Abstract Objective This study aims to evaluate bone repair and the development of the medication related osteonecrosis of the jaw (MRONJ) associated with the use of zoledronic acid in Wistar rats. Methodology 48 male Wistar rats were divided into four groups: ZA, treated with intraperitoneal zoledronic acid, 0.6 mg/kg every 28 days, totaling five doses; control (C), treated with 0.9% sodium chloride; ZA-surgical (SZA) and C-surgical (SC), submitted to extraction of the right upper molars 45 days after the first application. Alveolar bone repair was evaluated by macroscopic and histological analysis. Protein expression evaluations were performed by qPCR. Results Macroscopic evaluation showed that 91.66% (11) of the animals in the SZA group and 41.66% (5) from the SC group presented solution of epithelium continuity (P<0.05). All animals in the SZA group and none in the SC group had bone sequestration. The area of osteonecrosis was higher in the SZA group than in the SC group (P<0.05). In molecular evaluation, the SZA group presented changes in the expression of markers for osteoclasts, with increased RANK and RANKL, and a decrease in OPG. Conclusion The results highlighted strong and evident interference of zoledronic acid in bone repair of the socket, causing osteonecrosis and delayed bone remodeling.

Abstract Lipomas are very common benign slow-growing soft tissue neoplasms composed of mature adipose tissue mostly diagnosed in the fifth decade of life. These tumors rarely present in the oral cavity, representing less than approximately 5% of all benign mouth tumors. They are usually less than 2cm in size and etiology remains unclear. We report a young male patient presenting with a giant lipoma in the buccal mucosa. Histopathology revealed a large area of mature fat cells consistent with conventional lipoma and an area of the mucosal lining of the lesion suggestive of morsicatio buccarum. In the present article, we emphasize the clinicopathological features and differential diagnosis of the disease.

Apresentar revisão sistemática da literatura sobre o controle do biofilme bucal e a incidência da pneumonia nosocomial, avaliando e classificando os estudos quanto ao grau de recomendação e ao nível de evidência científica. A revisão foi realizada nas bases PubMed, LILACS e Scopus, de 1o de janeiro de 2000 até 31 de dezembro de 2012. Foram selecionados os estudos que avaliaram os cuidados com higiene bucal relacionando-os com infecções nosocomiais em paciente internados em unidades de terapia intensiva, seguindo os critérios de inclusão. Foram incluídos artigos na íntegra publicados em inglês, espanhol ou português, que abordavam alguma técnica de higiene bucal, química ou mecânica, na prevenção de pneumonia, as intervenções executadas e os resultados. Após análise dos dados, os artigos foram classificados quanto ao nível de evidência e o grau de recomendação, de acordo com os critérios daOxford Centre for Evidence-Based Medicine. Foram encontrados 297 resumos e, destes, 14 artigos na íntegra contemplaram nossos critérios. A maioria dos artigos incluía um grupo de estudo com uso de clorexidina e um controle com o uso de placebo para higiene bucal na prevenção de pneumonia. Quanto ao nível de evidência, todos os artigos foram classificados como B; quanto ao grau de recomendação, 12 artigos foram classificados como 2B e 2 como 2C. O controle do biofilme bucal reduz a incidência de pneumonia nosocomial, porém o nível de evidência e o grau de recomendação intermediário deixam evidente a necessidade da elaboração de estudos clínicos randomizados controlados com viés mínimo para estabelecer futuros protocolos para higiene bucal em unidades de terapia intensiva.

To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying studies as to the grade of recommendation and level of evidence. The review was based on PubMed, LILACS, and Scopus databases, from January 1st, 2000 until December 31st, 2012. Studies evaluating oral hygiene care related to nosocomial infections in patients hospitalized in intensive care units were selected according to the inclusion criteria. Full published articles available in English, Spanish, or Portuguese, which approached chemical or mechanical oral hygiene techniques in preventing pneumonia, interventions performed, and their results were included. After analysis, the articles were classified according to level of evidence and grade of recommendation according to the criteria of the Oxford Centre for Evidence-Based Medicine. A total of 297 abstracts were found, 14 of which were full articles that met our criteria. Most articles included a study group with chlorhexidine users and a control group with placebo users for oral hygiene in the prevention of pneumonia. All articles were classified as B in the level of evidence, and 12 articles were classified as 2B and two articles as 2C in grade of recommendation. It was observed that the control of oral biofilm reduces the incidence of nosocomial pneumonia, but the fact that most articles had an intermediate grade of recommendation makes clear the need to conduct randomized controlled trials with minimal bias to establish future guidelines for oral hygiene in intensive care units.