Adriana de Oliveira Lira Ortega

Frequency of temporomandibular disorder signs in individuals with cerebral palsy.

This study aimed to determine the frequency of temporomandibular disorder (TMD) signs in 68 individuals with cerebral palsy, aged between 3 and 23 years. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint sounds, lateral jaw deviation during opening and closing movements and limitation of maximum mouth opening (>40 mm). The frequency of TMD signs observed in the cerebral palsy group (46/68-67.6%) was higher than in the control group (17/68-25%). The clinical scenario of CP seems to make these individuals more prone to the development of TMD signs.

Oral motor performance in spastic cerebral palsy individuals: are hydration and nutritional status associated?

BACKGROUND Previous studies reported alterations in salivary parameters in cerebral palsy (CP) individuals; however, none of these considered oral motor performance as possibly responsible for these conditions. The aim of this study was to investigate the influence of oral motor performance on the nutritional status and salivary parameters in individuals with CP. METHODS Forty-three individuals aged 11-19 years-old, with spastic CP were included in this study. Oral motor performance was evaluated using the Oral Motor Assessment Scale, which classified the individuals into two groups: subfunctional or functional. Unstimulated saliva was collected and the flow rate was calculated (ml/min). Salivary osmolality was measured using a freezing point depression osmometer. Blood samples were collected to evaluate complete blood count, total protein, albumin/globulin ratio and transferrin levels. RESULTS The subfunctional (n = 21) and the functional group (n = 22) did not differ regarding sex (P = 0.193), however the functional group was older (P = 0.023) and had a higher mean BMI (P < 0.001). The subfunctional CP group presented a reduction in salivary flow rate (36.4%) (P < 0.01) and an increase in salivary osmolality (35.5%) (P < 0.001) compared to the functional group. Slightly lower values for red blood cells (millions/mm(3) ) (P < 0.001), hemoglobin (g/dl) (P < 0.009), hematocrit (%) (P = 0.001), number of platelets (N/mm(3) ), total protein (g/dl) and albumin/globulin ratio (P = 0.003 and P = 0.036, respectively) were determined for the subfunctional group, but within the normal range of normality. CONCLUSION Cerebral palsy individuals appear to present impaired adequate hydration due to compromised oral motor performance.

Focal dermal hypoplasia: a case report and literature review

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

Salivary parameters and oral health in the Moebius syndrome.

PURPOSE To evaluate salivary characteristics, such as flow rate, buffering capacity and amylase activity, and associate these parameters with oral health in individuals with Moebius syndrome (MS) and controls. METHODS The researchers assessed caries (ICDAS), periodontal disease (PSR), and plaque (Silness Löe) indexes in both groups. Unstimulated, stimulated, and bilateral parotid saliva were also collected. The salivary flow (milliliters/minute) and α-amylase activity were measured in all samples. The α-amylase activity was determined by maltose production. The buffering capacity was measured in stimulated saliva by titration of 0.01N HCl. RESULTS The occurrence of carious lesions, related to cut-off 2, as well as the occurrence of periodontal disease, was significantly higher (p > 0.05) in participants with MS when compared to the control group. Also, MS individuals presented decreased salivary flow, decreased buffering capacity, and amylase activity. CONCLUSIONS MS individuals present salivary alterations, which can be related to higher risk for caries.

Chediak-Higashi Syndrome and Premature Exfoliation of Primary Teeth

The Chediak-Higashi syndrome (CHS) is a rare hereditary fatal disease, if not treated. These changes are associated with various diseases and syndromes that mainly cause periodontal disease and thus the premature loss of teeth. This paper describes the monitoring of premature loss of primary teeth that began when the child was 5 years old. On presentation his teeth were mobile and there was a history of gingival bleeding. Panoramic radiography revealed generalized and severe bone loss, and the teeth showed no bony support enough for their stability. Blood test was ordered to assess the overall health of the child and giant cells with cytoplasmic granules were found, confirming the diagnosis of CHS. The management of periodontal disease focused on the control of infection and bacterial plaque by mechanical and chemical methods.

Anatomic and dynamic aspects of stomatognathic structures in osteogenesis imperfecta: a case report.

