Dental treatment of a patient with Opitz G/BBB syndrome.

Opitz G/BBB syndrome is a genetic condition characterized by several abnormalities along the midline of the body, such as hypertelorism, craniofacial deformities, and dysphagia. This study reports the clinical features of Optiz syndrome and its importance in the knowledge of patients who are developmentally challenged as a whole, in order to establish adequate dental treatment for a certain clinical case. A 19-year-old patient visited the Paulista University for a dental treatment. The extraoral examination revealed ocular hypertelorism (wide-spaced eyes), oblique eyelids, epicanthus, low-set cart, and intellectual disability. During the intraoral examination, large caries lesions were observed surrounding the braces of the fixed orthodontic appliance and poor oral hygiene. Preventive and restorative treatments were carried out. It was concluded that the knowledge of patients with special needs as a whole is mandatory for an adequate dental treatment. This is a case report that highlights the importance of dentist and interdisciplinary care attendance for all patient systems, the examination and analyses should not be restricted to the oral cavity.

Manejo quirúrgico de dientes supernumerarios en adolescente con Tetralogía de Fallot: Reporte de caso / Manejo cirúrgico para remoção de dentes supranumerários em adolescente com Tetralogia de Fallot: Relato de caso / Surgical Management of supernumerary teeth in adolescent with Tetralogy of Fallot: Case report

La tetralogía de Fallot (TOF) se ha asociado con varios defectos genéticos y puede presentarse simultáneamente con ma-nifestaciones craneofaciales. El paciente odontológico con TOF puede requerir algunos cambios en el plan de tratamiento. El objetivo del presente reporte de caso es mostrar que las extracciones dentales se pueden llevar a cabo en personas con TOF bajo anestesia local, una vez que se realiza la correcta planificación. Cinco dientes supernumerarios fueron extraídos de un paciente adolescente con TOF y se realizó profilaxis antibiótica para evitar la endocarditis infecciosa. La paciente regresó para una nueva evaluación al 7mo día postoperatorio. Él informó que no había sentido molestias o dificultades para comer. El examen bucal postoperatorio confirmó la reparación eficiente de los tejidos en todas las regiones expuestas al procedimiento quirúrgico, sin ninguna señal de infección.

Tetralogy of Fallot (TOF) has been associated with several genetic defects and may present concurrently with craniofacial manifestations. The dental patient with TOF may require some changes in the treatment plan. The aim of the present case report is to show that dental extractions can be carried out in TOF individuals under local anaesthesia, since the correct planning is done. Five supernumerary teeth were extracted in adolescent with TOF and antibiotic prophylaxis was performed to avoid infective endocarditis. The patient returned for re-evaluation on the 7th postoperative day. He reported that there had been no discomfort or difficulty in eating. An oral examination confirmed that all extraction sites were healing well, without any indication of infection.

A Tetralogia de Fallot (TOF) está associada a diversas alterações genéticas e pode concomitantemente apresentar manifes-tações craniofaciais. O paciente com comprometimento odontológico geralmente necessita de alterações em seu plano de tratamento. O objetivo do presente estudo, é mostrar, por meio de um relato de caso, que procedimentos cirúrgicos odon-tológicos podem ser realizados em pacientes em TOF sob anestesia local, desde que o correto planejamento seja realizado. Cinco dentes supranumerários foram extraídos de um paciente adolescente com TOF e a profilaxia antibiótica foi realizada previamente ao procedimento cirúrgico, devido ao risco de endocardite infecciosa. O paciente retornou para reavaliação após 7 dias da realização do procedimento relatando que não houve desconforto ou dificuldade para se alimentar. O exame bucal pós-operatório, mostrou reparação tecidual eficiente em todas as regiões expostas ao procedimento cirúrgico, sem qualquer sinal de infecção.

Manifestaciones orales del síndrome del cromosoma 18 en anillo / Oral manifestations in chromosome 18 ring

El síndrome del cromosoma 18 en anillo es un desorden inusual cromosómico con varios cambios generalizados en el cuerpo y boca. Este artículo presenta el reporte del caso de un niño con síndrome del cromosoma 18 en anillo con retardo mental. Esta combinación raramente estudiada, presenta cambios generales y bucales predominantes y retención prolongada de dientes deciduos. El odontólogo debe estar preparado para detectar estos hallazgos en este tipo de pacientes y tratarlos precozmente proporcionando mejoras en su calidad de vida.

Ring chromosome 18 syndrome is a rare chromosomal disorder, with many changes in the general body and mouth. This article reports the case of a child with the syndrome ring chromosome 18 and mental retardation. This combination rarely studied shows oral and general predominant changes and prolonged retention of deciduous teeth. The dentist must be prepared to recognize these findings and treat them at early stages to promote improvements in their quality of life.

