[Show abstract][Hide abstract] ABSTRACT: The purpose of the present study was to evaluate the prevalence of teeth malposition (rotated) in Brazilian patients with oral clefts and to contribute to the definition of subphenotypes. This study included 317 patients with nonsyndromic cleft lip with or without cleft palate. Tooth malposition was assessed clinically, through radiographs, and medical history records for each individual. Only teeth malpositions outside the area of the clefts were included. Comparisons were assessed by cross-tabulation and standard chi-square test, and statistical significance was set at p≤0.05. Cleft lip and palate was more prevalent in males, while cleft palate was more common in females. Regarding the presence of tooth malposition, of the 317 patients, 92 (29.02%) had at least one tooth with the dental anomaly. Tooth malposition was more common in patients with cleft lip and palate (16.1%), followed by, respectively, cleft palate (6.9%) and cleft lip (6%) (p=0.112). The highest occurrence of tooth malposition was in the mandible and involved the canines (p<0.01). Few studies have investigated the prevalence of tooth malposition in individuals with nonsyndromic cleft lip with or without cleft palate. Our results confirmed the highest occurrence of dental anomalies, particularly tooth malposition, in patients with oral clefts. Our findings also highlight that there was a higher occurrence of this condition in the mandible and not the maxilla.
[Show abstract][Hide abstract] ABSTRACT: Objectives:
The purpose of this study was to evaluate the prevalence of taurodontism in patients with nonsyndromic cleft lip and palate (NSCLP) within a Brazilian population.
The study was designed as an epidemiologic case-control single-center study. Three hundred eighty-eight patients were included: 88 had NSCLP, and 300 comprised the control group. The first and second permanent mandibular molars were included in this study. By using panoramic radiographs, taurodontism was categorized as mesotaurodontism, hypotaurodontism, and hypertaurodontism.
Seventy patients (23.3%) from the control group and 36 patients (40.9%) from the case group presented taurodontism (P < .001). In the control group, 108 (9%) teeth showed taurodontism, whereas in the case group with cleft lip and palate (CLP), 64 (18.2%) teeth showed dental anomalies (P < .001). In both groups, most taurodontic teeth presented hypotaurodontism, followed by mesotaurodontism, while hypertaurodontism was found in only two teeth. The probability of taurodontism in patients with cleft lip (CL) was 2.36 (P = .010) times higher compared with those with CLP, whereas the occurrence of taurodontism in patients with cleft palate (CP) was 3.15 (P = .002) times greater than in patients with CLP.
The results from this study indicate a close relationship between taurodontism and NSCLP and the possibility of different cleft subphenotypes.
No preview · Article · Aug 2015 · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
[Show abstract][Hide abstract] ABSTRACT: Objective: was to analyze the digital and palmar asymmetry of parents and individuals with non syndromic clef lip and/or palate.
Method: we analyzed a sample of 303 people divided into two groups, the case with 51 trios consisting of fathers, mothers and children affected by non syndromic cleft palate, since the control group was composed of 50 trios also shaped by individuals unaffected by cleft or other clinical syndromes or conditions of diseases, as well as their fathers and mothers. We made the fingerprints and palm prints of each participant, then calculated the dermatoglyphic patterns (arches, loops and whorls), ridge count the digits and palmar angles (atd, tda, tad). To measure the fluctuating asymmetry (right-left) if the case group was compared to the control using the Mann-Whitney and chi-square tests, and accepted a p value ≤ 0.05.
Result: We observed a statistically significant difference between the atd angles of the fathers, and dermatoglyphic patterns of the mothers of those affected by cleft, with a significantly greater number of arches in the case group (p=0.01). With respect to other measures there were no significant differences. Nor was it possible to observe differences in the ridge counts, palmar angles and dermatoglyphic patterns of the son.
Conclusion: From these results we can speculate that the mechanisms responsible for deviations in asymmetry of atd angles in fathers and dermatoglyphic patterns in mothers may be associated with the factors responsible for the formation of the CL/P in children.
