RESUMO

The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02-1.83; <0.00), low income (RR 2.19; 95%CI 1.63-2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01-1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57-0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby.

Assuntos

Obesidade , Saúde Bucal , Qualidade de Vida , Humanos , Feminino , Gravidez , Saúde Bucal/estatística & dados numéricos , Brasil/epidemiologia , Adulto , Estudos Prospectivos , Adulto Jovem , Obesidade/psicologia , Obesidade/epidemiologia , Estudos de Coortes , Fatores Socioeconômicos , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Cárie Dentária/epidemiologia , Índice de Massa Corporal , Higiene Bucal/estatística & dados numéricos

RESUMO

OBJECTIVE: To evaluate the effect of the association of potassium iodide to antimicrobial photodynamic therapy on human carious dentin produced with a microcosm biofilm model. METHODS: A microcosm biofilm model was used to generate a caries lesion on human dentin. Pooled human saliva diluted with glycerol was used as an inoculum on specimens immersed on McBain artificial saliva enriched with 1 % sucrose (24 h at 37 °C in 5 % CO2). After refreshing culture media for 7 days, the dentin specimens were divided in 5 groups (3 specimens per group, in triplicate; n = 9): C (NaCl 0.9 %), CX (2 % chlorhexidine), PKI (0.01 % methylene blue photosensitizer+50 mM KI), L (laser at 15 J, 180 s, 22.7 J/cm2), and PKIL (methylene blue + KI + Laser). After the treatments, dentin was collected, and a 10-fold serial dilution was performed. The number of total microorganisms, total lactobacilli, total streptococci, and Streptococcus mutans was analyzed by microbial counts (CFU/mL). After normality and homoscedasticity analysis, the Welch's ANOVA and Dunnett's tests were used for CFU. All tests used a 5 % significance level. RESULTS: CX and PKIL groups showed significant bacterial decontamination of dentin, compared to group C (p < 0.05) reaching reductions up to 3.8 log10 for CX for all microorganisms' groups and PKIL showed 0.93, 1.30, 1.45, and 1.22 log10 for total microorganisms, total lactobacilli, total streptococci, and S. mutans, respectively. CONCLUSION: aPDT mediated by the association of KI and methylene blue with red laser reduced the viability of microorganisms from carious dentin and could be a promising option for cavity decontamination.

Assuntos

Biofilmes , Cárie Dentária , Dentina , Azul de Metileno , Fotoquimioterapia , Fármacos Fotossensibilizantes , Iodeto de Potássio , Streptococcus mutans , Humanos , Azul de Metileno/farmacologia , Azul de Metileno/uso terapêutico , Fotoquimioterapia/métodos , Cárie Dentária/microbiologia , Cárie Dentária/tratamento farmacológico , Cárie Dentária/terapia , Dentina/microbiologia , Dentina/efeitos dos fármacos , Iodeto de Potássio/farmacologia , Iodeto de Potássio/uso terapêutico , Biofilmes/efeitos dos fármacos , Streptococcus mutans/efeitos dos fármacos , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/farmacologia , Saliva/microbiologia , Lactobacillus/efeitos dos fármacos , Streptococcus/efeitos dos fármacos , Clorexidina/farmacologia , Clorexidina/uso terapêutico , Técnicas In Vitro , Contagem de Colônia Microbiana , Saliva Artificial , Lasers

