All-on-four concept and immediate loading for simultaneous rehabilitation of the atrophic maxilla and mandible with conventional and zygomatic implants

We report the simultaneous rehabilitation of an edentulous patient with a hybrid (zygomatic and conventional implants) all-on-four implant-supported prosthesis for the maxilla and a standard (conventional implants) all-on-four implant-supported prosthesis for the mandible. The transfer impression was made with a multifunctional guide and the upper and lower prostheses were placed 24 h postoperatively. Clinical and radiographic examinations showed no infection or bony resorption 2 years later. Simultaneous maxillary and mandibular rehabilitation with all-on-four immediate loading is a viable, fast and effective option for edentulous patients. (C) 2009 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.

Ameloblastic fibro-odontosarcoma: a case report

This paper reports one case, of an ameloblastic fibro-odontosarcoma (AFOS) affecting the mandible, in a 12-year-old girl. This neoplasm is a rare odontogenic neoplasm. To the authors' knowledge this is the fifteenth case of AFOS reported in English. The patient's chief complaint was a swelling in the face For 6 months. An incisional biopsy was performed diagnosing the case as all ameloblastic fibroma. After radiography ameloblastic fibro-odontoma was diagnosed. Computed tomography was performed and a stereolithography model made to plan the surgical procedures. A hemimandibulectomy followed by a vascularized fibular flap was then proposed. The surgery was uneventful. Microscopic features diagnosed an AFOS. After 23 months of close follow-up there is no sign of recurrence or metastasis. Dental implants were recently placed in the fibular flap.

Histochemical and SEM evaluation of the neuromuscular junctions from alcoholic rats

In the present study morphological changes occurring in the neuromuscular junctions (NMJ) of the extensor digitorum longus (EDL) and soleus muscles from albino rats (Rattus norvegicus) submitted to experimental chronic alcoholism were evaluated. Seventy two male animals aged 4 months and weighing on average 400 g were divided into three groups: control, alcoholic and isocaloric. Six rats from each group were anesthetized and sacrificed after 5, 10, 15 and 18 months. The NMJ did not show detectable morphological changes in either muscle after treatment when examined by light microscopy. With respect to the dimensions, statistical analysis demonstrated a tendency to a statistically significant treatment x time interaction for the length of soleus muscle NMJ. The ultrastructural study, however, revealed that the NMJ of the soleus muscle of animals submitted to 18 months of experimental alcoholism presented important morphological alterations. Characteristically, the NMJ of these muscles is located on an elevation on the surface of the muscle fiber, presenting a regular round, oval or elliptical shape and continuous and not very deep synaptic grooves. Approximately 30% of the NMJ of alcoholic rats are irregular in shape, with the sarcolemmal elevations typical of the synapse region being flattened on at least one side, with discontinuous synaptic grooves, and deep and punctiform contacts of the synaptic buds. These data suggest that, although skeletal muscle has a greater natural resistance against the direct or indirect effects of alcohol, some submicroscopic morphological alterations are detectable in the NMJ, especially in muscles with oxidative metabolism (soleus) following long periods of ingestion of alcohol. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Treatment of oral myiasis caused by Cochliomyia hominivorax: two cases treated with ivermectin

The term myiasis is applied to the injurious action that larvae of certain diptera Cause to the organism of Vertebrate animals in the living or dead tissue in which they grow. Because of its great destructive potential. appropriate and preventative treatment are necessary. Among, the sites of infestation. the human mouth is a common site. mainly in tropical countries. We present two cases of oral myiasis Caused by Cochliomyia hominivorax spp. Ivermectin is all extremely effective semi-synthetic macrolides, in the treatment of, this condition. (C) 2008 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Clinicopathological analysis of head and neck chondrosarcoma: three case reports and literature review

Chondrosarcoma (CHS) is a malignant neoplasm characterized by the formation of cartilaginous matrix by neoplastic cells, with a high propensity for local recurrences. Head and neck CHS is rare, accounting for less than 12% of all cases of CHS, usually affecting the maxilla. The majority of affected patients are in the fourth decade of life, with a slight predilection for male patients. A painless swelling is commonly the most frequent complaint. Surgery with wide en-bloc resection is the preferred treatment for CHS; radiotherapy and chemotherapy are usually palliative options. Owing to its rarity, there are few clinical series evaluating the biological behaviour of head and neck CHS. The aim of this study is to analyse the clinicopathological characteristics of head and neck CHS by reporting 3 new cases of this neoplasia affecting the jaw bones and reviewing the clinical series previously published in the English literature.

