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The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyze the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period.The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20-39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2).This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.

This study evaluated, by mechanical testing, the strength of four-hole grid plates used for mandibular angle fracture fixation. Much has been discussed about the treatment of mandibular fractures with straight or curved plates. However, there are few studies about the use of grid plates. The geometry of such plates provides three-dimensional stability, resistance against torque associated with a low profile. Ninety polyurethane hemimandibles were used as substratum. The hemimandibles were divided into nine groups and fixation of the fractures was performed varying the type and position of plate and type of screw. An intact hemimandible group was used as control. It was possible to observe that plates positioned at the tension zone present the highest load values, both for dislocations of 3 and 5 mm. There was no statistical difference when plates with or without an intermediate bar were tested. The locking screws were more efficient than the non-locking screws when the plates were positioned at the neutral zone. Results allowed us to conclude that grid plates installed at the tension zone presented greater mechanical efficiency. If grid plates are positioned at the neutral zone, they should have an intermediate bar and be fixed with locking screws.

Made available in DSpace on 2022-04-29T08:39:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Background/Aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period. Methods: The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p

Study Design: A systematic review according to PRISMA statement has been designed to answer the preliminary question: “ In titanium mesh exposures, is there a treatment alternative which leads to an increased graft maintenance?” and fill the PICO assessment out. Objective: To review studies published in the past 20 years (1999-2019) in which mesh exposure has occurred, detecting the suitable approaches to treat exposure allowing the graft maintenance. Methods: Initial search on PUBMED, SCOPUS, and COCHRANE databases resulted in 777 articles, and hand-searching identified 6 articles. After removing duplicates and unrelated articles, eligibility criteria were applied, and 31 studies were selected (randomized clinical trials, retrospective/prospective clinical trials, and case series). Results: A total of 677 surgical sites and 225 cases of mesh exposure were identified. Eleven treatments have been identified. Chlorhexidine was the primary approach in 46% of cases, followed by oral hygiene instructions and follow-up with 22.5% of occurrences. In 21% of clinical situations, titanium mesh removal was the treatment of choice, associated with other measures (i.e., antibiotic prescription). There seems to be a consensus in cases of infection. When this complication was associated with tissue dehiscence, the primary treatment was mesh removal. The same does not occur when the site needs to be cleaned for long-term periods. Conclusion: In 2 decades of use of titanium meshes, the available treatments do not seem to have evolved, and there is not enough data to establish a guideline.

Purpose: Orbital fractures are high prevalent and result in volumetric changes which may result in clinical impairment as enophthalmos and diplopia. This study aims to evaluate orbital volume and anteroposterior eyeball position in orbital fractures treated by titanium mesh. Methods: This multicenter study evaluated 60 postoperative CT scans of unilateral orbital fractures treated using titanium mesh. Orbital defects were classified according to the extension and involved regions, and the orbital volumes were analyzed by two methods, image sectioning (IS) and computerized segmentation (CS). The eyeball position was obtained from the axial slice in the mid orbit region. Differences up to 8.0% (volume) and 2.0 mm (eyeball position) were considered normal. Results: Most of defects were class II (n=25) and class III (n=26). Volumetric differences between unaffected and reconstructed orbit ranged from -7.15% to 10.46% (mean: -0.15%), and from -6.32% to 9.69% (mean: -0.01%) in IS and CS method, respectively. In both methods, two reconstructions were greater than anatomical differences, however there was no statistical differences between the orbits in both methods, IS (p=0.852) and CS (p=0.987). Anteroposterior eyeball position ranged from -0.9 mm to 1.8 mm. The correlation between defect classification, eyeball position and IS or CS, were not positive. Conclusion: In conclusion, regardless of the extent of the orbital defect or evaluation method, fractures treated by titanium mesh reestablished adequately the orbital volume.

The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.

Made available in DSpace on 2022-04-29T08:40:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective This study aimed to evaluate the daytime sleepiness and sleep quality of students in different academic years of the dental school program. Materials and Methods A total of 221 students, from the 1st to the 5th year, answered the questionnaires: Epworth, Pittsburg, Nasal Obstruction Symptom Evaluation, and Berlin, related to daytime sleepiness, sleep quality, nasal obstruction, and obstructive sleep apnea syndrome (OSAS), respectively. Statistical Analysis The Kolmogorov-Smirnov test was used to assess the normality of continuous quantitative data and, posteriorly, the chi-square test was used to show if there were any associations. The significance level adopted was 5%. Results An association between daytime sleepiness and nasal obstruction was observed at the beginning of the school year (T1) (p = 0.002) and at the end of the school year (T2) (p = 0.043). In T2, an association between nasal obstruction and sleep quality was also observed (p = 0.026). The academic performance (AP) was only associated with the OSAS in T1 (p = 0.012). There was no significant difference in AP between the beginning and the end of the academic year (p = 0.935). Conclusion With the methodology used, it was observed that nasal obstruction influenced sleep quality and daytime sleepiness, and daytime sleepiness did not have any influence on AP. Department of Diagnosis and Surgery Dental School of Araraquara São Paulo State University, São Paulo Department of Oral Radiology Aarhus University Otolaryngology Division Medical School University of Araraquara Uniara, São Paulo Department of Diagnosis and Surgery Dental School of Araraquara São Paulo State University, São Paulo

Made available in DSpace on 2020-12-12T02:21:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 OBJECTIVE: To perform an integrative review associating current literature with a clinical series regarding the use of Le Fort I osteotomy for the removal of tumors located in the midface and central region of the skull base. METHODS: A systematic review was performed through the PubMed, SCOPUS, and Cochrane databases. In addition, 4 different patients operated using the above-cited technique are described in this study. RESULTS: Initially, 123 articles were found. After the removal of duplicates, and title and abstract reading, 27 articles were selected for data extraction. The Le Fort I surgical approach of tumors was performed in 183 patients. CONCLUSION: The Le Fort I surgical approach allows lesion exeresis with good visualization, low rates of recurrences and complications, and without aesthetic compromises for the patient. Department of Diagnosis and Surgery São Paulo State University Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP Department of Diagnosis and Surgery São Paulo State University Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP

The aim of this study was to compare the longitudinal stability of implants with Morse taper and external hexagon connections placed in the anterior mandible and subjected to immediate functional loading. Nine patients each received 4 mandibular implants placed between the mental foramina. In each patient, 2 implants on the left side of the arch had Morse taper prosthetic connections, and 2 implants on the right side had external hexagon prosthetic connections. Mandibular overdentures and opposing removable complete dentures were placed within 72 hours after implant surgery. Clinical evaluation of the implants via magnetic transduction resonance frequency analysis was performed immediately following surgery and 3 months, 6 months, and 2 years following surgery to obtain the implant stability quotient (ISQ). The data obtained were parametric according to the Kolmogorov-Smirnov normality test. The lowest ISQ of any implant was approximately 67, representing reliable osseointegration. The only statistically significant difference between the 2 types of prosthetic connection was found in the initial period (immediately following surgery), when the external hexagon connection in the distal position presented greater stability than did the Morse taper connection in the same position on the opposite side (P0.05; Student t test). In intragroup comparisons, no statistically significant differences were found regarding the positions of the implants in the mandible. When the different follow-up periods were evaluated, there were statistically significant differences only in the external hexagon group, with significant reductions in stability of both mesial and distal implants at 6 months compared to other time periods (P0.05; Tukey test). Within the limitations of the study, it can be concluded that both Morse taper and external hexagon prosthetic connections provide good stability in an immediate functional loading protocol.

