Expansão rápida de maxila assistida cirurgicamente por meio da piezocirurgia: relato de caso

Aim: the purpose of this study is to present a case of surgically assisted rapid maxillary expansion using piezosurgery and describe the benefits of using this device in this type of procedure. Case description: patient had adento-skeletal deformity Cl III with asevereatresia of jaw and underwent a rapid maxillary expansion and surgically assisted with the use of piezosurgery. Conclusion: the piezosurgerycan be used as an alternative in oral and maxillofacial surgery wich features provide greater accuracy and safety in surgery.

Avaliação comparativa do processo de incorporação de bloco sintético bifásico, e do osso autógeno: estudo histológico, histométrico e imunoistoquímico em coelhos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência da inalação da fumaça de cigarro no reparo de enxertos ósseos autógenos onlay em ratas ovarectomizadas: estudo histomorfométrico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tumor odontogênico queratocístico: considerações clínico-cirúrgico

Introduction: The tumor odontogenic keratocyst (toq) is a benign disorder, which is controversial in its diagnosis and treatment. It is characterized by a true neoplasms arising from remnants the dental lamina. It occurs predominantly in the angle mandible, which may or may not be related to a tooth and whose importance is due to its aggressive behavior and high recurrence rate. The causes of the high recurrence rates. The thin capsule and friable tissue may favor the toq retention of epithelial debris and, moreover, the presence of satellite cells in the lesion site is responsible for the increased proliferative capacity of clinical entity. Objective: To present the peculiarities toq inherent in using a clinical case of toq in mandible. Case report: TOQ in the jaw in patient, 16 years old male presenting important lesion radiographically radiolucent related to the impacted tooth. Final comments: In consideration of the high rate of recurrence chosen treatment proved effective and was not any evidence of recurrence.

Trauma traqueal associado à fratura mandibular: relato de caso

Introduction: The mandibular injuries account for about 20% to 50% of cases of facial fractures. Some consider the jaw the second most commonly fractured bone of the skull, and is the only mobile bone of the facial framework, which results in decreased stability compared to the trauma. When one takes into account the degree of airway obstruction in patients with facial fractures, the problem becomes much more serious since it is one of the most troubling complications of trauma. Objective: the relevance of the topic is aimed to report a case of a patient victim of mandibular fracture associated with trauma to the trachea. Case report: Case report: Patient 24 years old patient with tracheal trauma concomitant mandibular fracture surgically treated in conjunction with the thoracic surgeon. After 5 months postoperatively, the patient is in good condition general, no complaints. Final comments: This form is observed that the key to proper treatment of tracheal trauma associated with facial fractures is the knowledge of the type of injury, and an accurate diagnosis multidisciplinary.

Tumor odontogênico queratocístico: revisão de literatura

The odontogenic keratocyst is called keratocyst odontogenic tumor (TOQ), due to its features compatible with neoplasms, such as its high recurrence rate and mechanism of growth. Although its etiology has unknown, the origin seems to be connected with dental lamina remaining. This entity is generally benign, with slow progression, asymptomatic, and among the odontogenic tumors, its prevalence is high. It affects mainly males, with predilection for the posterior mandible, while in most cases associated with an impacted tooth. Radiographically, this lesion is unilocular. Histological features are stratified epithelial basal cells with hyperchromatic paraqueratinizado. Treatment ranges from conservative to radical interventions. As a result of the controversy as TOQ tumor entity, the present work is a literature review of current findings, emphasizing its intrinsic features to contribute to developments in the study of this new entity.

Histologic and histometric evaluation of calvarial autogenous bone graft in reconstruction of atrophyc maxilla for dental implants

The calvarial bone is highlighted as a good donor area for large reconstructions of atrophic jaw for subsequent rehabilitation with implant-supported prosthesis. The aim of this study was to observe and measure through histological and histometric evaluation, the cellular events that occur at the interface of union from onlay parietal bone graft on the maxilla of 10 patients, after a period of 6 months of incorporation. The biopsies were performed at the time of installation of osseointegrated implants. The bone contact area represented 78.75% and connective contact 21.25%. The region of connective union between the bone graft to the maxillae presented new bone formation (41.26%), marrow bone (36.06%), osteoid tissue (15.86%) and connective tissue (6.80%). All samples had good graft incorporation to the receptor bed with osteogenic activity and absence of inflammatory cells.

