Bruxismo y su asociación con la disfunción temporomandibular en niños. Revisión de literatura / Bruxism and its association with temporomandibular disorders in children. Literature review

Resumen Introducción: El bruxismo está definido como una actividad oral motora que consiste en el apretamiento o rechinamiento involuntario (rítmico o espasmódico no funcional) de los dientes, con una prevalencia de 5,9% a 49,6% en niños. Lo que podría contribuir a problemas clínicos asociados con la articulación temporomandibular. La asociación entre la disfunción temporomandibular (DTM) y el bruxismo en niños aún no está totalmente establecida. Objetivo: El objetivo de esta revisión de literatura es recopilar información actualizada de estudios que hayan abordado la asociación entre el bruxismo y la disfunción temporomandibular en niños de 3 a 12 años. Metodología: Se realizó una búsqueda en las bases de datos de Scopus, Pubmed y Scielo usando los descriptores "Niño", "Niños", "Preescolar", "Bruxismo", "Bruxismo del sueño", "Disfunción Temporomandibular"; y, "Síndrome de la Disfunción de Articulación Temporomandibular". Fueron incluidos artículos publicados en los últimos 15 años en idiomas español, inglés y portugués. Fueron incluidos estudios transversales, de cohorte, casos controles y ensayos clínicos aleatorizados. Resultados: Se evaluaron 242 artículos, de los cuales solo 11 fueron incluidos de acuerdo a los criterios de inclusión. Entre los estudios incluidos, dos de ellos no encontraron asociación entre DTM y bruxismo, tres encontraron una tendencia o probable asociación y seis encontraron una asociación positiva. Conclusiones: Existen estudios que relatan asociación entre el bruxismo y las disfunciones temporomandibulares en niños de 3 a 12 años, relacionando la presencia de signos y síntomas de la DTM con el bruxismo, pudiendo ser este último, un factor de riesgo para la presencia de DTM.

ABSTRACT Introduction: Bruxism is defined as an oral motor activity that consists of involuntary clenching or grinding (non-functional rhythmic or spasmodic) of the teeth, with a prevalence rate ranging from 5.9% to 49.6% in children, which could contribute to clinical problems associated with the temporomandibular joint. The association between bruxism in children and temporomandibular dysfunction (TMD) is not yet fully established. Objective: The objective of this literature review is to collect up-to-date information on studies that have addressed the association between bruxism and temporomandibular dysfunction in children ranging 3 - 12 years of age. Methods: A search was performed in the Scopus, PubMed and SciELO databases using the descriptors "Child", "Children", "Child, Preschool", "Bruxism", "Sleep Bruxism", "Temporomandibular Dysfunction" and "Temporomandibular Joint Dysfunction Syndrome." Articles published in the last 15 years in the Spanish, English and Portuguese languages were included. Results: A total of seventy-two articles were assessed. Only 11 articles were included according to the inclusion criteria. Among the included studies, two of them found no association between TMD and bruxism, three found a trend or probable association, and six found a positive association. Conclusion: There are studies that report an association between bruxism and temporomandibular dysfunctions in children ranging 3 - 12 years old, relating the presence of signs and symptoms of TMD with bruxism.

Pre-clinical validation of a vaginal cream containing copaiba oil (reproductive toxicology study).

The aims of this study was to evaluate the effects of oil-resin of Copaiba (Copaifera duckei Dwyer), aired in vaginal cream on the reproductive performance of female rats (Rattus norvegicus). To determine the components of the C. duckei oleoresin, gas chromatography coupled with mass spectrometry (CG-MS) was used, and considering the trans-caryophyllene sesquiterpene as a phytochemical marker in the oleoresin. Due to the extensive use of copaiba oleoresin in the suppository form for gynecological infections, an evaluation was carried out on the effects of copaiba oleoresin (Copaifera duckei Dwyer), delivered in a vaginal cream, on the reproductive performance of female Wistar rats. For this purpose, three groups (n=5-6/group) of female rats were treated as follows: 1--vaginal cream of copaiba oleoresin (28.6 mg/kg), 2--base vaginal cream and 3--control (physiological saline 0.9%), administered intravaginally, for 30 days before pregnancy, and from day zero to day 20 during pregnancy. Laparotomy was performed on the 21st day of pregnancy, followed by the determination of reproductive variables: number of live and dead fetuses, mass of the fetuses and placentas, number of implantations and resorptions, number of corpora lutea, pre- and post-implantation loss, and analyses of the fetuses with regard to external and internal anomalies and/or malformations (skeletal and visceral). The trans-caryophyllene present in the sample is suggested as a phytochemical marker and the results of this study demonstrate an absence of maternal toxicity and foetotoxicity embryofoetotoxicity at the dose administered, corresponding to ten times the recommended dose for use in humans. Accordingly, no significant statistical difference was observed between the treated and control groups, for the variables analyzed. Thus, it is concluded that the vaginal cream containing 2.5% copaiba oleoresin is safe during gestation, in female rats (Rattus norvegicus) of the Wistar strain.

[Hysteroscopic evaluation of the endometrium in 63 postmenopausal patients treated with tamoxifen for breast cancer]. / Valutazione isteroscopica dell'endometrio in 63 pazienti in post-menopausa trattate con tamoxifene per carcinoma della mammella.

This retrospective analysis intends to evaluate by histeroscopy the endometrial findings in a group of 63 patients in post-menopausal treated with tamoxifen for breast cancer. Our patients assumed tamoxifen for a different period between 6 and 120 months. Patients have been divided in two groups: I) patients undergoing hysteroscopy because of some clinical symptoms; II) patients who undergoing hysteroscopy as a routine examination. The most important observation of this work is the correlation between the presence of negative endometrium and low risk hyperplasia (LRH) associated to: symptomatology and duration of therapy. In the group of asymptomatic patients the LRH is found only after 3 years of treatment, while in the group of symptomatic patients, LRH is present within the first two years of treatment; beyond this period high risk hyperplasia (HRH) and endometrial carcinoma have been diagnosed. We also observed a higher incidence of endometrial polyps in this population than among the non treated group and among the symptomatic patients. From these data we conclude that hysteroscopy follow-up has to be performed in the group of patients treated with tamoxifen and that it would be necessary to have a hysteroscopy before the beginning of therapy and that this one has to be repeated once a year through the treatment. Obviously the symptomatic patients have to undergo hysteroscopy as soon as possible as a higher incidence of HRH and endometrial carcinoma has been detected in this group of patients.

Conizaçäo ambulatorial com laser de dióxido de carbono em pacientes com neoplasia intra-epitelial cervical / Ambulatorial conization with Carbon Dioxide Laser in patients with Intraepithelial Neoplasia

Analisou-se os resultados de conizaçäo ambulatorial com laser em 468 pacientes selecionadas, portadoras de Neoplasia Intra-epitelial Cervical, independente da presença de infecçäo por Papiloma-vírus humano. As indicaçöes constaram em todos os graus II ou III, grau I com colposcopia prejudicada quanto à junçäo escamo-colunar, inexistência de correlaçäo entre citologia, colposcopia e histologia. O achado de 3,4 por cento de carcinoma invasor apoia o tratamento excisional. Conclui-se que o método representa a melhor escolha nesses casos, face à baixa morbidade e elevada eficácia