Beatriz Helena Sottile França

Cirurgia ortognática: orientações legais aos ortodontistas e cirurgiões bucofaciais

AbstractThe authors created a highligths list with the day-by-day working, focusing the law and literature review suggesting some attitudes involved with orthognathic treatment cases. Data came from orthodontists and bucomaxilofacial surgeon experts interviews and literatureKey words: Orthognathic surgery. Liability. Legal orientations. Enviado em: Abril de 2004Revisado e aceito: Fevereiro de 2005 a Justica, pois no Direito ja se fala em cobranca de responsabilidade por falta de informacao ou in-formacao incompleta 49 . Portanto e recomendavel que o cirurgiao e o ortodontista discorram o mais detalhadamente possivel sobre os dados envolven-do casos orto-cirurgicos. 1. AGHABEIGI, B.; HIRANAKA, D.; KEITH, D. A.; KELLY, J. P. Effect of orthognathic surgery on the temporomandibular joint in pa-tients with anterior open bite. Int Adult Orthodon Orthognath Surg, Chicago, v. 16, no. 2, p. 153-160, 2001.2. AHMED, M. M. S. Long-term stability of anterior segmental maxillary osteotomy. Int J Adult Orthodon Orthognath Surg,Chicago, v. 14, no. 4, p. 297-303, 1999.3. ALONSO, N. et al. Midfacial advancement by bone distraction for treatment of craniofacial deformities. J Craniofac Surg,Boston, v. 9, no. 2, p. 114-118, 1998.4. ARAUJO, A. Cirurgia ortognatica. Sao Paulo: Ed. Santos, 1998.5. ARNETT, G. W.; MILAM, S. B.; GOTTESMAN, L. Progressive mandi-bular retrusion-idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop, St. Louis, v. 110, p. 8-15, 1996.6. ARNETT, G. W.; TAMBORELLO, J. A. Progressive class II develo-pment. Female idiopathic condylar resorption. J Oral Maxillo-fac Surg Clin, Philadelphia, p. 699-716, 1990.7. BERTOLINI, F. et al. Pre - and post surgical psycho-emotional as-pects of the orthognathic surgery patient. Int Adult Orthodon Orthognath Surg, Chicago, v. 15, p. 16-23, 2000.8. BRASIL. Codigo de defesa do consumidor. Sao Paulo: R. dos Tribunais, 1999.9. BRASIL. Novo Codigo Civil Brasileiro. Sao Paulo. R. dos Tribu-nais, 2002.10. BRASIL. Conselho Federal de Odontologia. Codigo de etica.Sao Paulo: R. dos tribunais, 2002.11. COCHRANE, S. M.; CUNNINGHAM, S. J.; HUNT, N. P. A com-parison of the perception of facial profile by the general public and 3 groups of clinicians. Int Adult Orthodon Orthognath Surg, Chicago, v. 14, no. 4, p. 291-295, 1990.

Responsabilidade civil do ortodontista

O objetivo da terapia ortodontica e a correcao de problemas dentarios e esqueleticos, visando resultados esteticos e funcionais estaveis. Tais objetivos, naturalmente, aumentam a expectativa do paciente quanto aos resultados e geram duvidas nos ortodontistas em diversas situacoes clinicas. Este trabalho teve como objetivo esclarecer as principais duvidas dos ortodontistas quanto a sua responsabilidade pelos casos tratados, seus direitos e deveres na relacao profissional/paciente e na prevencao de acoes judiciais. A comunicacao com o paciente e/ou responsavel, com a descricao do plano, riscos, beneficios e custos do tratamento, bem como a elaboracao, anuencia e guarda da documentacao ortodontica, sao fundamentais na prevencao de litigios judiciais. A conduta profissional deve ser embasada nos principios da etica e da moral.

Tratamento das ulcerações traumáticas bucais causadas por aparelhos ortodônticos

AbstractMouth ulcers are one of the most commom complaints in the dental clinic. They are, in general, caused for mecha-nic traumatism induced by non-fitted dentures, orthodontic appliances and fracturated crowns and fillings. Never-theless, those lesions that have persisted for more than three weeks should be submitted to biopsy or other exams to exclude neoplasic, infectious or immunologic lesions. During the orthodontic treatment, pain and soreness of the oral mucosa can occur as the result of mechanic traumatism caused by increased friction between soft tissues and brackets. Nowadays, the professional owns few resources to prevention or relieve this irritation on the oral mucosa. The aim of this article is to guide the orthodontist to realize the correct diagnoses of the mouth ulcers, the relieve the symptoms and the exact treatment for each type of case.Key words: Ulcer. Traumatism. Inflammation. Orthodontics. Anti-inflammatory. 1. ANDRADE, E. D. Terapeutica medicamentosa em Odontolo-gia

Eagle’s Syndrome: Treatment by Intraoral Bilateral Resection of the Ossified Stylohyoid Ligament. A review and Report of Two Cases

Abstract The complexities of Eagle’s syndrome are examined according to anatomical, historical, clinical, and treatment aspects. There appears to be little correlation between the extent, form, and size of the anomalies of the styloid process and the stylohyoid ligament and the predictability of patients with related symptoms. Surgical treatment and the advantages and disadvantages of each surgical approach (intra- and extraoral) are discussed. The probable causes of enlargement of the styloid process and ossification of the stylohyoid ligament are addressed. Two cases of Eagle´s syndrome are presented: one unilateral and the other bilateral. An intraoral modified surgical technique is presented.

