Candida albicans in patients with oronasal communication and obturator prostheses

Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.Os pacientes portadores de prótese obturadora freqüentemente apresentam estomatite protética. Com o objetivo de detectar a presença de Candida albicans oral em pacientes com comunicação oronasal e avaliar a eficácia de um tratamento tópico antifúngico foi realizada citologia esfoliativa da mucosa palatina e jugal e da superfície acrílica nasal da prótese obturadora. O protocolo terapêutico consistiu de nistatina (Mycostatin®) para tratamento da mucosa oral e uma solução de hipoclorito de sódio para desinfecção da prótese. Sete pacientes (70%) apresentaram resultado positivo para C. albicans na mucosa, com um resultado negativo para a superfície protética neste grupo. A avaliação após o tratamento revelou ausência de C. albicans na mucosa oral de todos os pacientes, bem como na superfície protética. A infecção por C. albicans das mucosas jugal e palatina diferiram significantemente, enquanto que a mucosa palatina e a superfície protética apresentaram valores semelhantes. O grau de infecção da mucosa palatina foi significantemente maior quando comparado àquele da mucosa jugal e semelhante ao apresentado pela prótese, sugerindo que a mucosa subjacente à prótese é mais susceptível à infecção. O protocolo terapêutico foi efetivo em todos os casos, o que enfatiza a necessidade da desinfecção protética para se evitar a reinfecção da mucosa oral

Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences

Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1) to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2) to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3) to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate

Portuguese translation and validation of the YQOL – FD (Youth Quality of Life Instrument—Facial Differences) for brazilian adolescents with craniofacial deformities

The Youth Quality of Life—Facial Differences (YQOL-FD), validated in the United States in 2005, was developed at the University of Washington by the Seattle Quality of Life Group (SeaQol), to evaluate quality of life of adolescents with facial deformities. Because no Portuguese version exists, the measure was not viable in Brazil. This study aimed to obtain linguistic and psychometric validation of a version of the YQOL-FD in Portuguese. Twenty-five patients with cleft lip and palate and five without facial deformity participated in Traumatology and Maxillofacial Prosthesis Surgery Clinic, School of Dentistry, University of São Paulo. The linguistic validation of the YQOL-FD was carried out by a team consisting of the researcher, as project manager, two native Portuguese-speaking consultants fluent in English, and one native English-speaking consultant fluent in Portuguese. After translation and back-translation, a Portuguese version was obtained, which was applied in a pilot test (n = 10); after the final adjustments the Seattle Quality of Life Group approved the official version of the YQOL-FD in Portuguese. To obtain the psychometric validation, we requested the participation of 20 patients with cleft lip and palate who answered the questionnaire twice in a range of 7 to 15 days. The Cronbach’s alpha test was applied in the 48-item block, showing a high degree of internal consistency (0.949). The Wilcoxon Signal Post Test was applied to verify if the test and retest values were similar; the general agreement was 4/5 = 80%, indicating high reproducibility. It was concluded that the Portuguese version of the YQOL-FD is adequate for evaluating Quality of Life of Brazilian adolescents with craniofacial deformities

Accuracy of face castings employing thermoplastic custom trays for facial molding

Aim: To evaluate the dimensional stability of a new facial molding technique using thermoplastic custom molding tray. Methods: The designs established demarcation of facial anthropometrics landmarks, making linear measurements with a digital caliper. Facial molding was carried out using thermoplastic custom trays, constructing a facial plaster cast with the anthropometric landmarks already transferred by measuring the linear dimensions on the plaster cast and statistical analysis. Results: All linear measurements in the palpebral and labial regions presented statistically significant distortions. Only one of the linear measurements from the orbital region did not demonstrate any significant distortion. The nasal region presented the least amount of distortion. Conclusions: Although statistically significant, distortions were due to the method of breathing and were considered to be clinically irrelevant. The reduction in the working time, the comfort provided to the patient and the dimensional accuracy of the plaster cast obtained by the facial molding technique using custom perforated molding tray suggest that this technique should be employed for making facial prostheses

Porosidade, liberação de monômero residual e sorção de água de resinas termoativadas convencionais, resinas termoativadas para microondas e resinas quimicamente ativadas com ligações cruzadas

