Evaluation of the condylar position in younger and older adults with or without temporomandibular symptoms by using cone beam computed tomography.

STATEMENT OF PROBLEM: Recent studies in young adults have questioned the influence of discrepancies between central and maximal intercuspal positions in temporomandibular disorders (TMDs). However, whether this finding was because this type of etiologic agent requires time for the development of changes in the condylar position is unclear. PURPOSE: The purpose of this clinical study was to use cone beam computed tomography (CBCT) to evaluate the presence or absence of discrepancies between the centric relation (CR) and maximum intercuspation (MI) in younger and older adults in populations with or without TMDs. MATERIAL AND METHODS: The sample was composed of 80 volunteers, 40 younger individuals aged 18 to 25 years (27 women and 13 men), half with and half without TMD symptoms, and 40 older participants aged 35 to 50 years (30 women and 10 men), half with and half without TMD symptoms. The TMD symptoms were diagnosed by using the diagnostic (standard) criteria for TMD research (RDC/TMD). Two CBCT scans were performed on each participant, one in MI and another in CR. Measurements of the joint space were performed in coronal and sagittal cuts of the temporomandibular joints, and the collected data were statistically analyzed by using the Mann-Whitney U test (α=.05). RESULTS: No significant differences were found when the CR and MI positions and the presence or absence of TMD symptoms were compared in the younger and older groups. However, when the younger and older groups were compared, significant differences were found in all measures used in this study. CONCLUSIONS: The condyle and mandibular fossa do not seem to be influenced by the CR or MI positions or by the presence or absence of TMD symptoms, but age seems to lead to a quantitative increase in the relationship between these structures.

Pênfigo Vulgar Oral em Idosa: Condutas de um Caso Desafiador / Oral Pemphigus Vulgaris in Old Woman: Conducts of a Challenging Case

A doença pênfigo é uma enfermidade autoimune que dependendo do nível de acometimento epitelial, pode ser classificada em pênfigo vulgar, vegetante, eritematoso e foliáceo. Além desses, há também o denominado pênfigo paraneoplásico, que ocorre especialmente em casos que há vínculo a neoplasias malignas com destaque para os linfomas. Somente os tipos vulgar e vegetante podem afetar a mucosa oral, sendo o pênfigo vulgar o mais prevalente. O mecanismo fisiopatológico da doença é caracterizado pela ação de autoanticorpos contra as proteínas desmogleínas dos desmossomos encontrados nas células epiteliais, desencadeando assim, a formação de fendas intraepiteliais e bolhas. O manejo dos pacientes com pênfigo vulgar oral é bastante desafiador, especialmente em casos de indivíduos idosos e portadores de comorbidades. O presente trabalho objetiva discutir aspectos contemporâneos do pênfigo vulgar oral e elucidar o caso de uma idosa acometida pela doença, destacando toda a propedêutica utilizada no seu atendimento e o tratamento empregado, com o uso de corticoides sistêmicos e acompanhamento constante da condição da paciente, uma vez que o pênfigo vulgar é uma doença que não tem cura.

Pemphigus is an autoimmune disease that, depending on the level of epithelial involvement, can be classified into pemphigus vulgaris, vegetans, erythematosus and foliaceus. In addition to these, there is also the so-called paraneoplastic pemphigus, which occurs especially when there is a link to malignant neoplasms with emphasis on lymphomas. Only the vulgaris and vegetans types can affect the oral mucosa, with pemphigus vulgaris being the most prevalent one. The pathophysiological mechanism of the disease is characterized by the action of autoantibodies against the desmoglein proteins of the desmosomes found in the epithelial cells, thus triggering the formation of intraepithelial clefts and blisters. The management of patients with oral pemphigus vulgaris is quite challenging, especially in cases of older individuals and patients with comorbidities. This study discusses contemporary aspects of oral pemphigus vulgaris and elucidate the case of an old woman affected by the disease, highlighting all the propaedeutics used in her care and the treatment employed, with the use of systemic corticosteroids and constant follow-up of the patient's condition, since pemphigus vulgaris is a disease that has no cure.

The Effect of Local Delivery Doxycycline and Alendronate on Bone Repair.

The aim of the present study was to investigate the local effect of 10% doxycycline and 1% alendronate combined with poly(lactic-co-glycolic acid) (PLGA) on bone repair. Thirty rats were divided into three groups, as follows: control group (CG), drug group (DG), and vehicle-PLGA group (VG). Bone defect was created in the right femur and filled with the following: blood clot (CG); PLGA gel, 10% doxycycline and 1% alendronate (DG); or vehicle-PLGA (VG). The animals were euthanized 7 or 15 days after surgery. Bone density, bone matrix and number of osteoclasts were quantified. At 7 days, the findings showed increased density in DG (177.75 ± 76.5) compared with CG (80.37 ± 27.4), but no difference compared with VG (147.1 ± 41.5); no statistical difference in bone neoformation CG (25.6 ± 4.8), VG (27.8 ± 4), and DG (18.9 ± 7.8); and decrease osteoclasts in DG (4.6 ± 1.9) compared with CG (26.7 ± 7.4) and VG (17.3 ± 2.7). At 15 days, DG (405.1 ± 63.1) presented higher density than CG (213.2 ± 60.9) and VG (283.4 ± 85.8); there was a significant increase in percentage of bone neoformation in DG (31.5 ± 4.2) compared with CG (23 ± 4), but no difference compared with VG (25.1 ± 2.9). There was a decreased number of osteoclasts in DG (20.7 ± 4.7) and VG (29.5 ± 5.4) compared with CG (40 ± 9.4). The results suggest that the association of 10% doxycycline and 1% alendronate with PLGA-accelerated bone repair.

Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals.

STATEMENT OF PROBLEM: Studies of the condyle-mandibular fossa relationship are common, although the role of this relationship in the development of a temporomandibular disorder remains controversial. PURPOSE: The purpose of this study was to quantitatively evaluate the condyle-mandibular fossa relationship in young individuals with intact dentitions and compare it to that between individuals with and without symptoms of temporomandibular disorder. MATERIAL AND METHODS: Volunteers were classified as asymptomatic (n=20) or symptomatic (n=20) according to research diagnostic criteria for temporomandibular disorders. Each participant underwent 2 cone beam-computed tomography scans of the middle and lower third of the face: 1 scan of the maximum intercuspation position and 1 of the centric relationship position. The distance between the condyle and mandibular fossa was measured on frontal and lateral images of the temporomandibular joint. The condylar position was compared across groups (asymptomatic, symptomatic) by using the Mann-Whitney U test (α=.05). Within each group, the condylar position was compared across maximum intercuspation and centric relationship positions by using the Mann-Whitney U test (α=.05). RESULTS: No statistically significant differences were found in condylar positions between centric relationships and maximum intercuspation in either asymptomatic or symptomatic young adults, and no significant differences were found between asymptomatic and symptomatic young adults. CONCLUSIONS: The condyle-mandibular fossa relationships of these young adults were similar in the centric relationships and maximum intercuspation positions when evaluated by computed tomography. The presence or absence of temporomandibular disorder was not correlated with the condyle position in the temporomandibular joint.

Panoramic radiography in the diagnosis of carotid artery atheromas and the associated risk factors.

Atherosclerosis is a serious chronic disease, responsible for thousands of deaths worldwide and is characterized by thickening and loss of elasticity of the arterial walls, associated with the presence of atheromatous plaques. Various risk factors act directly on predisposition to the disease, among which the following are pointed out: diabetes mellitus, arterial hypertension and inadequate diet and eating habits. More recent researches have elucidated new risk factors acting in the development of this disease, such as, for example: periodontitis, chronic renal disease and menopause. The panoramic radiograph, commonly used in dental practice, makes it possible to see calcified atherosclerotic plaques that are eventually deposited in the carotid arteries. The aim of this review article was to emphasize the dentist's important role in the detection of carotid artery atheromas in panoramic radiographs and the immediate referral of patients affected by these calcifications to doctors. In addition, the study intended to guide the dentist, especially the dental radiologist, with regard to differential diagnosis, which should be made taking into consideration particularly the triticeal cartilage when it is calcified.

El uso de la sialografía en el diagnóstico y tratamiento de la parotiditis recurrente juvenil: presentación de un caso / The use of sialography in the diagnosis and treatment of juvenile recurrent parotitis: case report

La parotiditis recurrente juvenil (PRJ) es una enfermedad inflamatoria de la glándula parótida, generalmente se caracteriza por episodios recurrentes de hinchazón, dolor y fiebre. Después de la parotiditis epidémica, es la PRJ en los niños, la segunda enfermedad más frecuente de las glándulas salivales. La aparición de PRJ se produce alrededor de 6 años de edad y hay una ligera predilección por los varones. La etiología de la enfermedad sigue siendo poco clara y los síntomas tienden a desaparecer con la pubertad. Este estudio reporta el caso de un joven de 12 años que se presentó a la Facultad de Odontología de la Universidad Estadual Paulista, Sao José dos Campos, con una historia de episodios recurrentes de hinchazón de la glándula parótida izquierda asociada con dolor, fiebre y secreción purulenta en los primeros eventos. Terminada la anamnesia, se decidió por obtener sialografías de las dos glándulas parótidas con el uso de material de contraste Lipiodol UF 38% y radiografías panorámicas, seguidas por las evaluaciones morfológicas y funcionales. El paciente se encuentra hoy sin presentar recurrencia de la enfermedad y está bajo seguimiento clínico

The Juvenile Recurrent Parotitis (JRP) is an inflammatory disease of the parotid gland, usually characterized by recurrent episodes of swelling, pain and fever. After mumps, the PRJ in children is the second most prevalent disease of salivary glands. The emergence of PRJ occurs around 6 years old and there is a slight predilection for males.The etiology of the disease remains unclear and the symptoms tend to disappear with puberty. This study reports the case of a twelve years old boy who presented to the Dentistry School of São Paulo State University - campus São José dos Campos- with a history of recurrent episodes of swelling of the left parotid gland associated with pain, fever and purulent discharge in the early events . Finished the anamnesis, sialography were performed with the use of Lipiodol UF 38% contrast material and panoramic radiographs on both parotid glands, followed by morphological and functional assessments. There was no recurrence of the disease and the patient is under follow-up