Vacterl syndrome: Medical and stomatological considerations for comprehensive patient management.

AIM: The VACTERL association or Syndrome consists of Vertebral, Anorectal, Cardiac, Tracheo-Esophageal, Renal, and Limb defects. The diagnosis relies on the presence of at least three of these structural abnormalities. This study reports a single case of a patient with VACTERL Syndrome (VS), aiming to assist dentists in recognizing the general aspects, systemic changes, and oral care related to this condition. CASE REPORT: A 14-year-old female patient medically diagnosed with VS. The study evaluated the presence of systemic alterations, medication use, behavioral deviations, cognitive development, and oral aspects. The patient exhibited cardiovascular alterations including a ventricular septal defect (C), anal atresia (A), polydactyly (considered limb alteration-L), and scoliosis (a possible indication of vertebral anomalies-V). In the intraoral examination, findings included tooth crowding, enamel hypomineralization in several teeth, a deep and atretic palate, generalized gingivitis, bleeding, gingival hyperplasia, Class III malocclusion, and a right unilateral crossbite. CONCLUSION: Patients diagnosed with VACTERL syndrome experience significant systemic impairments. The research subject presented compromised oral health, challenges in dental management, delays in neuropsychomotor development, though these are not inherent to the syndrome. It is crucial to prevent oral diseases and provide early dental care for these patients to avoid the need for complex and invasive dental treatments due to systemic impairments.

Myelomeningocele: Medical Considerations and Stomatologic Aspects in the Dental Treatment.

The aim was to analyze systemic and oral aspects of patients with myelomeningocele (MMC), relevant for their dental treatment. Dental treatment of these individuals requires the dentist's extensive knowledge and careful information to determine the dental treatment plan. Thirty participants aged 3 to 16 years were divided into 2 groups: study group (15 MMC individuals) and control group (15 healthy subjects). All patients were evaluated for: systemic conditions, use of medications, sequela of the underlying pathology, oral hygiene, diseases, convulsion, cerebrospinal fluid (CSF), allergy, behavior, learning, and mouth physical examination to assess the oral conditions. The study group presented: higher percentage using drugs (P < 0.05), 40% had convulsions (P < 0.05), 86.67% using CSF shunt, 53.33% presented latex allergies (P < 0.05), 53.33% were classified as anxious and with cognitive deficit (P < 0.05), showed more gingivitis (P < 0.05). The MMC individuals, in the majority, have shown cognitive impairment and anxious behavior, use of controlled drugs, convulsion, CSF shunt use, and latex allergy. The presence of periodontal tissue damage was higher in patients with MMC.

CAD/CAM system influence marginal fit of different ceramic types?

OBJECTIVE: This study aimed to evaluate the marginal fit of zirconia and lithium disilicate ceramic restorations processed by computer-aided design (CAD)/computer-aided manufacturing (CAM) system. MATERIALS AND METHODS: Ten models were prepared from a metal die, on which scanning was carried out to obtain the virtual model for the processing of zirconia and lithium disilicate ceramics using the CAD/CAM technique. Gypsum models were fabricated and used for scanning the restorations. The infrastructures were designed using software, and CAD/CAM was used to fabricate the restorations (n = 10). The analysis of the marginal discrepancy was measured at 12 points of the margin using the original metallic die. For each crown, an arithmetic average of the discrepancy values was obtained. RESULTS: The marginal fit of the copings of lithium disilicate was 133.10 ± 26.87 µm and zirconia was 127.34 ± 47.97 µm. There was no statistically significant difference (P = 0.7709) between the materials. CONCLUSION: The marginal fit is similar between lithium disilicate and zirconia ceramics milled in the CAD/CAM system used.

The importance of hospital dentistry: oral health status in hospitalized patients / Importância da Odontologia hospitalar: condição de saúde bucal de pacientes internados

ABSTRACT Objective: This research study aimed to evaluate the oral health status and the need for dental treatment in hospitalized patients, analyzing the importance of dentistry in hospitals. Therefore, the goal of this research study was to evaluate the oral health status, the need for dental intervention and the patient's opinion about the importance of having dental surgeons in hospital settings. Methods: 103 hospitalized patients were evaluated considering the DMFT index, gingival condition, visible biofilm index, and the need for invasive dental treatment. Volunteers were also asked about their opinion considering the importance of dentistry in hospital settings. Results: 68.9% of volunteers were male subjects and 31.1% female subjects. The mean DMFT was 17.9 and 96.1% of subjects had their oral hygiene kit with when came to hospital, 97.1% of subjects stated that the presence of dental surgeons is necessary in the hospital setting and 63.1% of subjects presented poor biofilm removal. The need for invasive dental treatment was as follows: restorations (68.9%), extractions (40.8%), endodontics (23.3%), dental pain (26.2%) and presence of abscess (7,8%). Conclusion: Oral health and hygiene status of patients were classified as poor and most of patients showed the need for invasive dental treatment. The majority of patients reported that dental care is very important in hospitals settings.