[Show abstract][Hide abstract] ABSTRACT: Hypohidrotic ectodermal dysplasia (HED) is a type of genodermatosis characterized by the abnormal development of sweat glands, teeth, and hair. The most prevalent form of HED is X-linked hypohidrotic ectodermal dysplasia (XLHED), which is associated with mutations in the EDA gene. The aim of this case report was to describe a family with XLHED with emphasis on differences in orofacial features between members. Family members were systematically evaluated to characterize the pattern of inheritance and clinical features. Dental examination included evaluation of agenesis and abnormal teeth structure. The pedigree of the last seven generations of the family was constructed. Clinical examination and medical history revealed five males affected by HED and nine female as heterozygous carriers. The males exhibited the classic phenotype of XLHED, with dental abnormalities, hypohydrosis, and craniofacial dysmorphologies. The heterozygous carriers of the X-linked gene defect principally exhibited dental agenesis of the lateral maxillary incisors. Careful clinical examination, including dental evaluation, is an important way to detect heterozygous carriers of X-linked HED. Heterozygous parents of patients with HED may also show some features of the disorder. The identification of female carriers results in genetic counseling being offered to affected families, as well as providing adequate treatment as necessary and long-term follow-up of these patients.
Full-text · Article · Mar 2012 · Head and Neck Pathology
[Show abstract][Hide abstract] ABSTRACT: Abstract Abstract Objective: To compare the caries experience of adolescents and young adults with cleft lip and/or palate (CL/P) with a non-cleft control group. Design: Thirty CL/P subjects and 30 controls were clinically examined to obtain the DMFT and DMFS indices, gingival bleeding index, plaque index, and active caries lesions. Data concerning oral hygiene, access to fluoridated water, mother's education level, and family income were also collected. Setting: Pro-Smile Center, a reference center for the treatment of facial deformities, Alfenas, Minas Gerais, Brazil. Subjects: Subjects aged 12-21 years with CL/P and without associated syndromes were matched to non-cleft controls by gender, age, living habits, and use of orthodontic devices. Null hypothesis formulated before the beginning of data collection: caries experience in CL/P adolescents and young adults is similar to that observed in the non-cleft controls. Statistical analysis: Data were analyzed using SPSS 17.0 software for Windows Data Editor. CL/P and control groups were compared using the McNemar test, paired t-test and Wilcoxon test. A significance level of 5% was adopted for all tests. Results: There were no significant differences between the groups for oral hygiene and contact with fluoride. Significant differences were found in per capita income, presence of active caries, decayed surfaces, plaque index and gingival bleeding. Conclusions: The caries experience of CL/P subjects was higher than that of the non-cleft individuals. Keywords: dental caries, cleft lip and/or palate, cross-sectional, controlled study.
No preview · Article · Jan 2012 · The Cleft Palate-Craniofacial Journal
[Show abstract][Hide abstract] ABSTRACT: Abstract Objective: Many studies have demonstrated a high frequency of dental anomalies in patients with cleft lip and/or palate (CL/P). Since dental anomalies may complicate dental treatment, we investigated the prevalence of dental anomalies in a group of Brazilian patients with nonsyndromic CL/P (NSCL/P). Design, Participants, Setting: Retrospective analysis was performed using clinical records of 296 patients with repaired NSCL/P aged between 12 and 30 years without history of tooth extraction and orthodontic treatment. Associations between oral clefts and presence of dental anomalies outside the cleft area were investigated. Results: Dental anomalies were identified in 39.9% of the NSCL/P patients, and tooth agenesis (47.5%), impacted tooth (13.1%) and microdontia (12.7%) were the most common anomalies. CL patients were less affected by dental anomalies compared with CP or CLP patients (p=0.057). Specifically, unilateral CLP patients were significantly more affected by dental anomalies than bilateral CLP patients (p=0.00002), and individuals with unilateral complete CLP (p=0.002) and complete CP (p=0.01) were significantly more affected by tooth agenesis than other cleft types. Ageneses of the premolars (p=0.043) and maxillary lateral incisors (p=0.03) were significantly more frequent in unilateral complete CLP patients. Conclusions: The present study revealed a high frequency of dental anomalies in NSCL/P patients, and further demonstrated that patients with unilateral CLP were frequently more affected by dental anomalies than bilateral CLP. Moreover, our results demonstrate that dental anomalies should be considered during dental treatment planning of individuals affected by NSCL/P. Keywords: Cleft lip and palate; dental anomaly; tooth agenesis; dental treatment.
