Search

Maxillary sinus lifting is a procedure for bone height gain in atrophic jaws. New safe and less complex manners have been evalueted, which use modifications of conventional techniques, through technologies such as devices and equipment that make them less traumatic. This study aims to conduct a literature review of articles found in the PubMed database between the years 2015 and 2020 that addresses advances in Maxillary sinus lifting techniques. We noticed that there is a development in the techniques that promotes the reduction of operative time, perforations and consequently a better postoperative for the patient, reducing the unpleasant perception of the surgery. The use of surgical ultrasound reduces the trauma to the soft tissues and the number of membrane perforations. A great step in the development of the sinus membrane lifting technique was the perception that bone formation is possible with the detachment of the membrane, not requiring the placement of a graft. There is no technique that replaces Maxillary Sinus Lifting yet. Only to improve it.

A extração de terceiros molares superiores é um procedimento cirúrgico comum aos cirurgiões-dentistas e que pode acarretar complicações e acidentes, como o deslocamento do elemento dentário para os espaços faciais. Objetivo: Relatar um caso de deslocamento de terceiro molar para a fossa infratemporal (FIT). Relato de caso: Paciente do sexo feminino procurou o serviço de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Regional de Osasco (SP), após apresentar sintomatologia dolorosa decorrente de insucesso e consequente deslocamento dentário para a FIT. O tratamento proposto e conduzido foi a remoção do dente deslocado via acesso intraoral sob anestesia geral. Conclusão: O profissional precisa estar capacitado tanto para a realização do procedimento como para o tratamento em casos de acidentes e complicações decorrentes da remoção cirúrgica desses dentes. Em casos de deslocamento para a FIT, diversas abordagens podem ser utilizadas, e cabe ao cirurgião-dentista escolher o tratamento indicado para cada situação.

This clinical note describes a case report where the patient notices that one of the symptoms suffered during COVID-19 infection is a mononeuropathy of the branches of the maxillary nerve, reviewing in the literature the findings of the affinity of the coronavirus to nerve fibers.

Objective. The aim of the study is to analyze the microbiota of the maxillary sinus of sheep as a viable biome to carry out experimental studies of biomaterials. Materials-Methods. 13 sheep (eight in isolation and five loose created) were used, making 26 maxillary sinuses, where swabs were performed by an extra-oral approach for microbiological analysis. Statistical tests such as Fisher's exact test, Mann Whitney U test, chi-square test, and proportional means were used in the experiment. Results. Only eight maxillary sinuses had positive bacterial growth. The presence of Staphylococcus aureus was statistically significant relative to other microorganisms found. On the other hand, among the animals in isolation and those raised loose, there was no statistically significant difference in the presence of Staphylococcus aureus. Conclusion. Staphylococcus aureus is the predominant bacteria in the maxillary sinus of this experimental model. The difference in environment and feeding did not influence the microbiota of the maxillary sinus. Objetivo. El objetivo del estudio es analizar la microbiota del seno maxilar de las ovejas como bioma viable para realizar estudios experimentales de biomateriales. Materiales-Métodos. Se utilizaron 13 ovejas (ocho aisladas y cinco sueltas creadas), lo que supone 26 senos maxilares, en los que se realizaron hisopos por vía extraoral para su análisis microbiológico. En el experimento se utilizaron pruebas estadísticas como el test exacto de Fisher, el test U de Mann Whitney, el test de chi-cuadrado y las medias proporcionales. Resultados. Sólo ocho senos maxilares presentaron un crecimiento bacteriano positivo. La presencia de Staphylococcus aureus fue estadísticamente significativa en relación con otros microorganismos encontrados. Por otra parte, entre los animales aislados y los criados sueltos, no hubo diferencias estadísticamente significativas en la presencia de Staphylococcus aureus. Conclusión. Staphylococcus aureus es la bacteria predominante en el seno maxilar de este modelo experimental. La diferencia de entorno y alimentación no influyó en la microbiota del seno maxilar. Objetivo. O objetivo do estudo é analisar a microbiota do seio maxilar de ovelhas como um bioma viável para realizar estudos experimentais de biomateriais. Materiais-Métodos. Foram utilizadas 13 ovelhas (oito isoladas e cinco criadas soltas), fazendo 26 seios maxilares, onde foram realizados esfregaços através de uma abordagem extra-oral para análise microbiológica. Foram utilizados os testes estatísticos exato de Fisher, Mann Whitney U, qui-quadrado, e meios proporcionais. Resultados. Apenas oito seios maxilares tiveram um crescimento bacteriano positivo. A presença de Staphylococcus aureus foi estatisticamente significativa em relação a outros microrganismos encontrados. Por outro lado, entre os animais em isolamento e os que foram criados soltos, não houve diferença estatisticamente significativa na presença de Staphylococcus aureus. Conclusão. O Staphylococcus aureus é a bactéria predominante no seio maxilar deste modelo experimental. A diferença no ambiente e na alimentação não influenciou a microbiota do seio maxilar.

