 13,11% nos pacientes submetidos a palatoplastia. Conclusão: A incidência de complicações durante os anos iniciais de estruturação do serviço foi semelhante a outros estudos da literatura.
Introduction: Cleft lip and palate is the most common congenital craniofacial malformation. Difficulties in eating, speaking, and hearing are common in these patients, requiring multidisciplinary treatment, which makes it difficult to create and maintain specialized services. The diversity of classifications and the large number of surgical techniques used in primary surgeries (cheiloplasty and palatoplasty) make it difficult to compare epidemiological data and complications between services, and there is a lack of studies evaluating newly created specialized centers for cleft lip and palate. Method: A prospective cohort study was carried out with patients diagnosed with cleft lip and palate who underwent primary surgical procedures at the Hospital de Clínicas of the Universidade Federal de Uberlândia, between July 2017 and February 2023. Patients under 18 years of age with follow-up were included. post-operative period of at least 3 months. Results: 79 patients participated in the study, who underwent 115 primary surgeries (54 cheiloplasties and 61 palatoplasties). 11 complications were reported in this period: 2 dehiscences in cheiloplasty (3.70%), 1 hypertrophic scar in cheiloplasty (1.85%), 6 fistulas in palatoplasty (9.83%) and 2 dehiscences in palatoplasty (3.28%). The incidence of complications was 9.56% when analyzing the total number of surgeries, being 5.55% in patients undergoing cheiloplasty and 13.11% in patients undergoing palatoplasty. Conclusion: The incidence of complications during the initial years of structuring the service was similar to other studies in the literature.
ABSTRACT
SUMMARY: Although almost all studies exclude lip conditions because they would affect furrow patterns, some authors maintain that they should be considered temporary or permanent disabilities, all of which require further research in this context.We present a study in which we associate lip conditions with lip print patterns to associate both morphological elements for fieldwork purposes. Fifty-seven women and 48 men aged between 19 and 38 years who resided in Temuco (Chile) were included. The lip conditions and their prints were recorded, and an analysis, comparison, evaluation, and verification protocol (ACE-V) for lip prints was applied. Of the participants, 27.4 % had healthy lips, while 71.7 % had some type of condition. Although patterns related to temporary and permanent lip conditions were recognized in the lip prints in a non-significant way, the diagnosis of "healthy" or "altered" lip status could be made significantly by a calibrated examiner. Although these conditions do not represent identifying variables without empirical studies to validate them, they can affect the quality of the evaluated lip print; therefore, they should be recognized during the analyses considering the prevalence of these conditions.
Aunque casi todos los estudios excluyen las afecciones labiales pues afectarían los patrones de sus surcos y huellas, algunos autores sostienen que deben ser consideradas alteraciones temporales o permanentes, por lo que se requiere mayor investigación en este aspecto. Se presenta un estudio en el que se asocian afecciones labiales con sus patrones de huellas para evaluar conjuntamente ambos elementos morfológicos con fines de trabajo forense de campo. Se incluyeron 57 mujeres y 48 hombres con edades entre 19 y 38 años residentes en Temuco (Chile). Se registraron las afecciones de los labios y sus huellas, y se aplicó un protocolo de análisis, comparación, evaluación y verificación (ACE-V) para las huellas labiales. De los participantes, el 27,4 % tenía labios sanos, mientras que el 71,7 % presentaba algún tipo de afección. Aunque los patrones relacionados con afecciones labiales temporales y permanentes se reconocieron en las huellas labiales de manera no significativa, un examinador calibrado podría realizar significativamente el diagnóstico de estado labial "sano" o "alterado". Si bien estas condiciones no representan variables de identificación sin estudios empíricos que las validen, pueden afectar la calidad de la impresión labial evaluada; por lo tanto, deben ser reconocidos durante los análisis considerando la prevalencia de estas condiciones.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Forensic Anthropology , Biometric Identification/methods , Lip/anatomy & histologyABSTRACT
Introdução: A fissura labiopalatina é a deformidade congênita mais comum, com uma incidência de 1,53/1000 nascidos vivos e o tratamento predominantemente realizado no Sistema Único de Saúde (SUS). Em 1999, o Sistema de Informações sobre Nascidos Vivos (SINASC) implantou a lacuna para preenchimento referente a deformidade congênita. Trabalhos vêm demostrando a subnotificação importante da fissura no SINASC. Método: Foi levantado o número de crianças nascidas por ano no Brasil entre 2012 e 2018 nas respectivas regiões, projetando o número de fissurados nascidos por ano usando a proporção 1,53/1000 nascidos vivos. A partir destes dados, observado o número de fissurados notificados no sistema SUS e comparado com a projeção feita observando uma estimativa de notificação por região. Verificada também a evolução dos gastos governamentais por região com cirurgia de fissura labiopalatina no período de 2012 a 2018. Resultados: Houve uma notificação de 54,1% a 36,7% das crianças nascidas com fissura, sendo a Região Sudeste com melhor índice e o Nordeste com o índice mais baixo de notificação. Os gastos federais em cirurgia de fissura labiopalatina diminuíram entre 2012 e 2018, frente ao número de nascimentos com fissuras, que se manteve estável neste período. Conclusão: Apesar do SINASC ser uma ferramenta importante, as subnotificações expressivas desta afecção impactam nas políticas públicas, pois utilizam dados inconsistentes com a realidade. Outra preocupação é a diminuição dos gastos federais com cirurgias de fissurados, o que demostra que mais crianças estão deixando de receber tratamento adequado.
