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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 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

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.

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

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 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

The purpose of this study was to evaluate a composite graft of ChronOS, a beta-tricalcium phosphate (β-TCP), mixed 1:1 with an autogenous bone graft in human maxillary sinus augmentation. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group), and 9 maxillary sinuses were grafted with ChronOS mixed 1:1 with an autogenous bone graft (test group). After 6 months, biopsy samples were obtained concurrent to the placement of dental implants and were subjected to histomorphometric and immunohistochemical analyses for Runt-related transcription factor 2 (RUNX2), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase, and osteocalcin. Histologic analysis of samples obtained from the test group revealed the presence of immature bone, while samples from the control group indicated lamellar bone formation. However, both types of bone grafts were well vascularized. The new bone formation averaged 25.4% ± 6.4% in the test group and 38.6% ± 10.5% in the control group (P = .001). Immunostaining of samples in the test group showed high cellular turnover. The outcomes of this study demonstrate a delay in bone formation but intense cellular differentiation after 6 months of bone graft healing in the test group. The amount of immature bone and the immunostaining for RUNX2 and VEGF provide evidence of an osteogenic pathway that can improve the bone formation rate.

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

Background Autogenous bone grafts are the most favorable and predictable types of bone graft due to their osteogenic, osteoinductive, and osteoconductive properties. The advantages of harvesting from mandibular bone are that it requires only local anesthesia, is less invasive, has less morbidity, and avoids harvesting from distant sites, thus making it the best choice for maxillary bone reconstruction. Purpose The aim of this study was to evaluate inferior alveolar nerve (IAN) neurosensory disturbances after autogenous bone graft harvesting from the mandibular symphysis and retromolar region to reconstruct maxillary sinus height for posterior dental implant placement and the effect of these disturbances on patient satisfaction. Materials and methods Fifty-four patients were invited to participate in this study. Autogenous bone graft was harvested from the mandibular symphysis and retromolar regions. After the procedure, the patients were evaluated by means of an adapted questionnaire to determine if they had complaints of neurosensory disturbances at the following time intervals: immediately, 1, 2-5, 6, 7-11, and 12 months postsurgery. Results Immediately after surgery, 28 patients described sensory changes and 25 reported paresthesia of inferior lip. Only three patients reported pain, and one patient experienced dental hypersensitivity after the surgical procedure. During the evaluation period, the patients reported a decrease in paresthesia and a return of sensation to areas innervated by the IAN. After 12 months, five patients still reported paresthesia of areas innervated by the IAN. Beside this, patients reported significant clinical improvement from the beginning of the evaluation, as 49 patients were satisfied with their treatment outcomes. Conclusion Harvesting bone grafts from the mandibular symphysis results in greater postoperative morbidity upon immediate evaluation compared with bone graft harvesting from the retromolar region. Nevertheless, during clinical follow-up, the results of both treatments showed that sensation was eventually recovered, depending on the healing period.

The central cement-ossifying fibroma (CCOF) is an uncommon fibro-osseous lesion affecting the jaws. It is classified as a benign neoplasm, slow growing, and asymptomatic. The objective of this study is to present the case of a melanoderma patient, 57 years old, with an increased volume located in the fundus of the alveolar ridge, in the region of the teeth 24 and 25, extending to 27, with expansion of the cortical vestibular bone. The radiograph showed a radiolucent area with no sharp limits, with diffuse radiopaque spots. Differential diagnoses involved odontogenic tumor and cyst, and then an incisional biopsy was performed, which allowed the microscopic identification of fragments with fibroblasts interspersed with collagenous matrix, neoformed bone tissue, and psammomatoid calcified formations, defining the diagnoses of CCOF, and subsequently the lesion was removed. Therefore, early diagnosis is important to prevent these lesions from reaching large proportions and compromising important anatomic structures.

The central lesion of giant cells is considered to be a non-neoplastic lesion. The highest incidence is in the younger age with predilection for female sex and prevalence in the anterior region of the mandible. This paper reports the case of a female patient, 33 years old, referring with a volumetric increase dated to 60 days ago, in the anterior region of the mandible in the vestibule fundus. It was about 20 mm of extension, soft and tender to palpation. Through complementary examinations and incisional biopsy, the central giant cell lesion diagnosis was confirmed. Biomodel was made for planning and pre-operative bending of the plaque, and a carotid angiography was performed. Surgical intervention was performed with combination access; extractions were performed, with curettage of the lesion, peripheral ostectomy, cryotherapy of the surgical cavity with liquid nitrogen, preservation of the healthy alveolar cortical, and installed plaque of reconstruction in the mandibular base. In postoperative follow-up, it shows good evolution.