Salivary flow rate, calcium, urea, total protein, and amylase levels in fanconi anemia.

Objectives Fanconi anemia (FA) is a genetic disease characterized by a chromosomal instability that develops a progressive pancitopenia, leukemia, and/or solid tumors. Nevertheless, it is unknown if this illness induces changes on the salivary gland parenchyma and function. The aim of this study was to assess the stimulated salivary flow rate (SSFR) and calcium, urea, total protein, and amylase levels in saliva of FA patients. Methods Stimulated whole saliva was collected from 34 randomly selected FA patients and 34 age-matched and sex-matched controls. Both samples were analyzed for salivary flow rate, calcium, urea, total proteins, and amylase. The SSFR was analyzed by gravimetric method and calcium, urea, total protein, and amylase concentrations were realized by chemistry tests. Results Mean values of SSFR for experimental and control groups were, respectively, 0.5 mL/min and 0.8 mL/min (P<0.05). Calcium concentration was 36% (P<0.05) and urea concentration was 21% (P<0.01) lower in the FA group saliva compared with saliva from the controls. The saliva concentration of amylase was almost equal in both groups. Conclusions FA patients may exhibit significant changes in SSFR, calcium, and urea concentration of saliva.

HIV Infection Induces Morphometrical Changes on the Oral (Buccal Mucosa and Tongue) Epithelial Cells

The aim of this study was to assess morphological and morphometrical alterations of oral squamous epithelial cells in type 1 HIV infected individuals. Oral smears were collected from tongue and buccal mucosa of 30 HIV infected (experimental) and 30 non-infected (control) individuals by liquid-based exfoliative cytology. The cells were morphologically analyzed and the nuclear area (NA), the cytoplasmic area (CA) and the nucleus-to-cytoplasm area ratio (NA/CA) were calculated. No morphological differences were found between the groups. The mean values of CA were decreased in tongue (P=.00006) and buccal mucosa (P=.00242) in HIV infected individual, while mean values of NA were increased (P=.00308 and .00095, respectively) in the same group. NA/CA ratio for experimental group was increased in both collected places, with P=.00001 (tongue) and P=.00000 (buccal mucosa). This study revealed that HIV infection was able to induce morphometrical changes on the oral epithelial cells.

Gestão de saúde coletiva e aperfeiçoamento de práticas sanitárias

Gestao de saude publica e uma atividade que engloba conhecimentos especiais de administracao de infraestrutura, de processos de trabalho e de resultados em saude coletiva. Embora a gestao de saude publica tenha avancado nos ultimos anos, diversos problemas ainda podem ser identificados nesta area de conhecimento, particularmente na gestao da saude coletiva no Sistema Unico de Saude (SUS). Praticas inadequadas naadministracao de recursos (humanos, fisicos e financeiros), e de servicos, somam-se a ausencia de capacitacao especifica para os trabalhadores da saude. Utilizando-se de revisao de literatura especializada em gestao, em suas mais diversas modalidades, este artigo teve o objetivo de discorrer sobre a evolucao da gestao em alguns periodos da Historia. Como resultado fornece informacoes sobre praticas gerenciais alternativas, concluindo que algumas dessas praticas podem ser incorporadas a saude publica. Embora este setor nao almeje lucros financeiros, visa a um maior aproveitamento de recursos, melhor resolutividade dos servicos e principalmente a satisfacao dos usuarios.

Public health management in Brazilian small municipalities with low municipal human development indices (HDI-M): a quest for innovation

This study deals with public health management in small Brazilian municipalities with low HDI-M through analysis of financial resources. Findings indicated some innovations, but not enough, with managers needing specific administration learning, although they state their desire to improve services. Unstructured reports do not contribute to health planning, showing no relationship between the scope of health actions and financial resources. Management needs to evolve to intersectoral decisions, with social participation in planning. This would make it possible to solve more health problems and provide a universal and equitable service to the population in the process of National Health System decentralisation.

Effects of Fluoxetine and Venlafaxine on the Salivary Gland - Experimental Study

Depression is the most common form of affective disorders and may range from discrete to severe. Various studies have worked with the hypothesis that depression arises from the deficiency of monoamines (noradrenaline, serotonin and dopamine), the most adequate treatment being to raise the supply of these neurotransmitters in the central nervous system (CNS). Statistical data have shown that depression has increased as a result of the longer life expectancy and is common among the elderly population (Glassman et al., 1984).

Comparação Entre a Citologia em Base Líquida e a Citologia Esfoliativa Convencional no Diagnóstico de Carcinomas da Região de Cabeça e Pescoço

Resumen pt: Objetivo: Comparar a citologia esfoliati va em base liquida em relacao a citologia convencional no diagnosti co de carcinomas da regiao de cabeca e pesco...