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Since the beginning of 2020, health authorities have been monitoring the cases of Coronavirus Disease 2019 (COVID-19), which has grown every day in Brazil and around the world, becoming pandemic. The new coronavirus, also called SARS-CoV-2 by scientists spreads rapidly, causing fear, deaths, and threats for the economy of several countries. This work aimed to describe the clinical characterization of the first cases of a new Brazilian variant of SARS-CoV-2 (P1) in the State of Alagoas, which occurred on February 16th, 2021. Two cases are described: first, a person infected in Amazonas State, where the new variant P1 was first described, who migrated to Alagoas State, and second, a case of probable community transmission within Alagoas, since the patient had no history of recent travel. In both confirmed cases the symptoms were mild. Further studies are necessary to better understand the clinical behavior of P1 SARS-CoV-2 variant and also the associated sequelae in the context of COVID-19.

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ABSTRACT Since the beginning of 2020, health authorities have been monitoring the cases of Coronavirus Disease 2019 (COVID-19), which has grown every day in Brazil and around the world, becoming pandemic. The new coronavirus, also called SARS-CoV-2 by scientists spreads rapidly, causing fear, deaths, and threats for the economy of several countries. This work aimed to describe the clinical characterization of the first cases of a new Brazilian variant of SARS-CoV-2 (P1) in the State of Alagoas, which occurred on February 16th, 2021. Two cases are described: first, a person infected in Amazonas State, where the new variant P1 was first described, who migrated to Alagoas State, and second, a case of probable community transmission within Alagoas, since the patient had no history of recent travel. In both confirmed cases the symptoms were mild. Further studies are necessary to better understand the clinical behavior of P1 SARS-CoV-2 variant and also the associated sequelae in the context of COVID-19.

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Juvenile idiopathic arthritis (JIA), the most common inflammatory autoimmune rheumatic disease in children, consists of a heterogeneous group of diseases with 7 distinct subtypes. Involvement of the temporomandibular joint (TMJ) in JIA varies from 17% to 87%, and can alter craniofacial growth due to damage to the condylar growth center. This study was a literature review and clinical report of bilateral ankylosis of the TMJ in a 13-year-old patient with polyarticular JIA. Temporomandibular joint reconstruction with a costochondral graft was carried out. The surgery was uneventful and the patient developed a mouth opening of 40 mm during the postoperative period of 24 months. The authors concluded that treatment of TMJ ankylosis should be surgical with removal of the ankylotic mass, and when necessary, joint reconstruction in patients undergoing a growth phase. Costochondral graft is still the gold standard due to its biological similarity and growth potential in patients with JIA. Research and early diagnosis of TMJ diseases should be carried out, because the earlier the identification of the disease, the better the chances of reducing its devastating effects, thus avoiding the worst possible outcome: TMJ ankylosis.

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Abstract Background The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path. Objectives The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel’s topography. Methods In this study, axillary dissections were carried out on twenty-four (24) human cadavers of both sexes that had been fixed with 10% formaldehyde. The upper limbs of the cadavers were still attached to the bodies and the axillary structures were preserved. Data collection was carried out and the axillary structures of the cadavers were compared. Results The incidence of accessory axillary veins was 58.3%, with no significant preference for sex or for side of the body. The accessory axillary vein originated from the lateral brachial vein in 39.28% of cases, from the common brachial vein in 35.71% of cases, and from the deep brachial vein in 25% of cases. Conclusions Its high incidence and clinical relevance make the accessory axillary vein important for provision of collateral circulation in the event of traumatic injury to the axillary vein.

Resumo Contexto A veia axilar é um importante vaso que participa da drenagem sanguínea do membro superior. Porém, em alguns indivíduos, é observada uma segunda veia axilar, denominada veia axilar acessória, que é uma notável via de drenagem colateral. Objetivos O objetivo desta pesquisa foi observar a prevalência da veia axilar acessória, bem como descrever a topografia desse vaso. Métodos Neste estudo foram realizadas dissecações das axilas em 24 cadáveres humanos fixados em formaldeído 10%, de ambos os sexos, que apresentavam os membros superiores articulados ao tronco e com as estruturas axilares preservadas. A coleta de dados foi realizada e as estruturas axilares dos cadáveres foram comparadas. Resultados Foi encontrada uma prevalência de 58,3% de veias axilares acessórias, não havendo predileção significativa por gênero nem por lado acometido. Também foi observado que, em 39,28% dos casos, a veia acessória era originada a partir da veia braquial lateral, em 35,71% a partir da veia braquial comum, e em 25% a partir da veia braquial profunda. Conclusão Devido à sua alta prevalência e relevância clínica, a veia axilar acessória também assume grande importância no tocante à circulação colateral diante de lesão traumática da veia axilar.

