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Novas tecnologias vêm sendo aplicadas ao planejamento em reconstrução óssea para implantodontia, prova disso é a aplicação do fluxo digital e de novas técnicas reconstrutivas de menor morbidade, mais versáteis e de fácil execução. Este trabalho objetiva ilustrar o uso do planejamento reverso digital para o tratamento de um defeito ósseo horizontal por meio da técnica Screw Tent-pole. Utilizando o planejamento reverso virtual, o paciente foi diagnosticado com defeito ósseo alveolar horizontal em região estética. Parafusos foram utilizados como mantenedores de espaço e enxerto ósseo xenógeno foi inserido entre os parafusos. Após seis meses foram posicionados implantes reproduzindo o planejamento digital inicial. Ferramentas digitais de diagnóstico e planejamento são recursos valiosos na condução de casos complexos com demandas estéticas elevadas. A técnica Screw Tent-pole representa uma alternativa interessante no tratamento de defeitos em espessura, de fácil execução, baixa morbidade e custo relativamente baixo.

Obtaining a satisfactory soft tissue architecture is a requirement of fundamental importance in rehabilitation with dental implants, especially in aesthetic areas. The objective of this paper is to report a clinical case, in which a connective tissue graft was used by the VISTA technique (Vestibular Incision Subperiosteal Tunnel Access) to gain thickness of the peri-implant mucosa in the premaxillary region. Conclusion: the technique proved to be satisfactory and predictable of success, and could be an excellent alternative for procedures to increase the thickness of the peri-implant mucosa.

The loss of dental elements leads to an intense remodeling of the alveolar process, resulting in important dimensional changes, which often make it difficult to install dental implants. Considering this, the objective of the present study was to evaluate the changes in height and thickness that occurred in dental alveoli after extraction. For this, 10 patients were evaluated and submitted to extraction of dental elements and followed up in the postoperative period in which there was natural healing. Cone beam computed tomography were obtained preoperatively and 3 months postoperatively and were used as a basis for assessing loss of height and thickness that occurred. Pearson correlation test with a significance level of 5% was used to assess dimensional changes. The results showed that vertical loss (average of 2.99 mm) was greater than the horizontal loss (average of 2.52 mm). The statistical analysis pointed out the existence of a very good and significant correlation between these bone losses and also revealed that the higher the loss of height, the greater the loss of thickness. In 8 of 10 patients in the sample, some grafting was necessary prior to the installation of the implants, thus increasing morbidity and time of treatment. Considering this, it was concluded that the clot was not a viable alternative for alveolar preservation aiming posterior installation of dental implants.

OBJECTIVE: To assess bone thickness augmentation and implant survival in ridges with horizontal atrophy managed through split crest technique with concomitant installation of dental implants. MATERIALS AND METHODS: Thirteen patients with maxillary bone atrophy underwent surgery and had their bone thickness assessed through cone beam computed tomography 6 months pre- and postoperatively. Comparative measurements of initial and final bone height and thickness were taken using Dolphin Imaging(®) 11.5 software. The distance between the nasal fossa floor or the maxillary sinus and the alveolar crest determined the bone height, while the measurement of bone thickness took into account the distance between the vestibular cortical bone and the palatal cortical bone at the crest level, and at 5 mm and 10 mm from it. RESULTS: The bone height loss of 0.68 mm was statistically significant (p = 0.01). The average horizontal bone gain was 3.45 mm at ridge level, 3.03 mm at 5 mm from it and 2.42 mm at 10 mm from it. The mean horizontal gain for the three regions was 2.97 mm, and the values were statistically significant for all three regions assessed (p

