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Tenório JR, Bueno MV, Franco JB, Peres MPSDM, Moratto BMN, Munhoz L, Arita ES, Ortega KL. Assessment of mandibular cortical index in patients with hepatic cirrhosis: A case-control study. Spec Care Dentist 2023; 43:119-124. [PMID: 35709388 DOI: 10.1111/scd.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/18/2022] [Accepted: 05/28/2022] [Indexed: 11/26/2022]
Abstract
AIMS To assess the presence of alterations suggestive of reduced bone mineral density (BMD) by using mandibular cortical index (MCI) in panoramic radiographs of cirrhotic individuals and to evaluate their relationship with other characteristics of hepatic cirrhosis (HC). METHODS AND RESULTS This is an observational case-control study assessing the medical records of 165 cirrhotic patients matched by sex and age with healthy individuals. MELD (model of end stage liver disease) score, etiology, complications, comorbidities, and serum levels of vitamin D were collected. MCI was used to obtain BMD. Binary logistic regression was used to test associations and the risk estimates were expressed in odds ratio. Most of the sample consisted of men (73.93%) with median age of 56 years old. In the study group, the mean value of MELD was 16.5 and hepatitis C was the main etiology of HC (33.9%). Cirrhotic individuals are 3.99 times more likely to present alterations suggestive of reduced BMD (p < .01). There was no statistical significance in the association of MCI with levels of vitamin D, comorbidities, etiology or cirrhosis complications. CONCLUSIONS MCI suggestive of reduced BMD is more likely to be identified in panoramic radiographs of cirrhotic individuals than of healthy ones.
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Affiliation(s)
- Jefferson Rocha Tenório
- Special Care Dentistry Centre (CAPE), Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
- Department of Pathology and Oral Diagnosis of the Federal University of Rio de Janeiro, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Marcus Vinícius Bueno
- Special Care Dentistry Centre (CAPE), Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Juliana Bertoldi Franco
- Division of Dentistry of the Clinics Hospital of the University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | | | - Beatriz Mota Nunes Moratto
- Special Care Dentistry Centre (CAPE), Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Luciana Munhoz
- Division of Oral Radiology, Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Emiko Saito Arita
- Division of Oral Radiology, Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Karem L Ortega
- Special Care Dentistry Centre (CAPE), Department of Stomatology of the University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
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Machado GG, Zambon CE, de Lima JMDS, Paiva GLA, Martins VADO, Peres MPSDM. Synovial chondromatosis of the temporomandibular joint - clinical, surgical and imaging findings of a Milgram Stage III case series. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:e94-e101. [PMID: 36535888 DOI: 10.1016/j.oooo.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022]
Abstract
Synovial chondromatosis of the temporomandibular joint (TMJ) is a rare disease characterized by cartilaginous metaplasia of the mesenchymal remnants of the synovial membrane with formation of loose cartilaginous nodules. It is prevalent in middle-aged women and the main clinical characteristics are swelling, pain, and limited jaw movements. Diagnosis is difficult, especially in the early stages, because the signs and symptoms are like other TMJ diseases such as internal derangements and tumors. Imaging exams are fundamental in differential diagnosis for detection of synovitis and free cartilaginous bodies. Magnetic resonance imaging with a gadolinium contrast would be of particular interest for this purpose. Treatment involves the removal of the cartilaginous nodules and synovectomy. It can be performed by arthroscopy or arthrotomy depending on the size of the lesion, the number of corpuscles, and the need for auxiliary surgical procedures. Final diagnosis is anatomopathologic. Postoperative follow-up is necessary due to the risk of recurrence.
