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Nasotracheal intubation is the preferred route for general anesthesia maintenance in patients undergoing maxillofacial surgery or dental procedures. However, compression of the tracheal tube may cause superficial necrosis of the nasal wing and deformation of the external nose. Thus, proper fixation of the tracheal tube during nasotracheal intubation is important for the patient's safety as well as that of the medical staff. Recently, a nasotracheal tube support device has been developed; thus, in this study, the aim was to present and describe the Sverzut nasotracheal tube support device and discuss the advantages of its use during nasal intubation in cervicomaxillofacial surgery. Findings from this study show that the Sverzut nasotracheal tube support device can contribute to the stabilization of the nasotracheal tube and all its connectors, aiding in the maintenance of the airway patency and minimizing the complications related to this type of intubation.

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.

Cephalometric tracing done manually was considered gold standard for the cephalometric analysis in the last decades. The digital radiographs began to be commonly used in order to make that in a digital way. The objective was to define the accuracy of the predictive and final cephalometric tracings performed manually and virtually. The authors selected 20 patients submitted to bimaxillary orthognathic surgery. The data were collected from lateral cephalometric radiographs, in the preoperative and postoperative periods. The interest were: points, angles (Sella-Nasion to A point angle; Sella-Nasion to B point angle; Frankfurt plane to Mandibular plane angle; Frankfurt plane to occlusal plane angle; Upper and lower central incisors long axes angle; Incisor to Mandibular plane angle; Upper incisor axis to Sella-Nasion plane angle) distances (Co-A; Co-Gn). Data were submitted to the Shapiro-Wilk, analysis of variance, and Kruskal-Wallis tests. The measurement differences were compared using a t test. Descriptive statistics were performed in Excel 2013 and SPSS software, P0.05 being considered significant. No statistically significant difference was found between the mean values predictive and postoperative of the angles and distances within the manual and digital groups. When comparing the means of the differences between the predictive values and the final values, only the 1:1 angle presented a statistically significant difference, indicating a greater accuracy of the digital predictive tracing for this measure. In conclusion, both methods for obtaining predictive tracings are accurate, which shows that clinical results can be successfully simulated by the most accessible technique.

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

Removal of the buccal fat pad (BFP) is an important topic of discussion in the literature. Several studies have reported improvements in facial esthetics as a result of this technique. The BFP is close to vital structures, such as the facial nerve, parotid duct, and vessels. Injuries related to these structures may occur during the surgical procedure. This manuscript aimed to report and discuss 2 clinical cases of the complications after removal of the BFP. Besides the case presentation, a comprehensive review of the literature was also provided. The reported cases were 2 patients aged 31 and 38 years who were attended by the oral and maxillofacial surgery teams after a complication in the BFP surgery. The first case involved swelling due to Stensen's duct injury, and the second involved uncontrolled bleeding from the internal maxillary artery. Removal of the BFP must have precise indications. Complications may occur during or after surgery; hence, anatomical knowledge is fundamental to appropriate patient management.

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

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 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 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

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.

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

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

Varied factors, whether intrinsic or extrinsic, may lead to a decrease in the bone volume of the jaws. Trauma and pathology can be listed as examples of such factors. The aim of this study is to present the osteogenic distraction technique as alternative to augmentation of low mandibular bone volume caused by different etiologies. The first case reports a mandibular marginal resection of ameloblastoma and the second one reports a male patient presenting mandibular fracture sequelae. Both cases were treated according to the osteogenic distraction technique. Several factors have influence on the decision of treatment management of these conditions. Although autogenous bonegraft is considered criterion standard for alveolar reconstruction, its high rates of resorption and the morbidity associated to donor sites lead surgeons to seek for other surgical alternatives such as osteogenic distraction. Therefore, it also aims to expose the advantages and benefits of this technique as well as the satisfactory results achieved.

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

This study aimed to assess the repair of surgically created bone defects filled with blood clot, autogenous bone, and calcium phosphate cement, by histomorphometric and immunohistochemical analyses. Ten adult male rabbits were used. Three bone defects were prepared with an 8-mm diameter trephine bur in the parietal region of each animal and filled with blood clot (Group BC), autogenous bone (Group AB), and calcium phosphate bone cement (Group CPC). The animals were euthanized at 40 and 90 postoperative days. The sections were subjected to histomorphometric analysis of the new bone formed inside the calvarial defects and immunohistochemical staining to determine the expression of osteocalcin (OC), osteopontin (OP), and tartrate-resistant acid phosphatase (TRAP) proteins. Histomorphometric data were analyzed statistically by analysis of variance and Tukey's post hoc test at 5% significance level. In the results at 40 and 90 days, Group AB differed significantly from Group CPC regarding the area of newly formed bone. The immunohistochemical analysis revealed expression of OP, OC, and TRAP proteins in all groups. Group AB showed prevalence of OC and OP, and lower TRAP expression. Therefore, the calcium phosphate bone cement assessed in the present study did not accelerate the protein expression dynamics during bone healing, compared with the autogenous group.

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.

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.

