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SUMMARY: The aim was to evaluate bone repair and gingival tissue repair in osteopenic rats. Fifteen female wistar rats were included; in all of them ovariectomy was realized to induce osteopenia; after 45 days, the animals were submitted to 2 surgical techinques 1) dental extraction of the upper central incisor with no socket preservation and 2) 5 mm cranial defect in the calvarium; 5 rats were included in the control group (G1) withput alendronate application; in the group 2 (G2) was used subcutenous alendronate (0.5 mg/kg) once for three weeks and then was realizd the both surgical techniques. In group 3 (G3), after ovariectomy was realized the both dental extraction and the calvarium defect and after that was realized the alendronate protocol. In each group, after six week was realized euthanasia and descriptive histological analysis of the surgical areas involved. In bone formation of the 5 mm cranial defect was observed with good progression in the 3 experimental models and no modification in quality of bone repair was observed. For the gingival tissue in the extraction socket, no differences were observed between G1 and G3. On other hand, in G2 a thinner and reduced gingival epithelium was found. Our results showed that alendronate was not an obstacle for bone repair; deficiencies in re-epithelialization of oral mucosa show the impact of alendronate before dental extraction.

Introdução: Infecções maxilofaciais em pacientes pediátricos são condições graves, caracterizadas pela disseminação do processo infeccioso aos tecidos adjacentes, com origem geralmente odontogênica. Objetivo: O objetivo do presente estudo foi ava- liar dados referentes às causas, características e tratamento realizado em pacientes pediátricos com infecção maxilofacial atendidos por um serviço de Cirurgia e Traumatologia Bucomaxilofacial em Maringá/PR, no período de 2007 a 2017. Métodos: A metodologia utilizada foi a análise retrospectiva dos prontuários, com o auxílio de um formulário estruturado. O formulário da pesquisa considerou as variáveis ida- de, sexo, temperatura de admissão, dente acometido, duração da infecção, terapia e prognóstico. Resultados: Como resultados, observou-se uma pequena predileção pelo sexo masculino (52,2%); a idade média encontrada foi de 7,3 anos; os dentes mais acometidos foram os primeiros molares decíduos inferiores (#75 e #85); a etiologia mais comum foi o acometimento pulpar por cárie; a temperatura de admissão média foi de 37,9oC; e as infecções duraram, em média, 3 dias. Com relação à terapia aplicada, o antibiótico mais utilizado foi a Amoxicilina e a conduta foi a drenagem do abscesso e o tratamento endodôntico. Conclusão: Faz-se necessário o conhecimento acerca dessa temática pelo cirurgião-dentista, visto que os pacientes pediátricos se tornam sistemicamente afetados muito rapidamente.

Osteonecrosis of the jaw is a possible oral complication resulting from antiresorptive therapies, such as bisphosphonates (Bfs). Although the etiology is not entirely clear, it has been shown to be dependent on several factors, with the traumatic stimulation caused by the placement of teeth implants indicated as one of the predisposing factors to this pathology. The indications and preventive methods for performing these procedures have been questioned, making it essential to determine the proper protocols. Thus, the present study aims to discuss the risks of the development of osteonecrosis in patients undergoing dental implant surgery who use Bfs as well as to discuss related local and systemic factors and possible methods for preventing this side effect. The study also aims to present a clinical case of an osteopenic patient who used Bfs and underwent rehabilitation through implants according to specific protocols, which resulted in successful treatment.

The aim of the present study was to evaluate the efficacy of Passiflora incarnata L for the control of anxiety during third mandibular molar extraction and compare it to midazolam, the most used benzodiazepine in dentistry.The investigators implemented a prospective, randomized, double-blind, split-mouth study. The degree of anxiety of the patients was assessed before the surgical procedure. The surgeries took place in two sessions: one on each side of the hemi-mandible and, on each of them, the patient received one of the drugs, crosswise. Anxiety control was measured through physical parameters, at the following periods during the surgery: (1) immediately administration of anxiolytic medication, (2) 30 minutes after anxiolytic medication, (3) after extraoral antisepsis, (4) after local anesthesia, (5) during incision, (6) during osteotomy, (7) between osteotomy and odontosection, (8) during odontosection, (9) during surgical store curettage, (10) during suture, and (11) immediately after postoperative care guidelines. Lastly, the volunteers received a self-assessment form in order to report their experience. Statistical analysis was performed using the Wilcoxon test.The final sample was composed of 20 patients, with a mean age of 22.5 years. The results of the physical parameters showed statistically significant differences (P.05) for certain times and physical parameters, especially heart rate (P = .036), which showed the highest control for Passiflora at time point (3). The undesirable effects reported by patients such as drowsiness, muscle relaxation, and dizziness were greater with benzodiazepine.The results of this study suggest that Passiflora may be considered as an alternative to midazolam in controlling anxiety in dentistry. Future studies will focus on other benzodiazepines and herbal medicines.

