Fenda cervical mediana

The midline cervical cleft is an unusual congenital anomaly of the ventral neck and fewer than 100 cases have been reported overall and the first described by Bailey in 1924. This anomaly is report in association with median cleft of lower lip, cleft mandible and tongue, and hypoplasia of other midline neck structures. Its considered an anomaly originated from the two first branchial arches. The treatment of this cleft is a vertical complete excision and a closure with multiple Z-plasty. Many authors recommend avoid linear closure and prefer multiple Z-plasty for evicted fibrosis and local retraction. In this paper we report 2 case of this anomaly and the literature is reviewed.

Aesthetic and functional ocular rehabilitation

The ocular losses are embarrassing to the bearer because they commit the face which has the essential organs for the human relationship. The present study shows the multidiscipline interaction in the treatment of a child who lost his left eye victim of a fire gun and needed an ocular plastic surgery for a correct prosthesis insertion. The ocular prosthesis fills in the ocular cavity simulating the facial growth and restoring its symmetry. Therefore, there are aesthetics, anatomic and physiological improvement on the child's face that allows her to be reinstated in society without being discriminated for her differences. © 2005 Elsevier Ltd. All rights reserved.

A comparison of human and porcine acellular dermal tissues in the subcutaneous space of a rat model

The study compared the host response to a human and a porcine acellular dermal tissue implanted in the subcutaneous space of a rat model. The human and porcine acellular grafts were surgically implanted in the subcutaneous tissue of rats (5 rats/group) and the materials were evaluated at 7, 15, 30, 60 and 180 postoperative days (PO). The histological immune response was quantified using a digital image analysis system, which evaluated the number of vessels present in the implants and in the surrounding soft tissue, the area of inflammatory cell infiltration in the grafts, the width of the capsular formation present around the tissues and the area of implants absorbed. The data were submitted to statistical analysis. Light microscopy showed mononuclear cellular infiltration, the presence of a capsular formation surrounding the grafts and the presence of vacuolar structures (optically empty spaces) inside the implants. The image analysis comparing both materials showed significant inflammatory cells in the human graft at 15 and 30 PO, thicker capsular formation in the porcine tissue at 60 PO, increased number of vessels inside the implants and in the surrounding tissues in the porcine graft and a similar absorption pattern in both materials at 180 PO. The histological findings showed that both tissues were well-tolerated when implanted in the subcutaneous tissue of rats, allowing us to consider the porcine acellular dermal graft as a provisional alternative material for reconstructive plastic surgery. Copyright © 2005 Taylor & Francis LLC.

Influence of implant positioning in extraction sockets on osseointegration: Histomorphometric analyses in dogs

Aim: To evaluate the influence of implant positioning into extraction sockets on osseointegration. Material and methods: Implants were installed immediately into extraction sockets in the mandibles of six Labrador dogs. In the control sites, the implants were positioned in the center of the alveolus, while in the test sites, the implants were positioned 0.8 mm deeper and more lingually. After 4 months of healing, the resorptive patterns of the alveolar crest were evaluated histomorphometrically. Results: All implants were integrated in mineralized bone, mainly composed of mature lamellar bone. The alveolar crest underwent resorption at the control as well as at the test sites. After 4 months of healing, at the buccal aspects of the control and test sites, the location of the implant rough/smooth limit to the alveolar crest was 2±0.9 mm and 0.6±0.9 mm, respectively (P<0.05). At the lingual aspect, the bony crest was located 0.4 mm apically and 0.2 mm coronally to the implant rough/smooth limit at the control and test sites, respectively (NS). Conclusions: From a clinical point of view, implants installed into extraction sockets should be positioned approximately 1 mm deeper than the level of the buccal alveolar crest and in a lingual position in relation to the center of the alveolus in order to reduce or eliminate the exposure above the alveolar crest of the endosseous (rough) portion of the implant. © 2009 John Wiley & Sons A/S.

