Prader-Willi syndrome (PWS) is a rare complex multisystem disorder and presents several aspects related to dentistry. The purpose of this review is to present current perspectives about oral health in patients with PWS. Delay development, hyperphagia, foamy and highly viscous saliva raise the risk of caries and contribute to tooth wear. Cariogenic foods uncontrolled consumption allows to obesity and dental problems progress worsening systemic disorders. These factors can be controlled. The success in follow-ups with caries free and oral health controlled demonstrate the importance of multidisciplinary team intervention corroborated by support at home from birth to adulthood. Thereby, current perspective on the disease is that there is possibility of proper maintenance of oral health in PWS patients. Guided care interferes positively with the overall well-being and quality of life of the individual with PWS and their family. A multidisciplinary team with a focus on teaching patients and family members will help minimize eventual problems.
In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student's t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.
Prader–Willi syndrome described in 1956 has a genetic origin, affecting both genders, varying in presence and intensity from individual to individual. A precocious diagnosis, before the manifestation of symptoms, has brought some improvement in the quality of life of the carriers in the last years. The objective of this case report was to describe the treatment realized in a 3-year-old boy who presented grade II obesity, difficulty of locomotion, hypotonia, and history of cardiopathy. A dental treatment under general anesthesia was defined, allowing an oral adequation in a single section, in which it was planned the extraction of the element 74 and atraumatic restorative treatment (ART) technique in the other teeth. The precocious intervention in this 3-year-old patient by the therapy realized with ART under general anesthesia was done with success, avoiding unnecessary extractions, preserving dental elements, and maintaining the oral cavity in adequate function.
A osteomielite é considerada uma doença incomum em pacientes saudáveis e de difícil diagnóstico e tratamento. Estudos sugerem que patologias infecciosas periodontais e peri-implantares como gengivites, periodontites e peri-implantites atuam como fatores mais comuns, predisponentes para osteomielites dos maxilares. Osteomielites crônicas exigem tratamento com cobertura antibiótica e procedimentos cirúrgicos. O tratamento envolve avaliação, determinação da etiologia, terapia antimicrobiana, desbridamento da lesão, remoção dos sequestros ósseos e decorticação óssea associada ao emprego sistêmico de antimicrobianos, geralmente de amplo espectro. O presente trabalho tem como objetivo relatar dois casos clínicos de osteomielite crônica infantil, bem como realizar uma análise comparativa de casos clínicos já publicados em artigos científicos. Pôde-se concluir que a associação de características clínicas, exames histopatológicos e achados radiográficos podem reunir características comuns para diversos tipos de osteomielite. Portanto, devem culminar em fatores contribuintes para o diagnóstico final. Em ambos os casos relatados, o tratamento foi eficaz utilizando terapia medicamentosa com o uso de anti-inflamatórios e antibióticos aliados a tratamento cirúrgico que consistiu em desbridamento da lesão. Ambos os pacientes foram acompanhados e proservados, não havendo recidiva. Descritores: Osteomielite; Antibacterianos; Patologia Bucal; Procedimentos Cirúrgicos Bucais.ReferênciasHupp JR, Ellis E, Tucker MR. Cirurgia oral e maxilofacial contemporânea. Rio de Janeiro: Elsevier; 2011.Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004;364(9431):369-79.Baltieri BR, Gabrielli MAC, Gabrielli MFR, Pereira Filho VA, Lopes FS, Leite VA. Osteomielite em mandíbula de criança. Rev Odontol Unesp. 