Evaluation of bone repair with platelet-rich fibrin following the extraction of impacted third molars - randomized clinical trial

Background: The aim of the present study was to evaluate postoperative effects of platelet-rich fibrin (PRF) in wound and bone healing, pain, swelling and periodontal complications outcomes after impacted third molars extraction. Material and methods: A prospective, randomized, split-mouth, double-blind clinical trial was conducted. PRF was placed within sockets following tooth removal and before suturing mucoperiosteal flap while no treatment was performed on control group's sockets. Patients were evaluated considering bone volume which was obtained in the 90-day postoperative period. Other variables included trabecular thickness, trabecular distance and grey values, pain, swelling, and wound healing. A Wilcoxon test and a t-Student test were used at a 5% significance level and a Friedman test was used to multiple comparisons. Results: Forty-four surgeries were performed in the present study. The patients' mean age was 22.41 (± 2.75 years) and 72.73% were women. PRF was associated to increased trabecular thickness and bone volume means (p < 0.001). The experimental group had significantly lower pain scores at 4h, 6h, 8h, 16h, 24h, and 72h (p ˂ 0.05). Mean swelling was lower on the experimental group (p < 0.001). The PRF group showed significant higher wound healing (p ˂ 0.001). Conclusions: Alveolar filling with PRF improves wound and bone healing after extractions while also decreasing pain and swelling in the postoperative period. (AU)

Sialólito Gigante em Ducto de Wharton: um caso incomum / Giant Sialolith in the Wharton Duct: An Unusual Case

A obstrução das glândulas salivares por cálculos acomete 90% dessas estruturas, apresentando geralmente tamanho menor que 1 cm. É encontrada, principalmente, nas glândulas submandibulares. Clinicamente, o paciente apresenta um aumento de volume na região referente à glândula salivar envolvida, podendo apresentar sintomatologia dolorosa e drenagem purulenta. O presente artigo relata um caso de sialólito gigante com 2,5 cm de diâmetro, em glândula submandibular, removido cirurgicamente, com preservação funcional da glândula submandibular. O tratamento pode variar de acordo com o tamanho, a forma e localização do cálculo... (AU)

The obstruction of the salivary glands by calculations affects 90% of these structures, usually exhibiting a size smaller than 1 cm. It is mainly found in the submandibular glands. Clinically, the patient presents an increase in volume in the region related to the salivary gland involved and may present painful symptoms and purulent drainage. The present article reports a case of giant sialolith with a diameter of 2.5 cm in the submandibular gland, which was removed surgically with functional preservation of the submandibular gland. The treatment may vary according to the size, shape and location of the calculus... (AU)

Efeito da fotobiomodulação na proliferação de células-tronco da polpa de dentes decíduos esfoliados cultivadas sobre filmes de ácido poliláctico / Effect of photobiomodulation on the perspective of stem cells from the pulp of exfoliated deciduous teeth cultured on polylactic acid films

