55 resultados para Sagittal split ramus osteotomy
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Purpose: The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities.Patients and Methods: Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery.Results: Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population.Conclusion: Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up. 0 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:346351, 2011
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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.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Background. Split liver transplantation (SLT) increases organ supply for hepatic transplantation. Long-term patient survival and complication rates seem to be equivalent between orthotopic liver transplantation (OLT) and SLT. There are controversies among transplant physicians due to an ethical dilemma between benefiting individual needs or those of society. Barshes and Goss (Am J Transplant 5:2047, 2005) demonstrated that the majority of adult liver transplant candidates are favorable to SLT. The aim of our study was to evaluate the opinions of patients at a Brazilian university hospital regarding SLT.Materials and Methods. A questionnaire with 14 questions was applied to 50 patients included in a hepatic transplant waiting list regarding SLT.Results. The overall attitudes of 66% of the participants were classified as utilitarian, 31% were classified as self-preserving, and 3% were undecided. Ninety-one percent of patients would be willing to share even if their expected survival after SLT was shorter than that with OLT. For 77% of patients, children must have priority over adults. However, 83% were unaware of the donors for pediatric transplantations.Conclusions. SLT is a consistent solution for organ demand despite controversies among transplant physicians. The present study demonstrated that most patients were favorable to SLT. In conclusion, attitudes toward graft sharing are not barriers to SLT.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Purpose: This study used bovine ribs to comparatively assess the deformation, roughness, and mass loss for 3 different types of surface treatments with burs, used in osteotomies, for the installation of osseointegrated implants.Materials and Methods: The study used 25 bovine ribs and 3 types of helical burs (2.0 mm and 3.0 mm) for osteotomies during implant placement (a steel bur [G1], a bur with tungsten carbide film coating in a carbon matrix [G2], and a zirconia bur [G3]), which were subdivided into 5 subgroups: 1, 2, 3, 4, and 5, corresponding to 0, 10, 20, 30, and 40 perforations, respectively. The surface roughness (mean roughness [Ra], partial roughness, and maximum roughness) and mass (in grams) of all the burs were measured, and the burs were analyzed in a scanning electron microscope before and after use. Data were tabulated and statistically analyzed by use of the Kruskal-Wallis test, and when a statistically significant difference was found, the Dunn test was used.Results: There was a loss of mass in all groups (G1, G2, and G3), and this loss was gradual, according to the number of perforations made (1, 2, 3, 4, and 5). However, this difference was not statistically significant (P < .05). Regarding the roughness, G3 presented an increase in Ra, partial roughness, and maximum roughness (P < .05) compared with G2 and an increase in Ra compared with G1. There was no statistically significant difference (P > .05) between G1 and G2. The scanning electron microscopy analysis found areas of deformation in all the 2.0-mm samples, with loss of substrates, and this characteristic was more frequent in G3.Conclusions: The 2.0-mm zirconia burs had a greater loss of substrates and abrasive wear in the cutting area. They also presented an increased roughness when compared with the steel and the tungsten carbide coating film in carbon matrix. There was no statistically significant difference (P < .05) between G1 and G2 in any mechanical test carried out. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:e608-e621, 2012
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INTRODUÇÃO: o problema transversal em Ortodontia pode ser de origem dentária, esquelética ou uma combinação de ambas e pode ser tratado de várias maneiras de acordo com o tipo de tecido envolvido e o arco dentário acometido. em se tratando de um problema esquelético e maxilar, o ortodontista poderá lançar mão da disjunção ortopédica, dependendo da idade óssea, obtendo uma correção da atresia, um alinhamento dentário espontâneo resultante do aumento no perímetro do arco e um sorriso mais amplo, beneficiando esteticamente o paciente. Porém, este tratamento de disjunção mandibular se torna inviável, já que este osso tem sua sutura fusionada precocemente. A expansão neste caso é alveolar e sua estabilidade é questionada. OBJETIVO: relatar um caso clínico, apresentando uma nova alternativa de tratamento para o apinhamento inferior: a Distração Osteogênica da Sínfise Mandibular (DOSM). Neste procedimento, é feita uma osteotomia sagital na sínfise, criando-se uma sutura artificial para que uma separação óssea seja conseguida, utilizando uma mecânica com aparelho disjuntor de Hyrax modificado. RESULTADOS: os resultados do tratamento apresentado mostram uma melhora na forma do arco, diminuição do corredor bucal, correção do apinhamento dentário e também uma estabilidade do tratamento, sem dano aos tecidos adjacentes. Neste caso clínico, a DOSM se mostrou uma excelente opção de tratamento.
