Letízia Monteiro de Barros

Avaliação da idade materna, paterna, ordem de paridade e intervalo interpartal para fissura lábio-palatina

UNLABELLED Cleft lip and palate (CL/P) are the most common congenital craniofacial anomalies. AIM To evaluate environmental risk factors for non-syndromic CL/P in a reference care center in Minas Gerais. MATERIALS AND METHODS we carried out a case-controlled study, assessing 100 children with clefts and 100 children without clinical alterations. The analysis dimensions (age, skin color, gender, fissure classification, maternal and paternal age, birth order and interpregnancy interval), obtained from a questionnaire; and later we build a data base and the analyses were carried out by the SPSS 17.0 software. The results were analyzed with the relative risk for each variable, in order to estimate the odds ratio with a 95% confidence interval, followed by a bivariate and multivariate analysis. RESULTS among 200 children, 54% were males and 46% were females. As far as skin color is concerned most were brown, white and black, respectively. Cleft palates were the most common fissures found (54%), followed by lip cleft (30%) and palate cleft (16%). CONCLUSION although with a limited sample, we noticed an association between maternal age and an increased risk for cleft lip and palate; however, paternal age, pregnancy order and interpregnancy interval were not significant.

Prevalence of Dental Anomalies in Patients With Nonsyndromic Cleft Lip and/or Palate in a Brazilian Population.

Objective Many studies have demonstrated a high frequency of dental anomalies in patients with cleft lip and/or palate. Because dental anomalies may complicate dental treatment, we investigated the prevalence of dental anomalies in a group of Brazilian patients with nonsyndromic cleft lip and/or palate. Design, Participants, Setting Retrospective analysis was performed using clinical records of 296 patients aged between 12 and 30 years with repaired nonsyndromic cleft lip and/or palate without history of tooth extraction and orthodontic treatment. Associations between oral clefts and presence of dental anomalies outside the cleft area were investigated. Results Dental anomalies were identified in 39.9% of the nonsyndromic cleft lip and/or palate patients, and tooth agenesis (47.5%), impacted tooth (13.1%), and microdontia (12.7%) were the most common anomalies. Cleft lip patients were less affected by dental anomalies compared with cleft palate or cleft lip and palate patients (p = .057). Specifically, patients with unilateral cleft lip and palate were significantly more affected by dental anomalies than those with bilateral cleft lip and palate (p = .00002), and individuals with unilateral complete cleft lip and palate (p = .002) and complete cleft palate (p = .01) were significantly more affected by tooth agenesis than other cleft types. Agenesis of the premolars (p = .043) and maxillary lateral incisors (p = .03) were significantly more frequent in patients with unilateral complete cleft lip and palate. Conclusions The present study revealed a high frequency of dental anomalies in nonsyndromic cleft lip and/or palate patients and further demonstrated that patients with unilateral cleft lip and palate were frequently more affected by dental anomalies than those with bilateral cleft lip and palate. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning for individuals affected by nonsyndromic cleft lip and/or palate.

Orofacial Features of Hypohidrotic Ectodermal Dysplasia

Hypohidrotic ectodermal dysplasia (HED) is a type of genodermatosis characterized by the abnormal development of sweat glands, teeth, and hair. The most prevalent form of HED is X-linked hypohidrotic ectodermal dysplasia (XLHED), which is associated with mutations in the EDA gene. The aim of this case report was to describe a family with XLHED with emphasis on differences in orofacial features between members. Family members were systematically evaluated to characterize the pattern of inheritance and clinical features. Dental examination included evaluation of agenesis and abnormal teeth structure. The pedigree of the last seven generations of the family was constructed. Clinical examination and medical history revealed five males affected by HED and nine female as heterozygous carriers. The males exhibited the classic phenotype of XLHED, with dental abnormalities, hypohydrosis, and craniofacial dysmorphologies. The heterozygous carriers of the X-linked gene defect principally exhibited dental agenesis of the lateral maxillary incisors. Careful clinical examination, including dental evaluation, is an important way to detect heterozygous carriers of X-linked HED. Heterozygous parents of patients with HED may also show some features of the disorder. The identification of female carriers results in genetic counseling being offered to affected families, as well as providing adequate treatment as necessary and long-term follow-up of these patients.