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

Purpose The aim of this paper was to study the healing of 1–1.4 mm wide buccal defects at implants placed immediately into extraction sockets (IPIES) filled with a mixture of synthetic hydroxyapatite (HA) 60% and beta-tricalciumphosphate (TCP) 40% or left with the clot alone and both covered with collagen membranes. Material and Methods Eight Labrador dogs were used and implants were placed immediately into the extraction sockets of the first molar bilaterally. A mixture of synthetic HA 60% and beta-TCP 40% at the test or the clot alone at the control sites were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membrane and a non-submerged healing was allowed. After 4 months, the animals were euthanized, biopsies harvested and processed for histomorphometric analysis. Results At the time of installation, residual buccal defects occurred that were 1.1 mm and 1.4 mm wide and 3 mm and 4 mm deep at the control and test sites, respectively. After 4 months of healing, the top of the bony crest and the coronal level of osseointegration were located respectively at 0.1 ± 1.8 mm and 1.5 ± 1.8 mm at the test, and 0.6 ± 1.6 mm and 1.2 ± 0.7 mm at the control sites apically to the implant shoulder. Bone-to-implant contact at the buccal aspect was 34.9 ± 25.9% and 36.4 ± 17.3% at the test and control sites, respectively. No statistically significant differences were found between test and control sites for any of the variables analyzed at the buccal aspects. Conclusions The use of a mixture of synthetic HA 60% and beta-TCP 40% to fill residual buccal defects 1–1.4 mm wide at IPIES did not improve significantly the results of healing.

Purpose The aim of this study was to evaluate bone regeneration at surgically created dehiscence buccal defects at implants placed immediately into extraction sockets (IPIES) of small dimensions filled with autogenous bone or deproteinized bovine bone mineral (DBBM) associated with a collagen membrane. Materials and Methods Eight Labrador dogs were used and implants were placed immediately into the extraction sockets of the second premolar. The buccal wall was subsequently removed to create a standardized defect, 4 mm wide coronally, 2 mm wide apically, and 6 mm high. Autogenous bone particles (AB) or DBBM granules were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membrane and a non-submerged healing was allowed. After 4 months, the animals were euthanized and bone blocks harvested and processed for histomorphometric analysis. Results The bony crest at the buccal aspect (C) was located 2.3 ± 0.8 mm and 1.7 ± 0.7 mm apically to the implant shoulder (IS) at the AB and DBBM sites, respectively. The coronal levels of osseointegration at the buccal aspect (B) were located 2.7 ± 0.7 mm and 2.2 ± 1.0 mm apically to IS at the AB and DBBM sites, respectively. At the AB sites, the peri-implant mucosa was located 4.3 ± 0.9 mm, 4.7 ± 0.9 mm, and 2.0 ± 1.6 mm coronally to C, B, and IS, respectively. The corresponding values at the DBBM sites were 4.3 ± 0.6 mm, 4.8 ± 0.6 mm, and 2.5 ± 0.8 mm, respectively. No statistically significant differences were found. Conclusions The treatment of surgically created buccal defects at IPIES sites using Bio-Oss® (Geistlich Biomaterials, Wolhusen, LU, Switzerland) or autogenous bone, concomitantly with a collagen membrane, engenders bone regeneration to a similar extent after 4 months of healing.

Background Few studies have been conducted to assess new bone formation using Biogran, a bioactive glass, in maxillary sinus bone augmentation through a prospective and randomized evaluation. Moreover, there are no studies that evaluate cellular behavior by immunohistochemical assessment for osteoblastic and vascular activity during bone repair. Purpose The aim of this study is to compare new bone formation and cellular behavior with Biogran alone, a 1:1 combination of Biogran and autogenous bone graft, and autogenous bone graft alone in human maxillary sinuses. Materials and methods Ten maxillary sinuses were grafted with Biogran (Group 1), 10 grafted with Biogran added to autogenous bone graft in a 1:1 ratio (Group 2), and 10 grafted with autogenous bone graft alone (Group 3). After 6 months of bone healing, samples were obtained concurrent to the dental implants' placement to be evaluated by histomorphometric and immunohistochemical assessment for RUNX2 and vascular endothelial growth factor (VEGF). Results The amount of new bone formation in Group 1 was 42.0 ± 7.3% in the pristine bone region, 40.7 ± 14.0% in the intermediate region, and 45.6 ± 13.5% in apical region. In Group 2, for pristine bone, intermediate, and apical regions, new bone formation was 36.6 ± 12.9%, 33.2 ± 13.3%, and 45.8 ± 13.9%, respectively. Group 3 showed new bone formation of 37.3 ± 11.6%, 35.3 ± 14.7%, and 39.9 ± 15.8% in pristine bone, intermediate, and apical regions, respectively. The immunolabeling for RUNX2 showed low cellular activity in osteoblasts for all groups, and the VEGF assessment demonstrated moderate cellular activity in Groups 1 and 2; however, Group 3 presented with low activity in the pristine bone region, followed by moderate activity in the intermediate and apical region. Conclusion This study demonstrates that Biogran and its combination with autogenous bone graft 1:1 are good bone substitutes due to their similarity to autogenous bone graft.