The treatment of mandibular angle fractures presents several possibilities for fixation methods and surgical approaches which can be intraoral or can be accessed through the skin. An important point would be intraoperative occlusal restoration. We present a method that replaces the traditional form using an erich bar and which, in our view, is a fast and effective method for intraoperative occlusal restoration.Descriptors: Inter Maxillary Fixation (IMF); Occlusion; Arch Bar Fixation.ReferencesJohnson AW. Dental occlusion ties: A rapid, safe, and non-invasive maxillo-mandibular fixation technology. Laryngoscope Investig Otolaryngol. 2017;2(4):178-83.Abbasi AJ, Parvin M. New method of arch bar fixation. Br J Oral Maxillofac Surg. 2017;55(6):631-32.Shinohara EH, Mitsuda ST, Miyagusko JM, Horikawa FK. Mandibular fracture reduction without intraoperative intermaxillary fixation: a technique using two modified reduction forceps. J Contemp Dent Pract. 2006;7(1):150-56.

Made available in DSpace on 2018-11-26T16:05:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-09-01 Objective: A biomechanical analysis of fixation devices to repair fractures or osteotomies of the mandible is carried out in hemi-mandibles fixed in the condylar process, the force is applied in the molar region and a single movement is allowed. This technical note presents a new setup for evaluating the biomechanics of the mandible with the following improvements: (1) providing freedom of mobility in three axes in the space; (2) applying forces in a way that closely replicates that of real cases; (3) capable of evaluating the fracture resistance and the stiffness and elastic recovery. Method: A rigid metal support mounted on bearings was developed that allowed the movement and deformation of the mandible during load application to mimic its freedom of movement when in function. Steadying was only in the mandibular fossae and free in all other regions. Ten fresh sheep mandibles were subjected to testing of their rigidity and capacity for elastic recovery after a displacement of 0.75 mm. Results: After three displacement cycles, the mean value of stiffness was 506 +/- 64 N/mm, and the mandibles showed visco-elastic recovery. Conclusion: This new apparatus and approach is promising for use in the evaluation of mandibular fixations. Univ Sao Paulo, Sch Dent, Dept Biomat & Oral Biol, Sao Paulo, SP, Brazil Univ Sao Paulo, Sch Dent, Dept Oral & Maxillofacial Surg, Av Prof Lineu Prestes 2227, BR-05508900 Sao Paulo, Brazil Univ Estadual Paulista, Grad Program, Aracatuba Dent Sch, Sao Paulo, SP, Brazil Univ Estadual Paulista, Grad Program, Aracatuba Dent Sch, Sao Paulo, SP, Brazil

Displaced fractures of the zygomatic bone that require surgical treatment are accessed transcutaneously but these accesses to the skin can cause a hypertrophy scar in patients with this predisposition. This paper indicates a modification in the lateral canthotomy that aim to minimize the hypertrophic scar in the treatment of zygomatic fracture.

Purpose: To analyze the process of repair of bone defects in diabetic rats filled with autogenous bone and covered with membranes of homogenous bone matrix or expanded polytetrafluoroethylene (ePTFE). Materials and Methods: One hundred twenty male rats were divided into two groups: group 1 (IC), without systemic alterations (control), received an intravenous injection of citrate buffer at 0.01 M, pH 4.5; group 2 (IID) (diabetic) received an intravenous injection of streptozotocin (Sigma-Aldrich) dissolved in 0.01 M citrate buffer (pH 4.5) at a concentration of 35 mg/kg. After glycemic control was achieved, the rats were subdivided into three groups: SM (surgical cavity of the left tibia filled with autogenous bone graft, not covered by membrane); MH (surgical cavity filled with autogenous bone graft and covered with homogenous membrane); and MX (surgical cavity filled with autogenous bone graft and covered with synthetic ePTFE membrane). At 10 and 60 days, the defects in the tibiae were analyzed histologically and histometrically. Results: At 10 days, no statistically significant differences were found between the groups. However, the bone tissue of the diabetic group was qualitatively worse than that of the control group. At 60 days, a delay was found in the bonerepair process in wounds covered by the membranes regardless of the systemic state, but the quality of the newly formed bone in the wounds covered by the membranes was better in both groups. At 60 days, the diabetic group treated with homogenous membrane experienced less bone formation when compared with the nondiabetic group, and this difference was statistically significant. Such differences were even greater between the groups treated without the membrane (P < .01). Conclusion: The homogenous membrane exhibited excellent biocompatibility and was incorporated into the newly formed bone in later periods, both in diabetic and nondiabetic rats.