RESUMO

Lidocaine is the most commonly used local anesthetic worldwide, known for its rapid onset and moderate duration of anesthesia. However, it is short-lived and does not effectively promote effective topical anesthesia in the oral cavity when used alone. Our aim was to investigate whether an approximate 50% encapsulation of lidocaine in poly(ε-caprolactone) nanocapsules (LDC-Nano) would be able to increase its permeation and analgesic efficacy and reduce cytotoxicity. In this study, we characterized LDC-Nano and conducted MTT tests with HaCaT cells to assess their in vitro cytotoxicity. Additionally, in vitro permeation assays across the pig esophageal epithelium and the anesthetic efficacy of the hind paw incision model in rats were performed. Plain lidocaine (LDC) was compared with LDC-Nano and lidocaine hydrochloride plus epinephrine (LDC-Epi). The physicochemical characteristics of LDC-Nano were satisfactory (pH: 8.1 ± 0.21; polydispersity index: 0.08 ± 0.01; mean diameter (nm): 557.8 ± 22.7; and encapsulation efficiency (%): 51.8 ± 1.87) and remained stable for up to 4 months. LDC-Nano presented similar in vitro cytotoxicity to LDC but was higher than LDC-Epi (LD50: LDC = 0.48%; LDC-Nano = 0.47%; and LDC-Epi = 0.58%; p < 0.0001). Encapsulation increased the permeability coefficient about 6.6 times and about 7.5 the steady-state flux of lidocaine across the mucosal epithelium. Both encapsulation and epinephrine improved anesthesia duration, with epinephrine demonstrating superior efficacy (100% of animals were anesthetized up to 100, 30, and 20 min when LDC-Epi, LDC-nano, and LDC were used, respectively). Although LDC-Epi demonstrated superior in vivo anesthetic efficacy, the in vitro permeation and cytotoxicity of LDC-Nano indicate promising avenues for future research, particularly in exploring its potential application as a topical anesthetic in the oral cavity.

RESUMO

This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

Assuntos

Carticaína , Lidocaína , Humanos , Carticaína/farmacologia , Lidocaína/farmacologia , Estudos Cross-Over , Anestésicos Locais/farmacologia , Epinefrina/farmacologia , Anestesia Local , Dor , Dente Molar , Método Duplo-Cego

RESUMO

The study aimed to assess the influence of excessive use of a photostimulable phosphor plate (PSP) on the density, image noise, and contrast of radiographs. For that, radiographs of an acrylic block were acquired with a PSP of the Express intraoral system to assess the density and image noise. Initially, five images were obtained and exported (first group). After 400 exposures to X-rays and scannings of PSP, other five images were obtained and exported (second group). The same procedure was done after 800 (third group), 1200 (fourth group), 1600 (fifth group), and 2000 acquisitions (sixth group), resulting in 30 images to be evaluated. The mean and standard deviation of the gray values were calculated for the images using the ImageJ software. For contrast analysis, radiographs of an aluminum step-wedge were acquired with a new PSP following the same acquisition intervals. The percentage of contrast variation was calculated. Another two unused PSP receptors were employed to evaluate the method's reproducibility. The comparison of the results among the acquisition groups was performed with one-way Analysis of Variance (α=0.05). Intraclass Correlation Coefficient (ICC) assessed the reproducibility of the receptors. Image noise did not differ among the groups (p>0.05). There was a slight increase in density after 400 acquisitions and a slight difference in contrast for all acquisition groups without a pattern of increase or decrease (p<0.05). ICC showed excellent reliability for the methods. Therefore, excessive PSP use slightly affected the radiograph's density and contrast.

Assuntos

Radiografia Dentária Digital , Radiografia Dentária Digital/métodos , Reprodutibilidade dos Testes

RESUMO

Abstract The study aimed to assess the influence of excessive use of a photostimulable phosphor plate (PSP) on the density, image noise, and contrast of radiographs. For that, radiographs of an acrylic block were acquired with a PSP of the Express intraoral system to assess the density and image noise. Initially, five images were obtained and exported (first group). After 400 exposures to X-rays and scannings of PSP, other five images were obtained and exported (second group). The same procedure was done after 800 (third group), 1200 (fourth group), 1600 (fifth group), and 2000 acquisitions (sixth group), resulting in 30 images to be evaluated. The mean and standard deviation of the gray values were calculated for the images using the ImageJ software. For contrast analysis, radiographs of an aluminum step-wedge were acquired with a new PSP following the same acquisition intervals. The percentage of contrast variation was calculated. Another two unused PSP receptors were employed to evaluate the method's reproducibility. The comparison of the results among the acquisition groups was performed with one-way Analysis of Variance (α=0.05). Intraclass Correlation Coefficient (ICC) assessed the reproducibility of the receptors. Image noise did not differ among the groups (p>0.05). There was a slight increase in density after 400 acquisitions and a slight difference in contrast for all acquisition groups without a pattern of increase or decrease (p<0.05). ICC showed excellent reliability for the methods. Therefore, excessive PSP use slightly affected the radiograph's density and contrast.