RESUMO Objetivo: Avaliar a condição de qualidade de saúde bucal e as necessidades de intervenção odontológica em pacientes hospitalizados, analisando a importância da presença da Odontologia em ambiente hospitalar. Métodos: Foram avaliados 103 pacientes hospitalizados, por meio do índice CPO-D, condição gengival, índice de biofilme visível e índice de necessidade de tratamento invasivo odontológico. Observando a importância que estes pacientes davam a Odontologia hospitalar. Resultados: Dentre os voluntários avaliados, 68,9% do gênero masculino e 31,1% feminino. A média do CPO-D foi de 17,9. Dentre os pacientes examinados: 96,1% levaram kit de higiene bucal, 97,1% achavam importante a presença do cirurgião-dentista no hospital, 63,1% apresentaram remoção de biofilme deficiente. Os pacientes apresentaram necessidade de tratamento odontológico invasivo: restauração (68,9%), exodontia (40,8%), endodontia (23,3%), dor de origem odontológica (26,2%), presença de abcesso (7,8%). Conclusão: A qualidade de saúde e de higiene bucal dos pacientes foi considerada insuficiente. A maioria dos pacientes necessitavam de algum tipo de tratamento odontológico invasivo, podendo levar a complicações na saúde bucal no momento da internação. A grande maioria dos pacientes acharam importante a assistência odontológica em hospitais.

Role of tyrosol on Candida albicans, Candida glabrata and Streptococcus mutans biofilms developed on different surfaces.

PURPOSE: To assess the effect of tyrosol on the production of hydrolytic enzymes (by Candida biofilm cells) and acid (by Streptococcus mutans biofilms), as well as to quantify single and mixed biofilms of these species formed on acrylic resin (AR) and hydroxyapatite (HA). METHODS: Candida and S. mutans biofilms were formed on AR and HA in the presence of tyrosol during 48 hours. Next, acid proteinase, phospholipase and hemolytic activities of Candida biofilm cells were determined, while acid production by S. mutans biofilms was assessed by pH determination. The effect of tyrosol on mature biofilms (96 hours) was evaluated through quantification of total biomass, metabolic activity, number of colony-forming units and composition of biofilms' extracellular matrix. Data were analyzed by one- and two-way ANOVA, followed by Tukey's and Holm-Sidak's tests (α = 0.05). RESULTS: Treatments with tyrosol were not able to significantly reduce hydrolytic enzymes and acid production by Candida and S. mutans. Tyrosol only significantly reduced the metabolic activity of single biofilms of Candida species. CLINICAL SIGNIFICANCE: Tyrosol on its own had a limited efficacy against single and mixed-species oral biofilms. Its use as an alternative antimicrobial for topical therapies still demands more investigation.

Caries experience and salivary aspects in individuals with fragile X syndrome.

Fragile X syndrome (FXS) is the most common cause of hereditary mental retardation, but studies on the oral health condition of these patients are rare. The aim of this study was to determine the experience of dental caries in individuals with FXS, by examining the saliva profile, oral hygiene, socioeconomic characteristics and use of controlled drugs in these patients. Dental health was estimated using the decayed, missing and filled teeth index (DMF-T) and sialometry, and the pH value and buffering capacity of the saliva, colony forming units of S. mutans (CFU/mL), visible biofilm index, and socioeconomic status were all examined. The sample, comprising 23 individuals, had an average age of 17.3 ± 5.6 years, a DMF-T index of 5.5, a diminished salivary flow (78.3%), and a low (73.9%) saliva buffering capacity. Most (52.2%) individuals presented with a high abundance (CFU/mL) of S. mutans. The experience of caries was correlated with salivary parameters, poor oral hygiene, lower socioeconomic status and an increased count of S. mutans in saliva.

Caries experience and salivary aspects in individuals with fragile X syndrome

Abstract Fragile X syndrome (FXS) is the most common cause of hereditary mental retardation, but studies on the oral health condition of these patients are rare. The aim of this study was to determine the experience of dental caries in individuals with FXS, by examining the saliva profile, oral hygiene, socioeconomic characteristics and use of controlled drugs in these patients. Dental health was estimated using the decayed, missing and filled teeth index (DMF-T) and sialometry, and the pH value and buffering capacity of the saliva, colony forming units of S. mutans (CFU/mL), visible biofilm index, and socioeconomic status were all examined. The sample, comprising 23 individuals, had an average age of 17.3 ± 5.6 years, a DMF-T index of 5.5, a diminished salivary flow (78.3%), and a low (73.9%) saliva buffering capacity. Most (52.2%) individuals presented with a high abundance (CFU/mL) of S. mutans. The experience of caries was correlated with salivary parameters, poor oral hygiene, lower socioeconomic status and an increased count of S. mutans in saliva.

