O processo para instalação de um implante dentário deve ser realizado com a precisão do planejamento que engloba um prontuário completo com todas as informações do paciente e do implante que será realizado. Muitos fatores devem ser considerados para a perfeita execução de um ou mais implantes dentários, de modo, a salvaguardar tanto paciente como profissional. O objetivo do presente trabalho foi esclarecer a importância de um bom planejamento, que aprofunde o conhecimento de particularidades do paciente, buscando verificar relação entre falhas de implantes e erros na colheita de dados prévios à cirurgia, abordando ainda tópicos de um prontuário odontológico, e os parâmetros legais para a digitalização e o tempo de guarda destes prontuários. Adequada composição de planejamento, prontuário odontológico e guarda da documentação carecem de maior destaque na literatura, posto que são temas que, ao se tornarem rotina clínica, podem fazer a diferença entre sucesso e fracasso na Implantodontia. Se destaca nos trabalhos revisados a importância de haver uma clara exposição do tratamento para o paciente com todas as informações sobre todo o processo, a fim de garantir o cumprimento do Código de defesa do consumidor e do Código de Ética Odontológico, levando a existência de um termo de consentimento para que ambas as partes tenham proteção legal e confiança no tratamento.
The bacteria involved in the gingival inflammatory process induce inflammatory responses characterized by the release of mediators, for example, interleukins, the cytokines involved in the course of development of periodontal disease are not yet fully established. The increase in the amount of interleukin-1beta (IL-1β) is correlated, in the periodontal lesion, with the progression from the stable lesion to the progressive lesion. The purpose of this literature review was to evaluate IL-1β and its influence on the development of periodontal disease. Initially, 860 articles from the following databases were evaluated in this literature review: Pubmed, Lilacs, Scielo, Web of Science, Embase and Cochrane. The search terms were: periodontal disease and IL-1β; periodontitis and IL-1β; oral health and IL-1β; gingivitis and IL-1β. With the adopted criteria, 28 articles were included in this literature review. The observed results showed that IL-1β is the one that most relates to the activity of the disease, since patients with periodontitis have a higher frequency of a genotype associated with increased production. These cytokines can be generated by immune cells, such as lymphocytes and monocytes in the medullary cavity or by other bone cells, particularly cells of the osteoblastic lineage. We conclude that IL-1β is directly related to the progression of periodontal disease, promoting the entry of inflammatory cells to the sites of infection and high levels of IL-1β are related to bleeding rates, probing depth and clinical level of insertion changed.
Anomalias dentárias são resultado de distúrbios que ocorrem no processo de odontogênese – responsável pelo desenvolvimento do órgão dental. Essas alterações geralmente acontecem na fase de formação e diferenciação celular. Sendo assim, o objetivo da presente pesquisa foi avaliar a prevalência de anomalias de forma e número em pacientes ortodônticos da Clínica de Especialização da Universidade Metropolitana de Santos. Foram analisadas 262 radiografias panorâmicas, de indivíduos do gênero masculino e feminino, com idade de 06 a 50 anos, que realizaram ou estão realizando tratamento ortodôntico, acrescentando à análise da radiografia panorâmica e de modelos, a consulta dos prontuários clínicos. Para coleta de dados das anomalias dentárias, foi elaborada uma planilha de dados no programa Microsoft Excel. O teste estatístico não paramétrico utilizado foi Mann-Whitney (p<0.05). Foi observado um total de 114 anomalias dentárias, sendo a agenesia a anomalia mais frequente, se apresentando em 27,86% dos pacientes, sendo 30% apresentada apenas por terceiros molares. A taurodontia é a segunda anomalia mais frequente apresentada por 7,25% dos casos, sendo 47,37% do gênero masculino e 52,63% do gênero feminino. Seguiu-se com os supranumerários acometendo 4,20%, apresentando-se mais em homens (81,8%) do que em mulheres (18,2%). As anomalias de número foram muito mais prevalentes do que as anomalias de forma, sendo agenesia e taurodontia as mais prevalentes entre pacientes ortodônticos.
