Lino João da Costa

Validation of the Portuguese version of the RDC/TMD Axis II questionnaire

The present paper aimed at evaluating the validity of the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II Questionnaire. The sample was comprised of 155 patients with signs and symptoms of Temporomandibular Disorders (TMD), evaluated at the Orofacial Pain Control Center, School of Dentistry, University of Pernambuco, Brazil, between July 2003 and February 2004. Data collection was performed with the following tools: the RDC/TMD Axis I (clinical evaluation and TMD classification), and Axis II (psychosocial evaluation), as well as specific questionnaires for evaluation of Oral Health Related Quality of Life, namely, Oral Impacts on Daily Performances and the Oral Health Impact Profile-14, considered to be gold standard criteria. Validity evaluation consisted of internal consistency evaluation by the Cronbach alfa reliability test, reliability and reproducibility estimated by the Kappa test and the Spearmans correlation, and concurring validation through Spearmans correlation. The Portuguese version of the RDC/TMD Axis II questionnaire was considered consistent (Cronbach alfa = 0.72), reproducible (Kappa values from 0.73 to 0.91, p < 0.01), and valid (p < 0.01). It was concluded that this version showed valid and reproducible results for the Brazilian population, thus paving the way for including Brazil in transcultural epidemiological studies on TMD.

Evaluation of mandibular implant sites: correlation between panoramic and linear tomography

The reliability of the linear tomography and panoramic radiography made with X-ray equipment was evaluated (Vera View Scope X-600; Morita). The sample was composed of 20 dry human hemimandibles, in which the area selected for analysis was 1.5 cm distal from the limit set before the mental foramen. Four measurements were made. The images obtained were drawn on acetate paper and the hemimandibles cut at the demarcated area. The measurements were made using a digital electronic pachymeter. The values found for the radiographic images were compared to those obtained in the mandibular specimens and submitted to statistical evaluation by the Wilcoxon test. It was concluded that both techniques were reliable for the accomplishment of vertical linear measurements in the selected area. However, a 2.0 mm safety margin is recommended.

Leucoplasias bucais: relação clínico-histopatológica

A relacao entre o aspecto clinico e as caracteristicas histologicas das leucoplasias bucais foi avaliada em 28 pacientes adultos, que apresentaram lesoes leucoplasicas na mucosa bucal. As lesoes foram divididas quanto ao aspecto clinico em homogeneas e nao-homogeneas, e classificadas segundo suas caracteristicas histopatologicas em seis grupos: hiperceratose com ausencia de displasia epitelial; displasia epitelial leve; displasia epitelial moderada; displasia epitelial severa, carcinoma in situ e carcinoma invasivo. Os resultados clinicos mostraram maior ocorrencia de leucoplasias homogeneas (78,6%) do que nao-homogeneas (21,4%). Os achados histopatologicos demonstraram que 32,2% dos casos apresentaram hiperceratose com ausencia de displasia epitelial, 53,5% evidenciaram displasia epitelial (39,3% leve, 7,1% moderada e 7,1% severa) e 14,3% diagnosticados como carcinoma invasivo. As leucoplasias homogeneas apresentaram alteracoes celulares discretas, enquanto as nao-homogeneas evidenciaram displasia epitelial severa e carcinoma invasivo. Os resultados sugerem um maior cuidado no diagnostico e controle de leucoplasias dada a possibilidade de transformacao maligna.

Titanium implants: A removal torque study in osteopenic rabbits

CONTEXT Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue. It may affect the craniomaxillofacial complex and result in less bone-implant contact. AIMS The objective of this study was to measure the endosseous integration of titanium implants using the removal torque test in low-mineral density experimental animal models. MATERIALS AND METHODS Thirty female New Zealand white rabbits were divided into two groups: control (n=14), sham-operated; and test (n=16), ovariectomized. All animals received 2.2 mm Χ 4.0 mm titanium implants in the right tibia, 120 days after ovariectomy or sham surgery. Animals were killed at 7 and 14 weeks of postimplant insertion, when implants were removed by reverse torque rotation using a digital torque meter. Statistical analysis used was Students t-test. RESULTS AND CONCLUSION At the 7-week period, the mean torque values for the control and test groups were 11.6 Ncm and 10.4 Ncm, respectively, with no statistical significance. Implant removal torque analysis showed statistically lower values (P < 0.05) for the test group at the 14-week period (control=16.7 Ncm and test=9.7 Ncm). The results of this study indicate that hormonal privacy compromise implants biomechanical performance.

