Influência da idade e do tempo de uso da Placa Palatina de Memória por crianças com Trissomia do 21 nas mudanças miofuncionais orofaciais percebidas pelos pais, na adaptação e satisfação da família após quatro meses de tratamento / nfluence of age and time of use of the Stimulating Palatal Plate by children with Trisomy 21 on orofacial myofunctional changes perceived by parents, children's adaptation, and family's satisfaction after four months of treatment / Influencia de la edad y el tiempo de uso de la placa de memoria palatina por niños con trisomía 21 sobre los cambios miofuncionales orofaciales percibidos por los padres, adaptación y satisfacción familiar después de cuatro meses de tratamiento

Objetivo: verificar se a idade das crianças com Trissomia do 21 e o tempo de uso por dia da placa palatina de memória influenciam a adaptação da criança à placa, as mudanças miofuncionais orofaciais percebidas pelos pais e a satisfação da família, após quatro meses de tratamento. Métodos: participaram do estudo14 pais ou responsáveis legais de crianças com Trissomia do 21, com idades de 3 a 20 meses. O tratamento com a placa palatina de memória foi realizado durante quatro meses. A adaptação da criança à placa, as mudanças miofuncionais orofaciais percebidas pelos pais e a satisfação das famílias em relação ao tratamento foram investigadas por meio de questionário elaborado pelos autores da pesquisa e respondido pelas mães após quatro meses de tratamento. Resultados: a média de idade das crianças que participaram do estudo foi 10 meses e o desvio-padrão de 4,9 meses. O resultado do questionário indicou associação entre idade e postura de lábios relatada pelos pais com o uso da placa palatina de memória, sendo que todas as crianças menores de 10 meses mantiveram o selamento labial, de acordo com os pais, durante o uso da placa; bem como entre idade e satisfação com o tratamento, sendo que as mães das crianças menores mostraram-se mais satisfeitas. Conclusão: os resultados do estudo indicam que houve associação entre idade e postura de lábios relatada pelos pais com o uso da placa, bem como entre idade e satisfação com o tratamento e sugerem que o tratamento precoce com a placa palatina de memória beneficia as crianças com Trissomia do 21. (AU)

Purpose: to verify if the age of children with Trisomy 21 and the time of use per day of the stimulating palatal plate influence the child's adaptation to the plate, the orofacial myofunctional changes perceived by the parents, and the family's satisfaction, after four months of treatment. Methods: 14 parents or legal guardians of children with Trisomy 21, aged between 3 and 20 months, participated in the study. Treatment with the stimulating palatal plate was carried out for four months. The child's adaptation to the plate, the orofacial myofunctional changes perceived by the parents, and the families' satisfaction with the treatment were investigated through a questionnaire prepared by the research authors and answered by the mothers after four months of treatment. Results: The mean age of the children who participated in the study was 10 months and the standard deviation was 4.9 months. The results of the questionnaire indicated an association between age and lip posture, reported by parents, during the use of the stimulating palatal plate, and all children under 10 months maintained lip closure, according to the parents, during the use of the plate. Age was also associated with satisfaction with the service, as the mothers of younger children were more satisfied. Conclusion: The study results indicate an association between age and lip posture, reported by the parents, during the use of the plate, and between age and satisfaction with the service. Thus, it suggests that early treatment with the stimulating palatal plate benefits children with Trisomy 21. (AU)

Objetivo: verificar si la edad de los niños con Trisomía 21 y el tiempo de uso por día de la placa palatina de memoria influyen en la adaptación del niño a la placa, los cambios miofuncionales orofaciales percibidos por los padres y la satisfacción de la familia, después de cuatro meses de tratamiento. Métodos: Participaron en el estudio 14 padres o tutores legales de niños con trisomía 21, con edades comprendidas entre los 3 y los 20 meses. El tratamiento con la placa de memoria palatina se llevó a cabo durante cuatro meses. La adaptación del niño al plato, los cambios miofuncionales orofaciales percibidos por los padres y la satisfacción de las familias con el tratamiento fueron investigados a través de un cuestionario elaborado por los autores y respondido por las madres, después de cuatro meses de tratamiento. Resultados: La edad media de los niños que participaron en el estudio fue de 10 meses y la desviación estándar fue de 4,9. El resultado del cuestionario indicó una asociación entre la edad y la postura de los labios, reportada por los padres, con el uso de la placa de memoria palatina, y todos los niños menores de 10 meses mantuvieron el sello de los labios, según los padres, durante el uso de la placa de memoria palatina, así como entre la edad y la satisfacción con el servicio. Las madres de niños más pequeños estaban más satisfechas. Conclusión: Los resultados del estudio indican que hubo asociación entre la edad y la postura de los labios, reportada por los padres, con el uso de la placa, así como entre la edad y la satisfacción con el servicio, y sugieren que el tratamiento temprano con la placa de memoria palatina beneficia a los niños con trisomía 21. (AU)

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.