No preview · Article · Oct 2011 · The Cleft Palate-Craniofacial Journal
[Show abstract][Hide abstract] ABSTRACT: The genetic diversity of C. albicans oral isolates from 75 healthy schoolchildren from eight schools located in different geographic areas of Piracicaba city, São Paulo state, Brazil, was established using isoenzymes marker (Multilocus Enzyme Electrophoresis - MLEE) and cluster analysis. Patterns of monoclonal and polyclonal oral colonization by C. albicans within and between groups of schoolchildren were identified. However, significant divergence between the observed and the expected genotypic frequencies (Hardy-Weinberg equilibrium test) was not detected in the geographically adjacent groups, suggesting the hypothesis that populations of healthy schoolchildren do not correspond to the selection factor (differential survival) of strains. Two highly polymorphic and distantly genetically related taxa (A and B) were identified within the total population of yeasts, each contained subgroups (A1, A2, A3, A4, B1 and B2) and clusters of moderately related strains (from I to X), suggesting the existence of strains restricted or not to certain groups of geographically limited, healthy students. However, the coexistence of identical strains in healthy schoolchildren from the same school (geographically related) reinforces the hypothesis of oral transmission, where the sources of propagation could be explored. Furthermore, this could also be used in current and retrospective analyses of C. albicans isolated from immunocompetent and immunocompromised people, in order to detect commensal or potentially pathogenic yeast groups, predominantly in candidiasis, and in the development of strategies to prevent transmission or human propagation.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To evaluate the frequency of craniofacial anomalies in patients treated at a Brazilian Reference Center for craniofacial deformities. METHOD: Retrospective epidemiological study evaluating the clinical records of 1,142 patients: 656 (57.4%) male and 486 (42.6%) female, between 1992 and 2008. RESULTS: Among birth defects, non-syndromic cleft lip and/or palate were the most frequent ones (778 cases; 68.1%), followed by single or multiple congenital anomalies without cleft lip and/or palate (240 cases; 21%), recognized syndromes or sequences (56 cases; 5%), syndromes with orofacial cleft as a component (41 cases; 3.5%), and orofacial clefts in association with systemic malformations (27 cases; 2.4%). CONCLUSIONS: Non-syndromic cleft lip and/or palate was the congenital defect most frequently identified, although, isolated anomalies and syndromes involving craniofacial structures were quite frequent. Furthermore, the need for studies to identify the frequency and risk factors associated with craniofacial anomalies in the Brazilian population is emphasized in order to plan comprehensive strategies and integrated actions for the development of preventive programs and treatment.
Preview · Article · Mar 2011 · Revista Brasileira de Epidemiologia
[Show abstract][Hide abstract] ABSTRACT: Cleft lip and/or palate (CL/P) are the most common congenital anomalies of the face. CL/P are non-syndromic (CL/PNS) in about 70% of subjects.
To describe clinical cases of non-syndromic CL/P (CL/PNS) associated with consanguinity, diagnosed at a reference hospital in Minas Gerais, Brazil, and to correlate these alterations with possible risk factors. SERIES AND METHODS: A retrospective study at a reference hospital for craniofacial deformities in Minas Gerais, Brazil from 2006 to 2009 based on data in medical records.
Of 246 CL/PNS cases diagnosed and treated at the institution, 15 (6.1%) were CL/PNS with reported first-degree consanguinity; 73.3% occurred in males. Four of 15 patients had complete right cleft palate and lip (CLP), 4 presented complete cleft palate and lip (right and left), 3 had complete unilateral left CLP, 3 had isolated cleft palate, and 1 presented cleft lip only. Among the risk factors, only three mothers reported smoking during pregnancy.
CLP (unilateral or bilateral) were more frequent in the group with a history of first-degree consanguinity; males predominated. Among the risk factors, only smoking was observed in three cases.
Full-text · Article · Feb 2011 · Brazilian journal of otorhinolaryngology
[Show abstract][Hide abstract] ABSTRACT: Fissuras do lábio e/ou palato representam as anomalias congênitas craniofaciais mais comuns. OBJETIVO: Avaliar fatores de risco ambientais em pacientes com fissuras lábio-palatinas não-sindrômicas, em um Serviço de Minas Gerais. CASUÍSTICA E MÉTODO: Realizou-se estudo caso-controle, avaliando 100 crianças com fissuras e 100 crianças sem alterações clínicas. As dimensões de análise (idade, cor de pele, sexo, classificação das fissuras, idade materna e paterna, ordem de paridade e intervalo interpartal) foram obtidas a partir de um questionário, sendo posteriormente construído banco de dados e as análises realizadas pelo programa SPSS 17.0. Os resultados foram analisados com risco relativo para cada variável, para estimar odds ratios com intervalo de confiança de 95% seguido de análise bivariada e multivariada. RESULTADOS: Entre as 200 crianças, 54% foram do sexo masculino e 46% do feminino. Com relação à cor da pele, houve predomínio de parda, branca e preta, respectivamente. Entre os tipos de fissuras, as mais comuns foram as fissuras lábio-palatinas (54%), seguidas pela fissura labial (30%) e fissura palatina (16%). CONCLUSÃO: Embora com uma população limitada, verificou-se associação entre idade materna e risco aumentado para fissuras lábio-palatinas, porém idade paterna, ordem de paridade e intervalo interpartal não foram significantes.