The aim of this study was to analyze the survival of dental implants installed in maxillae reconstructed with autogenous iliac crest grafts and to assess patient satisfaction with the treatment by means of a questionnaire. The study conducted medical record reviews and clinical/radiographic assessments of 10 patients with severe maxillary atrophy who had undergone reconstruction with autogenous iliac crest grafts and rehabilitation with dental implants between 2008 and 2011. Patients were assessed for the survival of the implants, considering implant diameter and length, smoking status, diagnosis of diabetes, type of loss, and region of implant loss. In addition, a questionnaire with specific questions on the patients' satisfaction with the treatment was administered. Seventy-six implants were installed in the sampled patients, and only 1 loss was observed (late loss in the anterior maxilla region) after an average follow-up of 7.9 years, which corresponds to a 98.60% survival rate. The installed implants were of the most frequently used dimension (3.75 × 10 mm). One sampled patient was diabetic, and a second patient was both diabetic and a smoker. No loss of implants was observed in these 2 patients. All patients reported being completely satisfied with the treatment and would undergo the procedure again or refer it to a friend/relative. Six patients reported regular maintenance of the prosthesis, and only 3 had changed the prosthesis prior to the time of questionnaire administration. The results of this limited study with a restricted sample population suggest that the reconstruction of the maxilla with an autogenous iliac crest graft provides both adequate implant survival and patient satisfaction.

For accurate repositioning of the maxilla in Le Fort I osteotomy, bone removal around the descending palatine neurovascular bundle and maxillary tuberosity is frequently required. Such task can be challenging due to the high vascularity of the region, which is the most common site of hemorrhage during removal of bony interferences. Although a rare occurrence, ligation of the descending palatine artery in cases of intraoperative vascular damage can be related to the development of aseptic necrosis. This article reports a simple technique for retraction and protection of the descending palatine neurovascular bundle during bony removal related to a posterior maxillary impaction, which can be easily reproduced in orthognathic selected cases.

Sialolithiasis is a common disease that affects the major salivary glands and can occur at any age. Parotid glands are rarely involved and, even rarer are the cases of sialoliths larger than 10 mm. This report presents the rare case of a giant parotid sialolith associated with facial cellulitis in a 75-year-old man. The treatment involved initially non-surgical approach followed by a minimally invasive surgery to restore health and function. The treatment protocol was completely successful and proved effective in clinical and surgical management of giant parotid sialolith associated with facial cellulitis. La sialolitiasis es una enfermedad común que afecta las glándulas salivales más grandes y puede ocurrir a cualquier edad. Las glándulas parótidas casi nunca están afectadas y, aún más raros, son los casos de sialolitos de más de 10 mm. Este reporte presenta el caso de un sialolito parotídeo gigante raro asociado a celulitis facial en un hombre de 75 años. El tratamiento involvió un enfoque inicialmente no quirúrgico seguido de una cirugía mínimamente invasiva para restaurar la salud y la función. El protocolo de tratamiento fue totalmente exitoso y demostró ser efectivo en el manejo clínico y quirúrgico del sialolito parotídeo gigante asociado con celulitis facial. A sialolitíase é uma doença comum que afeta as glândulas salivares maiores e pode ocorrer em qualquer idade. As glândulas parótidas raramente são envolvidas e, mais raros ainda são os casos de sialolitos acima de 10 mm. Este relato apresenta o caso de um raro sialolito parotídeo gigante associado à celulite facial em um homem de 75 anos. O tratamento envolveu uma abordagem inicialmente não cirúrgica seguida por uma cirurgia minimamente invasiva para restaurar saúde e função. O protocolo de tratamento foi totalmente bem-sucedido e se mostrou eficaz no manejo clínico e cirúrgico do sialolito parotídeo gigante associado à celulite facial.

The satisfactory positioning of an implant during dental surgery is essential to the success of the treatment. However, accidents can occur during the period of osseointegration, leading to implant movements that hinder or may even prevent prosthetic rehabilitation. Implants can be repositioned through sandwich osteotomy, which has been labeled a versatile, viable and predictable technique in the literature. The aim of the present study was to report a case involving the esthetic displacement of an implant, caused by a sports accident, which was repositioned using sandwich osteotomy, with the interposition of lyophilized bovine bone between the osteotomized segments. In order to adequately perform this repositioning, the authors devised a guide to assist with the positioning process.

