PENFIGÓIDE CICATRICIAL: MANIFESTAÇÕES BUCAIS E TRATAMENTO COM CORTICOSTERÓIDES

O penfigóide cicatricial é uma doença  auto-imune de caráter crônico com característica clínica vesiculobolhosa.  Lesões em mucosa bucal são observadas na maioria dos pacientes, no entanto mucosas conjuntiva, nasal, esofágica, laríngea e vaginal podem estar envolvidas. O objetivo desse trabalho é relatar a conduta clínica de um caso de penfigóide cicatricial. Paciente de 76 anos de idade, sexo masculino, leucoderma,  compareceu à Clínica de Estomatologia da Universidade Federal do Paraná com queixa de inflamação gengival. Através de exame clínico constatou-se o quadro de gengivite descamativa, com manchas brancas em área de gengiva marginal, sem sintomatologia dolorosa. Para confirmação de diagnóstico realizou-se biópsia incisional na região, sendo o laudo do exame anatomopatológico  inconclusivo, optou-se por prescrever bochecho com decadron elixir para reduzir a inflamação. Após a redução do quadro inflamatório realizou-se nova biópsia sendo o resultado  penfigóide cicatricial. Para o uso de propionato de clobetasol 0,05% confeccionou-se  uma placa de acetato, na qual o paciente inseriu o corticosteróide  três vezes ao dia durante 20 minutos. Após  terapêutica medicamentosa, houve remissão das lesões, sendo a medicação constante por 2 anos e meio. O diagnóstico para penfigóide cicatricial deve ser estabelecido com o exame histopatológico e a terapêutica medicamentosa pode ser fundamental para o tratamento como foi no caso relatado

Comparison between 3D volumetric rendering and multiplanar slices on the reliability of linear measurements on CBCT images: an in vitro study

OBJECTIVE: The purpose of this study was to determine the accuracy and reliability of two methods of measurements of linear distances (multiplanar 2D and tridimensional reconstruction 3D) obtained from cone-beam computed tomography (CBCT) with different voxel sizes. MATERIAL AND METHODS: Ten dry human mandibles were scanned at voxel sizes of 0.2 and 0.4 mm. Craniometric anatomical landmarks were identified twice by two independent operators on the multiplanar reconstructed and on volume rendering images that were generated by the software Dolphin®. Subsequently, physical measurements were performed using a digital caliper. Analysis of variance (ANOVA), intraclass correlation coefficient (ICC) and Bland-Altman were used for evaluating accuracy and reliability (

Influence of low-level laser on bone remodeling during induced tooth movement in rats

Objective: To analyze the effect of low-level laser on bone remodeling during induced tooth movement in rats. Materials and Methods: A diode laser (808 nm, 100 mW, 54 J on an area of 0.0028 cm2) was used. The application was continuous, punctual, and with contact. Forty-two 70-day-old Wistar rats had the maxillary left first molar moved using a force level of 25 g. In two experimental subgroups the movement was performed over 7 days and in three subgroups the movement occurred over 14 days. In the 7-day movement subgroups, one subgroup received laser irradiation on day 1 only; the other subgroup received laser irradiation on days 1, 3, and 5. In the 14-day movement subgroups, one subgroup received laser irradiation on day 1 only; the second on days 1, 3, and 5; and the third on days 1, 3, 5, 7, 9, 11, and 13. The control group was also divided into two subgroups, and movement occurred over two different periods of treatment (7 days and 14 days) without laser application; these were used as controls for the respective experimental subgroups. Inter-subgroup comparison was performed with Kruskal-Wallis, followed by Mann-Whitney and analysis of variance, followed by Tukey tests within the 7- and 14-day subgroups. Results: The subgroup with three laser applications showed significantly greater osteoclastic activity and bone resorption than the other subgroups in the 7-day movement subgroups. Conclusions: Low-level laser application significantly increased the osteoclastic but not the osteoblastic activity during the initial phases of tooth movement. In addition, the osteoclastic activity was dose-dependen