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BACKGROUND: The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path. OBJECTIVES: The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel's topography. METHODS: In this study, axillary dissections were carried out on twenty-four (24) human cadavers of both sexes that had been fixed with 10% formaldehyde. The upper limbs of the cadavers were still attached to the bodies and the axillary structures were preserved. Data collection was carried out and the axillary structures of the cadavers were compared. RESULTS: The incidence of accessory axillary veins was 58.3%, with no significant preference for sex or for side of the body. The accessory axillary vein originated from the lateral brachial vein in 39.28% of cases, from the common brachial vein in 35.71% of cases, and from the deep brachial vein in 25% of cases. CONCLUSIONS: Its high incidence and clinical relevance make the accessory axillary vein important for provision of collateral circulation in the event of traumatic injury to the axillary vein.

CONTEXTO: A veia axilar é um importante vaso que participa da drenagem sanguínea do membro superior. Porém, em alguns indivíduos, é observada uma segunda veia axilar, denominada veia axilar acessória, que é uma notável via de drenagem colateral. OBJETIVOS: O objetivo desta pesquisa foi observar a prevalência da veia axilar acessória, bem como descrever a topografia desse vaso. MÉTODOS: Neste estudo foram realizadas dissecações das axilas em 24 cadáveres humanos fixados em formaldeído 10%, de ambos os sexos, que apresentavam os membros superiores articulados ao tronco e com as estruturas axilares preservadas. A coleta de dados foi realizada e as estruturas axilares dos cadáveres foram comparadas. RESULTADOS: Foi encontrada uma prevalência de 58,3% de veias axilares acessórias, não havendo predileção significativa por gênero nem por lado acometido. Também foi observado que, em 39,28% dos casos, a veia acessória era originada a partir da veia braquial lateral, em 35,71% a partir da veia braquial comum, e em 25% a partir da veia braquial profunda. CONCLUSÃO: Devido à sua alta prevalência e relevância clínica, a veia axilar acessória também assume grande importância no tocante à circulação colateral diante de lesão traumática da veia axilar.

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Pathologic fractures may occur when a bone has been weakened by an underlying pathologic process. The treatment depends on the etiology. We report on a patient with pathologic fracture in the jaw caused by unicystic ameloblastoma. The lesion was subjected to marsupialization, and the size of the radiolucent lesion decreased. The fracture was consolidated by bone regeneration. For the remaining tumor, a secondary surgery was performed with enucleation followed by spray cryosurgery using a combination of propane, butane, and isobutane gases. The patient showed no signs of recurrence during the 3-year period after the second surgical procedure.

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Oral-source infections are a potential threat for transplant candidates because oral diseases tendto be more severe and untreated in people who have received transplants. Although not yetscientifically proven, evaluation and dental treatment during the pre-transplantation period isrecommended in order to prevent infections and resultant odontogenic-origin sepsis during thepost-transplant period, when patients receive immunosuppressive therapy. Aim: To evaluate theinvasive dental procedures for removing dental foci performed in patients scheduled for livertransplantation and its accompanying complications. Methods: The medical records of 33 prelivertransplant recipients who were undergoing invasive dental procedures were reviewed,including their laboratory tests, special handling needs and resulting complications. Results: Fiftyinvasive dental procedures were carried out on the 33 patients. Three of them were subjected tobasic periodontal treatment and 47 were subjected to multiple or simple extractions. Threesurgical procedures resulted in postoperative complications. Conclusions: Surgical interventionto remove dental foci in liver disease patients requires careful clinical evaluation, laboratory tests,knowledge and skills in the use of local and systemic hemostatic procedures, and a partnershipapproach between dentists and physicians, in order to reduce the risk of complications.