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Santos DSDA, Galvão GS, Ribas PF, Peres MPSDM, Franco JB. Photodynamic therapy in the treatment of oral lesions caused by paracoccidiomycosis. Photodiagnosis Photodyn Ther 2021; 37:102648. [PMID: 34823032 DOI: 10.1016/j.pdpdt.2021.102648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
Paracoccidioidomycosis (PCM) is an endemic disease caused by the dimorphic fungus Paracocdioides brasiliensis and Paracoccidioides lutzii. Oral ulcers are usually the first clinical signs of the disease. As it is a systemic fungal disease, local treatments are considered complementary, such as photodynamic therapy (aPDT). We present a patient with ulcerated lesions in the oral cavity of about 6 months duration. The pain complaint in the oropharynx led to a reduction in food acceptance and a weight loss of around 40 kg. He underwent biopsy of the lip lesion, and the histopathological report described yeast with multiple buds compatible with PMC. Our team opted for treatment with aPDT sessions. Two sessions were carried out in the ward and six in the ICU, showing satisfactory results in the remission of ulcerated lesions associated with PCM as well as the painful symptoms in the oral cavity. Also, the patient underwent Amphotericin B and Sulfamethoxazole-trimethoprim. We believe that the association of aPDT with pharmacological therapy possibly accelerated the repair process of oral lesions, as well as providing fungal lesion decontamination, improving progressively the healing of oral lesions.
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Affiliation(s)
| | - Gustavo Souza Galvão
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil
| | - Priscila Fernandes Ribas
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil.
| | | | - Juliana Bertoldi Franco
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil; Department of Dentistry, Auxiliary Hospital of Suzano - Clinical Hospital of Medical School of the University of São Paulo - São Paulo, SP, Brazil.
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Macedo LFDSL, Domaneschi C, Miguita Luiz L, Peres MPSDM, Franco JB. Fanconi anemia and hematopoietic stem cell transplant as risk factors for oral squamous cell carcinoma: A case report with a 12-year follow-up. Spec Care Dentist 2021; 42:299-303. [PMID: 34735020 DOI: 10.1111/scd.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/02/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022]
Abstract
Fanconi anemia is a rare disorder resulting from defects in genes responsible for DNA damage responses. It is characterized by congenital anomalies, aplastic anemia, and a predisposition to cancer. Currently, hematopoietic stem cell transplant (HSCT) is the only curative treatment available for bone marrow failure; however, HSCT increases oral squamous cell carcinoma (OSCC) risk. Here we report the case of a patient diagnosed with Fanconi anemia in childhood who was treated with HSCT and later diagnosed with multiple OSCCs during a 12-year follow-up. Despite multiple surgical interventions and radiotherapy regimens, the patient`s health deteriorated. Management of individuals with Fanconi anemia is challenging and must be provided by a multidisciplinary healthcare team to ensure better staging, treatment planning, and coordination.
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Affiliation(s)
| | - Carina Domaneschi
- Department of Stomatology, School of Dentistry, University of Sao Paulo (USP), São Paulo, Brazil
| | - Lucyene Miguita Luiz
- Department of Pathology, Institute of Biological Science, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Juliana Bertoldi Franco
- Dentistry Division, Clinics Hospital of the School of Medicine, University of Sao Paulo, São Paulo, Brazil
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Franco JB, Ribas PF, Valente Júnior LAS, Matias DT, Varotto BLR, Hamza CR, Araújo JF, Peres MPSDM. Hospital Dentistry and Dental Care for Patients with Special Needs: Dental approach during COVID-19 Pandemic. BDS 2020. [DOI: 10.14295/bds.2020.v23i2.2243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: The COVID19 pandemic brought a new panorama for the realization of dental treatment for the general population due to the risk of cross infection in the dental office - aerosol formation and insertion of new personal protective equipment. Emergency and emergency dental criteria were defined to limit the flow of patients in the office in order to improve biosafety conditions among patients. Objective: to describe the dental procedures pertinent to outpatient special care or during hospitalization in the VOCID19 pandemic - changes in care and implement biosecurity criteria. Basic procedures: The dental care of the special patient suffers changes - mainly referring to the difficulty of access to the offices - interruption of the conditioning process and difficulty to perform outpatient sedation and sedation with nitrous oxide. Dental care during hospitalization is essential in this patient due to prolonged time of tracheal oro intubation - traumatic oral lesions - preparation of specific oral care protocols - removal of mouth infectious and installation of mouth protectors. Conclusion: Change of care - inclusion of individual protection equipment and new knowledge about the COVID19 allows us to safely assist the patient with special needs both in the dental office and in hospital environment - providing quality of life - oral comfort and reducing oral infections during and after the pandemic. KEYWORDSDental care; Hospitals - Special; Needs assessment; Dental service - Hospital; Intensive care units; Pandemics.
