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This study aimed to compare the reconstruction with type 2.4 and three-dimensional (3D) grid plates relating the areas of weakness to anatomical regions of force incidence in atrophic mandibles with and without segmentation using finite element analysis (FEA). Strength and force quality in the mandible were also determined. The atrophic mandible models with and without segmentation were divided into four groups, and the behavior of each plate was analyzed using finite element analysis. In the atrophic mandible without segmentation using the type 2.4 reconstruction plate, the highest stress concentration in the plate was observed in the posterior region of the mandibular body and in the grid type 3D reconstruction plate was observed in the mandibular angle. In the segmented atrophic mandible with the 2.4 reconstruction plate, higher stress concentration was observed in the mandibular segment defect. Analysis of the 3D grid-like reconstruction plate revealed that the geometry of the plate conferred greater stiffness to the assembly, as the most significant stress concentration was observed at the mandibular angle. The width of the plate design may influence the strength, not the thickness.

O tumor queratocístico odontogênico (TOQ), anteriormente conhecido como queratocisto odontogênico, tem características únicas, incluindo comportamento localmente agressivo, alta taxa de recorrência e aparência histológica distinta. O TOQ é uma das neoplasias odontogênicas mais comuns da mandíbula, representando cerca de 12 e 14% de todos os quistos odontogênicos das mandíbulas. Seu comportamento apresenta potencial de destruição local e extensão em tecidos, crescimento rápido, maior taxa de recorrência e uma tendência à multiplicidade. Embora várias terapias para o TOQ tenham sido documentadas na literatura, a abordagem aceita permanece indecisa. Estas variam desde métodos conservadores, como enucleação, descompressão e marsupialização, até tratamentos agressivos que incluem ostectomia periférica, crioterapia, aplicação da solução de Carnoy e ressecção da mandíbula. Todas as técnicas têm objetivos similares: a erradicação do cisto e a redução dos riscos de recidiva e morbidade cirúrgica. Este artigo tem como objetivo relatar um caso de TOQ na região anterior da mandíbula e discutir os principais métodos de tratamento cirúrgico descritos na literatura.

Made available in DSpace on 2022-04-28T17:22:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-30 AOCMF Switzerland Objective: To evaluate the effects of inorganic bovine bone graft (Lumina Bone, Criteria, Brazil) and beta-tricalcium phosphate (beta-TCP) graft (ChronOS, Synthes, Brazil) in rats with the risk of developing post-extraction medication-related osteonecrosis of the jaw (MRONJ). Methods: Eighteen male Wistar rats weighing 350 to 450 g were induced to develop MRONJ using zoledronic acid for 5 weeks. In the sixth week, the right maxillary first molar was extracted. The animals in Group I (G1) did not receive bone grafts after tooth extraction, while Group II (G2) animals received inorganic bovine bone grafts, and Group III (G3) animals received beta-tricalcium phosphate (beta-TCP) grafts. Clinical evaluation and histomorphometric and immunohistochemical analyses were performed. ANOVA and Tukey's statistical tests were used and a level of significance was considered to be 5%. Results: In the clinical evaluation, animals from G2 and G3 did not present clinical manifestations of osteonecrosis, unlike the control group (G1) animals, which presented necrotic bone tissue exposure in all samples. In the histomorphometric evaluation, animals in G3 showed greater formation of bone tissue (66%) and less formation of bone lacuna (18%) than animals in G1 (58%/32%) and in G2 (59%/27%) (P < 0.05). Moderate (++) immunostaining was observed in G2 and G3 for RANKL, TRAP, and OC, while G1 showed moderate (++) labeling for OC and mild (+) immunostaining for TRAP and RANKL. Conclusions: Greater formation of bone tissue and fewer bone lacunae were found in animals treated with beta-TCP. In clinical evaluation, bone graft groups presented with the clinical manifestation of MRONJ and showed higher intensity of immunostaining for TRAP and RANKL. Despite the limitations of experimental animal studies, the results of this work may assist in the development of future clinical research for the prevention of MRONJ. Fundacao Educ Serra Orgaos, Dept Oral & Maxillofacial Surg, Av Alberto Torres 111 Alto, BR-25964004 Teresopolis, RJ, Brazil Univ Fed Fluminense, Dept Oral & Maxillofacial Surg, Nova Friburgo, RJ, Brazil Univ Estadual Paulista, Dept Oral & Maxillofacial Surg, Aracatuba, SP, Brazil Sao Paulo Estate Univ, Dept Oral & Maxillofacial Surg, Aracatuba, SP, Brazil Univ Estadual Paulista, Dept Oral & Maxillofacial Surg, Aracatuba, SP, Brazil AOCMF Switzerland: AOCMF-16-02 H.

Made available in DSpace on 2021-06-26T01:23:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 The presence of a tooth in the nasal cavity is a rare condition. There is an even more rare association, which is the presence with the mineral's deposition and formation of rhinoliths. This report shows a case of rare nasal tooth associated with rhinolithiasis and describes its surgical treatment based on an algorithm. The diagnosis was made by endoscopy with the aid of computed tomography, followed by surgical endoscopy excision. The algorithm and the proposed treatment was successful in its execution and the patient presents no complaints or complications at 3 years after surgery. Sao Paulo State Univ, Aracatuba Sch Dent, Dept Diag & Surg, St Jose Bonifacio 1193, BR-16015050 Aracatuba, SP, Brazil Campinas Univ, Campinas Dent Sch, Piracicaba, Brazil Paraiba Fed Univ, Dept Surg, Joao Pessoa, Paraiba, Brazil Sao Paulo State Univ, Aracatuba Sch Dent, Dept Diag & Surg, St Jose Bonifacio 1193, BR-16015050 Aracatuba, SP, Brazil

Made available in DSpace on 2020-12-12T02:49:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-06-01 Benign fibro-osseous lesions occur when normal bone is replaced by cellular fibrous connective tissue and mineralized structures. One rare type of these lesions is the ossifying fibroma (OF). The aim of this study is to report an unusual case of OF in a 57-year-old female. Physical examination showed facial asymmetry without any tenderness, fluctuation, ocular pain, or ophthalmoplegia. Imaging exams revealed a solid mass involving the left maxilla and orbital floor. Surgical resection was performed without any complications or sequelae, and the histopathological results confirmed OF. Although recurrence is rare in this condition, the patient remains under follow-up. Department of Diagnosis and Maxillofacial Surgery São Paulo State University (UNESP) Dental School, Humaitá Street, 1680 Department of Diagnosis and Maxillofacial Surgery São Paulo State University (UNESP) Dental School, Humaitá Street, 1680

The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms—(1) granules and (2) paste—in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.

