Naira Figueiredo Deana

Displasia Ectodérmica Hipohidrótica: un Síndrome de Interés para la Odontología

La displasia ectodermica hipohidrotica (DEH) es una enfermedad rara de etiologia genetica. La forma mas frecuente es la de herencia recesiva relacionada al cromosomo X con sujetos de sexo masculino afectados y de sexo femenino portadores. Pueden ocurrir a traves de mutaciones autosomicas, y en estas, las del gene EDA1 son responsables por la mayoria de los casos. Se caracteriza por la triada: hipohidrosis, oligodoncia e hipotricosis. Presentamos dos casos de pacientes con DEH en los cuales se observaron signos caracteristicos del sindrome: piel delicada; cabellos, cejas y pestanas escasos; arrugas periorbitales; hiperpigmentacion perioral y periorbital; labios prominentes y ademas de eso el paciente del caso 2 presentaba depresion del puente nasal. Se constato aun disminucion de la secrecion salival y lagrimal y hipoplasia de maxila en los dos casos. Al examen oral estaban presentes en el caso 1 los caninos superiores derecho e izquierdo temporales y el canino inferior derecho temporal y en el caso 2 los caninos superiores e inferiores (derechos e izquierdos) temporales y dos incisivos superiores (uno derecho y otro izquierdo) permanentes con morfologia alterada, siendo todos los elementos dentarios integros. El tratamiento odontologico precoz de los portadores de DEH, principalmente en la presencia de oligodoncia, como la que se observa en los casos aqui reportados, es importante no solamente para ofrecer mejor calidad de vida para estos pacientes en corto plazo, sino tambien en el intento de mitigar las alteraciones en el crecimiento facial a que estos pacientes estan sometidos.

Morphological study of the lingula in adult human mandibles of Brazilians individuals and clinical implications.

Objectives. The purpose of this research was to study, in macerated adult human mandibles, the height of the lingula and provide morphometric data for its location considering aspects such as shape of the lingula, gender, and race. Material and Methods. 132 macerated mandibles of Brazilian adult individuals, both sexes, Amerindian and Caucasian, were used. The distances: from mandibular notch to lingula; from anterior margin of ramus of mandible to lingula; from posterior margin of ramus of mandible to lingula; from mandibular base to lingula, and the height of lingula were obtained. To perform these measurements we used a digital caliper. The variables such as gender and race were analyzed. Results. The mean values found for the height of lingula and its location were determined according to the gender, race, and the lingula shape. Conclusion. This research provides additional data on height of the lingula and morphometric data for its location considering aspects such as shape of the lingula, gender, and race, information that had not been reported in the literature to date. We emphasize that a careful study considering gender and ethnic group makes procedures involving the region of lingula safer.

Frequency of Occurence of the Discomalleolar Ligament in the Adult Man

SUMMARY: The discomaleollar ligament is not described in the anatomy textbooks but was demonstrated by Pinto (1962) and others. It is a ligamentous structure connecting the malleus in the tympanic cavity and the articular disc and the capsule of the temporomandibular joint. This anatomical relationship between the middle ear and temporomandibular joint is supposed to be one of the explanations for the otological symptons associated with temporomandibular joint dysfunction. The aim of our study was to determine the frequency of occurence of the discomaleollar ligament. Twenty hemi-heads of adults human were carefully dissected from a superior approach through the middle cranial fossa. The bone of the middle cranial fossa over the temporomandibular joint region and the roof of the tympanic cavity were carefully removed to expose the articular disc, ossicles of the middle ear, lateral pterygoid muscle and other structures in the region. The discomalleolar ligament was found in all studied cases what allow us to suggest that it is an intrinsic ligament of the temporomandibular joint.