Abstract The osteogenesis imperfecta congenita (OMIM 166210) type II phenotype can be caused by mutation in either the COL1A1 gene or the COL1A2 gene that encode the chains of type I procollagen, the major protein in bones. Patients can therefore present a combination of features, including multiple long bone fractures and deformities, growth deficiency, joint laxity, hearing loss, blue sclera, and dentinogenesis imperfecta. The purpose of this study is to describe a clinical case of this syndrome, focusing on the anatomy of the temporomandibular joint (TMJ) that was assessed using computed tomography (CT) method. Clinical examination included evaluation of mandibular dynamics and investigation of temporomandibular dysfunction (TMD).

Sialometric analysis in young patients with chronic renal insufficiency

The present study aimed to evaluate whether or not quantitative changes occur in the salivary flow of patients with chronic renal insufficiency (CRI) who have been submitted to Hemodialysis. Twenty-nine chronic renal patients, between 4 and 25 years of age, submitted to Hemodialysis at Hospital Pequeno Príncipe in Curitiba, Paraná, Brazil participated in this study. The results form this study were compared with those of a group consisting of 29 healthy patients, paired by sex and age, whose parents sought out dental treatment at local health clinic in Campo Magro, Paraná. For Sialometric evaluations, samples were collected at the beginning, during and at the end of Hemodialysis, as well as after the analyses had been performed. Salivary flow was calculated by the Banderas-Tarabay formula (1997). The results revealed that the mean salivary flow values presented no difference between the groups. It could therefore be concluded that CRI did not determine quantitative alterations in salivary fluid.

Association between anticonvulsant drugs and teeth-grinding in children and adolescents with cerebral palsy

The relation between teeth-grinding and the use of drugs acting on the central nervous system of cerebral palsy (CP) patients has not yet been described. The aim of this research was to evaluate the presence or absence of teeth-grinding (sleep and/or awake periods) in normal and in CP children and adolescents, as well as the association of teeth-grinding and use of anticonvulsant drugs. The sample consisted of 207 children and adolescents, divided into three groups: G1, individuals with CP who did not take anticonvulsant drugs; G2, individuals with CP administered medications on a regular basis; and CG, normal individuals. Logistic regression analyses were performed to evaluate the association of teeth-grinding with some variables. No significant statistical differences were observed regarding the presence or absence of teeth-grinding when G1 and G2 were compared. However, compared with the CG, a statistically significant difference was determined, with the CG showing fewer children presenting teeth-grinding (P < 0·001). Among those children/adolescents prescribed drug therapy, the barbiturate group showed a greater frequency of teeth-grinding. CP children and adolescents show a greater and significant presence of grinding of the teeth compared with normal individuals. Subjects taking barbiturate drugs showed greater presence of teeth-grinding, than those who were taking medications from the other groups of anticonvulsant drugs.

Radiological findings and dynamic aspects of stomatognathic structures in Treacher Collins syndrome: clinical case report.

Treacher Collins syndrome usually affects bilateral and symmetric structures that include the orbits, mandible, and ears. The purpose of this report is to describe a clinical case of the syndrome, focusing on the anatomy of the temporomandibular joint, which was assessed using the computed tomography method. Clinical examination included evaluation of mandibular dynamics, investigation of temporomandibular dysfunction, and measurement of bite force. Significant morphological and functional alterations were observed but without significant documented clinical consequences.

Clinical evaluation of dental treatment needs in chronic renal insufficiency patients

OBJECTIVE To evaluate the need for dental treatment in chronic renal insufficiency (CRI) patients undergoing hemodialysis. DESIGN Transversal study and case control. SETTING CRI patients were examined at the Pequeno Príncipe Hospital in Curitiba, Brazil. The control group was examined at Nossa Senhora da Conceição Health Clinic in Campo Magro, Brazil. SUBJECTS (MATERIALS) AND METHODS Thirty-four CRI patients were undergoing hemodialysis. The control group consisted of 34 normoreactive individuals paired by gender and age. INTERVENTIONS The clinical examination was performed under an artificial light, using an oral mirror, an exploratory probe, a periodontal probe, and a tongue depressor. MAIN OUTCOME MEASURES This study adopted the methodology proposed by the World Health Organization (WHO). RESULTS The CRI patient group needs periodontal and orthodontic treatment. The control group needs restorative treatments, prostheses, as well as surgical and endodontic treatment. CONCLUSION The profile of dental treatment needs proved to be distinct among the studied groups.