A fotobiomodulação (PBM) estimula a proliferação de diferentes tipos celulares, incluindo células-tronco. A células-tronco da polpa do dente decíduo esfoliado (SHEDs) apresentam um potencial de diferenciação maior do que as demais célulastronco mesenquimais, sendo o foco de diversas pesquisas na área da engenharia tecidual. Para que as células proliferarem e se diferenciem in vitro é necessário o desenvolvimento de um microambiente favorável, o qual pode ser fornecido por um biomaterial que mimetize a matriz extracelular natural, destacando-se para esta finalidade o ácido poliláctico (PLA) por suas propriedades de biocompatibilidade e biodegradabilidade, além do baixo custo. O objetivo deste estudo foi avaliar o efeito da PBM em diferentes doses na proliferação e viabilidade de SHEDs cultivadas sobre arcabouços bidimensionais de PLA. As SHEDs foram cultivadas sobre os filmes e divididas em três grupos: (C) controle não irradiado; (L1) irradiadas com dose de 1 J/cm2 ; e (L4) irradiadas com dose de 4 J/cm2 . As irradiações foram realizadas com laser diodo InGaAlP, com comprimento de onda de 660 nm e potência de 30 Mw, em dose única. A viabilidade e a proliferação celular foram avaliadas nos intervalos de 24, 48 e 72 horas após a irradiação, através do ensaio do Alamar Blue, enquanto a morfologia e a distribuição das células na superfície dos filmes foram avaliadas por MEV no intervalo de 72 horas. Os dados quantitativos foram submetidos a testes estatísticos não paramétricos. Os dados do ensaio do Alamar Blue mostraram que os grupos L1 e L4 exibiram uma maior proliferação celular em comparação ao grupo C, sendo as diferenças significativas entre L1 e C em 48 e 72 h (p<0,0001) e entre L4 e C em 24 (p<0,01), 48 (p<0,001) e 72 h (p<0,0001). O percentual de redução do Alamar blue mostrou-se significativamente maior em L4 em comparação com L1 em 24 e 72 h (p<0,05). A análise das amostras por MEV mostrou que nos grupos irradiados as células apresentavam uma distribuição mais homogênea ao longo da superfície dos filmes e uma maior densidade celular em comparação com o grupo C, sendo esta diferença ainda mais evidente no grupo L4. Conclui-se que a PBM nos parâmetros estudados, especialmente na dose de 4 J/cm2 , estimula a proliferação de SHEDs em contato com filmes de PLA, constituindo assim uma ferramenta metodológica com potencial aplicação nas técnicas de engenharia tecidual (AU).

Photobiomodulation (PBM) stimulates the proliferation of different cell types, including stem cells. Stem cells from human exfoliated deciduous teeth (SHEDs) present a greater differentiation potential compared to other mesenchymal stem cells, being the focus of several studies in the field of tissue engineering. In order for cells to proliferate and differentiate in vitro it is necessary to develop a favorable microenvironment, which can be provided by a biomaterial that mimics the natural extracellular matrix, with polylactic acid (PLA) being distinguished for this purpose due to its properties of biocompatibility and biodegradability, as well as low cost. The aim of this study was to evaluate the effect of PBM in different doses on the proliferation and viability of SHEDs cultured on two-dimensional PLA scaffolds. SHEDs were cultured on the films and divided into three groups: (C) non-irradiated control; (L1) irradiated with a dose of 1 J/cm2 ; and (L4) irradiated with a dose of 4 J/cm2 . The irradiations were performed with an InGaAlP diode laser, with wavelength of 660 nm and power of 30 Mw, in a single dose. Cell viability and proliferation were evaluated at 24, 48 and 72 h after irradiation by Alamar Blue assay, while cell morphology and distribution on the surface of the films were evaluated by SEM at 72 hours. The quantitative data were submitted to non-parametric statistical tests. Data from Alamar blue assay showed that groups L1 and L4 exhibited greater cell proliferation compared to group C, with significant differences between L1 and C at 48 and 72 h (p<0.0001) and between L4 and C in 24 (p<0.01), 48 (p<0.001) and 72 h (p<0.0001). The percentage of reduction of Alamar blue was significantly higher in L4 compared to L1 at 24 and 72 h (p<0.05). Analysis of the samples by SEM showed that in the irradiated groups the cells had a more homogeneous distribution along the surface of the films and a higher cell density compared to the group C, with this difference being even more evident in the group L4. We conclude that PBM in the studied parameters, especially with the dose of 4 J/cm2 , stimulates the proliferation of SHEDs in contact with PLA films, thus constituting a methodological tool with potential application in tissue engineering techniques (AU).

