Clinical aspects and biochemical properties in the saliva of 21 patients prior to and following radiotherapy for head and neck cancer were evaluated (experimental group) and compared with the same properties in a control group of 21 subjects free of cancer. Salivary flow was evaluated by measuring the time necessary, in seconds, for the output of 2 ml of stimulated saliva; and the buffering capacity changes were determined using a simple colorimetric method. Total salivary protein concentration was determined by the Bradford4 method. Amylase activity was measured by reducing sugars released from a soluble starch substrate, quantified by the dinitrosalicylic method. The electrophoretic profile was evaluated in polyacrylamid gel (12% SDS-PAGE) using samples of 5 mg of salivary protein. A statistically significant reduction (p < 0.01) of the salivary flow was observed, (162.47 s ± 28.30 before and 568.71 s ± 79.75 after irradiation), as well as a reduction in the salivary buffering capacity (pH 5.45 ± 0.14 before and pH 4.40 ± 0.15 after irradiation). No statistically significant alteration was observed in total salivary protein concentration. A statistically significant reduction (p < 0.01) of salivary a-amylase activity (856.6 ng/mg ± 88.0 before and 567.0 ng/mg ± 120.6 after irradiation) was observed. Electrophoretic profile differences in salivary protein bands were also observed after radiotherapy, mainly in the range of molecular weight of 72,000 to 55,000 Daltons. Clinically, patients presenting xerostomia induced by radiotherapy presented an increase in oral tissue injury.

Objective The purpose of this study was to quantify the area covered by biofilm and identify bacteria and yeasts present in mandibular acrylic resin full‐arch implant‐supported fixed prostheses. Background Biofilm control of implant‐supported fixed prosthesis is hampered by their design, and it can cause oral and systemic problems, mainly in immunocompromised patients like the elder. Knowledge about microbiota reinforces the awareness about the need for periodic professional cleaning maintenance. Materials and methods Twenty prostheses were unscrewed, washed in 0.89% sodium chloride, stained with eosin 1% and photographed. The area covered by biofilm was digitally delimited and quantified. Biofilm samples were collected, diluted up to 1:107, seeded in chromogenic agar media and incubated for 48 hours, at 37°C, for counting of colony‐forming units (CFU/mL). DNA hybridization was performed to complement the identification and quantification of microorganisms. Data were analyzed using Mann‐Whitney test, Spearman correlation and Fisher's exact test (α = .05). Results An average of 62% of the gingival surface of the prostheses was covered by biofilm. Enterococcus spp. (5.82 ± 1.38 log10CFU/mL) and Staphylococcus aureus (5.75 ± 2.02 log10CFU/mL) showed higher prevalence in cultures. Patients with five implants had less biofilm compared to those with four implants (P = .031) but had higher Escherichia coli counts (P = .039). In DNA hybridization, Streptococcus pneumoniae, Veillonella parvula and Fusobacterium nucleatum presented higher quantification and were present in all the samples; patients over 65 years old contained more Candida tropicalis (P = .049); prostheses on five implants presented lower quantification for several species. Conclusion Biofilm was present on all prostheses, containing potentially pathogenic microorganisms. The number of implants may play a role in quantification of biofilm and in microorganism counts.

The prosthetic rehabilitation of an atrophic mandible is usually unsatisfactory due to the lack of support tissues, mainly bone and keratinized mucosa for treatment with osseointegrated implants or even conventional prosthesis. The prosthetic instability leads to social and functional limitations and chronic physical trauma decreasing the patient's quality of life. A 53-year-old female patient sought care at our surgical service complaining of impairment of her masticatory function associated with the instability of the lower total prosthetic denture. The clinical and complementary exams revealed edentulism in both arches, while the mandibular arch presented severe reabsorption resulting in denture instability and chronic trauma to the oral mucosa. The proposed treatment plan consisted in the mandibular rehabilitation with osseointegrated implants and fixed Brånemark's protocol prosthesis after mandibular reconstruction applying the modified visor osteotomy technique. The proposed technique offered predictable results for reconstruction of the severely resorbed edentulous mandible and posterior rehabilitation with osseointegrated implants.

Objetivo: Descrever a utilização de prótese fixa parcial metalocerâmica com gengiva cerâmica, como reabilitação estética em região anterior de maxila na impossibilidade de intervenções cirúrgicas com enxertia e instalação de implantes, em segundo momento, devido a condições sistêmicas ou questões financeiras. Detalhamento do caso: Paciente 50 anos de idade, sexo feminino, queixava-se da situação estética de seus dentes superiores. A dimensão vertical de oclusão e o suporte labial da paciente foram restabelecidos, melhorando o aspecto envelhecido, ainda na fase de prótese provisória. Foi confeccionada infraestrutura metálica recoberta por cerâmica feldspática, a partir da seleção de cores adequadas à paciente, além de preparo para coroas totais de cerâmica nos dentes vizinhos. O desenho da prótese incluiu uma área de gengiva com coloração similar à mucosa da paciente, respeitando a relação estética e funcional. Considerações finais: Esta modalidade protética foi a opção mais acessível diante de uma condição desfavorável à substituição de dentes perdidos por implantes com enxertia de tecidos duros e moles.

Firearm injuries in the lower jaw may cause significant loss of hard and soft facial tissues, resulting in aesthetic and functional deformity. In this article, we present a case of a patient who suffered avulsion of the soft and hard tissues of the left mandible body and symphysis. After the emergency treatment, the patient was referred to our service, and the treatment was performed in 3 stages: surgical reconstruction with vascularized fibula flap, distraction osteogenesis, and dental implant rehabilitation. During 5 years of follow-up period, the aesthetic and functional condition of the patient improved considerably.

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