Infecções agudas bucomaxilofaciais podem ser condições clínicas graves e de ocorrência comum, caracterizadas pela disseminação do processo infeccioso a tecidos adjacentes e espaços faciais da região de cabeça e pescoço, podendo resultar em várias complicações, até mesmo em óbito, embora seja raro. Objetivo: realizar uma análise epidemiológica de infecções maxilofaciais, relacionando os dados ao tratamento instituído e à sua efetividade, bem como analisar dados referentes a idade, sexo, principais dentes envolvidos e tempo total de internação. Sujeito e método: foram analisados retrospectivamente 240 prontuários de pacientes admitidos no Hospital Universitário de Maringá com infecção odontogênica, atendidos pela equipe de Cirurgia e Traumatologia Bucomaxilofacial no período de janeiro de 2009 a janeiro de 2017. Resultados: a média de idade dos pacientes foi de 38 anos, com 57 mulheres e 54 homens. A média de temperatura de admissão foi38,5°C. A região mais acometida foi o ramo posterior da mandíbula, tendo uma média de duração de infecçãoe hospitalização de 6,1 dias. A principal conduta foi drenagem e antibioticoterapia, sendo que cerca de 13pacientes não precisaram desse tipo de intervenção, e um paciente evoluiu a óbito. Conclusão: com base nestes resultados e na literatura, infecções odontogênicas merecem atenção, pois podem ser fatais e requerem internação rápida e tratamento adequado. Esse, portanto, é um assunto de grande importância para o cirurgião-dentista, que exerce papel fundamental na prevenção e no tratamento. A resolução precoce ainda é a forma mais adequada para evitar complicações mais graves.

Osteoradionecrosis (ORN) is one of the most severe oral complications after the head and neck cancer treatment. Tooth extraction, through its traumatic stimulation, is identified as an important predisposing factor. Indications and preventive methods for carrying out these procedures in irradiated patients are questioned, thus, establishing appropriate protocols is essential. This article reports a case of multiple tooth extractions in a cancer patient whose preventive measures were taken without the occurrence of complications. Based on a literature review, this paper accounts the appropriate indications of this procedure, the risk of developing osteoradionecrosis, and the prevention possibilities for this sequela. In addition, this report addresses a viable oral rehabilitation alternative after this kind of surgery by using overdenture on the lower jaw teeth.

Purpose The objective of the present study was to evaluate the effectiveness of an herbal drug (valerian) to control anxiety during mandibular third molar extraction compared with a reference benzodiazepine drug commonly used in dental procedures (midazolam). Materials and Methods Twenty anxious patients with an indication for bilateral extraction of mandibular third molars were selected. The patients received capsules containing valerian 100 mg or midazolam 15 mg orally 60 minutes before the procedures in a randomized, split-mouth, crossover design. Changes in the physiological parameters (eg, oxygen saturation, heart rate, blood pressure, respiratory rate) were assessed at specific times during surgery, and the patients completed a questionnaire postoperatively. The data were analyzed using the Wilcoxon and paired t tests, with a significance level of 5%. Results No statistically significant differences in oxygen saturation were observed, regardless of the drug used. However, the other physiological parameters were significantly lower when the patients had taken midazolam compared with valerian. Somnolence was the most common side effect reported with both drugs. Conclusions Although midazolam was more effective in reducing the physiological parameters studied, valerian seemed to provide the comfort and relaxation required, with no sedation and less somnolence than midazolam, during third molar extraction. Further studies are necessary before valerian can be clinically recommended.

Introduction Thrombocytopenia is the reduction in the number of blood ­platelets, which may be caused by ­several different conditions such as sepsis, disseminated intravascular ­clotting, and large blood losses. Additionally, in rare situations, thrombocytopenia may also be induced by the use of medicaments. One of these drugs is the vancomycin, a glycopeptide presently used against ­serious infections involving Gram-positive bacteria such as the methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus. Objective The objective of this study is to report on a case of serious vancomycin-induced thrombocytopenia in a patient infected with methicillin-resistant S. aureus after mandibular reconstruction with autogenous bone graft, and to draw attention to the importance of this clinically rare adverse effect. Conclusion Vancomycin-induced thrombocytopenia is a rare condition, which is also a significant disorder that demands attention and the rapid identification and replacement of the antimicrobial agent.