EditorialCaro(a) Leitor(a)Em 11 de abril de 2019, aconteceu o VIII Encontro de Pesquisa e Bioética e V Jornada de Egressos do Mestrado em Odontologia da Universidade Ibirapuera (UNIB), um evento que contou com especialistas que discutiram questões científicas, éticas e metodológicas pertinentes à pesquisa científica, promovendo a atualização e aprofundamento no conhecimento para o desenvolvimento de pesquisas clínicas e laboratoriais, de boas práticas clínicas e rigor no delineamento metodológico. Além disso, foram abordados temas de interesse direto ao Programa de Mestrado em Ciências Odontológicas, como produção científica e a internacionalizaçãoParticiparam alunos de graduação envolvidos em TCC e iniciação científica, alunos de pós-graduação/egressos (stricto e latu sensu), profissionais vinculados ao ensino e pesquisa, professores da pós-graduação e graduação (áreas de saúde, exata e humanas).Prof. Dr. Elio Hitoshi Shinohara - PresidenteVIII Encontro de Pesquisa e Bioética - V Jornada dos Egressos do Mestrado em Odontologia

A male patient with facial trauma by road traffic accident arrived in the emergency room and he was assisted by the Trauma and Neurosurgery team. After clinical evaluation a frontal sinus anterior wall fracture plus a nasal fracture were diagnosed. On the primary OMS examination was checked multiple facial lacerations and gross nasal dorsum deviation with pain, nasal airway obstruction and crepitus with clinical diagnosis of a nasal fracture. After radiologic exam a piece of windshield glass that was superimposed on the nasal bones simulating a nasal fracture was visualized. This paper presents clinical data and literature review of foreign body mimicking facial fractures. Descriptors: Road Traffic Accident; Facial Fractures; Windshield Glass. Referencias Mazinis E, Lambrianidis T, Margelos J. Detection of a residual foreign body during root canal treatment. J Endod. 2005;31(9):691-93. Gray ST. Windshield safety glass foreign body masquerading as a root fragment. Dentomaxillofac Radiol. 1994;23(1):49-51. Goldstein E, Gottlieb MA. Foreign bodies in the nasal fossae of children. Oral Surg Oral Med Oral Pathol. 1973;36(3):446-47 . Madhere S, Barba CA, Painter RL, Morgan AS. Aspiration of shattered windshield glass after blind nasotracheal intubation in a motor vehicle crash. J Trauma. 1997;43:353-56.

The Organoid Nevus Syndrome (ONS) is associated to skin, ocular and neurological anomalies. The musculoskeletal system may be affected by different bone injuries, in which facial bones are rarely affected. The present study aims to report the association of a bone injury (Central giant cell granuloma) in the maxilla of a patient with Organoid Nevus Syndrome. The case report is a nine-year-old male patient, showed bilateral eye injury diagnosed as choristoma, scalp alopecia over the right parietal region of the scalp attributable to a sebaceous nevus, congenital cafe-au-lait spots distributed over the chest, as well as facial asymmetry in the left orbital and maxillary region. Intraoral examination showed a hardening in the maxillary alveolar ridge, CT scan showed expansile osteolytic injury involving the left maxilla. The treatment included curettage with peripheral ostectomy. Patient has been undergoing monitoring for 3 years without signs or symptoms of recurrence of the injury. Despite the circumstances associated to the syndrome, our patient did not require a special treatment of its maxillary injury. However, it is recommended, at diagnosis, that systemic investigation is performed by the professionals, in order to ensure premature diagnosis of the syndrome and prevent the sequelae of delayed treatment.

Fibroma ossificante central (FOC) é neoplasia fibro-óssea benigna que foi primeiramente descrita por Menzel em 1872. O FOC também é chamado de Fibroma Cementificante ou Fibroma Cemento-Ossificante por apresentar um tecido fibrocelular composto de material mineralizado que microscopicamente apresenta trabéculas ou esférulas de material ósseo ou cementoide em estroma de tecido conjuntivo fibroso. O FOC acomete em sua maioria mulheres, entre a segunda e quarta década de vida, mais comumente na região posterior de mandíbula e possui como característica um crescimento volumétrico lento e indolor. Apesar de evidências científicas sobre a malignização do FOC não terem sido encontradas, a ausência de tratamento implica em continuo crescimento da lesão podendo levar a assimetria facial e distúrbios na acuidade visual. Neste relato, nós descrevemos o caso de paciente diagnosticada com FOC em hemimaxila esquerda, atendida no serviço de cirurgia e traumatologia bucomaxilofacial do Hospital Regional de Osasco “Dr.Vilvaldo Martins Simões”, em Osasco-SP, Brasil.Descritores: Neoplasias Ósseas; Fibroma Ossificante; Maxila.