Effectiveness of Low-Level Laser Therapy in Reducing Orthodontic Pain: A Systematic Review and Meta-Analysis

Objectives To assess the effectiveness of low-level laser therapy (LLLT) in reducing orthodontic pain after the application of orthodontic force (OF). Methods A systematic search was conducted in the MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science, and EBSCOhost databases. The study included randomized clinical trials (RCT) which analysed the effectiveness of LLLT in reducing orthodontic pain assessed at 24 and 72 hrs after the application of OF. The risk of bias of the eligible trials was assessed using the Cochrane Collaborations risk of bias tool. Standard mean difference was calculated and pooled by meta-analysis using random effect models. Results Of 467 identified articles, 20 RCT were finally included. In the risk of bias assessments, 13 studies presented a high risk, 5 an unclear risk, and 2 a low risk. The meta-analysis showed that in patients treated with laser versus placebo there was a difference in favour of LLLT in spontaneous pain 24 and 72 hrs after the installation of light archwires and spontaneous pain and chewing pain 24 and 72 hrs after the installation of elastomeric separators. Conclusions LLLT proved to be effective in promoting a reduction in spontaneous and chewing pain after the application of OF; however, the poor quality of the evidence requires these results to be treated with caution.

Morphological Features of Pycnodysostosis with Emphasis on Clinical and Radiographic Maxillofacial Findings

La picnodisostosis es un sindrome genetico raro caracterizado por baja estatura, angulo de la mandibula obtuso, prominencias frontal, parietal y occipital, suturas craneales y fontanelas abiertas, hipoplasia del tercio medio de la cara, acroosteolisis de las falanges distales, aumento de la densidad osea, ausencia o hiponeumatizacion de los senos paranasales y examenes de laboratorio normales. Se presenta un caso de paciente brasileno, 35 anos de edad, sexo masculino, remitido a clinica privada con historia de facies dismorfico para evaluacion. Las caracteristicas clinicas y radiologicas exhibidas por el paciente llevaron al diagnostico de picnodisostosis. Se describe las caracteristicas morfologicas de la picnodisostosis con enfasis en los hallazgos clinicos y radiologicos maxilofaciales, comparando los datos obtenidos en nuestro caso con los hallazgos reportados en la literatura revisada.

Electromyographic Study of the Masseter Muscle After Low-Level Laser Therapy in Patients Undergoing Extraction of Retained Lower Third Molars

La cirugia para extraccion del tercer molar mandibular retenido es uno de los procedimientos mas realizados en el campo de la cirugia maxilofacial. Durante este procedimiento, el trauma quirurgico puede causar dano a la funcion de los musculos involucrados en los movimientos mandibulares, entre ellos el musculo masetero. Con el objetivo de acelerar la recuperacion postoperatoria, son utilizados muchos recursos de fisioterapia, incluyendo la terapia con laser. El objetivo de este estudio fue analizar la actividad electrica del musculo masetero tratado con laser de baja intensidad (LBI) despues del trauma quirurgico. Se realizaron evaluaciones del musculo masetero en una muestra de 60 pacientes, a traves de electromiografia de superficie en cuatro momentos: preoperatorio inmediato, postoperatorio a los 7, 14 y 21 dias. Los pacientes fueron divididos en dos grupos: 1 - grupo no tratado con LBI en el postoperatorio; 2 - grupo tratado con LBI (810 nm; 10 J/cm2) en el postoperatorio inmediato y a los 3, 6 y 9 dias tras cirugia. Al septimo dia tras cirugia el 23,3 % de los pacientes del grupo tratado con LBI presentaron recuperacion de su actividad muscular equivalente a lo presentado en el preoperatorio inmediato, frente a solo el 3,3 % del grupo no tratado. En el dia 14, el 73,3% de los pacientes tratados presentaron rehabilitacion funcional, frente al 6,7% del grupo no tratado y en el vigesimo primer dia, el 80% frente al 10% del grupo no tratado. En el dia 14 postoperatorio la actividad electrica del musculo masetero tratado con LBI despues del trauma quirurgico fue compatible con una condicion de recuperacion funcional completa. Los hallazgos de este estudio electromiografico indicaron que el LBI es un eficiente metodo fisioterapico para estimular la recuperacion funcional del musculo masetero tras cirugia de terceros molares mandibulares retenidos.