This study compared the residual monomer release, water sorption and superfi cial porosity of different resins commonly employed in eye prostheses: heat-cured (HC); microwave-cured (MC) and self-curing cross-linked acrylic resins (SC). Four groups were established: G1, HC / water bath cycle; G2, MC / microwave cycle; G3, HC / microwave cycle; G4, SC. The amount of residual monomer was similar in G1 and G3, lower in G2 and higher in G4. Water sorption was similar in all groups. G2 showed more superfi cial porosity, and G1 and G3 were similar in this regard. Neither the conventional heat-curing cycle nor the microwave cycle affected the amount of residual monomer or porosity of the conventional heat-cured acrylic resin. Water sorption was not affected by the type of resin or polymerization cycle used. Residual monomer release and porosity were related to the type of resin employed rather than the polymerization cycle they were submitted to.Este estudo comparou a liberação de monômeros residuais, a sorção de água e a porosidade superfi cial de diferentes resinas acrílicas utilizadas na confecção de próteses oculares: ativadas por calor (HC); ativadas por micro-ondas (MC) e quimicamente polimerizáveis (SC). Quatro grupos foram estabelecidos: G1, HC / ciclo em banho aquecido; G2, MC / ciclo em micro-ondas; G3, HC / ciclo em micro-ondas; G4, SC. A quantidade de monômero residual foi similar nos grupos G1 e G3, menor no G2 e maior no G4. A sorção de água foi similar nos quatro grupos. O grupo G2 apresentou maior porosidade superfi cial, e os grupos G1 e G3 apresentaram porosidades similares. Os ciclos térmicos por banho aquecido e por micro-ondas não infl uenciaram a quantidade de monômero residual liberado ou a porosidade das resinas acrílicas polimerizadas por calor. A sorção de água não foi infl uenciada pelo tipo de resina ou pelo ciclo de polimerização utilizado. A liberação de monômero residual e a porosidade estão relacionadas ao tipo de resina utilizada e não ao ciclo de polimerização empregado

Accuracy of face castings employing thermoplastic custom trays for facial molding

evaluate the dimensional stability of a new facial molding technique using thermoplastic custom molding tray. Methods: The designs established demarcation of facial anthropometrics landmarks, making linear measurements with a digital caliper. Facial molding was carried out using thermoplastic custom trays, constructing a facial plaster cast with the anthropometric landmarks already transferred by measuring the linear dimensions on the plaster cast and statistical analysis. Results: All linear measurements in the palpebral and labial regions presented statistically significant distortions. Only one of the linear measurements from the orbital region did not demonstrate any significant distortion. The nasal region presented the least amount of distortion. Conclusions: Although statistically significant, distortions were due to the method of breathing and were considered to be clinically irrelevant. The reduction in the working time, the comfort provided to the patient and the dimensional accuracy of the plaster cast obtained by the facial molding technique using custom perforated molding tray suggest that this technique should be employed for making facial prostheses

The pediatric patient at a maxillofacial service: eye prosthesis

Congenital absence or loss of the ocular globe during childhood causes psycho-social and cosmetic disorders and compromise the normal development of the orbital region. The literature relating to congenital or acquired etiology, due to trauma or disease, demonstrates the necessity of prevention and early detection in order to minimize the sequelae and disturbances in orbital growth. Installation of an eye prosthesis is essential to the rehabilitation process, so as to produce satisfactory development of the region. In order to characterize a profile of the child patient with this condition, a survey was carried out at the Prosthetic Eye sector, Out-patient Clinic, Discipline of Maxillofacial Prosthodontics, School of Dentistry, University of São Paulo (FOUSP), during the period from 1988 to 2003. The 124 (14.02%) patients within the age group of 0-13 years registered for ocular prosthesis were divided into a first group of 64 patients (51.62%) with 0-7 years, and a second group of 60 patients (48.38%) with 8-13 years. Fifty nine were girls and 65 were boys. No statistical significance was observed regarding the distribution of genders in the two analyzed age groups (p = 0.069). However, there was statistical significance at the level of 0.01 in relation to etiology, with higher prevalence of congenital and pathological disturbances in the younger group and traumatic occurrences in the older group. The etiology also presented variation according to the gender, at the significance level of 0.05, where girls presented three times less trauma than boys in the older age group. The necessity of prosthetic ocular repair was evenly distributed along the childhood period and the eye losses that required prosthetic treatment equally affected both genders. However, the etiology of eye loss varied according to the considered gender and age bracket