Lip incompetence and psychosocial effects: a pilot study

OBJECTIVE: The purpose of the study was to determine whether children are more negatively perceived because of a lip incompetence. STUDY DESIGN: A sample survey study. METHODS: Two sets of colored pictures (1 set with the mouth open and 1 set with the mouth closed) were taken of four children with lip incompetence and mouth breathing and four children with normal lip closure and breathing patterns. These pictures were presented to a group of judges in Belgium and Brazil. Judges were presented either pictures of the closed mouth sets or pictures of the open mouth sets and were asked to rate on a 10-point scale the chance that the child was shy, had few friends, belonged to a lower socioeconomic class, had problems with reading, writing, or arithmetic, had ever manifested thumb-sucking, and had difficulties breathing through the nose. In each child, scores obtained for the open mouth set were compared with those obtained for the closed mouth set. RESULTS: There was no consistent pattern of higher scores being assigned to the pictures of the open mouth set, neither in the Belgian survey nor in the Brazilian survey. CONCLUSION: Contrary with past and present claims, results suggest that children with a lip incompetence are not necessarily perceived negatively.     

Adenotonsillectomy in facial growing patients: spontaneous dental effects

Children with hypertrophic tonsils and adenoids may have adverse effects on dental occlusion, which tend to worsen during the growth period. Diagnosis and early treatment is essential.AimProspective clinical study to compare the cephalometric measurements before and after adenotonsillectomy in mouth breathing patients.Material and MethodWe had 38 patients of both genders, aged between 7 and 11 years in our sample, broken down into: oral group, 18 patients with obstructive hypertrophy of pharyngeal tonsil and/or palate grade 3 or 4; control group, 20 patients with normal breathing. Angular and linear dental measurements were compared between the groups in a 14 months interval. We used the “t” Student and Wilcoxon tests for unpaired samples, at 5% significance, for statistical purposes.ResultsThe sagittal position and axial angle of the lower incisors increased significantly in the group with oral breathing, the sagittal position of the upper incisors increased significantly in the oral group, which still had a significant increase in overbite.ConclusionAdenotonsillectomy was very effective in improving some dental measurements, with benefits to growing patients preventing malocclusions from becoming difficult to treat or permanent.     

Predicting mandibular invasion in mouth cancer

This study assesses the role of orthopantomography, computerized tomography and intra-operative assessment in predicting the presence and extent of mandibular invasion by mouth tumours. Forty patients with squamous carcinoma of the oral cavity and oropharynx were studied. All had pre-operative orthopantomography and computerized tomography as well as intra-operative assessment of mandibular invasion and these factors were compared with the actual histological invasion to assess the role of each test. This study found that negative radiology is useful for excluding cortical invasion and as might be expected is of no real value in excluding periosteal invasion, a positive orthopantomogram accurately predicts invasion at least into the cortex, however, a positive CT must be judged cautiously due to false positives and intra-operative assessment by an experienced operator is a useful adjunct to radiology.     

Clinical study of the oral manifestations and related factors in type 2 diabetics patients

Diabetes Mellitus (DM) is reported with and associated to oral alterations, with conflicting results. The aim of this study was to identify the prevalence of oral soft tissue alterations in type 2 diabetes mellitus patients.Material and MethodsSocioeconomic variables, gender, heredity, capillary glucose control and local factors (prosthesis, dry mouth sensation) were analyzed in 196 diabetic and non-diabetic patients enrolled in HIPERDIA, at 41 Health Units of Natal, Brazil.Study DesignA case study.ResultsThe last blood glucose mean was 177.0 mg/dl for diabetics and 89.46 mg/dl for non-diabetics. Mean capillary blood glucose was elevated in diabetics (215.95 mg/dl); it was 102.31 mg/dl in non-diabetics. The family history confirmed the heredity nature of the disease in 68.8% of diabetic patients (n = 66) (p < 0.001); salivary flow was 49% (n = 47) in diabetics, and 34% (n = 34) in non-diabetics. Candidiasis was present in 30.5% of diabetic patients (n=29) and 36% of non-diabetics (n=36). Both groups had lesions in the palate - 81.4% (n = 35) in diabetics, and 71.1% in non-diabetics (n = 27) (p = 0.68).ConclusionThe alterations are not related to diabetes and are present independently of having or not type 2 Diabetes Mellitus.     

Characterization of oral cancer diagnostic delay in the state of Alagoas

Oral cancer in Brazil still presents high levels of incidence and mortality bearing different traits throughout the national territory. In most of the cases the diagnosis is late; however there is a great possibility for cure when treated early on.Aimto assess factors associated with the late diagnosis of oral cancer in the state of Alagoas.Material and Methodsa prospective cross-sectional study was carried out in 74 patients, all of them diagnosed with oral squamous cell carcinoma in a hospital of Alagoas, between July of 2007 and September of 2008. A semi-structured interview was given, obtaining socio-demographic data, the type of professional help sought, symptom onset, referrals and tumor clinical stage at the moment of diagnosis.ResultsAccording to the results obtained in this study, the patients usually sought professional medical help, rather than dental help when a lesion in the mouth appeared, being always referred to a specialist by the dentist, in advanced stages of the disease.ConclusionsThis study suggests the need for continued education programs for the population and professionals aiming at the early identification of symptoms of the illness; however needing further studies.     

The forehead flap: a modification in technique

The use of the forehead flap for reconstruction within the oral cavity after tumour resection is discussed. A minor modification in technique is described. The sub-zygomatic route to the oral cavity is used and a piece of teflon or sialalastic sheet is sewn over the raw surfaces of the flap which lies within the tunnel in the cheek to facilitate retrieval of the pedicle.     

Impact of modified radical neck dissections on the number of retrieved nodes,recurrence and survival

Neck dissection is an integral part of head and neck tumors. Throughout its history, it has undergone changes looking for an improvement in functional outcome without loss of oncologic efficiency.     

Objective and non-invasive evaluation of dry mouth

OBJECTIVE: This study was designed to evaluate the moisture checker (MucusIII), a new device for measuring moisture of the oral submucosa. METHODS: Defective salivary secretion was induced by sialoadenectomy (n=8), while the remaining five guinea pigs underwent sham surgery (control group). We measured the unstimulated salivary flow rate, wetness of the oral mucosa using the oral tester (L-SALIVO) and moisture of the submucosa of the tongue using MucusIII. All tests were performed before (baseline) and 1 month after surgery. RESULTS: Sialoadenectomy significantly reduced both the salivary flow rate and the tester reading at 10 and at 30s (p<0.01). The vale due to the MucusIII as significantly reduced in animals with sialoadenectomy (p<0.01). CONCLUSION: The MucusIII is a device for objective evaluation of the moisture of the oral cavity.