Effect of the association between the tray and impression techniques on angulated implants using the All-on-Four system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da espessura da mandíbula com relação à fixação interna rígida em osteotomia sagital: estudo anatômico

Purpose: Trying to provide more anatomical data to the oral and maxillofacial surgeons regarding to orthognathic surgery, specifically about sagittal split osteotomy, the authors accomplished an anatomical study in dry human jaws, measuring the thickness in four previously established points of the body and mandibular ramus, at the usual spots used for the internal fixation by screws. Material and Methods: The authors also use the data collected to evaluate if there are significant differences between the group I (human dry mandibles with teeth) and group II (edentulous human dry mandibles). Results: For the group I the authors found the following results: x1 = 14,48, x2 = 14,94, x3=12,82 and x4 = 9,41, being the x2 the thickest point, and the least thick the x4. However in the group II, the found medium values were: x1 = 13,38, x2 = 13,08, x3 = 11,63 and x4 = 12,18, being the thickest point in that group the x1 and the least thick x3. The coefficient of simple correlation between the variables (group I and II) revealed a value of 0,6194, being this difference no significant at the meaning level of 95%.

Estimativa da altura por dimensões dentárias: uma revisão da literatura

The knowledge of Forensic Anthropology is very importance in cases of identification of human remains. One phase of this process is the study of human height, which can be accomplished with relative ease when intact corpses, complete skeletons or long bones are available. However, the experience of Forensic Dentistry is essential in situations in which there is only information of the skull or of the teeth. The objective of this study was to review in the literature and evaluate works concerning the estimate of the height calculated from dental dimensions. Carrea, in 1920, proposed the estimation of the probable height of an individual by developing formulas for maximum and minimum heights from measurements of the lower central and lateral incisors and canines. The method was used in the case "Josef Mengele", to complement estimates. Tested in the Brazilian population, 70% of match between the actual and the estimated stature were obtained. Using more precise instruments, in the modified method, 96% of correct matching were verified. Recently, a new formula was introduced to estimate height, from measurements of upper teeth, because the technique cannot be used when jaw is not available. The correlation between height and dental dimensions is demonstrated. However, there is still a lack in scientific literature in this field, and further studies are necessary. The estimate of height from dental dimensions can be very useful and important, especially in situations where the complete skeleton it not found, and long bones are not available.

Prevalência de alterações locais e sistêmicas em indivíduos com disfunção temporomandibular

Temporomandibular disorder describes a variety of conditions including joint and muscle in the stomatognathic system, characterized by pain, TMJ sounds, functions irregular jaw and represent the leading cause of nondental pain in the orofacial region. The objective of this research was to evaluate the prevalence of ophthalmological, otological and cognitive-behavioral changes, parafunctional habits in individuals with temporomandibular disorders (TMD). A total of 117 medical records of female and male individuals, aged 18 to 60 years, from the Occlusion, Temporomandibular Dysfunction and Orofacial Pain of the Ribeirão Preto School of Dentistry – USP, between 2010 and 2011. The anamnesis index proposed by Helkimo was used to classify the individuals according to TMD severity degree and to divide them into two groups: AiI (mild to moderate) with 69 individuals and AiII (severe) with 48 individuals. The groups were then subdivided with respect to gender (72.64% female and 27.36% male) and age. There was predominance in the 18-40 year age group (60.68%) when compared to the 41-60 year age group (39.32%). Data were collected through an interview with questions about the presence of parafunctional habits, otological, ophthalmological and behavioral changes. Data were subjected to the statistical analysis using the Kruskal-Wallis test. The prevalence of each change was also evaluated. The results showed statistically significant for all groups according to gender, age and degree of severity. Individuals with temporomandibular disorders exhibited high prevalence of systemic and local dysfunctions.

Ovariectomy-associated changes in interradicular septum and in tibia metaphysis in different observation periods in rats

In order to standardize an experimental model to study the effects of absence of ovarian hormones in maxillary bones compared with long bones, the aim of this research was to analyze the influence of ovariectomy (OVX) on rat alveolar bone and tibiae, in different observation periods. Thirty-six female rats were ovariectomized or sham operated. After 60, 90 or 120 days, the animals were sacrificed and their hemimandibles, maxillae and tibiae were removed and routinely prepared for hematoxylin and eosin staining. The percentage of bone matrix area in bone septum in the first molar furcation region, and in tibial metaphysis was calculated, and data were submitted to statistical analysis (p < 0.05). As regards the histomorphometrical analysis in jaw bones, there was no statistical difference between groups, while the effects of ovariectomy on tibiae were seen as early as 60 days. According to the methods used, there was no significant influence of absence of ovarian hormones on interradicular septum of mandibular or maxillary first molars in the periods studied, despite the reduction in bone matrix area in tibia metaphysis as early as 60 days. (C) 2014 Elsevier GmbH. All rights reserved.