Repercussões da radioterapia na região orofacial e seu tratamento

Head and neck radiotherapy causes countless sequelae in irradiated patients, affecting the stomatognathic system, with significant systemic implications. Sequelae of exposure to ionizing radiation may be extensive and sometimes permanent, particularly in the salivary glands and bone tissue. It is of utmost importance that the surgeon dentist be aware of adverse reactions and appropriate forms of treatment to alleviate discomfort and improve the quality of life of the irradiated patient. Therefore, awareness and motivation of the patient, with promotion of oral health through the adaptation of the oral environment and guidance on preventive measures are essential to get a better prognosis.

In vitro antimicrobial effect of jabuticaba [Myrciaria cauliflora (Mart.)O.Berg] extract on Streptococcus from the oral cavity

Este estudo avaliou a acao do extrato etanolico das folhas de Myrciaria cauliflora (Mart.)O.Berg. sobre tres culturas de Streptococcus formadoras do biofilme dental. A atividade antimicrobiana foi determinada pelo metodo de difusao em meio solido. Os dados obtidos foram satisfatorios para todas as especies ensaiadas (Streptococcus mutans ATCC 25175, Streptococcus sobrinus ATCC 27609 e Streptococcus sanguis ATCC 10557) gerando halos de inibicao quando utilizado o extrato puro e diluicoes 1:2 e 1:4. Os resultados incentivam a realizacao de novas pesquisas que viabilizem a producao de compostos com finalidade terapeutica que possam ser utilizados clinicamente na odontologia.

Antifungal susceptibility of Candida albicans isolated from oral mucosa of patients with cancer

O crescente numero de infeccoes fungicas bucais em pacientes imunocomprometidos tem estimulado a pesquisa de drogas mais eficientes. Procuramos, assim, avaliar a suscetibilidade in vitro de cepas de Candida albicans de pacientes com câncer submetidos ou nao a radioterapia frente as seguintes drogas: anfotericina B, cetoconazol, miconazol e itraconazol. A tecnica de diluicao em agar YNB e o subcultivo em AS foram respectivamente utilizados para determinacao da CIM (Concentracao Inibitoria Minima) e da CFM (Concentracao Fungicida Minima). Com esta metodologia, a droga que mostrou melhor atividade antifungica para cepas de C. albicans isoladas de qualquer dos grupos de pacientes foi a anfotericina B, apresentando baixos valores de CIM em comparacao aos azois, e de CFM. Contudo, e necessario lembrar que o tratamento com antibioticos polienicos pode causar efeitos toxicos, mesmo em doses necessarias para se atingir bons resultados com os antifungicos. A coexistencia de outras especies nesses pacientes, principalmente entre os submetidos a radioterapia, as condicoes locais, bem como o uso de outras drogas, devem ser tambem considerados. Acredita-se, porem, que o uso adequado dos antifungicos atuais e a disponibilidade de novas drogas que nao produzam consequencias indesejaveis possam conduzir a melhores resultados na clinica diaria.

O DUPLO PAPEL DA INFLAMAÇÃO NO SURGIMENTO DAS LESÕES CANCERÍGENAS

This review demonstrated that in the same way the immune cells act to repair the affected tissues, cancer cells produce disorderly inflammation factors to sustain growth and development of the tumor. They produce exaggeratedly the same inflammatory substances such as cytokines, prostaglandins and leukotrienes, which usually play the natural tissue repair. The cancer uses those substances to induce its own proliferation and to make permeable barriers surrounding it. Then the process that allows the immune system to repair damage and to destroy aggressors in all reaches of the body is skewed in favor of cancerous cells. And due to inflammation, such cells will infiltrate through surrounding tissues, penetrate into lymphatic and blood flow until give rise to metastases. The excess of these inflammatory substances in the surrounding tissues, leads to blockage of a natural process called apoptosis, or genetically programmed cell suicide, thereby contributing to the uncontrolled proliferation of tissues. Cancerous cells are thus protected from cell destruction, and the tumor will increasingly gaining size and body. DESCRIPTORS Inflammation. Cancer. Immunology.

