Evaluation of the craniofacial and oral characteristics of individuals with Down syndrome: A review of the literature.

The aim of this investigation was to describe the craniofacial and oral characteristics of children and/or adolescents with and without Down syndrome (DS). A bibliographic search of the Medline database (via PubMed), Scopus and SCIELO was performed using the keywords "craniofacial characteristics", "dental characteristics" and "Down syndrome". Systematic reviews, observational cross-sectional and longitudinal studies were included. On the contrary, case reports, letters to the editor, editorials and opinion articles were excluded. 251 articles were recovered, and only 30 fulfilled the selection criteria. DS patients were characterized by reduced dimensions of the maxillary bone, mandible, and skull base, compared to normal patients. Likewise, some of these abnormalities influenced more frequent presentation of a class III malocclusion in these patients. On the other hand, this population group showed a higher prevalence of periodontal diseases, less risk of dental caries, and the presence of alterations in the tongue, lips, dental development and palate morphology. The quality of life of these individuals is affected by difficulties in swallowing, talking, eating or breathing through the nose. In conclusion, the craniofacial and oral characteristics of DS patients present various alterations compared to healthy patients, and these alterations have a negative impact on their quality of life.

Paratormônios e osteoporose: encontrando o fio da meada. Bases fisiológicas para utilização do PTH no tratamento da osteoporose / Parathyroid hormone and osteoporosis: finding the clue to the puzzle. Physiologic Bases for the therapeutic use of PTH in osteoporosis

O paratormônio (PTH) estará disponível em breve em nosso mercado como uma possibilidade terapêutica eficiente para a osteoporose. Esta revisão tem por objetivo apresentar os resultados das pesquisas clínicas e experimentais que justificaram tal fato, assim como procurar esclarecer por quais mecanismos o PTH pode ter ações diferenciadas sobre o esqueleto. Os trabalhos bastante recentes demonstram que existem vias diferentes para a atuação do PTH no osteoblasto, e que isto depende da dose, do tempo de exposição e dos fragmentos de PTH utilizados. Seu uso em dose única diária, por via subcutânea, tem demonstrado resultados surpreendentes em termos de ganho de massa óssea e prevenção de fraturas, superando em muito os resultados obtidos com as terapêuticas anti-reabsortivas. Sua disponibilização trará grandes modificações nos conceitos e atuais formas de tratamento da osteoporose.