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Resumo Objetivou-se avaliar a influência do uso excessivo de uma placa de fósforo fotoestimulável (PSP) na densidade, ruído e contraste das radiografias. Foram adquiridas radiografias de um bloco de acrílico com uma PSP do sistema intraoral Express para avaliar a densidade e o ruído da imagem. Inicialmente, cinco imagens foram obtidas e exportadas (primeiro grupo). Após 400 exposições aos raios X e escaneamentos, outras cinco imagens foram obtidas e exportadas (segundo grupo). O mesmo procedimento foi feito após 800 (terceiro grupo), 1200 (quarto grupo), 1600 (quinto grupo) e 2000 aquisições (sexto grupo), resultando em 30 imagens a serem avaliadas. A média e o desvio padrão dos valores de cinza foram calculados para as imagens usando o software ImageJ. Para análise de contraste, foram adquiridas radiografias de uma escala de alumínio com uma nova PSP seguindo os mesmos intervalos de aquisição. A porcentagem de variação do contraste foi calculada. Outras duas PSP sem uso prévio foram utilizadas para avaliar a reprodutibilidade dos métodos. A comparação dos resultados entre os grupos de aquisição foi realizada pela Análise de Variância one-way (α=0,05). O Coeficiente de Correlação Intraclasse (ICC) avaliou a reprodutibilidade dos receptores. O ruído da imagem não diferiu entre os grupos (p>0,05). Houve um leve aumento na densidade após 400 aquisições e uma pequena diferença no contraste para todos os grupos de aquisição sem padrão de aumento ou diminuição (p<0,05). O ICC mostrou excelente confiabilidade para os métodos. Portanto, o uso excessivo da PSP afetou levemente a densidade e o contraste radiográfico.

RESUMO

Abstract This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

RESUMO

We evaluated the influence of population size (POP), HDI (Human Development Index) and GDP (gross domestic product) on the COVID-19 pandemic in the Southeast region of Brazil, between February 2020 and May 2021. METHODS: Cases, deaths, incidence coefficient, mortality rate and lethality rate were compared among states. The cities were divided into strata according to POP, GDP, and HDI. Data were compared by Welch's ANOVA, nonlinear polynomial regression, and Spearman's correlation test (rS). RESULTS: The highest incidence coefficient (p < 0.0001) and mortality rate (p < 0.05) were observed in the states of Espírito Santo and Rio de Janeiro, respectively. Until the 45th week, the higher the POP, the higher the mortality rate (p < 0.01), with no differences in the remaining period (p > 0.05). There was a strong positive correlation between POP size and the number of cases (rS = 0.92, p < 0.0001) and deaths (rS = 0.88, p < 0.0001). The incidence coefficient and mortality rate were lower (p < 0.0001) for low GDP cities. Both coefficients were higher in high- and very high HDI cities (p < 0.0001). The lethality rate was higher in the state of Rio de Janeiro (p < 0.0001), in large cities (p < 0.0001), in cities with medium GDP (p < 0.0001), and in those with high HDI (p < 0.05). CONCLUSIONS: Both incidence and mortality were affected by time, with minimal influence of POP, GDP and HDI.

Assuntos

COVID-19 , Humanos , Produto Interno Bruto , COVID-19/epidemiologia , Densidade Demográfica , Brasil/epidemiologia , Pandemias

RESUMO

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

RESUMO

Knowledge about viral characteristics, mechanisms of entry into the host cell and multiplication/dissemination can help in the control and treatment of viral pathologies. Several nutritional factors linked to the host may favour viral multiplication and their control, may lead to new prophylactic alternatives and/or antiviral therapies. The objective of this review is to discuss the relationship between the amino acid L-lysine and the control of viral infections, aiming at a possible therapeutic property. This research used databases such as PubMed, Web of Science, Scielo, Medline and Google Scholar, as well as searching for references cited by journals. The time frame covered the period between 1964 and January 2022. The observed studies have shown that the usual antiviral therapies are not able to interfere with the viruses in their latent state; however, they can interfere with the adhesion and fusion of viral particles or the production of proteins, which play an important role in viral epidemiology and control, particularly in the initial moment and in reactivation. Lysine is an amino acid that can interfere mainly in the formation of capsid proteins and DNA by a competitive antagonism with amino acid arginine, which is an essential amino acid for some viruses, and also by promoting the increase of arginase, increasing the catabolism of arginine. Although there is evidence of the importance of L-lysine in viral control, more studies are needed, with a view to new antiviral therapies.

