Search

Statement of problem Whether oral rehabilitation with dental implants in patients with Down syndrome leads to an increased complication rate is unclear. Purpose The purpose of this systematic review was to determine the effectiveness of dental implants placed in patients with Down syndrome and whether the condition is a risk factor or contraindication for dental implant placement. Material and methods Searches were conducted in 6 databases, including the non–peer-reviewed literature, up to February 2021 by 2 independent reviewers according to established inclusion and exclusion criteria to answer this question: Is Down syndrome a risk factor or contraindication for oral rehabilitation with dental implants? Results A total of 655 studies were initially found in the databases. Five were included in this systematic review, all of which were observational studies. A total of 50 patients with 186 implants were evaluated, with a reported effectiveness of 79.1%. The risk of bias assessment determined that 3 of the 5 studies had a high risk of bias. Conclusions Treatment with dental implants in patients with Down syndrome is a suitable option, but more complications are to be expected than with patients without this condition. Controlled studies with better methodological design and less risk of bias should be developed to improve the scientific evidence for the treatment of these patients.

OBJECTIVE: This study investigated the antifungal and antibiofilm activity of Cymbopogon nardus essential oil (EO) and its major compound, citronellal, in association with miconazole and chlorhexidine on clinical strains of Candida albicans. The likely mechanism(s) of action of C. nardus EO and citronellal was further determined. MATERIALS AND METHODS: The EO was chemically characterized by gas chromatography coupled with mass spectrometry (GC-MS). The antifungal activity (MIC/MFC) and antibiofilm effects of C. nardus EO and citronellal were determined by the microdilution method, and their likely mechanism(s) of action was determined by the sorbitol and ergosterol assays. Then, the samples were tested for a potential association with standard drugs through the checkerboard technique. Miconazole and chlorhexidine were used as positive controls and the assays were performed in triplicate. RESULTS: The GC-MS analysis tentatively identified citronellal as the major compound in C. nardus EO. Both samples showed antifungal activity, with MIC of 256 µg/mL, as compared to 128 µg/mL and 8 µg/mL of miconazole and chlorhexidine, respectively. C. nardus EO and citronellal effectively inhibited biofilm formation (p < 0.05) and disrupted preformed biofilms (p < 0.0001). They most likely interact with the cell membrane, but not the cell wall, and did not present any synergistic activity when associated with standard drugs. CONCLUSION: C. nardus EO and citronellal showed strong in vitro antifungal and antibiofilm activity on C. albicans. CLINICAL RELEVANCE: Natural products have been historically bioprospected for novel solutions to control fungal biofilms. Our data provide relevant insights into the potential of C. nardus EO and citronellal for further clinical testing. However, additional bioavailability and toxicity studies must be carried out before these products can be used for the chemical control of oral biofilms.

A systematic review and meta-analysis was carried out to verify evidence regarding the efficacy and safety of the clinical applicability of natural products in the prevention and treatment of oral mucositis induced by chemotherapy and/or radiotherapy. An electronic research according to the PICOS strategy, using the terms “natural products” and “oral mucositis,” was carried out at Pubmed, Cochrane, Embase, and “gray literature.” The stages of eligibility, data extraction, and quality assessment of the studies were carried out independently and in duplicate. The number of studies identified as eligible was 151, including 47 randomized controlled trials, reporting a total of 3075 participants undergoing some therapy with natural products on oral mucositis. The included clinical trials covered a variety of 31 types of natural products. Considering the risk of bias of the clinical trials, 24 studies (51.1%) were considered to have a low overall risk of bias, nine (19.1%) were at moderate risk, and 14 clinical trials (29.8%) were at high risk of bias. Honey was the most assessed natural agent. Fourteen studies (3.4%) reported that natural agents reduced pain. The results of the meta-analysis support a positive effect of honey and Aloe vera in reducing mucositis in patients receiving cancer therapy. The results found add relevant information to the scientific community regarding the prevention and treatment of mucositis. Graphical abstract

Background Head and neck radiotherapy is typically associated with toxicities that can have profound effects on the patient's quality of life. Xerostomia, which may or may not be related to hypofunction of the salivary gland, leading to negative consequences, mainly in quality of life, leaving patients more susceptible to the development of oral mucositis, dental caries, oral infection and difficulties in speech is one of the most common side effects of such treatment. The aim of the present study was to evaluate salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation. Material and Methods A cross-sectional study with a quantitative approach was carried out in the Dentistry Department of the Hospital de Câncer de Pernambuco between February and September 2019. Results The study sample comprised 23 patients of both genders, treated with radiotherapy for cancer in the head and neck region. The patients were submitted to photobiomodulation with infrared laser, as intraoral applications in order to prevent mucositis and extraoral applications to stimulate salivary glands. The applications were undertaken three times a week on alternate days throughout the radiotherapy period. The following parameters were used: Intraoral 15mW, 12J / cm2, 10s / point, 2.4 J / point, and extraoral 30mW, 7.5J / cm2, 10s / point, 0.3J / point, both with a wavelength of 830nm and area of 0.028cm². Subjective and objective symptoms were evaluated by measuring the unstimulated salivary flow (USF) using the spitting technique before, during and after radiotherapy treatment. For statistical analysis, a significance level of 5% was adopted. Most patients were male (70%) with 60 years of age on average. At the beginning of treatment, 22 patients had USF> 0.2 ml / min (grade 1), at the end of which 15 patients remained unchanged and only 3 patients progressed to grade 3. As for the subjective classification, most (52%) remained in grade 1 (absence of disability) throughout the treatment. Conclusions Based upon the results of this study it was possible to conclude that the use of photobiomodulation did not significantly interfere with the xerostomia complaint of patients in treatment with radiotherapy, however, it does seem to prevent patients from reaching higher degrees of xerostomia taking into account salivary flow measures. Key words:Photobiomodulation, head and neck neoplasms, radiotherapy, xerostomia, saliva.

