Frênulo lingual: modificações após frenectomia / Lingual frenulum: changes after frenectomy

OBJETIVO: Descrever as mudanças ocorridas após a frenectomia com relação à mobilidade e funções da língua. MÉTODOS: Foram avaliados 53 sujeitos, os quais nunca haviam se submetido a fonoterapia ou a cirurgia do frênulo. Um protocolo com escores específicos para avaliação do frênulo lingual foi utilizado para avaliar os sujeitos com evidências de alteração neste aspecto. Foi encontrada alteração em dez sujeitos, que foram encaminhados a um otorrinolaringologista para frenectomia. Após a cirurgia, esses sujeitos foram reavaliados pelo fonoaudiólogo utilizando-se o mesmo protocolo. Fotos e vídeos foram usados para comparação. RESULTADOS: Trinta dias após a cirurgia, os sujeitos apresentaram a forma da ponta da língua modificada, assim como os movimentos melhorados. O fechamento labial e a fala também melhoraram. CONCLUSÃO: A frenectomia é eficiente para melhorar a mobilidade e a postura da língua, assim como suas funções, incluindo a produção da fala.

PURPOSE: To describe the changes after frenectomy concerning mobility and functions of the tongue. METHODS: Participants were 53 subjects who had never undergone speech therapy or lingual frenulum surgery. A specific lingual frenulum protocol with scores was used by speech-language pathologists when there was evidence of frenulum alteration. Ten subjects had abnormal frenulum and were referred to an otolaryngologist for frenectomy. After surgery, the subjects were re-evaluated using the same protocol. Photos and videos were taken for comparison. RESULTS: Thirty days after surgery, the subjects had the shape of the tip of the tongue and its movements improved. Lip closure and speech were also improved. CONCLUSION: Frenectomy is efficient to improve tongue posture, tongue mobility, oral functions, and oral communication.

Correlation of " in vivo" microcirculation and degeneration of the basal cells of the epithelium in lingual lichen planus.

Background: Oral lichen planus is an inflammatory chronic disease with an autimmune pathogenesis and unknown etiology that affects oral mucosa, with or without the involvement of the skin and other mucous membranes. The principal histological characteristics are the degeneration of the basal cell layer and the abnormal infiltration of inflammatory cells into the subepithelial layer of connective tissue. Objectives: This study is aimed to appraise if lingual lichen planus (LLP) is sustained by alteration of the oral microcirculation and if this abnormal vascularisation increases the degeneration of basal keratinocytes and the disruption of the basement membrane. Materials and Methods: Fifteen patients with a histological diagnosis of LLP with higher degree of degeneration of the basement membrane, fifteen LLP patients with lower degree of basement membrane (BM) degeneration and fifteen healthy patients were included in the study. The microcirculation of the left margin of the lingual mucosa of all the patients and subjects was analysed with the videocapillaroscopy. The following parameters were analyzed on each capillaroscopic image: c0 apillary loop length, loop diameter, and capillary density. The results obtained by videocapillaroscopy software were subjected to statistical analysis using Mann Whitney U-test (P < 0.001). Statistical analysis was performed using PAST software, v. 1.53. Results: Capillary density, loop length, and total diameter showed statistically significant differences between LLP patients with histologically lower degree of BM degeneration and healthy subjects and a meaningful significant difference between LLP patients with higher degree of BM degeneration. Conclusions: A remarkable increase in capillary density was showed by videocapillaroscopic exam. The increased value of the density could be associated with angiogenesis mechanism and it could be an indicator of the evolutionary condition of LLP. Videocapillaroscopy may be useful for the evaluation of the evolution or regression of the disease.

Burning mouth syndrome: clinical profile of Brazilian patients and oral carriage of candida species

Burning mouth syndrome (BMS) is a complex disease of unknown cause. It is characterized by a burning sensation in the oral mucosa, notwithstanding its clinical normal aspect. BMS is particularly seen in postmenopausal women. The purpose of this study was to investigate this syndrome on a clinical basis and, in addition, to analyze its possible relation to the frequency of Candida species. Thirty-one patients (28 women and 3 men; 13 Caucasians and 18 non-Caucasians; mean age = 61.3, range 30-85 years) were evaluated. Most patients (80.6 percent) were under long-term medication, antihypertensive, ansiolitic and antidepressant drugs being the most used. Burning mouth complaint was associated with other secondary oral complaints in 83.8 percent of the cases. Tongue was the most commonly affected site (70.9 percent), followed by the vermillion border of the lower lip (38.7 percent) and hard palate (32.2 percent). The association of the burning sensation with oral cancer (cancer phobia) was reported by 67.7 percent of the patients. Haematologic examination (hematocrit, haemoglobin and fasting blood glucose level) revealed 2 cases each of anemia and type 2 diabetes. Local factors, tooth extractions and dentures wearing, were associated with the onset of symptoms in 35.5 percent of the cases. Daily activities were changed as a consequence of BMS in 29 percent of the patients. Among the species of the genus Candida, C. albicans was the most frequent in BMS patients (9 - 29.03 percent) and controls (12 - 38.70 percent), followed respectively by C. parapsilosis (2 - 6.45 percent and 0 - 0 percent); C. tropicalis (1 - 3.22 percent and 2 - 6.45 percent); C. krusei and C. kefyr (1 - 3.22 percent and 0 - 0 percent). Therefore, such difference did not reach valuable results. In conclusion, these data were similar to those reported in other studies. The highlights of the present findings were the possible relation of BMS with chronic drug...

A Síndrome de ardência bucal (SAB) é uma doença complexa, de etiologia desconhecida. Caracteriza-se por uma sensação de queimação na mucosa bucal, não obstante seu aspecto clínico normal, sendo bastante freqüente em mulheres após a menopausa. O propósito deste estudo foi o de investigar a SAB em bases clínicas e, em adição, analisar sua possível relação com a freqüência de espécies do gênero Candida isoladas da cavidade bucal desses indivíduos. Foram estudados trinta e um pacientes, 28 mulheres e 3 homens, 13 caucasianos e 18 não caucasianos, média de idade 61,3 (faixa dos 30 - 85 anos). A maioria deles (80,6 por cento) estava sob medicação por longo período. Anti-hipertensivos, ansioliticos e antidepressivos foram as drogas mais utilizadas. A ardência bucal estava associada a outras queixas secundárias em 83,8 por cento dos pacientes. A língua foi o sítio mais afetado (70,9 por cento), seguida pelo vermelhão do lábio inferior (38,7 por cento) e palato duro (32,2 por cento). A associação de sensação de ardência com câncer bucal (cancerofobia) foi referida por 67,7 por cento dos pacientes. Exames hematológicos (hematócrito, hemoglobina e glicemia em jejum) revelaram dois casos cada, de anemia e diabetes tipo 2. Fatores locais, exodontias, e uso de próteses estavam associados com o conjunto de sintomas em 35,5 por cento dos casos. Foram referidas alterações importantes nas atividades cotidianas, em conseqüência da SAB, em 29 por cento dos pacientes. Leveduras do gênero Candida foram isoladas da cavidade bucal de 45,16 por cento dos indivíduos com SAB e igualmente do grupo-controle, não constituindo dado qualitativamente importante. Dentre as espécies do Gênero Candida, C. albicans foi a mais freqüente (9 - 29,03 por cento e 12 - 38,70 por cento), seguida de C. parapsilosis (2 - 6,45 por cento e 0 - 0 por cento), C. tropicalis (1 - 3,22 por cento e 2 - 6,45 por cento), C. krusei e C. kefyr (1 - 3,22 por cento e 0 - 0 por cento). Em conclusão, nossos...