Preview · Article · Feb 2010 · Brazilian journal of otorhinolaryngology
[Show abstract][Hide abstract] ABSTRACT: Cleft lip and palate (CL/P) are the most common congenital craniofacial anomalies.
To evaluate environmental risk factors for non-syndromic CL/P in a reference care center in Minas Gerais.
we carried out a case-controlled study, assessing 100 children with clefts and 100 children without clinical alterations. The analysis dimensions (age, skin color, gender, fissure classification, maternal and paternal age, birth order and interpregnancy interval), obtained from a questionnaire; and later we build a data base and the analyses were carried out by the SPSS 17.0 software. The results were analyzed with the relative risk for each variable, in order to estimate the odds ratio with a 95% confidence interval, followed by a bivariate and multivariate analysis.
among 200 children, 54% were males and 46% were females. As far as skin color is concerned most were brown, white and black, respectively. Cleft palates were the most common fissures found (54%), followed by lip cleft (30%) and palate cleft (16%).
although with a limited sample, we noticed an association between maternal age and an increased risk for cleft lip and palate; however, paternal age, pregnancy order and interpregnancy interval were not significant.
Preview · Article · Feb 2010 · Brazilian journal of otorhinolaryngology
[Show abstract][Hide abstract] ABSTRACT: Hemifacial hyperplasia is a developmental disorder characterized by marked unilateral facial asymmetry. It involves the hard and soft tissues of the face. The cause is unknown, although several predisposing factors have been described. A case report of an 8-year-old boy with hemifacial hyperplasia is presented to highlight the clinical and imaging findings.
Full-text · Article · Jan 2010 · Journal of Oral Science
[Show abstract][Hide abstract] ABSTRACT: Cleft lip and palate (CL/P) are the most common congenital anomalies of the craniofacial region.
to evaluate the surgical techniques used in CL/P treatment in a craniofacial deformities ward, in Minas Gerais.
In this retrospective study, carried out between 2002 and 2007, we studied 109 individuals with non-syndromic CL/P submitted to treatment. The aspects analyzed (personal identification, classification of CL/P and surgical treatment performed) were obtained from patient charts, and then we built a database and ran statistical analyses through the SPSS 13.0 software. Followed by descriptive analysis of the surgical procedures depending on the type of CL/P found.
Among the 109 patients, 65.1% were males and 34.8% females. We found that 45% of patients had cleft lip and palate, 37.6% cleft lip only and 17.4% cleft palate only. The surgical techniques employed were predominantly those from Millard and Spina for cheiloplasty, McComb for rhinoplasty and, Veau and Van Langenbeeck for palatoplasty.
This study is the first to address treatment procedures for individuals with CL/P in the state of Minas Gerais. For unilateral CL/P we predominantly used the association of McComb, Veau and Millard techniques, respectively, for rhinoplasty, palatoplasty and cheiloplasty, in 76.9% of the patients.
Preview · Article · Dec 2009 · Brazilian journal of otorhinolaryngology
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the oral colonization profile of Candida albicans strains isolated from diabetic patients and their non-diabetic consorts. In addition hydrolytic enzyme activity of these isolates was analysed.
The genetic diversity of C. albicans oral isolates from 52 couples was established using isoenzyme marker and cluster analysis. Hydrolytic enzyme characteristics, namely secreted aspartyl proteinases (SAPs) and phospholipases (PLs) were also analysed.
Simultaneous colonization by C. albicans was observed in the consorts of 12 couples (23.1%). Patterns of monoclonal and polyclonal oral colonization by C. albicans strains were identified and the coexistence of identical or highly related strains was observed in both members of eight couples. The genetic diversity observed in the total yeast population revealed four large, genetically distinct groups (A to D) and the coexistence of strains in couples or consorts conjugally unrelated. SAP and PL activity was observed in the majority of C. albicans isolates without any association to particular strain, strain clusters (highly related isolates), or clinical characteristics of the consorts (diabetic, non-diabetic, and gender).
Possible sources of transmission and oral propagation of groups (clusters) of strains of C. albicans can occur between diabetic and non-diabetic consorts. A conjugal genotypic identity exists in most C. albicans-positive couples, that is, both consorts share identical or highly related strains; however, this identity is not couple-specific as seen by the coexistence of clusters in couples and unrelated consorts.
