Delson João da Costa

Purpose: This prospective observational study investigates whether changes in the direction and magnitude of occlusal plane angulation influence upper airway volume in adult patients undergoing orthognathic surgery. Methods: Data were collected preoperatively and 7 days and 6 months postoperatively. Cone beam computed tomography (CBCT) was used to measure occlusal plane angulation and upper airway volume. All measurements were performed by a single, calibrated researcher trained by a gold standard specialist. Statistical significance was set at p < 0.05. Results: Forty-eight patients were included: 27 women (56,25%) and 21 men (43,75%), with a median age of 29 years (range 18–52). Skeletal classifications were as follows: 19 class II (39,58%), and 29 class III (60,42%). Occlusal plane rotation was counterclockwise in 24 patients (50%) and clockwise in 24 patients (52%). Rotational changes were minor (0–2°) in 24 cases (50%) and major (> 2°) in the remaining 24 cases. No significant differences were observed in rotation direction or magnitude between class II and III patients ( p > 0.05). Conclusion: Class II patients showed a significant increase in oropharyngeal volume ( p = 0.026), while class III patients showed an increase in nasopharyngeal volume ( p = 0.003), regardless of occlusal plane changes. Additionally, nasopharyngeal volume increased significantly in class III patients with clockwise ( p = 0.035) and counterclockwise ( p = 0.037) rotations.

Objetivo: relatar o caso de uma paciente neonatal, que apresentou uma massa tumoral no rebordo gengival de maxila, observada após o nascimento. Relato de caso: Paciente recém-nascida, do sexo feminino, parto normal, com peso de 3,460 kg, sem intercorrências no parto. Durante oroscopia feita pela equipe médica, observou-se tumefação no rebordo alveolar de maxila, e optou-se pela transferência para UTI neonatal para observação e passagem de sonda oral. Na avaliação odontológica, observou-se um nódulo liso e brilhante, de coloração rósea/arroxeada, com aproximadamente 2,4cm no longo eixo, pediculado, localizado em rebordo anterior de maxila esquerda. A proposta de tratamento foi a excisão cirúrgica, realizada sob anestesia local, 36 horas após o nascimento, sem intercorrências. A hipótese clínica de epúlide congênita foi confirmada pelo exame anatomopatológico. A paciente segue em acompanhamento de 4 meses, com ótimo aspecto do rebordo. Conclusão: o diagnóstico precoce e a intervenção rápida foram determinantes para o sucesso do tratamento e prevenção de possíveis complicações como a obstrução de vias aéreas e deficiências nutricionais.

Introduction: Somatosensory changes remain a disadvantage of orthognathic surgery (OS). This study evaluated mechanical and pain thresholds after OS. Methods: This cross-sectional study with control group (CG, paired by sex and age), included OS patients and patients without somatosensory changes. The orthognathic group (OG) was divided in OG1 and OG2, according to the median of postoperative follow-up in months. Mechanical detection threshold (MDT), mechanical pain threshold (MPT) and dynamic mechanical allodynia (DMA) were evaluated. Kruskal-Wallis and Mann-Whitney tests (alpha of 0.05) were used. Results: 27 patients were included in each group (OG and CG). Fourteen patients were included in OG1 (4-7 months follow-up) and 13 in OG2 (8-24 months follow-up). OG2 showed lower MDT values (p0.05). Eight patients reported allodynia, 5 from OG1 (18.51%) and 3 from OG2 (11.11%) (p<0.05). There was a statistically significant association between postoperative pain and DMA (p<0.001). Pain intensity correlated with DMA (Rs=0.77; p<0.05). Conclusion: OS significantly alters patients’ MDT. Patients with persistent post-operative pain have greater chances to have allodynia. In addition, pain intensity is correlated with DMA intensity.

O cisto odontogênico calcificante (COC) é uma lesão odontogênica de desenvolvimento rara, correspondendo a menos de 1% dos cistos odontogênicos diagnosticados. No exame microscópico, é caracterizado pela presença de células fantasmas – células desprovidas de núcleo, mas que preservam seu contorno e frequentemente exibem calcificações intracelulares, conferindo à lesão um aspecto singular. Este relato apresenta o caso de um paciente de 27 anos, sexo masculino, com tumefação facial indolor persistente na região anterior da maxila há cerca de quatro anos, causando assimetria facial significativa. A tomografia computadorizada de feixe cônico revelou uma lesão unilocular hipodensa, associada a um canino incluso, com material hiperdenso no interior, indicativo de calcificações. O tratamento envolveu excisão completa sob anestesia local, e o diagnóstico de COC foi confirmado pelo exame histopatológico. Este caso destaca a relevância da correlação clínico-radiológica e microscópica, essencial para a identificação precisa de lesões odontogênicas com envolvimento dentário e potencial calcificação. Com baixas taxas de recidiva após enucleação completa, o COC apresenta um prognóstico favorável, reforçando a importância do diagnóstico precoce e do manejo adequado para a preservação da saúde e da estética facial do paciente.