Made available in DSpace on 2018-11-26T17:42:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-01 The purpose of this study was to test whether associated subcranial Le Fort III (sLF III) and Le Fort I (LF I) osteotomies are stable after large advancements of the middle third of the face and maxilla. The authors designed a retrospective study and enrolled a sample of consecutive patients with midface hypoplasia treated with associated sLF III and LF I osteotomies in this IRB-approved study between September 2013 and February 2015. To test whether the long-term stability was satisfactory, the authors compared cephalometric changes from immediately after surgery to 18 months after surgery taken from multi-slice computed tomography using two different third-party imaging software programs. Statistical significance was set as P = 0.05. The sample comprised 11 patients (mean age 23.84 +/- 4.17 yr; 54% men). The mean advancement of the upper incisor immediately after surgery was 10.03 +/- 1.6 mm. After 18 months, the position of the upper incisor did not vary significantly (10.18 +/- 2.35 mm). All other cephalometric landmarks did not present statistically significant differences between immediately after and 18 months after surgery, with horizontal and vertical variations of less than one millimetre. This study supports that sLF III and LF I osteotomies are effective in maintaining stable horizontal and vertical skeletal positioning after surgery. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved. Univ Fed Minas Gerais, Oral & Maxillofacial Surg, Belo Horizonte, MG, Brazil State Univ Sao Paulo, Oral & Maxillofacial Surg, Araraquara, Brazil Univ Basel, Fac Med, Univ Hosp Basel, Dept Oral & Maxillofacial Surg, Basel, Switzerland MaterDei Healthcare Network, Div Oral & Maxillofacial Surg, Belo Horizonte, MG, Brazil State Univ Sao Paulo, Oral & Maxillofacial Surg, Araraquara, Brazil

The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in terms of stability, functional recovery, and postoperative complications. This systematic review sought scientific evidence regarding the best indication for the use of three-dimensional (3D) plates in the treatment of mandibular fractures. A systematic search of the PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases was conducted to include articles published up until November 2016. Following the application of the inclusion criteria, 25 scientific articles were selected for detailed analysis. These studies included a total of 1036 patients (mean age 29 years), with a higher prevalence of males. The anatomical location most involved was the mandibular angle. The success rate of 3D plates was high at this location compared to other methods of fixation. In conclusion, the use of 3D plates for the treatment of mandibular fractures is recommended, since they result in little or no displacement between bone fragments.

Background/Aim Injuries to bone during trauma may require bone grafts and/or fixation to ensure optimal healing. Autologous bone grafts are still very common but little data exists regarding the most effective means of fixation of such grafts. The aim of this study was to compare the fixation of autologous bone grafts with titanium screws and adhesives based on n-butyl cyanoacrylate. Material and Methods Twenty adult rabbits were used. In group I, the graft was fixed with titanium screws (in one side of the animal head), while in group II and III (in other spots in the same animal head), the graft was fixed with adhesive Tissuacryl ® and Histoacryl ® respectively. The animals were sacrificed on post-operative days 7, 15, 30, 60 and 120. Histological and histomorphometric analyses were performed. Results Inflammatory reactions were observed in all groups at 7 days. At 15 days, group I showed no inflammatory reaction. There was new bone formation in group I at 30 days and at 60 days in groups II and III. After 120 days, the grafts were completely incorporated in group I and partially incorporated in group II and III. Groups II and III presented less graft resorption at the final evaluation: 32.58 (±10.22) and 34.75 (±8.25), compared to 26.58 (±6.48) for group I (p=0.001). Conclusions The adhesives were compatible when they were in contact with bone structures, and they were effective in fixing the grafts. Groups II and III had less graft resorption. This article is protected by copyright. All rights reserved.

The present study aims to compare three types of internal fixation for fractures of the mandibular angle. Mechanical testing was performed on replicas of polyurethane hemimandibles sectioned at the angle region to simulate a fracture and fixed with three different hardwares. Fixation devices enrolled on this survey included the grid plates with and without an intermediate bar and the method described by Champy and colleagues in 1978 and the sample consisted of 10 hemimandibles for each group. Vertical loadings were applied on each hemimandible and recorded after a vertical displacement of 3 and 5 mm. Statistical analysis was made by means of the variance analysis (ANOVA) and the Duncan test with a significance level of 5%. The Champy technique showed a statistically significant increased resistance when compared to the grid plates after vertical displacements of 3 and 5 mm. The results of this survey suggest that the Champy technique, when compared to the grid plate positioned at the middle of the mandibular bone (placement site selected for this study), is more resistant than the grid plate and that the inclusion or not of an intermediate bar to the grid plates does not improve its resistance after linear vertical loadings.

The aim of this study was to compare the bone resorption rate and histometry of ChronOS, a beta-tricalcium phosphate (β-TCP), mixed with autogenous bone grafts (1:1) with that of autogenous bone grafts alone in maxillary sinus elevation surgery. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group) and 9 with ChronOS mixed with an autogenous bone graft (test group). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T₁), and 6 months later another CBCT scan was performed to evaluate the final graft volume (T₂) and determine the graft resorption rate. The resorption outcomes were 45.7% ± 18.6% in the control group and 38.3% ± 16.6% in the test group (P = .17); the bone formation rate was 38.6% ± 10.5% in the control group and 25.4% ± 6.4% in the test group (P = .001). ChronOS mixed with autogenous bone graft demonstrated a resorption rate similar to that of the autogenous bone graft but with a difference in bone formation after 6 months.