Oral health evaluation of cardiac patients admitted to cardiovascular pre-surgery intervention / Saúde bucal de pacientes cardiopatas internados em pré- intervenção de cirurgia cardiovascular

ABSTRACT Objective: To assess the oral health status of patients admitted to pre-intervention heart surgery, observing the need index concerning invasive treatment. Methods: hospitalized volunteers in number of 75 were evaluated in order to be investigated concerning which systemic changes were occurring, the patients' oral health conditions as well as the need for invasive dental procedures. Results: Volunteers analyzed in the study were: 69.3% male and 30.7% female. As for the reason for hospitalization were: valvuloplasty (41.3%), coronary artery bypass surgery (24%), pacemaker implantation (16%), cardiac catheterization (8%), placement of stent (6.6%), congenital heart disease (4%). The associated systemic changes were: hypertension (54.6%), diabetes mellitus (20.0%), hypertension and diabetes mellitus (13.3%). Most patients presented the need to undergo invasive dental treatment procedures such as: Periodontal (58.6%), Restorative Dentistry (26.6%), surgical (18.6%), endodontic (12%), dental pain source (2, 6%), abscess presence (1.3%). Conclusion: The oral health status of the patients was considered poor, a significant number of patients at the time of the oral examination, needed some type of invasive dental treatment and the oral environment adequacy indicated dental condition which may cause the formation of infectious sites which in turn can trigger complications both in the oral cavity and general health, as well.

RESUMO Objetivo: Avaliar a condição de saúde bucal dos pacientes internados em pré- intervenção de cirurgia cardíaca, observando o índice de necessidade de tratamento invasivo. Métodos: Foram avaliados 75 voluntários hospitalizados, investigando quais as alterações sistêmicas, as condições de saúde bucal e avaliando a necessidades de procedimentos odontológicos invasivos. Resultados: Os voluntários analisados no estudo foram: 69,3% do gênero masculino e 30,7% do gênero feminino. Quanto ao motivo de internação foram: valvuloplastia (41,3%), cirurgia de revascularização do miocárdio (24%), implante de marcapasso (16%), cateterismo cardíaco (8%), colocação de Stent (6,6%), cardiopatia congênita (4%). As alterações sistêmicas associadas: hipertensão arterial (54,6%), diabetes mellitus (20,0%), hipertensão arterial e diabetes mellitus (13,3%). A maioria dos pacientes apresentaram necessidade de realização de tratamento odontológico invasivo: periodontal (58,6%), restaurador (26,6%), cirúrgico (18,6%), endodôntico (12%), dor de origem odontológica (2,6%), presença abcesso (1,3%). Conclusão: A condição de saúde bucal dos pacientes avaliados foi considerada deficiente, um número significativo de pacientes, no ato do exame bucal, necessitava de algum tipo de tratamento odontológico invasivo e de adequação do meio bucal indicado condição dentária com possibilidade de formação de focos infecciosos, podendo levar a complicações na cavidade bucal e saúde geral.

General and stomatologic aspects of bardet-biedl syndrome.

OBJECTIVE: The purpose of this study is to present a clinical report of a patient with Bardet-Biedl syndrome, aiming to help the dentist to identify the general aspects, systemic changes, alterations. CLINICAL REPORT: Bardet-Biedl syndrome is defined as a genetic disorder of autosomal recessive condition; this case is a male patient, 20 years old. The general features presented by the patient were strabismus, polydactyly, hypogonadism, obesity, cognitive impairment, and autistic behavior. Dentally, this patient presents with hypotonic face, high-arched palate, dental crowding, unilateral crossbite, and difficulty in cleaning but with good-quality oral health. CONCLUSIONS: Many patients with this syndrome have compromised oral hygiene, difficulty in addressing dental cases, developmental delay, and autistic behavior. Thus, it is important to pay attention to these early children from an early age and encourage preventive approach.

Bases Para Interpretação de Exames Laboratoriais na Prática Odontológica / Bases for Interpretation of Laboratory Tests in Dental Practice

Exames laboratoriais são importantes na definição do diagnóstico, quando este não pode ser esclarecido exclusivamente pelos dados de história clínica e exame físico. Compete ao Cirurgião-Dentista solicitar exames complementares, pois alguns problemas sistêmicos poderão complicar e alterar o prognóstico ou, até mesmo, contraindicar a realização de cirurgias ou procedimentos invasivos. Este tema é relevante, pois grande porcentagem de profissionais formados em Odontologia apresenta dificuldade na solicitação e interpretação de exames laboratoriais. Este estudo tem como objetivo revisar conceitos básicos de interpretação e de critérios para solicitação de exames laboratoriais como: Hemograma e Coagulograma completo. O presente trabalho foi desenvolvido por meio da análise documental da produção bibliográfica obtida por meio da base de dados: Biblioteca Virtual em Saúde (BVS), Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) e na base Periódicos CAPES. Concluímos que os exames laboratoriais, quando bem indicados, colaboram para decidirmos quais as condutas que devemos tomar. Pois, diante dos valores encontrados, estando acima ou abaixo dos valores de referência, o profissional os interpretando de forma correta, pode prevenir situações de infecções secundárias, má cicatrização, hemorragias e complicações no tratamento odontológico. Sendo assim, profissionais que solicitam e sabem interpretar exames laboratoriais estão oferecendo maior segurança ao seu paciente.