La terapia endodóntica prevé la descontaminación químico-mecánica de los canales radiculares, siendo el hipoclorito de sodio (NaClO) la sustancia química más utilizada. Se buscó realizar una revisión crítica de la literatura sobre las consecuencias de accidentes por extravasación de NaClO durante el tratamiento endodóntico y las conductas clínicas necesarias en esos casos. Las búsquedas de bases de datos fueron realizadas en Scielo y Lilacs con descriptores em portugués, y la base de datos PubMed con descriptores en Inglés, obteniéndose 98 registros de artículos disponibles para la lectura completa, publicados desde 2003 hasta 2018. Se incluyeron aquellos cuya temática respondía a los cuestionamientos en discusión: HClO como irrigante endodóntico; factores que afectan la extrusión del hipoclorito en tratamientos endodónticos, consecuencias y manejo clínico en caso de extravasación del riego. La extrusión del hipoclorito más allá del agujero apical conduce a la destrucción del tejido y la necrosis. Sin embargo, son pocos los estudios con recomendaciones después de accidentes por extravasación de NaClO en la clínica endodôntica. En casos de accidentes, se debe aspirar la sustancia y lavar el área con solución salina estéril. No existe un protocolo único para la intervención, se debe evaluar el alcance y la gravedad del accidente. La prioridad es el alivio del dolor, el control del edema y la prevención de infecciones secundarias. El profesional debe atentar a la posibilidad diaria de accidentes y adoptar medidas preventivas.

A doenca coronariana tem grande impacto na saude global, potencial morbidade e mortalidade, e assim como a doenca periodontal apresenta alta prevalencia. Alem disso, as duas condicoes compartilham fatores de risco comuns, como tabagismo, diabetes melitus e idade. O objetivo deste estudo foi avaliar a associacao entre doenca periodontal, aterosclerose e espessura da intima-media da carotida . Trata-se de um estudo observacional transversal realizado no Hospital de Urgencia da Universidade de Pernambuco (PROCAPE) com amostra de 92 pacientes com idade entre 19 e 82 anos. Foi realizada anamnese e avaliacao periodontal atraves do indice de placa, indice de sangramento, profundidade de sondagem, recessao gengival. A espessura da intima-media da arteria carotida foi obtida por ultrassom. A prevalencia de indice de periodontite foi de 74,2% e 11,8% de gengivite. Na analise bivariada houve correlacao estatisticamente significativa entre doenca periodontal e a presenca de placa de ateroma, mas essa relacao nao se manteve na analise multivariada. A presenca de placas de ateroma foi maior em pacientes com doenca periodontal moderada a grave. Houve correlacao estatisticamente significativa entre a presenca de doenca periodontal e a presenca de placas de ateroma, bem como, aumento da espessura medio-intimal carotidea. No entanto, essa associacao nao foi verificada nas analises multivariadas.

Objective To describe oral alterations in children with congenital Zika syndrome (CZS). Methods This was a case series, whose research instrument was a structured questionnaire, associated with the use of medical record data and extra and intraoral clinical examination. Results Thirty-two children were evaluated, the majority male (18/32%-56.3%), mean age 22 months (SD = 2.71). It was also observed that the majority of the patients (19/32%-59.4%) presented a low family income. All the children had a mean head circumference of 29.43 cm (SD = 1.42). Regarding the alterations, an ogival-shaped palate was observed in 14 children (43.7%), and delayed chronology of eruption was observed in 15 children (46.9%), of whom 7 children (21.9%) did not present eruption of the upper left lateral incisor (p = .0002) and upper right lateral incisor (p = .002) until the moment of analysis. Additionally, 03 children with yellowish dental pigmentation were identified in erupted teeth after the onset of phenobarbital use. Enamel hypoplasia was identified in 9 children (28.1%) and only one child with ankyloglossia. Conclusion CZS may present delayed chronology of eruption, ankyloglossia, ogival-shaped palate, and enamel hypoplasia, requiring dental follow-up aimed at prevention, promotion, and rehabilitation of the health of these children.