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.

Evaluación del frenillo lingual en neonatos. Una revisión sistemática / Evaluation of the lingual frenulum in neonates. A Systematic Review

Introducción: el objetivo de esta revisión es responder al interrogante: ¿cuál es la metodología más eficaz de evaluación de frenillo lingual en neonatos? Bajo los pará-metros de objetividad, claridad y validación. Métodos: el estudio se realizó a través de una revisión sistemática, llevada a cabo con metodología Cochrane, en la que se utilizaron los descriptores de evaluación, frenillo lingual, anquiloglosia y recién nacido, y ejecutado en los bancos de datos Pubmed, Science Direct, Scielo. Para analizar el nivel de evidencia y grado de reco-mendación clínica, se tuvo en cuenta la clasificación GRADE y CEBM de Oxford. Resultados: por medio de la revisión se encontraron 2 evaluaciones y un tamizaje específicamente para recién nacidos, que evalúa de los 0 a los 30 días, los cuales se validan por medio de estudios de especificidad. Análisis y discusión: se identificó que los principales parámetros para diagnosti-car una alteración en el frenillo lingual son la anatomía y su funcionalidad. Conclusiones: según los estudios encontrados sí existe un método eficaz para el diagnóstico del frenillo lingual en neonatos.

Introduction: the objective of this review is to answer the question: What is the most effective methodology for assessing lingual frenulum in neonates? Under the parameters of objectivity, clarity and validation. Methods: the study was conducted through a systematic review carried out using the Cochrane methodology, in which the evaluation descriptors, lingual frenulum, ankyloglossia, and newborn were used, and developed in the Pubmed, Science Direct and Scielo data banks. To analyze the level of evidence and degree of clinical recom-mendation, the GRADE and CEBM classification of Oxford was taken into account. Results: through the review we found 2 evaluations and a screening specifically for new-borns that evaluates from 0 to 30 days, which are validated through specificity studies.Analysis and discussion: it was identified that the main parameters to diagnose an alteration in the lingual frenum are its anatomy and functionality. Conclusions: according to the studies found, there is an effective method for the diagnosis of the lingual frenulum in neonates.

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.

Características morfológicas encontradas na cavidade oral de neonatos: revisão de literatura / Morphological characteristics found in the oral cavity of newborns: a literature review

Objetivo: revisar a literatura sobre as característicasmorfológicas da cavidade oral de recém-nascidos. Revisãode literatura: as profissões da área de saúde estãocada vez mais voltadas para um acompanhamentoprecoce do indivíduo, iniciando-se antes mesmo donascimento ou nos primeiros dias de vida da criança.Sendo assim, recém-nascidos apresentam na cavidadeoral características peculiares da sua fase de desenvolvimentoque podem trazer dúvidas para os pais e/ouresponsáveis. As principais variações da cavidade oralde recém-nascidos envolvem tecidos duros e tecidosmoles. Considerando o posicionamento dos maxilares,as alterações mais comuns são: mordida aberta anterior,sobremordida e mordida topo a topo. Em relação aos tecidosmoles, o contorno dos lábios dos recém-nascidosse apresenta triangular e, com a amamentação constante,forma-se um aumento de volume na linha média dolábio superior. Considerações finais: além de ser necessárioque os profissionais da área tenham conhecimentodas características morfológicas da cavidade oral dosrecém-nascidos, também é imprescindível que estessaibam diagnosticar possíveis anormalidades e, quandohouver necessidade, indicar tratamento adequado. (AU)