Registros posicionais de protrusão e lateralidade em resinaacrílica à partir de diferentes posições iniciais

The lateral movement presents a combination of lateral condylar and protrusive displacement on the non-working side. The objective os this study was to check the differences in the adjustment of the semiadjustable articulator starting from two different initial positions, centric relation an intercuspal position using positional records of rotusion and lateral movements in acrylic resin for the adjustment of condylar guidance as for ennett Angle. Twenty pacients dentate and assintomatic were recruited and their adjustment were performed in the semiadjustable articulator checking the differences among the studied groups, not finding statistically significant differences. Concludes that, in semiadjustable articulator adjustment, starting the montage in centric relation or intercuspal position, the results obtained for the condylar guidande and Bennett Angle aren´t statistically diferents, as well there is no difference in condylar guidance adjustment using lateral or protrusive records.

Planejamento em reabilitação oral: restabelecimento da relação intermaxilar por meio de prótese provisória overlay

The present article describes the treatment planning and fabrication of overlay denture to restore the jaw relationship in a partial edentulous patient with bruxism. A male patient, 51 years old, was referred to the oral rehabilitation clinic complaining about the chewing and aesthetic. The occlusal surface of the superior teeth presented severe wear. The fabrication of an interim overlay denture to restore the jaw relationship was planned. The overlay had metallic projections and covered the occlusal surface of superior teeth. After overlay insertion both function and aesthetic of the patient were recovered. It was concluded that the use of overlay improved the physiological normal position of the jaw and could provide a favorable prognosis for a definitive oral rehabilitation with implant-supported fixed denture.

Fibroma ossificante periférico: relato de caso

The Peripheral ossifying fibroma is a reactive proliferative lesion, non neoplastic, slow growth, which can produce recurrence after removal. It´s etiology is uncertain, but is associated with local irritants, and is found mostly in the anterior maxilla. Clinically it is characterized by an asymptomatic increase in volume, which may, over time, facial asymmetry. The aim of this paper is to describe a case of peripheral ossifying fibroma in a patient 40, female, exophytic lesion in the jaw, unusual for its large dimensions and with a history of three recurrences, leading to facial asymmetry. She underwent surgery to remove the lesion along with the likely irritants, and the pathological diagnosis of peripheral ossifying fibroma. We conclude that it is fundamentally important for complete removal of the lesion to reduce the tendency to relapse, including the periosteum and the periodontal ligament, in addition to possible causes.

Epigenetic and genetic approach to the transmissibility of dental characteristics in twins: report of two cases

Transmissibility of dental and jaw characteristics is strongly influenced by environmental factors during the years of extra uterine life when odontogenesis occurs. Through biochemical factors, such as enzymes, proteins, hormones and other mediators, genes are activated or silenced to suit the cell or organism to its environment. These changes are not transmitted to our descendants, because of that, these factors are called epigenetic. Among the most cited epigenetic factors are food, pollution, drugs and exercise. The objective of this study was to assess the transmissibility of dental characteristics in two pairs of twins. In one case, 13-year-old boys had the same basic dental and jaw characteristics with prolonged retention of the second upper deciduous molars and the presence of permanent successors. In the other case, 14-year-old boys had prolonged retention of lower deciduous second molars and absence of permanent successors, but only one of them had the germs of third lower molars. The phenotypic difference in the dentition of twins from clinical case 2 could be due to epigenetic factors, showing the absence of genetic determinism in the transmissibility of dental characteristics.

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator

Objective: To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Materials and Methods: Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. Results: TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. Conclusions: This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

Mandibular cortical bone evaluation on cone beam computed tomography images of patients with bisphosphonate related osteonecrosis of the jaws

