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Made available in DSpace on 2020-12-12T01:40:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-10-01 Gunshot wounds can cause extensive destruction of soft tissue and bone, and the maxillofacial region is often affected. The reconstructive treatment is complex due to the difficulty to reestablish the central arch mandibular contour and volume. Moreover, the goal is to avoid postoperative infections and obtain bone graft neovascularization. Therefore, this report shows a clinical case of a patient presenting mandibular deformity with a mandibular central arch discontinuity caused by a firearm injury. The strategy to the reconstructive treatment as performed with a condensed and stabilized particulate autogenous bone graft was essential and effectiveness. After 1 year, it was obtained a satisfactory result to the patient. Department of Surgery and Integrated Clinic Araçatuba School of Dentistry University Estadual Paulista (UNESP), Jose Bonifacio, 1193 Department of Basic Science Araçatuba Dental School University Estadual Paulista (UNESP) Department of Oral and Maxillofacial Surgery Nova Friburgo - Universidade Federal Fluminense Department of Oral and Maxillofacial Surgery General Hospital of Nova Iguacu Department of Surgery and Integrated Clinic Araçatuba School of Dentistry University Estadual Paulista (UNESP), Jose Bonifacio, 1193 Department of Basic Science Araçatuba Dental School University Estadual Paulista (UNESP)

The aim of this study was to measure the thickness of the mandible from the external cortical plate to the teeth roots on premolar and molar regions using CT scan to determine the safety margin for the application of monocortical screws for internal rigid fixation. Thirty-one patients underwent CT-scan imaging for surgical planning. The images were used to measure bilaterally the distance from the external cortex of the mandible to the roots of teeth on premolar and molar region by means of Dental Slice software (Bioparts Prototipagem Biomedica, Brasília, DF, Brazil). Mean, median, standard deviation, one-way ANOVA and post hoc Tukey's test were used for statistical analysis. No statistical differences for thickness were found between right and left side ( p = 0.1652). The mean thickness for the left side was 4.17 ± 1.68 mm and for right side 3.93 ± 1.49 mm. Increase in mandibular thickness from anterior to posterior regions in both sides was observed and statistical difference was found among the different groups according to the measured region ( p < 0.05). The present results can predict the safety zone for the use of monocortical screws in the mandible, but the use of CT scan is imperative and individual analysis is desired owing to anatomical variations. Further studies with larger samples are necessary to confirm these data and should include other anatomic structures, different regions of mandible/maxilla, as well as other ethnic groups.

O tumor de Warthin é a segunda lesão mais comum da glândula parótida, sendo raro em qualquer outra glândula salivar. Possui comportamento benigno, com crescimento lento e indolor. Neste artigo é relatado um caso clínico onde o tumor apresentou evolução de um ano, sem sintomatologia associada, gerando assimetria facial ao paciente, sendo realizado tratamento cirúrgico conservador apenas por enucleação da lesão, visando reduzir cirurgias maiores como a parotidectomias parciais ou totais. Após acompanhamento de 5 anos o paciente não apresenta sequelas do tratamento cirúrgico ou sinal de recorrência da lesão.Descritores: Glândula Parótida; Neoplasia; Cirurgia Bucal.

Treatment of frontal sinus fractures depends on the structures involved: the anterior wall, the posterior wall and the nasofrontal duct. It may vary from the correction of the defect in the anterior wall to the cranialization with obliteration of the nasofrontal duct. The inversion of the frontal sinus's anterior wall to correct the defect in the fractured region is a good treatment option for sequelae, since this technique eliminates or reduces the use of biomaterial in the area, and allows direct assessment of the permeability of the nasofrontal duct. This work describes the technique of fractured segment inversion for the treatment of frontal sinus fracture sequelae in a motorcycle accident victim. RESUMO O tratamento das fraturas do seio frontal depende das estruturas envolvidas: a parede anterior, a parede posterior e o ducto nasofrontal. Os tratamentos podem variar entre corrigir um defeito na parede anterior até a realização de uma cranialização com obliteração do ducto nasofrontal. O uso da inversão da parede anterior do seio frontal para corrigir o defeito na região fraturada representa uma boa opção de tratamento para os casos de sequelas, já que esta técnica elimina ou reduz a utilização de biomaterial nesta área, e permite avaliação da permeabilidade do ducto nasofrontal por acesso direto. Este trabalho descreve a técnica de inversão do segmento fraturado para tratamento de sequelas de fratura do seio frontal em paciente vítima de acidente motociclístico.

Schwannoma (neurilemmona) is a benign nerve sheath composed of Schwann cells. This tumor represents 1 % of all benign tumor, usually observed in the head and neck region, and in, rare cases, this lesion may be observed in oral cavity. They are usually asymptomatic, do not recur, and malignant transformation is rare. We presented a case report of schwannoma in the lower lips.