Assuntos

Lisina , Viroses , Aminoácidos/uso terapêutico , Antivirais/farmacologia , Antivirais/uso terapêutico , Arginase , Arginina/metabolismo , Arginina/uso terapêutico , Proteínas do Capsídeo , Humanos , Lisina/metabolismo , Lisina/uso terapêutico , Viroses/tratamento farmacológico , Viroses/prevenção & controle

RESUMO

Introduction: The aim of this study was to assess the agreement between oral and maxillofacial radiologists (OMFR) and oral and maxillofacial surgeons (OMFS) for the detection of bifid mandibular canal (BMC) and accessory mental foramen (AMF) using cone-beam computed tomography (CBCT). Material and Methods: This retrospective study involved 22 examiners (11 OMFR and 11 OMFS) who independently assessed 30 CBCT volumes from patients (n = 60 hemi-mandibles) under preoperative radiographic evaluation for implant placement. The examiners scored the presence of BMC and AMF in each hemimandible. The interexaminer agreements were assessed using Fleiss' kappa statistics. Results: For intra-examiner agreement, 40% of the sample was reevaluated. The interexaminer agreement between OMFR and OMFS was slight (0.12) for the detection of BMC and fair (0.24) for AMF. The agreement among OMFR for detection of BMC was fair (0.22), and it was slight among OMFS (0.15). The agreement among OMFR for detection of AMF was substantial (0.61), and among OMFS it was fair (0.22). Agreements between OMFR and OMFS were slight for BMC and fair for AMF, independently of the years of experience. Intraexaminer agreement ranged from 60% to 90% among OMFR and from 55% to 90% among OMFS. Conclusion: A slight and a fair agreement between OMFR and OMFS was found for the detection of BMC and AMF, respectively. In general, OMFR obtained higher agreement among themselves, mainly for detection of AMF.

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Introducción: El objetivo de este estudio fue evaluar la con-cordancia entre los radiólogos orales y maxilofaciales (ROMF) y los cirujanos orales y maxilofaciales (COMF) para la detección del canal mandibular bífido (CMB) y el foramen mentoniano accesorio (FMA) mediante tomografía computarizada de haz cónico. CBCT). Material y Métodos: Este estudio retrospectivo involucró a 22 examinadores (11 ROMF y 11 COMF) que evaluaron de forma independiente 30 volúmenes CBCT de pacientes (n = 60 hemimandíbulas) bajo evaluación radiográfica preoperatoria para la colocación de implantes. Los examinadores puntu-aron la presencia de CMB y FMA en cada hemimandíbula. Los acuerdos entre examinadores se evaluaron utilizando las estadísticas kappa de Fleiss. Resultados: Por concordancia intraexaminador se reeva-luó el 40% de la muestra. El acuerdo entre examinadores entre ROMF y COMF fue ligero (0,12) para la detección de CMB y regular (0,24) para FMA. La concordancia entre ROMF para la detección de CMB fue regular (0,22) y leve entre COMF (0,15). El acuerdo entre ROMF para la detección de FMA fue sustancial (0,61), y entre COMF fue justo (0,22). Los acuerdos entre ROMF y COMF fueron leves para CMB y justos para FMA, independientemente de los años de experiencia. La concordancia entre examinadores varió del 60 % al 90 % entre ROMF y del 55 % al 90 % entre COMF. Conclusión: Se encontró un acuerdo leve y justo entre ROMF y COMF para la detección de CMB y FMA, respec-tivamente. En general, se obtuvo mayor acuerdo entre ROMF, principalmente para la detección de FMA.