Made available in DSpace on 2022-04-29T08:39:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Background/Aims: The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. Methods: The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. Results: Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2–7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p

Made available in DSpace on 2022-04-28T19:50:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Objectives: This study evaluated the cellular response of primary osteoblasts exposed to two different presentations of a low-temperature non-sintered deproteinized bovine bone matrix (DBBM). Materials and methods: Six different baths of a commercially available DBBM block (Bonefill® Porous Block) and one of DBBM granule (Bonefill® Porous) were evaluated to identify the mineral structure and organic or cellular remnants. Samples of the same baths were processed in TRIZOL for RNA extraction and quantification. For the immunologic cell reaction assay, primary human osteoblasts (pOB) were exposed to DBMM block (pOB + B) or granules (pOB + G), or none (control) for 1, 3, or 7 days of cell cultivation. Expression of proinflammatory cytokines by pOB was evaluated by crosslinked ELISA assay. In addition, total DNA amount, as well as cell viability via LDH evaluation, was assessed. Results: Organic remnants were present in DBBM blocks; 45.55% (±7.12) of osteocytes lacunae presented cellular remnants in blocks compared to 17.31% (±1.31) in granules. In three of five batches of blocks, it was possible to isolate bovine RNA. The highest concentration of TGF-β1 was found in supernatants of pOB + G on day 7 (218.85 ± 234.62 pg/mL) (p < 0.05), whereas pOB + B presented the lowest amount of TGF-β1 secretion at the end of evaluation (30.22 ± 14.94 pg/mL, p < 0.05). For IL-6 and OPG, there was no statistical difference between groups, while pOB + G induced more IL-8 secretion than the control (3.03 ± 3.38 ng/mL, p < 0.05). Considering the kinetics of cytokine release during the study period, all groups presented a similar pattern of cytokines, estimated as an increasing concentration for IL-6, IL-8, and OPG during cultivation. Adherent cells were observed on both material surfaces on day 7, according to H&E and OPN staining. Conclusion: Neither tested material induced a pronounced inflammatory response upon osteoblast cultivation. However, further studies are needed to elucidate the potential influence of organic remnants in bone substitute materials on the regeneration process. Department of Diagnosis and Surgery School of Dentistry Sao Paulo State University (Unesp) FORM-Lab Frankfurt Oral Regenerative Medicine Department for Oral Cranio-Maxillofacial and Facial Plastic Surgery Medical Center of the Goethe University Department of Diagnosis and Surgery School of Dentistry Sao Paulo State University (Unesp) CAPES: 001

Made available in DSpace on 2022-04-28T19:43:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-01 ABSTRACT: Necrotizing fasciitis (NF) is an infection of the deeper tissues that results in progressive destruction of muscle fascia and overlying subcutaneous fat. It has a fast and destructive course. Moreover, it is related to immunosuppression and could be fatal. The aim of this study is to report a clinical case of a young patient, without immunosuppression, who developed NF evolution due to an erroneous diagnosis of abscess at the beginning of the disease. Patient was submitted to broad-spectrum antibiotic therapy and aggressive surgical treatment. Adequate treatment led to a satisfactory evolution in a short period of time. Early recognition and adequate treatment are essential for a favorable prognosis. Department of Diagnosis and Surgery São Paulo State University (Unesp) School of Dentistry Department of Diagnosis and Surgery São Paulo State University (Unesp) School of Dentistry

Made available in DSpace on 2020-12-12T01:42:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-09-01 In this report, we describe the successful use of alternate rapid maxillary expansions and constrictions with a hybrid hyrax-mandibular miniplate combination and simultaneous orthodontic treatment for the management of severe Class III malocclusion due to maxillary hypoplasia in an 11-year-old girl. The devices were removed after 20 months of treatment, and the family was instructed about a careful control and retention program that should be followed in accordance with the patient’s growth. The final result included the correction of Class III malocclusion with adequate function and excellent facial esthetics, which restored the patient’s self-esteem and provided personal motivation. The outcomes showed good stability after 24 months of retention. The decrease in the duration of active treatment is the most important finding from the present case. Considering that facial esthetics in adolescence is a determining factor for the development of a personality and interpersonal relationships, we recommend the use of this protocol for growing patients, who will exhibit not only an improved physical appearance but also a better quality of life. [Korean J Orthod 2019;49(5):338-346] © 2019 The Korean Association of Orthodontists. Department of Orthodontics CES University Department of Orthodontics and Pediatric Dentistry Araraquara School of Dentistry Universidade Estadual Paulista - UNESP Department of Orthodontics Universidad del Valle Department of Diagnosis and Oral and Maxillofacial Surgery Araraquara School of Dentistry Universidade Estadual Paulista - UNESP Department of Orthodontics and Pediatric Dentistry Araraquara School of Dentistry Universidade Estadual Paulista - UNESP Department of Diagnosis and Oral and Maxillofacial Surgery Araraquara School of Dentistry Universidade Estadual Paulista - UNESP

Made available in DSpace on 2022-04-29T08:34:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 OBJECTIVES: This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry. METHODS: Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation. RESULTS: Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P ≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398; P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = -0.650, P = 0.016). CONCLUSIONS: Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the gold standard method for the evaluation of bone quality and greater bone density was observed in older men. Diagnosis and Surgery Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Pathology and Physiology Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Diagnosis and Surgery Department Araraquara Dental School São Paulo State University (FOAr/UNESP) Pathology and Physiology Department Araraquara Dental School São Paulo State University (FOAr/UNESP)

Made available in DSpace on 2022-04-29T08:32:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 Objective: The aim of this study was to compare bone formation between 2 distraction osteogenesis protocols by analyzing cone beam computed tomography (CBCT) scan data. Study Design: In this retrospective study, the efficacy of 2 different surgically assisted rapid maxillary expansion protocols (group 1 [G1], 3 × 0.25 mm/d; group 2 [G2], 1 mm start followed by 2 × 0.25 mm/d) was analyzed using CBCT scans obtained at 3 time points: preoperatively (T0), immediately after surgery (T1), and 6 months after surgery (T2). Bone formation at T0, T1, and T2 was analyzed using the Dolphin Imaging 11 program. Results: At T1, both groups had significantly higher bone volume than at T0 (G1, 135.6 vs 124.65 mm3, respectively; G2, 153.49 vs 118.9 mm3, respectively), with no significant difference between groups (P = .6). Moreover, bone density measured in the region of interest was similar between groups at all 3 time points; however, in both groups, bone density was significantly lower at T1 and T2 than at T0 (P < .01), with no difference between T1 and T2. Conclusions: Bone density between the incisors decreased with progressive distraction (i.e., increasing volume), regardless of the distraction protocol used; thus, both protocols can be used safely in clinical practice. Nevertheless, our results indicate that stress should not be applied to the incisors within 6 months of surgery, regardless of the protocol used. Surgeons and orthodontists should therefore consider immature bone formation and avoid using excessive force to close a diastema. Department of Oral and Maxillofacial Surgery Medical University of Vienna. Department of Diagnosis and Surgery Dental School of Araraquara São Paulo State University. Department of Diagnosis and Surgery Dental School of Araraquara São Paulo State University.