Cherubism: clinicoradiographic features and treatment

Cherubism is a congenital childhood disease of autosomal dominant inheritance. This disease is characterized by painless bilateral enlargement of the jaws, in which bone is replaced with fibrous tissue. The condition has sui generis clinical, radiographic and histological features, of which the clinician should be aware for a better differential diagnosis in the presence of a fibro-osseous lesion affecting the bones of the maxillomandibular complex. The purpose of present paper was to review the literature and to report the most important aspects of cherubism in order to facilitate the study of this disease. Literature was reviewed about cherubism, emphasizing the relevant clinicoradiographic features and treatment. Literature was selected through a search of PubMed and Scielo electronic databases. The keywords used for search were adolescent, cherubism, cherubism/physiopathology, cherubism/treatment, cherubism/radiography. A manual search of the reference lists of the identified articles and the authors' article files and recent reviews was conducted to identify additional publications. Those studies that described new features about cherubism were included in this review. In total 44 literature sources were obtained and reviewed. Studies that described new features about cherubism physiopathology, diagnostics and treatment were reviewed. Despite the exceptions, cherubism is a clinically well-characterized disease. In cases of a suspicion of cherubism, radiographic examination is essential since the clinical presentation, the location and distribution of the lesions may define the diagnosis. Histopathological examination is complementary. Nowadays, genetic tests should be used for final diagnosis of cherubism.

Oral rehabilitation with implantations: association of fixed partial prosthesis, UCLA system, and EsthetiCone

The objective of modern odontology is to reconstitute to the patient the comfort, the function, the aesthetic form, the phonetic capability, and normal health. However, the more the patient is toothless, the more this objective becomes difficult inside traditional dentistry. As a result of continuous research of materials and techniques, permissible success is now a reality, whitewashing many challenging clinical situations. Thus, the objective of the article was to present a clinical case where association of the universal cast to long abutment pillars and EsthetiCone were used for aesthetic whitewashing. A man presented to the clinic of the Faculty of Dentistry, Universidade Estadual Paulista. After clinical examination and radiographic evaluation evidenced the necessity of substitution of fixed prostheses (15-25), he was presented with disadaptation and a favorable aesthetic solution. Ahead of the evaluated picture and considering the extension of the toothless space made, it was opted more, to the accomplishment of surgery, the setting of 2 implantations in the region and 2 in each edentate side of the posterior portion of the jaw. On 6 implants and 2 teeth, 10 metal ceramic crowns had been confectioned: 4 of them being joined in the region of the 12 to the 22 and the other 6 as unit crowns in the region of the 13, the 14, the 15, the 23, the 24, and the 25. The carried-through treatment was capable to return the aesthetic form, the function, the phonetic capability, the comfort, and the health of the verbal socket.

Lateral periodontal cyst: a case report and literature review

The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts. A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp. A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was lateral periodontal cyst of developmental origin. There was no recurrence or complications for 24 months follow-up. The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.

Intraoperative blood loss and blood transfusion requirements in patients undergoing orthognathic surgery

Procedures for the surgical correction of dentofacial deformities may produce important complications, whether due to the potential for vascular injury or to prolonged surgery, both of which may lead to severe blood loss. Fluid replacement with crystalloid, colloid, or even blood products may be required. The aim of this study was to assess blood loss and transfusion requirements in 45 patients (18 males and 27 females; mean age 29.29 years, range 16-52 years) undergoing orthognathic surgery, assigned to one of two groups according to procedure type-rapid maxillary expansion or double-jaw orthognathic surgery. Preoperative hemoglobin and hematocrit levels and intraoperative blood loss were measured. There was a substantial individual variation in pre- and postoperative hemoglobin values (10.3-17 and 8.8-15.4 g/dL, respectively; p < 0.05). Mean hematocrit values were 41.53 % preoperatively (range 31.3-50.0 %) and 36.56 % postoperatively (range 25-43.8 %) (p < 0.05). Mean blood loss was 274.60 mL (range 45-855 mL). Only two patients required blood transfusion. Although blood loss and transfusion requirements were minimal in the present study, surgical teams should monitor the duration of surgery and follow meticulous protocols to minimize the risks.

Implant rehabilitation in bruxism patient

A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported.

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Squamous odontogenic tumor: literature review focusing on the radiographic features and differential diagnosis

Since its first publication in 1975, the squamous odontogenic tumor remains the rarest odontogenic lesion, with around 50 cases in the English-language literature in which the microscopic characteristics are frequently very well demonstrated. However, articles which discuss the radiographic aspects are scarce, especially with emphasis on the differential diagnosis. The present treatise proposes an assessment of jaw lesions with the same radiographic characteristics of the squamous odontogenic tumor to clarify the main findings for dental clinicians during routine diagnosis.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Estudo da assimetria da fossa mandibular, em crânios secos de crianças pelo método radiográfico

The Temporomandibular Joint is a noble structure of the complex mandibular, a lot of research was conducted on the to signs and symptoms of the alterations that attack those structures. ln spite of the high incidence of the DTM in children, there's little knowledge about it, wich makes difficult the treatment Desorders Craniomandibulares (DCM) or Desorders Temporomandibulars (DTM). The Temporomandibular Joint is composed basically by three elements: bones, muscles and disk, in relation to bony part, we have the fossae mandibular that is part of the temporary bone and wich houses the condyle mandibular, accomplishing the articulation among the cranium and the jaw (it leaves piece of furniture of the articulation). Our intention in that work was of verifying a possible asymmetry of the fossae mandibular on the left side and of the right side in relation to two straight line: a straight line that coincided with the plane medium sagittal and another perpendicular straight line to the plan medium sagittal. Analyzing, the fossae mandibular in 91 dry craniums of children, with age varying between four months of life intrauterina and five years, in x-rays in that the incidence was cranium-flow, we could end that: in spite of we find statistical significance in relation to that asymmetry, clinic cannot affirm that interferences on occlusion exists for that asymmetry