Dentigerous cysts are the second most common odontogenic cysts of the jaws, and sometimes inhibit the eruption of teeth. Almost all of the dentigerous cyst encloses the crown of an unerupted tooth and the radiolucent area is attached to the tooth at the cementoenamel junction. Dentigerous cyst is more common in male patients and most commonly develop in the second and third decades of life. Clinically, a localized swelling of the alveolar bone can be detected, however, dentigerous cysts can be asymptomatic during a long period of time, leading to a significant destruction of bone. The conventional treatment plan is cyst removal and marsupialization. Marsupialization therapy can be useful to promote the spontaneous eruption of the involved tooth within the cyst. However, tooth eruption does not always occur spontaneously after marsupialization. This article aims to report a clinical case of the diagnosis and treatment of a dentigerous cyst in the maxilla associated with an unerupted canine in a pediatric patient and discussion of the treatment performed. Los quistes dentígeros son los segundos quistes odontogénicos más comunes de los maxilares, y a veces inhiben la erupción de los dientes. Casi todo el quiste dentígero encierra la corona de un diente no erupcionado y la zona radiolúcida está unida al diente en la unión cemento-esmalte. El quiste dentígero es más común en pacientes masculinos y se desarrolla con mayor frecuencia en la segunda y tercera décadas de la vida. Clínicamente, se puede detectar una inflamación localizada del hueso alveolar, sin embargo, los quistes dentígeros pueden ser asintomáticos durante un largo periodo de tiempo, lo que conlleva una importante destrucción del hueso. El plan de tratamiento convencional es la extirpación del quiste y la marsupialización. La terapia de marsupialización puede ser útil para promover la erupción espontánea del diente afectado dentro del quiste. Sin embargo, la erupción del diente no siempre ocurre espontáneamente después de la marsupialización. Este artículo tiene como objetivo reportar un caso clínico del diagnóstico y tratamiento de un quiste dentígero en el maxilar asociado a un canino no erupcionado en un paciente pediátrico y la discusión del tratamiento realizado. Os cistos dentígeros é o segundo cisto odontogênico mais comuns dos maxilares, e às vezes inibem a erupção dos dentes. Quase todos os cistos dentígeros envolvem a coroa de um dente não irrompido e a área radiolúcida está localizada na junção do cemento e esmalte. O cisto dentígro é mais comum em pacientes do sexo masculino e normalmente se desenvolve na segunda e terceira décadas de vida. Clinicamente, um aumento de volume localizado do osso alveolar pode ser detectado, entretanto, os cistos dentígrados podem ser assintomáticos durante um longo período de tempo, levando a uma destruição significativa do osso. O plano de tratamento convencional é a remoção de cistos e marsupialização. A terapia de marsupialização pode ser útil para promover a erupção espontânea do dente envolvido dentro do cisto. Entretanto, a erupção do dente nem sempre ocorre espontaneamente após a marsupialização. Este artigo visa relatar um caso clínico do diagnóstico e tratamento de um cisto dentígero na maxila associado a um canino não irrompido em um paciente pediátrico e a discussão do tratamento realizado.

Made available in DSpace on 2022-04-29T08:36:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-06-01 The facial skeleton in pediatric patients can undergo several changes during development, according to their growth zones and the traumas they suffer. Thus, some of these traumas can lead to multiple complications if not treated properly. Epidemiology can vary according to the social, cultural, and environmental aspects of each individual. Therefore, each case must be treated individually, and it is important to consider age-specific aspects, such as the high osteogenic potential, which leads to faster bone healing. The use of resorbable fixation materials in facial fractures of pediatric patients is widespread, with good acceptance and great advantages over conventional titanium materials, mainly for the elimination of a second surgery to remove the materials. The present study aims to report a series of clinical cases of infants, who suffered trauma and evolved with fractures in the facial bones. Surgical treatment was instituted to reduce and fix fractures, using the resorbable system. Patients are followed up with periodic outpatient follow-up visits and have a good case evolution. Department of Diagnostic and Surgery Araraquara School of Dentistry São Paulo State University-UNESP, Humaitá street, 1680, 2nd floor, Center Department of Pediatric Araraquara School of Dentistry São Paulo State University-UNESP Grupo Leforte Department of Diagnostic and Surgery Araraquara School of Dentistry São Paulo State University-UNESP, Humaitá street, 1680, 2nd floor, Center Department of Pediatric Araraquara School of Dentistry São Paulo State University-UNESP

Made available in DSpace on 2022-04-29T08:34:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 OBJECTIVES: This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry. METHODS: Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation. RESULTS: Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P ≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398; P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = -0.650, P = 0.016). CONCLUSIONS: Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the gold standard method for the evaluation of bone quality and greater bone density was observed in older men. Diagnosis and Surgery Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Pathology and Physiology Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Diagnosis and Surgery Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Pathology and Physiology Department Araraquara Dental School São Paulo State University (FOAr/UNESP)

Made available in DSpace on 2022-04-28T19:45:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Central nervous system infections and cavernous sinus thrombosis are associated with high mortality rates and may be a consequence of oral infection propagation. A 24-year-old woman has attended a private dental office with a pain complaint in the upper right central incisor and had the endodontic treatment completed. However, the patient returned to the dental office reporting pain in the same tooth and the presence of swelling. Then, the root canal was retreated. After one week, the patient presented to a Basic Health Unit with a history of vomiting and convulsion crisis followed by loss of consciousness. A computed tomography exam showed cavernous sinus thrombosis and brain ischaemic areas. The present report describes a rare case of cavernous sinus thrombosis followed by brain ischaemia in a type-1 diabetic patient, associated with persistent endodontic infection, with subsequent patient’s death. Postgraduate Program in Dentistry University of Grande Rio (UNIGRANRIO) LeFort Hospital Metodista University São Bernardo do Campo São Paulo State University (UNESP) São Paulo State University (UNESP)

Made available in DSpace on 2022-04-28T19:47:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-06-01 Craniofacial harpoon injuries are extremely rare, especially when caused by attempted suicide. The approach to surgical removal becomes dependent on the characteristics of the device, with or without barbs on the spear, and its path, which presents with significant changes between accidents and suicide attempts. This report presents the successful treatment carried out in a dramatic case of harpoon suicide attempt. The approaches to complete and cautious removal of the spear from the occipital region, reconstruction of the orbital cavity, evisceration of the left eyeball due to amaurosis and psychiatric follow-up were successful, which allowed the restoration of the patient's physical and mental health. LeForte Hospital Leforte Group Hospital Santa Tereza UNIFESO-Teresópolis Univ Estadual Paulista-Araçatuba Univ Estadual Paulista Univ Estadual Paulista-Araçatuba Univ Estadual Paulista

Teeth displacement during extractions even tough rare are extremely unwanted, especially for infra temporal space. This accident generally necessitate additional treatment for their resolution, being either immediate or late. Several authors discribed surgical techniques for removal displaced teeth into the infratemporal space, varying according to the degree of displacement, being that in some of this cases, is necessary the utilization of complementary tools. This case describes the technique utilized for late removal of tooth 18 (upper right third molar) dislocated into the lower portion of the infratemporal space (confirmed by the Cone Bean Computer tomography Scan), exam was performed after the patient reported pain in the operated region and during mandibular movement too, with an interincisal opening maximum of 20 millimeters. The procedure was realized under local anesthesia by a conservative intraoral approach and aid of intermaxillary fixation screw to facilitate extraction. The patient recovered well, without complications, with remission of pain and restoration of mouth opening. Los desplazamientos dentales durante las extracciones, aunque sean raros, son extremadamente indeseables, especialmente hacia el espacio infratemporal. Este accidente generalmente requiere tratamiento adicional para su resolución, ya sea inmediato o tardío. Muchos autores describen técnicas quirúrgicas para la eliminación de dientes desplazados al espacio infratemporal, variando de acuerdo con el grado de desplazamiento, siendo que en muchos de estos casos ha sido necesario utilizar herramientas complementarias. Este caso describe la técnica utilizada para la extracción tardía del elemento dental 18 (tercer molar superior derecho) desplazado a la porción inferior del espacio infratemporal (confirmado por tomografía Cone Beam), examen se llevó a cabo después de que el paciente ha reportado dolor en la región operada y además durante los movimientos mandibulares, con la apertura máxima de boca siendo 20 mm. El procedimiento se realizó debajo anestesia local por medio de un acceso intraoral conservador y auxilio de un tornillo de bloqueo intermaxilar, para facilitar la extracción. El paciente se recuperó bien, sin complicaciones, con remisión del dolor y restablecimiento de la abertura bucal. Deslocamentos dentais durante extrações, mesmo que raros, são extremamentes indesejáveis, especialmente para o espaço infratemporal. Este acidente geralmente necessita de tratamento adicional para sua resolução, sendo ele imediato ou tardio. Muitos autores descrevem técnicas cirúrgicas para a remoção de dentes deslocados para o espaço infratemporal, variando de acordo com o grau de deslocamento, sendo que em muitos destes casos, há necessidade de utilização ferramentas complementares. Este caso descreve a técnica utilizada para remoção tardia do elemento dental 18 (terceiro molar superior direito) deslocado para a porção inferior do espaço infratemporal (confirmado por tomografia Cone Beam), exame realizado após o paciente ter relatado dor na região operada e também durante movimentos mandibulares, apresentando uma abertura bucal máxima de 20 milímetros. O procedimento foi realizado, sob anestesia local, por meio de um acesso intrabucal (conservador) e auxílio de um parafuso de bloqueio intermaxilar, para facilitar a exodontia. O paciente se recuperou bem no pós-operatório, sem complicações, evoluindo com remissão da dor e restabelecimento da abertura bucal.