Recurrent Monostotic Fibrous Dysplasia in the Mandible

Fibrous dysplasia (FD) is a condition in which normal bone marrow is replaced by an abnormal proliferation of new fibrous connective tissue. Female patient, white, 20 years old, attended the dental clinic reporting a slow increase in volume in the right mandible region over the last 5 years. She was examined by imaging: the panoramic X-ray revealed a lesion with the appearance of ground glass while the cone-beam computed tomography showed an extensive lesion in the region of the right hemimandible. The histopathological examination was compatible with fibrous dysplasia. Bone gammagraphy was indicated, plus an endocrinological study to eliminate polyostotic forms, which produced a negative result. Monostotic fibrous dysplasia in the right hemimandible was diagnosed. Conservative surgery was carried out and after 1 year recurrence of the tumour was observed. We may conclude that conservative surgery might not be the best choice for treatment for monostotic fibrous dysplasia in the mandible and that other options must be considered, such as radical surgery or the use of bisphosphonates. In our study, we may also conclude that it is very important to explain to the patient the possibility of recurrence of the lesion and the need for monitoring with periodic imaging studies.

Study of Frequency of the Palmaris Longus Musclem in Chilean Subjects

El musculo palmar largo (MPL), ubicado en la region anterior del antebrazo, es considerado como uno de los musculos mas variables del cuerpo humano, siendo su agenesia la variacion anatomica mas frecuentemente senalada por los investigadores. El objetivo de este estudio fue investigar la frecuencia del tendon del musculo palmar largo en individuos chilenos y verificar la simetria de la agenesia segun el sexo. Para ello, analizamos la presencia del tendon del MPL en 200 individuos chilenos, 114 mujeres y 86 hombres. Fueron utilizadas 3 pruebas: Prueba Schaeffer, Primera Prueba de Mishra y Prueba Thompson. Los datos obtenidos fueron registrados y tabulados. Se observo que el 91% de los sujetos presentaron el tendon del MPL al menos en uno de los antebrazos, mientras que un 80% lo presentaron en ambos antebrazos. Se observo aun que la agenesia unilateral estuvo presente en un 11% de los casos (5% en el lado derecho y 6% en el lado izquierdo), ya la agenesia bilateral estuvo presente en 9%. Al analizar la presencia (unilateral y bilateral) del tendon del PLM considerando el sexo, se observo en el 82,56% de los hombres y en el 78,07% de las mujeres (p>0,05). Se observo que la ausencia del tendon del MPL era mas frecuente en mujeres que en hombres, y en el lado izquierdo que en el derecho, no existiendo diferencias estadisticamente significativas (p>0,05).

Mandibular Canal Course and the Position of the Mental Foramen by Panoramic X-Ray in Chilean Individuals

The object of this study was to analyse the morphology and morphometry of the mandibular canal (MC) course and the mental foramen (MF) position in relation to the inferior teeth by panoramic X-ray (PAN). Vertical linear measurements were taken of each hemimandible to obtain the length of the distances analysed. We studied the MF position in relation to inferior premolar roots and the relation between the MC and mandibular teeth roots (MCR). The MF was usually located between the apices of the first and second premolars in younger individuals and immediately below the apex of the inferior second premolar in older individuals. The MC evinced proximity to the third molar, and this relation was not affected by sex or age group. The distances analysed in this study presented a marked difference between gender, with larger values in males than in females. The variations which may occur between individuals and different populations make it essential for dentists and surgeons to plan carefully before procedures involving this region.

Cone Beam CT in Diagnosis and Surgical Planning of Dentigerous Cyst

Diagnosis and preoperative planning are critical in the execution of any surgical procedure. Panoramic radiography is a routine method used in dentistry to assist clinical diagnosis; however, with this technique 3D anatomical structures are compressed into 2D images, resulting in overlapping of structures which are of interest in the diagnosis. In this study we report the case of a patient who presented with a dentigerous cyst of expressive dimensions in the body of the mandible region. The surgery was planned and executed after observing the margins of the lesion by Cone Beam Computed Tomography (CBCT). We conclude that CBCT is a precise method to help diagnosis; it provides greater accuracy in surgical treatment planning through 3D image display, allowing more effective results.