Background and Aim Surgically assisted rapid maxillary expansion (SARME) is a surgical technique widely used to correct deficiency of the transverse maxillary dimension. Although some studies investigated the effect of SARME on nasal and facial alterations, there is no evidence that correlates nasal septal deviation (NSD) to SARME as a possible postoperative sequel. The aim of this study is to address and quantify possible variations in the position of the nasal bony septum after SARME and identify any NSD as a postoperative outcome of this surgical technique. Patients and Methods This is a retrospective study, conducted at the Department of Oral and Maxillofacial Surgery of the University Hospital of Araraquara (Unesp, faculty of dentistry), SP, Brazil. Twenty-nine patients who underwent SARME were studied; every patient was evaluated by cone-beam computerized tomography (CBCT) before (T0) and six months after surgery (T1), and we collected the variation of nasal septal position by measuring the distance between the bony septum and the nasal lateral wall. Our measurements were carried out at the level of the head, midpoint and tail of the inferior turbinate. Results A mean NSD ranging from 0.4 to 1.2 mm was measured, and it is more pronounced at the anterior part of the bony septum. Twenty-seven patients (93.1%) presented minor changes in bony septum position; in 2 cases (6.8%), a significant NSD was found (p Conclusion A variation of bony nasal septum position can be expected in any direction after SARME, and it is more pronounced at anterior portion.

Made available in DSpace on 2020-12-12T02:21:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 Dental transplantation is an alternative for rehabilitation with a high success rate. This article presents a clinical case of autogenous dental transplantation in a 17-year-old male patient undergoing treatment for Class III dento-facial deformity. After 32 months followup, low-cost rehabilitation was possible, and without prejudice to ortho-surgical treatment. Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP Division of Oral and Maxillofacial Surgery Department of Diagnosis and Surgery Dental School at Araraquara-UNESP

Made available in DSpace on 2020-12-12T02:48:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-09-01 This study evaluated the optical bone density of the maxilla and mandible and correlate with the classification of bone quality of the Lekholm and Zarb (L & Z). Sixty edentulous areas were evaluated. Panoramic and periapical radiographs were performed with an aluminum scale to evaluate the optical bone density. L & Z classification was also applied. By using periapical radiographs, a statistically significant difference was observed in the optical bone density of the posterior maxilla (2.38 ± 1.06) and the posterior mandible (3.84 ± 0.68), when compared to the other regions (P ≤ 0.015). However, with panoramic radiographs, no differences were observed in the optical bone density (P = 0.6322). A negative correlation was observed between the L & Z classification and the optical bone density obtained by the periapical radiographs (rho = -0.463; P

A Síndrome do Tuner (TS) é um distúrbio genético causado pela ausência total ou parcial do cromossomo X. A condição foi descrita pela primeira vez em 1938 e representa o defeito cromossômico mais freqüente. 45, X é o cariótipo mais comumente apresentado em pacientes com essa patologia. Caracteriza-se por anomalias craniofaciais, baixa estatura, atraso no desenvolvimento puberal, esterilidade, peito grande, agenesia dentária, mordida aberta anterior, diastema, dentes supranumerários, entre outros. O objetivo deste estudo é descrever um caso sobre uma das manifestações orais da ST. Paciente do sexo feminino, 8 anos, encaminhada ao ambulatório de Odontopediatria da Faculdade de Odontologia do Centro Universitário Cesmac-Brasil. Durante o exame foram observadas as características patognomônicas da ST e ausência dos 11 e 21 dentes. A radiografia panorâmica mostrou dentes supranumerários na região anterior da maxila, afetando a erupção de 11 e 21 dentes. O tratamento proposto foi remover cirurgicamente os dentes supranumerários. É obrigatório associar o exame clínico e exames complementares ao diagnóstico precoce, a fim de planejar o tratamento preciso com o objetivo de reduzir possíveis complicações clinicamente associadas.Descritores: Síndrome de Turner; Dente Supranumerário; Anormalidades Congênitas.ReferênciasVasconcelos, B. Estudo da frequência de aberrações cromossômicas nos pacientes atendidos na Unidade de Genética do Instituto da Criança entre 1992 a 2002 [dissertação]. São Paulo: Faculdade de Medicina da Universidade de São Paulo – USP; 2007.Laranjeira C, Cardoso H, Borges T. Turner syndrom. Acta Pediatr Port. 2010;41(1):38-43.Selow MLC, Vieira I, Figueiredo AM, Miyaki MR. A síndrome de turner em odontologia. Dens. 2006;14(2):13-20Russell KA. Orthodontic treatment for patients with Turner. Am J Ortho Dentofacial Orthop. 2001;120(3):314-22Hwang CJ, Cha JY. Orthodontic treatment with growth hormone therapy in a girl of short stature. Am J Ortho Dentofacial Orthop. 2004;126(1):118-26.Midtbø M, Halse A. Occlusal morphology in Turner syndrome. Eur J Orthod. 1996;18(2):103-9.Mandelli SA, Abramides DVM. Manifestações clínicas e fonoaudiológicas na síndrome de turner: estudo bibliográfico. Rev CEFAC. 2012;14(1):146-55Ayoub F, Aoun N, El Husseini H, Jassar H, Sayah F, Salameh Z. Oral and craniofacial clinical signs associated to genetic conditions in human identification part I: a review. J Int Oral Health. 2015;7(5):81–86.Kasagani SK, Jampani ND, Nutalapati R, Mutthineni RB, Ramisetti A. Periodontal manifestations of patients with Turner's syndrome: Report of 3 cases. J Indian Soc Periodontol. 2012;16(3):451-55.Shankar RK, Backeljauw PF. Current best practice in the management of Turner syndrome. Ther Adv Endocrinol Metab. 2018;9(1):33-40.Duarte AC. Mulheres com síndrome de Turner: relação entre atividade física e qualidade de vida [dissertação]. São Carlos: Universidade Federal de São Carlos; 2016.Contreras JPO, Cepeda SEN, Gonzales GIM. Enfoque odontológico del Síndrome de Turner. Remexesto. 2017;4(2):27- 37.Wanderley CAP, Príncipe CSR, Pires EU, Ferreira LM, Ferreira LS, Santos MCO et al. Desenvolvimento sexual e cognitivo das portadoras da síndrome de Turner. Ciênc cogn. 2004;2:61-74.Midtbø M, Halse A. Root length, crown height and root morphology in Turner syndrome. Acta Odontol Scand. 1994:52(5):303-14.Wang XP, Fan J. Molecular genetics of supernumerary tooth formation. Genesis. 2011;49(4):261-77.Lopez, ME, Bazan C, Lorca IA, Chervonagura A. Oral and clinical characteristics of a group of patients with Turner síndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(2):196-204.Garvey MT, Barry HJ, Blake M. Supernumerary teeth: an overview of classification, diagnosis and management. J Can Dent Assoc.1999;65(11):612-16.Szilágyi A, Keszthelyi G, Nagy G, Madléna M. Oral manifestations of patients with Turner syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(5):577-84.Duarte F, Ramos C, Fonseca L. Dentes Supranumerários. Temática. 2006;1:53-66Peker I, Kaya E, Darendeliler-Yaman S. Clinical and radiographical evaluation of non-syndromic hypodontia and hyperdontia in permanent dentition. Med Oral Patol Oral Cir Bucal. 2009;14(8):e393-97.

Modern techniques for prosthetic dental rehabilitation would be unthinkable today without the use of osseointegrated implants. Although success rates are high, complications may occur, especially when complex soft tissue and/or bone reconstruction are necessary. Moreover, systemic conditions and use of antiresorptive drugs can have undesirable effects on healing and predispose to complications. This chapter deals with soft tissue and osseous complications related to the rehabilitation of the atrophic mandible, with emphasis on the etiology, prevention, and treatment of those problems.