Introduction There have been concerns that longstanding oral dryness secondary to Sjogren's syndrome may increase the risk of failure of dental implants. Aims The aim of the present study was to determine the level of methodological quality of systematic reviews that evaluated the effectiveness of dental implants in patients diagnosed with Sjogren's syndrome. Methods and results Databases of PubMed/Medline, LILACS, Science Direct and Dare Cochrane to October 2020 were evaluated. A total of 833 articles were initially identified but following use of appropriate inclusion and exclusion criteria 4 papers were identified for detailed analysis. An eventual study sample comprised 722 implants placed in 189 patients with a 95.22% success rate, the minimum follow-up time was 45.2 ± 23.8 months and the maximum 125.5 months. The studies were assessed for their methodological quality by the AMSTAR 2 tool, in which 3 had critically low quality and one low quality. Conclusion Oral rehabilitation with dental implants in patients with Sjogren's syndrome seems to have a high success rate; however, the low quality of relevant reports highlights the need for primary and secondary studies with better methodological design in order to reduce bias and provide reassurance for this treatment option.

TNF-α is a member of the vast cytokine family being considered a proinflammatory substance produced many by macrophages and other cells belonging to the innate immunity, many of them classified as indeed Antigen Presenting Cells (APCs) involved in the complex chemotactic process of activation of the adaptive immunity. The aim of this work was to accomplish a literature review concerning the main pathologies that have TNF-α as a modulating agent in other to bring light to the main interactions present in the inflammation installed.

Objective: To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods: A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson’s Chi-square test and Fisher’s exact test) were performed, with a 5% significance level. Results: The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion: There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice.

The objective of this umbrella review was to determine the effectiveness of rhBMP-2 in the reconstructive surgery of cleft patients through an evaluation of bone filling and volume of newly formed bone in the cleft area. A systematic search was carried out in PubMed/ Medline, Scopus, Cochrane Database of Abstracts of Reviews of Effects (DARE), Latin American and Caribbean Health Sciences Literature (LILACS), and the System for Information on Grey Literature in Europe (SIGLE) via Open Grey, until June 2020. Risk of bias was assessed using the ROBIS tool. A total of 2739 articles were identified and, based on the inclusion and exclusion criteria, six were included for final evaluation. The bone filling rate was 74.23% in the rhBMP-2 group and 72.38% in the autogenous group. Regarding the risk of bias, none of the articles had a low risk, four had an uncertain risk, and two a high risk. The results of this umbrella review show that the studies had high and uncertain risks of bias, and high heterogeneity. There was a lack of evidence regarding the possible complications offered by this therapy. The recommendation to use BMP-2 for alveolar cleft reconstruction, especially in a paediatric population, should be viewed with caution. New primary studies are needed to assess this variable and safely determine the use of rhBMP-2 in reconstructive surgery for cleft patients.

Coronaviridae is a family of single‐stranded positive enveloped RNA viruses. This article aimed to review the history of these viruses in the last 60 years since their discovery to understand what lessons can be learned from the past. A review of the PubMed database was carried out, describing taxonomy, classification, virology, genetic recombination, host adaptation, and main symptoms related to each type of virus. SARS‐CoV‐2 is responsible for the ongoing global pandemic, SARS‐CoV and MERS‐CoV were responsible for causing severe respiratory illness and regional epidemics in the past while the four other strains of CoVs (229‐E OC43, NL63, and HKU1) circulate worldwide and normally only cause mild upper respiratory tract infections. Given the enormous diversity of coronavirus viruses in wildlife and their continuous evolution and adaptation to humans, future outbreaks would undoubtedly occur. Restricting or banning all trade in wild animals in wet markets would be a necessary measure to reduce future zoonotic infections.

Este estudo tem como objetivo estudar as lesoes dentais nos laudos de lesao corporal do Nucleo de Medicina e Odontologia Legal do Instituto de Policia Cientifica na cidade de Joao Pessoa-PB. Trata-se de uma pesquisa documental e descritiva com abordagem quantitativa que utilizou dados secundarios da Instituicao responsavel pelos laudos traumatologicos de vitimas com lesoes dentais. A amostra foi composta por 185 laudos nos anos de 2012 a 2014. Os resultados revelaram maior frequencia do sexo masculino e a faixa etaria entre 18 e 27 anos. A violencia em acidentes terrestres foi o agente etiologico mais frequente (47%). A maioria das vitimas teve perdas de incisivos (84,3%). A avaliacao do dano de acordo com o Art.129 do Codigo Penal Brasileiro mostrou que 44,9% dos casos analisados foram considerados com debilidade permanente, apenas 0,5% dos casos tinham incapacidade para as ocupacoes habituais por mais de 30 dias e 40,5% causaram deformidade as vitimas periciadas. Conclui-se que nos laudos de lesoes dentais do NUMOL – PB existem distorcoes entre o que foi encontrado no exame fisico e nas respostas aos quesitos, o que pode remeter a uma formacao tecnica deficitaria ou falta de calibracao entre os peritos que avaliam as lesoes dentais.