Laboratory tests are important in defining the diagnosis, when this cannot be explained by data from clinical history and physical examination. Dentists must request exams because some systemic problems may complicate and alter the prognosis or even contraindicate performing surgeries or invasive procedures. This topic is relevant because a large percentage of graduates in dentistry have difficulty ordering and interpretation of laboratory tests. This study aims to review basic concepts of interpretation and criteria for requesting laboratory tests such as complete blood count and Coagulation. This study was developed through documentary analysis of bibliographic production obtained through the database: Virtual Health Library (VHL), Brazilian Digital Library of Theses and Dissertations (BDTD) and CAPES Journals. We conclude that the laboratory tests, when properly indicated, collaborate to decide the correct procedure. For the values found before, being above or below the reference values, when interpreting them correctly, the professional can prevent situations of secondary infections, poor wound healing, bleeding and complications during dental treatment. Thus, professional that interpret laboratory tests correctly can offer greater safety to the patient.

Estudo das características estomatológicas e sistêmicas em pacientes com lúpus eritematoso sistêmico / Study of characteristics and systemic stomatological in patients with lupus erythematosus

Introdução: O lúpus eritematoso sistêmico (LES) é uma doença inflamatória crônica, de causa desconhecida e de natureza autoimune. O uso de diversos medicamentos e a presença das múltiplas alterações sistêmicas podem comprometer o atendimento odontológico desses pacientes principal­ mente quando se encontram descompensados e debilitados. Objetivos: Avaliar a condição de saúde bucal e geral dos pacientes com LES, verificando: frequência e os tipos de danos sistêmicos perma­nentes e uso de medicamentos utilizados para o tratamento dessa enfermidade que comprometem o tratamento odontológico. Material e método: Foram analisados 34 pacientes portadores de LES, estes foram submetidos a uma entrevista estruturada sobre condição sistêmica e a um exame físico buco dental, avaliando: índice CPO-D, condição de saúde gengival e dor na articulação tem poro mandi­bular. Resultados: CPO-D média 15,3; Condição gengival: 65% com gengivite; artrite: 94%; envolvi­mento hematológico: 41%; envolvimento renal: 29%, envolvimento cardiovascular e pulmonar:18%. Medicamentos mais utilizados: glucocorticosteróides: 88%; anti-inflamatórios não esteróides 52%; hidroxicloroquina: 41%; antidepressivo: 32%. Conclusão: A condição de saúde bucal dos pacientes avaliados é deficiente; existe grande variabilidade de doenças sistêmicas; uso de diversos medica­mentos, com efeitos colaterais negativos e imunossupressores para a condição geral dos pacientes com LES. Esses pacientes se tornam de alto risco para o tratamento odontológico. Os Cirurgiôes-Den­tistas devem estar atentos e preparados para tratar as necessidades especiais do paciente com LES.

Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unkno­ wn cause and autoimmune nature. The use of multiple medications and the presence of multiple systemic changes may compromise the dental care of these patients especially when they are un­ compensated and debilitated. Objectives: The aim of this study was to analyze the condition of oral and general health of patients with SLE. The frequency, types of systemic damage, use of controlled medications used to treat this disease that undertake dental treatment. Methods: 34 patients were analyzed with SLE that were submitted a structured interview about systemic condition and dental exam: DMFT index, gingival health condition and temporo mandibular joint pain. Results: DMFT average 15.3%; gingival condition: 65 % with gingivitis; arthritis: 94%; hematologic involvement: 41%, renal involvement: 29%, cardiovascular and pulmonary involvement: 18%. Most widely used drugs: glucocorticosteroids: 88%, anti - inflammatory drugs 52%; hydroxychloroquine: 410f0; an­ tidepressant: 32 Ofo. Conclusion: The oral health of the patients is poor, there is great variability in systemic diseases, use of various drugs with negative side effects and immunosuppressants for the general condition of patients with SLE. These patients becomes an high risk for dental care and the dentists may be vigilant and prepared to apply special needs of patients with SLE.