Objectives: to analyze the possible etiological factors associated with mandibular fractures occurring during tooth extractions. Methods the following data were collected: sex, age, the extracted tooth, tooth classification, angulation, level of bone impaction, pathological association, recognized technical errors, instruments used at the time of the fracture, and the surgeon’s experience and specialization, if applicable. An electronic search of the following databases was performed: PubMed/Medline, Lilacs, Embase, and Scopus. The data were tabulated and analyzed using the Chi-square test, a P-value less than 0.05 was considered significant. Results: a total of 80 cases were selected. Sex and age were not statistically significant (P>0.05). The teeth most associated with fractures were the mandibular third molars; however, the location was not significant. Pell & Gregory classes II, B, C, mesio-angular teeth, partial bone impaction, teeth related to pathological process, application of excessive strength, extractions with elevators, and non-specialists showed greater association with mandibular fractures during transoperative time (P 0,05). Conclusión: Los dientes más asociados a fracturas fueron los terceros molares inferiores; sin embargo, la ubicación no fue significativa. Pell & Gregory clases II, B, C, dientes mesioangulares, impactación ósea parcial, dientes relacionados con el proceso patológico, aplicación de fuerza excesiva, extracciones con elevadores y no especialistas mostraron una mayor asociación con fracturas mandibulares durante el período transoperatorio (P 0,05). Conclusão: Os dentes mais associados às fraturas foram os terceiros molares inferiores; entretanto, a localização não era significativa. Pell & Gregory classes II, B, C, dentes mesioangulares, impactação óssea parcial, dentes relacionados ao processo patológico, aplicação de força excessiva, extrações com elevadores e não especialistas mostraram maior associação com fraturas mandibulares durante o tempo transoperatório (P < 0,05).

Made available in DSpace on 2021-06-25T10:25:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Purpose: This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts. Patients and methods: Patients underwent unilateral maxillary sinus bone height reconstruction using 5 bone substitutes allocated in different groups as follows: group 1 was grafted with autogenous bone graft alone; group 2 with beta-tricalcium phosphate (β-TCP); group 3 with β-TCP + autogenous bone graft 1:1; group 4 with bioactive glass; and group 5 with bioactive glass + autogenous bone graft 1:1. The patients were submitted to cone beam computed tomography in two periods: 15 days after the surgical procedure (T1) and after 6 months (T2). The results were evaluated as the formula T2-T1 expressing the three-volumetric changes of the biomaterials in elapsed time. Results: The resorption rate of autogenous bone graft was −630.699 ± 300.9 mm3; in the β-TCP group, it was −315.772 ± 125.6 mm3; in the group with β-TCP + autogenous bone graft 1:1, it was −336.205 ± 195.7 mm3; and in groups with bioactive glass and with the addition of autogenous bone graft 1:1, it was −428.878 ± 311.6 mm3 and −576.917 ± 471.6 mm3, respectively, without statistical difference (p = 0.167). Pearson’s correlated test revealed a strong correlation as well as a progressive resorption of the grafts during bone healing. Conclusion: The similar outcomes for the three-dimensional volumetric changes using the bone substitutes evaluated after 6 months of bone healing suggest that all these grafts can be performed to maxillary sinus reconstruction. Universidade Estadual Paulista – UNESP Universidade do Grande Rio – UNIGRANRIO UNIFESO - Centro Universitário Serra dos Órgãos Universidade Federal de Minas Gerais – UFMG Universidade Estadual Paulista – UNESP

Dentigerous cyst infection is a rare condition that can lead to life-threatening situations. A situation unusual is the development of osteomyelitis with proliferative periostitis from infection of this cyst, with only one possible case published in the literature. The purpose of this article is to relate a rare association of a dentigerous cyst with osteomyelitis and proliferative periostitis. An 11-year-old patient compared for dental care with infection from second molar pericoronitis, who reached the third molar germ and progressing to osteomyelitis with proliferative periostitis, thatwas treated under general anesthesia. Histological exam of the tissues removed during the surgery revealed infected dentigerous cyst and osteomyelitis with proliferative periostitis. After the surgery, the patient progressed satisfactorily with improvement of the clinical complaints. This condition, although rare, should be considered as a differential diagnosis of several stomatognathic system lesions. La infección del quiste dentígero es una condición rara que puede conducir a situaciones potencialmente mortales. Una situación inusual es el desarrollo de osteomielitis con periostitis proliferativa debido a la infección de este quiste, con solo un posible caso publicado en la literatura. El propósito de este artículo es informar una asociación rara de un quiste dentígero con osteomielitis y periostitis proliferativa. Un paciente de 11 años se presentó para recibir atención dental con infección por pericoronitis del segundo molar, que alcanzó el germen del tercer molar y progresó a osteomielitis con periostitis proliferativa, tratada con anestesia general. El examen histológico de los tejidos extirpados durante la cirugía reveló quiste dentígero infectado y osteomielitis con periostitis proliferativa. Después de la cirugía, el paciente progresó satisfactoriamente con una mejora en las quejas clínicas. Esta condición, aunque rara, debe considerarse como un diagnóstico diferencial de varias lesiones del sistema estomatognático. A infecção do cisto dentígero é uma condição rara que pode levar a situações de risco de vida. Uma situação incomum é o desenvolvimento de osteomielite com periostite proliferativa por infecção desse cisto, com apenas um caso possível publicado na literatura. O objetivo desse artigo é relatar uma associação rara de um cisto dentígero com osteomielite e periostite proliferativa. Um paciente de 11 anos de idade compareceu para o atendimento odontológico com infecção por pericoronite do segundo molar, que atingiu o germe do terceiro molar e evoluiu para osteomielite com periostite proliferativa, tratada sob anestesia geral. O exame histológico dos tecidos removidos durante a cirurgia revelou cisto dentígero infectado e osteomielite com periostite proliferativa. Após a cirurgia, o paciente evoluiu satisfatoriamente com melhora das queixas clínicas. Essa condição, embora rara, deve ser considerada como um diagnóstico diferencial de várias lesões do sistema estomatognático.