Frequency of congenital craniofacial malformations in a Brazilian Reference Center

OBJECTIVE: To evaluate the frequency of craniofacial anomalies in patients treated at a Brazilian Reference Center for craniofacial deformities. METHOD: Retrospective epidemiological study evaluating the clinical records of 1,142 patients: 656 (57.4%) male and 486 (42.6%) female, between 1992 and 2008. RESULTS: Among birth defects, non-syndromic cleft lip and/or palate were the most frequent ones (778 cases; 68.1%), followed by single or multiple congenital anomalies without cleft lip and/or palate (240 cases; 21%), recognized syndromes or sequences (56 cases; 5%), syndromes with orofacial cleft as a component (41 cases; 3.5%), and orofacial clefts in association with systemic malformations (27 cases; 2.4%). CONCLUSIONS: Non-syndromic cleft lip and/or palate was the congenital defect most frequently identified, although, isolated anomalies and syndromes involving craniofacial structures were quite frequent. Furthermore, the need for studies to identify the frequency and risk factors associated with craniofacial anomalies in the Brazilian population is emphasized in order to plan comprehensive strategies and integrated actions for the development of preventive programs and treatment.OBJETIVO: Avaliar a frequencia de anomalias craniofaciais em pacientes assistidos em um Centro de Referencia Brasileiro para deformidades craniofaciais. METODO: Estudo retrospectivo epidemiologico avaliando os prontuarios clinicos de 1.142 pacientes, sendo 656 (57,4%) do genero masculino e 486 (42,6%) do feminino, entre os anos de 1992 e 2008. RESULTADOS: Entre os defeitos congenitos, fissura labial e/ou palatina nao-sindromica foi o mais frequente (778 casos; 68,1%), seguido por anomalias congenitas simples ou multiplas sem fissura labial e/ou palatina (240 casos; 21%), sindromes ou sequencias reconhecidas (56 casos; 5%), sindromes com fissura orofacial como um componente do quadro sindromico (41 casos; 3,5%), e fissuras orofaciais em associacao com malformacoes sistemicas (27 casos; 2,4%). CONCLUSOES: Observou-se que o defeito congenito identificado mais frequente foi a fissura labial e/ou palatina nao-sindromica, no entanto, anomalias isoladas e sindromes envolvendo as estruturas craniofaciais foram bastante encontradas. Alem disso, ressalta-se a necessidade de estudos que identifiquem a frequencia e os fatores de riscos associados as anomalias craniofaciais na populacao brasileira, a fim de que se planejem estrategias e acoes integradas para o desenvolvimento de programas preventivos e de tratamento adequado.

Biopsychosocial profile of patients with anophthalmia in the south of Minas Gerais - Brazil

PURPOSE To evaluate the biopsychosocial profile of patients with anophthalmia, with emphasis on the psychological and functional impact of eye loss and the social reintegration of this population. METHODS Prospective analyses of 84 patients (50 males and 34 females), rehabilitated or in the rehabilitation process with ocular prostheses were interviewed by means of a questionnaire with dimensions involving the etiology of the ocular defect, degree of adaptation to the ocular prosthesis, and impact on professional, family and social activities. RESULT The right eye was affected in 45.2% of the patients, the left eye in 51.2%, and the rest of the patients had bilateral anophthalmia. Difficulty in adapting to monocular vision was reported by 47.6% of the patients. The main causes of anophthalmia in males were eye injuries due to accidents (54%), and, in females, acquired diseases (38.2%). For the total studied population, the eye loss occurred at a mean of 20.5 +/- 18.41 years, and the elapsed time until the first rehabilitation with ocular prosthesis was of 8.6 +/- 13.10 years. Most patients (66.1%) reported satisfaction and good adaptation to the prosthesis. Feelings of sadness, shame and shyness were frequently reported. CONCLUSION Anophtalmic patients often exhibit psychic and/or functional disorders which hinder their social, professional and family readaptation, and this is aggravated by both economic factors and lack of public services that provide rehabilitative treatment. Public information campaigns could also be useful to prevent causes that lead to ocular loss.

Técnicas cirúrgicas correntes para fissuras lábio-palatinas, em Minas Gerais, Brasil

Fissuras do labio e/ou palato (FL/P) representam as anomalias congenitas crânio-facial mais comuns. OBJETIVO: Avaliar as tecnicas cirurgicas correntes na reabilitacao de FL/P em um Servico de referencia no Estado de Minas Gerais. MATERIAL E METODOS: Realizou-se estudo retrospectivo, 2002 a 2007, avaliando 109 portadores de FL/P nao sindromicas que tiveram o tratamento concluido. As dimensoes de analise (identificacao pessoal, classificacao das FL/P e tratamento cirurgico realizado) foram obtidas a partir dos prontuarios, sendo posteriormente construido banco de dados e as analises estatisticas realizadas pelo programa SPSS 13.0. Seguiu-se analise descritiva dos procedimentos cirurgicos em funcao do tipo de FL/P encontrada. RESULTADOS: Entre os 109 pacientes, 65,1% foram do genero masculino e 34,8% do feminino. Verificou-se que 45% dos pacientes apresentaram fissuras labio-palatinas, 37,6% fissuras labiais e 17,4% fissuras palatinas. As tecnicas correntes empregadas foram as de Millard e Spina para as queiloplastias, McComb para as rinoplastias e as de Veau e Van Langenbeeck para as palatoplastias. CONCLUSAO: Este estudo e o primeiro a abordar reabilitacao em FL/P em Minas Gerais. Nas FL/P unilaterais houve a associacao das tecnicas de McComb, Veau e Millard, respectivamente, para rinoplastia, palatoplastia e queiloplastia, em 76,9% dos pacientes.