Study design The present case report demonstrated a reproducible and low-cost method to planning orbito-zygomatic reconstruction applied to a sequela of facial trauma. Aim This study aims to purpose a method to surgical planning orbito-zygomatic reconstruction and demonstrate it in a clinical report. Method An 89 years old male patient with severe sequela due to previous trauma surgery was submitted to a reconstructive surgery using cutting guides and mini-plates pre shaped using a stereolitographic printed model with mirroring healthy side. Results Computed assisted surgery (CAS) contributed to the advancement of surgical planning and reconstruction in Oral and Maxillofacial Surgery, and trauma-related injuries. Traumatic injuries at the orbito-zygomatic region and midface are challenging and satisfactory three-dimensional reconstruction is not often achieved with conventional techniques; therefore, it strongly benefits from CAS and 3D printing. However, the high costs and technical difficulties can impair the use of new technologies in the public health system of low-income countries. Conclusion Hence, the present case report demonstrated a reproducible and low-cost method to planning orbito-zygomatic reconstruction applied to a sequela of facial trauma.

Objective : Obstructive Sleep Apnea (OSA) occurs by recurrent collapse of the upper airway during sleep. It results in complete (apnea) or partial (hypopnea) reduction of airflow and has intimate relation with the upper airway anatomy. Cephalometric analysis has been used to quantify airway dimensions. The aim of this study is evaluate the correlation between the anteroposterior dimension of the upper airway and the severity of obstructive sleep apnea. Material and Methods : A retrospective analysis was performed reviewing polysomnographic data (AHI) and anteroposterior cephalometric measurements of pharynx subregions: nasopharynx, oropharynx, hypopharynx. Results : The sample consisted of 30 patients. The mean body mass index was 29.60 kg/m 2 and the average age was 46.8 years. Nine patients presented severe OSA, seven had moderate OSA , seven had mild OSA, and seven were healthy. The Pearson's correlation index between the anteroposterior dimension of the nasopharynx, oropharynx and hypopharynx and AHI was respectively -0.128 (p=0.517), -0.272 (p=0.162) and -0.129 (p=0.513). Conclusion: The correlation between anteroposterior linear dimension of the airway and OSA severity, assessed by AHI, was not positive. As an isolated parameter it did not correlate to the severity of the obstrucive sleep apnea syndrome and should be evaluated in conjunction with other factors. Keywords Upper Airway; Obstructive sleep apnea; Cone beam CT.

Osteoblastomas are benign bone tumors, which are unusual in the craniofacial skeleton, being most often observed in the axial skeleton and long bones. The most common site in the maxillofacial region is the mandible and the involvement of the maxilla and paranasal sinuses is extremely rare. Although it is a benign lesion, the aggressive variant raises concerns due to its huge local destructive potential and tendency to relapse. In this clinical case, an aggressive osteoblastoma is described in a 7-year-old patient. The lesion was large and fully involved the left maxilla, including the maxillary sinus and the nasal cavity. Recurrent volume increase was observed 2 months following enucleation of the lesion and en bloc resection of the maxillary segment was performed. Histological and immunohistochemical evaluation associated with clinical and imaging findings allowed to define the tumor as an aggressive variant of osteoblastoma and not osteosarcoma, despite the aggressive behavior. The patient recovered well and no relapses were observed after 12 months following maxillary resection.

Varied factors, whether intrinsic or extrinsic, may lead to a decrease in the bone volume of the jaws. Trauma and pathology can be listed as examples of such factors. The aim of this study is to present the osteogenic distraction technique as alternative to augmentation of low mandibular bone volume caused by different etiologies. The first case reports a mandibular marginal resection of ameloblastoma and the second one reports a male patient presenting mandibular fracture sequelae. Both cases were treated according to the osteogenic distraction technique. Several factors have influence on the decision of treatment management of these conditions. Although autogenous bonegraft is considered criterion standard for alveolar reconstruction, its high rates of resorption and the morbidity associated to donor sites lead surgeons to seek for other surgical alternatives such as osteogenic distraction. Therefore, it also aims to expose the advantages and benefits of this technique as well as the satisfactory results achieved.

Os defeitos mandibulares devido a resseccao de lesao ossea interferem a harmonia e estetica facial comprometendo a qualidade de vida dos pacientes. Grandes defeitos exigem planejamento minucioso, principalmente quando lancamos mao de enxertos e placas de reconstrucao, evitando assim resultados insatisfatorios ou ate mesmo sequelas. Apesar de algumas classificacoes dos defeitos mandibulares vem sendo discutidas ao longo dos anos, ainda nao ha um protocolo definido para reconstrucao mandibular. O uso de prototipagem na Cirurgia Bucomaxilofacial tem se tornado cada vez mais frequente; a precisao da reconstrucao, diminuicao do tempo de cirurgia reflete em recuperacao mais rapida do paciente. Mesmo com a ferramenta da prototipagem, grandes lesoes e perdas osseas permanecem como grande desafio ao cirurgiao. O objetivo deste trabalho e relatar um caso clinico de reconstrucao mandibular no qual houve a necessidade de ser tratado com remocao de placa de reconstrucao e nova reabilitacao cirurgica do paciente. Descritores: Mandibula; Reconstrucao Mandibular; Modelos Biologicos. Referencias Santos LCS, Seixas AM, Barbosa B, Cincura RNS. Adaptacao de placas reconstrutivas: uma nova tecnica. Rev Cir Traumatol Buco-Maxilo-Fac . 2011;11(2):9-14. Lin PY, Lin KC, Jeng SF. Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg. 2011;2011:824251. Martins Jr. JC, Keim FS. Uso de prototipagem no planejamento de reconstrucao microcirurgica da mandibula. Rev Bras Cir Craniomaxilofac. 2011;14(4):225-28. Montoro JR, Tavares MG, Melo DH, Franco Rde L, Mello-Filho FV, Xavier SP, Trivellato AE, Lucas AS. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Braz J Otorhinolaryngol . 2008;74(1):155-57. Noia CF, Ortega-Lopes R, Chaves Netto HDM, Nascimento FFAO, Sa BCM. Desafios na reconstrucao mandibular devido a lesoes extensas ou traumatismos. Rev Assoc Paul Cir Dent. 2015;69(2):158-63. Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-6. Rana M, Warraich R, Kokemuller H, Lemound J, Essig H, Tavassol F et al. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period. Head Neck Oncol. 2011;3:23. Farina R, Alister JP, Uribe F, Olate S, Arriagada A. Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm. Plast Reconstr Surg Glob Open. 2016;4(8):e845. Farina R, Plaza C, Martinovic G. New transference technique of position of mandibular reconstructing plates using stereolithographic models. J Oral Maxillofac Surg. 2009;7(11):2544-48. Mooren RE, Merkx MA, Kessler PA, Jansen JA, Stoelinga PJ. Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients. J Oral Maxillofac Surg. 2010;68(10):2459–67. Brown JS, Barry C, Ho M, Shaw R.A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1):23-30 Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects . Arch Otolaryngol Head Neck Surg. 1991;117(7):733-44. Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand JP, Wax MK. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm. JAMA Facial Plast Surg. 2015;17(5):367-73. Wei FC, Celik N, YangWG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37-42. Li BH, Jung HJ, Choi SW, Kim SM, Kim MJ, Lee JH. Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation. J Craniomaxillofac Surg. 2012;40(8):293-300.

