Etoricoxib did not promote additional improvement in the clinical parameters; however, it produced an initial reduction in the PGE(2) levels in the GCF, which could be related to the discrete improvement in the bone condition.

We investigated the effect of etoricoxib, a selective cyclooxygenase-2 inhibitor, and indomethacin, a non-selective cyclooxygenase inhibitor, on experimental periodontitis, and compared their gastrointestinal side effects. A ligature was placed around the second upper left molars of female Wistar rats (160 to 200 g). Animals (6 per group) were treated daily with oral doses of 3 or 9 mg/kg etoricoxib, 5 mg/kg indomethacin, or 0.2 mL saline, starting 5 days after the induction of periodontitis, when bone resorption was detected, until the sacrifice on the 11th day. The weight and survival rate were monitored. Alveolar bone loss (ABL) was measured as the sum of distances between the cusp tips and the alveolar bone. The gastric mucosa was examined macroscopically and the periodontium and gastric and intestinal mucosa were examined by histopathology. The ongoing ABL was significantly inhibited (P < 0.05) by 3 and 9 mg/kg etoricoxib and by indomethacin: control = 4.08 ± 0.47 mm; etoricoxib (3 mg/kg) = 1.89 ± 0.26 mm; etoricoxib (9 mg/kg) = 1.02 ± 0.14 mm; indomethacin = 0.64 ± 0.15 mm. Histopathology of periodontium showed that etoricoxib and indomethacin reduced inflammatory cell infiltration, ABL, and cementum and collagen fiber destruction. Macroscopic and histopathological analysis of gastric and intestinal mucosa demonstrated that etoricoxib induces less damage than indomethacin. Animals that received indomethacin presented weight loss starting on the 7th day, and higher mortality rate (58.3%) compared to etoricoxib (0%). Treatment with etoricoxib, even starting when ABL is detected, reduces inflammation and cementum and bone resorption, with fewer gastrointestinal side effects.

Professora Assistente do componente curricular Estomatologia II na EBMSP, Salvador, Bahia, Brasil. 1 2 3 4 RESUMO Introdução: Diabetes Mellitus é um grupo de doenças metabólicas que vem se tornando cada vez mais frequente na população mundial, sendo considerado um problema de saúde pública. Essa patologia pode apresentar na cavidade bucal suas primeiras manifestações, predispondo o paciente a várias alterações bucais. O cirurgião-dentista necessita conhecer a doença e conduzir um correto manejo desses pacientes. Objetivo: Propor um protocolo de atendimento e manejo odontológico para pacientes diabéticos. Desenvolvimento: Na anamnese, reunir informações sobre a doença: tipo, tempo de diagnóstico, farmacoterapia, manifestações sistêmicas e bucais, histórico de crise hipoglicêmica ou hiperglicêmica. Ao exame físico, atentar para verificação de sinais vitais, índice de massa corporal, avaliação de tecidos moles e preenchimento do odontograma e periograma. Avaliar hemoglobina glicada de pacientes previamente diagnosticados e encaminhar pacientes com suspeita para o médico. No dia da consulta, recomendar que o paciente se alimente normalmente e realize o uso de suas medicações. As consultas devem ser curtas, no início da manhã e glicosimetria deve ser realizada no início do atendimento. Pacientes compensados prescindem o uso de antibioticoprofilaxia e podem receber anestésico com vasoconstrictor adrenérgico. Em casos de urgência por crise hipoglicêmica, a mesma deve ser solucionada antes de torna-se uma emergência médica. Conclusão: Com exame clínico e complementares, coletar o máximo de informações sobre a doença para classificar o paciente em relação ao risco que apresenta ao atendimento. Pacientes compensados não necessitam de tratamento odontológico diferenciado. Pacientes descompensados não devem sofrer nenhum tratamento eletivo e devem ser tratados de acordo com as limitações presentes.

INTRODUCTION: During the COVID-19 pandemic, dentists were classified as a high-risk professional category for SARS-Cov2 infection and transmission, due to the proximity of the patient's face as well as the frequent performance of aerosol-generating procedures. Transmission of this pathogen during dental procedures can occur by inhaling aerosols/droplets from infected individuals or by direct contact with mucous membranes, oral fluids or contaminated instruments and surfaces. Aware of the risks inherent to the exercise of this profession and facing the world scenario, several recommendations have been suggested for dental surgeons and dental students in patient care. Although biosafety is already part of the dentist's routine, the pandemic context presupposes the need to revisit the guiding principles of this practice and to know the particularities imposed by a hitherto unknown virus. OBJECTIVE: This work aims to propose and discuss measures to deal with the spread of SARS-Cov2 in the dental environment, emphasizing the necessary care for the protection of professionals and patients, in the context of Dentistry in Brazil. METHODS: To this end, a compilation of measures and recommendations was made based on the main technical documents published in recent months by the health authorities. RESULTS: The main recommendations include patient screening, social distance, adjustments to personal protective equipment (PPE) and the use of appropriate disinfection products and techniques. CONCLUSION: This work presented, in an objective and practical way, essential measures for dental work during the COVID-19 pandemic, highlighting the probable permanence of these actions and the importance of adopting rigid, adequate and feasible measures.

ResumoO aumento gengival influenciado por drogas é caracterizado pelo crescimento excessivo do tecido gengival circunjacente à região das papilas interdentais. Somente nos casos mais graves é capaz de recobrir os elementos dentários e interferir na nutrição do indivíduo. Os principais fármacos associados a este tipo de alteração são: nifedipina, ciclosporina e fenitoína. As consultas de caráter preventivo são fundamentais para os indivíduos que apresentam risco de desenvolver esta alteração gengival, bem como o diagnóstico precoce, e ambos podem melhorar consideravelmente o prognóstico do paciente. O objetivo deste trabalho é realizar uma revisão de literatura sobre o aumento gengival influenciado por drogas, enfatizando os principais fármacos que podem ocasioná-lo, bem como os tratamentos indicados para este tipo de alteração.Palavras-chave: Hipertrofia. Hiperplasia. Gengival. Medicamento. DRUG-INDUCED GINGIVAL• a literature review • AbstractThe drug-induced gingival overgrowth is characterized by the excessive growth of gingival tissue surrounding the region of the interdental papillae. Only in severe cases can cover the dental elements and interfere the individual nutrition. The main associated drugs with this type of alteration are nifedipine, cyclosporine and phenytoin. Consultation preventive are fundamental for individuals who present risk