Importância do cirurgião-dentista em Unidade de Terapia Intensiva: avaliação multidisciplinar / Importance of dentist on intensive care unit: multidisciplinary analysis

Objetivo: verificar a importância que a equipe multidisciplinar de Unidade de Terapia Intensiva (UTI) e os cirurgiões-dentistas atribuem à integração de um cirurgião-dentista a essa equipe. Adicionalmente, investigar o protocolo de higienização bucal aplicado em pacientes internados em UTL Metodologia: O questionário foi aplicado em 58 profissionais que atuam diretamente na UTI: 38 técnicos em enfermagem, 08 médicos, 08 enfermeiros, 04 fisioterapeutas e 29 cirurgiões-dentistas que não atuam em equipe de UTL Após o recebimento dos formulários respondidos, os resultados foram tabulados e os percentuais relativos a cada questão foram calculados. Resultados: 57% da equipe multidisciplinar e 96% dos profissionais da odontologia responderam que é importante a presença do cirurgião-dentista neste setor. Sobre a influência do cirurgião-dentista na melhora do quadro clínico dos pacientes, foi verificado que 55% dos integrantes da equipe multidisciplinar concordaram que o cirurgião-dentista, atuando no atendimento a pacientes hospitalizados em UTI, resultaria em uma melhora no quadro clínico do paciente; e 100% dos voluntários concordaram que a higiene bucal eficiente é importante em pacientes internados em UTL Conclusão: Apesar da higiene bucal ser considerada fator importante em pacientes internados na UTI por todos os profissionais avaliados, não há unanimidade no reconhecimento da importância e do papel do cirurgião-dentista como integrante da equipe de profissionais da área da saúde que atuam em UTL Adicionalmente, os métodos de controle de biofilme atualmente usados como protocolo de higienização bucal nas UTls abordadas não foram os mais adequados.

Objective: The aim was to analysis the importance of multidisciplinary members of Intensive Care Unit (ICU) and dentists assign to the integration of dentist into that group. Additionally, evaluate the oral hygiene protocol used in ICU patients. Methods: The questionnaire was applied in 58 staff who directly work on the ICU: 38 nursing technicians, 08 doctors, 08 nurses, 04 physiotherapists and 29 dentists that they was not members staff of ICU. After ali volunteers completed questionnaire, then the results were analyzed and the percentages for each question were calculated. Results: 57% of the multidisciplinary member and 96% of dentists agree that it is important the presence of dentists in this group. Considering the positive influence of dentists on improvement of clinical case of the ICU patient, it was verified that 55% of multidisciplinary members staff agree that the dentist on ICU member staff will result an improvement of the patient clinical case. Additionally, 100% volunteers agree that efficient oral hygiene is important for patients on ICU care. Conclusion: Even though oral hygiene was considered important in ICU patients by ali professionals. There was no agreement on recognizing the importance of the dentist on multidisciplinary group of ICU. Additionally, the proto-cal of biofilm control currently used on ICUs was not the most appropriate.

Análise radiográfica de agenesia dentária / Radiographic analysis of tooth agenesis

Introdução: Agenesia é uma anomalia do desenvolvimento dentário frequente no ser humano, e é representada pela ausência de um ou mais dentes, fato relacionado com problemas estéticos e de maloclusão. Objetivo: Investigar a presença de agenesia dental, por meio de radiografias panorâmicas. Materiais e métodos: Foram avaliadas radiografias de pacientes atendidos em três clínicas odontológicas de Presidente Prudente (SP), relacionando a frequência da agenesia com o gênero, quadrantes e grupos dentários afetados. Os critérios de exclusão foram idade e perdas dentais por extrações ou outros motivos. A avaliação das tomadas radiográficas foi executada por dois avaliadores, utilizando negatoscópio em ambiente escuro para possibilitar a análise. Resultados: Foram avaliadas 600 radiografias panorâmicas de pacientes na faixa etária entre 9 e 16 anos. Foram encontrados 171 casos de agenesia; destes, 82 casos foram observados no gênero masculino e 89, no feminino. Quando avaliado o tipo de dente, os terceiros molares apresentaram maior frequência de agenesias (65%), seguido dos segundos pré-molares (5,8%), incisivo lateral (4,8%), primeiro pré-molar e incisivo central (0,6%) em todos os quadrantes, sendo mais frequente no quadrante superior e no gênero feminino. Conclusão: Há prevalência de agenesias no arco superior, com destaque para a do terceiro molar em relação ao de outros dentes. Adicionalmente, sugere-se que o gênero não é um fator predisponente para presença de agenesia.

Introduction: Agenesis is a frequent anomaly of dental development in humans, which is characterized by absence of one or more teeth, and has been related with aesthetic and malocclusion problems. Objective: To investigate the presence of dental agenesis using panoramic radiographs. Materials and methods: Patients radiography of three Dental Clinics of Presidente Prudente, São Paulo State, Brazil, were assessed, and requency of agenesis, gender, and quadrants of dental groups were scored. Exclusion criteria were age and the losses by dental extractions or other reasons. Two reviewers, using negatoscope in a dark room, undertook the analyses of panoramic radiographs. Results: Panoramic radiographs of 600 patients, 9 to 16 years old were evaluated. Agenesis was found in 171 patients, 82 male and 89 female. The third molars had a higher requency of tooth agenesis (65%), followed by the second premolars (5.8%), lateral incisor (4.8%) and one remolar and incisor central (0.6%) on all sides. Agenesis was more frequently found in the upper quadrant and female patients. Conclusion: It was concluded that the agenesis of maxilla and the third molar was the most observed. Additionally it is suggested that gender is not a predisposing factor for the presence of agenesis.

