Clinical and Radiographic Assessment of Secondary Bone Graft Outcomes in Cleft Lip and Palate Patients.

Purpose. To compare the results of secondary alveolar bone grafts in patients with complete cleft lip and cleft lip and palate using 2 radiographic scales and according to the rate of canine eruption through the newly formed bone. Materials and Methods. We analyzed pre- and postoperative radiographs of 36 patients for the amount of bone in the cleft site according to the Bergland and Chelsea scales. The associations between the variables and the correlation between the scales were measured. Results. A total of 54.2% and 20.8% of cases were classified as type I and type II, respectively, using the Bergland scale, whereas 50% and 22.5% were classified as types A and C, respectively, using the Chelsea scale. A positive correlation between the 2 scales was observed. In 33.3% of males, 58.3% of females, 54.5% of unilateral cleft cases, and 12.5% of bilateral cleft cases, the permanent canines had erupted. Bone grafts performed prior to canine eruption achieved more satisfactory results. Conclusions. Our results suggest that both radiographic scales are important tools for the evaluation of bone grafts. Additionally, longer time periods of evaluation were associated with improved results for patients with secondary alveolar bone grafts.

Oral manifestations leading to the diagnosis of acute lymphoblastic leukemia in a young girl.

BACKGROUND: oral complications may be leukemia's first presentation. AIM: to present a case of a young girl with a swelling on the face that led to the diagnosis of acute lymphoblastic leukemia is reported. RESULTS: a 10-year old anemic girl was referred for evaluation and treatment of a swelling at the left-nasolabial region. Symptoms reported (tiredness, poor appetite, fever, lethargy, and musculoskeletal pain) and clinical findings (enlargement at the presternal region and brownish stain in the lumbar region) led to the suspicion of a hematopoietic malignancy. The diagnosis of lymphoblastic leukemia was attained after specific examination conducted by the pediatric oncologist and hematologist. CONCLUSION: dentists must be able to clearly recognize oral physiological characteristics, and, when identifying changes of normalcy, to fully investigate it requesting additional tests or referring the patient to specialized professionals.

Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material.

AIM: To assess the efficacy of different retreatment rotary files in removing gutta-percha and endodontic sealer from canals. METHODOLOGY: Ninety straight single-rooted premolars were prepared up to a size 30 and filled with gutta-percha and sealer and then randomly assigned to six retreatment groups (n = 15). Groups I, III, and V were retreated using rotary systems ProTaper Universal Retreatment (PTUR), D-RaCe, and Mtwo Retreatment, respectively. Groups II, IV, and VI were retreated using the additional instruments F4, size 40, .04 taper RaCe, and size 40, .04 taper Mtwo, respectively. The roots were split vertically, and images of the halves were obtained using a high-resolution scanner and evaluated with AutoCAD software to calculate the percentage of residual material. Data were analyzed with Kruskal-Wallis and Student-Newman-Keuls tests using a 5% significance cutoff (P < 0.05). RESULTS: There were no statistically significant differences (P > 0.05) between groups when additional instruments were used. The percentage of residual material was lowest in the PTUR group and was statistically significant only when compared to the D-RaCe system (P = 0.0038). CONCLUSIONS: All root canals had residual filling material after retreatment even when additional instruments were used.

Bulas de medicamentos e profissionais de saúde: ajudam ou complicam a compreensão dos usuários? / Medicine information leaflets: help or hinder the understanding of users?

A não aderência e o não cumprimento ao tratamento medicamentoso são considerados graves problemas de saúde pública, podendo comprometer a eficácia da terapêutica. Assim, a presente pesquisa realizou um levantamento bibliográfico na base de dados Medline sobre a elaboração das bulas e seu efeito na compreensão do uso de medicamentos pelos pacientes. Observando os resultados foram constatados: dificuldade no entendimento das informações contidas nas bulas, as ilustrações auxiliam na compreensão, na aderência e no cumprimento ao tratamento e as ilustrações com informações escritas ou verbais são benéficas. Concluiu-se que uma linguagem de difícil compreensão e carregada de jargões técnicos, letras pequenas, ausência de ilustrações ou uso incorreto das mesmas nas bulas são elementos complicadores da aderência. Portanto, as informações contidas nas bulas devem ser claras, com linguagem de fácil compreensão, letras de tamanho adequado e devem detalhar como e quando administrar o medicamento; além disso, as ilustrações ajudam na compreensão do paciente e nos processos de aderência e cumprimento do tratamento medicamentoso.

The non-adherence to and non-compliance with the prescribed course of medication are considered serious public health problems that may threaten the effectiveness of therapy. This paper reports a literature search, in the Medline database, for data on the design of package inserts (drug information leaflets) and their effect on patient understanding of the use of medicines. The following points were noted among the results: users have difficulty in understanding the information in the leaflets, illustrations help the patient to understand, adhere to and comply with the treatment and illustrations with written or verbal information are beneficial. It was concluded that the incomprehensible language, full of technical jargon and small print, and the lack or misuse of pictures in these leaflets are factors that interfere with adherence. Therefore, the information contained in these inserts should be clear, expressed in plain language, printed in letters of adequate size and should detail how and when to take the drug; in addition, illustrations help the patient to understand the therapy and follow it correctly until the end of the prescribed period.

Reactive hemophagocytosis in Ki-l positive large cell lymphoma: a case study.

A case of large cell lymphoma presenting with hemophagocytic syndrome is reported. The clinicopathological findings suggested a diagnosis of malignant histiocytosis, but on the basis of immunohistological studies Ki-l lymphoma was diagnosed. Neoplastic cells expressed activation antigens such as HLA-DR, IL 2R, T10 and Ki-l, and showed high proliferative activity, but were devoid of T and B cell markers. The high percentage of reactive macrophages found in the bone marrow and lymph node probably reflected the release of lymphokines by the tumor population. The patient was treated with aggressive chemotherapy and is in complete remission at 8 months from diagnosis.