Chlorhexidine to treat oral mucositis in patients with acute leukemia: systematic review / Uso da clorexidina no tratamento da mucosite oral em pacientes com leucemia aguda: revisão sistemática

ABSTRACTBACKGROUND AND OBJECTIVES:Leukemias impair hematopoietic stem-cells shunting and promote a proliferation of malignant cells without functional competence. Studies point that oral manifestations such as pain, hyperplasia and gum bleeding may be one of the first signs in leukemia patients. In light of the above, this study aimed at carrying out a systematic analysis of articles published in the last 15 years, with regard to chlorhexidine to treat and prevent mucositis in acute leukemia children under chemotherapy.CONTENTS:A systematic search of articles published between January 2000 and January 2015 was carried out in Pubmed/Medline, Science Direct and LILACS databases. After systematic search, 6 articles have fulfilled all methodological inclusion criteria. Chlorhexidine is an important means of preventing and treating oral mucositis and studies refer that 0.12% chlorhexidine gluconate effectiveness is probably related to its bactericide action. Adequate oral hygiene is important to prevent mucositis and other therapeutic modalities have shown to be effective to treat and prevent oral mucositis.CONCLUSION:Chlorhexidine gluconate does not totally eliminate oral mucosa injuries, but is able to decrease their frequency and intensity without significant noxious effects. However, other drugs compared to chlorhexidine in this study may present better results.

RESUMOJUSTIFICATIVA E OBJETIVOS:As leucemias comprometem a derivação das células-tronco hematopoiéticas e promovem uma proliferação de células malignas sem competência funcional. Estudos apontam que manifestações orais como dor, hiperplasia e sangramento gengival podem ser um dos primeiros sinais em pacientes com leucemia. Diante do exposto, o objetivo deste estudo foi realizar uma análise sistemática de artigos publicados nos últimos 15 anos, no que diz respeito ao uso da clorexidina no tratamento e prevenção da mucosite em crianças com leucemia aguda em quimioterapia.CONTEÚDO:Uma busca sistemática de artigos publicados entre janeiro de 2000 e janeiro de 2015 foi feita nas bases de dados Pubmed/Medline, Science Directe LILACS. Após pesquisa sistemática 6 artigos preencheram todos os critérios de inclusão metodológica. A clorexidina é um importante meio de prevenção e tratamento da mucosite oral e estudos referem que a efetividade do gluconato de clorexidina a 0,12% está provavelmente relacionada à sua ação bactericida. A correta higienização oral tem importante papel na prevenção da mucosite e outras formas terapêuticas demonstram ser eficazes no tratamento e prevenção da mucosite oral.CONCLUSÃO:O gluconato de clorexidina não elimina totalmente as lesões de mucosa oral, mas é capaz de diminuir sua frequência e intensidade sem apresentar efeitos deletérios significativos no paciente. Entretanto, outros fármacos comparados à clorexidina neste estudo podem apresentar melhores resultados.

Clinicopathological characteristics and perineural invasion in adenoid cystic carcinoma: a systematic review / Características clinicopatológicas e invasão perineural do carcinoma adenoide cístico

INTRODUCTION: Adenoid cystic carcinoma is the most frequent malignant tumor of the submandibular gland and the minor salivary glands. It is a malignant neoplasm that, despite its slow growth, shows an unfavorable prognosis. OBJECTIVES: The aim of this study was to perform a systematic review of the literature on Adenoid cystic carcinoma in the head and neck region and its clinicopathological characteristics, with emphasis on the perineural invasion capacity of the tumor. METHODS: A systematic search of articles published between January 2000 and January 2014 was performed in the PubMed/MEDLINE, SciELO, Science Direct, and Scopus databases. RESULTS: Nine articles were selected for this systematic review. These demonstrated that the female gender was more often affected and that malignant tumors showed a high rate of distant metastasis, recurrence, and a low survival rate. The presence of perineural invasion ranged from 29.4% to 62.5% and was associated with local tumor recurrence. CONCLUSION: Adenoid cystic carcinoma is commonly characterized by the presence of pain, high rate of recurrence, metastasis, and a low survival rate. Reporting studies with patient follow-up is of utmost importance for a better clinical-pathological understanding and to improve the prognosis of this pathology. .

