Peeling with retinoic acid in microemulsion for treatment of melasma: A double-blind randomized controlled clinical study.

OBJECTIVE: To evaluate the clinical efficacy of peeling with a microemulsion formulation containing 1% retinoic acid. MATERIALS AND METHODS: After development of the product, 60 patients with melasma were randomly divided into three groups (n = 20): Group 1-application of conventional 1% retinoic acid peeling (RA 1%). Group 2-application of 1% retinoic acid peeling in microemulsion (RA 1%M). Group 3-Application of placebo. The groups were submitted to four peeling sessions, fortnightly on Days 0, 15, 30, and 45, and analyzed at the time intervals of 0, 15, 30, 45, and 60 days. Evaluation was made by using the Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MelasquoL) instrument. Hemato-biochemical parameters were also evaluated at Days 0 and 60. After obtaining the results, normality was evaluated by means of the Kolmogorov-Smirnov test and afterwards, the following tests were applied: Friedman statistical (to test the effect of the treatments on the MASI index); Wilcoxon, (for comparison between pairs to test the effect of treatments on the MelasQoL index); Kruskal-Wallis, (to test the differences between the groups); and Mann-Whitney, (comparisons between treatments). The level of significance adopted was 5% (α = 0.05). RESULTS: The three groups presented a significant reduction in the MASI index, indicating the effect of all the treatments on reducing the melasma (p < 0.001). A significant reduction in the stains was observed with the use of retinoic acid peeling delivered in microemulsion (62%) when compared with the conventional peeling with 1% retinoic acid in a conventional vehicle (26%) and the placebo (12%). There was also a significant reduction in the MelasQoL index (sum of all the aspects) in the three groups, indicating the effect of all the treatments, including the placebo, on the overall quality of life of those with melasma. However, RA 1%M the treatment that promoted the greatest effect on the quality of life of individuals. In percentage terms, the RA 1%M provided a mean reduction of 30% in the MelasQoL index, against 13% of the conventional treatment and only 4% of the placebo. When the hemato-biochemical parameters were compared on Days 0 and 60, there were no significant changes in the results. CONCLUSION: The chemical peeling performed with RA 1%M was effective for the treatment of melasma, and was shown to be superior to the peeling performed with retinoic acid in a conventional vehicle, in reducing the stains and improving the quality of life of patients.

Does dental trauma and its consequences influence the professional hiring process? Development, validation and application of an assessment tool.

OBJECTIVES: To develop and validate a questionnaire concerning the aspects evaluated during the hiring process by human resources professionals (HRPs); to apply the validated questionnaire; and to evaluate the perceptions and judgment of HRPs regarding different traumatic dental injuries (TDIs) and their consequences (TDI-Cs). MATERIALS AND METHODS: The acceptability, discriminative properties, internal consistency and test-retest reliability of the developed questionnaire were evaluated, using the same methodology as the main study and adopting a pilot sample. For both the validation process and the application phase, images of one male and one female were manipulated, or not (control), to create different types of TDI (enamel fracture, enamel and dentin fracture, avulsion) and TDI-Cs (crown discoloration, tooth loss due to avulsion). In the application phase, the images were analyzed by 100 HRPs using the validated questionnaire, and the results were analyzed using the Friedman, Wilcoxon and Mann-Whitney tests (P < 0.05). RESULTS: The developed questionnaire produced excellent acceptability, strong discriminative properties, satisfactory internal consistency and excellent to good test-retest reliability. The presence of TDIs and TDI-Cs had a negative effect on the evaluated aspects used during the hiring process (P < 0.001). Tooth loss provoked the worse level of judgment in all evaluated characteristics and in professional hiring. CONCLUSIONS: The developed questionnaire produced valid and reliable responses concerning the aspects evaluated during the hiring process by Brazilian HRPs. TDIs and TDI-Cs had a negative influence on the aspects evaluated during the HRP professional hiring process. CLINICAL SIGNIFICANCE: TDIs and TDI-Cs had a negative influence on the aspects evaluated during the HRP professional hiring process.

Impact of Orthognathic Correction of Class II Malocclusion on the Perception of Social Characteristics.