O abuso de drogas, lícitas ou ilícitas, é um dos principais problemas sociais e de saúde pública do mundo, sendo assim o contato do cirurgião dentista com pacientes dependentes dessas substâncias é inevitável. Estudos sugerem que o uso de drogas aumenta as manifestações orais, como alterações do fluxo salivar, desgaste dental, cárie, doença periodontal, xerostomia e dor. Por isso, o profissional deve estar preparado para atender esses pacientes, e ter conhecimento sobre as limitações e possíveis interações, principalmente em tratamentos invasivos, seja em ambiente hospitalar com o paciente sedado ou no consultório com anestésicos locais. O objetivo deste trabalho é relatar um caso de monitoramento da pressão arterial, saturação de oxigênio e frequência cardíaca, durante um procedimento com múltiplas exodontias em uma paciente dependente química. Apesar da paciente se manter estável, foi constatado aumento da pressão diastólica no pós-operatório, podendo estar relacionado com a vasoconstrição causada pelo uso da maconha e crack, e a ação da epinefrina do anestésico. Esse aumento se relaciona com alterações no sistema simpático e parassimpático, por isso a importância de se conhecer as substâncias empregadas no procedimento e em medicamentos receitados. Conclui-se que é preciso aprimorar o conhecimento das alterações fisiológicas, químicas e neurológicas que envolvem esses pacientes, para um tratamento odontológico seguro, e quando necessário em conjunto com uma equipe multiprofissional, saber encaminhar o paciente e identificar problemas de saúde não somente bucais.

RESUMEN: Los Trastornos Temporomandibulares (TTM) consisten en un conjunto de condiciones patológicas que afectan la articulación temporomandibular (ATM), los músculos de la masticación y las estructuras asociadas. Estudios epidemiológicos estiman que 40 % a 75 % de la población adulta presenta por lo menos un signo de TTM, como ruido articular y 33 % por lo menos un síntoma, como dolor facial o en la ATM. La toxina botulínica (BoNT) es una neurotoxina producida por la bacteria anaerobia Clostridium botulinum, solo la toxina A y B son utilizadas en la práctica clínica después de la aprobación de la Food and Drug Administration en 1989 y 2000; actualmente continúan siendo utilizadas para tratar varias condiciones de dolor, incluyendo la espasticidad muscular, distonia, dolor de cabeza y dolor miofascial. Las propuestas del mecanismo de acción fueron sugeridas a mediados de 1950 manifestando que esta neurotoxina posee alta afinidad con la sinapsis colinérgicas, ocasionando un bloqueo en la liberación de acetilcolina de esos terminales nerviosos, sin alterar la conducción neural de las señales eléctricas o en la síntesis de almacenamiento de acetilcolina. La inyección intramuscular en dosis y localización apropiada, provoca denervación química parcial y disminución de la contractura, sin ocasionar parálisis completa a lo que se le atribuye ser un innovador y eficaz método de tratamiento para el dolor crónico asociada con hiperactividad de los músculos masticatorios. La toxina botulínica tipo A es ser una alternativa para el control de la sintomatología dolorosa presente en los TTMs de etiología miogénica. Los autores recomiendan realizar un correcto diagnóstico, ya que la indicación de este tipo de tratamiento con diagnósticos incorrectos lleva a resultados inciertos.

Odontomas are mixed odontogenic tumors, composed by mineralized tissue of ectomesenchymal origin. According to the World Health Organization, odontomas are classifi ed into two main types: Complex and compound. They are generally found in routine radiographic exams and may be related to several causes. However, they are rarely associated with impacted teeth. This article aims to demonstrate the clinical and histopathological characteristics of this tumor through a clinical case report. The 18-year-old female patient sought dental assistance and reported pain, edema, and bleeding in the area around the impacted tooth 48, being submitted to biopsy after an injury was found on the imaging exam. After the result of the biopsy, the patient was diagnosed with complex odontoma, in the posterior region of the mandible, which was later removed by curettage.

