Luc Louis Maurice Weckx

Laser therapy in the treatment of dentine hypersensitivity

Cervical dentine hypersensitivity is the most frequent complaint among reported odontalgias. Thus, this study evaluated the effectiveness of two types of lasers (660 nm wavelength red, and 830 nm wavelength infrared) as dentine desensitizers, as well as both the immediate and late therapeutic effects in individuals 25 to 45 years of age. A total of 40 teeth with cervical exposure were treated in 4 sessions. They were divided into 2 groups according to treatment. A 660 nm wavelength red diode laser and an 830 nm wavelength infrared diode laser were used. Dentine sensitivity to cold nociceptive stimulus was evaluated by means of a pain numeric scale from zero to 10 before each treatment session, at 15 and 30 min after irradiation, and in a follow-up period of 15, 30 and 60 days after the end of treatment. Significant levels of dentinal desensitization were only found in patients ranging in age from 25 to 35 years. The 660 nm red diode laser was more effective than the 830 nm infrared laser and a higher level of desensitization was observed at the 15 and 30 minute post-irradiation examinations. The immediate and late therapeutic effects of the 660 nm red diode laser were more evident in 25-35-year-old patients compared with those of the 830 nm infrared diode laser, in terms of the different age groups.

AVALIAÇÃO CLÍNICA E VIDEOFLUOROSCÓPICA DA DEGLUTIÇÃO EM CRIANÇAS COM PARALISIA CEREBRAL TETRAPARÉTICA ESPÁSTICA

Cerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. The aim of this study was to characterize and compare the swallowing processes of 32 children with this condition, by clinical and videofluoroscopic evaluation, with special focus on tracheal aspiration detectability. Results show an important compromise of oral phase. The most important findings during the pharyngeal phase were velopharingeal incompetence and residuals on the pharyngeal recesses. Aspiration was more common with liquids, before and after deglutition. On clinical and videofluoroscopic evaluation, cervical hyperextension was the commonest postural abnormality. Videofluoroscopy confirmed the occurrence of aspiration on most of the cases that presented suggestive signs of aspiration during clinical evaluation. We conclude that clinical and videofluoroscopic evaluations are complementary on deglutition evaluation and together may point to the most specific rehabilitation procedure.

Microarray cDNA to Identify Inflammatory Genes in Nasal Polyposis

Background The objective of this study was to investigate the spectrum of inflammatory gene expression in patients with nasal polyposis. Methods The cDNA microarray technique was used to identify gene expression in tissue samples from nasal polyps and adjacent inflammatory nasal mucosa of 21 patients with nonallergic nasal polyposis. To validate the microarray analysis, we compared the expression of five genes by reverse transcription-polymerase chain reaction (RT-PCR): tumor necrosis factor, IL-5, IL-9, fibroblast growth factor, and transforming growth factor (TGF)-β1. Results We tested 96 different inflammatory genes in our samples. Thirty-six genes exhibited differences in expression between the two tissue types. In all 36 genes the level of expression was greater in the inflammatory mucosa than the polyps. The RT-PCR confirmed the cDNA results. Conclusion We believe that the high expression of TGF-β1 in inflammatory mucosa compared with the low expression in polyps may reflect an important role in the inhibitory mechanisms of nasal polyposis.

OSAS in children: correlation between endoscopic and polysomnographic findings.

OBJECTIVES: To correlate polysomnographic findings with clinical history of apnea, the degree of obstruction caused by tonsillar hypertrophy, and to age group. STUDY DESIGN AND SETTING: 267 children with a clinical diagnosis of obstructive sleep apnea (OSAS) were evaluated. Patients were divided into preschool- and school-age categories, and subdivided in 3 additional groups, according to tonsillar hypertrophy. Polysomnographic findings were compared within groups. RESULTS: 34% of children had history of OSAS and normal polysomnographic findings. Tonsillar hypertrophy was correlated to more severe apnea among preschool-age children, but not among school-age children. Among children with tonsillar hypertrophy, more severe apnea was observed in preschool-age children than in school-age children. CONCLUSIONS: There is little correlation between polysomnographic and clinical findings in children with OSAS. SIGNIFICANCE: Adenotonsillar hypertrophy leads to more severe polysomnographic patterns in preschool-age children. More severe apnea is observed in younger children with adenotonsillar hypertrophy than in older ones.

Actinic cheilitis: histopathology and p53

Background:  Chronic actinic cheilitis (AC) is a precursor of squamous cell carcinoma (SCC) of the lip.

Detection of Group A beta-hemolytic Streptococcus employing three different detection methods: culture, rapid antigen detecting test, and molecular assay.

In order to study the prevalence of Group A beta-hemolytic Streptococcus (GABHS) pharyngotonsillitis in our pediatric population and to compare different sampling methods of GABHS detection, oropharyngeal swabs from 50 children with acute pharyngotonsillitis, between 1 and 12 years old, were used simultaneously for culture, molecular assay and rapid GABHS antigen detection tests. All children were clinically examined at the Division of Pediatric Otorhinolaryngology of the Federal University of São Paulo. Diagnostic criteria were based on signs and symptoms, including sore throat, fever and oropharyngeal purulent secretion. Children that had been treated with antibiotics were excluded. Overall, combining the three methods, the prevalence of GABHS was 34%. GABHS was diagnosed in 30% of the bacterial cultures, in 25% of the samples tested with the molecular nucleic acid hybridization method and in 26% of the cases tested with the rapid antigen detection test. There was no significant difference between these three methods.