Objective: to review the literature on the morphological characteristics of the oral cavity of newborns. Literature review: health professions are increasingly focused on the early follow-up of individuals, starting even before birth or during the first days of life of the child. Therefore, the oral cavity of newborns presents characteristics particular to their development phase, which may cause doubts to parents and/or caregivers. The major variations of the oral cavity of newborns involve both hard and soft tissues. Considering the positioning of the jaws, the most common changes are anterior open bite, overbite, and edge-to-edge bite. Regarding the soft tissues, the contour of the lips of newborns is triangular and constant breastfeeding causes an increase of volume formed in the midline of the upper lip. Final considerations: therefore, health professionals are required not only to understand the morphological characteristics of the oral cavity of newborns, but it is also essential that they are able to diagnose potential abnormalities and to indicate appropriate treatment when necessary. (AU)

Toxina botulínica para tratamento de síndrome do Choro Assimétrico: relato de caso / Botulinum toxin in the treatment of asymmetric crying face syndrome: a case report

Síndrome do choro assimétrico é uma condição congênita secundária à hipoplasia ou ausência do músculo depressor do ângulo da boca. Trata-se de uma condição não tão incomum que pode cursar com assimetria facial ao chorar e sorrir, além de poder estar associadas a outras malformações congênitas. Crianças com essa deformidade podem sofrer dificuldades psicossociais e introversão. O arsenal terapêutico dessa condição já foi estudado e discutido na literatura com ênfase em abordagens cirúrgicas e invasivas. Relatamos aqui um caso de uma criança de 9 anos com essa síndrome, tratada, de forma menos invasiva, com toxina botulínica, com um bom resultado e satisfação.

Asymmetric crying face syndrome is a congenital condition secondary to hypoplasia or absence of the depressor muscle at the mouth angle. It is a common condition that presents with facial asymmetry while crying and smiling and may be associated with other congenital malformations. Children with this deformity may experience psychosocial difficulties and introversion. The therapeutic arsenal of this condition has already been studied and discussed in the literature with an emphasis on surgical and invasive approaches. We report here a case of a 9-year-old child with this syndrome, treated less invasively with botulinum toxin, with good result and satisfaction.

Determinantes sociales adversos y riesgo de labio y paladar fisurados, estudio de casos y controles. Ciudad de Cuenca. 2010-2015. / Adverse social determinants and risk of cleft lip and palate Study of cases and controls. Cuenca city. 2010-2015

Introduction Orofacial Cleft, in particular cleft lip and palate (LPF) constitute a problem of oral health due to its implications and impact in several aspects; Little has been studied of how much socioeconomic factors determine this pathology, such as: the place of housing, whether rural or urban, the age and educational level of the mother and socioeconomic. The objective was to determine the association between age and educational level of the mother at the time of delivery, the area of residence, access to folic acid consumption and socioeconomic level (social determinants) with the risk of having a child with cleft lip and palate in the city of Cuenca. Methodology. An observational, analytical, retrospective study of 138 cases (patients with cleft lip and palate) of hospitals Vicente Corral Moscoso and José Carrasco Arteaga and 162 controls of the same hospitals; Results. The association between socioeconomic level and LPF diagnosis shows an OR = 5,077 (CI 3,098-8,320) p <0.01. The association between the age of the mother and the diagnosis of LPF shows an OR = 1,782 (CI 1,090-2,911) for age at risk (adolescent mother and aged mother) p <0.021 and the association between the mother's educational level and the LPF diagnosis showed an OR = 6,106 (CI 3,690-10,105) p <0.000. The association between folic acid consumption by the mother and the diagnosis of LPF OR = 2,791 (IC 1.687-4.167) p <0.000 Conclusions. There is an interaction between the studied variables (place of residence, mother's level of education, folic acid consumption in pregnancy and socioeconomic level) that determine a higher probability of having a child with LPF.

Introducción Las fisuras orofaciales, en particular la de labio y paladar fisurado (LPF), constituyen un problema de salud bucodental debido a sus implicaciones en varios aspectos; Poco ha sido estudiado los factores socioeconómicos: lugar de vivienda, edad, nivel educativo y socioeconómico de la madre. El objetivo determinar la asociación entre la edad y nivel educativo de la madre en el momento del parto, la zona de residencia, el acceso al consumo del ácido fólico y el nivel socioeconómico, con el riesgo de tener un hijo con LPF. Metodología: observacional, analítico, retrospectivo; se analizó 138 casos (pacientes con LPF) del hospital Vicente Corral Moscoso y José Carrasco Arteaga y 162 controles de los mismos hospitales. Resultados. La Asociación entre el nivel socioeconómico y el diagnóstico de LPF muestra un OR=5.077 (IC 3.098-8.320) p<0.01. La Asociación entre la edad de la madre y el diagnóstico de LPF muestra un OR= 1.782 (IC 1.090-2.911) para la edad en riesgo (madre adolescente y madre añosa) p<0.021 y la Asociación entre el nivel educativo de la madre y el diagnóstico de LPF muestra un OR= 6.106 (IC 3.690-10.105) p<0.000. La Asociación entre el consumo de ácido fólico por la madre y el diagnóstico de LPF OR= 2.791 (IC 1.687-4.167) p<0.000 Conclusiones. Existe interacción entre las variables lugar de residencia, nivel de instrucción de la madre y consumo de ácido fólico en el embarazo y el nivel socioeconómico que determinan mayor probabilidad de tener un hijo con LPF.