OBJECTIVE: To evaluate the influence on the perception of social characteristics after orthognathic treatment for the correction of Class II malocclusion. METHODS: A cross-sectional study was conducted with the participation of 240 observers who evaluated images of individuals before and after orthognathic surgery for the correction of malocclusion. Based on the images, two different questionnaires were applied containing 44 questions each for evaluating social competence, intellectual ability, psychological adjustment, and attractiveness. The mean scores for evaluations of the images were compared using the Mann-Whitney U test at 5% level of significance (α=0.05). RESULTS: Orthognathic treatment significantly (p<0.05) improved the evaluation of individuals in the requisites of the score attributed to the image (p=0.008), extroversion (p=0.026), happiness (p=0.006), self-confidence (p=0.046), and attractiveness (p=0.015). CONCLUSION: Orthognathic treatment for the correction of Class II malocclusions has a positive effect on the perception of social characteristics of individuals. The individuals subjected to orthognathic surgery were evaluated as being more attractive, intelligent, socially competent, and psychologically adjusted.

Craniofacial features of patients with sickle cell anemia and sickle cell trait.

OBJECTIVE: To identify the craniofacial characteristics of patients with sickle cell trait (SCT) and sickle cell anemia (SCA) and to compare these measurements with those of nonaffected subjects. MATERIALS AND METHODS: Clinically normal patients and those with SCT and SCA were evaluated in this study. The patients were divided into three groups: normal (control), SCA, and SCT (n  =  with 15 in each group). Inclusion criteria were SCA or SCT verified by laboratory methods and no treatment with fixed orthodontics or facial orthopedics. Lateral cephalometric radiographs were carried out and were used to obtain angular and linear measurements of anatomic structures displayed. All markings and measurements were performed by a single examiner. RESULTS: The average ANB was increased in groups with SCA (5.47 ± 2.0°) and SCT (3.80 ± 1.4°), indicating a tendency to Class II. The mean SNA angle was 83.0 ± 3.8° and 82.1±3.5° for SCA and SCT, indicating a proper positioning of the jaw from the skull base. There was an interaction between the group and sex factors for the variable SN-GoGn; measures were higher for men in the SCA group. CONCLUSION: Patients with SCA and SCT exhibited characteristics of Class II skeletal pattern because of mandibular retrusion. Most patients showed no compensatory maxillary expansion, which was determined by the normal jaw length and absence of maxillary protrusion.

Facial lipodystrophy in an HIV-positive patient using an orthodontic appliance.

The aim of this article was to relate the clinical case of an HIV-positive orthodontic patient who reported that her cheeks had been hurting since treatment began. We started with the data collected in anamnesis and by contact with the patient's physician, and a diagnosis of facial lipodystrophy as a result of the use of retroviral drugs was reached. The patient was referred to a dermatologist for treatment of the facial lipodystrophy.

Sturge-Weber syndrome in an orthodontic patient.

The aim of this article was to describe the Sturge-Weber syndrome in a patient with orthodontic requirements. Pathologies involved in this syndrome affect facial cranial growth.

IINFLUENCE OF THE IMMUNOSUPPRESSANT TACROLIMUS (FK-506) ON THE FLEXURAL STRENGTH OF FEMUR: A STUDY IN RATS.

OBJECTIVE: To evaluate the resistance to femoral fractures among rats treated with the immunosuppressant tacrolimus FK-506 and compare these to untreated rats and rats treated with placebo. METHODS: Ninety male Wistar rats were used. The animals were nine weeks old and weighed between 220 g and 280 g. The immunosuppressive agent tacrolimus was used in this study at a dose of 2 mg/kg/day, administered orally. The suspension was administered using an insulin syringe, and the maintenance therapeutic dose was sufficient to maintain the immunosuppressive activity. The animals were randomly divided into three groups (n = 30): group 1, no substance administered; group 2, administration of the immunosuppressant tacrolimus FK-506; and group 3, administration of the vehicle alone. Treatment with FK-506 was administered for 28 days. Total leukocyte counts and differential counts (lymphocytes, monocytes, eosinophils and neutrophils) were evaluated in order to monitor the immunosuppressive effect. Bone densitometry analysis by means of dual-energy x-ray absorptiometry (DXA) was also performed before and after administration of the drug. To evaluate the resistance to flexion, a support device was developed so that mechanical tests using an EMIC universal testing machine could be carried out. RESULTS: The results from the flexion resistance tests showed statistical differences between groups 1 and 2 (p = 0.001) and between groups 2 and 3 (p = 0.001). No statistical difference was found between groups 1 and 3 (p = 0.995). CONCLUSIONS: The femurs of rats treated with the immunosuppressive agent had lower mechanical strength than did those of normal rats and those that received placebo.