The acute dislocation of the temporomandibular joint (TMJ) is usually reduced using the Hippocratic method/Nelaton maneuver. It is recommended the temporary immobilization of TMJ for pain relief and remission of the inflammatory process that affects the ligaments and articular capsule. This containment is traditionally made with cotton bands but difficult to find if this type of material in a dental office. We present a simple method of mandibular immobilization using disposable surgical mask. We believe it’s as effective as the traditional bandage, easily and quickly applied, cheaper and made with material that is readily available in dental offices. We are using this device for more than 15 years with excellent results and we recommend the use.Descriptors: Temporomandibular Joint; Fracture Fixation; Immobilization.

A pseudoquililose da articulação temporomandibular (ATM) é uma condição rara muito menos frequente que as anquiloses intracapsulares (verdadeiras). A infecção, o trauma e a artrite são algumas das causas das limitações progressivas para a abertura da boca. O tratamento mais comum consiste em coronoidectomia unilateral ou bilateral. Este artigo tem como objetivo relatar dois casos clínicos de pacientes com pseudoanquilose da ATM devido a uma lesão causada pelo ferimento de arma de fogo, submetidos a coronoidectomia unilateral e remoção de projéteis de arma de fogo sob anestesia geral e acesso intraoral.Descritores: Articulação Temporomandibular: Anquilose; Cirurgia Bucal.

The technique of sagittal split osteotomy of the mandibular ramus is an established technique that has been evolving over the years, with significant improvements regarding stability, better bone contact between the segments, and possibilities of osteosynthesis. However, paresthesia is common in the postoperatory, sometimes permanent, and undesirable fractures in the subcondylar region can occur leading to longer operative time and extraoral scars. The short lingual split technique is an easy technique that simplifies the horizontal osteotomy of the ramus and decreases the risk of undesirable fractures with a neurosensitive recovery of patients in a much shorter time because of minor trauma and nerve manipulation during the execution.

Surgical treatment of panfacial fractures usually requires intraoperative temporary occlusion of the teeth and simultaneous access to the nasal pyramid. In such cases, the standard method of airway management is to perform a tracheostomy, but this may be associated with a significant number of perioperative and late complications. This study aimed to determine if submental endotracheal intubation (SEI) is a viable alternative to tracheostomy, especially when short-term postoperative control of the airway is foreseen. This was an observational retrospective study, carried out between 2012 and 2014, which involved 32 consecutive patients who sustained panfacial fractures and were surgically treated during a 3-year period in a level I trauma center hospital. Only those who required SEI were included in the sample. Four cases were excluded because of incomplete registries, follow-up period less than 4 months after hospital discharge, or other unrelated complications. The medical charts of all patients involved in the sample were carefully reviewed in order to qualify and quantify perioperative and postoperative complications related to anesthetic management. We hypothesized that SEI would not interfere with the surgical procedures and would present less morbidity and reduced complication rates. Twenty-eight patients, 24 male and 4 female, met all the inclusion criteria. The mean age was 29.5 ± 9.05 years (range, 18–56 years). The mean duration time of surgery was 8.07 ± 4.0 hours (range, 4–16 hours). There were no perioperative complications. Postoperatively, only 1 patient (3.57%) experienced a cutaneous infection at the submental region, which was easily treated. Additionally, only 1 case (3.57%) of hypertrophic scar was reported. SEI appears to be a safe, simple, and effective technique of immediate perioperative airway management in selected cases of panfacial fractures.

The superior orbital fissure is a crack that communicates with the middle cranial fossa and is located between the greater and lesser wings of the sphenoid in the posterior region of the orbit. It presents a close relationship with several important structures such as the optic foramen and II, III, IV, V and VI cranial nerve and the sphenoid and ethmoid sinuses. Zygomatic-orbital fracture may trauma in the posterior region of the orbit and may result in the Superior Orbital Fissure Syndrome (SOFS) or Apex Orbital Syndrome (AOS). The superior orbital fissure syndrome results from compression structures that pass this region, resulting in paralysis of the cranial nerves III, IV and VI. Clinically, the patient has ptosis, mydriasis and ophthalmoplegia, it is very important that the diagnosis is made before the surgical manipulation of reduction and fixation of zygomatic fracture. Case report: A male patient, 37, hit and run victim was survived by Trauma Surgery Team. Diagnosed with head trauma and diffuse axonal injury, it was transferred to the Intensive Care Unit (ICU) where he stayed for three weeks. It was conducted by the Oral and Maxillofacial Surgery and was diagnosed zygomaticomaxillary fracture type Le Fort III and mandibular fracture associated with SOFS. The surgical treatment of mandibular and zygomaticomaxillary fractures was conducted. The ptosis devolved and postoperative 6 months was noted complete remission of the syndrome signals.Descriptors: Craving; Optical Nerve; Syndrome; Cranial Nerve.

