Position paper from the IBRA Symposium on Surgery of the Head - The 2nd International Symposium for Condylar Fracture Osteosynthesis, Marseille, France 2012

Background: This is a position paper from the 2nd International Bone Research Association (IBRA) Symposium for Condylar Fracture Osteosynthesis 2012 was held at Marseille, succeeding the first congress in Strasbourg, France, in 2007. The goal of this IBRA symposium and this paper was to evaluate current trends and potential changes of treatment strategies for mandibular condylar fractures, which remain controversial over the past decades.Methods: Using a cross-sectional study design, we enrolled the consensus based on the panel of experts and participants in the IBRA Symposium 2012. The outcomes of interest were the panel and electronic votes on management of condylar base, neck and head fractures, and panel votes on endoscopic and paediatric condylar fractures. Appropriate descriptive and univariate statistics were used.Results: The consensus derived from 14 experts and 41 participant surgeons, using 12 case scenarios and 27 statements. The experts and participants had similar decision on the treatment of condylar base, neck and head fractures, as well as similar opinion on complications of condylar fracture osteosynthesis. They had a parallel agreement on using open reduction with internal fixation (ORIF) as treatment of choice for condylar base and neck fractures in adults. Endoscopic approaches should be considered for selected cases, such as condylar base fractures with lateral displacement. There was also a growing tendency to perform ORIF in condylar head fractures. The experts also agreed to treat children (> 12 years old) in the same way as adults and to consider open reduction in severely displaced and dislocated fractures even in younger children. Nevertheless, non-surgical treatment should be the first choice for children <6 years of age. The decision to perform surgery in children was based on factors influencing facial growth, appropriate age for ORIF, and disagreement to use resorbable materials in children.Conclusions: The experts and participating surgeons had comparable opinion on management of condylar fractures and complications of ORIF. Compared to the first Condylar Fracture Symposium 2007 in Strasbourg, ORIF may now be considered as the gold standard for both condylar base and neck fractures with displacement and dislocation. Although ORIF in condylar head fractures in adults and condylar fractures in children with mixed dentition is highly recommended, but this recommendation requires further investigations. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Healing Process of Autogenous Bone Graft in Spontaneously Hypertensive Rats Treated With Losartan: An Immunohistochemical and Histomorphometric Study

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

Removable Partial Dentures: Use of Rapid Prototyping

The CAD/CAM technology associated with rapid prototyping (RP) is already widely used in the fabrication of all-ceramic fixed prostheses and in the biomedical area; however, the use of this technology for the manufacture of metal frames for removable dentures is new. This work reports the results of a literature review conducted on the use of CAD/CAM and RP in the manufacture of removable partial dentures.

Considerações clínicas em implantes imediatos

The biological principles of osseointegration caused the rehabilitation treatment with osseointegrated implant become a safe, well alternative accepted by the dental community for the high success rate, allowing the preparation of functional and aesthetic prostheses in edentulous and partial patients. We passed the initial phase of functional vision for an aesthetic approach, too, depending on the demands of the patient and the quest for excellence by professionals. Over these last years, implant treatment has undergone many changes in surgical and prosthetic protocols. The less invasive surgical techniques and the development of restorative materials, especially ceramics allow the prosthetic rehabilitation of high functional quality and aesthetics. The installation of implants in sockets immediately after extraction of teeth involved by fracture, periodontal disease, endodontic lesions, is part of the arsenal of techniques for rehabilitating a number of advantages that we get to the outcome of multidisciplinary treatment. For this, we must consider several criteria in its planning as a fundamental unit, adjacent teeth, multiple losses, system, form and number of implants, type of retention of the prosthesis components, the patient expectation of the outcome perspective, gingival biotype, standard of ridge resorption, the smile line, etc. occlusal analysis. With the three-dimensional placement of the implant can immediately join the biological processes of repair of the socket, implant osseointegration, speeding treatment time. Much has been made by companies in the surface treatment of endosseous implants to be osseointegration shortened and restorative procedures started earlier, bringing benefits to the patient and professional. Among the main advantages we can emphasize the preservation of the structures adjacent to the teeth replaced, minor resorption of bone tissue involved... (Complete abstract click electronic access below)

Desenvolvimento de um equipamento para análise de desgastes em prótese de articulação total de quadril

Pós-graduação em Engenharia Mecânica - FEG

Avaliação da adesão de Staphylococcus spp. em resina acrílica específica para prótese ocular e alteração de cor de botões de íris artificiais, variando a cor e as técnicas de obtenção, ambos após desinfecção química

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

Study of corrosion resistance of laser welded Au-Pd-Ag-In alloy using electrochemical.

The aim of this work was to evaluate the corrosion resistance of AuPdAgIn alloy, submitted to laser beam welding, in 0.9% NaCl solution, using electrochemical techniques. Measures of the open circuit potential (OCP) versus time were applied to electrochemical experiments, as well as potentiodynamic direct scanning (PDS) and electrochemical impedance spectroscopy (EIS) on AuPdAgIn alloy, submitted to laser beam welding in 0.9% NaCl solution. Some differences observed in the microstructure can explain the results obtained for corrosion potential, Ecorr, and corrosion resistance, Rp. EIS spectra have been characterized by distorted capacitive components, presenting linear impedance at low frequencies, including a non-uniform diffusion. The area of the laser weld presented corrosion potential slightly superior when compared to the one of the base metal. The impedance results suggest the best resistant corrosion behavior for laser weld than base metal region. This welding process is a promising alternative to dental prostheses casting.

