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No description available.

A hiperglicemia, bem como o diabetes, é reconhecida como fator de risco para infecções pós-cirúrgicas, assim manter o controle glicêmico perioperatório tem sido padrão de cuidado em saúde. Entretanto há poucos estudos sobre o impacto do controle glicêmico no processo de reparação de cirurgias de extração dentária. Apesar da escassez de estudos e de evidências clínicas e científicas que investiguem o risco de infecções pós-exodônticas em pessoas com diabetes, existem livros, artigos e guias que recomendam aos dentistas o uso de antibióticos profiláticos nesses indivíduos, especialmente para aqueles descompensados. O objetivo deste estudo foi avaliar clinicamente a cicatrização pós-exodôntica, em relação à cronologia dos eventos reparacionais e em relação à ocorrência de complicações pós-operatórias, em indivíduos com diabetes tipo 2 comparados a um grupo controle. Além disso, procuramos relacionar os eventos pós-cirúrgicos com o controle metabólico e com o perfil imunológico dos pacientes. Este estudo prospectivo longitudinal caso controle incluiu 53 indivíduos com diabetes tipo 2 (grupo de estudo=GE) e 29 indivíduos sem diabetes (grupo controle=GC). Foi aplicado questionário sobre a história médica, realizados exames clínicos intraoral e extraoral e exames laboratoriais para conhecimento do controle glicêmico e do perfil imunológico do indivíduo, tais como, hemograma completo, hemoglobina glicada (A1C), glicemia de jejum, IgA, IgG, IgM, C3, C4, linfócitos T CD3+, CD4+, CD8+, quimiotaxia de neutrófilos, oxidação de neutrófilos, fagocitose de neutrófilos e monócitos. Todos os participantes foram submetidos a extrações padronizadas de dentes erupcionados e as avaliações clínicas foram realizadas 3, 7, 21 e 60 dias após a cirurgia. A frequência de complicações pós-operatórias foi maior no GC, no qual 7 de 29 pacientes (24%) exibiu pelo menos uma complicação a saber: trismo (1 caso), queixa de paladar desagradável (3 casos), inapetência (1 caso) e queixa de indisposição (2 casos) (p=0,005). No GE apenas 1 sujeito (1,9%) exibiu complicação 13 uma vez que queixou-se de paladar desagradável, apesar de 36 (67,9%) pacientes desse grupo apresentarem hiperglicemia no momento da cirurgia, da maioria estar com o diabetes descompensado (A1C>6,5%) e apesar da maioria apresentar diminuição da quimiotaxia dos neutrófilos. Apesar da ocorrência de complicações, nenhum participante, de nenhum grupo, precisou tomar antibiótico e após 60 dias da exodontia todos os alvéolos dentais estavam reparados. O atraso na epitelização da ferida cirúrgica foi observado apenas no GE, onde 9 (17%) casos apresentaram incompleta epitelização nesse tempo pós-operatório (p=0,023). Não houve relação deste atraso com nível de A1C, diminuição da quimiotaxia de neutrófilos, diminuição da fagocitose dos neutrófilos e nem com a diminuição de oxidação dos neutrófilos. Nossos resultados permitiram concluir que o diabetes tipo 2 não representa um fator de risco para ocorrência de complicações pós-exodônticas. Podemos inferir que pessoas com diabetes tem risco aumentado de atraso na epitelização da ferida cirúrgica, mas que esse atraso não tem impacto na reparação final do alvéolo. / Hyperglycemia and diabetes are recognized as a risk factor for postoperative infections. Thus, maintaining perioperative glucose control has become the standard of care. However, there are scarce data on the appropriate glucose control during minor dental surgery. Despite the paucity of studies investigating the risk of postsurgical oral infections in persons with diabetes, there are text books, papers and guidelines recommending to dentists the use of prophylactic antibiotics for patients with poorly controlled diabetes undergoing invasive oral procedures. The aim of this study was to clinically evaluate the post extraction healing regarding to the chronology and to the occurrence of postoperative complications in patients with type 2 diabetes compared to a control group. Additionally, we associated the postoperative events with metabolic control and the immunological profile of the participants. This prospective case-control study included 53 subjects with type 2 diabetes (SG) and 29 controls without diabetes (CG). A questionnaire on medical history was applied, intraoral and extraoral clinical examinations were conducted and laboratory tests for glycemic control and immunological profile of the individual, such as complete blood count, glycated hemoglobin (A1C), fasting glucose, IgA, IgG, IgM, C3, C4, lymphocytes T CD3+, CD4+, CD8+, neutrophil chemotaxis, oxidation of neutrophil phagocytosis by neutrophils and monocytes, were obtained at the time of the extraction. All participants underwent standardized extractions of erupted teeth and clinical assessments were performed 3, 7, 21 and 60 days after surgery. The frequency of postoperative complications was higher in CG, where 7 of 29 patients (24%) exhibited at least one complication such as: trismus (1 case), complaints of unpleasant taste (3 cases), anorexia (1 case), and malaise (2 cases) (p=0.005). Only one patient from SG (1.9%) complained of bad taste in