Conhecimento dos Alunos do Curso de Graduação em Odontologia da Universidade Estadual da Paraíba sobre Hepatites Virais

6 Pos-Graduando em Implantodonti a pelo Centro Odontologico de Estudos e Pesquisas (COESP), Joao Pessoa/PB, Brasil. Objeti vo: Avaliar o conhecimento de academicos do curso de Odontologia sobre hepati tes virais. Metodo: A amostra foi consti tuida por 109 academicos dos 157 academicos do Curso de Odontologia da Universidade Estadual da Paraiba (UEPB), do terceiro ao quinto anos, selecionados aleatoriamente, os quais estao mais expostos aos fatores de risco inerentes ao nao conhecimento das hepati tes virais. Os dados foram coletados atraves de um questi onario com questoes de multi pla escolha que abordavam o conhecimento sobre hepati tes virais. As variaveis do estudo incluiam questoes como: ti po de Equipamento de Protecao Individual usado durante os procedimentos, opiniao sobre a exposicao ao virus da hepati te, quais seriam as vias de transmissao da hepati te, se o academico ja havia sofrido acidente com instrumental perfuro- cortante. Os dados foram analisados de forma descriti va. Resultados: Todos os alunos (100%) afi rmaram que usavam luvas,mascara e gorro, porem, apenas 92% deles achavam estar expostos aos virus da hepati te. Em relacao as vias de exposicao, 95% dos academicos afi rmaram ser o sangue contaminado uma das principais vias de transmissao da hepati te, porem, 36% apenas afi rmaram que as mucosas poderiam ser uma via de transmissao. De todos os academicos pesquisados, 28% ja haviam sofrido algum acidente perfuro-cortante. Os resultados da investi gacao com base no questi onario mostraram que apenas 75% dos academicos eram vacinados, 63% responderam que para a hepati te ti po B. Conclusao: Os estudantes de Odontologia tem consciencia dos riscos de contaminacao em relacao as hepati tes virais, mas os conhecimentos adquiridos sobre os mesmos nao estao sendo aplicados na prati ca clinica. Objecti ve: To evaluate the knowledge of undergraduate dental students about viral hepati tes. Methods: The sample was composed of 109 out of 157 3rd- 5th undergraduate dental students from the State University of Paraiba (UEPB), Brazil, selected at random, who are more exposed to the risk factors inherent to the unawareness of viral hepati tes. Data were collected using a questi onnaire with multi ple-choice questi ons arguing about the knowledge of viral hepati tes. The study variables included questi ons regarding individual protecti on equipment used during the procedures, opinion about exposure to hepati ti s virus, which would be the transmission routes, and whether the student had already suff ered any accident with perforati ng/cutti ng instruments. Data were subjected to descripti ve analysis. Results: All (100%) students affi rmed to use gloves, mask and cap, but only 92% of them believed to be exposed to the hepati ti s virus. Regarding the forms of exposure, 95% of the undergraduate students affi rmed that contaminated blood is one of the main transmission routes of hepati ti s, but only 36% of them believed that the mucosas could be a transmission route. From all undergraduate students interviewed for the study, 28% had already experienced some kind of perforati ng/cutti ng accident. The results of this questi onnaire-based investi gati on revealed that only 75% of the undergraduate students were vaccinated, 63% of them for type B hepati ti s. Conclusion: The dental students are aware of the risks of contaminati on by viral hepati tes, but the acquired knowledge about the risks are not being applied in the clinical practi ce.

Prevalence of Anterior Open Bite among the Children Aged 3 to 5 Years in Cabedelo, PB, Brazil, and its Relationship with Deleterious Oral Habits

Objetivo: Verificar a prevalencia de mordida aberta anterior e investigar sua associacao a habitos de succao nao-nutritiva, amamentacao, respiracao bucal e renda familiar em criancas entre 3 e 5 anos de idade matriculadas em creches publicas de um municipio do Nordeste do Brasil. Metodo: Um total de 117 criancas com denticao decidua completa foram examinadas e suas maes foram submetidas a uma entrevista estruturada a fim de se obter informacoes acerca dos habitos bucais infantis. Considerou-se como mordida aberta anterior qualquer valor negativo evidenciado. Os dados obtidos foram inseridos no pacote estatistico SPSS 13.0 e apresentados em tabelas de contingencia. Utilizou-se o teste do qui-quadrado para verificacao de associacao entre as variaveis e considerou-se significativo com p<0,05. Resultados: Observou-se que 54,7% das criancas possuiam o habito de morder objetos, 49,6% fazia uso de chupetas, 9,4% praticavam succao digital, 47,9% utilizava mamadeiras e 23,1% praticava bruxismo. A prevalencia de mordida aberta anterior foi de 36,8% estando a mesma associada de forma estatisticamente significativa ao genero masculino (p=0,038), a respiracao bucal (p=0,007) e ao uso de mamadeiras (p=0,040) e chupetas (p=0,0001). Conclusao: Politicas de promocao de saude bucal podem ser implementadas na populacao com enfase na amamentacao natural especialmente ate os 6 meses de idade, cuidado no uso de chupetas e bicos, observando tempo de uso e higiene e identificacao precoce das mordidas abertas anteriores para tomadas de medidas de prevencao e/ou controle.