Made available in DSpace on 2020-12-12T02:03:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-06-01 Objectives: Comparison of the mechanical stability of 2.0 plates made of commercially pure titanium (cpTi) and a titanium–molybdenum (Ti–15Mo) alloy and two methods of internal fixation employed mandibular angle fractures, using 3D finite element analysis. Materials and Methods: Four groups were evaluated. For the cpTi: group Eng 1P, one 4-hole plate and 4 screws 6 mm long, in the tension zone of the mandible; group Eng 2P, two 4-hole plates, one in the tension zone of the mandible and the other in the compression zone, both were fixed with 8 screws 6 mm long. The same groups were created for the Ti–15Mo alloy. A 100 N compressive load was applied to the occlusal surface of the mandibular first molar on the plated side. Results: When considering the von Mises equivalent stress (σvM) values for the comparison between both groups with one plate, a decrease of 10.5% in the plate and a decrease of 29.0% in the screws for the Ti–15Mo group was observed. Comparing the same groups with two plates, a decrease of 28.5% in the screws was shown for the Ti–15Mo alloy group. No significant differences were observed when considering maximum and minimum principal stresses (σmax, σmin), and maximum principal strain (εmax) to the mandibular bone. The Ti–15Mo alloy plates substantially decreased the stress concentration in the screws for both internal fixation techniques and in the plate for the Ti–15Mo 1 plate group. Conclusion: From a clinical standpoint, the use of Ti–Mo alloy with reduced stiffness will decrease the stress shielding between the hardware and bone, influencing the outcome of the treatment. Department of Diagnosis and Surgery School of Dentistry São Paulo State University (Unesp), Humaitá Street, 1680 Department of Dental Materials and Prosthodontics School of Dentistry São Paulo State University (Unesp) Department of Physical Chemistry Institute of Chemistry São Paulo State University (Unesp) Department of Diagnosis and Surgery School of Dentistry São Paulo State University (Unesp), Humaitá Street, 1680 Department of Dental Materials and Prosthodontics School of Dentistry São Paulo State University (Unesp) Department of Physical Chemistry Institute of Chemistry São Paulo State University (Unesp)

Made available in DSpace on 2020-12-12T02:15:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-07-01 Orbital trapdoor fractures are characterized by tissue entrapment between the fractured bone fragment and the remnant of the orbital floor. This entrapment can result in immediate local and systemic complications and poor outcomes when approached late. This article presents the case of an orbital floor fracture in a child with dystopia, pain, edema and entrapment of the inferior rectus muscle and consequent limitation of ocular motility. The strategy proposed in the early approach to orbital floor reconstruction and release of incarcerated tissue allowed the patient to achieve satisfactory results without morbidity, as compared to the outcomes of corrective sequel surgery. Oral and Maxillofacial Surgery Department of Diagnostic and Surgery Araraquara School of Dentistry Sao Paulo State University (UNESP) Department of Oral and Maxillofacial Surgery Hospital Leforte/Hospital e Maternidade Dr. Christovão da Gama Oral and Maxillofacial Surgery Department of Surgery and Integrated Clinic Aracatuba School of Dentistry Sao Paulo State University (UNESP) Oral and Maxillofacial Surgery Department of Diagnostic and Surgery Araraquara School of Dentistry Sao Paulo State University (UNESP) Oral and Maxillofacial Surgery Department of Surgery and Integrated Clinic Aracatuba School of Dentistry Sao Paulo State University (UNESP)

Made available in DSpace on 2022-05-01T16:02:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background: This study aims to analyze the process of bone formation, maturation and mineralization promoted by Cerabone® functionalization with raloxifene in rabbit sinus floor elevation, through immunohistochemical and histomorphometric analyses. Methods: Twenty-four male rabbits had their maxillary sinuses filled. To access the sinus cavity a circular window with a diameter of 5 mm was made bilaterally to the midline of the nasal dorsum, the sinus membrane was detached and elevated using special curettes. Autogenous bone (G1), Cerabone® (G2), Cerabone® submitted to ultrasonic processing (G3), Cerabone® associated to raloxifene submitted to ultrasonic processing (G4) were used to fill the maxillary sinus, 14 and 42 days postoperatively. Immunohistochemical and histomorphometric analyses were performed at 14 and 42 days postoperatively. Results: At 14 days postoperatively: the immunolabeling for vascular endothelial growth factor (VEGF) was moderate in groups G1, G3 and G4, while in group G2, the same protein was expressed in a mild way. The immunolabeling for alkaline phosphatase (ALP) was moderate in all experimental groups. Histomorphometric analysis showed a greater amount of newly formed bone in groups G1 (55.2%) and G4 (50.1%), which differed statistically from groups G2 (37.5%) and G3 (38.2%). At 42 days postoperatively: receptor activator of nuclear factor kappa-B ligand (RANKL) immunolabeling was slight in G1, intense in G2 and moderate in G3 and G4. The tartrate resistant acid phosphatase (TRAP) protein was slightly expressed in all experimental groups. The osteocalcin (OCN) protein was moderately expressed in the G1 group and intensely in the G2, G3 and G4 groups. As for the histomorphometric analysis, the greatest amount of neoformed bone was found in group G1 (83.5%), followed by group G4 (75.0%). Less neoformed bone was observed in G3 (56.7%), followed by G2 (64.2%). Statistical differences were observed between all experimental groups. Conclusions: Better performance was observed in the group in which Cerabone was used in association with raloxifene (G4), with better bone formation responses compared to the experimental groups. Araçatuba Dental School São Paulo State University Júlio de Mesquita Filho Grande Rio University UNIGRANRIO Araraquara Dental School São Paulo State University Júlio de Mesquita Filho Bauru School of Sciences São Paulo State University Júlio de Mesquita Filho Araçatuba Dental School São Paulo State University Júlio de Mesquita Filho Araraquara Dental School São Paulo State University Júlio de Mesquita Filho Bauru School of Sciences São Paulo State University Júlio de Mesquita Filho CAPES: 001

Made available in DSpace on 2022-04-29T08:40:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 This study aimed to compare two beta-tricalcium phosphates with different particle sizes in human maxillary sinuses lifting. The immunolabeling of cells for RUNX2 and VEGF were performed to evaluate the osteoblast precursor cells and the vascular formation after 6 months of bone repair. Ten maxillary sinuses were grafted with autogenous bone graft (Group 1), 10 were grafted with ChronOs® (Group 2), and 10 were grafted with BETA-TCP® (Group 3). After 6 months of bone healing, biopsies were obtained to assess the new bone formed by histomorphometric and immunohistochemical evaluation for RUNX2 and VEGF. The mean bone formation for Group 1 was 51.4 ± 17.4%. Group 2 presented 45.5 ± 9.9%, and Group 3 conferred 35.4 ± 8.0% of new bone formation. The RUNX2 offered low for Groups 1 and 2 with high cellular activity for osteoblast in Group 3. The VEGF immunolabeling was moderate for Groups 1 and 2 and intense for Group 3. In conclusion, it was possible to show that the bone substitutes evaluated in the present study presented suitable outcomes for bone regeneration, being an alternative for the autogenous bone graft in maxillary sinus bone height reconstruction. Department of Oral & Maxillofacial Surgery Aracatuba School of Dentistry Sao Paulo State University Department of Oral & Maxillofacial Surgery University of Grande Rio—UNIGRANRIO Clinical Research Unit of the Antonio Pedro Hospital Fluminense Federal University Department of Dental Prosthesis Aracatuba School of Dentistry Sao Paulo State University Department of Human Anatomy Aracatuba School of Dentistry Sao Paulo State University Department of Oral & Maxillofacial Surgery Aracatuba School of Dentistry Sao Paulo State University Department of Dental Prosthesis Aracatuba School of Dentistry Sao Paulo State University Department of Human Anatomy Aracatuba School of Dentistry Sao Paulo State University