Lip cavernous hemangioma in a young child

Hemangiomas are benign tumors of infancy and childhood, characterized by a phase of fast growth with endothelial cell proliferation, occurring in 10-12% of children at 1 year of age. It is known that hemangiomas of infancy are most commonly located on the head and neck region (around 60% of cases) and occur more frequently in the lips, tongue, and palate. Approximately 50% of hemangiomas have complete resolution, and 90% of them are resolved up to the age of 9. Complications occur in only 20% of the cases, the most common problem being ulceration with or without infection. The treatment depends on lesion location, size and evolution stage, and the patient's age. Surgery is usually indicated when there is no response to systemic treatments, or even for esthetic reasons, being performed as a simple excision in combination or not with plastic surgery. This paper reports a case of lip cavernous hemangioma in a 4-year-old child, who was submitted to 3 sessions of vascular sclerosis due to the size of the lesion, before undergoing simple excision of the hemangioma. Two years of postoperative clinical follow-up shows treatment success with no recurrence of the lesion.

Functional and esthetic rehabilitation with In-Ceram alumina and zirconia system: A multidisciplinary approach

The development of all-ceramic systems following metalceramics restorations allowed simulation of natural dentition due to favorable esthetics and resistance. In-Ceram is an alternative when esthetics is primordial as well as resistance required in rehabilitation. However, an ideal smile is associated to not only shape, color, texture and translucency but also harmony with gingival tissue. So, the aim of this study is to report a clinical case based on periodontal and fixed partial dentures principles to perform periodontal plastic surgery followed by esthetic rehabilitation. A female patient, 40-year-old, presented complaint about dental esthetics. After clinical and radiographic exams, metal-ceramics crowns (teeth 11, 12, 13, 21, 22 and 23) were considered unsatisfactory due to marginal leakage, color change in gingival tissue associated to metallic margin, and gummy smile. So, a crown lengthening surgery of anterior teeth was performed followed by rehabilitation of superior teeth with In-Ceram single crowns. Clinical significance: The interaction between periodontics and fixed prosthodontic area is the key of an adequated treatment planning which involves gingival smile to provide function and an esthetic condition in association with an esthetic, resistant and predictable material.

Undesirable effect of cosmetic lip augmentation with autologous fat tissue

Background: Facial cosmetic procedures are commonplace nowadays, especially techniques that aim to increase lip volume. Full lips provide a youthful, healthy, feminine and sensual appearance. There are many techniques and materials used to recover the loss of contour that occurs with age. Case presentation. An unusual case of fat tissue accumulation following cosmetic upper lip augmentation in a 61 year-old female was reported. Surgical treatment was performed for esthetic concerns. Microscopically, the tissue removed was composed of muscle fibers and mature adipocytes. Conclusion: Undesirable effects of esthetic treatment can occur and the clinician should be familiar with such complications to diagnose and manage them. © 2013 Kaminagakura et al.; licensee BioMed Central Ltd.

Evaluation of the biocompatibility of silicone gel implants - histomorphometric study

Breast implants are medical devices that are used to augment breast size or to reconstruct the breast following mastectomy or to correct a congenital abnormality. Breast implants consist of a silicone outer shell and a filler (most commonly silicone gel or saline). Approximately 5 to 10 million women worldwide have breast implants. Histomorphometric study to evaluate the biological tissue compatibility of silicone implants suitable for plastic surgery and the adverse effects and risks of this material. Thirty Wistar white rats received subcutaneous implants and the revestiment of silicone gel Silimed ®®, and randomized into six groups of five animals each, according to the type of implanted material and the time of sacrifice. Eight areas of 60.11mm2 corresponding to the obtained surgical pieces were analyzed, counting mesenchymal cells, eosinophils, and foreign body giant cells, observing an acceptable biocompatibility in all implants, for subsequent statistical analysis by Tukey test. Silicone gel showed inflammation slightly greater than for other groups, with tissue reactions varying from light to moderate, whose result was the formation of a fibrous capsule around the material, recognized by the organism as a foreign body. Despite frequent local complications and adverse outcomes, this research showed that the silicone and top layer presented an acceptable chronic inflammatory reaction, which did not significantly differ from the control group. In general, it is possible to affirm that silicone gel had acceptable levels of biocompatibility, confirmed the rare presence of foreign body giant cells, and when of the rupture, formed a fibrous capsule around the material, separating the material of the organism. © AVICENA 2013.

