Características dentárias e faciais de pacientes com artrite idiopática juvenil

OBJECTIVE: It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital. METHOD: Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children. RESULTS: The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P = .032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P = .055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P = .017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P = .015). CONCLUSION: This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health.OBJETIVO: A articulação temporomandibular é freqüentemente afetada pela artrite idiopática juvenil, e esta doença degenerativa, durante o crescimento facial, resulta em disfunção mandibular grave. No entanto, não há estudos que avaliam conjuntamente alterações na saúde oral (cáries e doenças gengivais) e na articulação temporomandibular decorrentes da artrite idiopática juvenil. O objetivo deste estudo é avaliar a condição dentária e a função mandibular de pacientes com artrite idiopática juvenil tratados em um hospital escola. MÉTODO: Trinta e seis pacientes com artrite idiopática juvenil (26 meninas e 10 meninos) foram submetidos a uma avaliação clínica sistemática de suas estruturas dentárias, orais e faciais (índice CPO-D, índice de placa e sangramento gengival, relação dentária, perfil facial e índice de Helkimo para articulação temporomandibular). O grupo controle foi composto por 13 crianças saudáveis. RESULTADOS: A média de idade dos pacientes com diagnóstico de artrite idiopática juvenil foi 10,8 anos; o perfil facial convexo foi encontrado em 12 pacientes com artrite idiopática juvenil e relação molar classe II esteve presente em 12 deles (p=0,032). Os índices de placa e sangramento gengival foram significantes em pacientes com artrite idiopática juvenil que apresentavam maior número de articulações dos membros superiores comprometidas (p=0,055). Mordida aberta anterior (cinco) e ruídos articulares (oito) foram encontradas no grupo com artrite idiopática juvenil . Este grupo apresentou 94% dos pacientes com disfunção da articulação temporomandibular (p=0,017), além de amplitude mandibular diminuída (p=0,0002) e mobilidade mandibular gravemente comprometida em 33% (p=0,015). CONCLUSÃO: Este estudo confirma que pacientes com artrite idiopática juvenil: a) têm alto índice de disfunção mandibular, que pode ser atribuído ao efeito direto da doença sobre a articulação temporomandibular e b) maior índice de doença gengival, que pode ser considerado como efeito indireto da artrite idiopática juvenil na saúde oral

The Multidisciplinary Management Of Avulsed Teeth: A Case Report

This paper reports multidisciplinary treatment of a dental trauma case to achieve a favorable prognosis. A healthy 14-year-old girl reported avulsion of teeth 11 and 21 which had occurred three months earlier. The initial treatment consisting of replantation with a semi-rigid splint was performed in hospital. At presentation, the patient was still using the semi-rigid splint. The clinical examination revealed the presence of increased mobility in teeth 11 and 21, and absence of vitality in both. Radiographic examination showed the presence of inflammatory external root resorption in both teeth. The treatment proposed consisted of teeth extraction, a temporary prosthesis followed by adhesive prosthesis, and finally, implant surgery associated with porcelain crowns.74203206Koca, H., Topaloglu-Ak, A., Sutekin, E., Koca, O., Acar, S., Delayed replantation of an avulsed tooth after 5 hours of storage in saliva: A case report (2010) Dent Traumatol, 26 (4), pp. 370-373Lux, H.C., Goetz, F., Hellwig, E., Case report: Endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion (2010) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 110 (5), pp. e61-7Flores, M.T., Andersson, L., Andreasen, J.O., Bakland, L.K., Malmgren, B., Barnett, F., Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth (2007) Dent Traumatol, 23 (3), pp. 130-136Roskamp, L., Westphalen, V.P., Carneiro, E., Fariniuk, L.F., Silva, N.U.X., The positive influence of atopy on the prognosis of avulsed and replanted teeth despite differences in post- trauma management (2011) J Endod, 37 (4), pp. 463-465Andreasen, J.O., Andreasen, F., (2007) Textbook and Color Atlas of Traumatic Injuries to The Teeth, p. 912. , 4th Edition, Copenhagen: Denmark: MunksgaardMajorana, A., Bardellini, E., Conti, G., Keller, E., Pasini, S., Root resorption in dental trauma: 45 cases followed for 5 years (2003) Dent Traumatol, 19 (5), pp. 262-265Andreasen, J.O., Borum, M.K., Jacobsen, H.L., Andreasen, F.M., Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications (1995) Endod Dent Traumatol, 11 (2), pp. 51-58Soares, A.J., Gomes, B.P., Zaia, A.A., Ferraz, C.C., de Souza-Filho, F.J., Relationship between clinical-radiographic evaluation and outcome of teeth replantation (2008) Dent Traumatol, 24 (2), pp. 183-188Heithersay, G.S., Management of tooth resorption (2007) Aust Dent J, 52 (1 SUPPL.), pp. S105-S121Gold, S.I., Hasselgren, G., Peripheral inflammatory root resorption. A review of the literature with case reports (1992) J Clin Periodontol, 19 (8), pp. 523-534Emerich, K., Czerwinska, M., Ordyniec-Kwasnica, I., Immediate self-replantation of an avulsed permanent mandibular incisor - a case report (2010) Dent Traumatol, 26 (5), pp. 443-446Guzeler, I., Uysal, S., Cehreli, Z.C., Management of trauma-induced inflammatory root resorption using mineral trioxide aggregate obturation: Two-year follow up (2010) Dent Traumatol, 26 (6), pp. 501-504Drummond, S., Pessica, L.S., Monnerat, A.B., Monnerat, A.F., de Oliveira, A.M.A., Multidisciplinary solution for an avulsed upper central incisor: Case report (2011) Dent Traumatol, 27 (3), pp. 241-246Estevez, R., Aranguren, J., Escorial, A., de Gregorio, C., De La Torre, F., Vera, J., Invasive cervical resorption Class III in a maxillary central incisor: Diagnosis and follow-up by means of cone-beam computed tomography (2010) J Endod, 36 (12), pp. 2012-2014Vitale, M.C., Caprioglio, C., Martignone, A., Marchesi, U., Botticelli, A.R., Combined technique with polyethylene fibers and composite resins in restoration of traumatized anterior teeth (2004) Dent Traumatol, 20 (3), pp. 172-177Iseri, H., Solow, B., Growth displacement of the maxilla in girls studied by the implant method (1990) Eur J Orthod, 12 (4), pp. 389-398Odman, J., Grondahl, K., Lekholm, U., Thilander, B., The effect of osseointegrated implants on the dento-alveolar development. A clinical and radiographic study in growing pigs (1991) Eur J Orthod, 13 (4), pp. 279-286Graber, T.M., Vanarsdall, R., (2000) Orthodontics: Current Principles and Techniques, p. 1040. , 3th Edition. St Louis, Missouri: MosbyPolat, Z.S., Tacir, I.H., Restoring of traumatized anterior teeth: A case report (2008) Dent Traumatol, 24 (3), pp. e390-