This article presents an unusual case of maxillary sinus mucocele as a late complication of zygomatic-orbital complex fracture, 23 years after the initial treatment. The patient was referring diplopia and decreased visual acuity with signs of dystopia, proptosis, and epiphora. Computed tomographic scan revealed an expansive lesion in the maxillary sinus with surrounding bone erosion and displacement of the eyeball. Treatment option was excisional biopsy and orbital floor reconstruction with titanium mesh restoring the appropriate orbital position. We propose that in the case of postoperative ophthalmological sequelae of facial fractures involving paranasal sinuses, mucocele should be considered in the differential diagnosis.

Orbital infection is an uncommon devastating infection and is usually a complication of paranasal sinus infection. Without appropriate treatment, orbital infection may lead to serious complications, even death. Prompt treatment is mandatory to avoid visual loss or intracranial complications. The literature shows that initially, intravenous antibiotics should be administered, and after 48 h, if no improvement appears, the affected orbit and the sinuses must be surgically drained. The authors describe two cases of orbital cellulitis with a brief literature review. The authors describe two cases of orbital abscess caused by paranasal sinus infection. In case 1, the patient presented a decreased visual acuity associated with ophthalmoplegia of the right eye. In case 2, the patient presented a decreased visual acuity. Thus, administration of intravenous antibiotic combined with surgical drainage was performed. After surgical procedure, eye movements were normalized in case 1, and in both patients, the visual acuity returned to normal parameters. The authors recommend early surgical drainage with parenteral antibiotic administration and careful postoperative observations by monitoring the signs and symptoms of the orbital complaint.

The aim of this study is to report the case of a quick growing brown tumour in the jaw after a parathyroidectomy due to the presence of a rare fifth parathyroid gland. The patient had chronic renal disease and the diagnosis was tertiary hyperparathyroidism. Thirty days after the parathyroidectomy, the patient returned with a significant increase in the tumour size. The suspicion of a supernumerary gland was confirmed by parathyroid scintigraphy. The treatment of brown tumour is dependent on the treatment of the hyperparathyroidism. However, curettage should be considered if a large lesion is disturbing mastication. In conclusion, this case should attract the attention of general practitioner dentists, since they may be the first professionals who have contact with the patient with a brown tumour in the jaws. Likewise, this case emphasises the importance of knowing the type of hyperparathyroidism involved to allow for effective treatment planning.

The aim of this study was to evaluate the efficacy and safety of traumatic orbital defect reconstruction with titanium mesh. A retrospective study was made. Evaluations were made after a minimum postoperative follow-up of 12 months, looking for the main complications. Twenty-four patients were included in this evaluation; 19 were male (79.1%) and 5 (20.8%) were female. The main injury etiology was vehicle accidents (50%) followed by other causes. Fourteen patients (58.3%) presented orbital floor fractures, and 10 had more than one wall fractured (41.6%). Permanent infraorbital nerve hypoesthesia was observed in two patients (8.3%), enophthalmos occurred in five patients (20.8%), and exophthalmos was found in two patients (8.3%). Four patients (16.6%) still presented evidence of residual prolapsed intraorbital content, and one of those needed further surgical correction; sinusitis occurred in one patient (4.1%). Titanium mesh is a reliable option for orbital reconstruction, despite some complications found in this sample.

Purpose: In vivo bone response was assessed by removal torque, hystological and histometrical analysis on a recently developed biomedical Ti-15Mo alloy, after surface modification by laser beam irradiation, installed in the tibia of rabbits. Materials and Methods: A total of 32 wide cylindrical Ti-15Mo dental implants were obtained (10 mm × 3.75 mm). The implants were divided into two groups: 1) control samples (Machined surface – MS) and 2) implants with their surface modified by Laser beam-irradiation (Test samples – LS). Six implants of each surface were used for removal torque test and 10 of each surface for histological and histometrical analysis. The implants were placed in the tibial metaphyses of rabbits. Results: Average removal torque was 51.5 Ncm to MS and >90 Ncm to LS. Bone-to-implant-contact percentage was significantly higher for LS implants both in the cortical and marrow regions. Conclusions: The present study demonstrated that laser treated Ti-15Mo alloys are promising materials for biomedical application.

