Avaliação da percepção dos estudantes de odontologia sobre emergências médicas / Evaluación de la percepción de los estudiantes de odontología sobre emergencias médicas / Evaluation of Dental Students' Perception about Medical Emergencies

RESUMO Introdução: Diversas situações no consultório odontológico podem gerar quadros de emergência. A administração de anestésicos locais, o atendimento odontológico aos pacientes com comprometimento sistêmico, ansiedade e medo são muitas vezes as causas mais comuns. Objetivo: O objetivo deste estudo foi avaliar o nível de percepção dos alunos de Odontologia frente às principais emergências odontológicas. Métodos: Tratou-se de um estudo transversal e descritivo com abordagem quantitativa dos dados por meio dos questionários. Foram entrevistados 138 alunos cursando do 5º ao 10º período de odontologia da Universidade Federal de Campina Grande, na cidade de Patos, Paraíba. Resultados: Foi observado que 86,2 porcento do total de entrevistados responderam saber a diferença entre urgência e emergência; 52,2 porcento dos alunos confirmaram receber ou terem recebido instruções extracurriculares sobre o assunto; 59,4 porcento responderam que o aprendizado fornecido na graduação sobre este tema não está sendo suficiente. Cerca de 17,4 porcento destes alunos responderam saber realizar as manobras de Reanimação Cardiopulmonar, 11,6 porcento dos entrevistados relataram que se sentiam preparados para lidar com uma situação de emergência e 81,9 porcento dos alunos pretendem buscar uma formação complementar durante ou após a graduação. Conclusão: Verificou-se que os alunos de graduação em odontologia apresentaram um baixo nível de percepção sobre as emergências médicas no consultório odontológico(AU)

RESUMEN Introducción: Varias situaciones en el consultorio dental pueden generar casos de emergencia. La administración de anestésicos locales, el cuidado dental a pacientes con deterioro sistémico, ansiedad y miedo, son a menudo las causas más comunes. Objetivo: Evaluar el nivel de percepción de los alumnos de odontología frente a las principales emergencias odontológicas. Métodos: Se trató de un estudio transversal y descriptivo de los datos por medio de los cuestionarios. Se entrevistaron 138 alumnos del 5.º al 10.º periodo de odontología de la Universidade Federal de Campina Grande, en la ciudad de Patos, Paraíba. Resultados: Se observó que el 86,2 por ciento del total de alumnos entrevistados sabían la diferencia entre urgencia y emergencia; 52,2 por ciento de los alumnos confirmaron recibir o haber recibido instrucciones extracurriculares sobre el asunto. El 59,4 por ciento respondió que el aprendizaje proporcionado en la graduación sobre este tema no está siendo suficiente. Alrededor del 17,4 por ciento de estos alumnos respondieron a saber realizar las maniobras de resucitación cardiopulmonar, 11,6 por ciento de los entrevistados se sentían preparados para lidiar con una situación de emergencia y el 81,9 por ciento de los alumnos entrevistados pretenden buscar una formación complementaria durante o después de la graduación. Conclusión: Se descubrió que los estudiantes de odontología tenían un bajo nivel de percepción sobre emergencias médicas en el consultorio odontológico(AU)

ABSTRACT Introduction: Several situations in the dental office may cause emergency cases. Administration of local anesthetics, dental care to patients with systemic deterioration, anxiety and fear are often the most common causes. Objective: To evaluate the dental level of perception of dental students facing the main dental emergencies. Methods: This was a cross-sectional and descriptive study of the data through questionnaires. We interviewed 138 students from the 5th to the 10th period of Dental Medicine at the Federal University of Campina Grande, in the city of Patos, Paraíba. Results: We observed that 86.2 percent of the interviewed students knew the difference between urgency and emergency; 52.2 percent of the students confirmed receiving or having received extracurricular instructions about the topic; 59.4 percent answered that the learning provided about this topic after graduation is not being sufficient. About 17.4 percent of these students responded positively to knowing how to perform cardiopulmonary resuscitation maneuvers; 11.6 percent of those interviewed felt themselves prepared to deal with an emergency situation, while 81.9 percent of the students interviewed intended to seek complementary training during or after graduation. Conclusion: Dental students were found to have a low level of perception about medical emergencies in the dental office(AU)

Tratamiento conservador de tumor epitelial odontogénico calcificante asociado al canino inferior retenido: relato de caso clínico / Conservative treatment of a calcifying epithelial odontogenic tumour associated with an impacted mandibular canine: A case report

El tumor epitelial odontogénico calcificante corresponde a menos de 1% de todos los tumores odontogénicos de origen ectodérmica, afectando principalmente la región posterior de la mandíbula, relacionada muchas veces a un diente molar retenido. En este artículo son realizadas las consideraciones en relación a las características clínicas, radiográficas, histopatológicas y sobre las modalidades de tratamiento del tumor epitelial odontogénico calcificante por medio de una revisión de literatura, siendo relatado la asociación de un tumor de este tipo a un canino inferior retenido, en un paciente de género masculino, de 32 años de edad, tratado de forma conservadora y en el cual no se observó recurrencia de la lesión después de 5 años de acompañamiento(AU)