Introdução: A sialolitíase é a desordem mais comum das glândulas salivares acometendo principalmente a glândula submandibular e o seu ducto. Caracteriza-se pela formação de cálculos ou sialólitos no interior do ducto ou do próprio parênquima glandular. A etiologia pode estar associada ao pH alcalino e aumento da concentração de cálcio na saliva, além de fatores anatómicos como estenose ou diverticulação do ducto salivar. Objetivo: relatar um caso clínico de sialólito localizado no ducto da glândula submandibular, bem como discutir a literatura pertinente sobre o tema. Métodos: Paciente do gênero masculino, compareceu ao Hospital Geral de Areias com queixa de aumento em região de soalho bucal direito. Foram solicitadas radiografias panorâmica e oclusal e observou-se massa radiopaca de formato cilíndrico e alongado na região submandibular. A excisão cirúrgica foi realizada sob anestesia local. Paciente não apresentou complicações e retomou-se o reestabelecimento da patência do ducto e normalidade do fluxo salivar. Conclusões: A conduta mostrou-se eficaz no manejo da lesão através de remoção cirúrgica por acesso intrabucal. Estas desordens são facilmente diagnosticadas através do exame clínico e de imagem.Descritores: Glândula Submandibular; Soalho Bucal; Cálculos das Glândulas Salivares.ReferênciaRibeiro J, Mourão CF, Magacho LF, Albieiri F, Vicentis G, Fernandes O, et al. Tratamento cirúrgicos dos sialolitos gigantes das glândulas submandibulares: relato de dois casos. In J Sci Dent. 2016;22(46).Acevedo JAD, Trocino BS, Mercado HR. Sialolitiasis del conducto submandibular: reporte de un caso reporte de un caso. Rev Mex Cir Bucal Maxilofac. 2017;13(3):100-7.França DCC, Facio JC, Maia CMP, Monteiro AD, Carvalhosa AA, Moi GP et al. Sialolito no ducto da glândula submandibular: relato de casa. Connection Line. 2012;7:78-89.Landgraf H, Assis AF, Klüppel LE, Oliveira CF, Grabielli MAC. Extenso sialolito no ducto da glândula submandibular : relato de caso Rev Cir Traumatol Buco-Maxilo-Fac. 2006;6(2):29-34.Kim JH, Aoki EM, Rodriguez A, Cortes ARG, Abdala-Júnior R, Asaumi J, Arita ES. Comparison of the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths. Imaging Sci Dent. 2016;46(2):87-92.Tahher AA. The incidence and composition of salivary stones (sialolithiasis) in Iran: analysis of 95 cases—a short report. Singapore Dent J. 1990:14(1):33-5.Cho S, Han J, Kim J, Lee S, Jo J, Kim C et al. Removal of submandibular calculi by surgical method and hydraulic power with curved needle : a case report. J Korean Assoc Oral Maxillofac Surg. 2017;43(3):182-85.Pereira RS, Bonardi JP, Silva JR, Mourão CFAB, Souza FI, Pimentel RM. Remoção cirúrgica de sialolito no ducto da glândula submandibular : relato de caso. Arch Health Invest. 2017;6(4):185-88.Folchini S, Stolz AB. Sialolitos na glândula submandibular : relato de caso. Odontol ClínCient. 2016;15(1):67-71.Ogura I, Hayama K, Sue M, Oda T, Sasaki Y. Submandibular sialolithiasis with CT and scintigraphy : CT values and salivary gland excretion in the submandibular glands. Imaging Sci Dent. 2017;47(4):227-32.Alves NS, Soares GG, Azevedo RS, Camisasca DR. Sialolito de grandes dimensões no ducto da glândula submandibular. Rev Assoc Paul Cir Dent. 2014;68(1):49-53.Baurmash HD. Submandibular salivary stones : current management modalities. J Oral Maxillofac Surg. 2004;62(3)369-78.

Introducao: o zigoma articula-se com quatro ossos e e de extrema importância na forca e estabilidade do terco medio da face. Por sua projecao anterior na face, torna-se um osso bastante susceptivel aos traumas. Fraturas podem resultar em sequelas funcionais significantes e esteticas. Objetivo: relatar um caso clinico de fratura de zigoma, bem como debater sobre possiveis formas de fixacao, suas indicacoes e sequencia cirurgica. Materiais e metodos: paciente genero masculino, 26 anos de idade e com historico de agressao fisica. Ao exame clinico e de imagem, constatou-se fratura de complexo zigomatico-orbitario direito, que foi tratado com osteossintese em dois pontos de fixacao. Resultados: a abordagem de fixacao da fratura nas suturas zigomatico-frontal e zigomatico-maxilar foi satisfatoria e concedeu estabilidade e projecao anteroposterior na face. Paciente segue em acompanhamento de seis meses sem apresentar sequelas ou complicacoes. Conclusoes: o manejo das fraturas do complexo zigomatico-maxilar ainda e discutido e controverso na literatura. Porem a abordagem com fixacao de dois pontos se mostrou precisa, menos invasiva e com menor custo. Descritores: Zigoma; Fixacao de Fratura; Traumatologia. Referencias Nagaprasad N, Praveen Harish G, Reddy GSG. Clinical Study of Isolated Zygomatic Fractures. Int J Contemp Med Res. 2016;3(7):1983-86. Jardim ECG, Santiago Junior JF, Melo RL, Mendonca JCG, Faverani LP, Garcia Junior IR et al. Combinacao de tecnicas para tratamento cirurgico de fratura do complexo zigomatico-maxilar: relato de caso. Arch Health Invest. 2013; 2(3):33-6. Sassi LM, Dissenha JL, Bezeruska C, Guebur MI, Hepp V, Radaelli RL et al. Fraturas de zigomatico: revisao de 50 casos. Rev Bras Cir Cabeca Pescoco. 2009; 38:246-7. Mendonca JCG, Crivelli DMB. Tratamento de fratura cominutiva do complexo zigomatico orbitario com utilizacao de fio de aco: relato de caso. Rev Bras Cir Cabeca Pescoco. 2012;41(2):93-5. Oliveira JAGP. Fratura do arco zigomatico: relato de caso utilizando o acesso pre-auricular. Rev Cir Traumatol Bucomaxilofac. 2009; 9(1):47-52. Oliva MA. Acesso subciliar para fraturas do complexo zigomatico-orbitari. Rev Bras Cir Cabeca Pescoco. 2013;42(2):106-8. Meslemani D, Kellman RM. Zygomaticomaxillary complex fractures. Arch Facial Plast Surg. 2012; 14(1):62-6 Rana M, Warraich R, Tahir S, Igbal A, von See C, EcKardt AM et al. Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation– a randomised prospective clinical trial. Trials 2012; 13:36 Ellis E 3rd, Kittidumkerng W. Analysis of treatment for isolated zygomatic maxillary complex fractures. J Oral Maxillofac Surg. 1996; 54(4):386-400. Ellis E 3rd, Daniel Perez. An algorithm for the treatment of isolated zygomatico-orbital fractures. J Oral Maxillofac Surg. 2014;72(10):1975-83. Tripathi N, Goyal M, Mishra B, Dhasmana S. Zygomatic complex fracture: A comparative evaluation of stability using titanium and bio‑resorbable plates as one point fixation. Nat J Maxillofac Surg. 2013;4(2):181-87. Yonehara Y, Hirabayashi S, Tachi M, Ishii H. Treatment of zygomatic fractures without inferior orbital rim fixation. J Craniofac Surg. 2005;16(3):481-85. Eski M, Sahin I, Deveci M, Turegun M, Isik S Sengezer M. A retrospective analysis of 101 zygomatico-orbital fractures. J Craniofac Surg. 2006;17(6):1059-64. Chrcanovic BR, Cavalcanti YS, Reher P. Temporal miniplates in the frontozygomatic area-an anatomical study. J Oral Maxillofac Surg. 2009;13(4):201-6. Davidson J, Nickerson D, Nickerson B. Zygomatic fractures: comparison of methods of internal fixation. Plast Reconstr Surg. 1990;86(1):25-32. Kim ST, Godh, Jung JH. Comparison of one point fixation with two point fixation in treating tripod fractures of zygoma, J Oral Maxillofac Surg. 2011; 69(11):2848-52 Kovacs AF, Ghahremani M. Minimization of zygomatic complexfracture treatment. Int J Oral Maxillofac Surg. 2001; 30(5):380-83. Nasr WF, ElSheikh E, El-Anwar MW, Sweed AH, Bessar A, Ezzeldin N. Two-versus three-point internal fixation of displaced zygomaticomaxillary complex fractures. Craniomaxillofac Trauma Reconstr. 2018;11(4):256-64.