Purpose The aim of this study was to evaluate the clinical outcome of patients with mandibular angle fractures treated by intraoral access and a rectangular grid miniplate with 4 holes and stabilized with monocortical screws. Patients and Methods This study included 45 patients with mandibular angle fractures from the Department of Oral and Maxillofacial Surgery Sao Paulo State University, Araraquara, Brazil, and from the Clinic of Oral and Maxillofacial Surgery at the University of Frankfurt, Germany. The 45 fractures of the mandibular angle were treated with a rectangular grid miniplate of a 2.0-mm system by an intraoral approach with monocortical screws. Clinical evaluations were postoperatively performed at 15 and 30 days and 3 and 6 months, and the complications encountered were recorded and treated. Results The infection rate was 4.44% (2 patients), and in 1 patient it was necessary to replace hardware. This patient also had a fracture of the left mandibular body; 3 patients (6.66%) had minor occlusal changes that have been resolved with small occlusal adjustments. Before surgery, 15 patients (33.33%) presented with hypoesthesia of the inferior alveolar nerve; 4 (8.88%) had this change until the last clinical control, at 6 months. Conclusions The rectangular grid miniplate used in this study was stable for the treatment of simple mandibular angle fractures through intraoral access, with low complication rates, easy handling, and easy adjustment, with a low cost. Concomitant mandibular fracture may increase the rate of complications. This plate should be indicated in fractures with sufficient interfragmentary contact.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:45:15Z No. of bitstreams: 1 S2176-94512010000400016.pdf: 253940 bytes, checksum: f2eee7c62b0692c9074cbf7f4855de31 (MD5) Made available in DSpace on 2013-08-22T18:45:15Z (GMT). No. of bitstreams: 1 S2176-94512010000400016.pdf: 253940 bytes, checksum: f2eee7c62b0692c9074cbf7f4855de31 (MD5) Previous issue date: 2010-08-01 Made available in DSpace on 2013-09-30T18:29:48Z (GMT). No. of bitstreams: 2 S2176-94512010000400016.pdf: 253940 bytes, checksum: f2eee7c62b0692c9074cbf7f4855de31 (MD5) S2176-94512010000400016.pdf.txt: 22482 bytes, checksum: 69888d7f60c5eaef71e3de7546c73785 (MD5) Previous issue date: 2010-08-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:43:27Z No. of bitstreams: 2 S2176-94512010000400016.pdf: 253940 bytes, checksum: f2eee7c62b0692c9074cbf7f4855de31 (MD5) S2176-94512010000400016.pdf.txt: 22482 bytes, checksum: 69888d7f60c5eaef71e3de7546c73785 (MD5) Made available in DSpace on 2014-05-20T13:43:27Z (GMT). No. of bitstreams: 2 S2176-94512010000400016.pdf: 253940 bytes, checksum: f2eee7c62b0692c9074cbf7f4855de31 (MD5) S2176-94512010000400016.pdf.txt: 22482 bytes, checksum: 69888d7f60c5eaef71e3de7546c73785 (MD5) Previous issue date: 2010-08-01 OBJETIVO: a proposta desse trabalho foi analisar a fidelidade dos traçados predictivos realizados para cirurgias ortognáticas, por meio de análise cefalométrica do pré e pós-operatório de sete dias, em pacientes submetidos à correção de deformidade mandibular. MÉTODOS: foram utilizadas telerradiografias cefalométricas de perfil de 17 pacientes submetidos à cirurgia ortognática de mandíbula. Foram realizados traçados cefalométricos do pré e do pós-operatório de 7 dias com marcação dos pontos côndilo (Co), pogônio (Pog), goníaco (Go), mento (Me), ponto B (B) e incisivo (I). A análise foi baseada na diferença obtida pela sobreposição dos traçados pré-operatório, predictivo e pós-operatório. Os pontos foram projetados em um plano cartesiano para medição das suas distâncias em milímetros. Os dados obtidos foram submetidos à análise estatística por meio do teste t de Student pareado (± = 0,05). RESULTADOS: no eixo horizontal, foi observada diferença média, entre a mudança planejada e a obtida nos traçados cefalométricos pós-operatórios, estatisticamente significativa nos pontos Pog (p = 0,014) e I (p = 0,008). No eixo vertical, não verificou-se diferença estatística significativa para os pontos cefalométricos marcados (p > 0,05). CONCLUSÕES: o traçado predictivo contribuiu para a avaliação pré-operatória do paciente e, consequentemente, para a otimização do tratamento. Entretanto, ele não se mostrou totalmente fiel nos casos analisados, com leve subestimação das alterações esqueléticas horizontais. Essas alterações devem ser consideradas no planejamento e acompanhamento pós-operatório dos pacientes submetidos à cirurgia ortognática em mandíbula. OBJECTIVE: The purpose of this study was to assess the accuracy of cephalometric prediction tracings-performed for orthognathic surgery-by means of the cephalometric analysis of preoperative and seven-day postoperative tracings, in patients subjected to correction of mandibular deformities. METHODS: The lateral cephalograms of 17 patients who had been submitted to mandibular orthognathic surgery, three years earlier, were used. Cephalometric tracings were performed in the preoperative and seven-day postoperative periods and the following landmarks were traced: condyle (Co), pogonion (Pog), gonial (Go), menton (Me), B (B) and incisor (I). The analysis was based on the difference obtained by superimposing preoperative, prediction and postoperative tracings. The landmarks were projected onto a Cartesian plane for measuring distances between points in millimeters. The data were statistically analyzed using the paired Student t test (a = 0.05). RESULTS: A statistically significant mean difference was observed between the planned change and the change effectively achieved in the postoperative cephalometric tracings for points Pog (p = 0.014) and I (p = 0.008) on the horizontal axis. No statistically significant difference was found for the aforementioned cephalometric points on the vertical axis (p > 0.05). CONCLUSIONS: Cephalometric prediction tracings contributed to the preoperative evaluation of the patients and consequently to treatment optimization. However, they was not entirely reliable in these cases due to a slight underestimation of horizontal skeletal changes. These changes should be considered in planning and postoperative follow-up of patients subjected to orthognathic surgery in the mandible. Centro Universitário de Araraquara UNESP Faculdade de Odontologia de Araçatuba Departamento de Cirurgia e Clínica Integrada da Disciplina de Cirurgia e Traumatologia Bucomaxilofacial UNESP Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia da Disciplina de Cirurgia e Traumatologia Bucomaxilofacial UNESP Faculdade de Odontologia de Araçatuba Departamento de Cirurgia e Clínica Integrada da Disciplina de Cirurgia e Traumatologia Bucomaxilofacial UNESP Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia da Disciplina de Cirurgia e Traumatologia Bucomaxilofacial