Odontogenic infections are commonly found in the oral and maxillofacial region, therefore, the correct management of this condition becomes an essential condition for maxillofacial surgeons. This study aims to point out complex infections arising from odontogenic sources, analyzing the concept, diagnosis and form of appropriate treatment in order to contribute to a better evolution of the clinical picture. A literature review was carried out through the crossing of selected descriptors in electronic search between the years 2006 and 2021, found in the journals of the SCIELO, LILACS and MEDLINE databases. Among the complex infections of odontogenic origin, one can mention Ludwig's Angina, Septic Cavernous Sinus Thrombrosis, Necrotizing Descending Mediastinitis, Odontogenic Sinusitis, Cerebral Abscess and Necrotizing Fasciitis. Although they are all complications in the face of infection and similar symptoms, each one has peculiar characteristics where it is possible to differentiate between them. The approach adopted in the face of these infections is a primordial factor for the success of the treatment. Conclusion: Knowledge of anatomical areas as well as professional training in prevention, diagnosis and, above all, in clinical resolution, is essential to alleviate the severity of these infections.

Os casos de fratura do complexo zigomático orbitário têm altos índices, logo, é necessário o conhecimento de seus sinais e sintomas, pois possibilita um diagnóstico precoce e um melhor prognóstico. Este trabalho é um relato de um caso clínico de fratura do complexo zigomático orbitário, onde foram descritos os sinais e sintomas clínicos observando disfunções estéticas e funcionais a fim de fornecer um melhor diagnóstico e planejamento cirúrgico e de avaliar as técnicas empregadas, mostrando a importância do cirurgião bucomaxilofacial no tratamento desses tipos de fraturas. Paciente do sexo masculino procurou o serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial, vítima de acidente automobilístico. No exame físico foram identificados: ptose palpebral, equimose periorbitária, hiposfagma, diplopia e oftalmoplegia no olho direito, enoftalmia, perda de projeção ântero-posterior do zigomático, edema difuso em terço médio de face, alargamento de terço médio de face e limitação de abertura bucal. Foi solicitado o exame tomográfico o qual confirmou as fraturas no complexo zigomático e a presença de solução de continuidade compatível com fratura blow-out, seguindo para procedimento cirúrgico. Paciente foi submetido a 3 acessos cirúrgicos, 3 pontos de fixação interna (com placas e parafusos do sistema de fixação de 1,5mm, 2,0mm) e colocação de tela orbitária para reconstrução do assoalho de órbita. Obteve-se sucesso no tratamento, mostrando que o procedimento cirúrgico é seguro e eficaz, resultando em ganho estético e funcional.

Introdução: A malformação de Chiari trata-se da herniação do tecido cerebelar através do forame magno, podendo levar a uma série de sinais e sintomas que podem afetar qualitativamente a vida do portador dessa síndrome. Por apresentar muitos sintomas, estes podem direcionar ao diagnóstico e tratamento incorreto se não houver o conhecimento adequado. Objetivo: este estudo tem o objetivo de correlacionar os achados clínicos orofaciais em pacientes que apresentam a malformação de Chiari e seu diagnóstico diferencial com DTM. Metodologia: Realizou-se uma revisão literária através do cruzamento dos descritores selecionados em busca eletrônica, encontrados nos periódicos das bases de dados SCIELO, LILACS, SCOPUS e MEDLINE. Discussão: A Malformação de Chiari apresenta um grupo de malformações congênitas que afetam diretamente a qualidade de vida dos pacientes. Esta condição pode estar associada à neuralgia trigeminal, porém seu mecanismo exato ainda não é claramente compreendido. A ressonância magnética é o exame de imagem padrão ouro para o diagnóstico desta condição e, a escolha pela terapia ideal, tanto o manejo clínico quanto o cirúrgico, deve ser corretamente indicado em pacientes sintomáticos, pela chance, embora rara, da possível diminuição espontânea ou resolução completa da herniação tonsilar. Conclusão: As manifestações clínicas da Malformação de Chiari são variáveis, podendo apresentar semelhanças e até mesmo serem confundidas com outras condições do sistema estomatognático como a DTM. Dessa forma, é importante o conhecimento acerca das suas manifestações clínicas, para que possa ser corretamente diagnosticada e melhor tratada.

Xeroderma pigmentosum is a disorder in the repair of DNA of the skin characterized by the occurrence of pigmented freckles and skin cancer in areas exposed to the sun. A 13-year-old boy from Agrestina, Brazil, had xeroderma pigmentosum for 7 years. The lesions of the face were treated with surgery. The last of these was also treated with radiotherapy (20 sessions). Early in 2011, he underwent removal of a basal cell carcinoma (BCC) concomitantly with radiation therapy, and the condition progressed with aggressive tumor growth. Chemotherapy (docetaxel [Taxotere (Sanofi-Aventis)] and cisplatin) was then associated. Chemotherapy was fractionated in 3 cycles with tumor cytoreduction. The tumor was removed. Histopathologic examination revealed a well-differentiated squamous cell keratinizing, ulcerated with base and free margin. In 2017, he presented a new lower eyelid injury, which made rehabilitation impossible because of the risk of osteoradionecrosis and bone limitation.

Introduction Systemic sclerosis (SS) is a systemic autoimmune disease characterized by microvascular and macrovascular lesions and fibrotic changes and frequently affects the mouth. Objective To evaluate the oral patterns of systemic sclerosis. Methods A descriptive case series with consecutives patients from November 2015 to October 2016. Systemic features and orofacial parameters were evaluated according to disease type. Results The sample consisted of 50 individuals with SS and 43 controls. A high frequency of orofacial alterations was observed, with orofacial telangiectasia (42/50, 84%), microstomia (35/50, 70%), and oral candidosis (31/50, 62%) being the most frequent findings. Gingival bleeding index was higher in controls (21.57 ± 15.66) than in SS (7.05 ± 7.25) (P Conclusions The pattern of periodontal manifestation is unique and characterized by few gingival bleeding and severe periodontitis.