Background: The rampant spread of SARS-CoV-2 worldwide increases the likelihood that dental health care professionals will treat this subset of the patient population. Due to the characteristics of the profession and the virus, two situations deserve attention: the disinfection of surfaces that can be contaminated during dental treatment and the presence of the virus in the oral cavity and the countless possibilities of microbial interaction with microorganisms in the oral cavity. Objective: The objective of this review was to point out, the current stage of the discussion on dental biosafety involving professionals, the work team and patients. Methods: The following databases were consulted: MEDLINE (National Library of Medicine, USA - NLM), Lilacs, Scielo, Embase, Web of Science and Google Academic with the keywords COVID-19 and dental practice, dentistry, oral conditions, mouthrinses. Results: Disinfection of surfaces has always been paramount and the protocol to prevent the spread of SARS-CoV-2 seems to be established. SARS-CoV-2 is vulnerable to oxidation, it is recommended to use a mouth rinse containing oxidizing agents. Conclusions: Dentists are among the professionals who are most at risk of Covid-19 infection, and they must have extra attention during this period, biosafety measures must be reinforced and patients must be motivated to maintain a strict oral hygiene routine so that there is no accumulation of biofilm and this may somehow interfere with your systemic condition.
INTRODUCTION: Intraoral appliances (IOA) are indicated for treatment of Obstructive Sleep Apnea Syndrome (OSAS) even in patients with poor adherence to CPAP. Polysomnography with IOA may confirm therapeutic benefit. METHODS: Polysomnographic results of a semiflexible IOA in patients under inadequate use of CPAP were compared by a retrospective pilot study including 17 patients (11 men and 6 women) aged 53.7 +- 7.8 years, BMI of 27.05 +- 4.1kg/m2 and basal apnea-hypopnea index (AHI) of 35.0 +- 19.8/h. Confirmed the inappropriate use or refusal of CPAP, the patients received a semiflexible propulsion device (AQUALITY) and, after complete titration, new polysomnographies were compared to baseline and CPAP registers. ANOVA was used for repeated and post-hoc Bonferroni measurements (p <0.05). RESULTS: There was a similar reduction in AHI with OA (7.7 +- 1.7/h) and CPAP (6.1 +- 1.6/h), both compared to baseline (p <0.001). The O2 desaturation index was reduced with IOA (2.4 +- 0.6 h) and CPAP (1.3 +- 0.6/h), both compared to baseline (15.7 +- 3.8) (p <0.001). Awakening rates were also minimized with IOA (7.2 +- 1.9/h) and CPAP (4.2 +- 0.7/h), both compared to baseline (18.9 +- 5.3) (p <0.001). Sleep efficiency was higher with IOA compared to CPAP (87,2 +- 2,1 x 75,6 +- 3,9) (p <0.05). CONCLUSION: Treatment with the selected device resulted in improved polysomnographic records in this sample and may be indicated as an alternative to CPAP in undertreated patients.
The rampant spread of SARS-CoV-2 worldwide increases the likelihood that dental health care professionals will treat this subset of the patient population. Due to the characteristics of the profession and the virus, two situations deserve attention: the disinfection of surfaces that can be contaminated during dental treatment and the presence of the virus in the oral cavity and the countless possibilities of microbial interaction with microorganisms in the oral cavity. The objective of this review was to point out, the current stage of the discussion on dental biosafety involving professionals, the work team and patients, some measures can and should be taken against the spread of SARS-CoV-2. Disinfection of surfaces has always been paramount and the protocol to prevent the spread of SARS-CoV-2 seems to be established. SARS-CoV-2 is vulnerable to oxidation, it is recommended to use a mouth rinse containing oxidizing agents. Dentists are among the professionals who are most at risk of COVID-19 infection, and they must have extra attention during this period, biosafety measures must be reinforced and patients must be motivated to maintain a strict oral hygiene routine so that there is no accumulation of biofilm and this may somehow interfere with your systemic condition.
Objective: To evaluate the Microimplant-assisted Rapid Palatal Expansion (MARPE), considered an alternative to surgical interventions for disjunction of the midpalatal suture in adolescent patients and young adults with maxillary transverse deficiency. The stage of ossification of the midpalatal suture, bone quality and adequate activation protocols are factors that can influence the quantity and quality of the orthopedic separation. Methodology: This paper demonstrates the application of MARPE in an unfavorable case report, of an adult patient with total crossbite, in an advanced stage of fusion of the palatine and maxillary processes, with poverty in the posterior bone volume, in comparison with the same therapy in an adolescent at an earlier stage of sutural maturation. In both cases, after tomographic examinations and oral scanning, the installations and recommended activation protocol were performed. These were not sufficient in the case of the adult patient, and generated side effects that, to be overcome, required changes in activations and additional maneuvers. Results: The application of MARPE may require clinical versatility to adopt differentiated protocols in relation to chronological age, bone thickness and sutural ossification stage. Conclusion: In the end, new computer tomography scans and a clinical examination showed satisfactory results in both patients. In the unfavorable case, the opening of the midpalatal suture occurred at more modest levels, but it was sufficient to correct the posterior crossbite.
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