Purpose This study sought to evaluate the effect of repeated implant drilling on the immediate bone-cell viability, and to evaluate drill wear by scanning electron microscopy. Materials and Methods The tibiae of 10 rabbits were used, divided into 5 groups (G): G1 corresponded to new drills, and G2, G3, G4, and G5 corresponded to drills used 10, 20, 30, and 40 times, respectively. The animals received 10 sequential osteotomies in each tibia. The animals were euthanized immediately after the osteotomies by perfusion with 4% formaldehyde. Samples then underwent immunohistochemistry processing for ordinal qualitative analysis of osteoprotegerin (OPG), the RANK ligant (RANKL; a tumor-related necrosis factor receptor family), and osteocalcin protein immunolabels, as detected by the immunoperoxidase method and revealed with 3,3-diaminobenzidine. Drill wear and plastic deformation were analyzed by scanning electron microscopy (SEM). Results The proteins were expressed in osteocytes of the superior bone cortical during the 40 drillings. However, in G4 and G5, a discrete increase in the expression of RANKL was observed, when compared with OPG; this increase was statistically significant in G5 ( P = .016). The SEM analysis revealed major plastic deformation and drill wear in G4 and G5. Conclusion Based on the present methodology, it may be concluded that cell viability is preserved if a less traumatic surgical protocol is used. However, the repeated use of drills alters the protein balance as of the thirtieth perforation.

Purpose The purpose of this study was to evaluate complications occurring after immediate reconstruction of severe frontal sinus fractures, including cases where the fracture was not limited to the anterior wall and also involved the posterior wall and/or sinus floor. Patients and methods The records of twenty-six patients presently undergoing follow-up for frontal sinus fracture reconstruction were reviewed. Information regarding demographics, fracture characteristics and causes, associated facial fractures, use of grafts or implants, type of fixation used, nasofrontal duct management, use of antibiotics, and complications were noted. Patients were asked to return for clinical and radiographic follow-up to access late complications. Results The average age of patients with frontal fractures was 29.1 years and 92.3% were male. Mean follow-up was 3.6 years. The most common causes of fracture were motor vehicle accidents and physical aggression. All patients presented with comminuted and dislocated anterior wall fractures, 34.6% presented with posterior wall fractures, and 46% had sinus floor fractures. Complications occurred in 7 patients (26.92%) and included pneumoencephalus, frontal cutaneous fistula, frontal bone irregularity, and sinusitis. Conclusions Frontal sinus reconstruction is a good procedure for immediate fracture treatment if there is not excessive comminution, dislocation, or instability of the posterior wall and if the frontonasal duct area is intact or can be repaired. Most complications result from incorrect indication for reconstruction.

Our goal was to study the use of 2.0-mm miniplates for the fixation of mandibular fractures.Records of 191 patients who experienced a total of 280 mandibular fractures that were treated with 2.0-mm miniplates were reviewed. One hundred twelve of those patients, presenting 160 fractures, who attended a late follow-up were also clinically evaluated. Miniplates were used in the same positions described by AO/ASIF. No intermaxillary fixation was used. All patients included had a minimum follow-up of 6 months. Demographic data, procedures, postoperative results, and complications were analyzed.Mandibular fractures occurred mainly in males (mean age, 30.3 years). Mean follow-up was 21.92 months. The main etiology was motor vehicle accident. The most common fracture was the angle fracture (28.21%). Twenty-two fractures developed infection, for an overall incidence of 7.85%. When only angle fractures are considered, that incidence is increased to 18.98%. Although only 1 patient (0.89%) described inferior alveolar nerve paresthesia, objective testing revealed sensitivity alterations in 31.52% of the patients who had fractures in regions related to the inferior alveolar nerve. Temporary mild deficit of the marginal mandibular branch was observed in 2.56% of the extraoral approaches performed and 2.48% presented with hypertrophic scars. Incidence of occlusal alterations was 4.0%. Facial asymmetry was observed in 2.67% of the patients, whereas malunion incidence was 1.78%. Fibrous union, mostly partial, occurred in 2.38% of the fractures, but only 1 of those presented with mobility (0.59%). Condylar resorption developed in 6.25% of the fixated condylar fractures. Mean mouth opening was 42.08 mm.The overall incidence of complications, including infections, was similar to those described for more rigid methods of fixation.