Análise das tensões em próteses implantossuportadas esplintadas, variando a localização dos implantes, pôntico e cantilever: estudo pelo método dos elementos finitos tridimensionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desenvolvimento de um novo sistema dinâmico para avaliação da liberação de fármacos

Pós-graduação em Biociências - FCLAS

Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

Aim: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation.

Maxillary molar intrusion with zygomatic anchorage in open bite treatment: lateral and oblique cephalometric evaluation

Purpose We aimed to use lateral and oblique radiographs to evaluate dental and skeletal changes arising from maxillary molar intrusion with zygomatic anchorage in open bite patients. Methods We conducted a pilot study including nine patients (six females and three males; mean age, 18.7±5.1 years) with skeletal open bite treated with titanium miniplates for posterior dentoalveolar intrusion. Lateral and oblique (right and left, 45°) radiographs were obtained before (T1) and 6 months after intrusion (T2). A paired t test was used for statistical evaluation. Results The maxillary posterior teeth were intruded 2.03± 0.87 mm (p<0.01) with 450×g of force, which resulted in counterclockwise rotation of the mandible (1.57°, p=0.02) and clockwise rotation of the occlusal plane (4.27±2.66°, p=0.01). Anterior facial height decreased by a mean of 1.79±1.51 mm (p<0.01). No significant change in the palatal plane or in anteroposterior molar movement was observed. Conclusion The oblique radiograph at 45° was useful for the assessment of molar intrusion and anteroposterior displacement. The treatment of anterior open bite with skeletal anchorage provided intrusion of molars and counterclockwise rotation of the mandible, resulting in open bite closure.

Aparelho de Thurow modificado e aparelho ortodôntico fixo no tratamento da classe II com mordida aberta anterior

This work had aim to present two clinical cases with open bite Class II malocclusion that treated in the phase of the mixed dentition with the modified Thurow appliance and in the permanent dentition with fixed appliance. The dentoskeletal effects of these appliances were carefully analyzed with the aid of metallic implants inserted in both maxilla and mandible. The correction of the malocclusion and the improvement of the skeletal, dental and facial relationship were observed in both cases. The modified Thurow appliance followed by fixed-appliance as a two-phase treatment protocol revealed to be an effective treatment approach for the two young people that initially presented a Class II division 1 malocclusion associated to anterior open bite presented.

Estabilidade sagital da condiloplastia associada à cirurgia ortognática para o tratamento do osteocondroma mandibular

The aim of this study was to evaluate the stability of the conservative condylectomy technique and articular disc repositioning as the surgical treatment approach for management of mandibular condylar osteochondroma, with appropriate Orthognathic surgery. Fifteen patients (12 females and 3 males), average age of 32.3 years (range, 13 to 56 years), with unilateral active osteochondroma of the mandibular condyle were analyzed. All patients underwent conservative condylectomy, recontouring of the remaining condylar neck stump and articular disc repositioned and indicated orthognatic surgical procedures. Average post surgical follow-up was 19 months. Each patient's lateral cephalograms were traced at 3 intervals (presurgery, immediate post surgery and long-term follow-up). Immediate after surgery the oclusal plane angle decreased -2.8 ± 4.5o, the maxillomandibular complex rotated counter-clockwise with advancement at menton 5.3 ± 5.6 mm, pogonion 5.0 ± 5.1 mm, B point 3.4 ± 4.2 mm and A point 1.0 ± 1.5 mm. The long-term follow-up showed significant changes in overbite (-0.6 ± 0.5 mm) and SNGoMe (0,93° ± 1,53°). Horizontally and vertically small instabilities occurred in Me (-1.21 ± 1.94 mm) and PNS (-1.48 ± 1.67 mm) respectively. The treatment protocol studied produced counterclockwise rotation and maxillofacial mandibular advancement. The long-term follow-up showed solid dental and skeletal stability with horizontal instability of Me and PNS in the vertical direction.

Estudio histológico del processo de reparación alveolar después de la aplicación tópica de la solucioón anestésica prilocaína 3 % con felipressina o,o3 ui/ml

The aim of this study was to evaluate the local anesthetic solution, composed by Prilocaine 3% and felipressin 0,03 UI/ml, influence on the alveolar repair process in rats after dental extraction. This research was previously approved by the Ethic Committee in Research of the Masters Degree Program in Oral and Maxillofacial Surgery of the Marília University (UNIMAR), Marília, São Paulo, Brazil. It was an experimental, randomly controlled study, with bifactorial analysis (group control versus experimental group, in function of the postoperative times (2 X 4)). For the accomplishment of this study 32 rats were used (Rattus norvegicus, albinus, Wistar), males, adults, weighing between 280 and 320 grams. The animals were selected and divided into Group I (control) and Group II (Citocain 3%® - Prilocaine 3% with felipressin 0,03UI/ml) with 16 rats each; being four animals of the Group I and four of the Group II, destined to the euthanasia in the postoperative periods of 3rd, 7th, 15th and 24th days. The histological analysis with base in the developed methodology, allowed us to conclude that the anesthetic solution of Citocain 3%® applied with gauze compress on the surgical dental wound, produced tissue events that committed the basic biological principles, that are responsible for the regeneration of the gingival epithelium and the alveolar process repair in rats. The Group I presented better results in the alveolar repair when compared to the Group II.