The orbit is an irregular conical cavity formed from 7 bones including the frontal, sphenoid, zygomatic, maxillary, ethmoid, lacrimal, and palatine bones. Fractures of the internal orbit can cause a number of problems, including diplopia, ocular muscle entrapment, and enophthalmos. Although muscle entrapment is relatively rare, diplopia and enophthalmos are relatively common sequelae of internal orbital fractures. Medial orbital wall fracture is relatively uncommon and represents a challenge for its anatomical reconstruction. In this context, autogenous bone graft has been the criterion standard to provide framework for facial skeleton and orbital walls. Therefore, it is possible to harvest grafts of varying size and contour, and the operation is performed through the bicoronal incision, which is the usual approach to major orbital reconstruction. Thus, this article aimed to describe a patient with a pure medial orbital wall fracture, and it was causing diplopia and enophthalmos. The orbital fracture was treated using autogenous bone graft from calvarial bone. The authors show a follow-up of 12 months, with facial symmetry and without diplopia and enophthalmos. In addition, a computed tomography scan shows excellent bone healing at the anterior and posterior parts of the medial orbital wall reconstruction.

A osteotomia sagital bilateral é uma das técnicas mais comumente empregada para correções de deformidades mandibulares, tendo se mostrado uma técnica extremamente versátil, por resultar em um íntimo contato dos segmentos, favorecendo uma efetivo reparo ósseo e além de permitir uma fixação adequada e precisa. O objetivo do presente estudo foi realizar uma comparação mecânica de quatro métodos para fixação interna da osteotomia sagital bilateral após avanço com giro horário da mandíbula. Foram utilizadas 56 réplicas de mandíbulas inteiras de poliuretano rígido, customizadas e padronizadas com osteotomia sagital bilateralmente conforme técnica descrita por Epker BN em 1977, mas modificada. Após a simulação de um amplo avanço, onze milímetros (mm) com giro horário da mandíbula (6 graus) em relação ao plano oclusal, os segmentos ósseos foram fixados com placas e parafusos do sistema 2,0mm do lado direito e esquerdo. Grupo I, uma placa em \"H\" duplo, grupo II, duas miniplacas, grupo III, \"técnica híbrida\" e grupo IV, três parafusos bicorticais \"L-invertido\". As mandíbulas foram submetidas a carga entre os incisivos centrais e entre a cúspide mésio e disto vestibular do primeiro molar direito. Na carga entre os incisivos, houve diferença estatisticamente significante no grupo I (placa em \"H\" duplo), em que a média foi maior que as médias dos grupos IV e II no deslocamento de 1 mm (F=4,705; p=0,010). Na carga no primeiro molar, houve diferença das médias de carga quando comparado os grupos no deslocamento de 1 mm (F=5,166; p=0,007). A média do método \"técnica-híbrida\" foi maior que as médias dos métodos da placa em \"H\" duplo e duas placas. Já o método \"L invertido\" não se diferenciou dos outros métodos. Houve diferença das médias de carga quando comparado os grupos no deslocamento de 3 mm (F=3,582; p=0,029). A média do método \"técnica-híbrida\" foi maior que a média do método \"duas placas\". Já os demais métodos não apresentaram diferenças. Houve diferença das médias de carga quando comparado os grupos no deslocamento de 5 mm (F=3,142; p=0,044). A média do método \"L invertido\" foi maior que a média do método \"duas placas\". Os demais métodos não apresentaram diferenças. Entre os deslocamentos de 7 mm não foi observada diferença estatisticamente significante (7 mm: p=0,057). No presente estudo o método \"técnica-híbrida\" foi o de melhor desempenho mecânico, mostrando um comportamento superior em mais momentos quando avaliou-se a carga empregada e os respectivos deslocamentos. Bilateral sagittal osteotomy is one of the most commonly used techniques for correction of mandibular deformities, showing an extremely versatile technique, resulting in an intimate contact of the segments, favoring an effective bone repair and besides allowing an adequate and precise fixation. The objective of the present study was to perform a mechanical comparison of four methods for internal fixation of bilateral sagittal osteotomy after advancement with clockwise rotation of the mandible. We used 56 replicates of rigid polyurethane jaws, customized and standardized with bilateral sagittal osteotomy according to the technique described by Epker BN in 1977, but modified. After simulation of a wide advancement, eleven millimeters (mm) with clockwise rotation of the mandible (6 degrees) in relation to the occlusal plane, the bone segments were fixed with plates and screws of the system 2.0mm of the right and left side. Group I, a double \"H\" plate, group II, two miniplates, group III, \"hybrid technique\" and group IV, three \"L-inverted\" bicortical screws. The mandibles were loaded between the central incisors and between the mesial cusp and the buccal aspect of the right first molar. In the load between the incisors, there was a statistically significant difference in group I (double \"H\" plate), in which the mean was greater than the means of groups IV and II in the displacement of 1 mm (F = 4.705, p = 0.010) . In the first molar load, there were differences in the load means when compared to the groups at 1 mm displacement (F = 5,166, p = 0.007). The mean of the \"technique-hybrid\" method was higher than the mean of the \"double\" H-plate and two-plate methods. The \"inverted L\" method did not differ from the other methods. There was a difference in loading averages when compared to groups at 3 mm displacement (F = 3,582, p = 0.029). The mean of the \"technique-hybrid\" method was higher than the mean of the \"two-plate\" method. The other methods did not present differences. There was a difference in loading means when comparing the groups in the 5 mm displacement (F = 3.142; p = 0.044). The mean of the \"inverted L\" method was higher than the average \"two plate\" method. The other methods did not present differences. Among the 7 mm displacements, no statistically significant difference was observed (7 mm: p = 0.057). In the present study the \"technique-hybrid\" method was the one with the best mechanical performance, showing a superior behavior in more moments when the load used and the respective displacements were evaluated.