Purpose: In this study, we evaluated the results of spontaneous osteoneogenesis of the frontal sinus with autogenous bone plug versus obliteration with heterogeneous (human) bone in monkeys (Cebus apella). Materials and Methods: Eight young adult male C apella monkeys underwent an ostectomy of the anterior wall of the frontal sinus, removal of the sinus mucosa, and inner decortication of the bony walls and then were divided into 2 groups of 4 each, as follows. Group I monkeys underwent obliteration of the nasofrontal ducts with a free segment of frontallis muscle and corticocancellous heterogeneous bone, followed by full obliteration of the sinus with corticocancellous heterogeneous bone (Dayton Regional Tissue Bank, Dayton, OH). Group II monkeys underwent obliteration of the nasofrontal ducts with a frontal muscle segment and tibial autogenous bone plug, without full obliteration of the frontal sinus. In all animals, the sinus anterior wall was repositioned and fixed with 1.0 plate and screws. The monkeys were killed after 180 days, and routine laboratory procedures were followed for hematoxylin-eosin staining and histologic evaluation of the specimens. Results: The 2 studied techniques were both effective in obliterating the frontal sinus with newly formed bone. The nasofrontal ducts were obliterated by new bone formation or fibrous tissue (1 animal only). Conclusions: Both methods used for frontal sinus obliteration were effective; the heterogeneous bone (human bone) was well tolerated and presented low antigenicity. The nasofrontal duct obliteration with autogenous muscle associated with autogenous tibial bone (group II) or with heterogeneous bone (group I) was effective, isolating the frontal sinus from the nasal cavity. The spontaneous obliteration resulted, in the period analyzed, in earlier bone maturation compared with the obliteration by heterogeneous bone. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:214-221, 2003

Ankylosis of the temporomandibular joint in children is one the most difficult and complex conditions managed by oral and maxillofacial surgeons, and often leads to some facial deformity. Distraction osteogenesis of the mandible provides an excellent treatment for mandibular airway obstruction in children who do not respond to conservative measures, and allows for early removal of the tracheostomy. We report the case of a 1-year-old boy with severe micrognathia and temporomandibular ankylosis who was dependent on a tracheostomy; he was treated with piezosurgery and mandibular advancement by distraction osteogenesis.

The correction of bone defects can be performed using autogenous or alloplastic materials, such as beta-tricalcium phosphate (β-TCP). This study compared the changes in bone volume (CBV) after maxillary sinus lifting using autogenous bone (n = 12), autogenous bone associated with β-TCP 1:1 (ChronOS; DePuy Synthes, Paoli, CA, USA) (n = 9), and β-TCP alone (n = 11) as grafting material, by means of cone beam computed tomography (CBCT). CBV was evaluated by comparing CBCT scans obtained in the immediate postoperative period (5-7 days) and at 6 months postoperative in each group using OsiriX software (OsiriX Foundation, Geneva, Switzerland). The results showed an average resorption of 45.7 ± 18.6% for the autogenous bone group, 43.8 ± 18.4% for the autogenous bone+β-TCP group, and 38.3 ± 16.6% for the β-TCP group. All bone substitute materials tested in this study presented satisfactory results for maxillary sinus lifting procedures regarding the maintenance of graft volume during the healing phase before the insertion of implants, as assessed by means of CBCT.

The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient’s systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixation by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, especially by an intra-oral approach, and warrants further biomechanical and clinical studies.

Aims: The purpose of this study was to evaluate the expression of proteins that participate in the osteoinduction stage (VEGF, BMP2 and CBFA1) of the process of bone regeneration of defects created in rat calvariae and filled with autogenous bone block grafts. Materials and methods: 10 adult male rats (Rattus norvegicus albinus, Wistar) were used, who received two bone defects measuring 5 mm each in the calvariae. The bone defects constituted two experimental groups (n ¼ 10): Control Group (CONT) (defects filled with a coagulum); Graft Group (GR) (defects filled with autogenous bone removed from the contralateral defect). The animals were submitted to euthanasia at 7 and 30 days post-operatively. Results: Quantitative analysis demonstrated significantly greater bone formation in Group GR, but the presence of the studied proteins was significantly greater in the CONT Group in both time intervals of observation. Conclusion: It was not possible in this study in cortical bone block groups to detect the osteoinductive proteins in a significant amount during the repair process. 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Objectives The purpose of this study was to evaluate the surfaces of commercially pure titanium (cp Ti) implants modified by laser beam (LS), without and with hydroxyapatite deposition by the biomimetic method (HAB), without (HAB) and with thermal treatment (HABT), and compare them with implants with surfaces modified by acid treatment (AS) and with machined surfaces (MS), employing topographical and biomechanics analysis. Methods Forty-five rabbits received 75 implants. After 30, 60, and 90 days, the implants were removed by reverse torque and the surfaces were topographically analyzed. Results At 30 days, statistically significant difference (P