The calcifying epithelial odontogenic tumour is a rare benign odontogenic neoplasm that accounts for approximately 1% of all odontogenic tumours. They are mainly located in the premolar/molar mandibular region, and are associated with an unerupted molar tooth. We present a literature review of the clinical, radiographic, pathological findings and treatment options of the calcifying epithelial odontogenic tumour, as well as describing the case of an calcifying epithelial odontogenic tumour associated with an impacted right mandibular in a 32-year-old male patient, who was treated conservatively, without no sign of recurrence of the lesion after five years(AU)

Comparison of buccal infiltration of 4% articaine with 1 : 100,000 and 1 : 200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study.

We compared the buccal infiltration of 4% articaine with 1 : 100,000 or 1 : 200,000 epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with pericoronitis. Group 1 (15 patients) received 4% articaine with 1 : 100,000 epinephrine and group 2 (15 patients) received 4% articaine with 1 : 200,000 epinephrine by buccal infiltration. None of the patients in group 1 reported pain, but 3 patients in group 2 reported pain, which indicated a need for a supplementary palatal injection. The palatal injections were all successful in eliminating the pain. Two additional patients in group 2 experienced pain when the suture needle penetrated their palatal mucosa. Based on these results, 4% articaine with 1 : 100,000 epinephrine was found to be more effective for the removal of upper third molars in the presence of pericoronitis than 4% articaine hydrochloride with 1 : 200,000 epinephrine when only a buccal infiltration was used.

Xeroderma Pigmentosum - A case report with oral implications.

Xeroderma Pigmentosum is a rare autosomal recessive genetic disorder characterized by defective DNA repair leading to clinical and cellular hypersensitivity to ultraviolet radiation and carcinogenic agents. Important clinical features are: intense cutaneous photosensitivity, xerosis, poikiloderma, actinic keratosis, acute burning under minimal sun exposure, erythemas, hyperpigmented lentiginous macules, and malignant lesions in sun-exposed areas, including basocellular carcinoma, squamous cell carcinoma, and melanoma. There is a great involvement of many parts of the body, especially head and neck. The oral manifestations are mainly related to the occurrence of malignant tumors in the lips, tongue and buccal mucosa. This paper reports a rare case of Xeroderma Pigmentosum in a 41-year-old male presenting mainly dermatological, neurological and ophthalmological involvement. Oral implications such as severe oral pain and mouth opening limitation were present due to perioral scars. In addition, this paper discuss some important aspects concerning the role of the dental professional management of this entity, since XP patients require constant dental care and follow-up in order to control the occurrence of new lesions on the lips or inside oral cavity. Key words:Actinic cheilitis, oral involvement, Xeroderma pigmentosum.

Large calcifying epithelial odontogenic tumor with extension into the maxillary sinus: a case report.

Calcifying epithelial odontogenic tumor (CEOT) is a rare, locally invasive neoplasm characterized by the presence of amyloid material that can become calcified. It often is found in the posterior region of the mandible. Such tumors in the maxilla and those that invade the maxillary sinus are extremely rare. This article presents the sixth reported clinical case of a CEOT that invaded the maxillary sinus and extended to the interior of the nasal cavity. The tumor had grown toward the sinus roof, but there was no association with an impacted tooth. Histopathologically, the tumor was composed of plates of polyhedral epithelial cells with highly eosinoplilic cytoplasm, nuclear polymorphism, clear-cell contours, and intercellular bridges in fibrous conjunctive tissue. Amorphous eosinophilic material and diverse calcifications permeated the epithelial cells.

Avaliação das posições dos terceiros molares impactados de acordo com as classificações de Winter e Pell & Gregory em radiografias panorâmicas / Evaluation of the positions of impacted third molars according to the Winter and Pell & Gregory classifications in panoramic radiography

Os terceiros molares apresentam as maiores taxas de não irrompimento retenção dental, seguidos dos caninos superiores e dos dentes supranumerários. Os terceiros molares podem ser classificados de acordo com as classificações propostas por Winter e Pell & Gregory. OBJETIVOS: O presente trabalho tem como objetivo avaliar a prevalência das posições de terceiros molares inclusos em relação às classificações de Winter e Pell & Gregory. MATERIAIS E MÉTODOS: Realizou-se um estudo retrospectivo, descritivo, com dados de 2629 prontuários de pacientes atendidos nas clínicas de Cirurgia da Faculdade de Odontologia de Bauru - Universidade de São Paulo (FOB-USP), Bauru/SP, Brasil no período de janeiro de 1997 a dezembro de 2002. RESULTADOS: Do total de prontuários avaliados, 2290 foram incluídos no presente estudo. Pacientes do gênero feminino foram observados com maior frequência (61,1 por cento). Foi observado um total de 7222 terceiros molares. A posição mais comum para os dentes superiores foi a vertical, seguida da distal, enquanto que, nos dentes inferiores, observou-se maior frequência de dentes verticais seguidos dos mesiais e na posição IIA, seguida da IIB. CONCLUSÃO: O conhecimento do posicionamento dos terceiros molares facilita o planejamento da cirurgia para sua extração.