Objectives The objective of this study was to develop a technique for detecting cortical bone dimensional changes in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Study Design Subjects with BRONJ who had cone-beam computed tomography imaging were selected, with age- and gender-matched controls. Mandibular cortical bone measurements to detect bisphosphonate-related cortical bone changes were made inferior to mental foramen, in 3 different ways: within a fixed sized rectangle, in a rectangle varying with the cortical height, and a ratio between area and height. Results Twelve BRONJ cases and 66 controls were evaluated. The cortical bone measurements were significantly higher in cases than controls for all 3 techniques. The bone measurements were strongly associated with BRONJ case status (odds ratio 3.36-7.84). The inter-rater reliability coefficients were high for all techniques (0.71-0.90). Conclusions Mandibular cortical bone measurement is a potentially useful tool in the detection of bone dimensional changes caused by bisphosphonates. Long-term administration of bisphosphonates (BPs) affects bone quality and metabolism following accumulation in bone.1 Since the first cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were published in 2003,2 there has been a search for factors that can predict the onset of the condition. Oral and intravenous BPs reduce bone resorption, increase mineral content of bone, and alter bony architecture.3, 4, 5 and 6 Previous studies have demonstrated these changes both radiographically and following histologic analysis.1, 3, 7, 8, 9 and 10 The BP-related jaw changes may present radiological features, such as thickening of lamina dura and cortical borders, diffuse sclerosis, and narrowing of the mandibular canal3 and 11; however, oral radiographs of patients taking BPs do not consistently show radiographic changes to the jaws.11 and 12 The challenge is to find imaging tools that could improve the detection of changes in the bone associated with BP use. Various skeletal radiographic features associated with BRONJ in conventional periapical and panoramic radiographs, computed tomography, magnetic resonance imaging, and nuclear bone scanning have been described.3, 8, 9, 10 and 11 There has also been a search for BP-related quantitative methods for the evaluation of radiographic images, to avoid observer subjectivity in interpretation. Factors thought to be important include trabecular and cortical structure, and bone mineralization.4 Consequently, measurable bone data have been reported in subjects taking BPs through many techniques, including bone density, architecture, and cortical bone thickness.1, 4, 7 and 13 Trabecular microarchitecture of postmenopausal women has been evaluated with noninvasive techniques, such as high-resolution magnetic resonance images showing less deterioration of the bone 1 year after initiation of oral BP therapy.4 A decrease in bone turnover and a trend for an increase in the bone wall thickness has been detected by histomorphometry in subjects taking BPs.1 Alterations in the cortical structure of the second metacarpal have been detected in digital x-ray radiogrammetry of postmenopausal women treated with BPs.7 Mandibular cortical width may be measured on dental panoramic radiographs, and it has been suggested as a screening tool for referring patients for bone densitometry for osteoporosis investigation.14 and 15 Inhibition of the intracortical bone remodeling in the mandible of mice taking BPs has been reported.16 Thus, imaging evaluation of the mandibular cortical bone could be a biologically plausible way to detect BP bone alterations. Computed tomography can assess both cortical and trabecular bone characteristics. Cone-beam computed tomography (CBCT) can provide 3-dimensional information, while using lower doses and costing less than conventional CT. The CBCT images have been studied as a tool for the measurement of trabecular bone in patients with BRONJ.13 Therefore, cortical bone measurements on CBCT of the jaws might also help to understand bone changes in patients with BRONJ. There is no standard in quantifying dimensional changes of mandibular cortical bone. We explored several different approaches to take into consideration possible changes in length, area, and volume. These led to the 3 techniques developed in this study. This article reports a matched case-control study in which mandibular cortical bone was measured on CBCT images of subjects with BRONJ and controls. The aim of the study was to explore the usefulness of 3 techniques for detecting mandibular cortical bone dimensional changes caused by BP.

Expansão rápida de maxila assistida cirurgicamente por meio da piezocirurgia: relato de caso

Aim: the purpose of this study is to present a case of surgically assisted rapid maxillary expansion using piezosurgery and describe the benefits of using this device in this type of procedure. Case description: patient had adento-skeletal deformity Cl III with asevereatresia of jaw and underwent a rapid maxillary expansion and surgically assisted with the use of piezosurgery. Conclusion: the piezosurgerycan be used as an alternative in oral and maxillofacial surgery wich features provide greater accuracy and safety in surgery

Avaliação clínica e radiográfica de pacientes submetidos ao levantamento da membrana do seio maxilar

Implant dentistry is a dental specialty which presents great predictability in the rehabilitation at posterior, partially edentulous maxillary areas. Early tooth loss results in significant jaw remodeling. The maxillary sinus lifting followed by implant placement is a predictable technique initially described in 1980. Since then, several different techniques have been investigated varying filling materials and the management of complications in order to provide effective guidance in the rehabilitation of these patients. The current study evaluated ten patients who underwent sinus lifting before implant placement and crown installation. First, a retrospective analysis of the medical records was conducted to obtain information about possible postoperative complications. Clinical and radiographic analyses were performed at baseline and 180 days after surgeries. The sinus lifting with immediate implant placement provided satisfactory outcomes and can be considered a safe procedure. Treatment predictability was demonstrated in 90% of patients and for 86.96% of implants placed. It is important to highlight knowledge of anatomical structures at this area, the use of delicate surgical techniques, and strict patient follow-up.