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.

Procedimento de bichectomia: uma discussão sobre os aspectos éticos e legais em odontologia / Bichectomy procedure: a discussion on the ethical and legal aspects in odontology

Introdução: O procedimento denominado de bichectomia consiste na remoção parcial de uma estrutura adiposa na região das bochechas e ganhou recente popularidade entre a classe odontológica, que passou a executá-lo amplamente, com demandas predominantemente estéticas e, com isso, dúvidas e incertezas surgiram a respeito dos seus aspectos éticos e legais. Objetivo: O objetivo deste trabalho foi buscar legislações nacionais, bem como normativas e resoluções emitidas por conselhos profissionais, visando abordar tais controvérsias, alumiando os profissionais quanto à legitimidade do procedimento. Resultados: Verificou-se que desde 1978, os Conselhos Federais de Medicina e de Odontologia vêm emitindo resoluções para determinar limiares de atuação profissional, em especial, com enfoque na especialidade Cirurgia e Traumatologia Bucomaxilofacial, visto que é a especialidade odontológica clínica que mais se aproxima de campos de atuação médica. Com o tempo, estes Conselhos foram atualizando estas Resoluções, tendo em vista os avanços técnicos e científicos da área, porém todas as resoluções analisadas são unânimes em afirmar que a realização de bichectomia com finalidade estritamente estética é atribuição médica. Conclusão: Desta forma, com base nos documentos atualmente vigentes, verifica-se que o cirurgião-dentista que estiver disposto a realizar a cirurgia de bichectomia com finalidade exclusivamente estética estará incorrendo em transgressões administrativas e, consequentemente, tais interpretações podem ser vislumbradas em outras esferas (cíveis e criminais).

Introduction: Bichectomy consists of removing part of a fat structure in the region of the cheeks, and it recently gained popularity in the field of odontology, which began to widely perform the procedure, with predominantly aesthetic demands and, with that, doubts and uncertainties arose with respect to its ethical and legal aspects. Objective: The objective of this work was to seek national laws, as well as normative and resolutions issued by professional councils, aiming to address such controversies, enlightening professionals to the legitimacy of the procedure. Results: Since 1978, the Federal Councils of Medicine and Dentistry have issued resolutions to determine thresholds for professional performance, which particularly focused on Oral and Maxillofacial Surgery and Traumatology because it is the closest clinical dental specialty of medical practice. Over time, these Councils have been updating these resolutions, considering the technical and scientific advances of the area, but all the resolutions analyzed were unanimous in affirming that the accomplishment of bichectomy with a strictly aesthetic purpose is a medical attribution. Conclusion: Subsequently, based on the documents currently in force, it is verified that the dental surgeon who is willing to perform bichectomy surgery for aesthetic purposes will be incur administrative infractions and, consequently, such interpretations can be seen in other legal areas (civil and criminal).

Comportamiento de la oclusión dentaria en pacientes operados de cirugía ortognática / Behavior of dental occlusion in patients undergoing orthognathic surgery