Paciente autista: métodos e estratégias de condicionamento eadaptação para o atendimento odontológico / Autistic patient: methods and strategies of conditioning andadaptation for dental care

Introdução: O autismo consiste em uma desordem complexa, caracterizada por alterações do comportamento relacionadas ao convívio social, linguagem e limitações motoras. Objetivos: Apresentar as principais características do autismo para o cirurgião-dentista, abordar as diferentes formas de condicionamento odontológico, manejo e novos métodos e estratégias usadas para o atendimento desses pacientes; e ainda discutir a importância da prevenção das doenças bucais que deve ser iniciada o mais precocemente possível. Fontes de dados: O presente estudo foi desenvolvido por meio da análise da produção bibliográfica obtida nas bases de dados: BVS – Bireme, LILACS, IBECS, MEDLINE e BBO –, PubMed, SciELO, Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) e na base Periódicos Capes. As estratégias de busca utilizadas incluíram o uso dos termos: “autismo”; “assistência odontológica”; “manejo”; “comportamento”; “saúde bucal”. Seleção dos trabalhos: Após a análise dos estudos, foram selecionadas 35 referências entre os anos de 1997 e 2012. Conclusões: O cirurgião-dentista deverá dispor dos métodos convencionais de manejo odontológico, além de aprender estratégias de interação, como estímulos audiovisuais e corporais utilizando métodos subjetivos (TEACCH, PECS, ABA e Son-Rise). Os detalhes que devem ser observados durante o atendimento desses pacientes incluem: eliminação de estímulos sensoriais estressantes; ordens claras e objetivas; rotina de atendimento; anamnese minuciosa; diminuição do tempo de espera na recepção; cuidado com o uso de palavras que provoquem medo; e contenção física apenas com consentimento dos pais. Adicionalmente, destaca-se a necessidade de ter programas de prevenção para paciente autista, buscando a redução de atendimentos sob anestesia geral.

Introduction: Autism is a developmental disorder, characterized by behavioral changes related to social interaction, language and motor impairments. Objectives: To review the features of autism, discussing the different forms of conditioning and treatment on dental care. To analyze the new methods and strategies used for treatment of autistic patients. To discuss the relevance of oral diseases prevention. Data Sources: We performed a comprehensive search of VHL – BIREME, LILACS, IBECS, MEDLINE and BBO –, PubMed, SciELO, Brazilian Digital Library of Theses and Dissertations (BDTD) and Capes periodicals. The search strategies used included the using the terms: “autism”, “dental care”, “management”, “behavior”, “oral health”. Selection of papers: We reviewed papers published between 1997 and 2012 and selected 35 of them. Conclusions: The dentist may have the conventional methods of dental approach, and learn different interaction strategies, such as audiovisual and body stimuli using subjective methods (TEACCH, PECS, ABA and Son-Rise). The details that may be observed during the treatment of these patients include: elimination of stressful sensory stimuli; clear and objective orders; routine care; detailed anamnesis; reduced time of waiting; nonuse of words that may be caused fear. Physical restraint only with parents consent. Additionally, we highlight the need for prevention programs for autistic patient for reduction of care under general anesthesia.

Características físicas e bucais em pacientes portadores da Síndrome do X-Frágil / Physical and oral characteristics in patients with fragile X syndrome

A Síndrome do X-Frágil é um distúrbio genético, identificado microscopicamente por uma cons- trição denominada sítio frágil no braço longo do cromossomo X; é considerada como principal causa hereditária de deficiência mental associada a diversas alterações neurológicas. O objetivo deste estudo foi verificar características físicas e bucais, presença de alterações sistêmicas e características comportamentais presentes em pacientes portadores da Síndrome do X-Frágil, além de divulgar esta síndrome aos Cirurgiões-Dentistas. Foram analisados 31 voluntários portadores da Síndrome do X- -Frágil por meio da aplicação de questionário estruturado, exame físico geral, bucodental e análise de prontuário multidisciplinar. Os dados obtidos foram tabulados e submetidos ao teste Qui-Quadrado (p

The fragile X syndrome is a genetic disorder, identified microscopically by a constriction called fragile site on the long arm of chromosome X, considered the main inherited cause of mental disability associated with severa I neurological disorders. The aim of this study were analyzed physical and oral characteristics, medical problems and behavioral characteristics in patients with fragile X syndrome, and diffuse this syndrome among dentists. Volunteers (n=31) with fragile X syndrome were submitted a structured form, physical and oral exam and the multidisciplinary form was analyzed. The data were submitted to statistical analyses (Chi-square; P<.05). Regular use of medicine was reported by 68% (P<.05), the most commonly used was the anticonvulsants (61%). The presence of biofilm (93%) and gingivitis (81%) was statistically significant when the amount of positive and negative cases were compared. Malocclusion and atresic palate were present in 93% ofthe volunteers (P<.05). Ali subjects reported the presence of family history of mental retardation. Among the facial features elongated face, ears and forehead prominent and behavioral aspects of hyperactivity and anxiety were statically significant differences. Thus, we conclude that there are large variability among the characteristics expressed by individuais with the Fragile X syndrome, frequently these individuais have elongated face, prominent ears and mental retardation associated with oral problems such as malocclusion, atresic palate and enamel hypoplasia. In addition poor oral hygiene and regular medicine is common in this patients.