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Osteonecrose dos maxilares relacionada aos bisfosfonatos pode ser uma complicação importante do tratamento da osteoporose a longo prazo. A possibilidade de osteonecrose dos maxilares em pacientes expostos a bisfosfonatos nitrogenados foi descrita pela primeira vez em 2003. Desde então, relatos de casos e estudos retrospectivos demonstraram maiores percentuais de ocorrência de osteonecrose em pacientes que fizeram ou fazem uso de bisfosfonatos. Embora esta complicação possa ser espontânea, os procedimentos invasivos orais têm um papel como fatores de risco associados aos procedimentos odontológicos, tais como as extrações dentárias e cirurgias de outros ossos. Além disso, infecções dentárias e doença periodontal são relatadas como principais fatores de risco para o desenvolvimento de osteonecrose dos maxilares induzida por bisfosfonatos. Por isso, dentistas, clínicos gerais, ortopedistas, geriatras e cirurgiões bucomaxilofaciais precisam estar cientes do problema e trabalhar em um ambiente multidisciplinar, incentivando o diagnóstico precoce e a prevenção de novos casos potenciais.

Bisphosphonate-related osteonecrosis of the maxillae may be an important complication of long-term osteoporosis treatment. The possibility of osteonecrosis of the maxillae in patients exposed to nitrogenated bisphosphonates was first described in 2003. Since then, case reports and retrospective studies have demonstrated higher percentages of occurrence of osteonecrosis in patients who have used or are using bisphosphonates. Although this complication may be spontaneous, invasive oral procedures have a role as risk factors associated with dental procedures such as tooth extractions and other bone operations. In addition, tooth infections and periodontal disease have been reported to be the main risk factors for development of bisphosphonate-induced osteonecrosis of the maxillae. For this reason, dentists, general clinicians, orthopedists, geriatricians and oral-maxillofacial surgeons need to be aware of this problem and work in a multidisciplinary environment, thereby stimulating early diagnosis and prevention of further potential cases.

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Quando bem executada, a escovação é um dos métodos mais eficazes de prevenção da cárie e doenças periodontais. Quando não há fiscalização, isso pode resultar em trauma grave e involuntário dos tecidos moles da cavidade oral. Isto é particularmente verdadeiro em uma população infantil onde a falta de coordenação aumenta o risco de lesões da cavidade oral. Este relato descreve o caso grave de trauma para os tecidos moles da boca durante a escovação, onde a escova penetrou os tecidos moles e teve que ser removida cirurgicamente mostrando as características clínicas e imagens radiográficas e as condutas terapêuticas aplicadas.

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Bisphosphonate-related osteonecrosis of the maxillae may be an important complication of long-term osteoporosis treatment. The possibility of osteonecrosis of the maxillae in patients exposed to nitrogenated bisphosphonates was first described in 2003. Since then, case reports and retrospective studies have demonstrated higher percentages of occurrence of osteonecrosis in patients who have used or are using bisphosphonates. Although this complication may be spontaneous, invasive oral procedures have a role as risk factors associated with dental procedures such as tooth extractions and other bone operations. In addition, tooth infections and periodontal disease have been reported to be the main risk factors for development of bisphosphonate-induced osteonecrosis of the maxillae. For this reason, dentists, general clinicians, orthopedists, geriatricians and oral-maxillofacial surgeons need to be aware of this problem and work in a multidisciplinary environment, thereby stimulating early diagnosis and prevention of further potential cases.