Collagen and reticular fibers in left ventricular muscle in diabetic rats: Physical exercise prevents its changes?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Investigation of the effect of movement and irrigation systems on temperature in the conventional drilling of cortical bone

We have compared the results of the external irrigation technique with those of a double irrigation technique with continuous intermittent movement. Maximum thermal measurements were made in the cortical part of 10 samples of bovine ribs during osteotomy to simulate the preparation of a surgical bed for the installation of dental implants at a depth of 10 mm Twenty specimens were drilled for each group: external irrigation and continuous movement (control group 1, CG1); external irrigation and intermittent movement (control group 2, CG2); double irrigation and continuous movement (test group 1, TG1); and double irrigation and intermittent movement (test group 2, TG2). The double irrigation technique gave significantly better results regardless of the drilling movement used. Thermal increases between samples was 19.2% in group CG1, 10.4% in CG2, 5.4% in TG1, and 3.4% in TG2. The double irrigation technique produced a significantly smaller increase in temperature in the cortical bone during both types of drilling (p = 0.001), which illustrated its greater efficiency compared with that of the external irrigation technique. (C) 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Orthognathic surgery with or without induced hypotension

This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n = 50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n = 50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery.

Resveratrol improves bone repair by modulation of bone morphogenetic proteins and osteopontin gene expression in rats

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

Tomographic follow-up of bone regeneration after bone block harvesting from the mandibular ramus

Autogenous bone is still considered the gold standard, and the applicability of autogenous bone grafts is well established. However, the possibility of second harvesting from the same donor region remains unclear. The aim of this study was to perform a prospective evaluation of hard tissue deposition in the mandibular ramus after bone block harvesting using cone beam computed tomography (CBCT). Twenty-two patients with indications for augmentation procedures using autogenous bone from the mandibular ramus were selected. Three CBCT scans were performed with a tomographic guide before bone harvesting (T1) and at 14 days (T2) and 6 months (T3) after the surgical procedures. Measurements were obtained in 2D (area, mm(2)) and 3D (volume, mm(3)), and were subsequently compared. In the 2D analysis, the mean bone formation rate was 56%, while for the 3D analysis the mean rate was 9.7%. Despite this difference, there was a significant correlation between area and volume measurements. Our findings demonstrated the presence of hard tissue in the mandibular ramus at 6 months after bone harvesting, which suggests that it would be possible to reuse the same region for a second block harvesting. However, the second bone harvesting would involve less bone for transplantation when compared to the first bone harvesting.

Transverse changes after surgically assisted rapid palatal expansion

The aim of this retrospective study was to investigate the amount of skeletal and dental expansion in patients submitted to surgically assisted rapid palatal expansion (SARPE). The sample consisted of 21 patients (14 female and seven male) with a mean age of 25.4 years (range 17.4-41.8 years). Postero-anterior (PA) cephalograms were taken pre-expansion (T1), immediately after expansion (T2), and at post-expansion retention of 120 days (T3). SARPE promoted significant transverse skeletal changes, which were maintained from T2 to T3. Dentoalveolar expansion and dental tipping were also observed in the region of the first molars and first premolars; however the net effect at the first molars was significantly less than that at the first premolars. No statistically significant effect on the width of the nasal cavity was observed. The findings indicate that peculiarities inherent to dental effects may influence the clinical options for SARPE. Skeletal expansions with SARPE were significant and stable. Dental changes were different between molars and premolars. The transverse changes after SARPE should be observed for future procedures related to the retention and the completion of orthodontic treatment.

Implants in the zygomatic bone for maxillary prosthetic rehabilitation: a systematic review

The purpose of this systematic review was to evaluate clinical studies on the follow-up survival of implants inserted in the zygomatic bone for maxillary rehabilitation. A comprehensive search of studies published from 2000 to July 2012 and listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases was performed in accordance with the PRISMA statement. Relevant studies were selected according to predetermined inclusion and exclusion criteria. The initial database search yielded 751 titles. After filtering, 313 abstracts were selected, culminating in 42 full text articles. Application of eligibility criteria led to the elimination of 17 articles. Hence 25 full-text articles were considered clinically relevant and were included. Calculations of the interval survival rates and cumulative survival rates of implants could be carried out on the data extracted from the final list of included studies for the different time intervals. These studies reported the insertion of a total of 1541 zygomatic implants and 33 implant failures. Failure generally occurred during the first year interval and was related to clinical complications, such as recurrent acute and chronic sinusitis. After a 36-month follow-up, the survival rate was 97.86%. Additional studies with longer follow-up periods, including the number of zygomatic implants inserted and details of the variations in the surgical techniques used and the impact of the maxillary morphology are still required.

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion

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

Neuromuscular electrical stimulation for stroke rehabilitation: Is spinal plasticity a possible mechanism associated with diminished spasticity?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)