Made available in DSpace on 2018-12-11T16:50:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-05-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) The aim of this study was to compare the volumetric changes and the new bone microarchitecture in human maxillary sinuses augmented with bioactive glass (Biogran) alone, bioactive glass combined with autogenous bone graft (1:1), or autogenous bone graft alone. Twelve maxillary sinuses were grafted with bioactive glass (group 1), nine with bioactive glass mixed with autogenous bone graft 1:1 (group 2), and 12 with autogenous bone graft (group 3). Patients underwent cone beam computed tomography 15 days after the procedure to determine the initial volume of the graft (T1) and again 6 months later (T2). Biopsies were obtained at the time of dental implant placement and were subjected to micro-computed tomography. The volumetric change was 44.2% in group 1, 37.9% in group 2, and 45.7% in group 3 (P > 0.05). The trabecular microarchitecture results showed that the materials used in groups 1 and 2 were good bone substitutes. However, the addition of 50% bioactive glass to autogenous bone graft improved the microarchitecture of the graft. Furthermore, the results for volumetric changes indicated that bioactive glass, its association with autogenous bone graft in a 1:1 ratio, and autogenous bone graft alone have similar resorption. Araçatuba Dental School Universidade Estadual Paulista – UNESP Araçatuba Dental School Universidade Estadual Paulista – UNESP

Made available in DSpace on 2018-11-29T06:33:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Purpose: The aim of this study was to compare ChronOS (beta-tricalcium phosphate), Bio-Oss, and their addition to an autogenous bone graft in a 1: 1 ratio in human maxillary sinus bone augmentation. Materials and Methods: Thirty maxillary sinuses were divided in 5 groups: group 1 included 6 maxillary sinuses grafted with autogenous bone graft alone; group 2 included 6 maxillary sinuses grafted with ChronOS; group 3 included 6 maxillary sinuses grafted with ChronOS and autogenous bone graft in a 1: 1 ratio; group 4 included 6 maxillary sinuses grafted with Bio-Oss; and group 5 included 6 maxillary sinuses grafted with Bio-Oss and autogenous bone graft in a 1: 1 ratio. The number of samples for each group was determined by the statistical power test. Results: The median areas of new bone formation in groups 1, 2, 3, 4, and 5 were 121,917.0, 83,787.0, 99,295.0, 65,717.0, and 56,230.0 mu m(2), respectively. Statistically significant differences were found between groups 3 and 5, groups 1 and 4, and groups 1 and 5 (P

Extraction is one of the most common procedures performed by dental surgeons in their daily clinical practice. Among the trans and postoperative complications associated with this procedure can be mentioned the occurrence of trismus, infections, edema, alveolitis, paresthesia or fractures. The purpose of this study was to report a clinical case of a mandibular fracture associated with first molar extraction, approaching its main risk factors and treatment. Patient JSS, 24 years old, female, was referred to the service of Maxillofacial Surgery due to complications resulted from the extraction of element 36. On physical examination, was observed the presence of fragment mobility, communication of bone tissue with the oral environment and pain complaint was reported by the patient. Computed tomography showed the presence of a fracture in the region of the mandibular body on the left side. The planned surgical proposal was the intraoral debridement of bone fragments, extraoral access in the base of the mandible, fixation of the fracture with plate 2.4 and intraoral and extraoral access suture. During the surgical procedure, it is of great importance that the dental surgeon be aware to the signals emitted by the patient, such as clicks associated with severe pain, profuse bleeding or crackling as these symptoms may be the result of mandibular fracture. When any of these signs are found during the operation, the professional must investigate the occurrence of a possible fracture. It is concluded that in addition to performing a good preoperative evaluation, the dental surgeon must carry out a correct planning of the surgical act based on the basic principles of the surgical technique. La exodoncia es uno de los procedimientos más habituales que realizan los cirujanos dentistas en su práctica clínica diaria. Entre las complicaciones trans y postoperatorias asociadas a este procedimiento, se pueden mencionar la aparición de trismus, infecciones, edemas, alveolitis, pareteia o fracturas. El objetivo de este estudio fue reportar un caso clínico de fractura mandibular asociada a la extracción del primer molar, abordando sus principales factores de riesgo y tratamiento. Paciente JSS, 24 años, mujer, fue remitida al servicio de Cirugía Maxilofacial por complicaciones derivadas de la extracción del elemento 36. Al examen físico se observó presencia de movilidad de fragmentos, comunicación del tejido óseo con el medio bucal y queja. dolor informado por el paciente. La tomografía computarizada mostró la presencia de una fractura en la región del cuerpo mandibular del lado izquierdo. La propuesta quirúrgica planificada fue desbridamiento intraoral de fragmentos óseos, acceso extraoral en la base de la mandíbula, fijación de la fractura con placa 2.4 y sutura de acceso intraoral y extraoral. Durante el procedimiento quirúrgico, es de gran importancia que el cirujano dental esté atento a las señales que emite el paciente, tales como clics asociados a dolor severo, sangrado profuso o crepitaciones ya que estos síntomas pueden ser el resultado de una fractura mandibular. Cuando se encuentre alguno de estos signos durante la operación, el profesional deberá investigar la ocurrencia de una posible fractura. Se concluye que además de realizar una buena evaluación preoperatoria, el cirujano dentista debe realizar una correcta planificación del acto quirúrgico basado en los principios básicos de la técnica quirúrgica. A exodontia é um dos procedimentos mais realizados por cirurgiões dentistas em sua prática clínica cotidiana. Dentre as complicações trans e pós-operatórias associadas a esse procedimento pode-se mencionar a ocorrência de trismo, infecções, edema, alveolites, paretesia ou fraturas. Objetivou-se com o presente trabalho relatar um caso clínico de uma fratura mandibular associada à exodontia de primeiro molar, abordando seus principais fatores de risco e tratamento. Paciente J.S.S, 24 anos, sexo feminino, foi encaminhada ao serviço de Cirurgia Bucomaxilofacial devido a complicações decorrentes da exodontia do elemento 36. Ao exame físico, observou-se a presença de mobilidade de fragmento, comunicação de tecido ósseo com o meio bucal e queixa álgica relatada pela paciente. A tomografia computadorizada evidenciou a presença de fratura na região de corpo mandibular do lado esquerdo. A proposta cirúrgica planejada foi a debridamento intrabucal de fragmentos ósseos, acesso extrabucal na região de base da mandíbula, fixação da fratura com placa 2.4 e sutura intrabucal e extrabucal do acesso. Durante o procedimento cirúrgico, é de grande importância que o cirurgião dentista esteja atento aos sinais emitidos pelo paciente, como estalidos associados à dor intensa, sangramento abundante ou crepitação pois esses sintomas podem ser resultado de fratura mandibular. Quando algum desses sinais é encontrado durante o ato operatório, o profissional deve investigar a ocorrência de uma possível fratura. Conclui-se que além da realização de uma boa avaliação pré-operatória, o cirurgião dentista deve realizar um correto planejamento do ato cirúrgico fundamentando-se nos princípios básicos da técnica cirúrgica.

O tratamento com implantes dentários tem evoluído significativamente desde a década de 70 até os dias atuais, tanto na questão de planejamento quanto na bioengenharia e tratamento da superfície desses implantes, com o objetivo de tornar o tratamento mais eficaz. Atualmente o uso de implantes imediatos tem sido cada vez mais estudado pelos pesquisadores e utilizado para a reabilitação oral dos pacientes. A literatura nos mostra que a inserção imediata de implantes dentários pós-extração é um tipo de tratamento com altas taxas de sucesso, possibilitando ao paciente ser submetido a apenas uma cirurgia, retorno à função mastigatória e estética mais rápidas. Para isso são necessários planejamento correto e seleção adequada do paciente para o sucesso do tratamento, levando em consideração a condição óssea e periodontal. O objetivo deste estudo é discorrer sobre o planejamento da reabilitação oral de uma paciente que foi submetida da extração dentária total dos dentes inferiores, instalação de 4 implantes dentários imediatos e confecção de uma prótese total com carga imediata do tipo protocolo.