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Dal Prá KJ, de Assis Tristão SDSS, Franco JB, Matias DT, Carrillo CM, de Melo Peres MPS, Ribas PF. Oral management of pemphigus vulgaris in the intensive care unit. Spec Care Dentist 2020; 40:280-284. [PMID: 32162360 DOI: 10.1111/scd.12454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 01/13/2023]
Abstract
Pemphigus vulgaris (PV) is a rare and potentially lethal autoimmune disease that affects the skin and mucous membranes. Injuries caused by the disease cause pain, risk of infection, and other complications that result in a high mortality rate. Frequently, management of the PV requires intensive care and a multidisciplinary approach. Oral lesions of PV are usually the first clinical signs of the disease and the last lesions to heal, requiring treatment by a specialized dental team. The aim of this study was to report two clinical cases of PV with involvement of the oral mucosa. The patients were admitted to an intensive care unit, and underwent multidisciplinary management of their condition along with low-level laser therapy. Both cases demonstrated the importance of specialized dental care in improving the quality of life of patients with PV.
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Affiliation(s)
- Ketelin Juliane Dal Prá
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Juliana Bertoldi Franco
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Diogo Toledo Matias
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Camila Merida Carrillo
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Priscila Fernandes Ribas
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
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Franco JB, Cacita N, Freua KA, Ortega KL, de Melo Peres MPS. Treatment of drooling with scopolamine in pediatric ICU: A case series report. Spec Care Dentist 2018; 38:362-366. [PMID: 30238487 DOI: 10.1111/scd.12326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/03/2018] [Accepted: 07/13/2018] [Indexed: 11/27/2022]
Abstract
Drooling is a condition that affects patients with difficulties in swallowing, being common in patients with mental, neurological or dysphagic deficiency. This condition is difficult to diagnose, as it is often confused with sialorrhea, and in many cases we have a hyposalivation scenario. Its diagnosis is subjective, which is why scales should be used for the standardization of the evaluation of the degree of drooling before and after the proposed treatment, as the Thomas-Stonell and Greenberg scale. It causes problems such as perioral infections, rashes, wet clothing, leading to social embarrassment, and may be a risk factor for respiratory infections caused by asymptomatic aspiration of saliva. It presents several treatments, among them the pharmacological one, that is dependent of the clinical picture of each patient that must be evaluated daily. This article refers to a series of reports of cases of children in mechanical ventilation by tracheostomy, hospitalized, with clinical diagnosis of drooling, and clinical improvement with the use of scopolamine by gastrostomy, without intercurrences during its use. The objective of this study is to show other professionals the importance of drooling management, and to expose the adopted behavior in the described cases, providing reduction of respiratory infections and improvement of the clinical and social complications resulting from drooling.
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Affiliation(s)
- Juliana Bertoldi Franco
- Hospital Auxiliar de Suzano, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil.,Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Nadia Cacita
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Karina Albuquerque Freua
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Karem López Ortega
- Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Bassan LT, Peres MPSDM, Franco JB. Oral care in prevention of ventilator-associated pneumonia in neonatal and pediatric intensive care unit: protocol proposal. Rev Bras Odontol 2018. [DOI: 10.18363/rbo.v75.2018.e1183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: revisar a literatura sobre pneumonia associada à ventilação mecânica em uma unidade de terapia intensiva neonatal e pediátrica, principais substâncias e veículos utilizados na higiene bucal, e propor um protocolo de higiene bucal para prevenção de pneumonia associada à ventilação mecânica, priorizando o conforto bucal e proporcionando uma melhor qualidade de vida. Material e Métodos: busca em bases de dados de 2000 a 2018, com enfoque na higiene bucal em unidades de terapia intensiva neonatal e pediátrica, utilizando os seguintes descritores: Pneumonia associada à ventilação mecânica; Pneumonia por aspiração; UTI neonatal; Unidade de terapia intensiva pediátrica; Higiene oral. Resultados: foram selecionados 26 artigos com abordagem neonatal e pediátrica para elaboração da proposta de protocolo, os quais devem ser planejados de acordo com a disponibilidade de recursos materiais e humanos, perfil hospitalar, e devem ser baseados em evidências científicas. Conclusão: os protocolos de higiene bucal contribuem para reduzir o risco de infecções em unidades de terapia intensiva, reduzindo o tempo de permanência e os custos hospitalares. Cada hospital deve desenvolver seu próprio protocolo com base na literatura científica disponível e na experiência clínica dos profissionais envolvidos.