Made available in DSpace on 2020-12-10T19:40:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-11-06 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ObjectivesThe objective of this study was to evaluate the peri-implant bone tissue formation around titanium implants with different surface treatments, placed in bone defects filled or not with bone substitute material (BSM). Materials and MethodsTen animals were divided into two groups according to implant surface treatment. In each tibia, a bone defect was created followed by the placement of one implant. On the left tibia, the defect was filled with blood clot (BC), and on the right tibia, the defect was filled with biphasic hydroxyapatite/beta-tricalcium-phosphate (HA/TCP) generating four subgroups: BC-N: blood clot and porous surface; BC-A: blood clot and porous-hydrophilic surface; HA/TCP-N: BSM and porous surface; HA/TCP-A: BSM and porous-hydrophilic surface. The animals were submitted to euthanasia 60days after implant installation. After light-curing resin inclusion, the blocks containing the implant and the bone tissue were stained and evaluated by means of histomorphometry to assess the percentages of bone implant contact (% BIC). Data was normally distributed and the group differences were examined using the parametric tests of Two-Way ANOVA. ResultsThe BC-A group presented the higher mean value of BIC (46.43%). The HA/TCP-A group presented the higher mean value of BIC. The porous-hydrophilic surfaces presented better results of BIC when compared to the porous surface in both conditions of defect filling. No statistically significant differences were found among all groups (95% confidence interval and P

Made available in DSpace on 2020-12-10T19:50:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-02-23 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objective To evaluate the histological and microtomographic response of peri-implant bone tissue around titanium implants with different surface treatments, placed in bone defects filled or not filled with bone substitute materials. Materials and Methods Thirty rabbits were divided into two groups according to the implant surface treatment. A bone defect was created in both tibias of all the rabbits, followed by the placement of one implant in each of these defects. On the left tibia, the defect was filled with a blood clot (BC), and on the right tibia, the defect was filled with biphasic hydroxyapatite/beta-tricalcium-phosphate (HA/TCP); thus, there were four groups in total: BC-N: bone defect filled with a BC and porous surface titanium implant (control group); BC-A: bone defect filled with a BC and porous-hydrophilic surface titanium implant; HA/TCP-N: bone defect filled with a bone substitute material and porous surface titanium implant; HA/TCP-A: bone defect filled with a bone substitute material and porous-hydrophilic surface titanium implant. The animals were submitted for euthanasia at three distinct periods: 15, 30, and 60 days after implant installation. The samples were evaluated histologically and histometrically, to assess the quantity and quality of cells and the remaining bone substitute material in the grafted areas. The bone quantity was assessed by micro-computed tomography (CT). Results For both surface types, the presence of a bone substitute material led to higher values in all evaluated micro-CT parameters, except in the bone surface/volume ratio parameter. No significant statistical difference was found for new bone formation between the four groups (P < .05; CI 95%). At all periods, the HA/TCP-A group had a higher percentage of new bone formation. Conclusion These results suggest that a porous hydrophilic surface in the presence of bone substitute material can accelerate peri-implant bone tissue formation. Sao Paulo State Univ, Sch Dent, Dept Diag & Surg, Araraquara, SP, Brazil Aarhus Univ, Fac Hlth, Sect Oral Radiol, Dept Dent & Oral Hlth, Aarhus, Denmark Sao Paulo State Univ, Sch Dent, Dept Oral & Maxillofacial Surg, Aracatuba, Brazil Sao Paulo State Univ, Sch Dent, Dept Diag & Surg, Araraquara, SP, Brazil Sao Paulo State Univ, Sch Dent, Dept Oral & Maxillofacial Surg, Aracatuba, Brazil FAPESP: 2016/07837-1 FAPESP: 2017/04017-6

Made available in DSpace on 2018-11-12T17:27:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-12-01. Added 1 bitstream(s) on 2018-11-12T17:35:06Z : No. of bitstreams: 1 S1807-25772016000600356.pdf: 1037176 bytes, checksum: ccd25d19367f959d2eaa70766c3e7ba3 (MD5) ResumoIntrodução A deficiência anteroposterior da maxila pode estar associada com a diminuição do volume da via aérea superior. O avanço de maxila por resultar em um aumento do espaço aéreo superior.Objetivo Correlacionar mensurações cefalométricas (2D) e volumétricas (3D) da via aérea superior em pacientes classe III tratados por meio de avanço maxilar.Material e método Este estudo retrospectivo transversal foi realizado em dez pacientes adultos submetidos ao avanço de maxila para correção de deficiência anteroposterior de maxila e deformidade classe III. Foram incluídos os dados de tomografias computadorizadas Cone beam em dois períodos: pré-operatório (T1) e pós-operatório de 6 a 8 meses (T2). Os arquivos DICOM foram importados e reconstruídos para avaliação volumétrica e cefalométrica da via aérea superior, dividida em nasofaringe, orofaringe e hipofaringe (Arnett & Gunson FAB Surgery).Resultado A idade variou de 26 a 55 anos, com média de 36,3±9,2 anos. Não foram verificadas diferenças estatisticamente significantes para os parâmetros cefalométricos e volumétricos das três regiões da faringe entre os períodos T1 e T2. Este resultado ocorreu devido à pequena quantidade de avanço maxilar (4,7±1,89mm) necessário para a correção da deformidade na amostra. A correlação entre área e volume não foi estatisticamente significante apenas para as mensurações pré-operatórias da nasofaringe (r=0,30; p=0,40). Nas outras regiões e períodos a correlação foi estatisticamente significante (p

The aim of this study was to evaluate the mechanical behavior of different rigid fixation methods in mandible angle fractures. Three different plates were tested: one 4-hole grid miniplate, one 8-hole curved grid miniplate, and one 4-hole straight miniplate. For the loading tests, 30 polyurethane hemimandibles sectioned at the angle area to simulate a simple angle fracture were used: 10 hemimandibles for each group. The mechanical evaluation revealed that the straight plate positioned at the tension zone presented the best results in supporting vertical loading in the predefined displacement moments of 1, 3, and 5 mm. Regarding the grid plates, there was no statistically significant difference between the smaller and the larger plate. According to this sample, the straight plate positioned in the tension zone presented better results than the other 2 different grid plates positioned at the neutral zone.