mouth despite 36 (67,9%) among the subjects from this group had hyperglycemia at the time of surgery, the majority present uncontrolled diabetes (A1C>6.5%), and despite most of them 15 present decreased neutrophils chemotaxis. Regardless of the occurrence of some complications, no participant in any group had to take antibiotics, and after 60 days of extraction all dental alveoli were repaired. The delay in epithelialization of the wound was observed only in SG, where 9 (17%) cases showed incomplete epithelialization at 21 days after surgery (p=0.023). There was no relationship with the epithelization delay and values of A1C, decreased neutrophil chemotaxis, decrease of neutrophil phagocytosis or with decreased oxidation of neutrophils. Our results showed that type 2 diabetes is not a risk factor for the occurrence of postoperative dental extractions. We can infer that people with diabetes have increased risk of delayed epithelialization of the surgical wound but that this delay has no impact on the final repair of the alveoli.

O objetivo desta pesquisa foi realizar um estudo cefalométrico radiográfico com o propósito de avaliar as mudanças no perfil tegumentar do terço inferior da face em casos com maloclusões de Classe I, biprotrusos, tratados ortodonticamente com extrações de quatro premolares, por meio da técnica do arco contínuo preconizada por Roth. A amostra constou de 56 radiografias cefalométricas de 26 pacientes leucodermas chilenos, com média de idade de 19,56 + 5,71 anos tomadas ao início e ao término do tratamento. Foram mensuradas as variações na espessura e comprimento do perfil tegumentar, bem como as alterações posturais anteroposteriores dento-alveolares e tegumentares ocorridas. Foram realizadas comparações entre os valores iniciais e finais e correlações entre as variações das grandezas analisadas por meio de análises estatísticas. Após análise dos resultados concluiu-se que, após a retração dos dentes anteriores, a espessura do lábio superior apresentou aumento na sua porção basal e na região do vermelhão labial, enquanto que sua porção intermediária não apresentou variação estatisticamente significante. No lábio inferior, somente a espessura do vermelhão do lábio inferior apresentou aumento significativo. O comprimento total do lábio superior também apresentou aumento estatisticamente significante, enquanto que no comprimento do lábio inferior não foi observado aumento significante. Os lábios superior e inferior sofreram retração estatisticamente significante e o movimento de retração do vermelhão do lábio superior correlacionou diretamente com o movimento do incisivo superior, tanto em nível incisal (0,33:1), como em nível coronário (0,57:1), assim como o movimento de retração do sulco do lábio superior que correlacionou diretamente com o movimento do incisivo superior, tanto em nível incisal (0,26:1) como em nível coronário (0,42:1). O movimento de retração do vermelhão do lábio inferior correlacionou diretamente não só com o movimento da incisal do incisivo inferior (0,54:1) como também com o movimento do incisivo superior tanto em nível incisal (0,57:1), como em nível coronário (0,85:1). Não se constatou correlação entre a alteração postural dos lábios e as alterações tegumentares de espessura e comprimento em todas as variáveis estudadas, exceto a variação do ângulo mentolabial que correlacionou com a variação do comprimento da base do lábio inferior. Essas duas variáveis, no entanto, não apresentaram alterações significativas. / The purpose of this prospective cephalometric study was to evaluate soft tissue profile changes in biprotrusive Class I patients treated with first premolars extractions and maximum anchorage control. The sample was composed of 52 lateral cephalometric roentgenogram from the beginnig and end of treatment of 26 white chilean patients (18 females and 8 males) with age average of 19,56 + 5,71 years old, treated with Roth straight-wire technique. Linear and angular cephalometric values in relation to thickness, lengths, lips posture, convexity of the skeletal and integumental profile, as well as incisors and alveolar profile points posture were evaluated. After statistical analysis, the results showed that upper lip thickness increased in the vermillion and basal area. Lower lip thickness also increased in the vermillion area. Upper lip total length increased while lower lip showed no change in its length. The retraction of the lips as well as the incisors were significant. Upper incisor retraction correlated with upper lip vermillion retraction at the incisor border (0,33 mm :1 mm) and at the crown level (0,57 mm : 1mm). Likewise it was verified with the upper lip sulcus (point A?), that retracted on a proportion of 0,26 mm : 1mm at the upper incisor border level and 0,42 mm : 1 mm at the crown level. Lower lip vermillion retraction correlated with lower incisor retraction at the incisor border level (0,54:1) as well as with upper incisor retraction at the incisor border (0,57:1) and at the crown level (0,85:1). Lip postural changes did not correlated with lip length or thickness changes except lower lip basal length that correlated with the increase of mentolabial angle.

