Bruno Vieira Caputo

Laser Therapy of Recurrent Aphthous Ulcer in Patient with HIV Infection

The recurrent aphthous ulcer (RAU) is a pathological change found in the oral mucosa, characterized by painful single or multiple ulcers. The etiologic aspect of RAU is not well understood; however it is known that due to lower CD4 cell counts patients had higher prevalence of these oral lesions, and immunosuppressed patients with HIV are predisposed. Patient FC is African descent, 26 years old, male, HIV + CD4 67 cells/mm3, with minor RAU in the upper and lower right side lip, measuring about 4 mm, and major RAU in tongue and the tonsillar pillar measuring 2 cm. The patient was treated with laser therapy with the objective to help reverse the damage and decrease the symptoms. After one week there was remission of the lesions. The laser showed to be an important alternative therapy that promoted analgesic, healing effects and improving the quality of life of patients.

Evaluation of bone alterations in the jaws of HIV-infected menopausal women.

The advent of highly active antiretroviral therapy (HAART) has caused a reduction in mortality, thus contributing to an increase in the number of women with HIVࢧAIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I) and women with no known HIV infection (Group II). Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI), Panoramic Mandibular Index (PMI) and Antegonial Depth (AD). A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054) and AD (p < 0.0001) for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003). Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.

Sjögren´s syndrome: clinical dentistry case management sjögren´s syndrome: case report

The Syndrome of Sjögren (SSj) is a chronic systemic illness of auto-immune etiology that affects mainly the exocrine glands, especially salivary and lacrimal. The objective of this case report was to present the importance of the diagnosis of the illness, as well as the recognition and accompaniment of the clinical case relating the systemic alterations to the buccal ones. The clinical condition of the illness and its implications had remained for long periods characterized for phases of increase and remission until the definitive diagnosis of non-Hodgkin’s lymphoma resulting in generalized prostration, and death. The multiprofessional relation is important front to the case, which had to the appearance of diverse general and buccal alterations. The options of dental treatment as the lasertherapy, oral health guidelines and control of the signals and symptoms decurrent of the illness become the intervention of the excellent. Correspondence to: Elcio Magdalena Giovani, Paulista University –Indianópolis Campus – São Paulo, SP, R. Dr. Bacelar, 1212, São Paulo – SP (04026-002), Brazil, Tel: (55+11) 5586-4066. E-mail: elciomg@unip.br

PDT in periodontal disease of HAART resistance patients

HIV/Aids patients present a change of microbiota associated with host immunodeficiency. Photodynamic therapy (PDT) showed as a promising and viable alternative in reducing microbiota. Present study evaluate effectiveness of photodynamic therapy in periodontal disease of AIDS patients with highly activity antiretroviral therapy (HAART) failure, measuring the clinical periodontal parameters and periodontal microbiota. Twelve patients with HARRT resistance (R group) divided into two groups (control and PDT) and 12 patients with no HAART resistance (NR group) divided into two groups (control and PDT). The results show the difference in baseline of CD4 cells count, NR group 640.0 ± 176.2 cells/mm3 R group and 333.3 ± 205.8 cells / mm3 (p<0.05), and in 8.3% detectable viral load in NR group and 75% detectable (p <0.001) in R group. As clinical periodontal parameters (PD and CAL), PDT was more effective than the control group only in the NR group (p <0.05%), moreover, there was no difference in the evaluation of clinical periodontal parameters between the both R groups (p>0.05%). Microbiological evaluation in R group presents a general reduction in the Aa at 3 and 6 months. Furthermore, demonstrated a reduction of Pg in all groups at 6 months and in R group at 3 months. The impact assessment of photodynamic therapy in patients with different levels of immunosuppression determined that the combination of mechanical periodontal treatment with photodynamic therapy in patients with HAART failure did not cause additional benefits. Therefore, PDT in this study could not been indicated in HAART resistance patients.