2014;43(N Especial):262.Gaetti Júnior E, Gaetti Jardim EC, Faverani LP, Landucci KC, Landucci LF. Osteomielite crônica dos maxilares: aspectos clínicos, terapêuticos e microbiológicos. Salusvita. 2008;27(1):125-39.Carek PJ, Dickerson LM, Sack JL . Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12):2413-20.6. Miloro M, Ghali GE, Larse PE, Waite PD. Princípios de cirurgia bucomaxilofacial de Peterson. 2ed. São Paulo: Santos; 2008.Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia oral e maxilofacial. Rio de Janeiro: Elsevier; 2011.Watanabe T, Ono H, Morimoto Y, Otsuki Y, Shirai M, Endoh A et al. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis. Nagoya J Med Sci. 2015;77(3):493-500.Suei Y, Taguchi A, Tanimoto K. Diagnosis and classification of mandibular osteomyelitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):207-14.Masocatto DC, Oliveira MM, Mendonça JCG. Osteomielite crônica mandibular: relato de caso. Arch Health Invest.2017;6(2):48-52Ferraria N, Marques JG, Ramos F, Lopes G, Fonseca JG, Neves MC. Osteomielite crónica multifocal recorrente: série de 4 casos clínicos tratados com bifosfonatos. Acta Reumatol Port. 2014;39(1):38-45Paim LB, Liphaus BL, Rocha AC, Castellanos LZA, Silva CAA. Osteomielite crônica multifocal recorrente da mandíbula: relato de três casos. J Pediatr. 2003;79(5):467-70.Sousa MV, Malheiro R, Neves J, Varandas L, Conde M. Osteomielite crónica não bacteriana unifocal da mandíbula. Acta Reumatol Port. 2014:39;94-95Kadom N, Egloff A, Obeid G, Bandarkar A, Vezina G. Juvenile mandibular chronic osteomyelitis: multimodality imaging findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(3):e38-43.Theologie-Lygidakis N, Schoinohoriti O, Iatrou I. Surgical management of primary chronic osteomyelitis of the jaws in children: a prospective analysis of five cases and review of the literature. Oral Maxillofac Surg. 2011;15(1):41-50.Wang L, Wu Y, Tan Y, Fei X, Deng Y, Cao H et al. Cytotoxic effects of the quinolone levofloxacin on rabbit meniscus cells. J Appl Toxicol. 2014;34(8):870-77.Deng Y, Chen B, Qi Y, Magdalou J, Wang H, Chen L. The effects of levofloxacin on rabbit anterior cruciate ligament cells in vitro. Toxicol Appl Pharmacol. 2011;257(1):67-73.Obel G, Krogdahl A, Thygesen T, Godballe C. Juvenile mandibular chronic osteomyelitis: 3 cases and a literature review. J Oral Maxillofac Surg. 2013;71(2):305-9.
Objetivo: Apresentar uma revisão sobre o perfil clínico e epidemiológico do fibroma condromixoide. Métodos: Foi realizado buscas através de uma revisão integrativa dos casos de fibroma condromixóide. Resultados: O fibroma condromixoide (FCM) tem origem cartilaginosa, sendo um tumor benigno e raro com ínfima possibilidade de transformação maligna. O diagnóstico deve ser cuidadoso devido à semelhança com o condrossarcoma, condroblastoma, condroma, osteossarcoma e mixoma. O tratamento pode ser feito por curetagem, enucleação ou excisão em bloco com prognóstico favorável e pouca recorrência. A distribuição entre os sexos é equivalente. A média de idade é de 30,7 anos e seus sinais e sintomas são variados. Os casos mais observados na cabeça ocorreram nos ossos esfenoide e etmoide, seguidos da mandíbula e maxila. Sua ocorrência no crânio não segue um padrão, podendo surgir em qualquer segmento. O estudo de imagem é obrigatório para a determinação do diagnóstico e tratamento adequado. Considerações finais: O cirurgião precisa estar atento para definir uma avaliação e um diagnóstico corretos para as lesões raras como nos casos do FCM. Igualmente, necessita manter alerta o paciente sobre eventuais recidivas, assim como realizar reavaliações periódicas de forma preventiva. A ocorrência de recidiva precisa de intervenção célere com o intuito de minimizar sequelas ao paciente.
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