Objective Evaluate the presence and viral load of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) through the real-time polymerase chain reaction (PCR) technique. Study design Epidemiologic and observational study, with the presence of 2 groups: hemodialysis and control (healthy as chronic kidney disease). All patients responded to a clinical file and submitted to a clinical examination of the oral cavity to evaluate the presence of oral lesions compatible with the presence of the virus studied. Subsequently, 3 mL of blood were collected, from which the DNA was extracted and the viral load of CMV and EBV was obtained. Results In the hemodialysis group, 10 patients (18.51%) were positive for this virus, with a mean viral load of 196.4 copies/mL. In the control group, 8 (14.54%) were positive, with a mean viral load of 34.7 copies/mL, with no significant difference. Regarding CMV, the control group did not present any patients with detectable viral load, while in the hemodialysis group 29 patients were positive, with a mean viral load of 265,282.8 copies/mL. No patient had systemic or oral manifestations characteristic of viral diseases. Conclusions Relative immunosuppression due to hemodialysis was not significant to the point of initiating oral and systemic alterations.

The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws. Twenty-five patients diagnosed with osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily (tid) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of osteoradionecrosis of the jaws. Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months. Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.

Polymorphisms in the structural gene MBL-2 (mannose-binding lectin-2) may result in low MBL serum concentration, associated with greater susceptibility to infection. The study evaluated the effects of MBL-2 polymorphisms with the oral manifestations of the HSV in human immunodeficiency virus (HIV)-infected patients. An observational case-control study was carried out, with the sample comprising 64 HIV+ and 65 healthy individuals. The signs and symptoms of HSV oral infection were evaluated, and oral mucosa buccal smears were collected. Polymorphisms of the MBL-2 gene and HSV-1 DNA were amplified through real-time PCR. The data revealed that of 64 HIV+, 29.6% presented signs and symptoms of HSV oral infection. Of these, the HSV-1 DNA was detected through real-time PCR in 21% of cases, and in 13.3% of asymptomatic individuals. There was no statistically significant difference between the symptomatic (p = 1) and the asymptomatic (p = 0.52) individuals, HIV+ and HIV−. Different genotypes (AA, A0, or 00) did not contribute to the oral manifestation of HSV in the HIV+ patients (p = 0.81) or HIV− (p = 0.45). There was no statistically significant difference in either group (p = 0.52). No significant association was identified between the MBL-2 gene polymorphisms in the oral manifestation of HSV infection. However, further studies are recommended with larger population groups before discarding this interrelationship.

Objective: The aim of this study was to evaluate the orofacial parameters of systemic sclerosis (SSc) and its related systemic features. / Subjects and Methods: A descriptive case–control study was performed from November 2015 to October 2016. Ninety‐three individuals were included and divided into SSc group (n = 50) and healthy controls (C, n = 43). / Results: Systemic sclerosis individuals were mostly women (43/50, 86%), with a mean age of 46 years (±11.6 years). Telangiectasia (42/50, 84%) and reduced mouth opening (35/50, 70%) were the most frequent orofacial findings. The periodontitis frequency was much higher in SSc individuals than in healthy controls (90.7% × 48.83%; p < .001). In addition, SSc individuals presented a distinctive pattern of periodontitis, with low probing pocket depth (2 ± 0.65 mm × 2 ± 0.24; p < .001), higher gingival recession (4 ± 2.13 × 0.14 ± 0,22; p < .001), higher periodontal attachment loss (6 ± 1.34 mm × 2 ± 0.43, p < .001), and lower gingival bleeding index values (7.05 ± 7.25 × 21.57 ± 15.66; p < .001). / Conclusions: Orofacial manifestations were common in SSc and included a unique pattern of periodontal manifestation, characterized by lower gingival bleeding index, higher periodontal attachment loss, and low probing depth.

Background The aim of the present work was to evaluate the impact of xerostomia on the quality of life of patients who underwent radiotherapy in the head and neck region. Material and Methods This was a cross-sectional, quantitative study. The sample comprised 40 patients whose xerostomia was classified through the xerostomia inventory and the quality of life evaluated through the oral health impact profile questionnaire (OHIP). Results The majority of participants were male (75%), mean age 58.7 years. According to the degree of severity of the xerostomia, the average score among the participants was 36 points, this being considered moderate xerostomia. A significant impact was observed, with the median score 11 points, with the highest scores in the domains related to functional limitation, physical pain and physical disability. The majority of the participants (97.5%) had reduced salivary flow after the end of radiotherapy. There was a significant positive correlation between the degree of xerostomia and reduced quality of life, Pearson correlation 0.5421, (p< 0.05). Conclusions Based upon the results it is concluded that xerostomia has a negative impact on the quality of life of patients who undergo radiotherapy in the head and neck region. Key words:Head and neck neoplasms, radiotherapy, xerostomia, quality of life.