The third molars present the highest rates of unerupted teeth, followed by the upper canines and supernumerary teeth. Third molars can be classified according to the classifications proposed by Winter and Pell & Gregory. AIMS: The present study set out to evaluate the prevalence of the positions of impacted third molars in relation to the Winter and Pell & Gregory classifications in panoramic radiography. MATERIALS AND METHODS: A documental, retrospective, descriptive study was carried out using the records of 2,629 patients seen in the oral surgery clinics of the Bauru Dental School, University of São Paulo, Bauru/SP, Brazil, between January 1997 and December 2002. RESULTS: The sample was composed of 2,290 records selected in accordance with the inclusion criteria. The majority of patients (61.1 percent) were female. It was found that 7,222 specimens represented impacted third molars. Regarding position, in the maxilla, the vertical position was the most frequent, followed by the distoangular, while in the mandible the vertical position was the most common, followed by the mesioangular, and in the IIA position, followed by the IIB one. CONCLUSIONS: Knowledge of the position of third molars facilitates the surgical planning of extraction.

Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions

Aims: The aim of this study was to evaluate the vestibular-palatal diffusion of 4% articaine with epinephrine 1:100,000 and 1:200,000, in impacted maxillary third molar extractions, without palatal injection. Materials and Method: Two hundred teeth were selected from patients age 15 to 46. Patients were divided into 4 groups: 1A, were anesthetized with 4% articaine 1:100,000 and the surgery was initiated 5 minutes following anesthesia. 1B, used 4% articaine 1:100,000 but the surgery was started 10 minutes after anesthesia. 2A, used 4% articaine 1:200,000 the surgery was started 5 minutes after. 2B, used 4% articaine 1:200,000 but 10 minutes was allowed for anesthetic diffusion before the initiation of in groups (50 extractions each) only buccal vestibule anesthesia was initially administered (i.e. no palatal injections were used). Results: The rate of sufficient vestibule-palatal diffusion, as determined by the lack of necessity of supplemental palatal anesthesia, was: 1A(84%), 1B(98%), 2A(78%), 2B(82%). Chi-square (X2) and residual analyses showed that a higher vestibule-palatal diffusion was obtained using 4% articaine 1:100,000 with a period of 10 minutes (p<0.05). Conclusions: Most of the extractions could be performed only with vestibule anesthesia. However, vasoconstrictor concentration and the time interval between administration of the anesthetic and initiation of surgery did influence buccal vestibule-palatal diffusion of 4% articaine in the extraction models used (AU)

Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions.

AIMS: The aim of this study was to evaluate the vestibular-palatal diffusion of 4% Articaine with epinephrine 1:100,000 and 1:200,000, in impacted maxillary third molar extractions, without palatal injection. MATERIALS AND METHOD: Two hundred teeth were selected from patients age 15 to 46. Patients were divided into 4 groups: 1A, were anesthetized with 4% articaine 1:100,000 and the surgery was initiated 5 minutes following anesthesia. 1B, used 4% articaine 1:100,000 but the surgery was started 10 minutes after anesthesia. 2A, used 4% articaine 1:200,000 the surgery was started 5 minutes after. 2B, used 4% articaine 1:200,000 but 10 minutes was allowed for anesthetic diffusion before the initiation of in groups (50 extractions each) only buccal vestibule anesthesia was initially administered (i.e. no palatal injections were used). RESULTS: The rate of sufficient vestibule-palatal diffusion, as determined by the lack of necessity of supplemental palatal anesthesia, was: 1A(84%), 1B(98%), 2A(78%), 2B(82%). Chi-square (Chi2) and residual analyses showed that a higher vestibule-palatal diffusion was obtained using 4% articaine 1:100,000 with a period of 10 minutes (p<0.05). CONCLUSIONS: Most of the extractions could be performed only with vestibule anesthesia. However, vasoconstrictor concentration and the time interval between administration of the anesthetic and initiation of surgery did influence buccal vestibule-palatal diffusion of 4% articaine in the extraction models used.

Treatment of mandibular fracture bybio-absorbable fixation: case report / Tratamento de fratura de mandíbula através de material reabsorvível: relato de caso

Among the fracture in oral and maxillofacial trauma compound, the one in lower third occupy prominent place due to its frequency and immediate esthetic and functional damage. Several techniques and materials are used for its treatment, for example, the titanium screws and plates and, more recently, a bio-absorbable system in which, once intalled the plate and screws, it will be degraded by the organism. The present work describes a clinical case of a facial trauma with consequent mandible fracture in a female patient aging 39 years old. Once reduced the fracture, the stabilization was accomplished by the bio-absorbable system. There was not any rejection to the material and the patient developed satisfactorily after the treatment.