Efficacy of denture cleansers on Candida spp. biofilm formed on polyamide and polymethyl methacrylate resins.

STATEMENT OF PROBLEM: Although new materials have emerged as options to fabricate removable dental prostheses, the development of Candida biofilms on these materials and the effectiveness of methods to control these pathogenic biofilms are poorly understood. PURPOSE: The purpose of this study was to evaluate the efficacy of denture cleansers on Candida single- and dual-species biofilms formed on polyamide resin. MATERIAL AND METHODS: Polymethyl methacrylate (PMMA) resin (Acron MC) and polyamide resin (Flexite M.P.) specimens (n=116) were prepared, and their surface roughness was standardized (0.34 ±0.02 µm). Surface free energy (SFE) was measured for some specimens (n=20 per resin), while the remainder were randomly divided by lottery into 24 groups (n=8) for biofilm assay. C. albicans and/or C. glabrata biofilm was formed for 72 hours, and then specimens were treated with an enzymatic cleanser solution (Polident 3 Minutes), a cleanser solution (Corega Tabs), or 0.5% sodium hypochlorite (NaOCl) solution. Water served as the negative control. Remaining adherent microorganisms were removed from the treated specimens by ultrasonic waves, and colony-forming units (CFU) of each microorganism were calculated. SFE data were analyzed by 1-way ANOVA, and Candida species data were analyzed by 3-way ANOVA followed by the Tukey-Kramer test (P=.05). RESULTS: All tested biofilms displayed significantly higher growth on polyamide resin (P<.001), which presented the lowest SFE. Denture cleansers significantly decreased Candida levels; however, the 0.5% NaOCl solution was the only effective cleanser. C. glabrata revealed significantly higher CFU counts under all experimental conditions (P<.001). CONCLUSIONS: The highest Candida spp. biofilm growth was shown to occur on polyamide resin when compared with PMMA. Denture cleansers were able to remove Candida spp. biofilm formed on both denture base resins.

Preload loss and bacterial penetration on different implant-abutment connection systems.

Preload loss can favor the occurrence of implant-abutment interface misfit, and bacterial colonization at this interface may lead to implant failure. The aim of this study was to evaluate the preload loss and bacterial penetration through the implant-abutment interface of conical and external hexagon connection systems subjected to thermal cycling and mechanical fatigue (TM). Four different implant-abutment connection systems were evaluated (n=6): external hexagon with universal post, Morse taper with universal post, Morse taper with universal post through bolt, and locking taper with standard abutment. The assemblies (implant-abutment) were subjected to a thermal cycling regimen (1,000 cycles of 5 degrees C and 55 degrees C) and to mechanical fatigue (1.0 million cycles, 1.0 Hz, 120 N). The assemblies were immersed in Tryptic Soy + Yeast Extract broth containing Streptococcus sanguinis and incubated at 37 degrees C and 10% CO(2) for 72 h. Detorque values were recorded. The bacterial penetration was assessed and the abutments were observed by scanning electron microscopy. The preload data were analyzed statistically by two-way ANOVA and Tukey's test at 5% significance level. All screw abutment systems showed significantly higher (p<0.05) detorque values when subjected to TM and all conical systems presented bacterial penetration. The results show no relationship between the preload loss and the bacterial penetration.

Polytetrafluorethylene added to acrylic resins: mechanical properties.

The addition of different polymers, such as polytetrafluorethylene (PTFE), to denture base resins could be an option to modify acrylic resin mechanical properties. This study evaluated the surface hardness, impact and flexural strength, flexural modulus and peak load of 2 acrylic resins, one subjected to a long and another subjected to a short polymerization cycle, which were prepared with or without the addition of 2% PTFE. Four groups were formed according to the polymerization cycle and addition or not of PTFE. Forty specimens were prepared for each test (10 per group) with the following dimensions: hardness (30 mm diameter x 5 mm thick), impact strength (50 x 6 x 4 mm) and flexural strength (64 x 10 x 3.3 mm) test. The results of the flexural strength test allowed calculating flexural modulus and peak of load values. All tests were performed in accordance with the ISO 1567:1999 standard. Data were analyzed statistically by ANOVA and Tukey's test with the level of significance set at 5%. No statistically significant differences (p>0.05) were found for surface hardness. Flexural strength, impact strength and peak load were significantly higher (p<0.05) for resins without added PTFE. The flexural modulus of the acrylic resin with incorporated 2% PTFE polymerized by long cycle was significantly higher (p<0.05) than that of the other resins. Within the limits of this study, it may be concluded that the addition of PTFE did not improve the mechanical properties of the evaluated acrylic resins.