A 26-year-old male meloderm patient complained of painful lowering of the lower lip 5 years ago. His medical history was not relevant. He reported a habit of onychophagy in addition to a history of trauma in the lesion region. At the intraoral physical examination, there was a nodular volume increase of firm consistency at palpation extending from the lower lip to the right jugal mucosa, with a larger diameter of 5 cm, painless and not bleeding. Aspiration puncture was performed with observation of viscous liquid of a brownish color. Next, an excisional biopsy was performed, and histologic slices stained in hematoxylin and eosin showed a cystic cavity covered by keratinized squamous epithelium associated with the foreign body reaction. Based on the histologic findings, a diagnosis of epidermoid cyst was instituted. The patient is undergoing observation without signs of relapse.

The purpose : To characterize the clinical and genetic profile of periodontal disease in patients with chronic renal disease. Methodology: This is an observational epidemiologic study. The patients were divided into 2 groups: the study group (undergoing hemodialysis) and control group (healthy). The patients were subjected to anamnesis, periodontal clinical examination, and blood collection of 5 mL. The DNA was extracted from whole blood using the Wizard Genomic DNA Purification Extraction Kit (Promega Bio Sciences) according to the manufacturer’s recommendations. The final product was evaluated in NanoDrop-2000 to verify the quality of the extracted DNA. Finally, a real-time polymerase chain reaction (PCR) was performed to evaluate the polymorphisms studied. Results: Data were tabulated and analyzed statistically. As a result, 84 patients participated in the study, of which 43 (51.2%) were patients on hemodialysis and 41 (48.8%) were in the control group. A total of 54.8% were female, and 75% had periodontal disease, of which 55.6% were severe and 60.3% were generalized. In relation to the interleukin 6 (IL-6) gene, the most frequent genotype was GG (58.3%). Conclusion: It was evident that the presence of the G allele had a greater relation with the severe degree in the 2 groups. However, when the 2 groups were compared, the variables analyzed did not present statistically differences.

Objective: Address the Population/patients problem; I: intervention; C: control/comparison; O: outcome (PICOS) issue: Is there evidence for indicating the use of cryotherapy and heat therapy after surgical extraction of impacted third molars? Additionally, scientific evidence for the development of therapeutic protocols was found. Design Study: Searches using the Ovid MEDLINE, SCOPUS (Elsevier), PubMed, Cochrane Library, Lilacs, and Livivo databases were performed, from January 1, 1990 to December 31, 2018, complemented by Open Grey platform and manual searches using references from related articles and journals. Studies of the anti-inflammatory benefits of postoperative cryotherapy and heat therapy (pertaining to the extraction of impacted third molars) were included; the searches were performed independently by 2 reviewers. Meta-analysis were analyzed via the Review Manager. Results: From 271 citations, 11 articles were selected for evaluation. Ten addressed the effects of cryotherapy, with only 1 referencing heat therapy. Of these, 5 essays were adequate for meta-analysis, all regarding cryotherapy. The difference between the groups with the use of ice and those without the use of ice was statistically significant for pain on the days assessed (P

The parents of a 4-year-old boy reported a lesion in his mouth with approximately 4-month evolution. Extraoral physical examination revealed left facial asymmetry. Intraoral examination showed expansive ulcerated lesion on the ipsilateral hard palate, rigid to palpation and painless. Computed tomography evidenced solid expansive formation, infiltrative not limited, invading the maxillary sinus and the nasal fossa with bone erosion. Incisional biopsy was performed, and histologic slices in hematoxylin and eosin showed mucosa with areas of ulceration and formation of granulation tissue, proliferation of spindle cells with eosinophilic cytoplasm, and vesicular nuclei in the collagenized stroma medium with extravasation of red blood cells and typical mitotic figures. Immunohistochemical analysis revealed muscle actin expression in myofibroblastic pattern, leading to the diagnosis of myofibroma. The patient underwent maxillectomy with immediate adaptation of the palatal obturator, made by 3-dimensional planning and is followed up with good adaptation of the prosthesis.

Aim: Evaluate influence of DMARDs (disease-modifying antirheumatic drugs [synthetic and biological]) on periodontal pattern and on salivary cytokines levels. Methods: One hundred twenty women (aged 18 years and older) diagnosed with rheumatoid arthritis (RA) were evaluated and analyzed according to treatment regimen in use (synthetic DMARD and biological DMARD; 60 women in each group). Patients underwent periodontal assessment and had their resting salivary flow measured. Saliva samples were obtained to measure interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17; tumor necrosis factor-alpha (TNFα); and interferon-gamma (IFNγ) cytokine levels. Results: The use of DMARDs was associated with frequency of periodontitis (P = .028). Patients using glucocorticoids had a higher frequency of periodontitis (80.22% vs 19.78%; P ≤ .001). Salivary levels of cytokines were similar between the 2 groups; however, patients treated with biological DMARDs had lower rates of salivary flow (P = .001). Conclusion: Patients using synthetic DMARDs had a higher frequency of periodontitis. However, the use of glucocorticoids in women with RA increases the frequency of periodontitis more importantly than DMARD therapy. We did not observe differences in relation to the periodontal parameters and in the expression of the salivary cytokines.