Introducción: la cirugía ortognática corrige las alteraciones del componente esquelético en las anomalías dentomaxilofaciales. Estas deformidades provocan deficiente relación de los huesos maxilares, afectando la oclusión dentaria y sus funciones. Objetivo: identificar el comportamiento de la oclusión dentaria en pacientes que fueron intervenidos por cirugía ortognática. Materiales y Métodos: se realizó un estudio observacional descriptivo con el objetivo de identificar características oclusales en pacientes intervenidos por cirugía ortognática. Se utilizaron las variables: relación de molares, guías de función lateral, tipo de masticación, interferencias oclusales en movimiento de protrusión y de lateralidad. Resultados: se observaron pacientes con relación de molares en mesioclusión, lo cual es un indicio de recidiva de la neutroclusión que había sido alcanzada. La intervención quirúrgica de mayor incidencia fue la retroposición mandibular acompañada de centralización. Existió una gran mejoría de la función masticatoria. La mayoría de los pacientes, se encontraban libres de interferencias oclusales. Conclusiones: los examinados se encontraron entre los grupos de edades de 24 a 38 años, y el sexo femenino predominó con un 60,5 %. El 13, 2 % de los sujetos presentaron mesioclusión, con mayor incidencia en los casos intervenidos con retroposición y centralización de la mandíbula. Predominó la función canina en los movimientos de lateralidad. La mayoría de los pacientes se encontraban libres de interferencias oclusales, representando el 71,1 % de los pacientes estudiados.

Introduction: the orthognatic surgery corrects the alterations of the skeletal component in dentomaxillafacial anomalies. These deformations cause deficient relations of the maxillary bones, affecting the dental occlusion and its functions. Objective: to identify dental occlusion behavior in patients undergoing orthognatic surgery. Materials and methods: an observational, descriptive study was carried out with the objective of identifying oclussal characteristics in patients who underwent orthognatic surgery. The used variables were: molars relation, guides of lateral functioning, kinds of chewing, occlusive interferences in protrusion movements and in movements of laterality. Results: patients were found with molars relation of mesiooclussion, which is an indication of recidivism in the achieved neutroclussion. The surgical intervention with higher incidence was mandibular retro positioning accompanied by centralization. There it was a great improvement of the chewing function. Most of the patients were free of oclussal interferences. Conclusions: the assessed patients were in the age-groups from 24 to 38 years, and female sex predominated with 60.5 %. 13.2 % of the subjects had mesiocclusion, with higher incidence in the cases surgically treated with jaw retroposition and centralization. The canine tooth function in the lateral movements predominated. Most of the patients were free from occlusive interferences, being 71.1 % of the studied patients.

As principais alterações dentárias de desenvolvimento / The main changes of dental development

Introdução: os distúrbios no desenvolvimento das estruturas dentárias podem ter origem hereditária, congênita ou adquirida. Tais alterações podem afetar tanto a forma, tamanho, número, posição, constituição e\ou função dos dentes, portanto é de extrema importância à atuação do cirurgião dentista no diagnóstico e tratamento. Objetivo: discorrer sobre as anomalias dentárias de desenvolvimento, apresentando as alterações quanto ao número, tamanho, forma e estrutura dos dentes, ressaltando a importância do cirurgião dentista em conhecer essas anomalias, saber identificá-las e estabelecer a melhor conduta terapêutica. Método: foi realizado uma revisão sistemática da literatura nas bases de dados eletrônicos: PubMED/Medline, Lilacs, Portal Capes-Periódicos, Scielo, Bireme, Scopus e livros específicos sobre a temática da pesquisa. Conclusão: alterações dentárias do desenvolvimento, são postas diante do cirurgião-dentista geralmente por insatisfação estética ou descobertas em consulta de rotina, então cabe ao profissional saber diagnosticar, e traçar o plano de tratamento mais adequado a cada caso.

Introduction: the disturbances in the development of dental structures can be hereditary, congenital or acquired. Such changes can affect both the shape, size, number, position, constitution and \ or function of the teeth, so it is of utmost importance the role of the dentist in the diagnosis and treatment. Objective: this study aims to discuss the dental anomalies of development, addressing the changes in the number, size, shape and structure of the teeth, emphasizing the importance of dental surgeons to meet these anomalies, learn to identify them and establish the best treatment. Method: it was conducted a systematic review of literature in electronic databases: PubMed / Medline, Lilacs, Capes-Journal Portal, Scielo, Bireme, Scopus and specific books on the subject of research. Conclusion: dental developmental changes are usually presented to the dental surgeon due to aesthetic dissatisfaction or findings in routine consultation, so it is up to the professional to know how to diagnose, and to draw the most adequate treatment plan for each case.

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.

