The aim of this study was to perform a literature review about the composition and functions of saliva as well as describe the factors that influence salivary flow (SF) and its biochemical composition. Background: Saliva represents an increasingly useful auxiliary means of diagnosis. Sialometry and sialochemistry are used to diagnose systemic illnesses, monitoring general health, and as an indicator of risk for diseases creating a close relation between oral and systemic health. Review: This review provides fundamental information about the salivary system in terms of normal values for SF and composition and a comprehensive review of the factors that affect this important system. Conclusion: Since several factors can influence salivary secretion and composition, a strictly standardized collection must be made so the above-mentioned exams are able to reflect the real functioning of the salivary glands and serve as efficient means for monitoring health. Clinical Significance: Since many oral and systemic conditions manifest themselves as changes in the flow and composition of saliva the dental practitioner is advised to remain up-to-date with the current literature on the subject.
Os autores entrevistaram especialistas em Ortodontia e em Cirurgia Bucomaxilofacial, elaboraram uma lista de ocorrências específicas do dia-a-dia do exercício da especialidade, redigindo, com base na legislação vigente e na literatura, uma série de orientações, atitudes e comportamentos que sugerem como rotina aos profissionais. INTRODUÇÃOA cirurgia ortognática é assim denominada por constituir-se de técnicas de osteotomias realizadas no sistema mastigatório com o objetivo de corrigir as discrepâncias relacionais maxilares e, por conseguinte, estabelecer o equilíbrio entre a face e o crânio.A relação maxilo-mandibular corrigida pela cirurgia ortognática favorecerá a função mastigatória, a fonética, a respiração e a estética facial. Portanto, muitas implicações estão envolvidas neste tratamento cirúrgico, pois as mudanças faciais repercutem na vida pessoal e social do indivíduo, e por vezes o componente psicológico do paciente deverá ser preparado para receber um procedimento cirúrgico de tal magnitude.Os sentimentos dos pacientes também são determinados pela sua face e a deformidade dentofacial pode prejudicar suas relações sociais. Após a cirurgia ortognática, observa-se uma plena disposição do paciente para novas relações, pois os resultados funcional e estético são observados rapidamente e o indivíduo sente-se seguro para vislumbrar novos horizontes 7 . O incentivo da família pode ser um fator positivo para o paciente, sendo um valioso recurso complementar terapêutico, segundo Ponzoni 42 . Porém, existem algumas famílias que por medo e por preconceito não aceitam a idéia da realização de uma cirurgia, muitas vezes por achar que se está negando uma característica hereditária, sendo um fator negativo para a recuperação do paciente.A decisão para se fazer o tratamento cirúrgico deve partir do paciente. O profissional e a família não devem induzi-lo à realização de um procedimento cirúrgico que irá produzir alterações irreversíveis na sua face e na sua personalidade.A cirurgia ortognática é um tratamento que não se resume apenas ao ato cirúrgico e sim a um trabalho prévio de preparação de 18 a 24 meses, onde estará incluído o tratamento ortodôntico, fonoaudiológico e psicológico. Realizada a cirurgia, segue o tratamento ortodôntico por mais 8 a 12
Completely and partially edentulous patients with Sjogren's syndrome (SS) experience severe hyposalivation, xerostomia, and considerable difficulty in using tissue-supported prosthesis. This clinical paper describes the management, treatment, and 6-year follow-up of a patient diagnosed with SS type II, who uses corticosteroids and antihyperglycemic drugs. The patient received restorative, periodontal, and surgical treatments followed by implant-supported fixed prosthesis. Radiographic evaluation and probing depth showed gingival health and no bone loss after 6 years. Treatment with implant-retained dental prosthesis greatly increased comfort and function, offering an alternative to patients with SS.