Introduction: Cleft lip and palate is the most common congenital deformity, with an incidence of 1.53/1000 live births, and treatment is predominantly carried out in the Unified Health System (Sistema Único de Saúde SUS). In 1999, the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos SINASC) implemented the gap to be filled in regarding congenital deformities. Studies have demonstrated the significant underreporting of the fissure in SINASC. Method: The number of children born per year in Brazil between 2012 and 2018 was surveyed in the respective regions, projecting the number of cleft children born per year using the proportion 1.53/1000 live births. From these data, the number of cleft patients notified in the SUS system was observed and compared with the projection made by observing an estimate of notification by region. The evolution of government spending by region on cleft lip and palate surgery in the period from 2012 to 2018 was also verified. Results: There was a notification of 54.1% to 36.7% of children born with cleft, with the Southeast Region having the best rate and the Northeast with the lowest notification rate. Federal spending on cleft lip and palate surgery decreased between 2012 and 2018, compared to the number of births with clefts, which remained stable during this period. Conclusion: Although SINASC is an important tool, the significant underreporting of this condition impacts public policies, as it uses data inconsistent with reality. Another concern is the decrease in federal spending on cleft surgery, which shows that more children are failing to receive adequate treatment.
ABSTRACT
Introducción: Actualmente existe un aumento en el uso del pirsin orofacial en adolescentes, sobre todo atribuible a la popularidad de la perforación por muchos iconos del momento. Objetivo: Identificar las alteraciones orofaciales asociadas al uso del pirsin en adolescentes del preuniversitario Tony Alomá. Método: Se realizó un estudio descriptivo y transversal de 1 071 adolescentes matriculados en dicho centro escolar, durante el curso 2020-2021. Las variables analizadas fueron portador del pirsin, sexo, causas que motivaron la colocación del pirsin, hábitos nocivos o tóxicos, apoyo de los tutores legales, tipo de pirsin, localización, momento en que aparecieron las alteraciones orofaciales; alteraciones orofaciales locales y funcionales. Resultados: Se halló que por cada 100 escolares, 6 llevaban pirsin y 76,8 % eran féminas. Las localizaciones intrabucales predominaron en la lengua (50,0 %) y los frenillos labiales (41,7 %). Se identificaron alteraciones orofaciales locales, tales como las lesiones en piel (38,3 %) y vasculares (36,7 %), así como la sialorrea (31,7 %). Los problemas funcionales estuvieron representados por trastornos del habla (21,7 %). Conclusiones: La frecuencia de adolescentes con pirsin fue baja, aunque los más utilizados, al ser intrabucales, provocaron lesiones en piel y vasculares, sialorrea y trastornos del habla.
Introduction: Currently, there is an increase in the use of orofacial piercing in adolescents, especially attributable to the popularity of piercing by many icons of the moment. Objective: To identify the orofacial changes associated with the use of piercing in adolescents from Tony Alomá high school. Method: A descriptive and cross-sectional study was carried out on 1 071 adolescents registered in this school center during the 2020-2021 academic year. The analyzed variables were: wearer of the piercing, sex, causes that motivated the use of piercing, harmful or toxic habits, legal tutors' support, piercing type, localization, moment in which the orofacial changes appeared; local and functional orofacial changes. Results: It was found that for every 100 schoolchildren, six had piercing and 76.8 % were female. Intraoral locations predominated on the tongue (50.0 %) and labial frenums (41.7 %). Local orofacial changes were identified, such as the skin (38.3 %) and vascular (36.7 %) lesions, as well as sialorrhea (31.7 %). The functional problems were represented by speech disorders (21.7 %). Conclusions: The frequency of adolescents with piercing was low, although the most commonly used ones, being intraoral, caused skin and vascular lesions, sialorrhea and speech disorders.