Burkitov limfom agresivni je oblik non-Hodginova limfoma B-stanica. U ovom prikazu dajemo presjek podataka o tom limfomu iz literature i ukratko navodimo njegove kliničke, etiološke, genske i histopatološke aspekte. Opisujemo i slučaj Burkitova limfoma u obliku maksilarne otekline kod HIV-negativnog 35-godišnjeg muškarca crne rase. Klinički izgled toga limfoma može se zamijeniti s nizom poremećaja u usnoj šupljini. Moramo istaknuti da je za njegovo rano otkrivanje u usnoj šupljini i u maksilofacijalnom području nužno razumijevanje bolesti i njezine etiologije te pravodobni diferencijalnodijagnostički postupak. Samo će se tako izbjeći prekasna i neodgovarajuća terapija., Burkitt’s Lymphoma is an aggressive form of non-Hodgkin's B-cell lymphoma. Here, we review the literature on Burkitt’s Lymphoma and briefly summarize some clinical, etiological, genetic and histopathological aspects. We also present a case of Burkittt’s lymphoma presenting as a maxillary swelling in an HIV-negative 35-year-old black man. The clinical presentation of Burkitt’s Lymphoma can be confused with a variety of other disorders in the oral cavity. Understanding the disease, its epidemiology, and including it in the differential diagnosis is essential for early detection of Burkitt’s lymphoma of the oral and maxillofacial area, in order to avoid delay and inappropriate treatment strategies.

ResumenIntroducciónLa articulación temporomandibular (ATM) puede ser afectada por alteraciones que comprometan su morfología y fisiología normales, llevando al cirujano, en algunos casos, a la necesidad de resecarla y reconstruirla. La reconstrucción de los defectos óseos de la ATM ha sido un desafío para el cirujano maxilofacial y puede ser realizada utilizando injertos autógenos o materiales aloplásticos. Entre estos materiales resaltamos la prótesis total de ATM, que en su forma y composición actual cumplen las exigencias de reposición funcional. Entre las diferentes prótesis, resaltamos el modelo de la prótesis W. Lorenz®, de alta tecnología y con detalles específicos que determinan una gran mejoría clínica y funcional.ObjetivoEste estudio evalúa los aspectos clínicos y funcionales observados en pacientes tratados quirúrgicamente.Materiales y métodosEn este estudio fueron evaluados 15 pacientes entre 24 y 44 años de edad, sometidos a colocación de 23 prótesis totales de ATM, siendo 8 bilaterales y 7 unilaterales entre el año 2000 y el año 2008, siendo todas las cirugías realizadas por el mismo cirujano.ResultadosSe observó una gran mejoría funcional, particularmente en los casos de anquilosis de ATM.ConclusionesSe deben realizar más estudios y seguimientos clínicos para establecer a largo plazo si estas prótesis ofrecen realmente una mejoría efectiva para el sistema estomatognático, con una fisiología duradera.AbstractIntroductionThe temporomandibular joint (TMJ) can be affected by injuries that alter its morphology and compromise its normal function, and in some cases leading to the need for surgery to resect it and rebuild it. The reconstruction of the TMJ bone articular defects has been a challenge for the maxillofacial surgeon. It can be achieved by using alloplastic materials. Among these, we highlight the total temporomandibular joint prosthesis, developed until achieving its current form and composition, and which has led to the establishment of clear protocols for its use. Among these, we highlight the W.Lorenz™ prosthesis with a high technology and specific details that lead to an increased clinical and functional improvement.ObjectiveTo study the important clinical and functional aspects observed in surgically treated patients.Materials and MethodsThis study evaluated 15 patients between 24 to 44 years, who underwent TMJ replacement surgery with 23 TMJ implants, 8 bilateral and 7 unilateral, between the years 2000 to 2008. All surgeries were performed by the same surgeon.ResultsA large increase in functional improvement was observed, particularly in the cases of TMJ ankylosis.ConclusionsMany more studies and monitoring should be conducted to establish, especially in the long term, that these prostheses offer the stomatognathic system an effective and durable physiology.

Fraturas mandibulares são comuns dentre as fraturas faciais. Acidentes automobilísticos e agressões físicas estão entre as principais etiologias. Quando tratadas de forma adequada, raramente ocorrem complicações. Este trabalho relata paciente com fratura de parasínfise direita, tratada temporariamente com redução fechada via barra de Erich e bloqueio maxilomandibular (BMM) para conforto do paciente e posterior conduta cirúrgica. Perdido de seguimento, o paciente retornou após 6 (seis) semanas, já com o BMM aberto, drenagem purulenta via fistula cutânea e pseudoartrose mandibular. Optou-se por correção de pseudoatrose com redução aberta e fixação interna estável com uso de miniplaca de reconstrução mandibular.Descritores: Pseudoartrose; Fraturas Mandibulares; Fixação Interna de Fraturas; Procedimentos Cirúrgicos Bucais.