The oroantral communication is considered one of the most frequent complications in oral surgery, especially in extractions of posterior teeth in the maxilla, treatment of cystic lesions, neoplasms, osteomyelitis and trauma in the region of the maxillary sinus, forming fistulas. However, ectopic third molar and lesions such as odontomas are rarely found simultaneously in the maxillary sinus. This report shows a successful treatment performed in a specific case of oroantral communication, associated to an underdiagnosed complex odontoma and an impacted ectopic third molar into the maxillary sinus and discuss the requirement of intervention. The treatment strategy involved clinical and surgical management through the oroantral communication, avoiding additional bone access to the maxillary sinus. This proposal presented a satisfactory result, and at six months after surgery, the patient has an excellent evolution, proving to be a successful strategy. La comunicación oroantral se considera una de las complicaciones más frecuentes en la cirugía oral, especialmente en extracciones de dientes posteriores en el maxilar, tratamiento de lesiones quísticas, neoplasias, osteomielitis y traumatismos en la región del seno maxilar, formando fístulas. Sin embargo, el tercer molar ectópico y las lesiones como los odontomas rara vez se encuentran simultáneamente en el seno maxilar. En este artículo se muestra un tratamiento exitoso realizado en un caso específico de comunicación oroantral, asociado a un odontoma complejo infradiagnosticado y un tercer molar ectópico impactado en el seno maxilar y se discute la necesidad de abordaje. La estrategia de tratamiento implicó un abordaje clínico y quirúrgico a través de la comunicación oroantral, evitando el acceso óseo adicional al seno maxilar. Esta propuesta presentó un resultado satisfactorio y a los seis meses de la cirugía el paciente presenta una excelente evolución, demostrando ser una estrategia exitosa. A comunicação oroantral é considerada uma das complicações mais frequentes em cirurgia oral, principalmente nas exodontias de dentes posteriores da maxila, tratamento de lesões císticas, neoplasias, osteomielites e traumas na região do seio maxilar, formando fístulas. No entanto, terceiros molares ectópicos e lesões como odontomas raramente são encontrados simultaneamente no seio maxilar. Este relato apresenta um tratamento bem-sucedido realizado em um caso específico de comunicação oroantral, associado a um odontoma complexo subdiagnosticado e um terceiro molar ectópico impactado em seio maxilar e discute a necessidade de abordagem. A estratégia de tratamento envolveu abordagem clínica e cirúrgica por meio da comunicação oroantral, evitando acesso ósseo adicional ao seio maxilar. Essa proposta apresentou um resultado satisfatório e, aos seis meses de pós-operatório, o paciente apresenta excelente evolução, mostrando-se uma estratégia de sucesso.

Made available in DSpace on 2022-04-28T19:47:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-06-01 Maxillomandibular fixation in pediatric facial fractures is quite challenging to be achieved, especially in mid-mixed dentition. Traditional well established intermaxillary devices have a lot of limitations in these patients. This article presents a case of a 9-year-old female patient with a displaced mandibular fracture in which orthodontic buttons were used for transoperative maxillomandibular fixation followed by internal fixation after adequate occlusion reestablishment and fracture reduction. The method showed high efficacy and celerity, allowing the success of treatment, with satisfactory evolution of the patient. Piracicaba School of Dentistry University of Campinas-UNICAMP Department of Dentistry São Lucas University Center-UNISL Department of Diagnosis and Surgery Araçatuba School of Dentistry São Paulo State University-UNESP João Paulo II Hospital Rondônia State Government Department of Diagnosis and Surgery Araçatuba School of Dentistry São Paulo State University-UNESP

A reabilitacao atraves de Implantes Dentarios possui como caracteristica o restabelecimento da morfologia, funcao, estetica e a saude do sistema estomatognatico. Atualmente, esse tipo de reabilitacao e considerado o padrao ouro no tratamento para os pacientes edentulos unitarios, totais ou parciais. Com o advento de tecnicas cirurgicas modernas e assepticas, o uso de enxertos osseos para reconstrucao da regiao maxilo-facial tornou-se rotina. As reconstrucoes podem ser realizadas com a utilizacao de enxertos autogenos, alogenos, xenogenos ou aloplasticos. Em pacientes com necessidade de reconstrucoes com atrofia severa de maxila a crista iliaca e considerada o padrao ouro, devido as propriedades de osteogenese, osteoinducao e osteoconducao. No entanto, falhas falhas podem ocorrer antes da reabilitacao protetica do implante, sendo chamada de falha primaria, ou apos a reabilitacao protetica do mesmo, sendo denominada de falha tardia. O objetivo do presente trabalho e analisar a perda primaria de Implantes Dentarios instalados em maxilas reconstruidas com enxerto autogeno de crista iliaca. Para isso, foram utilizados prontuarios de pacientes submetidos a reabilitacao com Implantes Dentarios na Area de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba – FOP/UNICAMP, no periodo de Janeiro de 1996 a Dezembro de 2017.