Polytetrafluorethylene added to acrylic resins: mechanical properties

The addition of different polymers, such as polytetrafluorethylene (PTFE), to denture base resins could be an option to modify acrylic resin mechanical properties. This study evaluated the surface hardness, impact and flexural strength, flexural modulus and peak load of 2 acrylic resins, one subjected to a long and another subjected to a short polymerization cycle, which were prepared with or without the addition of 2 percent PTFE. Four groups were formed according to the polymerization cycle and addition or not of PTFE. Forty specimens were prepared for each test (10 per group) with the following dimensions: hardness (30 mm diameter x 5 mm thick), impact strength (50 x 6 x 4 mm) and flexural strength (64 x 10 x 3.3 mm) test. The results of the flexural strength test allowed calculating flexural modulus and peak of load values. All tests were performed in accordance with the ISO 1567:1999 standard. Data were analyzed statistically by ANOVA and Tukey's test with the level of significance set at 5 percent. No statistically significant differences (p>0.05) were found for surface hardness. Flexural strength, impact strength and peak load were significantly higher (p<0.05) for resins without added PTFE. The flexural modulus of the acrylic resin with incorporated 2 percent PTFE polymerized by long cycle was significantly higher (p<0.05) than that of the other resins. Within the limits of this study, it may be concluded that the addition of PTFE did not improve the mechanical properties of the evaluated acrylic resins.

A adição de diferentes polímeros como o politetrafluoretileno (PTFE) às resinas para base de próteses removíveis pode ser uma opção para modificar as propriedades mecânicas das resinas acrílicas. Este estudo avaliou a dureza de superfície, a resistência ao impacto e à flexão, o módulo flexural e a carga de ruptura de duas resinas acrílicas, uma submetida ao ciclo longo e a outra ao ciclo curto de polimerização, as quais foram preparadas com ou sem a adição de PTFE a 2 por cento. Quatro grupos foram formados de acordo com os ciclos de polimerização e a adição ou não de PTFE. Quarenta espécimes foram preparados para cada teste (10 espécimes por grupo) com as seguintes dimensões: dureza de superfície (30 mm diametro x 5 mm espessura), resistência ao impacto (50 x 6 x 4 mm), resistência à flexão (64 x 10 x 3,3 mm). O módulo flexural e a carga de ruptura foram calculados a partir dos valores obtidos no teste de resistência à flexão. Todos os testes foram realizados em conformidade com a Norma ISO 1567:1999. Os dados foram submetidos à análise de variância e teste de Tukey com nível de significância de 5 por cento. Não foram encontradas diferenças estatisticamente significantes (p>0,05) para dureza de superfície. Os valores de resistência à flexão, resistência ao impacto e carga de ruptura foram maiores para as resinas sem a adição de PTFE (p<0,05). O valor do módulo flexural da resina acrílica com adição de PTFE a 2 por cento, polimerizada por ciclo longo, foi maior do que as outras resinas (p<0,05). Dentro das limitações deste estudo, pode-se concluir que a adição de politetrafluoretileno não melhorou as propriedades mecânicas das resinas acrílicas avaliadas.

Polytetrafluoroethylene added to acrylic resin: surface properties and Candida albicans adherence.

PURPOSE: To evaluate the surface properties and Candida albicans adherence on two acrylic resins, one polymerized by long cycle and the other by short polymerization cycle, with added 2% PTFE (wt/wt) (experimental groups) or not added (control groups). METHODS: The specimens were divided into four groups (n = 10 per group): (1) acrylic resin polymerized by long cycle; (2) acrylic resin polymerized by long cycle with added 2% PTFE; (3) acrylic resin polymerized by short cycle; and (4) acrylic resin polymerized by short cycle with added 2% PTFE. After finishing and polishing, all specimens were assessed for their surface roughness (pm), contact angle (degree) and surface free energy (erg/cm 2) Saliva-coated specimens were submitted to the adherence assay with C. albicans (ATCC 90028). Adhered cells were detached from the acrylic resin surface by ultrasonic waves at 7 watts for 30 seconds in phosphate buffered saline solution (PBS). This cell solution was serially diluted in PBS and plated on Sabouraud agar. The results were expressed in colony forming units per surface area (CFU/mm2). The data was analyzed by two-way ANOVA. The significance limit was set at 5%. RESULTS: No statistical differences were found for roughness, contact angle and surface free energy. There was a reduction trend in C. albicans adherence in PTFE added to resins, but it was not statistically significant.