Implantes curtos e ultracurtos sobre carga imediata em estruturas ósseas edêntulas e atróficas - uma revisão de literatura

Planejar uma reabilitação protética nos casos de edentulismo em estruturas ósseas atróficas envolve uma alta e extensa complexidade. Os implantes-suportados precisam de uma espessura óssea que acomode a fixação do implante funcionalmente e, nos casos de atrofia óssea, reabilitações com implantes convencionais (10mm) envolvem técnicas cirúrgicas de aumento do rebordo, que são mais invasivas e apresentam maiores riscos. Atualmente, a literatura apresenta os implantes curtos (<10mm) e ultracurtos (4mm) como uma alternativa mais segura e econômica, que tem mostrado eficiência e um bom prognóstico. O objetivo deste estudo foi avaliar as taxas de sobrevivência de próteses totais sobre implantes curtos/ultracurtos com carga imediata em estruturas ósseas atróficas. Na maioria dos casos, o carregamento imediato tem sido um pré -requisito para os pacientes e os resultados têm sido promissores. O tratamento de superfície do implante atrelado a um minucioso planejamento da prótese, viabilizam esta condição. Entretanto, o que determina o sucesso clínico é a estabilidade primária, a resposta biológica óssea e o número de implantes a serem instalados.

Detection of Merkel cell polyomavirus in oral samples of renal transplant recipients without Merkel cell carcinoma.

Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine cancer, with approximately 80% of cases associated with Merkel cell polyomavirus (MCPyV). The lack of information concerning its occurrence in non-MCC immunosuppressed populations led to the investigation of MCPyV DNA in saliva and oral biopsies from 60 kidney allograft recipients and 75 non-transplanted individuals (control group). In contrast to herpesviruses, which was also investigated (CMV, HHV-6A, and B, HHV-7) MCPyV was detected predominantly in patients with oral lesions (gingivitis and/or periodontitis) of both transplanted and non-transplanted groups (P=0.016) and in the saliva of the transplanted group (P=0.009). MCPyV co-detection with CMV (P=0.048), and HHV-6 (P=0.020) in the saliva of transplanted patients requires further investigation on a possible role of co-infection.

Human papillomavirus infections and renal transplantation: a review / Infecções causadas por papilomavírus humanos e transplante renal: uma revisão

The immune suppressive therapy in renal allograft recipients provides a favorable environment to the development of viral infections. Among them,human papillomavirus (HPV) infections are usually related to potential life-threatening mucocutaneous neoplasias. Data from clinical surveys suggestthat transplant recipients may have up to 5-fold increased risk of developing multiple malignancies due to the increased susceptibility to persistent HPV infection. High risk HPV induced oncogenesis is a multi-step process in which a persistent infection is the initiating causative event, though subsequentgenetic and epigenetic alterations may be necessary for malignant transformation. The main tumoral types associated with persistent HPV infection areanogenital, oral and skin cancers, common conditions in transplant recipients and responsible for substantial morbidity and mortality. Since prophylactic vaccines with high rates of efficacy have been approved for human population, studies to evaluate its immunogenicity and efficacy should be considered forlong-term survivors after allogeneic transplantation. Hence, we conducted an extensive revision published data for the last 10 years regarding the theme.To achieve our objectives, we searched in diverse data basis such as Lilacs, ScIELO, Medline, Scopus. We concluded that, concerning the increase in thepopulation of transplant recipients as well as in the incidence of HPV associated diseases, measures for prevention and control are necessary, and includecapaciting human resources and the use of last generation methodologies of diagnosis and prophylaxis.

A terapia imunossupressora em pacientes receptores de transplante renal fornece um ambiente favorável ao desenvolvimento de infecções virais. Dentreestas infecções, aquelas causadas pelos papilomavírus humanos (HPV) são geralmente associadas a neoplasias mucocutâneas que podem ameaçar asobrevida pós-transplante. Pesquisas clínicas sugerem que receptores de transplante podem apresentar um risco até cinco vezes maior de desenvolverem quadros de doenças malignas múltiplas, devido à maior frequência da persistência do HPV. A oncogênese induzida por HPV de alto risco é um processo demúltiplos estágios, no qual a infecção persistente é o evento fundamental, apesar de alterações genéticas e epigenéticas adicionais serem necessárias para a transformação maligna. Os principais tipos tumorais relacionados à infecção persistente por HPV são os cânceres anogenitais, orais e de pele, comunsem receptores de transplante e responsáveis por grande morbidade e mortalidade. Uma vez que vacinas profiláticas de alta eficácia contra a infecçãopelo HPV foram aprovadas para uso na população humana, estudos para avaliar a imunogenicidade e eficácia destas vacinas em imunossuprimidos são recomendáveis. Assim, objetivamos fazer extensa revisão sobre o tema. Para tal, pesquisamos o assunto nas bases de dados Lilacs, ScIELO, Medline,Scopus nos últimos 10 anos. Concluímos que, com o aumento na população de receptores de transplantes e a crescente incidência das doenças associadasao HPV, medidas de prevenção e controle se fazem necessárias e englobam desde a formação de profissionais capacitados até a aplicação de metodologias de diagnóstico e profilaxia, de última geração.