Surgeries for dentofacial deformity correction are procedures which are executed with considerable frequency nowadays and, due to their complexity concerning complications inherent to technique, such as arteriovenous lesions or even surgery time, may cause severe hypovolemia. Necessity of replacement of blood level through infusion of crystalloid solutions, colloids or even blood transfusion is always mandatory. This way, it is proposed in this study to quantify blood loss, as well as evaluate necessity of blood transfusion in 19 patients who underwent maxilla expansion. It was evaluated average arterial pressures, surgery procedure time, gender, volemic loss and ASA classification. Average blood loss was 296,84mL, with minimal value of 50mL and maximum 1000mL. We can conclude that hypovolemia and blood transfusion request in such surgeries was of small number, however, professionals should always be aware of surgical time and development of discerning surgical technique.Descriptors: Surgery; Hypovolemia; Blood Transfusion.

As lesões faciais causadas por arma de fogo ainda são motivo de muita preocupação no âmbito da saúde pública e podem causar grandes prejuízos estéticos e funcionais para o paciente, além de perda de qualidade de vida. Sendo assim, o objetivo deste estudo é relatar um caso clínico de paciente do sexo masculino, 39 anos, encaminhado por policiais militares à equipe de cirurgia e traumatologia bucomaxilofacial para avaliação de lesão facial apresentando trauma em face decorrente de projétil de arma de fogo, foi submetido à cirurgia para a remoção do projétil e reconstrução maxilofacial em ambiente hospitalar, sob anestesia geral, devido às condições sistêmicas do paciente. Foi removida a jaqueta do projétil alojada em mucosa jugal direita e fragmentos dentários que se encontravam na linha de trajeto do projétil. Notou-se mobilidade do segmento anterior da mandíbula e lacerações em mucosa oral interna. No quarto dia foi realizada glossectomia parcial, em região de terços anterior e médio e fixação de fratura. Optou-se pelo acesso extraoral, realizou-se remoção de fragmentos ósseos, redução da fratura em sínfise, instalação de placa de reconstrução do lado esquerdo e placa e parafusos de 2,0 mm em sínfise, sendo os parafusos bicorticais em zona compressiva e monocorticais em zona de tração. Foi possível concluir que a redução aberta com fixação com placas e parafusos é uma boa opção de tratamento para fraturas cominutivas causadas por projéteis de arma de fogo, devolvendo ao paciente aspectos estéticos, funcionais e psicológicos.Descritores: Ferimentos por Arma de Fogo; Fraturas Mandibulares; Glossectomia.

To assess the role of ultrasonography as a possible tool for diagnosis of intra-osseous lesions.Our sample comprised five macerated pig jaws. The regions of bony crypts of third molars were examined on both sides, totaling 10 examinations. The degrees of difficulty for both ultrasound image visualization and bone translucency were rated by two groups of evaluators (i.e. dental radiologists and physician ultrasonographers).Our results showed that it is possible to detect images of the intra-osseous cavity at a low-degree difficulty by using both radiographic and ultrasonic techniques (46.6% and 43.3%, respectively). However, the crypts were not fully detected by both groups (16.6% and 13.3%, respectively).We concluded that ultrasonography is a useful method for evaluation of intra-osseous lesions in jaws, provided that the cortical bone is thin enough to allow ultrasound waves to pass through.

This study used bovine ribs to comparatively assess the deformation, roughness, and mass loss for 3 different types of surface treatments with burs, used in osteotomies, for the installation of osseointegrated implants.The study used 25 bovine ribs and 3 types of helical burs (2.0 mm and 3.0 mm) for osteotomies during implant placement (a steel bur [G1], a bur with tungsten carbide film coating in a carbon matrix [G2], and a zirconia bur [G3]), which were subdivided into 5 subgroups: 1, 2, 3, 4, and 5, corresponding to 0, 10, 20, 30, and 40 perforations, respectively. The surface roughness (mean roughness [Ra], partial roughness, and maximum roughness) and mass (in grams) of all the burs were measured, and the burs were analyzed in a scanning electron microscope before and after use. Data were tabulated and statistically analyzed by use of the Kruskal-Wallis test, and when a statistically significant difference was found, the Dunn test was used.There was a loss of mass in all groups (G1, G2, and G3), and this loss was gradual, according to the number of perforations made (1, 2, 3, 4, and 5). However, this difference was not statistically significant (P.05). Regarding the roughness, G3 presented an increase in Ra, partial roughness, and maximum roughness (P.05) compared with G2 and an increase in Ra compared with G1. There was no statistically significant difference (P.05) between G1 and G2. The scanning electron microscopy analysis found areas of deformation in all the 2.0-mm samples, with loss of substrates, and this characteristic was more frequent in G3.The 2.0-mm zirconia burs had a greater loss of substrates and abrasive wear in the cutting area. They also presented an increased roughness when compared with the steel and the tungsten carbide coating film in carbon matrix. There was no statistically significant difference (P.05) between G1 and G2 in any mechanical test carried out.