Nasal obstruction (NO) is a common symptom present in 25% of the general population, which significantly interferes with the quality of life. The different facial profiles and malocclusion patterns could be associated with the degree of NO. In order to evaluate the nasal function in patients with different facial morphology patterns, the authors developed a prospective study in which 88 patients from a dentofacial deformities center were included. These patients were submitted to fibrorhinoscopy (Mashida, ENT PIII) with a 3.2-mm cannula under topical anesthesia to evaluate septal deviation, inferior and medium turbinates, and pharyngeal tonsils. The 88 patients included in the study were divided into 3 groups according to the classification of the facial profile, distributed as follows: 32 class I, 28 class II, and 28 class III; the data collected was statistically analyzed by analysis of variance and the results are shown. The patients included in this study presented similar prevalence of NO with the reduction of airway function efficiency. Although it was not a statistically different, the group II presented higher mean Nasal Obstruction Syndrome Evaluation scores.

Objective: to report a surgical case of comminuted mandible fracture caused by a firearm projectile treated with external fixation. Methodology: male patient, 18 years old, attended the Emergency Department of the Maxillofacial Surgery service after trauma in the mandibular region by a firearm projectile. On clinical examination, edema was observed in the cervical zone II and mandibular region, penetrating orifice of entry of the projectile in the genial region and mobility in the mandibular body. CT scan revealed a comminuted fracture in the mandible. Transcutaneous perforations were performed with pins, anatomical reduction of the fracture and stabilization to the external nail, adapting to the mandibular anatomy. Following postoperative follow-up, the patient progresses without pain complaints, with functional and satisfactory mouth opening, without mobility in bone fragments, and reestablished mandibular framework. Results and Conclusion: mandibular fractures by firearms are frequent in the routine of the buccomaxillofacial surgeon. Cases of bone comminution present individual peculiarities that must be taken into account in their management. The correct indication of external fixation proved to be adequate and satisfactory for cases of mandible comminution. Objetivo: reportar un caso quirúrgico de fractura conminuta de mandíbula por proyectil de arma de fuego tratado con fijación externa. Metodología: paciente masculino de 18 años que acudió al Servicio de Urgencias del servicio de Cirugía Maxilofacial tras traumatismo en región mandibular por proyectil de arma de fuego. Al examen clínico se observó edema en la zona cervical II y región mandibular, un orificio penetrante para la entrada del proyectil en la región genial y movilidad en el cuerpo mandibular. La tomografía computarizada reveló una fractura conminuta en la mandíbula. Se realizaron perforaciones transcutáneas con clavos, reducción anatómica de la fractura y estabilización al clavo externo, adaptándose a la anatomía mandibular. En el seguimiento postoperatorio el paciente evoluciona sin quejas de dolor, con apertura bucal funcional y satisfactoria, sin movilidad en fragmentos óseos y marco mandibular reestablecido. Resultados y Conclusión: las fracturas mandibulares por arma de fuego son frecuentes en la rutina del cirujano buccomaxilofacial. Los casos de conminución ósea presentan peculiaridades individuales que deben tenerse en cuenta en su manejo. La correcta indicación de la fijación externa resultó ser adecuada y satisfactoria para los casos de conminución mandibular. Objetivo: relatar um caso cirúrgico de fratura cominutiva de mandíbula por projétil de arma de fogo tratado com fixação externa. Metodologia: paciente gênero masculino, 18 anos de idade, compareceu ao Pronto Atendimento do serviço de Cirurgia Bucomaxilofacial após trauma em região mandibular por projétil de arma de fogo. Ao exame clínico, foi observado edema em zona cervical II e região mandibular, orifício penetrante de entrada do projétil em região geniana e mobilidade em corpo mandibular. Ao exame tomográfico foi percebida fratura cominutiva em mandíbula. Realizou-se perfurações transcutâneas com pinos, redução anatômica da fratura e estabilização à haste externa, adaptando-se a anatomia mandibular. Em acompanhamento pós-operatório, o paciente evolui sem queixas álgicas, com abertura bucal funcional e satisfatória, sem mobilidade nos fragmentos ósseos, arcabouço mandibular restabelecido. Resultados e Conclusão: as fraturas mandibulares por arma de fogo são frequentes na rotina do cirurgião Bucomaxilofacial. Casos de cominuição óssea apresentam particularidades individuais que devem ser levadas em consideração em seu manejo. A correta indicação da fixação externa mostrou-se adequada e satisfatória para casos de cominuição de mandíbula.

Biphenotypic sinonasal sarcoma is a rare and recently recognized entity. It is a low-grade sarcoma which exhibits both neural and myogenic differentiation. The objective of this study is to report a case of a 25-year-old male patient with nasal congestion and bleeding. Computed tomography showed a tumor mass in the nasopharynx. Microscopic analysis showed a cellular proliferation of spindle cells, forming mainly a herringbone-like fascicular growth pattern. Immunohistochemical analysis showed focal positivity for S100, alpha-smooth muscle actin, and calponin, and negativity for desmin, SOX 10, and FXIIIA. We present an uncommon case of biphenotypic sinonasal sarcoma of the nasopharynx and emphasize the importance of recognizing rare entities with impact on the health of these patients.

Horizontal maxillary osteotomy, or Le Fort I type osteotomy, allows wide access to midface structures and adjacent areas such as the pterygomaxillary, nasopharynx, and base of the skull. Described and used initially as an access to treatment of tumors in the region, it became no longer used for this purpose, being more frequently used to correct facial deformities. Nasoangiofibroma is a rare vascular lesion of the nasopharyngeal region, which despite being benign, shows aggressive local behavior, with high rates of relapse and prevalence among young people. Tumors of the nasal cavity and skull base are treated by multidisciplinary teams. This case report shows the treatment of a 15-year-old male patient with juvenile nasoangiofibroma using a Le Fort I osteotomy. The patient underwent 2 surgical removals because of recurrence of the tumor in a period of 1 year, without any sequelae.

Necrotizing fasciitis (FN) is a rapidly progressive infection of the deeper tissues with destruction of muscle fascia and a high mortality rate. It is extremely rare and usually it is related to immunosuppression or other systemic debilitating conditions. A 26-year-old white male presented with upper lip edema, with phlogistic signs and infiltration through the infraorbital space along with the presence of tissue necrosis. According to the report, the condition was marked by rapid progression, and the initial manifestation was an acnelike lesion. The treatment was done immediately by incision, drainage, debridement, and installation of drains. The muscle fascia was necrotic, gray, and there was an absence of resistance. Laboratory tests were performed and the microbiologic culture was positive for Staphylococcus aureus. Endovenous antibiotic therapy was administered and the wound was irrigated daily. Healing was completed within a month. NF is a rare infection that must be diagnosed and treated aggressively to avoid tissue loss and to decrease the mortality rate.

Juvenile ossifying fibroma (JOF) is a benign bone-producing fibrous neoplasm of the skeleton. Clinically, children and adolescents are affected without preference for sex. There are 2 clinicopathologic variants, psammomatoid and trabecular (JTOF). JOF can be aggressive, suggesting a malignant neoplasm. A 26-year-old male patient with volumetric increasing of the mandible with a history of evolution of 2 months was referred for evaluation. Intraoral examination showed expansion of both bone cortical of the right mandibular body. Imaginological examinations evidenced a large osteolytic lesion with diffuse and nonsclerotic borders involving the right mandibular angle and body. Diagnostic hypotheses were ameloblastoma, fibrous dysplasia, central giant cell lesion, and JOF. Incisional biopsy was performed, which easily released lesional tissue. Microscopy showed fibrous stroma admixed with varying degrees of immature and mature osseous trabeculae. Final diagnosis was JTOF. The current case shows that strict clinicopathologic correlation is essential to differentiate JTOF from other bone-forming lesions.