Objetivo: realizar estudo epidemiologico retrospectivo atraves da avaliacao de prontuarios de pacientes diagnosticados com fratura de osso frontal entre 2009 a 2012 e confrontar seus dados com a literatura recente. Metodos: avaliacao de 51 prontuarios de pacientes diagnosticados com fratura de osso frontal e revisao da literatura recente . Resultados: os dados obtidos estao, em sua grande maioria, em consonância com os apresentados pela literatura. Conclusoes: fraturas de osso frontal correspoderam a cerca de 5,37% da nossa casuistica. O diagnostico e tratamento devem ser precisos afim de se evitar procedimento morbidos.

The purpose of this case report is to describe a previously unpublished association between focal cemento-osseous dysplasia (FCOD) and an aneurysmal bone cyst (ABC) and review the literature with regard to associated benign fibro-osseous lesions and cysts. A 41-year-old woman without a history of trauma presented with asymptomatic swelling in the right side of the mandible. Radiographs of the region revealed a unilocular radiolucent area with radiopaque foci. After aspiration of the lesion was positive for serosanguineous fluid, complete excision of the lesion was performed. Microscopic examination revealed a hybrid ABC and FCOD. The 12-month follow-up showed significant bone repair and no signs of recurrence. A review of the English-language literature from 1980 to 2012 revealed 1 retrospective study, 4 case series, and 18 single-case reports on the topic of cemento-osseous dysplasias, fibro-osseous lesions, and aneurysmal bone cysts. Of 59 cases, none reported an association between an ABC and FCOD. Although fibro-osseous lesions do not require intervention, surgical excision is recommended when they are associated with cysts. This case, in which an ABC and FCOD were associated, reinforces the need for a careful diagnostic process in radiographically mixed lesions that respond positively to aspiration biopsy.

Resumen pt: Objetivo: O objetivo do presente estudo foi comparar e testar a confiabilidade e eficiencia de dois aferidores de pressao arterial, aneroide (BD®) e digi...

The surgical removal of impacted, supernumerary, or ectopic teeth is a routine procedure to the dental surgeon. Because any and all surgical interventions involve anatomic considerations that predispose the patient to a high risk of incidents or complications, it is absolutely necessary to precisely determine the location of the enclosed teeth, to better plan the procedure. Even though the conventional radiographic techniques are commonly used to detect the presence of such teeth, they can present deficiencies. In those situations, additional examinations can be requested. In this article, we are reporting the case of a 12-year-old patient, whose third superior molars appeared in a very atypical position. We chose to request a computed tomography and three-dimensional manipulation of the obtained images. This article, as its main goal, highlighted the importance of computed tomography and of three-dimensional reconstructions as a tool to precisely determine the location of enclosed teeth, thus allowing for a better planning of the surgery and a safer surgical intervention.

The term myiasis is applied to the injurious action that larvae of certain diptera cause to the organism of vertebrate animals in the living or dead tissue in which they grow. Because of its great destructive potential, appropriate and preventative treatment are necessary. Among the sites of infestation, the human mouth is a common site, mainly in tropical countries. We present two cases of oral myiasis caused by Cochliomyia hominivorax spp. Ivermectin is an extremely effective semi-synthetic macrolides, in the treatment of this condition.

Purpose The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability. Patients and Methods Twenty ASA I patients, between 17 and 44 years of age who had dental and skeletal deformities were subdivided into 2 groups: group I (clonidine associated to remifentanil), and group II (dexmedetomidine associated to isoflurane), in addition, other drugs were common to both groups. The following responses were assessed: arterial blood pressure, heart rate, temperature during intra- and postoperative periods, incidence of nausea and vomiting, postoperative pain, awakening time, extubation time, and postanesthetic recovery time. Results The results of the study using Repeated Measures Test statistical analysis showed that there were no significant differences between the 2 groups in respect to physiologic responses or surgery time. Conclusion Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.

m s a he first reports on enlargement of the styloid proess date from the 17th century, when anatomists xplored this region. These postmortem findings ere only useful as a mere anatomic curiosity and had o clinical correlation. In 1937, W.W. Eagle reported arious cases of a cervicopharyngeal symptomatology nd associated them with radiographic findings. It as believed that trauma in the cervicopharyngeal egion, especially after tonsillectomy, might stimulate subsequent growth of the styloid process. Various names were proposed for the syndrome: tyloid process neuralgia, styloid syndrome, stylohyid syndrome, elongated styloid process syndrome, agle’s syndrome, and styloalgia. The most approriate, however, is styloid-stylohyoid syndrome beause such anomalies may be of the styloid process, of he stylohyoid ligament, or a combination of both