Muscle Loss: The New Malnutrition Challenge in Clinical Practice

Recent definitions of malnutrition include low muscle mass within its diagnostic criteria. In fact, malnutrition is one of the main risk factors of skeletal muscle loss contributing to the onset of sarcopenia. However, differences in the screening and diagnosis of skeletal muscle loss, especially as a result of malnutrition in clinical and community settings, still occur mainly as techniques and thresholds used vary in clinical practice. The objectives of this position paper are firstly to emphasize the link between skeletal muscle loss and malnutrition-related conditions and secondly to raise awareness for the timely identification of loss of skeletal muscle mass and function in high risk populations. Thirdly to recognize the need to implement appropriate nutritional strategies for prevention and treatment of skeletal muscle loss and malnutrition across the healthcare continuum. Malnutrition needs to be addressed clinically as a muscle-related disorder and clinicians should integrate nutritional assessment with muscle mass measurements for optimal evaluation of these two interrelated entities to tailor interventions appropriately. The design of monitoring/evaluation and discharge plans need to include multimodal interventions with nutrition and physical exercise that are key to preserve patient’s muscle mass and function in clinical and community settings

Measurement of the p-pbar -> Wgamma + X cross section at sqrt(s) = 1.96 TeV and WWgamma anomalous coupling limits

The WWgamma triple gauge boson coupling parameters are studied using p-pbar -> l nu gamma + X (l = e,mu) events at sqrt(s) = 1.96 TeV. The data were collected with the DO detector from an integrated luminosity of 162 pb^{-1} delivered by the Fermilab Tevatron Collider. The cross section times branching fraction for p-pbar -> W(gamma) + X -> l nu gamma + X with E_T^{gamma} > 8 GeV and Delta R_{l gamma} > 0.7 is 14.8 +/- 1.6 (stat) +/- 1.0 (syst) +/- 1.0 (lum) pb. The one-dimensional 95% confidence level limits on anomalous couplings are -0.88 < Delta kappa_{gamma} < 0.96 and -0.20 < lambda_{gamma} < 0.20.Comment: Submitted to Phys. Rev. D Rapid Communication

Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt{s} = 1.96 TeV using Kinematic Characteristics of Lepton + Jets Events

We present a measurement of the top quark pair ttbar production cross section in ppbar collisions at a center-of-mass energy of 1.96 TeV using 230 pb**{-1} of data collected by the DO detector at the Fermilab Tevatron Collider. We select events with one charged lepton (electron or muon), large missing transverse energy, and at least four jets, and extract the ttbar content of the sample based on the kinematic characteristics of the events. For a top quark mass of 175 GeV, we measure sigma(ttbar) = 6.7 {+1.4-1.3} (stat) {+1.6- 1.1} (syst) +/-0.4 (lumi) pb, in good agreement with the standard model prediction.Comment: submitted to Phys.Rev.Let

Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt(s)=1.96 TeV using Lepton + Jets Events with Lifetime b-tagging

We present a measurement of the top quark pair ($t\bar{t}$) production cross section ($\sigma_{t\bar{t}}$) in $p\bar{p}$ collisions at $\sqrt{s}=1.96$ TeV using 230 pb$^{-1}$ of data collected by the D0 experiment at the Fermilab Tevatron Collider. We select events with one charged lepton (electron or muon), missing transverse energy, and jets in the final state. We employ lifetime-based b-jet identification techniques to further enhance the $t\bar{t}$ purity of the selected sample. For a top quark mass of 175 GeV, we measure $\sigma_{t\bar{t}}=8.6^{+1.6}_{-1.5}(stat.+syst.)\pm 0.6(lumi.)$ pb, in agreement with the standard model expectation.Comment: 7 pages, 2 figures, 3 tables Submitted to Phys.Rev.Let