The osseous dysplasias (ODs) are nonneoplastic conditions characterized by replacement of bone with abnormal fibrous tissue accompanied by gradual deposition of mineralized masses in the jaws. The classification of ODs includes focal OD, periapical OD, florid OD, and familial gigantiform cementoma. An expansive growth is rare and occurs most frequently in the latter group. We will present a case of osseous dysplasia in the mandible. The first surgical procedure occurred when the patient was 13 years old. The patient was surgically treated because of the large bone volume developed in the mandible, making it asymmetric. The patient was followed up until the age of 20 and again presented bone growth in the body region and mandibular angle. There was a second surgical intervention to regularize the area and return mandibular symmetry. The patient has 3 years of follow-up of the second surgical intervention and no intercurrences of the lesion.

Made available in DSpace on 2020-12-12T02:18:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Introduction: Obstructive sleep apnea is a consequence of upper airway collapse. Any obstructive sector in the upper airway can contribute to pharyngeal collapse. Obesity and obesity-related disorders play an important role in obstructive sleep apnea and its relationship with increased upper airway resistance. Objective: This study was designed to evaluate the relationship between obesity and properties of the nasal cavity in patients with obstructive sleep apnea. Methods: The study was conducted retrospectively by review of medical records of adult patients. The nasal obstruction symptom evaluation, NOSE instrument, was used to measure nasal obstruction. Sleep breathing disorders were evaluated by polysomnography exams. Nasal volume was obtained by computed tomography scans and volumetric reconstruction of nasal airway. Nasal anatomic alterations were assessed by nasal endoscopy. Results: Analysis of 83 patient records, among whom 54 were male and 29 females, found the mean body mass index of 28.69 kg/m2. Obese and non-obese groups were determined by using cut-off 30 kg/m2. In the comparison between groups, the obese group had a positive and significant correlation with apnea/hypopnea index (p = 0.02), NOSE instrument (p = 0.033) and inferior turbinate hypertrophy (p = 0.036), with odds ratio 1.983 (95% IC 1.048 − 3.753). nasal septum deviation (p = 0.126) and nasal airway volume evaluation (p = 0.177) showed no significant results. Conclusion: Obesity was significantly correlated with subjective nasal obstruction, NOSE scale, and inferior turbinate hypertrophy in patients with obstructive sleep apnea. There was no correlation with the nasal volume evaluation. Level of Evidence: 3b - Individual case-control study. Universidade de Araraquara (Uniara) Faculdade de Medicina Divisão de Otorrinolaringologia Universidade Estadual de São Paulo (UNESP) Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia Universidade Estadual de São Paulo (UNESP) Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia Divisão de Cirurgia Oral e Maxilofacial Universidade de Araraquara (Uniara) Faculdade de Medicina Universidade Estadual de Campinas (UNICAMP) Faculdade de Ciências Médicas Departamento de Cirurgia Universidade Estadual de São Paulo (UNESP) Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia Universidade Estadual de São Paulo (UNESP) Faculdade de Odontologia de Araraquara Departamento de Diagnóstico e Cirurgia Divisão de Cirurgia Oral e Maxilofacial

The interest about upper airway evaluation has increased lately. Therefore, many softwares have been developed aiming to improve and facilitate the analysis of airway volume. The objective of this study was to compare two different softwares packages, Mimics and Dolphin, in their accuracy and precision in upper airway space measurements. Preoperative cone beam computed tomography scans of nine nonsyndromic patients submitted to surgically assisted rapid maxillary expansion were included in this study. The imaging exams were converted to DICOM (digital imaging and communications in medicine) files and imported to the softwares. The mean volume for the Dolphin group (G1) was 10.791 cm3 (SD = 4.269 cm3) and for the Mimics group (G2) was 10.553 cm3 (SD = 4.564 cm3). There was no statistically significant difference between the two groups ( p = 0.105).

Oral rehabilitation with osseointegrated implants is frequently the best alternative for replacement of lost teeth. Several techniques and materials allow achievement of excellent function and esthetics. In the case of maxillary or mandibular atrophy, extensive grafting may be necessary before implants can be properly placed. This is a case of maxillary reconstruction with autogenous iliac crest bone grafts, followed by placement of guided implants. After integration of the grafts, planning and insertion of implants allowed installation of an implant-supported prosthesis, recovering the morphology, function, and esthetics.

This study aimed to perform a systematic review about the use of xenogenous bonegraft in horizontal ridge augmentation to answer the following question: In implant patients, treated with xenografts for horizontal ridge augmentation, what would be the outcomes in terms of bone gain, bone resorption, implant survival, and complication rates? The main search was performed at PubMed, Cochrane, and Scopus databases, and found 2610 articles. After selection and duplicate removal, 29 studies were included in the final review. The collected data were sample size, number and type of graft, site, horizontal gain, resorption rate, and complications. A total of 610 patients were submitted to 853 bone grafts, both in the maxilla and mandible. Most studies (n = 26) used particulate grafts, isolated or associated with autogenous bone, and covered by collagen membrane or titanium mesh. The mean of horizontal bone gain was 4.44 mm. In addition, the augmented ridges allowed placement of 1325 successful dental implants. The complication rate was 7.85%, and membrane exposure was the most reported complication. Although the autogenous bone graft remains as the gold standard for alveolar reconstruction, this review suggests that xenogenous bone graft is a feasible alternative for horizontal bone augmentation.

Made available in DSpace on 2018-12-11T17:22:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-09-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Purpose: Double and multiple mandibular fractures are associated to high morbidity and functional damage. This study aimed to evaluate the characteristics and outcomes of double unilateral, bilateral, and multiple mandibular fractures. Methods: A 7-year observational retrospective analysis was performed, and the injury-related data were collected from the medical records. Statistical analysis was performed using Fisher’s exact test (p < 0.05). Results: In this period, 283 patients showed mandibular fractures. Of them, 83 (29.7%) had double or multiple mandibular fractures and were included in the study. Double bilateral fractures were more prevalent than multiple or double unilateral. Multiple fractures presented significant association with the combination of load-bearing and load-sharing fixation protocols. Most cases (94.0%) applied at least one type of internal fixation system. However, there was a positive association between condylar fractures and non-surgical treatment (p < 0.01). Moreover, mandibular body fractures were associated with load-bearing fixation (p < 0.01). In 56 cases, no complications were observed (67.5%). Complications were divided into treatment failure (10.8%) and transitory or minor complications (21.7%). There was no statistical association between complications and fracture pattern, fracture-tooth relation, and treatment modality. Conclusion: Double and multiple mandibular fractures represented almost one third of all mandibular fractures, and regardless to treatment protocol, there was no difference about complications. Moreover, although a considerable complication rate was found, most of them were minor or transitory. Department of Diagnosis and Surgery Division of Oral and Maxillofacial Surgery Dental School at Araraquara UNESP - São Paulo State University, Rua Humaitá, 1680 Department of Diagnosis and Surgery Division of Oral and Maxillofacial Surgery Dental School at Araraquara UNESP - São Paulo State University, Rua Humaitá, 1680 FAPESP: 2015/04521-0