Falhas na terapia com Implantes Dentarios podem ser atribuidas a uma serie de fatores. Essas falhas podem ser chamadas primarias ou tardias de acordo com a epoca em que ocorrem. O objetivo do presente trabalho foi analisar retrospectivamente a perda primaria de Implantes realizados na Area de Cirurgia Buco-Maxilo-Facial da FOP-UNICAMP. Foram analisadas as seguintes variaveis: genero, tabagismo, enxertia ossea previa, tipo de implante, regiao anatomica, regiao nos maxilares, alem do diâmetro e comprimento dos implantes. Na analise estatistica foi realizada uma analise descritiva e comparativa com auxilio do programa SPSS 18.0 para Windows. Para estabelecer comparacoes entre os pacientes que tiveram implantes perdidos daqueles que nao tiveram perda foi utilizado o teste qui-quadrado, sendo considerado resultado estatisticamente significativo para valores de p

This study was a comparative evaluation of the bending resistance of metallic and resorbable plates and screws in a mandibular body fracture model. Forty polyurethane synthetic hemimandibles were used; a vertical linear cut was made between the second and first premolars. These 40 hemimandibles were divided into four groups of 10 and were fixed with titanium plates and screws or resorbable plates and screws, with monocortical screws in the upper sector and bicortical screws in the lower sector. Bending resistance tests were done on a universal testing machine with a linear displacement speed of 1mm/min, a cell load of 500 N, and a load cell on the lower central incisor or on the lower second premolar. Results were analyzed using the Student's t-test, with the significance level set at 5%. No statistically significant differences were observed between the groups studied, either in the analysis of the osteosynthesis materials or related to the load-bearing points. The variables of displacement and peak load did not present any significant differences. In this in vitro model of a mandibular body fracture, the mechanical behaviour of a resorbable osteosynthesis was similar to that of a titanium osteosynthesis.

Purpose To evaluate the vertical bone gain after osteotomy sandwich. Materials and methods Fourteen patients (mean age, 41 years) underwent 17 procedures of osteotomy sandwich. Of these 17 procedures, 15 involved reconstructive surgery and 2 involved the repositioning of implants. The patients were submitted to computed tomography before the surgical procedure and 4 months after the completion of the graft, with measurements taken to assess the vertical gain that had been achieved. Results The results confirmed a satisfactory vertical gain in all cases (mean, 5.12 mm). The use of autogenous graft or biomaterial particles (in isolation) between the osteotomized segments proved to be viable. Three patients reported postoperative paresthesia, which healed spontaneously after 3 months. One patient exhibited dehiscence due to not following the postoperative recommendations. Forty implants were installed in the grafted regions, and 2 implants were repositioned. Conclusion The technique of sandwich osteotomy was found to be effective for height gain, and different materials can be used between the osteotomized segments.

PROPOSAL Evaluate pulp vitality of mandibular teeth after chin bone harvesting. MATERIALS AND METHODS Thirty patients underwent chin bone harvesting and accompanied for 12 months, being submitted to testing for pulp vitality with Endo Ice refrigerant spray to produce a local temperature of -50 °C. The statistical analysis was executed with McNemar test with P value < 0.05. RESULTS Results show that canine teeth are most susceptible to alterations; 68.82% (181) of the teeth tested showed no loss of pulp sensitivity to cold 30 days after surgery (P < 0.05), and at the end of the study, that figure had risen to 100% (263) of all teeth included in the sample. CONCLUSIONS Pulp vitality testing showed that 31.18% (82) of teeth experienced some loss of sensitivity, but by 12 months after surgery, all teeth had recuperated their pulp sensitivity to cold unaided.

