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SUMMARY: The aim of this research is to show a simple technique to obtain control in the alar base width in Le Fort I osteotomy. The technique was used in eighteen patients submitted to maxillary impaction and/or advancements (≥ 3 mm). Inter-alar width, alar base width and right/left nostril were studied before surgery and 6 months of follow-up. Data were reported as means and standard deviations; statistical analysis was realized by t test considering a p-value

SUMMARY: Facial harmony is the consequence of a proper balance between all facial structures. The identification and classification of morphologic characteristics that detract from facial harmony is most effectively accomplished by clinical examination. The maintenance of the ratios between the facial thirds, correct spatial bone position and soft tissues accommodation are all factors that directly contribute in a balanced facial profile. The chin, likewise, contributes significantly in facial balance, mainly in the profile view. Expressive changes on chin position are associated with the perception of strong or delicate characters. Thus, over the years, a series of studies has been constructed focusing on mandibular osteotomies techniques that enable changes in chin position: advances, setback, extrusion, intrusion, widening, narrowing and asymmetry. This study aims to address historical and technical aspects of genioplasty; associating patient's condition with the surgical techniques that can be applied for correction of chin deformities.

BackgroundAnorganic bovine bone (Bio-Oss®) has been extensively used for reconstruction of posterior area of maxilla in sinus lift procedure; however, a new graft material (Lumina-Bone Porous®), that has a different manufacturing process, has not been yet compared in clinical and histological terms. The manufacturing process of bovine bone graft is related to size and porosity of the particles, and this can change osteoconductive property of the material and bone formation. The use of Lumina-Porus® could improve bone formation, reduce the remaining particles of the biomaterial using a low-cost material. The aim of this research was to compare the clinical, radiological, and histomorphometrical results from maxillary sinus lift with two different anorganic bovine bone substitutes Bio-Oss® (control) and Lumina-Bone Porous® (test).ResultsA split-mouth study was performed with 13 volunteers. The mean bone ridge height in the deepest portion of maxillary sinuses floor was 3.11 ± 0.83 mm in the Bio-Oss® and 2.38 ± 0.75 mm in the Lumina-Bone Porous®. After sinus lift, the Bio-Oss® group shows bone ridge height of 11.56 ± 2.03 mm and Lumina-Bone® of 10.62 ± 1.93 mm. The increase in alveolar bone height scores was significant between pre-augmentation and 6 months after SL in both groups (p< 0.001). No statistical significant difference in newly formed bone in the Bio-Oss® group (20.4 ± 5.4%), and Lumina-Bone Porous® (22.8 ± 8.5%) was histomorphological observed (p> 0.05). On the other hand, the residual graft particles showed significant difference between the Bio-Oss® group (19.9 ± 8.6%) and Lumina-Bone Porous® (14.6 ± 5.6%) (p< 0.05). The survival rate of dental implants for augmented area with Lumina Bone Porous® was 88.88%, while for Bio-Oss® group was 100%.ConclusionBoth materials Bio-Oss® and Lumina-Bone Porous® can be used in the maxillary sinus floor augmentation with good predictability in clinical, radiographical, and histological point of view.

Cementoblastoma is considered an odontogenic tumor of neoplastic cementoblasts. The lesion was first recognized by Noeberg in 1930 and is considered as the only true neoplasm of cementum origin. Radiographically, a well-delimited radiopaque mass is observed, mainly involving one or more tooth roots of mandible. The treatment is well established in the international literature, and enucleation of the lesion is recommended in association with the extraction of the involved element with the attached calcified mass. We present a case of benign tumor (cementoblastoma) associated with the root apex of the third molar upper right quadrant, involving the maxillary sinus in a patient with class II dentofacial deformity. The treatment chosen was tumor enucleation in association with orthognathic surgery in the same procedure under general anesthesia. International literature is dedicated to discussing this case report. Keywords: Cementoblastoma, Odontogenic tumor, Osteotomy, Le Fort, Paranasal sinuses, Pathology, Oral, Orthognathic surgery

Odontogenic myxoma (OM) is a benign neoplasm often affecting mandibular molars. Although small tumors may be asymptomatic, bigger lesions may result in bone swelling, and aggressive cases show fast growth. Radiographies show unilocular lesions, multilocular lesions, and bone trabeculae arranged at right angles, with irregular margins and dental displacement/resorption. Sometimes soap bubbles appearance is present. A 50-year-old male patient was referred for examination of an asymptomatic radiographic finding in the right mandible. Cone beam computed tomography showed an irregular hypodense area, with poorly defined margins, in the right mandibular body extending to the anterior region, with small cortical expansion. After incisional biopsy, the histopathologic analysis showed proliferation of spindled- and stellate-shaped cells in an abundant loose and myxoid stroma. The diagnosis of OM was given. Subsequent hemimandibulectomy was performed for total tumor excision. The patient remains in follow-up.