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Background Surgical procedures under local anesthesia are routinely employed by the dentist and are susceptible to significant complications which demand immediate care from the dental professional. Report This report presents a case of severe arterial hemorrhage during a simple removal of a lesion during an incisional biopsy. Summary In the event of severe arterial hemorrhage in a conventional dental office, manual compression for containing the hemorrhage and use of an adequate light source to correctly visualize the origin of the bleeding is recommended. If visible, the dental surgeon must attempt to perform vascular ligature or an occlusive suture. If the hemorrhage cannot be controlled after these measures, the patient must be transported to a hospital while continuing local compression during transit. Citation Cheng CK, Gaia BF, de Oliveira Neto HG, Martini MZ, Aburad A, Shinohara EH. Severe Hemorrhage during an Incisional Biopsy: A Report of a Case. J Contemp Dent Pract 2007 March;(8)3:097-103.

Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. The most common sites for piercings are the tongue and lower lip in the oral cavity. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. This paper is a case report of a patient who had a complication from a piercing on the tongue located under the overlying mucosa. It also suggests a local habit was a possible initiator of this complication. Citation Shinohara EH, Horikawa FK, Ruiz MM, Shinohara MT. Tongue Piercing: Case Report of a Local Complication. J Contemp Dent Pract 2007 January;(8)1:083-089.

This article reviews cases of mandibular fractures treated at the Service of Oral and Maxillofacial Surgery of the Hospital Complex of Mandaqui (SUS/SP), which is a reference hospital complex for trauma in the northern area of the city of São Paulo, Brazil. Ninety-eight patients with mandibular fractures were seen at the hospital between January and December, 2001. Out of this total, 91 cases whose files were deemed adequate in terms of data accuracy and completeness were reviewed. The following data were collected for the study: age, gender, etiology, anatomical fracture site, treatment modality, relation to other facial bone fractures, hospitalization time and posttrauma complications. Motorcycle accident was the major cause of mandibular fractures followed by physical aggression and height fall. The mandibular anatomical sites of higher fracture incidence were: body, symphysis and condyle. The most commonly performed treatment modes were conservative approach or open reduction and intraosseous fixation. In conclusion, motorcycle accidents were associated with a larger number of facial fractures and most predominantly affect 21-30 year-old males. On the average, motor vehicle accident victims had more (and more severe) fractures than physical aggression victims. Complications were mostly associated with angle fractures and hospitalization period. Polytraumatized patients presented greater morbidity for complications. O artigo tem como objetivo revisar casos de fraturas de mandíbula atendidos no Serviço de Cirurgia Bucomaxilofacial do Conjunto Hospitalar do Mandaqui (SUS/SP), hospital de referência para trauma na região norte de cidade de São Paulo. De janeiro a dezembro de 2001, foram atendidos 98 pacientes com fraturas de mandíbula no hospital. Dentre estes, 91 casos que dispunham de dados suficientes em prontuários foram analisados. Para o estudo foram considerados: idade, gênero, etiologia, local anatômico da fratura, modalidade de tratamento, relação com fraturas de outros ossos faciais, tempo de hospitalização e complicações. Acidente motociclístico foi a principal causa de fraturas mandibulares, seguido de agressão e queda de altura. Os três locais anatômicos de maior incidência foram: corpo, sínfise e côndilo. O modo de tratamento consistiu de abordagem conservadora ou redução aberta e fixação interna. Conclui-se que acidentes motociclísticos estão associados a um maior número de fraturas mandibulares com predominância em homens de 21 a 30 anos. Vítimas de acidentes com veículos apresentaram, em média, mais fraturas do que vítimas de agressões. As complicações mostraram-se associadas ao maior período de hospitalização e fraturas de ângulo mandibular, e tiveram maior incidência em pacientes politraumatizados.

Inappropriate treatments of frontal sinus fractures may lead to serious complications, such as mucopyocele, meningitis, and brain abscess. Assessment of nasofrontal duct injury is crucial, and nasofrontal duct injury requires sinus obliteration, which is often accomplished by autogenous grafts such as fat, muscle, or bone. These avascular grafts have an increased risk of resorption and infection and donor site morbidity. For these reasons, pericranial flap, which is vascular, should be used for frontal sinus obliteration. The pericranial flap presented with less morbidity procedure and has decreased infection rates, which justifies its use in frontal sinus obliteration. This study aimed to report a case of a comminuted frontal sinus fracture with a brief literature review, regarding the use of pericranial flap. The authors report a case of a 23-year-old male subject with a severely comminuted fracture of the anterior and posterior walls of the frontal sinus. The patient was successfully treated by cranialization with frontal sinus duct obliteration, using anterior pericranial flap. The patient was followed up for 16 months with no postoperative complication, such as infection. Pericranial flap is a good resource for frontal sinus duct obliteration because it is a durable and well-vascularized flap, which determines low rates of postoperative complications.