Association between oronasopharyngeal abnormalities and malocclusion in Northeastern Brazilian preschoolers

Abstract Objective: Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers. Methods: A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05). Results: The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC. Conclusion: Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers.

resumo Introdução: não há consenso na literatura quanto à associação entre alterações oronasofaríngeas e as más oclusões. Objetivo: o objetivo do presente estudo foi avaliar a associação entre as alterações oronasofaríngeas e as más oclusões (mordida aberta anterior e mordida cruzada posterior) em pré-escolares. Métodos: um estudo transversal foi conduzido com uma amostra representativa de 732 pré-escolares com 3 a 5 anos de idade, aleatoriamente selecionados em pré-escolas privadas e públicas. A mordida aberta anterior (MAA) e a mordida cruzada posterior (MCP) foram avaliadas a partir de exames clínicos. Pais/cuidadores responderam a um questionário relativo a indicadores sociodemográficos e problemas oronasofaríngeos. A análise estatística envolveu análise descritiva e regressão de Poisson (p < 0,05). Resultados: as prevalências de MAA e MCP foram de 21,0% e 11,6%, respectivamente. Ter três anos de idade (RP = 1,244; IC = 1,110 - 1,394; p < 0,001, considerando-se RP = Razões de Prevalência e IC = Intervalo de Confiança 95%), ter quatro anos de idade (RP = 1,144; IC = 1,110 - 1,394; p = 0,015), ausência de alergia (RP = 1,158; IC = 1,057 - 1,269; p = 0,002), não ter se submetido a cirurgias do nariz (RP = 1,152; IC = 1,041 - 1,275; p = 0,006) e ter tido dor de garganta mais de cinco vezes no mesmo ano (RP = 1,118; IC = 1,011 - 1,237; p = 0,030) foram significativamente associados com MAA. Ausência de asma (RP = 1,082; IC = 1,012 - 1,156; p = 0,020), não ter realizado adenoidectomia (RP = 1,112; IC = 1,068 - 1,158; p < 0,001) e não ter se submetido a cirurgias do nariz (RP = 1,114; IC = 1,069 - 1,160; p < 0,001) permaneceram associados à MCP. Conclusão: associações significativas foram encontradas entre as alterações oronasofaríngeas relatadas e a presença de MAA e MCP em pré-escolares.

Síndrome de trisomía 18: reporte de un caso clínico / Trisomy 18 syndrome: a case report

Introducción El síndrome de trisomía 18 (T18) ocurre por la presencia de un cromosoma 18 extra completo en la mayoría de los casos. La prevalencia en recién nacidos oscila entre uno en 6.000 a uno en 8.000. Los afectados tienen una elevada mortalidad, solo el 4% supera el primer año de vida. Son pocos los casos reportados que superan los 5 años. Objetivo El objetivo de este artículo es reportar un caso de T18 de larga sobrevida con características en la cavidad oral no descritas en la literatura, y aportar información a médicos y pediatras sobre la etiología, el fenotipo, la sobrevida y el consejo genético. Reporte de caso Paciente de sexo femenino de 7 años con 2 cariotipos realizados en cultivo de linfocitos que mostraron 47,XX+18 en todas las metafases. Con talla y peso bajos, facies dismórficas, retardo severo del desarrollo psicomotor y cognitivo, imposibilidad para alimentarse, ausencia del lenguaje verbal, sordera neurosensorial, marcha atáxica, hipoplasia cerebelosa; genitales con labios mayores y menores hipoplásicos. En la cavidad oral paladar en forma de cúpula, macroglosia, no se observaron incisivos centrales superiores y primeros molares superiores e inferiores. En las radiografías se encuentran hallazgos de formación de las piezas dentales ausentes en la boca, concluyéndose erupción tardía. Conclusiones En los casos de T18 la mortalidad in útero y neonatal es alta, las características clínicas in útero y en recién nacidos han sido bien descritas. Dado que son pocos los casos que superan los 5 años el fenotipo aún está por establecerse. En la paciente aquí reportada se encontraron hallazgos en la cavidad oral no descritos en la literatura.