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A síndrome de Moebius (SM) é pouco frequente e caracterizada por paralisia total ou parcial de certos pares cranianos, obrigatoriamente VI e VII, podendo associar-se a outras anormalidades. Clinicamente ocorre falta de expressão facial, hipoplasia da língua, micrognatia, lábio curto e maloclusão. Disfunção temporomandibular (DTM) não tem sido estudada em pacientes com SM. O objetivo deste estudo é conhecer a prevalência de DTM em pacientes com SM e comparar a incidência e tipo de DTM com um grupo controle. Para tanto, foi realizado um estudo clínico caso controle observacional randomizado, no Centro de Atendimento a Pacientes Especiais (CAPE) da Faculdade de Odontologia da Universidade de São Paulo (FOUSP), entre julho de 2007 e dezembro de 2009, que avaliou 101 pacientes divididos em dois grupos: Grupo de estudo (GE) composto por 36 pacientes com SM, sendo 16 do gênero masculino e 20 do gênero feminino, com idade média de 10,2 anos, variando de 3 a 18 anos de idade; e grupo controle (GC) composto por 65 pacientes sem SM e sem nenhuma deformidade crânio facial, sendo 36 do gênero masculino e 29 do gênero feminino, com idade média de 10,7 anos, variando entre 3 e 18 anos. Nossos resultados mostraram que dos 36 pacientes do GE, 20 tinham DTM ou sinal de DTM (bruxismo). Desses 20 pacientes com DTM, 15 realizaram tomografias computadorizadas de ATM (TCs). Dos 65 pacientes do GC, 8 tinham DTM ou sinal de DTM (bruxismo) e 6 concordaram em realizar as TCs. Foram obtidas imagens volumétricas multiplanares e 3D. As alterações morfológicas indicando processo degenerativo encontrado nos exames de imagem encontradas nos dois grupos foram semelhantes. Concluimos que DTM é mais frequente em pacientes com SM e que o diagnóstico em idade tenra pode representar uma oportunidade de prevenção e tratamento precoce da doença evitando sequelas futuras. Por esta razão a avaliação da ATM deve ser incluída no exame clínico odontológico rotineiro de pacientes com a SM.

Moebius syndrome (MS) is rare and characterized by partial or total paralysis of some cranial nerves, unavoidably VI and VII, and may be associated with other abnormalities. The clinical aspects include lack of facial expression, hypoplasia of the tongue, micrognathia, short lip and malocclusion. Temporomandibular Joint disorders (TMJ) has not been studied in patients with MS. The aim of this study is to assess the prevalence of TJD in patients with MS and to compare the incidence and type of TMJ with a control group. We conducted a case-control randomized observational clinical study at the Special Care Dentistry Center, Dental School, University of São Paulo, between July 2007 and December 2009, which evaluated 101 patients divided into two groups: Study group (SG), composed of 36 patients with MS, 16 males and 20 females, mean age 10.2 years, ranging from 3 to18 years of age, and the control group (CG) composed of 65 patients without MS and with no craniofacial deformity, 36 male and 29 female, mean age 10.7 years, ranging between 3 and 18 years. Among 36 patients of the SG, 20 had TMJ. Among them, 15 were submitted to computed tomography (CT). Of the 65 CG patients, 8 had TMJ and 6 were submitted to CTs. Volumetric multiplanar and 3D images were obtained. The morphological changes of the TMJ demonstrating the pattern of the degenerative process found in patients with SM was similar to that found in people from control group. We concluded that the prevalence of TMJ in patients with MS is higher in SM patients and the diagnosis at an early age may represent an opportunity for prevention and early treatment of disease by avoiding future sequels. For this reason the evaluation of the TMJ should be included in routine clinical dental examination of patients with MS.

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A síndrome de Moebius (SM) é pouco freqüente e caracterizada por paralisia total ou parcial de certos pares cranianos, obrigatoriamente VI e VII, podendo associar-se a outras anormalidades. Clinicamente ocorre falta de expressão facial, hipoplasia da língua, micrognatia, lábio curto e maloclusão. Disfunção temporomandibular (DTM) não tem sido estudada em pacientes com SM. O objetivo deste estudo é conhecer a prevalência de DTM em pacientes com SM e comparar a incidência e tipo de DTM com um grupo controle. Para tanto, foi realizado um estudo clínico caso controle observacional randomizado, no Centro de Atendimento a Pacientes Especiais (CAPE) da Faculdade de Odontologia da Universidade de São Paulo (FOUSP), entre julho de 2007 e dezembro de 2009, que avaliou 101 pacientes divididos em dois grupos: Grupo de estudo (GE) composto por 36 pacientes com SM, sendo 16 do gênero masculino e 20 do gênero feminino, com idade média de 10,2 anos, variando de 3 a 18 anos de idade; e grupo controle (GC) composto por 65 pacientes sem SM e sem nenhuma deformidade crânio facial, sendo 36 do gênero masculino e 29 do gênero feminino, com idade média de 10,7 anos, variando entre 3 e 18 anos. Nossos resultados mostraram que dos 36 pacientes do GE, 20 tinham DTM ou sinal de DTM (bruxismo). Desses 20 pacientes com DTM, 15 realizaram tomografias computadorizadas de ATM (TCs). Dos 65 pacientes do GC, 8 tinham DTM ou sinal de DTM (bruxismo) e 6 concordaram em realizar as TCs. Foram obtidas imagens volumétricas multiplanares e 3D. As alterações morfológicas indicando processo degenerativo encontrado nos exames de imagem encontradas nos dois grupos foram semelhantes. Concluimos que DTM é mais freqüente em pacientes com SM e que o diagnóstico em idade tenra pode representar uma oportunidade de prevenção e tratamento precoce da doença evitando seqüelas futuras. Por esta razão a avaliação da ATM deve ser incluída no exame clínico odontológico rotineiro de pacientes com a SM