Made available in DSpace on 2022-04-29T02:16:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-01-01 The aim of the present study was to evaluate the postoperative complications of bicoronal flaps used to treat facial fractures. One hundred and thirty two patients that received bicoronal flaps for the treatment of upper and middle third facial fractures were called for clinical and radiographic examination. Minimum follow-up was 1 year and all patients had charts with adequate information about their perioperative care pertinent to the study. Results showed as complications hypoesthesia (17%), partial unilateral frontal motor deficit (11%), infection (3%), hypertrophic scars (3%), varying degrees of alopecia (18%), seroma or hematoma in the immediate postoperative period (5%). The flap provided wide surgical access to the upper and middle facial thirds with very few serious complications, most frequently allowing good aesthetic results. © 2011 European Association for Cranio-Maxillo-Facial Surgery. Araraquara Dental School UNESP - Univ Estadual Paulista Departamento de Diagnóstico e Cirurgia, Rua Humaitá, no. 1680, 14801-903, São Paulo Araraquara Dental School UNESP - Univ Estadual Paulista Departamento de Diagnóstico e Cirurgia, Rua Humaitá, no. 1680, 14801-903, São Paulo

The purpose of this study was to evaluate the association of the combination of polylactic/polyglycolic acid around implants installed with and without primary stability through the histometric analysis of bone-implant interface. We used male rabbits, each of which received 2 titanium implants in each tibial metaphysis. The animals were divided into 4 groups: control with primary stability (CPS), control without primary stability (C), polymer with primary stability (PPS), and polymer without primary stability (P). Euthanasia was performed at postoperative days 40 and 90. The pieces were embedded in resin, sectioned, scraped, and stained with alizarin red and Stevenel blue. Histometric analysis evaluated the linear extension of contact between the bone and implant surface on the implant collar (CIC) and contact between the bone and implant surface on the first thread (CFT). Also evaluated was the area of newly formed bone (ANB) in the first thread. The results showed that there was new bone formation in all groups and during all periods. At 40 days, the ANB was higher in the PPS group than in the P group (P < .001); the CFT was statistically higher in the CPS group than the PPS group (P < .001) and was higher in the CPS group than the C group (P < .001). At 40 and 90 days, the CIC was higher in the P group than in the C group (P < .001). In conclusion, the copolymer had biocompatibility, enhanced bone healing, and presented osteoconductive properties, thus raising the contact between bone and implant, even without primary stability.

Dento-alveolar process fracture is an important and common event in the dental office practice usually managed under the well-established protocols, but sometimes this kind of lesion is evaluated in the hospital emergency rooms without attention to the dental injuries. In this type of trauma, the time between the injury and the definitive resolution is essential for the treatment success, usually 1 h in cases of dento-alveolar fractures (tooth and alveolar bone). This paper describes the management of a patient with unusual dento-alveolar fracture caused by gunshot and treated using screw fixation.

Made available in DSpace on 2013-08-12T19:20:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 Made available in DSpace on 2013-09-30T18:32:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:45:37Z No. of bitstreams: 0 Made available in DSpace on 2014-05-20T13:45:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-01-01 The present study evaluated the effect of platelet-rich plasma (PRP) on pen-implant bone healing. A total of 9 mongrel dogs received 36 dental implants with sandblasted acid-etched surface in lower jaws in a split-mouth design: in the PRP group (n = 18 implants) the implants were placed in association with PRP, and in the control group (n = 18 implants) the implants were placed without PRP. Biopsies were obtained and prepared for histologic and histometric analysis after 15, 30, and 55 days of healing. The biopsies retrieved at 15 days showed delicate bone trabeculae formed by immature bone with presence of numerous osteoblasts for both groups. At 30 days the trabeculae presented reversal lines and evident lamellar disposition, where some thread spaces were filled by bone and dense connective tissue. At 55 days, bone healing was not altered in the control group, and histologic aspects were variable for the group treated with PRP. There was no significant difference between the groups for bone-to-implant contact (P > .05). PRP did not enhance bone formation around sandblasted acid-etched implants. São Paulo State Univ, Div Periodontol, Dent Sch Araraquara, São Paulo, Brazil São Paulo State Univ, Div Surg & Orthoped, São Paulo, Brazil Univ Guarulhos, Dept Periodontol, Dent Res Div, Guarulhos, Brazil São Paulo State Univ, Div Periodontol, Dent Sch Araraquara, São Paulo, Brazil São Paulo State Univ, Div Surg & Orthoped, São Paulo, Brazil

Osteopetrosis (OP) is a rare hereditary disorder characterized by a dysfunction of the osteoclasts that impairs bone resorption, which together with the normal osteoblastic activity forms intense bone sclerosis with reduction of marrow. A common complication that arises, most frequently, as a result of tooth extraction is mandibular osteomyelitis. There is no consensus on the literature about the treatment of this infection in an osteopetrotic patient, therefore, the purpose of this paper is to report a case of marginal resection for treatment of mandibular osteomyelitis in an osteopetrotic patient and discuss relevant features of this procedure.