Sleep is a fundamental biological function, and any disturbances can lead to alterations in an individual’s physical, occupational, cognitive, and social functioning. Aim: This study aimed to evaluate the quality of sleep and its association with factors such as age, sex, facial profile, and genetic polymorphisms in individuals who underwent dental treatment. Methods: The study comprised a total of 227 individuals. The “Sleep Assessment Questionnaire” was utilized to evaluate sleep quality. For the genetic assessment, oral mucosa cells were collected and markers from the COMT (rs174675, rs165656), HTR2A (rs4941573, rs6313), and FKBP5 (rs1360780, rs3800373) genes were selected for real-time PCR analysis. The data were subjected to statistical analysis with a significance level of 0.05. Results: The results showed that women had a poorer perception of sleep quality (p<0.05). There was a significant association between sleep quality and facial profile (p<0.05). Individuals with facial profiles I and II had a poorer perception of sleep quality in general and in the domains of non-restorative sleep, sleep time disturbance, and restlessness. Individuals with facial profile II had a poorer perception of sleep apnea than those with profile III (p=0.034). There was a significant association between the COMT rs174675 polymorphism and restlessness (p=0.035). Conclusion: The poorest perception of sleep quality was associated with women and individuals with facial profiles I and II. The poorest perception of restlessness was associated with COMT rs174675 polymorphism.

Objective This study evaluated the efficacy of Valeriana officinalis L. and Passiflora incarnata L. to control anxiety, surgical discomfort, and changes in vital signs of patients undergoing extraction of two unilateral third molars. Materials and methods This study is a randomized, triple-blinded clinical trial. Fifty-four patients were allocated into three groups (Valeriana officinalis L., Passiflora incarnata L., and placebo). Anxiety levels were assessed using the State-Trace Anxiety Inventory (STAI) index, surgical discomfort using the QCirDental, and through the measurement of vital signs. The surgical times evaluated were before (T0), during (T1), and after surgery (T2). Results There was evidence that both Valeriana officinalis L. and Passiflora incarnata L., reduced STAY-S scores between T0 and T2 (p < .05), unlike placebo (p = .129). There was no change in surgical discomfort in all groups over time, and vital signs presented variable results. Conclusion Phytotherapy drugs showed a reduction in anxiety state compared to the placebo group during third molar extraction procedure. Clinical trial registration klRBR-6kcxvrc, March 10, 2022.

This study aimed to evaluate the associations between oral health-related quality of life (OHRQoL) and patient-associated factors and polymorphisms in the estrogen receptor 1 (ESR1) and 2 (ESR2) genes in patients with dentofacial deformities (DFD). This cross-sectional study included 234 adult individuals. Data such as age, sex, and the type of facial profile (I, II, or III), were collected, and the short-form oral health impact profile 14 (OHIP-14) questionnaire was used to assess their OHRQoL. DNA was collected from oral mucosa cells, and the polymorphisms in ESR1 (rs2234693 and rs9340799) and ESR2 (rs1256049 and rs4986938) were evaluated using real-time polymerase chain reaction. The data were subjected to statistical analysis at a significance level of 5%. Individuals over 28 years of age exhibited worse OHRQoL (p = 0.003) than individuals aged less than or equal to 28 years. Women had worse OHRQoL than men (p < 0.001). Profile II individuals had worse OHRQoL in the social disability domain than profile III individuals (p = 0.030). Genetic analysis showed that rs9340799 was associated with OHRQoL in the functional limitation domain, and GG individuals exhibited worse OHRQoL than individuals carrying the AA/AG genotypes (p < 0.030). In the social handicap domain, individuals with GG genotype in rs9340799 exhibited worse OHRQoL than AG individuals (p < 0.043). Collectively, our results reveal that factors including age, sex, and type of facial profile, are associated with OHRQoL in patients with DFD. In addition, individuals with the GG genotype in rs9340799 (ESR1) may experience a negative impact on OHRQoL in the functional limitation and social handicap domains.

The objective of this study was to evaluate if individuals with dentofacial deformities (DFD) who require orthognathic surgery are affected more by depression and pain. A case-control study was performed with 195 individuals. In the DFD group, 145 individuals with Class II and III malocclusion requiring orthognathic surgery were selected. The control group was composed of 50 individuals with no DFD. All patients were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Data were analyzed with a significance level of 0.05. The DFD group more often presented severe depression (p = 0.020) and chronic pain (p = 0.017). They also presented higher prevalence of Nonspecific Physical Symptoms Including Pain (P = 0.002) and Nonspecific Physical Symptoms Excluding Pain (p = 0.002). Concerning TMD symptoms, the DFD group had more myofascial (p = 0.002) and articular pain (p = 0.041). Therefore, the results of this study suggest that depression and pain are more common in individuals with DFD requiring orthognathic surgery compared with individuals without DFD.

The aim of this study was to evaluate patient perception of surgical discomfort in third molar surgery and the association with clinical variables and polymorphisms associated with the FKBP5, SLC6A4, and COMT genes. This cross-sectional observational study was carried out on 196 participants aged between 18 and 64 years at the Federal University of Paraná in 11 months. The intensity of surgical discomfort was assessed using the QCirDental questionnaire. Data on surgical and individual procedures were also cataloged. The oral health related quality of life was assessed by the Oral Health Impact Profile questionnaire (OHIP-14). The DNA sample was obtained from cells of the oral mucosa. Five markers of the FKBP5, SLC6A4, and COMT genes were genotyped. The data were submitted to statistical analysis with a significance level of 5%. Women reported greater intensity of discomfort associated with third molar surgery compared to men (p = 0.001). In the recessive model, the AA genotype of the rs3800373 marker was associated with greater surgical discomfort (p = 0.026). Therefore, women and individuals of the AA genotype for the rs3800373 marker in the FKBP5 gene reported greater surgical discomfort associated with third molar surgery.