Taurodontism in patients with nonsyndromic cleft lip and palate in a Brazilian population: a case control evaluation with panoramic radiographs

OBJECTIVES The purpose of this study was to evaluate the prevalence of taurodontism in patients with nonsyndromic cleft lip and palate (NSCLP) within a Brazilian population. STUDY DESIGN The study was designed as an epidemiologic case-control single-center study. Three hundred eighty-eight patients were included: 88 had NSCLP, and 300 comprised the control group. The first and second permanent mandibular molars were included in this study. By using panoramic radiographs, taurodontism was categorized as mesotaurodontism, hypotaurodontism, and hypertaurodontism. RESULTS Seventy patients (23.3%) from the control group and 36 patients (40.9%) from the case group presented taurodontism (P < .001). In the control group, 108 (9%) teeth showed taurodontism, whereas in the case group with cleft lip and palate (CLP), 64 (18.2%) teeth showed dental anomalies (P < .001). In both groups, most taurodontic teeth presented hypotaurodontism, followed by mesotaurodontism, while hypertaurodontism was found in only two teeth. The probability of taurodontism in patients with cleft lip (CL) was 2.36 (P = .010) times higher compared with those with CLP, whereas the occurrence of taurodontism in patients with cleft palate (CP) was 3.15 (P = .002) times greater than in patients with CLP. CONCLUSIONS The results from this study indicate a close relationship between taurodontism and NSCLP and the possibility of different cleft subphenotypes.

Caries Experience in a Sample of Adolescents and Young Adults With Cleft Lip and Palate in Brazil

Objective To compare the caries experience of adolescents and young adults with cleft lip and/or palate (CL/P) with a noncleft control group. Design Thirty CL/P subjects and 30 controls were clinically examined to obtain the decayed, missing and filled teeth (DMFT) and the decayed, missing and filled surfaces (DMFS) indices, gingival bleeding index, plaque index, and active caries lesions. Data concerning oral hygiene, access to fluoridated water, mothers education level, and family income were also collected. Setting Pro-Smile Center, a reference center for the treatment of facial deformities, Alfenas, Minas Gerais, Brazil. Subjects Subjects aged 12 to 21 years with CL/P and without associated syndromes were matched to noncleft controls by sex, age, living habits, and use of orthodontic devices. Null Hypothesis Formulated Prior to Data Collection Caries experience in CL/P adolescents and young adults is similar to that observed in noncleft controls. Statistical Analysis Data were analyzed using SPSS 17.0 software for Windows Data Editor. The CL/P and control groups were compared using the McNemar test, paired t test and Wilcoxon test. A significance level of 5% was adopted for all tests. Results There were no significant differences between the groups for oral hygiene and contact with fluoride. Significant differences were found in per capita income, presence of active caries, decayed surfaces, plaque index, and gingival bleeding. Conclusions The caries experience of CL/P subjects was higher than that of the noncleft individuals.

Study of patients with cleft lip and palate with consanguineous parents

UNLABELLED Cleft lip and/or palate (CL/P) are the most common congenital anomalies of the face. CL/P are non-syndromic (CL/PNS) in about 70% of subjects. AIM To describe clinical cases of non-syndromic CL/P (CL/PNS) associated with consanguinity, diagnosed at a reference hospital in Minas Gerais, Brazil, and to correlate these alterations with possible risk factors. SERIES AND METHODS: A retrospective study at a reference hospital for craniofacial deformities in Minas Gerais, Brazil from 2006 to 2009 based on data in medical records. RESULTS Of 246 CL/PNS cases diagnosed and treated at the institution, 15 (6.1%) were CL/PNS with reported first-degree consanguinity; 73.3% occurred in males. Four of 15 patients had complete right cleft palate and lip (CLP), 4 presented complete cleft palate and lip (right and left), 3 had complete unilateral left CLP, 3 had isolated cleft palate, and 1 presented cleft lip only. Among the risk factors, only three mothers reported smoking during pregnancy. CONCLUSIONS CLP (unilateral or bilateral) were more frequent in the group with a history of first-degree consanguinity; males predominated. Among the risk factors, only smoking was observed in three cases.

Uso de Dentes Humanos Extraídos e os Bancos de Dentes nas Instituições Brasileiras de Ensino de Odontologia

Resumen pt: Objetivo: Avaliar aspectos relacionados ao uso de dentes humanos extraidos nos cursos de graduacao e pos-graduacao do Brasil e a existencia de Banco de D...