Infections of the maxillofacial complex caused by caries disease are common in dental practice. The professionals have to have technical knowledge to treat it at the onset of the condition and avoid the spread to deep anatomical spaces of face and neck, which can implicate in a risk of patients' life.In Brazil, current dental professionals usually denied oral surgical treatments in patients with some clinical conditions, not because of fear to resolve it but for lack of knowledge to treat it. An example of these conditionals is pregnancy. It is well known that during the pregnancy period, the patient can be treated in the correct period of gestation. Early diagnosis is crucial for effective therapy in serious infections. The treatment has to be crucial during pregnancy because of the potentially fatal situation that the disease can create to the pregnant woman and the fetus.The aim of this article is to demonstrate a case of dental caries in a pregnant patient, which was evaluated by other professionals and had the treatment denied, evolving to a serious maxillofacial infection.

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 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

To the Editor: Large dentigerous cysts are uncommon and can cause expansion of the cortical bone and consequently facial asymmetry.1,2 Clinically and imaging, they are similar to ameloblastoma and odontogenic keratocystic tumor which requires more invasive treatment.1,3,4 The precise diagnosis is es

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

The objective of this study was to review the medical records of patients with a history of mandibular angle fracture who were attended at the Service of Oral and Maxillofacial Surgery and Traumatology of FOAr/UNESP in the last 5 years. The data collected were subjected to chi-squared test (significance level of 5%). The authors reviewed 19 medical records. The main cause was physical aggression (58.00%), but with no statistical difference in relation to the other etiologies (P > 0.05). Regarding the type of fixation, one 2.0-mm system plate associated with one 2.4-mm system plate and the fixation using only two 2.0-mm system plates were used in 7 patients each. The fixation method with a monocortical plate at the upper border was used in 5 patients. However, there was no statistically significant difference in the frequency of complications among the 3 fixation methods used (P > 0.05). In 52.64% of the patients, the third molar was removed intraoperatively. Despite this, there was no statistically significant difference in the frequency of complications when the third molar was in the fracture line or when it was removed postoperatively (P > 0.05). The complications observed were dehiscence associated with pain (44.44%), trismus (22.22%), infection (22.22%), and presence of bone spicules (11.11%). However, no statistical differences were observed between the frequency of different types of complications (P = 0.779). In the sample studied, there were no differences in the frequency of complications among the fixation methods applied.

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.

Ameloblastoma is the most common benign odontogenic tumor of the jaw, being most frequently found in the mandible, especially in the body and branch regions. The treatment depends on the aggressiveness of the lesion and if not properly treated, can result in significant morbidity. The objective of this study is to report the case of a 29-year-old patient with a history of ameloblastoma which had been enucleated, recurring after 8 years of evolution. The tumor recurrence was treated through mandibular resection and reconstruction with an iliac crest bone graft. The patient is being monitored and is currently post-operative 50 months, showing no signs of recurrence to date. Ameloblastomas are lesions which present unpredictable behavior and thus require close monitoring irrespective of the treatment.Descriptors: Ameloblastoma; Mandibular Neoplasms; Odontogenic Tumors.

The aim of this study was to perform a physicochemical and morphological characterization and compare the mechanical behavior of an experimental Ti-Mo alloy to the analogous metallic Ti-based fixation system, for mandibular angle fractures. Twenty-eight polyurethane mandibles were uniformly sectioned on the left angle. These were divided into 4 groups: group Eng 1P, one 2.0-mm plate and 4 screws 6 mm long; group Eng 2P, two 2.0-mm plates, the first fixed with 4 screws 6 mm long and the second with 4 screws 12 mm long. The same groups were created for the Ti-15Mo alloy. Each group was subjected to linear vertical loading at the first molar on the plated side in a mechanical testing unit. Means and standard deviations were compared with respect to statistical significance using ANOVA. The chemical composition of the Ti-15Mo alloy was close to the nominal value. The mapping of Mo and Ti showed a homogeneous distribution. SEM of the screw revealed machining debris. For the plates, only the cpTi plate undergoes a surface treatment. The metallographic analysis reveals granular microstructure, from the thermomechanical trials. A statistically significant difference was found (P < 0.05) when the comparison between both internal fixation techniques was performed. The 2P technique showed better mechanical behavior than 1P.

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 treatment of extensive pathologic lesions in the jaw, most of the time, can generate rehabilitation problems to the patient. The solid ameloblastoma is a locally invasive odontogenic tumor with a high recurrence rate. Its treatment is aggressive and accomplished through resection with safety margin. The criterion standard for reconstruction is autogenous bone, but it can provide a high degree of resorption, causing inconvenience to the patient because of lack of rehabilitative option. This study aimed to describe a patient with ameloblastoma treated through resection and reconstruction with autogenous bone graft, in which, after an extensive resorption of the graft was made, a modified bar was applied to support a prosthetic implant overdenture.

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.

Made available in DSpace on 2018-12-11T17:01:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01 Intraoral administration of local anesthetics is one of the most common dental procedures. Although this procedure is well known for its safety, complications can still occur. A 17-year-old female patient developed transient diplopia and ipsilateral lateral rectus muscle paralysis following administration of local anesthesia for right maxillary third molar extraction. The patient was informed and proper instructions were given regarding the complications. Complete resolution occurred within 2 h. In this article, we review the clinical examination and management of this uncommon occurrence. Department of Diagnosis and Surgery Division of Oral and Maxillofacial Surgery Dental School at Araraquara - Unesp Department of Diagnosis and Surgery Division of Oral and Maxillofacial Surgery Dental School at Araraquara - Unesp