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Ceccheti MM, Negrato GV, Peres MPSDM, Deboni MCZ, Naclério-Homem MDG. Analgesic and adjuvant anesthetic effect of submucosal tramadol after mandibular third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:e249-54. [DOI: 10.1016/j.oooo.2012.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 05/01/2012] [Accepted: 05/23/2012] [Indexed: 12/29/2022]
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Lima AGD, Antequera R, Peres MPSDM, Snitcosky IML, Federico MHH, Villar RC. Efficacy of low-level laser therapy and aluminum hydroxide in patients with chemotherapy and radiotherapy-induced oral mucositis. Braz Dent J 2011; 21:186-92. [PMID: 21203698 DOI: 10.1590/s0103-64402010000300002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 09/16/2009] [Indexed: 02/07/2023] Open
Abstract
This study evaluated the efficacy of low-level laser therapy (LLLT) and aluminum hydroxide (AH) in the prevention of oral mucositis (OM). A prospective, comparative and non-randomized study was conducted with 25 patients with head and neck cancer subjected to radiotherapy (RT) or radiochemotherapy (RCT). Twelve patients received LLLT (830 nm, 15 mW, 12 J/cm²) daily from the 1st day until the end of RT before each sessions during 5 consecutive days, and the other 13 patients received AH 310 mg/5 mL, 4 times/day, also throughout the duration of RT, including weekends. OM was measured using an oral toxicity scale (OTS) and pain was measured using the visual analogue scale (VAS). EORTC questionnaires were administered to the evaluate impact of OM on quality of life. The LLLT group showed lower mean OTS and VAS scores during the course of RT. A significant difference was observed in pain evaluation in the 13th RT session (p=0.036). In both groups, no interruption of RT was needed. The prophylactic use of both treatments proposed in this study seems to reduce the incidence of severe OM lesions. However, the LLLT was more effective in delaying the appearance of severe OM.
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Rezende FMDC, Gaujac C, Rocha AC, Peres MPSDM. A prospective study of dentoalveolar trauma at the Hospital das Clínicas, São Paulo University Medical School. Clinics (Sao Paulo) 2007; 62:133-8. [PMID: 17505697 DOI: 10.1590/s1807-59322007000200007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Accepted: 11/13/2006] [Indexed: 03/31/2023] Open
Abstract
PURPOSE This prospective study evaluated the profile of patients with dentoalveolar trauma assisted at the emergency room of the Oral and Maxillofacial Trauma and Surgery Service at the Hospital das Clínicas, São Paulo University Medical School (Brazil). METHODS A prospective study by a questionnaire applied during the first attendance of those patients, in a period of eight months. RESULTS The collected data were statistically analyzed. It was observed that 4.7% of the patients that sought treatment at the Service had sustained dentoalveolar trauma and among these 74% were male. The most affected individuals were children aged 0 to 5 years and fall was the most prevalent etiologic factor. Avulsion and coronal/crown-root fractures were the most common types of dentoalveolar traumatic injures. As the age increases, the most common etiologic factors are traffic accidents and physical assault. CONCLUSION The incidence of dentoalveolar trauma decreased with age and the main etiologic factors in adult patients were traffic accidents and physical assault.
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Affiliation(s)
- Fernanda Mendes do Carmo Rezende
- Oral and Maxillofacial Trauma and Surgery Service, Hospital das Clínicas, Medical School, São Paulo University, São Paulo, SP, Brazil
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