INTRODUÇÃO: O carcinoma adenoide cístico (CAC) é o tumor maligno mais frequente da glândula Submandibular e das glândulas salivares menores. Sendo uma neoplasia maligna, apesar de ter crescimento lento, apresenta um prognóstico desfavorável. Objetivos: O objetivo deste trabalho foi realizar uma revisão sistemática de literatura sobreo carcinoma adenóide cístico na região de cabeça e pescoço e suas características clínico-patológicas com ênfase na capacidade de infiltração perineural do tumor. MÉTODO: Uma busca sistemática de artigos publicados entre janeiro de 2000 a janeiro de 2014 foi executada nas bases de dados PubMed/MEDLINE, SciELO, Science Direct e Scopus. RESULTADOS: Nove artigos foram selecionados para realização da revisão sistemática. Nestes, o sexo feminino foi o mais afetado e o tumor maligno apresentou uma alta taxa de metástase a distância, recidiva e baixa taxa de sobrevida. A presença de invasão perineural variou entre 29,4% a 62,5% e foi relacionada à recidiva local do tumor. CONCLUSÃO: O CAC é comumente caracterizado pela presença de dor, alta taxa de recidiva, metástase e baixa sobrevida. A realização de estudos com acompanhamento dos pacientes é de extrema importância para uma melhor avaliação clinico-patológica visando melhorar o prognóstico da doença. .

Clinicopathological characteristics and perineural invasion in adenoid cystic carcinoma: a systematic review.

INTRODUCTION: Adenoid cystic carcinoma is the most frequent malignant tumor of the submandibular gland and the minor salivary glands. It is a malignant neoplasm that, despite its slow growth, shows an unfavorable prognosis. OBJECTIVES: The aim of this study was to perform a systematic review of the literature on Adenoid cystic carcinoma in the head and neck region and its clinicopathological characteristics, with emphasis on the perineural invasion capacity of the tumor. METHODS: A systematic search of articles published between January 2000 and January 2014 was performed in the PubMed/MEDLINE, SciELO, Science Direct, and Scopus databases. RESULTS: Nine articles were selected for this systematic review. These demonstrated that the female gender was more often affected and that malignant tumors showed a high rate of distant metastasis, recurrence, and a low survival rate. The presence of perineural invasion ranged from 29.4% to 62.5% and was associated with local tumor recurrence. CONCLUSION: Adenoid cystic carcinoma is commonly characterized by the presence of pain, high rate of recurrence, metastasis, and a low survival rate. Reporting studies with patient follow-up is of utmost importance for a better clinical-pathological understanding and to improve the prognosis of this pathology.

Oral manifestations resulting from chemotherapy in children with acute lymphoblastic leukemia.

INTRODUCTION: Acute lymphocytic leukemia is a type of cancer most common in children and it is characterized by excessive and disordered immature leukocytes in the bone marrow. AIM: Identify most frequent oral manifestations in children with acute lymphocytic leukemia under chemotherapy treatment. METHODOLOGY: The research was conducted on the electronic database PubMed/Medline, Science Direct, Scielo and Scopus. It has been sought papers with full presentation, wrote in Portuguese, English and Spanish, published between January 1992 and April 2013. RESULTS: From studies primarily selected, only eight met the criteria of inclusion. All studies performed intraoral examinations to diagnose oral lesions. According to results, the most frequent lesions were mucositis, candidiasis, periodontitis and gingivitis. The oral health condition from acute lymphocytic leukemia carriers varied according oral hygiene of the patient. CONCLUSION: The results of studies identified such a great part of patients with ALL presented some lesion in oral cavity during or after chemotherapy treatment. The dentist surgeon needs to recognize oral manifestations and intervene in the oral health of patients with ALL, contributing and helping with treatment.

Manifestacoes orais decorrentes da quimioterapia em criancas portadoras de leucemia linfocitica aguda / Oral manifestations resulting from chemotherapy in children with acute lymphoblastic leukemia