Introduction The trisomy 18 syndrome occurs due to the presence of an extra chromosome 18 in most cases. The prevalence in infants is estimated at 1:6000 to 1:8000. Those affected have a high mortality rate, only 4% may survive their first year of life. There are few reported cases exceeding five years of age. Objective The aim of this paper is to report a case of trisomy 18 of long survival with oral cavity features not described in the literature, and to provide information to physicians and paediatricians about aetiology, phenotype, survival and genetic counselling. Case report A 7 year-old female patient with 2 karyotypes performed by lymphocyte culture showing 47XX+18 in all metaphases. She presented with growth deficiency, dysmorphic facies, severe psychomotor retardation and cognitive disability, inability to feed, lack of verbal language, sensorineural hearing loss, ataxia, cerebellar hypoplasia, and genitals with hypoplastic labia majora and minora. In the oral cavity: dome shaped palate, macroglossia, absence of upper central incisors and first upper and lower molars in mouth. X-ray findings showed formation of missing teeth, with late eruption being concluded. Conclusions In cases of trisomy 18 syndrome there is an increased risk of neonatal and infant mortality. The clinical characteristics in utero and in neonates have been well described. Since few cases exceeding five years of age have been reported, the phenotype is yet to be established. In the case being reported we describe oral cavity findings not documented in the literature.

TEAS for prevention and treatment of orthodontic toothache and oral dysfunction: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy of transcutanclus electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache and oral dysfunction.</p><p><b>METHODS</b>A total of 85 patients of malocclusions in the preliminary diagnosis were randomly divided into a control group (20 cases), a psychological intervention group (22 cases), a medication group (20 cases) and a TEAS group (23 cases). Orthodontics treatment was given in all the groups. Patients in the control group received no further treatment; patients in the psychological intervention group received comprehensive psychological intervention, including cognitive education and music therapy; patients in the medication group received oral administration of ibuprofen; patients in the TEAS group received TEAS at Juliao (ST 3), Jiachengjiang (Extra) and auricular point Ya (LO1). The treatment was given twice a day, one in morning and one at night, for 7 days. The pain scores of orthodontic toothache and changes of oral dysfunction were observed in all groups.</p><p><b>RESULTS</b>(1) At 5 time points from the 12th hour to the 4th day, the scores of spontaneous pain in TEAS group were lower than those in the control group (all P < 0.01); during the time points, the scores in TEAS group were lower than those in the psychological intervention group (P < 0.05, P < 0.01), which were similar to those in the medication group (all P > 0.05). (2) During the peak cycle of spontaneous toothache, the scores of irritation pain in TEAS group were significantly lower than those in the control group (all P < O.01), regardless of time-point statistics or general statistics; the scores of irritation pain in the TEAS group were also significantly lower than those in the psychological intervention group (all P < 0.01), which were similar to those in the medication group (all P > 0. 05). (3) Compared with control group, the grading of talking disorder in the remaining groups did not change significantly (P > 0.05). (4) Compared with control group, the grading of moderate-severe eating disorder in TEAS group was significantly reduced (P < O.05), which was not different from that in the medication group (P > 0.05). The differences of the grading of moderate-severe eating disorder were not significantly different between the psychological intervention group and control group (P > 0.05). (5) There were 3 cases of digestive system adverse reactions in the medication group.</p><p><b>CONCLUSION</b>TEAS can efficiently prevent orthodontic toothache and oral dysfunction, which is superior to psychological intervention and similar to medication. In addition, it can avoid possible side-effect of medication.</p>

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

Systemic and oral alterations associated with stress in nurses of public referral hospital

Jobs that require great responsibility can cause serious damage to the body such as stress and its consequences. Stress can be one of the triggers of disease systemic and oral diseases in different professionals. Aim: To associate emotional stress with the systemic and oral alterations in the nurses of public referral hospital. Methods: All 60 nurses of both genders, with higher education level, different ethnicities and ages were invited to join this study. Nurses filled out the Inventory of Stress Symptoms for Adults (ISSL) and questionnaire of diseases/psychosomatic symptoms. Next, they were subjected to a stomatological examination of the oral cavity, according to the Boraks (1996) criteria. Stress was associated with most outstanding psychosomatic and oral variables by the Fisher's exact test for calculating the p value (0.05). Results: The sample was comprised of 37 nurses, most of them female (91.9%), young (83.7% are less than 36-years old), full range 22-50 years old, white ethnicity (86.5%). The level of stress in level II (resistance) and III (exhaustion) was observed in 51.3% of the nurses. Symptoms of headache and gain of body weight lately were present in 48.6% of the nurses. With regard to oral alterations, 32.4% reported cold sore sometimes and 59.5% nibbled mucosa always. There was no significant association between the stress and psychosomatic and oral variables. Conclusions: Based on the results of this study it may be concluded that the nursing profession can lead to emotional stress, although no significant association between stress and disease/psychosomatic and oral symptoms was found. Future studies should be performed to evaluate this association.