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Hay-Wells syndrome is a rare genetic disorder caused by a heterozygous mutation in the TP63 gene that affects the development of ectodermal derivatives. While the exact prevalence of hearing loss in this condition is not well established, it has been suggested that approximately 50% of patients may present with varying degrees of hearing impairment. Here we present a case of a 6-year-old female patient diagnosed with Hay-Wells syndrome since birth who has been developing hearing loss predominantly on the right side for the past year. Considering the embryological origin of the external ear, an associated abnormality with the syndrome cannot be disregarded. Early recognition and diagnosis of this syndrome are crucial for appropriate management and potential interventions for hearing loss. Utilizing imaging methods can aid in demonstrating the characteristic alterations of the syndrome, which is important given its low incidence in the general population. This case report emphasizes the significance of prompt diagnosis, which is critical for implementing genetic counseling and effective disease prevention measures. We should be well-versed in the characteristic imaging findings that aid in early identification and genetic diagnosis of the disorder.
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The pyogenic granuloma (PG) Also called lobular capillary hemangioma, is a prevalent tumorlike growth and vascular hyperplasia of the skin and mucous membranes. The condition arises in reaction to a chronic, recurring tissue injury that stimulates an exuberant or excessive tissue repair response. It can manifest at any age. The most common site is gingiva, extra gingival occurrence of PG is rare, although have been reported. Management of PG Depends on the area, size of lesion and patient preferences. However, the conservative surgical excision usually the curative treatment of PG. Alternative treatment modalities that have been employed include laser therapy, corticosteroid injections, cryosurgery, and sclerotherapy. In the case report has described an extra gingival PG which occurred on the lower lip in a 19-year-old female patient. The clinical and histopathological assessments confirmed the diagnosis of PG.
ABSTRACT
Background: The normal nasolabial structure of infants and chil-dren from East Asian, specifically Indonesian, descent groups has been less explored in the literature. This anthropometric study is used as a guide in lip repair in patients with clefts. This retrospective study used archived CT images from the Indonesian population. Materials and Methods: Computed tomography records of children under 5 years of age were extracted from a provincial hospital. The images were then filtered based on the inclusion and exclusion criteria and then the 2D slices were reconstructed using the open source software Invesalius. Twenty-five variable nasolabial parameters of the nasolabial structure were then measured in the 3D rendering mode. Images with craniofacial dysmorphism or cannulas that passed over the nasolabial structure were excluded. Results were summarized using descriptive statistics. Results: Fourteen of 128 CT images were included in this study. The samples were divided into two age groups: 0-12 months and 25-54 months. There were moderate to strong, positive correlations between age and all nasolabial variables, which were statistically significant (p<0.05) except for nasal length, nares circumference, columella width, superior philtrum width, philtrum column height, and cutaneous upper lip height. Conclusions: This study described anthropometric measurements of normal nasolabial structures as a reference point for lip correction surgery. However, to obtain more accurate anthropometric guidelines, further studies with larger sample sizes are desirable. Although surgical repair of the lip is usually performed within the first year of life, some cases of surgery are performed after infancy.
Antecedentes: La estructura nasolabial normal de bebés y niños de grupos de ascendencia de Asia oriental, específicamente de Indonesia, ha sido menos explorada en la literatura. Este estudio antropométrico se utiliza como guía en la reparación del labio en pacientes con fisuras. Este estudio retrospectivo utilizó imágenes de tomografía computarizada archivadas de la población indonesia. Materiales y Métodos: Se extrajeron los registros de tomografía computarizada de niños menores de 5 años de un hospital provincial. Luego, las imágenes se filtraron según los criterios de inclusión y exclusión y luego se reconstruyeron los cortes 2D utilizando el software de código abierto Invesalius. Luego se midieron veinticinco parámetros nasolabiales variables de la estructura nasolabial en el modo renderizado 3D. Se excluyeron imágenes con dismórfica craneofacial y cánula que pasa sobre la estructura nasolabial. Los resultados se resumen mediante estadística descriptiva. Resultado: En este estudio se incluyeron catorce de 128 imágenes de TC. Las muestras se dividieron en dos grupos de edad: 0-12 meses y 25-54 meses. Hubo una correlación positiva de moderada a fuerte entre la edad y todas las variables nasolabiales, que fueron estadísticamente significativas (p<0,05) excepto la longitud nasal, la circunferencia de las narinas, el ancho de la columela, el ancho del filtrum superior, la altura de la columna del filtrum y la altura cutánea del labio superior. Conclusión: Este estudio describió las medidas antropométricas de estructuras nasolabiales normales como base para la cirugía de corrección de labios. Sin embargo, para obtener directrices antropométricas más precisas, son deseables más estudios con tamaños de muestra más grandes. Aunque la reparación quirúrgica del labio normalmente se realiza dentro del primer año de vida, en algunos casos la cirugía se realiza después de la infancia.