Retalho ósseo de gálea e periósteo preenchido com pó de osso: estido em coelhos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da biocompatibilidade de vários elastômeros de silicone implantados no tecido subcutâneo de ratos: estudo histológico e histomorfométrico

Pós-graduação em Odontologia - FOA

Avaliação de pacientes com sequência de Robin no pós-operatório imediato após palatoplastia primário

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Gliding Mentoplasty: A New Technique

The goal of mentoplasty is to improve chin projection. Traditionally, this is accomplished by either mandibular osteotomy or alloplastic implants. However, these procedures are not free of complications. This report describes gliding mentoplasty, a novel, simple technique for chin projection.The 12 patients in this study underwent gliding mentoplasty. By means of a 2-cm intraoral incision, a subcutaneous dissection was made in the caudal direction. The dissection then proceeded in the subperiosteal plane, leaving a 1-cm cuff of muscle attached to the bone, and advanced toward the lower border of the chin. Subsequently, the dissection was extended laterally, and the whole mental area was dissected from the surrounding tissue. Three 2-0 monofilament nylon sutures were placed in the submandibular periosteum and connected through the remaining muscle cuff to the periosteum. These key sutures allowed the submandibular region to slide forward, project the subcutaneous tissue and mentalis muscle, define the labiomental fold, and improve the pogonion projection.Gliding mentoplasty resulted in a symmetric projection of the chin in all cases. In two patients, a submandibular dimple developed, which spontaneously resolved in 1 month. No revision surgery was performed, and no tissue relapse was noted. The mean follow-up period was 24.7 +/- A 5.17 months (range 19-33 months). All the patients were satisfied with the result.Gliding mentoplasty is a simple, easy-to-perform, rapid surgical technique of chin projection that produces low pain, rapid recovery, and excellent cosmetic results.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Facial Reanimation Utilizing Combined Orthodromic Temporalis Muscle Flap and End-to-Side Cross-Face Nerve Grafts

Individuals with facial paralysis of 6 months or more without evidence of clinical or electromyographic improvement have been successfully reanimated utilizing an orthodromic temporalis transfer in conjunction with end-to-side cross-face nerve grafts. The temporalis muscle insertion is released from the coronoid process of the mandible and sutured to a fascia lata graft that is secured distally to the commissure and paralyzed hemilip. The orthodromic transfer of the temporalis muscle overcomes the concave temporal deformity and zygomatic fullness produced by the turning down of the central third of the muscle (Gillies procedure) while yielding stronger muscle contraction and a more symmetric smile. The muscle flap is combined with cross-face sural nerve grafts utilizing end-to-side neurorrhaphies to import myelinated motor fibers to the paralyzed muscles of facial expression in the midface and perioral region. Cross-face nerve grafting provides the potential for true spontaneous facial motion. We feel that the synergy created by the combination of techniques can perhaps produce a more symmetrical and synchronized smile than either procedure in isolation.Nineteen patients underwent an orthodromic temporalis muscle flap in conjunction with cross-face (buccal-buccal with end-to-side neurorrhaphy) nerve grafts. To evaluate the symmetry of the smile, we measured the length of the two hemilips (normal and affected) using the CorelDRAW X3 software. Measurements were obtained in the pre- and postoperative period and compared for symmetry.There was significant improvement in smile symmetry in 89.5 % of patients.Orthodromic temporalis muscle transfer in conjunction with cross face nerve grafts creates a synergistic effect frequently producing an aesthetic, symmetric smile.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.spinger.com/00266.

Avaliação da integração de implantes de silicone com superfícies lisa, texturizada e de poliuretano em cavidades anoftálmicas evisceradas de coelhos

Pós-graduação em Bases Gerais da Cirurgia - FMB