Marcia André

Candida albicans in patients with oronasal communication and obturator prostheses

Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.

Evaluating aesthetics of the nasolabial region in children with cleft lip and palate: professional analysis and patient satisfaction

Cleft lip and palate is one of the most common deformities of the craniofacial region, and treatment of this deformity is essential for social reintegration. One of the major goals of surgery and treatment of craniofacial deformities is to improve the aesthetic appearance of the face, and thereby improve the patient’s social acceptability. Here, we present a critical review of the criteria for aesthetic evaluation of the nasolabial region in cleft patients by assessing publications with the highest level of evidence, including professional evaluation, and patient satisfaction. The findings indicate treatment of this condition represents a major challenge for multidisciplinary team care.

Aesthetic Evaluation of the Nasolabial Region in Children with Unilateral Cleft Lip and Palate Comparing Expert versus Nonexperience Health Professionals

Esthetic evaluation of cleft lip and palate rehabilitation outcomes may assist in the determination of new surgical interventions and aid in reevaluation of treatment protocols. Our objective was to compare esthetics assessments of the nasolabial region in children with a unilateral cleft lip and palate between healthcare professionals who were experienced in the treatment of cleft lip and palate and those who were inexperienced. The study group included 55 patients between 6 and 12 years of age who had already undergone primary reconstructive surgery for unilateral cleft lip. Standardized digital photographs were obtained, and the esthetic features of the nose, lip, and nasolabial region were evaluated. We used only cropped photographic images in the assessments of healthcare professionals with and without experience in cleft lip and palate. Interrater analysis revealed highly reliable assessments made by both the experienced and inexperienced professionals. There was no statistically significant difference in the esthetic attractiveness of the lip and nose between the experienced and inexperienced professionals. Compared with the inexperienced professionals, the experienced professional evaluators showed higher satisfaction with the esthetic appearance of the nasolabial region; however, no difference was observed in the analysis of the lip or nose alone.

Prevalence of caries in Brazilian children with cleft lip andor palate, aged 6 to 36 months

The aim of this study was to assess the prevalence of caries in children with cleft lip and∕or palate aged 6-36 months of life. This study was conducted at the University of São Paulo School of Dentistry, Brazil. A total of 143 children were selected (73 male, 70 female), all of whom had at least two erupted teeth. The children were distributed as follows: 88 had cleft lip and palate, 35 had cleft palate, 20 had cleft lip. Dental caries disease was diagnosed according to criteria set by the World Health Organization. It was observed that 18.9% of the study children had caries. No correlation between prevalence of caries and gender or type of cleft was observed. Mean dmf-t was 0.47. The prevalence of caries was higher in the upper arch, and the most affected tooth was the central incisor (p=0.001). Children with cleft lip and∕or palate did not have high caries indices.

Challenges for a successful career as a PhD student

php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Clinical Epidemiology 2017:9 93–94 Clinical Epidemiology Dovepress

Association of orthodontic treatment needs and oral health-related quality of life.

Dear editor We have read with great interest the recent paper by Hassan et al1 published in Patient Preference and Adherence. Quality of life is an important consideration in children with malocclusion due to the impacts in social life, especially at school.2 In this paper, Hassan et al1 highlighted the impact of malocclusion on quality of life, using an oral health-related quality of life (OHRQoL) scale in 120 children. Measuring quality of life is complex due to the lack of consensus about what it really means; but in an academic setting, it is a tool commonly used to allow comparisons and evaluation of interventions.3 Previous clinical studies in orthodontics evaluated the quality of life of patients using several tools with the aim of measuring health care.3,4 This study has strengths. First, the authors have used two examiners calibrated for analysis of the dental health component using the index of orthodontic treatment needs, which gives reliability to the results. The second strength of this study is that it is the first study to use the Michigan OHRQoL scale to assess the association between OHRQoL and index of orthodontic treatment needs; also, in the present study, children with no/little need, children with borderline need, and children who need treatment were included. However, despite important results and widespread discussion, this study presents some limitations. The original Michigan OHRQoL scale was designed to investigate the effects of early childhood caries on children’s OHRQoL, and is usually applicable to younger children.5 But in this study, patients up to 15 years old were included. Another important consideration is that the study could be performed including other settings to ensure generalization to Saudi children. Finally, the authors highlighted methodological accuracy used in the translation of questionnaires from English to Arabic; however, no validation study was performed, and this lack of construct validity may limit the interpretation of results. These questions, however, do not take away the main relevant messages raised in this interesting paper by Hassan et al.1