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The trabecular projections of the human superior sagittal sinus were classified into types and subtypes according to spatial arrangement and shape. The horizontal and vertical projections direct laminar blood flow, while the conic type, which is avalvular, protects the openings of the superior cerebral veins in the superior sagittal sinus. Copyright (C) 2003 S. Karger AG, Basel.
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The worldwide decline in amphibians has been attributed to several causes, especially habitat loss and disease. We identified a further factor, namely habitat split- defined as human- induced disconnection between habitats used by different life history stages of a species- which forces forest- associated amphibians with aquatic larvae to make risky breeding migrations between suitable aquatic and terrestrial habitats. In the Brazilian Atlantic Forest, we found that habitat split negatively affects the richness of species with aquatic larvae but not the richness of species with terrestrial development ( the latter can complete their life cycle inside forest remnants). This mechanism helps to explain why species with aquatic larvae have the highest incidence of population decline. These findings reinforce the need for the conservation and restoration of riparian vegetation.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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OBJETIVO: Avaliar a morfologia da bulla tympanica de gatos após osteotomia lateral unilateral. MÉTODOS: Foram utilizados 20 gatos distribuídos em dois grupos de 10 animais cada, de acordo com o período de observação: B1 (8 semanas) e B2 (16 semanas). RESULTADOS: Nas radiografias em projeção lateral oblíqua realizadas no pós-operatório imediato observou-se a interrupção do meato acústico externo da bulla tympanica operada de todos os gatos de ambos os grupos (McNemar, p=0,0010*). Esta característica ainda pode ser observada nas radiografias realizadas 8 ou 16 semanas após a cirurgia (McNemar: B1 p=0.0020*; B2 p=0.0312*). Os exames macroscópicos revelaram que a bulla tympanica operada apresentava conformação semelhante a da bulla tympanica normal, com preservação da cavidade timpânica. Na maioria das bullae tympanicae operadas observou-se a presença de tecido conjuntivo na área de osteotomia. O resultado do teste de McNemar foi significante em ambos os grupos (B1 p=0,0020*; B2, p=0,0010*). A histomorfometria mediu a extensão de tecido conjuntivo presente no local da osteotomia. Não houve diferença estatisticamente significante entre os dois grupos (Mann-Whitney, p=0,0524). CONCLUSÕES: A osteotomia lateral não alterou de maneira significativa a conformação da bulla tympanica. A regeneração total da bulla tympanica geralmente não ocorreu antes de 16 semanas de pós-operatório.
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A simple and inexpensive way to fabricate arrays of gold microelectrodes is proposed. Integrated circuit chips are sawed through their middle, normal to the longest axis, leading to destruction of the silicon circuit and rupture of the gold wires that interconnect it with the external terminals. Polishing the resulting rough surface converts the tips of the wires embedded in the chip halves into arrays of gold microdisks of about 25 mu m diameter. The number of active microelectrodes (MEs), of an array depends on the number of pins in the chip, n, being typically (n/2)-4. These MEs can be used individually or externally interconnected in any combination. X-ray images of the chips and micrographs of the resulting surface of the polished arrays have revealed variable distances between neighbor MEs, which are, however, larger than 10 times the radius of the disks. This feature of the MEs prevents diffusional cross-talk between electrodes. The use of these microdisk electrodes for analytical purposes exhibits sigmoidal voltammograms, and chronoamperometric experiments confirm the nonlinear i vs. t(1/2) plots, typical for processes where radial diffusion prevails. Satisfactory uniformity was observed for the response of each electrode of an array, indicating similarity of geometry and disk areas. The potentialities of these MEs were demonstrated by the determination of cadmium at ppb levels using square wave voltammetry with preconcentration. Due to the relative ease with which these MEs can be manufactured and their good performance in (chemical) analysis, wide applications in electrochemistry and electroanalysis is envisioned.