ResumoIntrodução: A pesquisa das condições bucais de usuários de drogas é importante para ser conhecida esta população, cujo crescimento é ascendente no Brasil, a fim de que metas preventivas e atendimento adequado sejam traçados. Objetivo: Identificar o perfil sociodemográfico e a condição bucal desta população, em dois municípios paranaenses. Material e método: Foram coletados, por meio de questionário e de exame físico, dados de 100 indivíduos. Foram obtidos os seguintes valores: índice CPOD, profundidade de sondagem (PS), nível de inserção clínica (NIC), índice gengival (IG), índice de placa (IP) e sangramento à sondagem (SS). Após análise descritiva inicial, empregaram-se os testes t de Student e ANOVA one-way. Resultado: A média da idade foi 29,12 anos. As maiores frequências foram: gênero masculino (95,5%), solteiros (69,0%), baixa escolaridade (41%) e maior consumo de drogas lícitas -tabaco (90,9%) e álcool (84,5%) -, seguidas de crack (80,9%) e maconha (77,3%). A média do CPOD foi 15,21 (DP=5,84) e quanto maior o tempo de dependência, maior este índice (p<0,05). A média da PS foi 3,55 e do NIC, 3,59. O SS ocorreu em 82,7% dos casos e a inflamação moderada, em 79,5%. Placa detectável e moderado acúmulo de placa foram identificados em 39,5% e 35,3%, respectivamente. Conclusão: Predominaram indivíduos do gênero masculino, jovens, solteiros, com baixa escolaridade e consumidores de drogas lícitas e ilícitas, com condição bucal ruim. Sugere-se mais atenção dos profissionais da área odontológica e dos elaboradores de políticas públicas, com vistas a esta população.Descritores: Saúde bucal; usuários de drogas; epidemiologia. AbstractIntroduction: Epidemiological survey of the oral conditions of drug users is an important strategy to know this population, whose growth is increasing in Brazil, so that preventive goals and adequate treatment can be proposed. Aim: The aim of this study was to identify the sociodemographic profile and oral health condition of drug users in rehab of two municipalities of the State of Paraná. Material and method: One hundred individuals participated in the study, which data were collected by questionnaire and physical exam. The following values were obtained: DMFT index (decay-missing-filled index), probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BOP). Data analyses were performed by Student t test and one-way ANOVA. Result: The mean age of participants was 29.12 years. The major frequencies were: male (95.5%), single (69.0%), lower schooling (41%) and higher consumption of licit drugs tobacco (90.9%) and alcohol (84.5%), followed by crack (80.9%), and marijuana (77.3%). The mean DMFT index was 15.21 (SD=5.84), and the longer the dependence time, the greater this index (p<0.05). Mean PD was 3.55 and mean CAL was 3.59. BOP occurred in 82.7% and 79.5% showed moderate inflammation. Detectable plaque and moderate plaque accumulation were observed in 39.5% and 35.3%, respectively. Conclusion: Prevalence was observed in ...
Objective: To test the null hypothesis that metal and ceramic brackets have no effect on the epithelial cells of the buccal mucosa. Materials and Methods: Two metal and two ceramic brackets were bonded in 21 individuals of both sexes. With the use of liquid-based exfoliative cytology, morphometric and morphologic changes in buccal mucosa cells adjacent to these brackets were determined and were compared at three time points: baseline (T0), 60 days after placement (T1), and 30 days after removal of the brackets (T2). Results: A decrease in nuclear area and an increase in cytoplasmic area occurred in the buccal mucosa cells adjacent to the brackets at T1 (P Ͻ .01). At T2, this altered morphometry persisted only in cells adjacent to the metal brackets, although to a lesser degree than at T1 (P Ͻ .01). A greater decrease in nuclear area was noted in cells adjacent to the metal brackets than in those next to the ceramic brackets (P Ͻ .01). At T0, the proportions of surface and subsurface cells were similar, but at T1, a predominance of surface cells was observed (P Ͻ .05). At all time points, smears of cells appeared normal or normal with some inflammatory changes. Conclusion:The hypothesis is rejected. Placement of metal and ceramic brackets in the buccal cavity induces cellular alterations. These alterations do not suggest malignancy. (Angle Orthod. 2008;00:373-379.)
Summary. Background. This report describes the case of a patient with focal epithelial hyperplasia (FEH), a rare but distinctive entity of viral aetiology with characteristic clinical and histopathological features. Case report. The condition is usually seen in children and adolescents of American Indian and Eskimo background. Surgical removal of papillomatous lesions is the treatment of choice, either for aesthetic reasons, or when the lesions interfere with function or are readily traumatized. Recurrence and the site of new lesions are unpredictable, and continued review of the patient is often necessary. The patient described here has been followed for 24 months without recurrences or changes in the aspect of the remaining lesions. Conclusion. This case highlights a possible genetic predilection for FEH, since the patient is a descent of a Brazilian Xavante Indian.
Benzodiazepines are among the most frequently prescribed drugs and are often related with dry mouth. Pilocarpine is a cholinergic agonist that increases salivary flow rate and has been used to treat xerostomia. This study aimed to measure salivary flow rate of rats under chronic treatment with benzodiazepine (Diazepam), to analyze by histomorphometry the effects of the drug in the parotids glands and to verify the effect of the pilocarpine in glandular parenchyma and in the salivary flow rate. Seventy-two male Wistar rats were allocated to four groups. Control groups received saline during 60 days (C60) and pilocarpine (Pilo) during 60 days. Experimental groups were dealt with Diazepam associated with saline (DS), and Diazepam associated with pilocarpine (DP) during 60 days. The stimulated salivary flow rate was obtained by using the gravimetric method. After the animals were killed, parotid glands were removed and mass and size were determined. The specimens were processed and stereological analysis revealed cell volume. Mean values of size and salivary flow rate varied from 9.007 mm and 0.015 mg/min in DS to 7.854 mm and 0.029 mg/min in DP, respectively. ANOVA showed statistically significant differences between groups for size (p=0.0028) and salivary flow rate (p=0.0003). Psychotropic drugs caused hyposalivation in rats and acinar hypertrophy in their parotid glands. Pilocarpine, a cholinergic agonist with topical appliance, showed significant secretagogue action in the treatment of hyposalivation induced by Diazepam chronic use.
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