Potential toxicity of dental nanomaterials to the central nervous system

Dear editor It was enlightening to read this comprehensive review of dental nanomaterials toxicity to the central nervous systems (CNSs) by Feng et al1 published in the International Journal of Nanomedicine. There are many potential applications of nanomaterials in dentistry.2 Composite resins have been widely used in restorations of dental caries;3 however, it is estimated that approximately 50% of prepared restorations need to be remade, the secondary caries is one of the most frequent causes of failure,4 and the use of nanomaterials could decrease the incidence of these complications. Thus, the application of nanomaterials can bring numerous benefits in dentistry, especially in caries prevention; however, there is an important question about the safety of these materials for the nervous system. In the study by Feng et al1 a vast array of nanomaterials types and their major applications were outlined. A strong point of this study1 is the detailed description of the role of blood–brain barrier (BBB) to prevent potentially harmful substances from entering into the CNS.5 This BBB is formed by tight junctions, basement membrane, and glial cells that protect the neurons and glial cells, preventing the passive transport of molecules >500 Da between CNS and blood capillaries.6,7 However, as discussed by Feng et al1 some nanomaterials that have been utilized as drug carriers can cross the BBB. This possibility to cross the BBB has important concerns about the use of nanomaterials and possible neurotoxicity, especially in children. Another important point in the paper is the discussion about a complex topic as nanomaterials is comprehensive, but in simple language, which makes it accessible for general dentists and neurologists. First and foremost, it becomes clear to the reader how faster and more efficient it has been the development and spread of nanoparticles (NPs) than its biosecurity research counterpart. As an example, the authors could not find any study on NPs elimination from the CNS. Moreover, on the exploration of this final via in the metabolism of NPs, the new recent findings regarding a CNS lymphatic system should be considered.8 On the other hand, although not entirely understood, the pathways for systemic absorption and CNS distribution of NPs could be reviewed extensively by the authors and this is a major virtue of this study. Given all the current and potential future impacts to human health, there is a need for the regulatory and governmental agencies to lean over this matter. This could have been better explored in this study. There are some ongoing initiatives from the Food and Drug Administration: its National Center for Toxicological Research is conducting toxicity studies on nanomaterials and the Center for Drug Evaluation and Research has ongoing research projects to identify the limitations of current test methods to assess the quality and safety of NP-based therapeutics.9 The main research challenges, as discussed in Figure 5 regarding the existing problems in assessing the neurotoxicity of NPs, could be summarized in three main front lines. Methodological standardization is a must to enable interpretation of results of multiple studies and to allow replicability, an undervalued step for science progress. As the authors demonstrated, standard procedures are still lacking to evaluate NPs toxicity. Second, the process of translating the current knowledge from pre-clinical experiments to human Phase I/II studies is still in its beginning. In this regard, we may have even more incognito after effects in different age groups and/or comorbid conditions. Ultimately, considering that many toxicity effects present on the long-term, to achieve early results with clinical significance, identification of reliable surrogate endpoints will be demanded.

Prevalência da fissura de úvula em familiares de fissurados lábio-palatinos

RESUMO O objetivo deste estudo foi verificar se a prevalencia da fissura de uvula (FU) e maior em familiares de portadores de fissura labiopalatina em relacao a populacao em geral. Esta pesquisa foi realizada com um grupo de estudo composto por 136 familiares de pacientes fissurados e com um grupo controle formado por 287 individuos sem historia familiar de qualquer deformidade craniofacial. A metodologia consistiu em inspecao da cavidade oral por 2 examinadores, com luz direcionada ao palato posterior e auxilio de abaixador de lingua e jatos de ar para elicitar o reflexo do vomito e definir e extensao da FU, segundo a classificacao de Meskin. Os resultados mostraram que a prevalencia da FU no grupo de estudo foi 2,9:100, sendo todas classificadas como parciais 25% de extensao, e no grupo controle 2,4:100, sendo que prevaleceu a parcial 25%. Concluiu-se que a FU nao prevalece em familiares de portadores de fissuras labiopalatinas; nao ha correlacao com o genero e a fissura de uvula parcial 25% foi a mais incidente. Palavras chave: Uvula; Epidemiologia; Fissura Palatina.