To evaluate patients' perceptions of alterations occurring after chin bone harvesting.Thirty patients were evaluated subjectively by visual analog scale-related sensitivity, facial aesthetics, eating, speaking, and lower lip movement, during 12 months. Objective analysis used the static light touch neurosensorial test. The statistical analysis was executed with Friedman test with P0.05 for both samples.Subjective analysis revealed no alterations (1) to facial aesthetics, eating, speaking or lower lip movement but sensitivity of the mental region went from a lot of alteration initially (5) to little at the end of the study (3). Objective analysis results showed normal sensitivity (1) in the region after 12 months.The discrepancy between subjective and objective analyses may be indicative of the limited precision of clinical testing for subjective impressions assessment.

El objetivo de esta investigación fue describir la influencia del diámetro y largo de los implantes en la pérdida tardía del implante. Se diseñó un estudio retrospectivo para estudiar 375 pacientes que habían sido sometidos a rehabilitación oral sobre implantes durante un periodo de 11 años; se incluyeron en el estudio todos aquellos documentos debidamente completados y con estudios radiográficos preoperatorios, posterior a la instalación del implante y posterior a la instalación de la prótesis. Los implantes fueron clasificados de acuerdo al diámetro como estrecho, regular y ancho y de acuerdo al largo como corto, medio y largo; el análisis de datos fue realizado con la prueba Chi Cuadrado con valor de p

El retiro de hueso de sínfisis mandibular ha sido utilizado ampliamente para diferentes procedimientos reconstructivos maxilofaciales. El objetivo de esta investigación fue establecer la existencia de la reparación ósea en el defecto creado en sínfisis debido al retiro de hueso. Treinta pacientes (22 mujeres, 8 hombres) de entre 21 y 65 años fueron operados para retirar hueso de mentón que fue posteriormente aplicado en reconstrucción ósea alveolar; las cirugías fueron realizadas por dos cirujanos maxilofaciales y los pacientes fueron evaluados con telerradiografías en la etapa preoperatoria, postoperatoria inmediata (PIn) y postoperatoria tardía (PTar), donde se realizaron medidas horizontales y verticales del defecto óseo; los valores fueron estudiados con la prueba t de Student con valor de p

The aim of this prospective research was to assess soft tissue morbidity in the symphyseal region after bone graft harvest- ing. Thirty patients, with average age 45 years, underwent symphy- seal bone graft harvesting followed up for a period of 12 months. Follow-up involved neurosensory testing of 2-point discrimination, static light touch, brush directional stroke, pinprick, and thermal dis- crimination to cold and hot; the statistical analysis was performed using McNemar test and Friedman test with P G 0.05. The results showed that 50% of patients had postoperative morbidity in the first month after surgery showing statistical positive relation with surgery (P G 0.05); at 6 months, this situation diminished to 23%, and at the end of the monitoring period (1 year); the neurosensory tests revealed no persistent morbidity. In conclusion, all neurosensory tests revealed high morbidity in the first month with total resolutions at 1-year follow-up; however, this complication associated to surgery is indispensable to discharge the patient properly.

Resumo Inicialmente, o perfil dos pacientes que se submetiam a terapias com implantes dentarios eram basicamente constituidos por individuos idosos edentulos totais. Atualmente, esse perfil vem mudando a cada dia, sendo observada uma reducao cada vez maior na quantidade de pacientes totalmente desdentados. Sendo assim, o objetivo do presente trabalho foi avaliar retrospectivamente o perfil dos pacientes submetidos ao tratamento com implantes dentarios na Area de Cirurgia Bucomaxilofacial da FOP/Unicamp no periodo de junho de 2003 a julho de 2010. Os resultados mostram que a faixa etaria que mais se submeteu ao tratamento foram adultos entre 40-49 anos (29,63%), enquanto que apenas 14, 11% dos individuos apresentavam 60 anos ou mais. O tipo de reabilitacao mais comum foram as reabilitacoes unitarias (50,23%), seguidas pelas reabilitacoes multiplas (34,50%) e totais (15,27%). Em conclusao podemos afirmar que neste estudo os pacientes adultos jovens (30-49 anos) foram os que mais buscaram reabilitacao com implantes, sendo estas em sua maioria reposicoes unitarias.