Every year countless patients are treated in emergency units around the world due to fireworks trauma. The conduct of the clinical case is challenging due to the great devastating potential characteristic of this type of trauma. These can range from small first-degree burns to large avulsions and multiple complex facial fractures. This article aims to discuss the clinical case of a patient affected by a fibro-osseous lesion in a fronto-zygomatic region that has progressed for 12 years due to fireworks explosion accident and local foreign body penetration. And in this way, to approach the conduct of the case, treatment and result, as well as to contribute to the limited scientific literature on this subject.

Made available in DSpace on 2018-12-11T16:45:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) The aim of this study was to compare the use of beta-tricalcium phosphate (β-TCP) (chronOS) with autogenous bone grafts alone in maxillary sinus elevation surgery. The test samples were β-TCP alone, β-TCP mixed with autogenous bone grafts (1:1), and autogenous bone grafts alone. Twelve maxillary sinuses were grafted with β-TCP (group 1), nine with β-TCP + autogenous bone graft (group 2), and 12 with autogenous bone graft (group 3). After 6 months, biopsies were obtained concurrent to the placement of dental implants; these were subjected to histomorphometric analysis and immunohistochemical analysis for runt-related transcription factor 2 (RUNX2) and vascular endothelial growth factor (VEGF). The average bone formation in group 1 was 46.3 ± 11.6% in the pristine bone region, 47.6 ± 9.9% in the intermediate region, and 44.8 ± 22.1% in the apical region; in group 2, values were 35.0 ± 15.8%, 32.5 ± 13.7%, and 32.8 ± 16.0%, respectively; in group 3, values were 43.1 ± 16.0%, 31.0 ± 13.0%, and 46.1 ± 16.3%, respectively. Immunostaining of samples in group 2 showed high cellular activity and immature bone; this differed from groups 1 and 3, in which mature bone was demonstrated. Thus, this study showed that β-TCP presents the same behaviour as autogenous bone graft, which makes it a good bone substitute. Araçatuba Dental School Universidade Estadual Paulista – UNESP Araraquara Dental School Universidade Estadual Paulista – UNESP Araçatuba Dental School Universidade Estadual Paulista – UNESP Araraquara Dental School Universidade Estadual Paulista – UNESP FAPESP: 2012/08455-4 FAPESP: 2012/10028-7

Made available in DSpace on 2020-12-12T02:21:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Osteoma is the most frequent benign tumor in the craniomaxillofacial region. The most common initial manifestation is facial pressure or headache.The clinical examination showed increased volume in the right supraorbital region, asymmetry of the orbital contour, exophthalmia, dystopia, proptosis and clinical restraint of ocular movement for supraversion. The lesion measured approximately 4 cm in diameter with irregular contour. Osteotomy was performed with saw surrounding the tumor, with aid of a surgical piezo on the orbital medial wall.The result of histopathological examination was osteoma. The patient is 2.5 years postoperatively and so far without complications. Department of Diagnosis and Surgery São Paulo State University School of Dentistry Araraquara - UNESP Department of Oral and Maxillofacial Surgery Hospital Leforte Department of Diagnosis and Surgery São Paulo State University School of Dentistry Araraquara - UNESP

Made available in DSpace on 2020-12-12T02:06:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-01 Zygomatic-coronoid ankylosis is a rare complication in maxillofacial trauma. Currently, less of 30 cases reported in the literature. The aim of this study was to report a case of zygomatic-coronoid ankylosis after trauma. A 26-year-old male, with zygomatic-coronoid ankylosis after 7 years of facial trauma, was treated by intraoral bilateral coronoidectomy. However, the literature continues to discuss the best approach, intraorally or extraorally. This study observed that the intraoral approach was easily performed and without complications. Department of Surgery and Integrated Clinic Sao Paulo State University-Unesp Araçatuba School of Dentistry Health Sciences Center Paraiba Federal University-UFPB Department of Diagnostic and Surgery Sao Paulo State University-Unesp Araraquara School of Dentistry Department of Surgery and Integrated Clinic Sao Paulo State University-Unesp Araçatuba School of Dentistry Department of Diagnostic and Surgery Sao Paulo State University-Unesp Araraquara School of Dentistry

Osteomas are benign osteogenic tumors, which clinically manifest as well-defined and asymptomatic lesions. This article aims to report a case of extensive osteoma in the mandibular branch, addressing the main tools used for diagnosis and treatment modalities. Patient L.M.S, 55 years old, male, sought the service of Maxillofacial Surgery, reporting the appearance of a nodule on the face with evolution of 2 years. On physical examination, a significant volumetric increase was observed in the pre-auricular region on the left side, asymptomatic on palpation and non-bleeding. Computed tomography was requested, which showed a hyperdense bone lesion in the mandibular ramus region. The planned surgical proposal was for extra-oral access in the pre-auricular region on the left side, excision of the lesion by osteotomy followed by osteoplasty for the regularization of the remaining bone tissue and suture by planes. Subsequently, the piece was sent for histopathological analysis that identified the lesion as a compact osteoma. The patient was followed up for 1 and a half years, through clinical and radiographic evaluation, through which an excellent bone repair was observed, with no signs of recurrence. Carrying out the clink exam is essential for the diagnosis of osteoma, as it is an asymptomatic pathology. Due to the fact that it has a low probability of recurrence and does not present malignancy, a conservative approach can be performed with the appropriate postoperative follow-up. Therefore, it is concluded that the performance of a thorough clinical examination associated with the imaging and microscopic information are essential for a good clinical management of this pathology. Los osteomas son tumores osteogénicos benignos, que clínicamente se manifiestan como lesiones bien definidas y asintomáticas. Este artículo tiene como objetivo reportar un caso de osteoma extenso en la rama mandibular, abordando las principales herramientas utilizadas para las modalidades de diagnóstico y tratamiento. Paciente L.M.S, 55 años, varón, acude al servicio de Cirugía Maxilofacial, reportando la aparición de un nódulo en el rostro con evolución de 2 años. Al examen físico se observó un aumento volumétrico significativo en la región preauricular del lado izquierdo, asintomático a la palpación y sin sangrado. Se solicitó tomografía computarizada, que mostró una lesión ósea hiperdensa en la región de la rama mandibular. La propuesta quirúrgica planificada fue el acceso extraoral en la región preauricular del lado izquierdo, escisión de la lesión por osteotomía seguida de osteoplastia para la regularización del tejido óseo remanente y sutura por planos. Posteriormente, se envió la pieza para análisis histopatológico que identificó la lesión como un osteoma compacto. El paciente fue seguido durante 1 año y medio, mediante evaluación clínica y radiográfica, mediante la cual se observó una excelente reparación ósea, sin signos de recidiva. La realización del examen de clink es fundamental para el diagnóstico de osteoma, por tratarse de una patología asintomática. Debido a que presenta baja probabilidad de recurrencia y no presenta malignidad, se puede realizar un abordaje conservador con el adecuado seguimiento postoperatorio. Por tanto, se concluye que la realización de un examen clínico minucioso asociado a la imagenología y la información microscópica son fundamentales para un buen manejo clínico de esta patología. Osteomas são tumores osteogênicos benignos, que clinicamente, manifestam-se como lesões bem definidas e assintomáticas. O presente artigo tem o objetivo de relatar um caso de extenso osteoma em ramo mandibular, abordando as principais ferramentas utilizadas para o diagnóstico e modalidades de tratamento. Paciente L.M.S, 55 anos, sexo masculino, procurou o serviço de Cirurgia Bucomaxilofacial, relatando o aparecimento de um nódulo no rosto com evolução de 2 anos. Ao exame físico, observou-se aumento volumétrico significativo em região pré-auricular do lado esquerdo, assintomático a palpação e não sangrante. A tomografia computadorizada evidenciou uma lesão óssea hiperdensa em região de ramo mandibular. A proposta cirúrgica planejada foi de acesso extraoral em região pré-auricular do lado esquerdo, exérese da lesão por osteotomia seguida por osteoplastia para a regularização do tecido ósseo remanescente e sutura por planos. Posteriormente, a peça foi enviada para análise histopatológica que identificou a lesão como um osteoma compacto. O paciente seguiu em acompanhamento durante 1 ano e meio, mediante avaliação clínica e radiográfica, por meio da qual se observou excelente reparo, não apresentando sinais de recidiva. A realização do exame clínico é fundamental para o diagnóstico do osteoma, por se tratar de uma patologia assintomática. Devido ao fato de apresentar baixa probabilidade de recorrência e não apresentar malignização, uma abordagem conservadora pode ser realizada com o devido acompanhamento pós-operatório. Diante disso, conclui-se que a realização de um minucioso exame clínico associado as informações imaginológicas e histológicas são imprescindíveis para um bom manejo clínico dessa patologia.