Nasopalatine duct cyst (NDC) is a development originating from epithelial remnants of the nasopalatine duct. NDC has a slow growth and is usually asymptomatic. The aim of this study is to describe a case of NDC in a 26-year-old male who presented with swelling in the anterior palate measuring approximately 2.5 cm on its longest diameter. Tomographic examination showed a unilocular, well-defined radiolucency with sclerotic border located between the maxillary central incisors roots. The microscopic examination revealed fragments of cystic capsule lined by a thin stratified squamous epithelium in combination with simple columnar and pseudostratified ciliated columnar epithelium. The diagnosis of NDC was made. The lesion was surgically removed by enucleation. The patient remains under follow-up.

The macroglossia is a rare condition, congenital or acquired, characterized by hypertrophy of the lingual muscles that can cause both aesthetic and functional changes such as mandibular prognathism and malocclusion. Diagnosis is through clinical examination. Treatment consists of excision of part of the tongue and different surgical techniques have been described in the literature. The keyhole lingual resection technique has shown satisfactory results in reducing the volume and preservation of the neurovascular bundles of the tongue. This work aims to present a clinical report of true macroglossia associated with dental-skeletal discrepancies, submitted to partial glossectomy previously to orthognathic surgery.

A osseointegração de implantes de titânio (Ti) é dependente da interação entre a superfície de Ti e células, a qual é modulada por diversas vias de sinalização intracelular. Sabe-se que as quinases reguladas por sinais extracelulares (ERKs), membros da família das proteínas quinases ativadas por mitógenos (MAPKs), atuam tanto na osteogênese, quanto na adipogênese e, portanto, podem estar envolvidas no processo de osseointegração de Ti. Nesse contexto, o objetivo do presente estudo foi avaliar se a interação entre células-tronco mesenquimais (CTMs) e superfícies de Ti usinada e com nanotopografia é modulada, ao menos em parte, por ERK1/2 e o consequente efeito da inibição dessas ERKs na diferenciação osteoblástica e adipocítica. Para isso, CTMs derivadas de medula óssea de ratos foram cultivadas sobre discos de Ti usinados e com nanotopografia em condições osteogênicas e adipogênicas, na presença ou não do inibidor de ERK1/2, PD98059, em concentração previamente determinada (25 μM) e foram avaliados parâmetros relacionados à diferenciação osteoblástica e adipocítica. Os resultados mostraram que a expressão gênica dos marcadores osteoblásticos RUNX2, osterix (OSX), fosfatase alcalina (ALP) e osteocalcina (OC) foi aumentada pela inibição da via de sinalização de ERK1/2 nas células crescidas sobre Ti usinado e apenas ALP e OC, naquelas crescidas sobre Ti com nanotopografia. A expressão proteica de RUNX2 foi discretamente maior nas células crescidas sobre Ti usinado, mas não sobre Ti com nanotopografia, quando ERK1/2 foram inibidas e essa inibição não afetou a formação de matriz extracelular mineralizada, independentemente da superfície de Ti avaliada. Com relação à diferenciação adipocítica, a inibição da via de sinalização de ERK1/2 aumentou a expressão gênica dos marcadores adipocíticos PPARγ, adiponectina (ADIPOQ) e proteína ligadora de ácido graxo do adipócito ( AP2) nas células crescidas sobre ambas as superfícies de Ti, com efeito mais acentuado na superfície usinada, sem afetar a formação de acúmulo lípidico. Em conclusão, os resultados mostraram que a inibição de ERK1/2 favoreceu a diferenciação osteoblástica de CTMs crescidas sobre a superfície de Ti usinada, mas não sobre Ti com nanotopografia. Além disso, a inibição de ERK1/2 favoreceu a diferenciação adipocítica de CTMs crescidas sobre as superfícies de Ti com nanotopografia e usinada, sendo o efeito mais acentuado na usinada. Considerando aplicações terapêuticas, esses resultados são relevantes para direcionar o desenvolvimento de superfícies de biomateriais que atuem em vias de sinalização que sabidamente modulam o processo de osteogênese. Osseointegration of titanium (Ti) implants depends on interaction between Ti surface and cells, which is modulated by several intracellular signaling pathways. Extracellular signal-regulated kinases (ERKs) are members of mitogen-activated protein kinases (MAPKs) family and act on both osteogenesis and adipogenesis and, therefore, may be involved in the process of Ti osseointegration. In this context, the aim of this study was to evaluate if the interaction between mesenchymal stem cells (MSCs) and Ti surfaces, either machined or with nanotopography, is modulated, at least in part, by ERK1/2 and the effect of ERK1/2 inhibition on osteoblast and adipocyte differentiation. Rat bone marrow MSCs were cultured on Ti discs either machined or with nanotopography under osteogenic and adipogenic conditions, in presence or not of the ERK1/2 inhibitor, PD98059, at a concentration previously determined (25 μM) and it was evaluated parameters related to osteoblast and adipocyte differentiation. The results showed that gene expression of the bone markers RUNX2, osterix (OSX), alkaline phosphatase (ALP) and osteocalcin (OC) was increased by ERK1/2 signaling inhibition in cells grown on machined Ti and only ALP and OC in cells grown on Ti with nanotopography. RUNX2 protein expression was slightly higher in cells grown on machined Ti, but not on Ti with nanotopography, when ERK1/2 signaling was inhibited and such inhibition did not affect extracellular matrix mineralization, irrespective of the evaluated Ti surface. Regarding adipocyte differentiation, ERK1/2 signaling inhibition increased gene expression of the adipose tissue markers PPARγ, adiponectin (ADIPOQ) and adipocyte fatty acid-binding protein (AP2) in cells grown on both Ti surfaces, with more prominet effect on machined one, without affecting lipid accumulation. In conclusion, our results showed that ERK1/2 signaling inhibition favored osteoblast differentiation of MSCs grown on machined Ti, but not on Ti with nanotopography. In addition, ERK1/2 signaling inhibition favored adipocyte differentiation of MSCs grown on both Ti surfaces, being more noticeable on machined one. Considering therapeutical applications, these results are relevant to drive the development of biomaterial surfaces to act on signaling pathways that regulate the process of osteogenesis.