Objective: Evaluate the association between periodontal disease, atherosclerosis, and carotid artery intima-media thickness. Study design: Cross-sectional observational study, which was performed through patient anamnesis and periodontal evaluation through plaque index, bleeding index, probing depth, and gingival recession. Thickness of carotid artery intima-media (cIMT) was obtained by ultrasonography. Results: The sample consisted of 92 patients aged 19 to 82 years. The prevalence of periodontal disease index was 74.2%, and the prevalence of gingivitis was 11.8%. The bivariate analysis showed a statistically significant correlation between periodontal disease and the presence of atheromatous plaque, but this relationship was not maintained in the multivariate analysis. The presence of atheromatous plaques was higher in patients with moderate to severe periodontal disease. Conclusions: Unlike some recent studies, there was a statistically significant correlation between periodontal disease and the presence of atheromatous plaque and increase in cIMT, but this relationship was not maintained in the multivariate analysis. The probing depth was significantly associated with a thickness of the intima-media greater than 1 mm and when depth was greater than 3 mm increased by 11 times the chance of having a cIMT> 1 mm.

Objective: To identify the presence of high-risk serotypes (subtypes 16 and 18) of human papillomavirus (HPV) in the saliva of patients with human immunodeficiency virus (HIV). Study Design: Observational cross-sectional study with a sample of 90 patients of both genders, between June and December 2014. An interview was conducted to identify the sociodemographic profile of the sample. A saliva collection was performed employing falcon tubes and solution for mouthwash with 5% sucrose, with subsequent freezer storage at –20°C. The identification of HPV virus and genotyping for serotype 16 and 18 was by standard polymerase chain reaction (PCR). Results: The predominant sample was male (65.6%), with a mean age of 38.8 years, ranging from 18 to 69 years, and a mean family income of 1.95 minimum wages (SD = 1.37). Specifically on the detection of HPV, 23 of 90 (25.6%) of the sample population evidenced the presence of the infection in the individuals surveyed. Serotypes 16 and 18 were present in 8 of 90 (8.9%) of the entire sample and 8 of 23 (4.7%) if only HPV-infected. Conclusion: HPV coinfection is commonly observed in patients with HIV.

Objective To compare trans- and postsurgical results of patients undergoing excision of lesions clinically compatible with oral mucoceles through 2 forms of treatment: Conventional surgery using scalpel and cryosurgery with liquid nitrogen. Study design A randomized clinical trial was performed with 17 patients with a clinical diagnosis of oral mucoceles. Patients were divided into 2 groups: 7 patients of group 1 underwent surgical excision and 10 patients of group 2 (G2) had lesions treated by cryosurgery. The parameters used in the comparison were: Need for anesthesia; intensity of transoperative bleeding; need for suture; postoperative pain, and need for analgesic administration. Results The variables transsurgical bleeding, need for anesthesia, and need for suturing are totally different procedures among the treatments, since patients of group 1 presents 100.0% of scarce bleeding, 100.0% needed anesthesia and 100, 0% needed suture while in group 2 all these percentage was zero. Conclusions Cryosurgery is an effective method for the treatment of oral mucoceles, and can offer considerable advantages because it is a simple and painless technique, in which sutures are unnecessary, as the bleeding is nonexistent.

Chikungunya (CHIK) fever is a tropical arbovirosis characterized by sudden fever, headache, rash, and severe arthralgia. The disease has been suggested to act as a trigger for several autoimmune disorders, especially rheumatoid arthritis. This abstract reports 2 cases of Sjogren syndrome (SS) following CHIK infection. Both patients were female and presented with fever, arthralgia, rash, and arthritis during CHIK outbreak in Recife, Brazil. After several months, they developed severe sicca symptoms and 1 of them presented with parotid enlargement. Clinical salivary gland biopsy and serologic examination rendered the diagnosis of SS for both patients. No systemic features of SS were noted. New evidence has pointed to the development of autoimmune inflammatory musculoskeletal diseases following CHIK fever, such as rheumatoid arthritis, spondylitis, and systemic lupus as a sequel of the infection. Nevertheless, SS has rarely been associated with CHIK and this association should be better evaluated.

Venlafaxine hydrochloride is a structurally novel antidepressant that inhibits reuptake of 5-hydroxytryptamine and noradrenaline but, unlike the older antidepressants, has few adverse effects. A 57-year-old female patient, a smoker with anxiety, on psychiatric treatment with venlafaxine hydrochloride attended our oral medicine unit complaining of a white spot on the right cheek with 1 year since the onset, which did not regress after the use of nystatin and triamcinolone acetonide. The intraoral clinical examination revealed the presence of white striae and leucoplastic plaque on the buccal mucosa and on the right lateral border of the tongue with no symptoms. The following complementary examinations were performed: full blood cell count, coagulogram, fasting blood glucose, and incisional biopsy, with a diagnostic hypothesis of lichenoid reaction and differential diagnosis of lichen planus. Histopathologic findings revealed a chronic lymphocytic inflammatory reaction characteristic of the lichenoid reaction.