No preview · Article · Dec 2009 · Oral Microbiology and Immunology
[Show abstract][Hide abstract] ABSTRACT: Interferon regulatory factor 6 (IRF6) gene has emerged as a potential susceptibility gene for non-syndromic cleft lip and/or palate (NSCL/P) in different populations. The aim of this study was to determine the association of IRF6 rs2235371 and rs642961 polymorphisms with NSCL/P in a Brazilian population.
Two hundred and twenty-eight patients affected by NSCL/P and 126 healthy individuals were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.
Overall genotype distributions of rs2235371 and rs642961 polymorphisms were as expected by Hardy-Weinberg equilibrium test. The rs2235371 polymorphic genotype GA was identified in 10.1% of the patients with NSCL/P and in 10.3% of the control group, revealing no statistical difference. Similarly, the frequency of rs642961 minor genotypes (GA and AA) was quite similar between control group (28.6%) and NSCL/P group (25.4%), without significant difference.
Our findings are consistent with a lack of involvement of IRF6 rs2235371 and rs642961 polymorphisms in the NSCL/P pathogenesis in the Brazilian population.
[Show abstract][Hide abstract] ABSTRACT: Objective: To evaluate the knowledge of laymen, undergraduate dental students and dentists of Human Tooth Bank (HTB). Methods: Observational study with non-probabilistic sample. Onehundred-and-fifty subjects (50 dentists, 50 undergraduate dental students and 50 laymen) were interviewed about their knowledge of donation of organs, valuing of the tooth as an organ, HTB, the use and origin of teeth used in dental schools and acceptance of biological restorations. Results: As much as 97.6% of the interviewees were favorable to organ donation, but only 48% declared themselves as organ donors. The tooth was considered an organ by 94% of the dentists, 90% of the students and 54% of the laymen. During the graduation course, 90% of the dentists and 86% of the undergraduate students confirmed the use of human teeth obtained from dental offices or cemeteries. For improvement of research and teaching purposes, 94% of the students and dentists considered important the implementation of HTBs; however, only 2% of the students, 6% of the laymen and 28% of the dentists declared being familiar with a HTB. Most of the interviewees (90%) were favorable to the donation of teeth to HTBs, but only 44% of them would accept a biological restoration, alleging "repulsion" and the existence of alternative restorative materials. Conclusion: Most interviewed individuals were favorable to tooth donation to a HTB, but ignored its existence as well as the ethical and biosecurity guidelines regulating the maintenance of private tooth collections.
Preview · Article · Jan 2009 · Pesquisa Brasileira em Odontopediatria e Clínica Integrada
[Show abstract][Hide abstract] ABSTRACT: OBJETIVO: Avaliar o perfil biopsicossocial de portadores de anoftalmia, com ênfase no impacto psicológico e funcional da perda ocular e na reintegração social dessa população. MÉTODOS: Realizou-se estudo transversal com 84 pacientes (50 do gênero masculino e 34 do feminino), reabilitados ou em processo de reabilitação com próteses oculares, avaliados por meio de questionário que contemplava dimensões como: etiologia da perda ocular, grau de adaptação à prótese e impacto nas atividades profissionais, sociais e escolares. RESULTADOS: O olho direito foi afetado em 45,2% dos pacientes, o olho esquerdo em 51,2%, e os demais apresentavam anoftalmia bilateral. Relataram dificuldade, atual ou já superada, de adaptação à visão monocular 47,5% dos participantes. No gênero masculino as principais causas da anoftalmia foram os traumatismos oculares por acidentes (54%), e no feminino, as doenças adquiridas (38,2%). Na população estudada, a perda ocular ocorreu, em média, aos 20,5 ± 18,4 anos, e o tempo decorrido até a primeira reabilitação protética foi de 8,6 ± 13,1 anos. A maioria dos pacientes (66,1%) relatou satisfação e boa adaptação à prótese ocular. Sentimentos de tristeza, vergonha e timidez foram freqüentemente relatados. CONCLUSÃO: Pacientes com anoftalmia freqüentemente apresentam transtornos psíquicos e/ou funcionais que dificultam sua readaptação ao meio social, profissional e familiar, o que é agravado por fatores econômicos e pela carência de serviços públicos que ofereçam tratamento reabilitador. A realização de campanhas de esclarecimento à população também pode ser útil para a prevenção das causas que levam à perda ocular.
Full-text · Article · Dec 2008 · Arquivos Brasileiros de Oftalmologia