Assuntos

Humanos , Masculino , Feminino , Cirurgiões Bucomaxilofaciais , Radiologistas , Forame Mentual/diagnóstico por imagem , Canal Mandibular/diagnóstico por imagem , Brasil , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada de Feixe Cônico , Variação Anatômica , Mandíbula/diagnóstico por imagem

RESUMO

OBJECTIVES: To evaluate the influence of digital filters of intraoral radiographic systems on the diagnosis of simulated internal and external root resorptions and image quality. MATERIALS AND METHODS: Internal root resorption (IRR) and external root resorption (ERR) were simulated in 34 teeth. For image acquisition, two radiographic systems were used: Digora Toto and VistaScan. All filters available in these systems were applied. Three observers scored the detection of root resorptions in a 5-point scale. The noise and the contrast-to-noise ratio (CNR) were calculated. The area under ROC curve, sensitivity, specificity, and accuracy were obtained. One-way ANOVA with Tukey's post hoc tests compared the diagnostic values, noise, and CNR between the filters (α = 0.05). RESULTS: For ERR, there were no significant differences in diagnostic values between the filters tested for both systems. For IRR, Original and Noise Reduction filters presented higher sensitivity than the Sharpen2 filter for images from Digora Toto, with no differences between the other groups. For VistaScan, there were no significant differences of diagnostic values between the groups studied. Noise values differed among the filters of both systems. The CNR of the filters differed only for the bone region for Digora Toto, while for VistaScan, both tooth and bone regions differed. CONCLUSIONS: Despite promoting changes in pixel intensities and affecting the noise level of the radiographic images, the digital filters of Digora Toto and VistaScan systems do not affect the diagnosis of internal or external root resorptions. CLINICAL RELEVANCE: Digital filters are common tools in digital radiographic systems and may be used by the professional without impairment in root resorptions diagnosis.

Assuntos

Reabsorção da Raiz , Humanos , Curva ROC , Radiografia Dentária Digital/métodos , Reabsorção da Raiz/diagnóstico por imagem , Raiz Dentária

RESUMO

BACKGROUND: Obesity and bariatric surgery may be related with mental and oral disorders. AIM: To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients. METHODS: Eighty-nine patients were divided in two groups: Control Group (CG) - obese patients and Experimental Group (EG) - patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered. RESULTS: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG. CONCLUSION: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.

Assuntos

Cirurgia Bariátrica , Cárie Dentária , Ansiedade , Humanos , Obesidade , Estudos Prospectivos

Assuntos

COVID-19 , ChAdOx1 nCoV-19 , Humanos , Lisina , SARS-CoV-2 , Vacinação

RESUMO

ABSTRACT The aim of this study was to emphasize the importance of monitoring vital signs, especially blood pressure, during dental care. Through a narrative review, the changes in blood pressure that may occur during outpatient procedures and the measures to be taken were discussed. The available literature was consulted in databases (PubMed, Scielo, Web of Science and Google Scholar), complemented by the analysis of the bibliographic references included and updated until April 2021. The keywords were used: "Anamnesis", "Arterial Pressure", "Arterial Hypertension", "Hypertensive Crisis", "Risk factors", "Stroke", "Subclavian Theft Syndrome" and "Atherosclerosis". It was concluded that care should be applied to all patients, but mainly to those over 50, hypertensive or not, with hypercholesterolemia, diabetes, anxious and fearful. All vital signs must be monitored, including the pain score. The situations of anxiety, pain and fear are triggers for changes in blood pressure even in normotensive patients as in controlled hypertensive patients. The blood pressure measurement, in the first consultation, must be performed in both arms and repeated annually or whenever there is a change in the patient's health status. In all other consultations, blood pressure control, as well as the assessment of all vital signs, must be performed before, during, after the procedure and before discharge. In the face of any major change, it is necessary to assess the risk/benefit ratio of the continuity of the procedure, so that risks to patients are avoided or minimized, as well as for the necessary referrals to be made.