Prevalência de cárie dentária em crianças de um Programa de Atenção inicial e sua relação com Streptococcus mutans / Prevalence of dental caries in children from an Early Attention Program and its relation with Streptococcus mutans

Introdução: A cárie dentária é uma doença crônica de caráter multifatorial, envolvendo os fatores determinantes: microbiota, dieta inadequada, hospedeiro susceptível e tempo. Essa doença é um importante problema de saúde pública, tanto em países industrializados como naqueles em desenvolvimento. Assim, o objetivo desta pesquisa foi verificar a prevalência de cárie em crianças na faixa etária de três a cinco anos de idade, que participaram de um programa de atenção precoce e verificar a relação com a presença de Streptococcus mutans (SM). Métodos: Fizeram parte do estudo cento e trinta e duas crianças que compareceram para as revisões agendadas anteriormente, no período de dezembro de 2010 a novembro de 2011. Após o estabelecimento dos critérios de diagnóstico para a cárie dentária, 10 crianças com as mesmas características que não fizeram parte da amostra foram examinadas e reexaminadas num intervalo de 1 semana pelo autor da pesquisa, obtendo um valor de Kappa de 0.95. A amostra de saliva foi Coletada com auxílio de swab estéril, inserido gentilmente na boca da criança. O material Coletado foi processado no laboratório multidisciplinar da Unigranrio. Os níveis salivares de SM foram categorizados em escores: escore 1: <105/ml saliva (baixa colonização); escore 2: >105 e <106/ml (colonização média); escore 3: >106/ml (colonização alta). As crianças não deveriam ter usado antibiótico nos últimos trinta dias. Conclusão: A prevalência de cárie no estudo foi de 15,9%, e existe relação com a presença dos SM. Em relação aos escores, ocorreu associação apenas na idade de 5 anos.

Introduction: Dental caries is a chronic disease presenting a multifactorial character and involving at least four determinant factors: microbiota, inadequate diet, host susceptibility and time. This disease is still an important public health problem, both in industrialized and under development countries. Thus, the aim of this research was to evaluate the dental caries prevalence and presence of Streptococcus mutans (SM) in children aged three to five years of age attending an early attention and prevention program. Methods: One hundred and thirty-two children who attended previously scheduled revisions from the prevention program during December 2010 to November 2011 were included in this study. After application of diagnostic criteria for dental caries, 10 children with the same characteristics that were not part of the sample were examined and re-examined with a 1 week interval by the main author, with a resulting Kappa value of 0.95. The saliva sample was collected with the aid of sterile swab inserted gently in the child's mouth. The material collected was processed in the multidisciplinary laboratory of Unigranrio University. The MS salivary levels were categorized into scores: score 1 - 105/ml saliva < (low colonization); 2 score - 105 and 106 > </ml (average colonization); 3 score - 106/ml > (high colonization). Children were not to have used antibiotic in the past thirty Days of the saliva sampling. Conclusion: The prevalence of dental caries in the study was 15.9%, and there was no relationship with the prevalence of caries and MS presence. In relation to the scores, association between these two variables only occurred at the age of 5 years.

Detection of human herpesvirus 6 and 7 DNA in saliva from healthy adults from Rio de Janeiro, Brazil.

In this study, we aimed to evaluate virus shedding in the saliva of healthy adults from the metropolitan region of the city of Rio de Janeiro, Brazil, in order to verify the prevalence of both human herpesviruses 6 and 7 (HHV-6, HHV-7). The studied group comprised 182 healthy individuals at Pedro Ernesto University Hospital, who were being seen for annual odontologic revisions. Saliva specimens were subjected to a multiplex polymerase chain reaction (PCR) to detect the presence of HHV-6A, HHV-6B and HHV-7. The total Roseolovirus DNA prevalence was 22.4%. The PCR detected a HHV-6 prevalence of 9.8%, with HHV-6A detected in 7.1% of the samples and HHV-6B in 2.7%. HHV-7 DNA was revealed in 12.6% of the studied cases. Multiple infections caused by HHV-6A and 7 were found in 2.1% of the samples. No statistical differences were observed regarding age, but for HHV-7 infection, an upward trend was observed in female patients. Compared to studies from other countries, low prevalence rates of herpesvirus DNA were detected in saliva from the healthy individuals in our sample. PCR methodology thus proved to be a useful tool for Roseolovirus detection and it is important to consider possible geographic and populations differences that could explain the comparatively low prevalence rates described here.

Detection of human herpesvirus 6 and 7 DNA in saliva from healthy adults from Rio de Janeiro, Brazil

In this study, we aimed to evaluate virus shedding in the saliva of healthy adults from the metropolitan region of the city of Rio de Janeiro, Brazil, in order to verify the prevalence of both human herpesviruses 6 and 7 (HHV-6, HHV-7). The studied group comprised 182 healthy individuals at Pedro Ernesto University Hospital, who were being seen for annual odontologic revisions. Saliva specimens were subjected to a multiplex polymerase chain reaction (PCR) to detect the presence of HHV-6A, HHV-6B and HHV-7. The total Roseolovirus DNA prevalence was 22.4 percent. The PCR detected a HHV-6 prevalence of 9.8 percent, with HHV-6A detected in 7.1 percent of the samples and HHV-6B in 2.7 percent. HHV-7 DNA was revealed in 12.6 percent of the studied cases. Multiple infections caused by HHV-6A and 7 were found in 2.1 percent of the samples. No statistical differences were observed regarding age, but for HHV-7 infection, an upward trend was observed in female patients. Compared to studies from other countries, low prevalence rates of herpesvirus DNA were detected in saliva from the healthy individuals in our sample. PCR methodology thus proved to be a useful tool for Roseolovirus detection and it is important to consider possible geographic and populations differences that could explain the comparatively low prevalence rates described here.