Tratamiento quirúrgico de mesiodents en odontopediatría

Supernumerary teeth are a relatively frequent disorder of odontogenesis that can interfere with the development of the germs teeth. This pathology is most common in the maxillary anterior area, called mesiodens, and their prevalence is generally reported to occur more frequently in male than female, in a ratio of 2:1. The aim of this article was to report the clinical procedures performed in the Clinic of Pediatric Dentistry at the Araraquara School of Dentistry when the presence of two mesiodens, radiographically shown, caused retention of permanent anterior teeth, resulting in esthetic and funcional disturb. All the surgical procedures, etiology and the importancy of the early diagnostic for the appropriate treatment was detailed described.

Reabilitação total da maxila com enxerto intraoral: relato de caso

The early tooth loss and periodontal disease often leave inadequate bone volume for installation of osseointegrated implants. The autogenous bone graft is considered the gold standard for reconstruction of residual bone defects. Some surgical techniques can be performed, including extra or intraoral donor sites depending on the degree of bone loss, depending on surgical-prosthetic planning and general condition of the patient. The intraoral bone grafts offer a safe option to rebuilt bone volume in smaller rehabilitations, with low morbidity and minimal postoperative discomfort. Among the possible donor sites, the mandibular ramus and body, which offer predominantly cortical bone, and the chin area, which offers corticomedullary bone tissue, can be harvested. The graft will be suitable both in quantity and quality, preserving the capacity of osteogenesis, osteoinduction and osteoconduction, which differentiate autogenous grafts from other biomaterials. The aim of this study was to report a clinical case in which the mandibular ramus graft was used for total reconstruction of an edentulous maxilla, showing that even large areas can be reconstructed with grafts from intraoral origin. All the steps that allowed the complete reconstruction of the maxilla done by an intraoral donor area are listed in the text, culminating in an extremely satisfactory clinical result.

Estudo comparativo sobre a eficácia de duas drogas de ação anti-inflamatória (Etoricoxib e Diclofenaco) após exodontia de terceiros molares inferiores inclusos.

In this article the authors clinically compare the efficacy of two different anti-inflammatory drugs - Etoricoxib (Arcoxia®) and Diclofenac (Olfen®) – in the control of postoperative pain resulting from the surgical removal of impacted lower third molars. Fifteen patients requiring the extraction of bilaterally impacted lower third molars were selected at the Department of Oral and Maxillofacial Surgery at the Araraquara School of Dentistry – UNESP. The drugs were randomly administered during the first and second surgical procedures. Pain was evaluated by means of a visual analogic scale for 72 hours following the surgical procedure. After statistical analysis of the results, the authors concluded that there were no significant differences in terms of postopoerative pain control between the two drugs studied.

Uso de hialuronidato de sódio para tratamento de deslocamento anterior de disco articular com travamento bucal

Temporomandibular joint disorders causing limitation of mouth opening and pain may be related to the restriction of slipping or forward displacement of the mandibular condyle. Temporomandibluar arthrocentesis is the lavage of the joint and is regarded as a simple method that produces good results in patients with these symptoms. This article reports a case of disc displacement and closed lock in a patient who reported limited mouth opening and pain as the main symptoms. The treatment proposed was arthrocentesis and lavage, combining a corticosteroid with a sodium hyaluronate solution. It is concluded that arthrocentesis is a simple, efficient and barely invasive method for particular types of temporomandibular joint disorders and should be considered before opting for more invasive surgical procedures.

Improvement of an anterior infrabone defect using combined periodontal and orthodontic therapy: a 6-year follow-up case report

Extensive intraosseous lesions represent a clinical challenge for the periodontist. Sites with bone defects have been shown to be at higher risk of periodontitis progression in patients who had not received periodontal therapy. Thus, the aim of this case report was to describe a novel approach for the treatment of 1-walled intraosseous defect by combining nonsurgical periodontal therapy and orthodontic movement toward the bone defect, avoiding regenerative and surgical procedures. A 47-year-old woman underwent the proposed procedures for the treatment of her left central incisor with 9 mm probing depth and 1-walled intraosseous defect in its mesial aspect. Initially, basic periodontal therapy with scaling and root planning was accomplished. Two months later, an orthodontic treatment was planned to eliminate the intraosseous lesion and to improve the interproximal papillary area. Orthodontic root movement toward the osseous defect was performed for 13 months with light forces. After 6 years postoperative it was concluded that combined basic periodontal therapy and orthodontic movement was capable of eliminating the intraosseous defect and improve the esthetics in the interproximal papillary area between the central incisors.

Osteotomia sagital da crista alveolar para instalação de implantes Bicon

This case report presents details of a new surgical technique for mandibular ridge sagittal osteotomy and expansion associated to immediate dental implants in atrophic ridges. The bone atrophies represents a challenge for the surgeons that intends to modify this situation. In the past, the only viable option was the onlay bone graft. However, the bone graft requests a second surgical site that certainly increases the postoperative morbidity, without mentioning the longer treatment time required. The sagittal osteotomy of the alveolar crest represents a faster option, because it eliminates the time requested for bone graft integration, providing rehabilitation of edentulous areas with thin alveolar crests that otherwise would need additi onal surgical procedures for a satisfactory result. The authors report a clinical case in which this technique was used with the installation of a Bicon dental implant in the same surgical time, showing all the steps for this single-tooth rehabilitation.

