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SANTOS, Andrea Paula dos. Ponto de Vida: cidadania de mulheres faveladas.São Paulo: Loyola, 1996.

Embolic stroke is the most dangerous complication of atrial fibrillation (AF). Oral anticoagulation represents the treatment of choice for thromboembolic (TE) prophylaxis in patients with a CHADS2VASc score ≥ 1 but is associated with a significant increase in haemorrhagic events. Almost 90 % of thrombi originate in the left atrial appendage. Registries have shown that percutaneous occlusion of this appendage reduces embolic risk and may be considered for TE prophylaxis in patients with a high TE (CHADS2VASc score ≥ 2) and haemorrhagic (HAS-BLED score ≥ 3) risk. However, available randomized trials of this technique did not include patients with contraindication to oral anticoagulants., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

A young patient complained of missing inferior second premolars. Clinical and cephalometric parameters suggested the indication for a prosthetic solution, opening the spaces between first premolars and molars, aiming to correct occlusal relationships. Space closure was thus excluded. After full arch alignment a selective conservative channel-like wedge shaped osteotomy, distal to the second molars, was performed, applying a piezo-microsurgery technique, which uses fine inserts (0.5-0.7 mm) and ultrasound. The method allows for good patient compliance, improved rapid healing, and no secondary adverse effects. Both second and first molars can then be easily and rapidly distalized with a bodily movement, avoiding distal tipping. After space opening implants could be applied and the occlusion finalized. Though further tests will be needed, the method appears a valid improvement to conventional methods, facilitating distalization in selected cases and possibly shortening treatment time.