Moebius syndrome (MS) is rare and characterized by partial or total paralysis of some cranial nerves, unavoidably VI and VII, and may be associated with other abnormalities. The clinical aspects include lack of facial expression, hypoplasia of the tongue, micrognathia, short lip and malocclusion. Temporomandibular Joint disorders (TMJ) has not been studied in patients with MS. The aim of this study is to assess the prevalence of TJD in patients with MS and to compare the incidence and type of TMJ with a control group. We conducted a case-control randomized observational clinical study at the Special Care Dentistry Center, Dental School, University of São Paulo, between July 2007 and December 2009, which evaluated 101 patients divided into two groups: Study group (SG), composed of 36 patients with MS, 16 males and 20 females, mean age 10.2 years, ranging from 3 to18 years of age, and the control group (CG) composed of 65 patients without MS and with no craniofacial deformity, 36 male and 29 female, mean age 10.7 years, ranging between 3 and 18 years. Among 36 patients of the SG, 20 had TMJ. Among them, 15 were submitted to computed tomography (CT). Of the 65 CG patients, 8 had TMJ and 6 were submitted to CTs. Volumetric multiplanar and 3D images were obtained. The morphological changes of the TMJ demonstrating the pattern of the degenerative process found in patients with SM was similar to that found in people from control group. We concluded that the prevalence of TMJ in patients with MS is higher in SM patients and the diagnosis at an early age may represent an opportunity for prevention and early treatment of disease by avoiding future sequels. For this reason the evaluation of the TMJ should be included in routine clinical dental examination of patients with MS

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A articulação têmporo-mandibular apresenta algumas características peculiares que a tornam de grande complexidade estrutural e funcional. Usualmente, ela está associada a disfunções intra-articulares que são acompanhadas por mudança na composição bioquímica do líquido sinovial, um dos componentes dessa articulação. Novas pesquisas no ramo da biologia molecular são atualmente frequentes, incluindo a articulação têmporomandibular. Com base nisso, o estudo constituiu-se em uma revisão de literatura para abordar as alterações bioquímicas do líquido sinovial na ocorrência das principais disfunções intra-articulares. Como resultado, foi observada à presença de diversos mediadores inflamatórios envolvidos na presença e manutenção dos processos degenerativos da articulação têmporo-mandibular.

The temporomandibular joint has some peculiar characteristics, which makes it very complex structural and functional. Usually, it is associated with intraarticular disorders that are accompanied by biochemical changes in the composition of the synovial fluid, one of the components of this joint. New researchs in the of molecular biology are now frequent, including temporomandibular joint. On that basis, the study consisted of a review of literature to address the biochemical changes of synovial fluid in the occurrence of major intraarticular disorders. As a result, it was noted the presence of several inflammatory mediators involved in the presence and maintenance of the degenerative processes of temporomandibular joint.

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Objetivo:Relatar caso de anquilose da articulação temporomandibular (ATM) mostrando os aspectos clínicos e radiográficos, assim como a descrição cirúrgica do caso. Método:Realizado procedimento cirúrgico em paciente de 9 anos de idade, onde se utilizou parte da fáscia/músculo temporal para interpor as superfícies articulares. Observações finais: Pasaram-se dois anos do período pós-operatório, e a paciente não encontrou limitação de abertura bucal, e,além disso, se observou grande melhora na simetria facial

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Os autores fazem um relato de um caso de inclusäo dentária envolvendo um dente canino superior em que foi utilizada como forma de tratamento a desinclusäo pelo tracionamento cirúrgico-ortodôntico. A técnica utilizada foi a colagem de aparatos ortodônticos, bracket, tendo em vista as vantagens oferecidas por esta técnica quando comparada com as demais

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