Aplicação do laser Er,Cr:YSGG em periodontia e implantodontia: revisão de literatura

Lasers are widely used tools in many therapeutic modalities in medical lasers and can be divided into low and high intensity. For the treatment of periodontal disease, lowintensity lasers are related to reduce the number of bacteria and to induce inflammatory and analgesic properties. The high intensity lasers can be used in surgical procedures, improving hemostasis, promoting more accurate cuts, removal of dental calculus as well as thermomechanical and photochemical interactions with tissue. The high-intensity laser Erbium impregnated with chromium: YSGG laser has shown satisfactory results when applied in endodontic, restorative denstistry, surgical procedures and non-surgical periodontal treatment. The purpose of this review is to evaluate the studies that investigated the effects of Er, Cr: YSGG laser on the morphology and biocompatibility of titanium and root surfaces irradiated with these lasers, even beyond the effect on the treatment of periodontitis and periimplantitis.

Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

Forced orthodontic eruption (FOE) is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

A combined approach for the treatment of resorbed fresh sockets allowing immediate implant restoration: a 2-year follow-up

Introduction: The demand for optimal esthetics has increased with the advance of the implant dentistry and with the desire for easier, safer and faster technique allowing predictable outcomes. Thus, the aim of this case report was to describe a combined approach for the treatment of a periodontally compromised tooth by means of atraumatic tooth extraction, immediate flapless implant placement, autogenous block and particulate bone graft followed by connective tissue graft and immediate provisionalization of the crown in the same operatory time. Case Report: A 27-year-old woman underwent the proposed surgical procedures for the treatment of her compromised maxillary right first premolar. The tooth was removed atraumatically with a periotome without incision. A dental implant was inserted 3 mm apical to the cement-enamel junction of the adjacent teeth enabling the ideal tridimensional implant position. An osteotomy was performed in the maxillary tuber for block bone graft harvesting that allowed the reconstruction of the alveolar buccal plate. Thereafter, an autogenous connective tissue graft was placed to increase both the horizontal and vertical dimensions of the alveolar socket reaching the patient functional and esthetic expectations. Conclusion: This treatment protocol was efficient to create a harmonious gingival architecture with sufficient width and thickness, maintaining the stability of the alveolar bone crest yielding excellent aesthetic results after 2-years of follow-up. We suggest that this approach can be considered a viable alternative for the treatment of periodontally compromised tooth in the maxillary esthetic area enhancing patient comfort and satisfaction.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.

Interação entre odontologia restauradora e periodontia - parte 2: reanatomização dentária

The development of new dental materials has expanded dental therapeutic modalities ensuring excellence in aesthetic restorative treatments. Thus, the direct restorative procedures have been used in cases of dental reconstruction allowing an effective treatment with a low cost, while preserving healthy tooth structure. However, the clinician must be used to the techniques and the material in order to ensure longevity and success in the direct restorative procedure. The aim of this paper is to descrive, after completion of periodontal surgical procedures, the direct restorative step performed for dental reconstruction and diastema closure. The integration between Restorative Dentistry and periodontics enableb the restoration of a harmonious smile in a conservative manner, ensuring aesthetics and patient stisfaction.

Dificuldades relatadas por estudantes de odontologia diante de procedimentos relacionados à periodontia

Objective: This study aimed at evaluating the difficulties reported by last-year dentistry course students regarding basic and surgical periodontal procedures. Methods: A proposed questionnaire with 24 questions, 14 related to basic periodontal procedures and 10 to surgical procedures, was applied to 45 undergraduate students with jobs involving these procedures, during the practical activities of the Integrated Clinic Discipline, a compulsory subject in the curriculum of the course, taught to last-year students. Students were asked about their own perceptions of the difficulties in implementing the various steps related to the treatments. The degree of individual difficulty was determined according to the Likert scale: 0 = none, 1 = mild, 2 = moderate, 3 = high, 4 = very high. Exploratory analysis of data was applied, and the difficulty level was also dichotomized into none to mild (scores 0 and 1) and moderate to very high (scores 2–4). Results: Regarding the basic periodontal treatment, bone level probing was the procedure with the highest number of student difficulties (57.5%). As for the difficulties reported by students regarding the stages of periodontal surgery, only the procedures related to anesthesia and suture removal had no report of doubts. Conclusion: Periodontal surgery was the procedure involving the most prevalent questions reported as moderate to very high, and the indication for the most suitable surgical technique was the stage with the highest percentage of questions (66.6%) among the undergraduates.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.

Validação de técnica hemostática do complexo arteriovenoso ovariano na ovariosalpingohisterectomia de gatas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da lipocalina associada à gelatinase de neutrófilos (NGAL) em idosos após osteossíntese de fêmur

Pós-graduação em Anestesiologia - FMB