Magister Scientiae Dentium - MSc(Dent) / The aim of this study was to determine whether there are changes in the interdental arch widths and arch lengths of the mandibular and maxillary arches during nonextraction and extraction orthodontic treatment. The records of 78 patients treated by one orthodontist were used for this study. Three treatment groups were selected: a nonextraction group (Group NE), a group treated with extraction of maxillary and mandibular first premolars (Group 44), and a group treated with extraction of maxillary first premolars and mandibular second premolars (Group 45). The arch width measurements were measured in the inter-canine, inter-premolar and inter-molar areas. The arch length was measured as the sum of the left and right distances from mesial anatomic contact points of the first permanent molars to the contact point of the central incisors or to the midpoint between the central incisor contacts, if spaced.Statistical analysis included descriptive statistics of the data, analysis of the correlation matrices, Wilcoxon Signed Rank tests and Kruskal-Wallis tests of the changes which occurred during treatment. The intercanine widths in the mandible and maxilla increased during treatment in all three groups, with the extraction groups showing a greater increase than Group NE (p<0.05). In Group NE the mandibular arch length increased (p>0.05), while the maxillary arch length remained essentially unchanged. Both extraction groups showed decreases in arch length in the dentitions (p<0.05), with greater decreases occurring in the maxilla. The difference in arch length change between the two extraction groups was not significant (p<0.05). The inter-canine arch width increased in all three treatment groups, more so in the two extraction groups. From this it is evident that extraction treatment does not necessarily lead to narrowing of the dental arches in the canine region. The inter-second premolar arch width decreased in both extraction groups. Non-extraction treatment resulted in an increase in the inter-premolar and inter-molar arch widths. / South Africa

O objetivo desta pesquisa foi realizar um estudo cefalométrico radiográfico com o propósito de avaliar as mudanças no perfil tegumentar do terço inferior da face em casos com maloclusões de Classe I, biprotrusos, tratados ortodonticamente com extrações de quatro premolares, por meio da técnica do arco contínuo preconizada por Roth. A amostra constou de 56 radiografias cefalométricas de 26 pacientes leucodermas chilenos, com média de idade de 19,56 + 5,71 anos tomadas ao início e ao término do tratamento. Foram mensuradas as variações na espessura e comprimento do perfil tegumentar, bem como as alterações posturais anteroposteriores dento-alveolares e tegumentares ocorridas. Foram realizadas comparações entre os valores iniciais e finais e correlações entre as variações das grandezas analisadas por meio de análises estatísticas. Após análise dos resultados concluiu-se que, após a retração dos dentes anteriores, a espessura do lábio superior apresentou aumento na sua porção basal e na região do vermelhão labial, enquanto que sua porção intermediária não apresentou variação estatisticamente significante. No lábio inferior, somente a espessura do vermelhão do lábio inferior apresentou aumento significativo. O comprimento total do lábio superior também apresentou aumento estatisticamente significante, enquanto que no comprimento do lábio inferior não foi observado aumento significante. Os lábios superior e inferior sofreram retração estatisticamente significante e o movimento de retração do vermelhão do lábio superior correlacionou diretamente com o movimento do incisivo superior, tanto em nível incisal (0,33:1), como em nível coronário (0,57:1), assim como o movimento de retração do sulco do lábio superior que correlacionou diretamente com o movimento do incisivo superior, tanto em nível incisal (0,26:1) como em nível coronário (0,42:1). O movimento de retração do vermelhão do lábio inferior correlacionou diretamente não só com o movimento da incisal do incisivo inferior (0,54:1) como também com o movimento