Tooth loss is followed by a natural bone resorption process that often leads to defects in the alveolar ridge, making the installation of dental implants unfeasible. Correction of such bone defects, especially loss of height of the ridge or associated loss of thickness, is a great challenge to dental surgeons. The technique of segmental osteotomy accompanied by interpositional bone grafting has been shown to be a viable option for addressing the problem. This report describes a successful application of the technique in the treatment of vertical dimension deficiency in the posterior maxillary region. Four months after graft surgery, 3 implants were successfully placed in accordance with the original reverse planning.

This study sought to evaluate changes in the soft tissue contour after chin bone graft harvesting. Thirty selected patients underwent chin bone graft harvesting and evaluations were made using lateral cephalograms preoperatively and postoperatively at 30 and 180 days. Fixed points and lines were established on cephalometric tracings and used to measure the selected vertical and sagittal parameters. Results showed statistically significant alterations to the vertical position values of the vermilion (V-VPV) which increased from 9.70 to 11.01 and the exposure of lower incisors (V-ELI) which increased from 1.85 to 3.5, showing an increase in their distance from the plane of reference and a lowering of their position, the clinical equivalent of a labial ptosis condition. None of the sagittal parameters analysed showed any statistically significant variation in the final evaluation. The study concluded that the alterations to patients' soft tissue contours resulted mainly from failure to ensure precise reattachment of the mentalis muscles and identified the need for further investigation of that aspect.

Maxillary sinus floor augmentation procedure, aka sinus floor lift surgery, stand out within the universe of bone reconstruction given that the maxillary sinus is a closed cavity with favorable nutrition, which enables the use of biomaterials alone. Therefore, this study aimed to report and discuss the technical and biological peculiarities of Lumina-Porous® biomaterial alone in the maxillary sinus by describing a sinus lift case which presented with little remaining bone. After the graft incorporation period two implants were installed in the grafted area to provide proper patient rehabilitation.

ResumoActualmente existe uma grande demanda de pacientes que necessitam de tratamentos com implantes dentários osseointegráveis, entretanto esta situação é muitas vezes dificultada por alterações no rebordo alveolar desdentado, o que pode tornar a instalação do implante mais complicada. Os enxertos ósseos autógenos são nos dias actuais os tratamentos de escolha para aqueles pacientes com volume de osso insuficiente e que desejam receber implantes osseointegráveis. Sendo assim, o objectivo deste trabalho foi analisar retrospectivamente o uso de enxerto ósseo autógeno em pacientes tratados pela área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba, da Universidade Estadual de Campinas no período de Junho de 2001 a Julho de 2008. Os resultados mostram que as áreas doadoras intrabucais foram utilizadas em 95,1% dos casos, sendo que a tuberosidade maxilar foi empregada em 39,8% dos casos, o ramo ascendente em 31,4% e a sínfise mandibular em 28,8% dos casos. O enxerto em bloco “onlay” foi à técnica mais usualmente empregada (53,7%), seguida pelo enxerto com osso particulado (36,6%) e pelo levantamento de seio maxilar (9,7%). Em conclusão, sempre que possível devemos optar por áreas doadoras intrabucais, e no presente trabalho essas áreas doadoras foram as mais comummente empregadas, sendo a tuberosidade maxilar a mais utilizada.AbstractCurrently, there is great demand for patients who requires treatment with bone integrable dental implants, however this situation is often hampered by the changes in the edentulous alveolar ridge, which may make the installation of the implant more complicated. The autogenous bone graft are current days the choice of treatments for patients with insufficient bone volume to receive implants and that to receive bone integrable implants. The purpose of this study was to evaluate retrospectively the use of autogenous bone graft in patients treated in the Surgery Area of Oral and Maxillofacial from the College of Dentistry of Piracicaba, by de State University of Campinas in the period July 2001 to July 2008. The results show that the intraoral donors areas were used in 95,1% of the cases, and that the maxillary tuberosity was used in 39.8% of the cases, the ascending branch in 31,4% and the mandibular symphysis in 28,8% of the cases. The “onlay” block graft was the most commonly technique employed (53,7%), followed by the particulate bone graft (36,6%) and by sinus lifting of the maxillary (9,7%). In conclusion, whenever possible we should choose intraoral donors areas, and in this work, these donors areas were the most commonly employed, and the maxillary tuberosity the most used.