The fascicular composition and organisation of the inferior alveolar nerve (IAN) were determined to confirm the microarchitecture of the IAN bundles into each of the mandibular teeth, including the composition of the mental nerve. The aim of this study was to evaluate peripheral nerve repair after the application of an antioxidant compound to the damaged nerve tissue to elevate the concentration and bioavailability of elements capable of favouring tissue repair. Twenty-five Wistar rats were divided into groups: The Control 1 (Ctl 1) (n = 5) animals had the ischiatic nerve exposed with no suture injury and were sacrificed at 30 days post-operatively. The Control 2 (Ctl 2) (n = 10) animals had the ischiatic nerve exposed, and the nerve was injured using suture in three distinct regions. In the experimental (Exp) animals (n = 10), an antioxidant organic compound was applied to the nerve injury site. The animals with nerve injury (Ctl2 and Exp group) were sacrificed at 15 and 30 days post-operatively. The histological analysis showed less degeneration in the Exp group at 15 and 30 days post-operatively. Nerve neoformation forming a connection between the distal and proximal suture sites was observed in the experimental group. This study presented an alternative to nerve repair using an antioxidant compound.

O objetivo desta revisão sistemática de literatura é avaliar indicações para remoção ou não do material de síntese utilizado no tratamento cirúrgico das fraturas da face. Utilizou-se para a revisão de literatura o índice “Medline” com as palavras-chave “facial fracture and miniplates removal”, onde foram encontrados 06 artigos publicados entre os anos de 1998 a 2007 e que apresentavam indicações para a remoção de material de síntese. As principais indicações para a remoção foram: infecção, dor, placas palpáveis e exposição. Concluiu-se que não existem estudos definitivos quanto a melhor conduta a ser tomada, cabendo ao cirurgião avaliar cada caso para definir qual a melhor conduta a ser tomada.

Foreign bodies, although they are often found throughout the body, to a lesser degree in the face, still constitute a diagnostic challenge for the trauma surgeon. Its removal means danger of damaging important facial anatomic structures, even if its exact position from the image data was known. So, the objective is to describe a clinical report of a patient (42 years of age, male sex) who experienced falling to the ground, attended by the Department of Surgery and Traumatology Bucco-Maxillo-Facial Surgery, Faculty of Dentistry of Araçatuba, São Paulo State University, and 2 days after the trauma, he reported difficulty in mouth opening and pain. After clinical evaluation, we observed the presence of injury in the left preauricular region already in the process of healing. During the intraoral physical examination, a limitation of the mouth opening was noted. Radiographic posteroanterior and profile of the face showed 2 radiopaque foreign bodies in the left side, lying apparently at the region of the mandibular condylar process. Under local anesthesia, foreign body removal was carried from there with access to it through the preexisting facial injury. Further clinical examinations showed an improvement in mouth opening, absence of pain complaints, and/or functional complaints.

This study aims to review anatomical, clinical, and pathological concepts as well as to discuss the most adequate therapeutic approach to the mucoceles of the glands of Blandin-Nuhn.The glands of Blandin-Nuhn are localized in the ventral part of the tongue, next to the apex in the lingual median plane. Development of a mucocele in this site is rarely seen; besides, as the glands of Blandin-Nuhn are not encapsulated and are directly overlapped to the muscle tissues, their manipulation tends to be different from the other oral mucoceles.As Blandin-Nuhn mucoceles are uncommon and their clinical appearance could be similar to other lesions, it is important that health professionals know their clinical and histopathological features to avoid having them misdiagnosed.

Panfacial fractures usually refer to simultaneous facial fractures, which affect the upper, middle, and lower thirds of the face. The management of panfacial fracture is complex because of the lack of reliable landmarks. Literature has shown many approaches for management of panfacial fractures. Every segment of bone has a precise function in the repair. Therefore, the "bottom-up and outside-in" sequence is the most widely used approach in the management of panfacial fractures. These facial fractures present remarkable challenges for both experienced and inexperienced surgeons. This article aimed to report a case of a panfacial fracture (mandibular condylar and symphysis fractures associated with an atypical Le Fort III fracture) in a 48-year-old man. The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and esthetic outcomes.

Purpose The present case describes an inferior alveolar nerve lateralization for implant placement that caused mandible fracture a few days after surgery. Clinical report In this case, a 56-year-old female patient who had a severely atrophied jaw and showing bone height less than 7 mm from the bone crest and the mandibular canal was submitted to surgery lateralization of the inferior alveolar conducted with piezzo. Even with all postoperative care, the patient suffered an incomplete fracture of the mandible a few days after lateralization of the inferior alveolar nerve for implant placement. The patient was treated with soft diet and medications for pain and antibiotics, besides removing the implant associated with the fracture. Conclusion It is suggested that this procedure may be conducted in 2 operative periods: firstly, the lateralization of the inferior alveolar; and secondly, after a period of 3 months, the implant placement in a situation of more bone stability.