A ausência de tecido ósseo remanescente dos rebordos alveolares tem sido um grande problema para a reabilitação estética e funcional nos pacientes. O enxerto ósseo autógeno é o material ideal para reconstrução dos rebordos maxilares e mandibulares. A escolha da área doadora, seja intrabucal ou extrabucal, está relacionada com a quantidade e a qualidade do enxerto ósseo necessária para cada caso. O presente estudo tem por objetivo relatar um caso clínico de reconstrução maxilar em paciente após cirurgia ortognática utilizando-se como área doadora, a região de ramo mandibular, e revisar as principais características relacionadas à técnica cirúrgica.

Aunque el dolor orofacial es una condición de etiopatogenia multifactorial y en ocasiones es difícil de diagnosticar, una posible causa de esta condición son los cambios musculares, que a su vez pueden originarse en condiciones sistémicas, como la hipocalcemia. El presente artículo tiene como objetivo presentar una situación clínica de dolor orofacial por hipocalcemia en una paciente joven con enfermedad renal crónica. El paciente acudió a atención hospitalaria con fuertes quejas de dolor en el rostro, siendo evaluado por el equipo de Cirugía Maxilofacial y el equipo médico de Neurología, sin la determinación precisa de una etiología. A pesar de que se le prescribió medicación oral, el paciente regresó con la queja de dolor y con un nuevo síntoma de calambres en el rostro, ante lo cual se solicitó pruebas hematológicas donde se encontró una condición de hipocalcemia. El enfoque terapéutico consistió en suplementos de calcio por vía oral, que fue suficiente para suprimir las molestias faciales. Se concluye que existe una correlación entre la concentración de calcio en sangre y los cambios musculares en el rostro, requiriendo estudios clínicos para explicar mejor esta relación.

Panfacial fractures are due to high-energy trauma, making the treatment of patients since the first visit is challenging. Generally, these involve soft tissue injuries, comminuted fractures and even fragment loss. In addition to this, the surgical approach to facial reconstruction through the fixation of bone fragments can be postponed due to the patient's clinical conditions, which can lead the treatment to a more complex condition due to the possibility of infection, poor union of bone fragments and tissue contraction. The aim of this study is to discuss the clinical case of high-energy trauma caused by an air accident, leading to multiple facial and body fractures. And in this way contribute to the extremely limited scientific literature on the subject, with such etiology and significant facial trauma. Las fracturas panfaciales se deben a traumatismos de alta energía, lo que dificulta el tratamiento de los pacientes desde la primera consulta. Suelen implicar lesiones de tejidos blandos, fracturas conminutas e incluso pérdida de fragmentos. Además, el abordaje quirúrgico de la reconstrucción facial mediante la fijación de fragmentos óseos puede retrasarse debido a las condiciones clínicas del paciente, lo que puede derivar en un tratamiento más complejo por la posibilidad de infección, mala consolidación de los fragmentos óseos y contracción del hueso tela. El objetivo de este estudio es discutir el caso clínico de un traumatismo de alta energía provocado por un accidente aéreo que provocó múltiples fracturas faciales y corporales. Y de esta manera contribuir a la literatura científica extremadamente limitada sobre el tema, con tal etiología y traumatismos faciales importantes. As fraturas panfaciais são decorrentes de traumas de alta energia, tornando o tratamento dos pacientes desde a primeira consulta um desafio. Geralmente, envolvem lesões de tecidos moles, fraturas cominutivas e até mesmo perda de fragmentos. Além disso, a abordagem cirúrgica da reconstrução facial por meio da fixação de fragmentos ósseos pode ser postergada devido às condições clínicas do paciente, o que pode direcionar o tratamento a um quadro mais complexo pela possibilidade de infecção, má consolidação dos fragmentos ósseos e contração do tecido. O objetivo deste estudo é discorrer sobre o caso clínico de um paciente que sofreu trauma de alta energia causado por acidente aéreo, levando a múltiplas fraturas faciais e corporais. E desta forma contribuir para a literatura científica extremamente limitada sobre o assunto, com tal etiologia e traumas faciais significativos.

The calcifying odontogenic cyst (COC) is an uncommon lesion, with variable clinical and histopathological behavior. The cystic form is the most frequent and the most common histological characteristic is the presence of a variable number of phantom cells in the epithelial component. The standard treatment for this injury is enucleation followed by curettage or excision. However, when other factors are associated, this single-step approach can lead to complications such as pathological fractures. A common treatment for keratocysts and dentigerous cysts, but uncommon for COC has been showing high effectiveness. Thus, a two-stage approach using a tubular object to perform initial decompression of the lesion and later excision of the lesion can be performed in order to prevent complications. Here we report a two-stage treatment, through initial surgical decompression, of a COC associated with a lower second molar in the mandibular basilar region, using a tubular device, in which a pathological fracture was prevented. The results of this case corroborate the use of decompression applied to the treatment of COC. El quiste odontogénico calcificante (QOC) es una lesión infrecuente, con comportamiento clínico e histopatológico variable. La forma quística es la más frecuente y la característica histológica más común es la presencia de un número variable de células fantasma en el componente epitelial. El tratamiento estándar para esta lesión es la enucleación seguida de legrado o escisión. Sin embargo, cuando se asocian otros factores, este enfoque de un solo paso puede dar lugar a complicaciones como fracturas patológicas. Un tratamiento común para los queratoquistes y los quistes dentígeros, pero poco común para los AOC, ha mostrado una alta efectividad. Por lo tanto, se puede realizar un abordaje en dos etapas utilizando un objeto tubular para realizar la descompresión inicial de la lesión y la escisión posterior de la lesión con el fin de prevenir complicaciones. A continuación presentamos un tratamiento en dos etapas, mediante descompresión quirúrgica inicial, de un AOC asociado a un segundo molar inferior en la región basilar mandibular, mediante un dispositivo tubular, en el que se evitó una fractura patológica. Los resultados de este caso corroboran el uso de la descompresión aplicada al tratamiento de los AOC. O cisto odontogênico calcificante (COC) é uma lesão incomum, com comportamento clínico e histopatológico variável. A forma cística é a mais frequente e a característica histológica mais comum é a presença de número variável de células fantasmas no componente epitelial. O tratamento padrão para essa lesão é a enucleação seguida de curetagem ou excisão. No entanto, quando outros fatores estão associados, essa abordagem em uma única etapa pode levar a complicações, como fraturas patológicas. Um tratamento comum para ceratocistos e cistos dentígeros, mas incomum para COC, tem mostrado alta eficácia. Assim, uma abordagem em dois estágios utilizando um objeto tubular para realizar a descompressão inicial da lesão e posterior excisão da lesão pode ser realizada a fim de prevenir complicações. Relatamos aqui o tratamento em dois estágios, por meio da descompressão cirúrgica inicial, de um COC associado a um segundo molar inferior na região basilar mandibular, por meio de um dispositivo tubular, no qual foi evitada uma fratura patológica. Os resultados deste caso corroboram o uso da descompressão aplicada ao tratamento do COC.