Objective To study the relation between the dosimetric parameters of the radiotherapy design protocols for head and neck cancers and the acute oral complications resulting from this treatment. Study Design This was a cross-sectional, quantitative approach. Radiotherapy was planned according to established design protocols. The constraints used were those described in QUANTEC (Quantitative Analyses of Normal Tissue Effects in the Clinic) and the complications were classified based on the CTCAE (National Cancer Institute's Common Criteria Chart of Toxicity). Results Eleven patients participated, most of them male (89%), with a mean age of 60.2 years. The most frequent tumor site was oropharynx (55%) and the degree of staging IV (64%). Among the participants, 73% were smokers and 82% had a habit of drinking alcohol. The most frequent oral complications were dysphagia (91%), xerostomia (82%), mucositis (54%), and oral pain (54%). For the complications dysphagia, xerostomia, and mucositis, relations were found between the dosimetric data and the development of these; for oral pain, the difference between the groups was not significant. Conclusions Dosimetric data are directly related to the development of certain oral complications resulting from radiotherapy treatment for malignant head and neck neoplasms.

Objective To describe oral alterations in children with Zika congenital syndrome (ZCS). Study Design A cross-sectional study, whose research instrument was a structured questionnaire, associated with the use of medical record data and extra and intraoral clinical examination. Results Thirty-two children were evaluated, the majority male (18/32, 56.3%) with a mean age in months ± SD of 22 ± 2.71. It was also observed that the majority of the patients (19/32, 59.4%) presented from low-income families. All the children had intracranial calcifications and a mean head circumference ± SD of 29.43 ± 1.42. As for functional difficulties, 12 children (37.5%) were unable to breast-feed and 24 (75%) had dysphagia. An ogival-shaped palate was observed in 14 children (43.7%) and their correlation with dysphagia was also not statistically significant (P = .09). Regarding the oral alterations, delayed chronology of eruption was observed in 15 children (46.9%), of whom 7 children (21.9%) did not present eruption of the upper left lateral incisor (P = .0002) and right (P = .002) until the moment of analysis. Enamel hypoplasia was identified in 9 children (28.1%) and only 1 child with ankyloglossia. Conclusions ZCS may present with oral alterations requiring dental follow-up care aimed at prevention, promotion, and rehabilitation of the health of these children.

Objective To evaluate the efficacy of the oral medium adequacy protocol in patients with cancer subjected to antineoplastic treatment. Study Design A cohort was performed. The sample consisted of 100 adult patients, 72 patients undergoing head and neck radiotherapy, 3 receiving bisphosphonate, and 69 receiving 5-fluoruracil, cyclophosphamide, taxol, and metrotrexate. The protocol established for the adaptation of the oral medium included: dental scaling and polishing, tooth extraction, and composite resin restorations. In addition to mouthwashes with chlorhexidine 0.12% without alcohol (12 in 12 hours); dexpanthenol ointment for lip hydration (2/2 per hr), mouthwashes with iced chamomile tea (2 in 2 hours), carboxymethylcellulose 2% artificial saliva (6 every 6 hours) for patients with xerostomia, and 20-second and 2-J low intensity laser therapy, toothed patients were also prescribed 0.05% sodium fluoride for mouthwashes every 24 hours. Results Of the treated patients 2 developed grade I mucositis, 23 developed grade II mucositis, and 69 did not present mucositis. We did not observe the need to enter parenteral nutrition nor to interrupt the antineoplastic treatment in any of the patients. Conclusions The oral medium adequacy protocol was effective in preventing grade III and IV mucositis and discontinuation of antineoplastic treatment.

Introduction Delayed bone repair postdental extraction in patients who underwent head and neck radiation is a clinical challenge, and an adequate management is necessary to prevent osteoradionecrosis. Objective To evaluate the effect of photobiomodulation (PBM) in the alveolar mucosal healing of patients submitted to simple dental extraction after 3+ months of head and neck radiation therapy. Study Design Forty surgical procedures were performed into 2 groups: G1 dental extraction + PBM and G2 dental extraction + sham-PBM. Both groups received antibiotic therapy and closed surgical alveoli under first intention. The primary outcome was complete mucosal coverage at 14 days, with secondary outcomes being infection, postoperative pain, and analgesic use at 7 days. Results G1 presented a mucosal lining in a shorter time, where 94.7% presented complete mucosal lining (P Conclusions The use of PBM has been shown to promote mucosal lining of the surgical alveolus in less time and with less postoperative pain.

Objective To verify the association between serum interleukin 6 (IL-6) levels and IL-6 genetic polymorphisms in patients with rheumatoid arthritis (RA), as well as its association with disease activity and exocrine gland function. Methods. The study included 295 women, 173 had a diagnosis of RA and 122 were healthy. Clinical data and blood samples were collected. Serum IL-6 levels were measured by flow cytometry, and IL-6 genotypes were performed by real-time polymerase chain reaction (PCR) using TaqMan SNP genotyping assay. Results Patients in the RA group had higher levels of IL-6 (P Conclusions The presence of the C allele of IL-6 rs1800796 plays an important role in the pathogenesis of RA and, if confirmed in other populations, may be used as a genetic marker of the disease.