do incisivo superior tanto em nível incisal (0,57:1), como em nível coronário (0,85:1). Não se constatou correlação entre a alteração postural dos lábios e as alterações tegumentares de espessura e comprimento em todas as variáveis estudadas, exceto a variação do ângulo mentolabial que correlacionou com a variação do comprimento da base do lábio inferior. Essas duas variáveis, no entanto, não apresentaram alterações significativas. / The purpose of this prospective cephalometric study was to evaluate soft tissue profile changes in biprotrusive Class I patients treated with first premolars extractions and maximum anchorage control. The sample was composed of 52 lateral cephalometric roentgenogram from the beginnig and end of treatment of 26 white chilean patients (18 females and 8 males) with age average of 19,56 + 5,71 years old, treated with Roth straight-wire technique. Linear and angular cephalometric values in relation to thickness, lengths, lips posture, convexity of the skeletal and integumental profile, as well as incisors and alveolar profile points posture were evaluated. After statistical analysis, the results showed that upper lip thickness increased in the vermillion and basal area. Lower lip thickness also increased in the vermillion area. Upper lip total length increased while lower lip showed no change in its length. The retraction of the lips as well as the incisors were significant. Upper incisor retraction correlated with upper lip vermillion retraction at the incisor border (0,33 mm :1 mm) and at the crown level (0,57 mm : 1mm). Likewise it was verified with the upper lip sulcus (point A?), that retracted on a proportion of 0,26 mm : 1mm at the upper incisor border level and 0,42 mm : 1 mm at the crown level. Lower lip vermillion retraction correlated with lower incisor retraction at the incisor border level (0,54:1) as well as with upper incisor retraction at the incisor border (0,57:1) and at the crown level (0,85:1). Lip postural changes did not correlated with lip length or thickness changes except lower lip basal length that correlated with the increase of mentolabial angle.

A hiperglicemia, bem como o diabetes, é reconhecida como fator de risco para infecções pós-cirúrgicas, assim manter o controle glicêmico perioperatório tem sido padrão de cuidado em saúde. Entretanto há poucos estudos sobre o impacto do controle glicêmico no processo de reparação de cirurgias de extração dentária. Apesar da escassez de estudos e de evidências clínicas e científicas que investiguem o risco de infecções pós-exodônticas em pessoas com diabetes, existem livros, artigos e guias que recomendam aos dentistas o uso de antibióticos profiláticos nesses indivíduos, especialmente para aqueles descompensados. O objetivo deste estudo foi avaliar clinicamente a cicatrização pós-exodôntica, em relação à cronologia dos eventos reparacionais e em relação à ocorrência de complicações pós-operatórias, em indivíduos com diabetes tipo 2 comparados a um grupo controle. Além disso, procuramos relacionar os eventos pós-cirúrgicos com o controle metabólico e com o perfil imunológico dos pacientes. Este estudo prospectivo longitudinal caso controle incluiu 53 indivíduos com diabetes tipo 2 (grupo de estudo=GE) e 29 indivíduos sem diabetes (grupo controle=GC). Foi aplicado questionário sobre a história médica, realizados exames clínicos intraoral e extraoral e exames laboratoriais para conhecimento do controle glicêmico e do perfil imunológico do indivíduo, tais como, hemograma completo, hemoglobina glicada (A1C), glicemia de jejum, IgA, IgG, IgM, C3, C4, linfócitos T CD3+, CD4+, CD8+, quimiotaxia de neutrófilos, oxidação de neutrófilos, fagocitose de neutrófilos e monócitos. Todos os participantes foram submetidos a extrações padronizadas de dentes erupcionados e as avaliações clínicas foram realizadas 3, 7, 21 e 60 dias após a cirurgia. A frequência de complicações pós-operatórias foi maior no GC, no qual 7 de 29 pacientes (24%) exibiu pelo menos uma complicação a saber: trismo (1 caso), queixa de paladar desagradável (3 casos), inapetência (1 caso) e queixa de indisposição (2 casos) (p=0,005). No