Anophthalmia is mainly caused by two etiological groups, trauma and medical conditions. In addition, anophthalmia creates difficulties in social, professional, and family adaptation due to psychological, and functional disorders related to eye loss. Studies show a positive influence on the personal relationship of patients with anophthalmia after being rehabilitated with ocular prostheses. However, in order to achieve a good aesthetic result in prosthetic eye rehabilitation, it is essential that the size and positioning of the orbital skeleton are adequate. Facial trauma can also cause defects associated with bone loss, and in these cases, reconstructive techniques aim to restore the appropriate bone contour. The aim of this work is to report a case where reconstructive treatment was performed on a patient victim of a long-term traffic accident sequel, using an alloplastic implant in polymethylmethacrylate (PMMA) and bone repositioning, so that an ocular prosthesis could be made. At the end of the treatment, after reconstruction of the frontal-nasal region in PMMA and repositioning of the left zygoma, the aesthetic objectives were achieved and the patient improved his self-esteem and social life. La anoftalmia es causada principalmente por dos grupos etiológicos, traumatismos y afecciones médicas. Además, la anoftalmia genera dificultades en la adaptación social, profesional y familiar debido a los trastornos psicológicos y funcionales relacionados con la pérdida de la vista. Los estudios muestran una influencia positiva en la relación personal de los pacientes con anoftalmia tras ser rehabilitados con prótesis oculares. Sin embargo, para lograr un buen resultado estético en la rehabilitación del ojo protésico, es fundamental que el tamaño y la posición del esqueleto orbitario sean los adecuados. El trauma facial también puede causar defectos asociados con la pérdida ósea y, en estos casos, las técnicas reconstructivas tienen como objetivo restaurar el contorno óseo adecuado. El objetivo de este trabajo es reportar un caso en el que se realizó un tratamiento reconstructivo a un paciente víctima de secuelas de accidente de tránsito de larga duración, utilizando un implante aloplástico en polimetilmetacrilato (PMMA) y reposicionamiento óseo, para que se pudiera realizar una prótesis ocular. Al final del tratamiento, tras la reconstrucción de la región fronto-nasal en PMMA y el reposicionamiento del cigoma izquierdo, se lograron los objetivos estéticos y el paciente mejoró su autoestima y vida social. A anoftalmia é causada principalmente por dois grupos etiológicos, trauma e condições médicas. Além disso, a anoftalmia gera dificuldades na adaptação social, profissional e familiar devido aos transtornos psíquicos e funcionais relacionados a perda ocular. Estudos demonstram influência positiva no relacionamento pessoal dos pacientes com anoftalmia após serem reabilitados com próteses oculares. No entanto, para que seja alcançado um bom resultado estético na reabilitação protética ocular é essencial que o tamanho e posicionamento do esqueleto orbitário estejam adequados. O trauma facial também pode ocasionar defeitos associados a perda óssea, sendo que nestes casos, técnicas reconstrutivas objetivam devolver o contorno ósseo apropriado. O objetivo deste trabalho é relatar um caso onde foi realizado tratamento reconstrutivo de um paciente vítima de sequela de acidente de trânsito de longa data, por meio da utilização de implante aloplástico em polimetilmetacrilato (PMMA) e reposicionamento ósseo, para que fosse confeccionada uma prótese ocular. Ao final do tratamento, após a reconstrução da região fronto-nasal em PMMA e reposicionamento do zigoma esquerdo, os objetivos estéticos foram alcançados e o paciente obteve melhora da autoestima e do convívio social.

The retention mucous cyst of the maxillary sinus is a benign lesion that occurs in the interior of the maxillary sinus due ductal obstruction. In the majority of the cases it is asymptomatic, and discovered on routine radiographic examinations. However, in some cases, this cyst can become large and cause symptoms as paresthesia, sensitivity to palpation, chronic headache, nasal blockage, and dizziness. Conservative treatment is conduct in most cases. Symptomatic retention cysts are treated by enucleation or curettage. Objective and case report: This study aimed to report a clinical case of symptomatic mucous retention cyst accidentally discovered in a patient treated by surgically-assisted rapid maxillary expansion. Conclusion: The curettage of the cyst allowed for the regression of symptoms and at 12 months postoperatively the patient is free of symptoms and no signs of recurrence of lesion were noted.

Introduction: A young boy presented with mandibular swelling at the Department of Oral and Maxillofacial Surgery in Hospital Leforte, São Paulo, Brazil. Radiography showed a mixed bone lesion. Computed tomography (CT) findings were compatible with ameloblastic fibro-odontoma (AFO). Case Report: An excisional biopsy was performed under general anesthesia. At the 6-year follow-up, local inflammation and mild exudates were found. Local recurrence of the lesion was observed on CT. Therefore, excision and curettage were performed. No signs of recurrence have been detected to date. Ameloblastic fibro-odontoma is a rare benign neoplasm most commonly occurring in the first decade of life, with minimal probability of malignancy. Conclusion: Clinical, radiological, and histopathological findings aid in the diagnosis, and long-term follow-up is necessary as recurrence can develop even after 6 postoperative years.

Made available in DSpace on 2019-10-06T16:05:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Keratoacanthoma is a low-grade tumor originated from the pilosebaceous glands that nearly resembles squamous cell carcinoma under histopathological analysis. Giant keratoacanthoma is a rare subtype with a size exceeding 2 cm, with a high aggressiveness potential. Head and neck giant keratoacanthomas are uncommon and mainly affect male patients with a mean age of 59.1 years old, usually affecting the nose. Excision of the lesion is the preferred treatment for giant keratoacanthoma. The aim of this study is to analyze the clinicopathological characteristics of head and neck giant keratoacanthoma by reviewing the previously published English literature and reporting one new case of a rare lesion affecting the lower lip. Oral Surgery and Pathology Department João de Barros Barreto University Hospital Federal University of Pará Division of Oral and Maxillofacial Surgery Dental School at Araraquara UNESP Division of Oral and Maxillofacial Surgery Dental School at Araraquara UNESP

Made available in DSpace on 2018-12-11T17:17:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-06-01 The removal of displaced dental elements from deep anatomical spaces is a condition that requires the knowledge of the region and skills to perform the procedure. The lateral pharyngeal space contains important structures such as the internal carotid artery and close proximity with the cranium basis. The aim of this paper is to report a clinical case of a lower third molar displaced to the lateral pharyngeal space after a mandibular angle fracture and its treatment by surgical intervention. The tooth was removed under general anesthesia by direct approach and the fracture was reduced and fixed with a plate and screws. This case report illustrates the importance of an immediate procedure to avoiding severe complications and further damage to important anatomical structures. Department of Surgery and Clinic Integrated Araçatuba Dental School UNESP, José Bonifácio Street, number 1193 Department of Surgery and Clinic Integrated Araçatuba Dental School UNESP, José Bonifácio Street, number 1193

Actinomycosis is a bacterial infection caused by Actinomyces species, which usually affect the soft tissues of the cervicofacial region of adult males. Clinically, it’s characterized by a slow-growing indurated mass, especially in the submandibular area. However, in a few cases, the jaws bones can be affected developing osteomyelitis characteristics. The aim of this paper is to report a rare clinical case of Actinomycotic Osteomyelitis affecting the maxilla of a child, involving the maxillary sinus, orbital and zygomatic areas that was treated by the association of antibiotic therapy and surgical debridement. The patient’s 2 years follow-up was uneventful and no signs of the lesion recurrence.