The purpose of this study was to evaluate the profile of pediatric oral lesions in northeastern Brazil.Biopsy records of oral lesions were retrieved from patients aged zero to 18 years who were treated over 18 years in two university hospitals in northeastern Brazil. Routine pathological sections were re-examined and classified into six groups: (1) odontogenic and nonodontogenic cysts; (2) odontogenic tumors; (3) salivary gland pathology; (4) nonodontogenic tumors and tumor-like lesions; (5) bone pathology; and (6) miscellaneous.From a total of 4,690 oral biopsies, 564 (12 percent) were from children and adolescents. The largest number of cases was salivary gland pathology, followed by nonodontogenic tumors and tumor-like lesions. The most common oral biopsies were mucocele, pericoronal dental follicle, pyogenic granuloma, dentigerous cyst, and odontoma. Only three cases of malignant tumors were observed. Our results were similar to most studies.Although malignant tumors comprised a small portion of the pediatric oral biopsies, the possibility of their occurrence in children and adolescents should not be overlooked.

Objective: it was to evaluate intra- and interexaminer reliability and reproducibility of linear measurements in cone-beam tomography (CBCT) images. Materials and Methods: CBCT scans were obtained from 50 patients of a private clinic. Two examiners located the landmarks twice in two-dimensional and three-dimensional images on different days, with images performed 1 week apart. Intra- and interexaminer reproducibility and reliability were analyzed. Results: the measurement error (ME) did not show significant differences between intra- and interexaminers. The intraclass correlations (ICC) between the intra- and interexaminer readings obtained with the different methods showed almost perfect matches. The results demonstrated high examiner reproducibility for linear and volumetric parameters with high intraclass correlation coefficient (ICC) and coefficient of variation (CV). The ICC showed that the methodology was highly reliable and reproducible (ICC- >0.99 and CV

To evaluate the clinicopathologic features of pediatric mucoceles diagnosed in two public institutions in Brazil during an 18-year period.Clinical data (age, sex, history of trauma, location, and size) of 138 cases of mucoceles in children 0 to 16 years of age were obtained from medical records. The lesions were classified as mucus extravasation phenomenon and mucus retention phenomenon, depending on the presence of epithelial lining in the microscopic analysis.Mucoceles made up 24.5% of the oral pediatric lesions diagnosed in the period of study. Age at diagnosis ranged from 0.4 to 16.0 years, with a mean age of 10.8 years. Of the total of mucoceles, 87 were observed in females and 51 in males. The lower lip was the most commonly affected site, and a history of trauma was related by 87% of the patients. Histologically, 96.4% of mucoceles were diagnosed as mucus extravasation phenomenon. Cases of mucus retention phenomenon were relatively more common in the floor of the mouth, since one in three lesions in this location belonged to this histologic type. Regarding lesions in the lower lip, only 2.65% were diagnosed as mucus retention phenomenon.Trauma is the main etiologic factor involved in the development of mucoceles in children. The mucus extravasation phenomenon is the most common histologic type in this age group. Although rare, the retention type seems to be more common in lesions on the floor of the mouth.