Introdução: A leucemia linfocítica aguda é um dos tipos de câncer mais comuns em crianças e é caracterizada pela produção excessiva e desordenada de leucócitos imaturos na medula óssea. Objetivo: Identificar as manifestações orais mais frequentes em crianças portadoras de leucemia linfocítica aguda sob o tratamento quimioterápico. Metodologia: A pesquisa foi realizada nas bases de dados eletrônicas PubMed/Medline, Science Direct, Scielo e Scopus. Procurou-se por artigos apresentados na íntegra, escritos em português, inglês e espanhol, publicados entre janeiro de 1992 e abril de 2013. Resultados: Dos estudos selecionados primariamente, apenas oito atenderam aos critérios de inclusão. A população avaliada foi um grupo de crianças portadoras de leucemia linfócitica aguda. Todos os estudos realizaram exames intraorais para o diagnóstico das lesões bucais. De acordo com os resultados, as lesões mais frequentes foram mucosite, candidíase, periodontite e gengivite. A condição de saúde bucal dos portadores de leucemia linfócitica aguda variou de acordo com a higiene bucal do paciente. Conclusão: Pacientes com LLA podem apresentar alguma lesão na cavidade oral durante ou após o início da quimioterapia. O cirurgião dentista necessita reconhecer as manifestações orais e intervir na saúde bucal do paciente com LLA, contribuindo e auxiliando no seu tratamento. .

Introduction: Acute lymphocytic leukemia is a type of cancer most common in children and it is characterized by excessive and disordered immature leukocytes in the bone marrow. Aim: Identify most frequent oral manifestations in children with acute lymphocytic leukemia under chemotherapy treatment. Methodology: The research was conducted on the eletronic database PubMed/Medline, Science Direct, Scielo and Scopus. It has been sought papers with full presentation, wrote in Portuguese, English and Spanish, published between January 1992 and April 2013. Results: From studies primarily selected, only eight met the criteria of inclusion. All studies performed intraoral examinations to diagnose oral lesions. According to results, the most frequent lesions were mucositis, candidiasis, periodontitis and gingivitis. The oral health condition from acute lymphocytic leukemia carriers varied according oral hygiene of the patient. Conclusion: The results of studies identified such a great part of patients with ALL presented some lesion in oral cavity during or after chemotherapy treatment. The dentist surgeon needs to recognize oral manifestations and intervene in the oral health of patients with ALL, contributing and helping with treatment. .

Factors related to dry mouth and low salivary flow rates in diabetic elderly: a systematic literature review / Fatores relacionados a boca seca e hipossalivação em idosos diabéticos: uma revisão

This study aimed to perform a systematic review of studies on factors related to xerostomia and/or hyposalivation in elderly patients with diabetes. SciELO, Science Direct, Scopus, and PubMed/Medline databases were searched for articles published from January 1992 to January 2013, concerned with factors associated with/related to xerostomia or hyposalivation in elderly patients with diabetes. Five articles were selected, including four transversal studies and one longitudinal study. Some of the studies found relationship between poor glycemic control and hyposalivation. Others found that xerostomia was more frequent in patients who worked in nondomestic environments and in women. However, there was considerable variation in the methods used by the researchers in the selected studies. We could not draw definitive conclusions based on our analysis of the selected studies. Longitudinal studies with appropriate sample sizes are needed to provide more complete information about the factors related to xerostomia and hyposalivation in elderly patients with diabetes.

O objetivo deste estudo foi realizar uma revisão sistemática de estudos existentes sobre os fatores relacionados à xerostomia e/ou à hipossalivação em idosos diabéticos. Busca sistemática foi realizada nas bases de dados SciELO, Science Direct, Scopus e PubMed/Medline entre janeiro de 1992 e janeiro de 2013, coletando artigos cujo objetivo tenha sido encontrar fatores associados/relacionados à xerostomia e/ou à hipossalivação em idosos diabéticos. Cinco artigos foram selecionados, sendo quatro estudos transversais e um longitudinal. Alguns trabalhos encontraram relação entre o mau controle glicêmico e o surgimento de hipossalivação. Outros encontraram que a xerostomia foi mais frequente em pacientes que trabalhavam em ambientes não domésticos e em mulheres. Entretanto, os aspectos metodológicos utilizados pelos pesquisadores variaram bastante entre os trabalhos selecionados. Conclusões definitivas não puderam ser retiradas com base na análise dos trabalhos selecionados. Estudos longitudinais com adequado tamanho da amostra são necessários para fornecer informações mais adequadas quanto aos fatores relacionados xerostomia e hipossalivação em idosos diabéticos.