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RESUMO O objetivo deste trabalho foi enfatizar a importância da monitorização dos sinais vitais, particularmente da pressão arterial durante o atendimento odontológico. Por meio de uma revisão narrativa foram discutidas as alterações pressóricas que podem ocorrer durante procedimentos ambulatoriais e as medidas a serem tomadas. A literatura disponível foi consultada em bancos de dados (PubMed, Scielo, Web of Science e Google Scholar), complementada analisando as referências bibliográficas incluídas e atualizada até Abril de 2021. Foram usadas as palavras-chave: Anamnese, Pressão Arterial, Hipertensão Arterial, Crise Hipertensiva, Fatores de Risco, Acidente Vascular Cerebral, Síndrome do Roubo da Subclávia e Aterosclerose. Foi concluído que os cuidados devem ser aplicados em todos os pacientes mas em especial naqueles com idades superiores a 50 anos, hipertensos ou não, com hipercolesterolemia, diabetes, ansiosos e medrosos. Todos os sinais vitais devem ser monitorados, dentre eles, o score de dor. As situações de ansiedade, dor e medo são gatilhos para alterações pressóricas tanto em pacientes normotensos como nos hipertensos controlados. A aferição da pressão arterial, já na primeira consulta, deve ser realizada em ambos os braços e repetida anualmente ou sempre que houver modificação no quadro de saúde do paciente. Em todas as demais consultas, o controle pressórico como também a avaliação de todos os sinais vitais, deve ser no pré-, trans-, pós-procedimento e antes da alta. Diante de qualquer alteração importante, a relação risco/benefício da continuidade do procedimento precisa ser avaliada, para que seja evitado ou minimizado os riscos aos pacientes bem como para realizar os encaminhamentos necessários.

RESUMO

Permeation assays are important for the development of topical formulations applied on buccal mucosa. Swine buccal and esophageal epithelia are usually used as barriers for these assays, while frozen epithelia have been used to optimize the experimental setup. However, there is no consensus on these methods. In transdermal studies, barrier integrity has been evaluated by measuring electrical resistance (ER) across the skin, which has been demonstrated to be a simple, fast, safe, and cost-effective method. Therefore, the aims here were to investigate whether ER might also be an effective method to evaluate buccal and esophageal epithelium mucosa integrity for in vitro permeation studies, and to establish a cut-off ER value for each epithelium mucosa model. We further investigated whether buccal epithelium could be substituted by esophageal epithelium in transbuccal permeation studies, and whether their permeability and integrity were affected by freezing at -20 °C for 3 weeks. Fresh and frozen swine buccal and esophageal epithelia were mounted in Franz diffusion cells and were then submitted to ER measurement. Permeation assays were performed using lidocaine hydrochloride as a hydrophilic drug model. ER was shown to be a reliable method for evaluating esophageal and buccal epithelia. The esophageal epithelium presented higher permeability compared to the buccal epithelium. For both epithelia, freezing and storage led to decreased electrical resistivity and increased permeability. We conclude that ER may be safely used to confirm tissue integrity when it is equal to or above 3 kΩ for fresh esophageal mucosa, but not for buccal epithelium mucosa. However, the use of esophageal epithelium in in vitro transmucosal studies could overestimate the absorption of hydrophilic drugs. In addition, fresh samples are recommended for these experiments, especially when hydrophilic drugs are involved.

RESUMO

Evaluating factors that may influence the nose dimensions and, therefore, contribute to the singularity of a person, is important for obtaining a precise facial reconstruction (FR) in forensic anthropology. Thus, the aim in this study was to evaluate the influence of sex, skeletal class, and facial type on nose dimensions of Brazilian individuals using cone-beam computed tomography (CBCT) scans. CBCT images of 54 males and 67 females were classified according to skeletal class (class I, II, or III) and facial type (brachycephalic, dolichocephalic and mesocephalic). Linear and angular measurements of the nose were performed using the CS 3D Imaging software. The measurements obtained for males and females were compared by one-way ANOVA. Two-way ANOVA was used to compare the measurements in the different skeletal classes and facial types. Significance level was set at 5%. All linear measurements were greater in males (p < 0.05); the angular measurements, however, did not differ between sexes (p > 0.05). Linear and angular measurements of class III males were significantly different from the other classes; the same was observed for the angular measurements in females (p < 0.05). Regarding facial types, some linear measurements were significantly greater in dolichocephalics males (p < 0.05). For females, there was no influence of facial type (p > 0.05), except for the nasal convexity angle. Nose dimensions differed in specific points among different skeletal classes and facial types, and there was sexual dimorphism in all linear nose dimensions. This information may be applicable for nose reconstructions, allowing more reliable FR.