GE apenas 1 sujeito (1,9%) exibiu complicação 13 uma vez que queixou-se de paladar desagradável, apesar de 36 (67,9%) pacientes desse grupo apresentarem hiperglicemia no momento da cirurgia, da maioria estar com o diabetes descompensado (A1C>6,5%) e apesar da maioria apresentar diminuição da quimiotaxia dos neutrófilos. Apesar da ocorrência de complicações, nenhum participante, de nenhum grupo, precisou tomar antibiótico e após 60 dias da exodontia todos os alvéolos dentais estavam reparados. O atraso na epitelização da ferida cirúrgica foi observado apenas no GE, onde 9 (17%) casos apresentaram incompleta epitelização nesse tempo pós-operatório (p=0,023). Não houve relação deste atraso com nível de A1C, diminuição da quimiotaxia de neutrófilos, diminuição da fagocitose dos neutrófilos e nem com a diminuição de oxidação dos neutrófilos. Nossos resultados permitiram concluir que o diabetes tipo 2 não representa um fator de risco para ocorrência de complicações pós-exodônticas. Podemos inferir que pessoas com diabetes tem risco aumentado de atraso na epitelização da ferida cirúrgica, mas que esse atraso não tem impacto na reparação final do alvéolo. / Hyperglycemia and diabetes are recognized as a risk factor for postoperative infections. Thus, maintaining perioperative glucose control has become the standard of care. However, there are scarce data on the appropriate glucose control during minor dental surgery. Despite the paucity of studies investigating the risk of postsurgical oral infections in persons with diabetes, there are text books, papers and guidelines recommending to dentists the use of prophylactic antibiotics for patients with poorly controlled diabetes undergoing invasive oral procedures. The aim of this study was to clinically evaluate the post extraction healing regarding to the chronology and to the occurrence of postoperative complications in patients with type 2 diabetes compared to a control group. Additionally, we associated the postoperative events with metabolic control and the immunological profile of the participants. This prospective case-control study included 53 subjects with type 2 diabetes (SG) and 29 controls without diabetes (CG). A questionnaire on medical history was applied, intraoral and extraoral clinical examinations were conducted and laboratory tests for glycemic control and immunological profile of the individual, such as complete blood count, glycated hemoglobin (A1C), fasting glucose, IgA, IgG, IgM, C3, C4, lymphocytes T CD3+, CD4+, CD8+, neutrophil chemotaxis, oxidation of neutrophil phagocytosis by neutrophils and monocytes, were obtained at the time of the extraction. All participants underwent standardized extractions of erupted teeth and clinical assessments were performed 3, 7, 21 and 60 days after surgery. The frequency of postoperative complications was higher in CG, where 7 of 29 patients (24%) exhibited at least one complication such as: trismus (1 case), complaints of unpleasant taste (3 cases), anorexia (1 case), and malaise (2 cases) (p=0.005). Only one patient from SG (1.9%) complained of bad taste in mouth despite 36 (67,9%) among the subjects from this group had hyperglycemia at the time of surgery, the majority present uncontrolled diabetes (A1C>6.5%), and despite most of them 15 present decreased neutrophils chemotaxis. Regardless of the occurrence of some complications, no participant in any group had to take antibiotics, and after 60 days of extraction all dental alveoli were repaired. The delay in epithelialization of the wound was observed only in SG, where 9 (17%) cases showed incomplete epithelialization at 21 days after surgery (p=0.023). There was no relationship with the epithelization delay and values of A1C, decreased neutrophil chemotaxis, decrease of neutrophil phagocytosis or with decreased oxidation of neutrophils. Our results showed that type 2 diabetes is not a risk factor for the occurrence of postoperative dental extractions. We can infer that people with diabetes have increased risk of delayed epithelialization of the surgical wound but that this delay has no impact on the final repair of the alveoli.

