Adaptações em escovas dentais para pacientes com distúrbios motores: relato de caso / Adaptations on toothbrushes for patients with motor disorders: case report

Objetivo: O objetivo desse trabalho é discutir adaptações de escovas dentais para pacientes com distúrbios motores, através de um relato de caso de um paciente com Doença de Wilson. Descrição do caso: Paciente de 32 anos, sexo masculino, procurou a Escola Bahiana de Medicina e Saúde Pública (Salvador, Bahia) para atendimento odontológico. Na anamnese, relatou ser portado da doença de Wilson e cirrose hepática. Apresentava tremor do membro superior direito, o que dificultava a escovação dentária. A adaptação de escova selecionada para o paciente foi a manopla de bicicleta associada à silicona de condensação. Uma manopla de borracha antiderrapante foi preenchida com silicona de condensação pesada (Elite HD+, da Zhermack), com cuidado para evitar a penetração de ar. Uma escova dentária (Colgate 360, da Colgate) foi introduzida na silicona dentro da manopla, e esperado o tempo de vulcanização do material. A manopla permite um maior controle da escova pelo paciente por aumentar o calibre do cabo da escova (tornando-o mais volumoso) e por ser antiderrapante. A silicona estabiliza a escova no dispositivo, mas permite, com um movimento de tração firme, a substituição regular da escova. Conclusão: Através de adaptações específicas em escovas dentais, pode-se conseguir uma melhora na qualidade de escovação, na motivação e na autoestima do paciente.

Objective: The aim of this paper is to discuss adaptations of toothbrushes for patients with motor disorders, through a case report of a patient with Wilson's disease. Case Report: Patient with 32 years old, male, sought the Bahiana School of Medicine and Public Health (Salvador, Bahia) for dental care. In the interview, he reported being a carrier of liver cirrhosis and Wilson's disease. It could be observed tremor of the right upper limp, making difficult to toothbrushing. The selected brush to adapt to the patient was the bicycle-handle grip associated with condensation silicone. The slip resistant rubber grip was filled with heavy condensation silicone (Elite HD +, of the Zhermack), carefully to avoid the penetration of air. A toothbrush (360 Colgate, Colgate) was introduced into the silicone within the handle, and expected time of vulcanization of the material. The handle allows better control of the toothbrush by the patient due to increase of the brush handle calibre (making it more bulky) and be slip resistant. The silicone stabilizes the toothbrush on the device. However it allows the regular brush exchange with a firm traction movement for removal. Conclusion: Through specific adaptations on toothbrushes, it is possible achieve an improvement in quality brushing, motivation and self-esteem of the patient.

Subepithelial connective tissue graft for root coverage in smokers and non-smokers: a clinical and histologic controlled study in humans.

BACKGROUND: The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers. METHODS: Thirty subjects, 15 smokers and 15 non-smokers, were selected. Each subject had one Miller Class I or II recession in a non-molar tooth. Clinical measurements of probing depth (PD), relative clinical attachment level (CAL), gingival recession (GR), and width of keratinized tissue (KT) were determined at baseline and 3 and 6 months after surgery. The recessions were treated surgically with a coronally positioned flap associated with a subepithelial connective tissue graft. A small portion of this graft was prepared for immunohistochemistry. Blood vessels were identified and counted by expression of factor VIII-related antigen-stained endothelial cells. RESULTS: Intragroup analysis showed that after 6 months there a was gain in CAL, a decrease in GR, and an increase in KT for both groups (P <0.05), whereas changes in PD were not statistically significant. Smokers had less root coverage than non-smokers (58.02% +/- 19.75% versus 83.35% +/- 18.53%; P <0.05). Furthermore, the smokers had more GR (1.48 +/- 0.79 mm versus 0.52 +/- 0.60 mm) than the non-smokers (P <0.05). Histomorphometry of the donor tissue revealed a blood vessel density of 49.01 +/- 11.91 vessels/200x field for non-smokers and 36.53 +/- 10.23 vessels/200x field for smokers (P <0.05). CONCLUSION: Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results.

Amelogenesis imperfecta and unusual gingival hyperplasia.

BACKGROUND: Amelogenesis imperfecta (AI) is a group of hereditary conditions that primarily involves the defective formation and/or calcification of enamel. The association of AI with gingival enlargement-like lesions has also been reported. METHODS: This paper reports a case of a hypoplastic AI associated with unusual generalized gingival hyperplasia. RESULTS: Histological aspect of the gingival growth was characterized by a dense connective tissue with a mild mononuclear inflammatory infiltrate, calcified bodies, and islands of odontogenic epithelium. CONCLUSION: The present case represents a very interesting demonstration of the fact that, although rare, AI may be associated with generalized gingival enlargement.

Fitoestrógenos na periodontia: um futuro promissor? / Phytoestrogens in periodontics: a promising future?

Estudos têm estabelecido uma relação entre osteopenia, osteoporose e doença periodontal, em que a perda de massa óssea sistêmica foi relacionada com a perda dental pela reabsorção do osso alveolar de sustentação. No intuito de inibir a perda óssea provocada pela osteoporose, a literatura médica tem sugerido o uso de drogas que atuam na fisiopatologia óssea como os estrógenos. os bisfosfonatos, os flavonóides sintéticos e mais recentemente os fitoestrógenos naturais. Os fitoestrógenos (flavonóides naturais) são substâncias encontradas naturalmente no gérmen de soja e que têm sido indicados na prevenção da osteoporose. devido à sua ação direta no metabolismo ósseo. Além disso, tem sido destacado seu efeito anti-inflamatório moderado. Logo. este trabalho visa apresentar e questionar os possíveis benefícios deste novo medicamento na perda óssea periodontal.