Study of emotional and psychological factors that may interfere in the dental treatment / Estudo dos fatores emocionais e psicológicos que podem interferir no tratamento odontológico

Introduction - Submission to dental treatment has been reported by patients as a condition giving rise to stress because they may experience some discomfort causing them to postpone visits to the dental office because of situations that include pain. Identify these conditions is a challenge that dentists should include their care procedures in order to modify this pessimistic view where the main focus (oral health) can be achieved. This work results in the identification of factors that interfere with patient-dentist approximation for the dental treatment. Material and Method - We interviewed 54 patients. Results - The results were significant: 14.85% said they going to the dental office is stressful, 83.3% reported that the dentist managed to deal with fear and anxiety during the dental treatment, 22.0% had requested to stop a consultation because of not keeping the self control. The most common symptoms: palpitations, cold hands, panic, increased sweating. When questioned about what most frightened them: equipment used during the consultations is the main cause of fear. Conclusion - It was concluded that the patient-dentist relationship is a complex and extensive subject, however, it identifies situations that may be related to fear, so that when controlled it facilitates adherence and reduce the dropout to dental treatments, improving clinical and practical care and the patient approach to the dentist.

Introdução - Submeter a tratamento odontológico (TO) tem sido relatado, por pacientes, como condição geradora de estresse, pois acredita-se experimentar algum desconforto levando-os a adiar idas aos consultórios odontológicos a situações limítrofes como a dor. Identificar tais condições é mais um desafio que os cirurgiões-dentistas (CD) devem incluir aos seus atendimentos, com objetivo de modificar esta visão pessimista onde o foco principal (saúde bucal) possa ser atingido. Este trabalho resulta na identificação dos fatores que interferem na aproximação paciente-CD para o TO. Material e Método - Foram entrevistados 54 pacientes. Resultados - Os resultados foram significativos: 14,85% afirmaram que ir ao consultório odontológico é estressante, 83,3% relataram que o CD conseguiu lidar com situações de medo e ansiedade durante o TO; 22,0% já solicitaram interromper a consulta por não conseguir manter o autocontrole. Os sintomas mais frequentes: palpitações, mãos frias, pânico, sudorese aumentada. Quando interrogados sobre o que mais os amedrontam: equipamentos utilizados durante os atendimentos são principais desencadeadores de medo. Conclusão - Conclui-se que a relação paciente-CD é um assunto complexo e extenso, contudo, identifica as situações que devem ser relacionadas ao medo, para que, ao contorná-las possam facilitar aderência e diminuir evasão aos TO, melhorando o atendimento clínico-prático bem como a aproximação dentista-paciente.

Micromorphological analysis of the interaction between a one-bottle adhesive and mineralized primary dentine after superficial deproteination.

It has been claimed that resin monomers may incompletely penetrate into demineralized collagen network, which could form a weak hybrid layer. In consequence, it has been proposed that removal of the exposed collagen network could improve adhesion to dentine. The interface between a water/ethanol-based one-bottle adhesive (Single Bond, 3M) which is devoid of acid monomers, and deproteinated surface of primary dentine was evaluated by SEM. Dentine disks were obtained from 20 primary teeth. Two disks were used to standardize the application time of sodium hypochlorite (NaOCl) for getting an effective deproteination. The remaining 18 disks were equally divided into two groups and treated as follows: control group (CG) 35% phosphoric acid (PA) for 15s; treated group/deproteination (TG) 35% PA for 15s+10% NaOCl for 3 min. Single Bond and Z250 (3M) were placed on all disks according to the manufacturer's instructions. The 18 resin-dentine disks were fractured to obtain hemi-disks and processed for SEM. The examination of the CG specimens showed a typical hybrid layer and the presence of numerous tags with few and short microtags. The TG specimens, which did not present hybrid layer, also exhibited numerous tags, with few and short microtags. Some areas between the tags showed fibrillar-like projections, which appeared to be mineralized collagen fibrils, which were incorporated into the adhesive. Thus, our results suggest that some chemical interaction may occur between mineralized dentinal collagen and the adhesive used.

Displasia ectodérmica relato de dois casos clínicos / Ectodermal dysplasia report of two cases

Os autores apresentam uma breve revisão sobre as displasias ectodérmicas, um conjunto de alterações que invariavelmente comprometem diversas estruturas bucais. Descrevem, ainda, dois casos de displasia ectodérmica hipoidrótica atendidos no Núcleo Integrado de Atendimento Preventivo ao Paciente Especial (NIAPE) da Universidade Paulista (UNIP), onde é ressaltada a conduta odontológica seguida durante o tratamento