<p>The aim of this study was to determine whether there are changes in the interdental arch widths and arch lengths of the mandibular and maxillary arches during nonextraction and extraction orthodontic treatment. The records of 78 patients treated by one orthodontist were used for this study. Three treatment groups were selected: a nonextraction group (Group NE), a group treated with extraction of maxillary and mandibular first premolars (Group 44), and a group treated with extraction of maxillary first premolars and mandibular second premolars (Group 45). The arch width measurements were measured in the inter-canine, inter-premolar and inter-molar areas. The arch length was measured as the sum of the left and right distances from mesial anatomic contact points of the first permanent molars to the contact point of the central incisors or to the midpoint between the central incisor contacts, if spaced.</p> <p>Statistical analysis included descriptive statistics of the data, analysis of the correlation matrices, Wilcoxon Signed Rank tests and Kruskal-Wallis tests of the changes which occurred during treatment. The intercanine widths in the mandible and maxilla increased during treatment in all three groups, with the extraction groups showing a greater increase than Group NE (p&lt / 0.05). In Group NE the mandibular arch length increased (p&lt / 0.05), while the maxillary arch length remained essentially unchanged. Both extraction groups showed decreases in arch length in the dentitions (p&lt / 0.05), with greater decreases occurring in the maxilla. The difference in arch length change between the two extraction groups was not significant (p&gt / 0.10). The inter-canine arch width increased in all three treatment groups, more so in the two extraction groups. From this it is evident that extraction treatment does not necessarily lead to narrowing of the dental arches in the canine region. The inter-second premolar arch width decreased in both extraction groups. Non-extraction treatment resulted in an increase in the inter-premolar and inter-molar arch widths.</p>

Identification of fungi is based on macroscopic observations of morphology and microscopic characteristics. These conventional methods are time-consuming and requires expert knowledge. For the past years Matrix-assisted laser desorption ionization-time of flight mass spectrometry has been used for routine bacterial identification in clinical laboratories but not yet in the same extension for fungi. In this study three preanalytic preparation methods for fungi were evaluated in order to shorten the processing time in routine laboratory performance. Clinically relevant strains (n=18) of molds and dermatophytes were cultivated on agar plates and prepared according to the different preparation methods for protein extraction. Each strain was analyzed in quadruplicate by the MALDI Biotyper and the database Filamentous Fungi Library 1.0. The results showed that the genus and species identification rates of the least time-consuming direct extraction method were 33% and 11% respectively. Using the formic acid extraction method, the genus and species identification rates were 83% and 44%, respectively. For the longest sample preparation method, liquid media culturing before formic acid extraction, successfully identified all strains except one, which resulted in an identification rate of 94% and 78% respectively. This study shows that preparing samples in cultured liquid media MADLI-TOF MS effectively identified fungal strains to both genus- and species-level. This method was however too time-consuming and cumbersome to be recommended as a replacement to the conventional method. Future studies should be aimed at expanding the reference library and making the direct extraction method more reproducible in terms of obtaining more reliable identification rates.

<p>The aim of this study was to determine whether there are changes in the interdental arch widths and arch lengths of the mandibular and maxillary arches during nonextraction and extraction orthodontic treatment. The records of 78 patients treated by one orthodontist were used for this study. Three treatment groups were selected: a nonextraction group (Group NE), a group treated with extraction of maxillary and mandibular first premolars (Group 44), and a group treated with extraction of maxillary first premolars and mandibular second premolars (Group 45). The arch width measurements were measured in the inter-canine, inter-premolar and inter-molar areas. The arch length was measured as the sum of the left and right distances from mesial anatomic contact points of the first permanent molars to the contact point of the central incisors or to the midpoint between the central incisor contacts, if spaced.</p> <p>Statistical analysis included descriptive statistics of the data, analysis of the correlation matrices, Wilcoxon Signed Rank tests and Kruskal-Wallis tests of the changes which occurred during treatment. The intercanine widths in the mandible and maxilla increased during treatment in all three groups, with the extraction groups showing a greater increase than Group NE (p&lt / 0.05). In Group NE the mandibular arch length increased (p&lt / 0.05), while the maxillary arch length remained essentially unchanged. Both extraction groups showed decreases in arch length in the dentitions (p&lt / 0.05), with greater decreases occurring in the maxilla. The difference in arch length change between the two extraction groups was not significant (p&gt / 0.10). The inter-canine arch width increased in all three treatment groups, more so in the two extraction groups. From this it is evident that extraction treatment does not necessarily lead to narrowing of the dental arches in the canine region. The inter-second premolar arch width decreased in both extraction groups. Non-extraction treatment resulted in an increase in the inter-premolar and inter-molar arch widths.</p>