Effects of cervical headgear appliance: a systematic review

OBJECTIVE: Although much has been investigated about the effects of cervical headgear, there remains some controversy. Therefore, the objective of this systematic review is to disclose the actual effects of the cervical headgear appliance, based on articles of relevant quality.METHODS: A literature review was conducted using PubMed, Web of Science, Embase, Scopus and Cochrane databases. Inclusion criteria consisted of human studies written in English; published between 1970 and 2014; in which only the cervical headgear was used to correct Class II malocclusion; prospective or retrospective; with a clear description of cervical headgear effects; with a sample size of at least 15 individuals. No comparative studies, clinical cases or cases with dental extractions were included and the sample should be homogeneous.RESULTS: Initially, 267 articles were found. A total of 42 articles were selected by title and had their abstracts read. Finally, 12 articles were classified as with high quality and were used in this systematic review.CONCLUSIONS: The cervical headgear appliance proved efficient to correct Class II, Division 1 malocclusion. Its effects consisted in correction of the maxillomandibular relationship by restriction of maxillary anterior displacement; distalization and extrusion of maxillary molars; and slight maxillary expansion

Comparison of dentoskeletal and soft tissue effects of Class II malocclusion treatment with Jones Jig appliance and with maxillary first premolar extractions

Abstract Objective: The aim of this study was to compare the cephalometric changes in Class II division 1 malocclusion patients treated with Jones Jig appliance or with maxillary first premolar extractions. Methods: The sample consisted of 88 lateral cephalograms of 44 patients, divided into two groups. Group 1 consisted of 21 patients treated with Jones Jig appliance, with a mean initial age of 12.88 ± 1.23 years and final mean age of 17.18 ± 1.37 years, and a mean treatment time of 4.29 years. Group 2 comprised 23 patients treated with maxillary first premolar extractions, with a mean initial age of 13.59 ± 1.91 years and mean final age of 16.39 ± 1.97 years, and a mean treatment time of 2.8 years. Intergroup treatment changes were compared with t and Mann-Whitney tests. Results: Class II correction in G2 (maxillary first premolar extractions) presented significantly greater maxillary retrusion, reduction of anteroposterior apical base discrepancy, smaller increase in the lower anterior face height and significantly greater overjet reduction than G1 (Jones Jig). Conclusions: Treatment with maxillary first premolar extractions produced greater overjet reduction, but the two treatment protocols produced similar changes in the soft tissue profile

Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: A computed tomography evaluation

Introduction: The force delivered during rapid maxillary expansion (RME) produces areas of compression on the periodontal ligament of the supporting teeth. The resulting alveolar bone resorption can lead to unwanted tooth movement in the same direction. The purpose of this study was to evaluate periodontal changes by means of computed tomography after RME with tooth-tissue-borne and tooth-borne expanders. Methods: The sample comprised 8 girls, 11 to 14 years old, with Class I or II malocclusions with unilateral or bilateral posterior crossbites Four girls were treated with tooth-tissue-borne Haas-type expanders, and 4 were treated with tooth-borne Hyrax expanders. The appliances were activated up to the full 7-mm capacity of the expansion screw. Spiral CT scans were taken before expansion and after the 3-month retention period when the expander was removed. One-millimeter thick axial sections were exposed parallel to the palatal plane, comprising the dentoalveolar area and the base of the maxilla up to the inferior third of the nasal cavity. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal alveolar bone crest level by means of the computerized method. Results and Conclusions: RME reduced the buccal bone plate thickness of supporting teeth 0.6 to 0.9 mm and increased the lingual bone plate thickness 0.8 to 1.3 mm. The increase in lingual bone plate thickness of the maxillary posterior teeth was greater in the tooth-borne expansion group than in the tooth-tissue-borne group. RME induced bone dehiscences on the anchorage teeth's buccal aspect (7.1 ± 4.6 mm at the first premolars and 3.8 ± 4.4 mm at the mesiobuccal area of the first molars), especially in subjects with thinner buccal bone plates. The tooth-borne expander produced greater reduction of first premolar buccal alveolar bone crest level than did the tooth-tissue-borne expander. © 2006 American Association of Orthodontists

sj-docx-1-joo-10.1177_14653125231166437 – Supplemental material for Finite element analysis of two skeletally anchored maxillary molar distalisation methods

Supplemental material, sj-docx-1-joo-10.1177_14653125231166437 for Finite element analysis of two skeletally anchored maxillary molar distalisation methods by Lorena Vilanova, Silvio Augusto Bellini-Pereira, Mayara Paim Patel, Roberto Grec, José Fernando Castanha Henriques, Guilherme Janson, Daniela Garib and Aron Aliaga-Del Castillo in Journal of Orthodontics</p