Assessment of cognitive learning function in children with obstructive sleep breathing disorders

UNLABELLED Sleep obstructive breathing disorders are frequent in children but the impact of sleep deprivation on the cognitive learning function is unclear. AIM To establish whether patients with sleep obstructive breathing disorders show any functional change in learning, memory and attention. MATERIAL AND METHODS Eighty-one children aged from 6 to 12 years were divided into 3 groups: obstructive sleep apnea syndrome (OSAS), n=24; primary snoring (PS), n=37; and control, n=20. The groups were assessed using learning (Rey) and psychological (Digit, Code, Letter Concealing, and Symbol) tests. RESULTS OSAS and PS children showed statistically significant worse performance on the variable A1 in Rey test (learning and memory) when compared with controls (p=0.011). PS children had an even worse performance on the variables A2, A4, AT and A6 compared to OSAS participants and controls (p=0.020;p=0.050;p=0.004,p=0.05). CONCLUSION Children with obstructive sleep breathing disorders, in particular PS, show worse Rey test scores. PS and OSAS children performed similarly in attention tests.

Avaliação da função cognitiva da aprendizagem em crianças com distúrbios obstrutivos do sono

Sleep obstructive breathing disorders are frequent in children but the impact of sleep deprivation on the cognitive learning function is unclear. AIM: To establish whether patients with sleep obstructive breathing disorders show any functional change in learning, memory and attention. MATERIAL AND METHODS: Eighty-one children aged from 6 to 12 years were divided into 3 groups: obstructive sleep apnea syndrome (OSAS), n=24; primary snoring (PS), n=37; and control, n=20. The groups were assessed using learning (Rey) and psychological (Digit, Code, Letter Concealing, and Symbol) tests. RESULTS: OSAS and PS children showed statistically significant worse performance on the variable A1 in Rey test (learning and memory) when compared with controls (p=0.011). PS children had an even worse performance on the variables A2, A4, AT and A6 compared to OSAS participants and controls (p=0.020;p=0.050;p=0.004,p=0.05). Conclusion: Children with obstructive sleep breathing disorders, in particular PS, show worse Rey test scores. PS and OSAS children performed similarly in attention tests.

Oral breathing and speech disorders in children

OBJECTIVE To assess speech alterations in mouth-breathing children, and to correlate them with the respiratory type, etiology, gender, and age. METHOD A total of 439 mouth-breathers were evaluated, aged between 4 and 12 years. The presence of speech alterations in children older than 5 years was considered delayed speech development. The observed alterations were tongue interposition (TI), frontal lisp (FL), articulatory disorders (AD), sound omissions (SO), and lateral lisp (LL). The etiology of mouth breathing, gender, age, respiratory type, and speech disorders were correlated. RESULTS Speech alterations were diagnosed in 31.2% of patients, unrelated to the respiratory type: oral or mixed. Increased frequency of articulatory disorders and more than one speech disorder were observed in males. TI was observed in 53.3% patients, followed by AD in 26.3%, and by FL in 21.9%. The co-occurrence of two or more speech alterations was observed in 24.8% of the children. CONCLUSION Mouth breathing can affect speech development, socialization, and school performance. Early detection of mouth breathing is essential to prevent and minimize its negative effects on the overall development of individuals.

Immune-expression of HSP27 and IL-10 in recurrent aphthous ulceration

BACKGROUND Recently, abnormal cellular immune response has been considered responsible for the oral lesion in the recurrent aphthous ulceration (RAU). For reasons not yet defined, antigens of the oral microbiota would trigger abnormal Th1 immune response against epithelial cells. On the other hand, studies have demonstrated that heat shock proteins (HSP) can block the production of proinflammatory cytokine through inhibition of NF-kappaB and mitogen-activated protein kinase pathways or activate anti-inflammatory cytokines and therefore control the magnitude of the immune response. HSP27 has been considered a powerful inductor of IL-10, a major inhibitor of Th1 response. METHODS Using immunohistochemistry, we studied the expression and location of HSP27 and IL-10 in ulcerated lesions clinically diagnosed as RAU (n = 27) and to compare it with that of oral clinically normal mucosa (CT; n = 6) and of other inflammatory chronic diseases such as oral fibrous inflammatory hyperplasia (FIH; n = 18), Crohns disease (CD; n = 10) and ulcerative colitis (UC; n = 9). RESULTS A lower proportion of HSP27-positive epithelial cells in RAU and CD were observed when compared with CT and FIH (P < 0.001**; P = 0.013**). A lower proportion of IL-10-positive interstitial cells in RAU was observed when compared with FIH, UC, CT and CD (P < 0.001**; P < 0.001**; P < 0.001**; P = 0.034*). CONCLUSION Altogether the data suggest that a reduced cellular expression of HSP27 and IL-10 in RAU might be related with the aetiopathogenesis of the ulcerated oral lesions.