Assuntos

Tomografia Computadorizada de Feixe Cônico Espiral , Brasil , Tomografia Computadorizada de Feixe Cônico , Face/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Nariz/diagnóstico por imagem

RESUMO

To determine whether the permeation capacity and analgesic efficacy of articaine (ATC) could be increased and cytotoxicity decreased by encapsulation in poly(ɛ-caprolactone) nanocapsules (ATCnano), aiming at local or topical anesthesia in dentistry. Cellular viability was evaluated (using the MTT test and fluorescence microscopy) after 1 h and 24 h exposure of HaCaT cells to ATC, ATCnano, ATC with epinephrine (ATCepi), and ATC in nanocapsules with epinephrine (ATCnanoepi). The profiles of permeation of 2% ATC and 2% ATCnano across swine esophageal epithelium were determined using Franz-type vertical diffusion cells. Analgesic efficacy was evaluated with a von Frey anesthesiometer in a postoperative pain model in rats, comparing the 2% ATC, 2% ATCnano, 2% ATCepi, and 2% ATCnanoepi formulations to 4% ATCepi (a commercially available formulation). We show that use of the nanocapsules decreased the toxicity of articaine (P<0.0001) and increased its flux (P = 0.0007). The 2% ATCepi and 4% ATCepi formulations provided higher analgesia success and duration (P<0.05), compared to 2% ATC, 2% ATCnano, and 2% ATCnanoepi. Articaine-loaded poly(ɛ-caprolactone) nanocapsules constitute a promising formulation for intraoral topical anesthesia (prior to local anesthetic injection), although it is not effective when injected in inflamed tissues for pain control, such as irreversible pulpitis.

Assuntos

Anestesia Dentária/métodos , Anestesia Local/métodos , Carticaína/administração & dosagem , Nanocápsulas/administração & dosagem , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Humanos , Queratinócitos/efeitos dos fármacos , Ratos , Ratos Wistar

RESUMO

Objective: To evaluate the presence of joint effusion and morphology of the articular disc (AD) viewed in the sagittal plane in patients with disc displacement with reduction (DDWR) and to correlate the results with clinical findings.Methods: The sample consisted of 116 patients with DDWR who were evaluated clinically and with magnetic resonance imaging. The AD's morphology was assessed from the sagittal view with the mouth both open and closed. The statistical analysis demonstrated a significance level of 5%.Results: With a mean age of 35 years, 79 patients (68.10%) showed joint effusion, and the female gender was most prevalent (p < 0.05). The results showed a relationship between joint effusion and DDWR in both sides (p < 0.05).Conclusion: Clinically, the present study can infer that DDWR is associated with joint effusion, and females are the most affected. It can be suggested that the pain may be associated with joint effusion.

Assuntos

Luxações Articulares , Transtornos da Articulação Temporomandibular , Adulto , Feminino , Humanos , Luxações Articulares/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Articulação Temporomandibular , Disco da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem

RESUMO

OBJECTIVES: To present the ballistic gelatin as a new material capable of simulating the soft tissues in cone-beam CT (CBCT) images. METHODS: CBCT images of three piglet heads were acquired with their soft tissues intact (standard group). Subsequently, the piglet heads were fixed in a container using metallic pins and moulded with acrylic resin; the soft tissues were then removed and replaced by ballistic gelatin, with the same thickness of the original soft tissues. The images were evaluated by two oral radiologists, to check the adaptation on bone surfaces, thickness and density, penetration into large bone cavities and cancellous bone, and the presence of air bubbles using a 5-score scale. Additionally, an objective analysis was carried out by one oral radiologist. For each CBCT scan, three axial reconstructions were selected to represent the mandibular, occlusal, and maxillary levels. The mean and standard deviation (SD) of the grey values were calculated in four regions of interest determined on soft tissue areas and compared by two-way ANOVA. RESULTS: The ballistic gelatin showed subjective scores ranging from good to excellent for all parameters evaluated. There was no significant difference in the mean and SD values of the grey values between ballistic gelatin and the gold standard groups for all levels (p > 0.05). Higher SD values were observed in the occlusal level for both groups (p < 0.05). CONCLUSIONS: Ballistic gelatin has visual and objective similarity with the gold standard. Thus, the ballistic gelatin is a promising material capable of simulating soft tissues in CBCT images.

Assuntos

Gelatina , Tomografia Computadorizada de Feixe Cônico Espiral , Animais , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula/diagnóstico por imagem , Radiografia Dentária , Suínos