Camuflagem ortodôntica com dispositivos de ancoragem temporários ou cirurgia ortognática: parâmetros para a decisão

The polemical discussion between orthodontic therapeutic and surgical approaches with relation to borderline cases receives a new impulse with the emergence of temporary anchorage devices. This branch of Orthodontics has brought new treatment perspectives, but it has still been applied empirically, while the various factors involved in determining and conducting the treatment planning are neglected. The objective of the present study is to identify the several factors to be considered in both forms of treatment in order to provide the orthodontist with information that may contribute for the correct decision.

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.

Treatment of Atrophic Mandibular Fractures with the Pencilboneplate: Report of 2 Cases

The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient’s systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixa- tion by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, espe- cially by an intra-oral approach, and warrants further bio- mechanical and clinical studies.

Lack of bone healing: an unusual complication following surgically assisted rapid palatal expansion

Bone defects at interdental osteotomy sites are as a complication of surgi-cally assisted rapid palatal expansion (SARPE). The replacement of osseoustissue by fibrous connective tissue impairs the spontaneous closure of adiastema between central incisors, and orthodontic tooth movementthrough the defect area may lead to root resorption. Treatment of such asituation requires an orthodontic-surgical approach. In this report, wedescribe the lack of bone healing at the midline osteotomy site after SARPE,which was treated by autogenous bone grafting as assessed by cone beamcomputed tomography. In addition, we discuss factors related to the aetiol-ogy and treatment of a bone defect after SARPE.

Cirurgia estética para remoção de hiperplasia gengiva: granuloma piogênico

The pyogenic granuloma, a lesion considered hyperplastic regenerative inflammatory reaction is a finding commonly found in the oral cavity, affecting large numbers of individuals, being more prevalent in females. But its pathogenesis is not well defined and may be associated with numerous factors that stimulate tissue proliferation. Correct diagnosis and treatment plan are essential for success in approach, restoring function and aesthetics to the periodontal tissues. In agreement with the literature, the most common treatment and greater predictability is surgical removal, which involves resection of the lesion, together with its base inserted into the underlying tissue, periosteum and bone tissue. However, the excision can promote aesthetic defects, particularly in anterior regions where it is most affected. This article reports on the importance of a correct surgical approach for removal of pyogenic granuloma in the region of the interdental papilla between teeth 42 and 43, resulting in a good anatomical result and aesthetic.

Diagnóstico e planejamento em cirurgia parendodôntica: utilização da tomografia cone beam

The ability to tridimensionally evaluate pathological and anatomical areas, in apical surgery planning, presents a number of advantages. Cone beam computed tomography (CBCT) was developed for dental applications. This paper aims to present a literature review on CBCT, highlighting its advantages over both conventional computed tomography (CT) and radiography. Moreover, its clinical applications in apical surgery are discussed. LITERATURE REVIEW AND CONCLUSION: Unlikely CT, CBCT captures a volume of data in a single 360º rotation, providing benefits such as higher accuracy, better resolution, reduced scanning time and reduced radiation dose. In the maxillofacial region, CBCT has been mainly used in the assessment of dento-alveolar pathology and oral traumatology. CBCT provides a better diagnosis and quantitative information on periodontal bone levels than conventional radiography. It has also been used for patients requiring surgical facial reconstruction, orthognathic surgery, dental implants, and more complex tooth extractions. Besides that, it seems to be a significant tool in modern endodontic practice, presenting useful applications in apical surgery.

Effect of topical application of chlorhexidine and metronidazole on the tissue repair of palatal wounds of rats: a clinical and histomorphometric study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cone-beam evaluation of pharyngeal airway space in class I, II, and III patients

The purpose of this study is to make a 3-dimensional (3-D) evaluation of the pharyngeal airway space (PAS) in patients with class I, II, and III malocclusion. Sixty patients were evaluated. The patients were divided in 3 groups according to their occlusion classification. The volume and area of PAS were evaluated using the software Dolphin 3-D Imaging in the preoperative period for orthognathic surgery. PAS volume and area were influenced by different patterns of malocclusion. The mean volume and area for class III patients were statistically bigger than for classes I and II patients (P < .001). There was also a significant difference for volume values between class I and II patients, being the bigger volume for the class I patients (P < .05). It was possible to conclude that the class III patients presented a bigger PAS compared with classes I and II patients.

Evaluation of crystallized biosilicate in the reconstruction of calvarial defects

The objective of this study was to assess the bone repair process of crystallized Biosilicate in surgically created defects on rats' calvaria. This biomaterial was recently developed for odontological use. We used fifteen rats (rattus norvegicus albinus, Wistar), and two 5 mm surgical defects were performed on each of them; the defects were made with trephine drill on the calvarium region prior to the biomaterial placement. Groups were divided as follows: Group 1-defect filled with clot; Group 2-defect filled with crystallized Biosilicate. After 7, 14 and 28 days the animals were killed, the parts were retrieved and slides were prepared for histological studies. Bone formation was satisfactory in all groups, with direct contact between biomaterial surface and bone and absence of infection signs. The 28 days periods showed better results, and statistically significant difference between Clot Group (90.2 %) and Biosilicate (58 %; p = 0.002) was seen, regarding presence of bone tissue on the surgical defects. Our study revealed that defects filled with clot present better results on bone formation compared to crystallized Biosilicate, which is considered a biocompatible material with favorable osteoconductive properties.

Assistência cirúrgico-odontológica a pacientes com história de infarto do miocárdio

The execution of a appropriate odontological surgical treatment for patients with Myocardial Infarction has been based in established protocols for important works in world wide literature during the sixty’s and seventy’s decade, established with a minimum of six months before the noncardiac surgery. The recent advancements in the medical assessment of surgical risk based on the individual analysis of each case with availability of new therapeutic tools in reference to medical or dental treatment, allowing for new procedures that can be used in the execution of safer odontological surgery for each patients. This review of the literature shows the actual tendencies of the treatment of patients with Myocardial Infarction concerning specific care before, during and after surgery based on laboratory evaluation and drug therapy as well as the possibility of surgical treatment before six months post-infarction.

O uso de drogas anticoagulantes e antiplaquetárias orais em pacientes cirúrgicos ambulatoriais: revisão de literatura

The oral anticoagulants (AOC) and platelet antiagregants are drugs used for the prevention of thromboembolic phenomena, such as pulmonary embolism in patients with atrial fribrilation heart valves, thrombosis and pulmonary embolism. For patients who are undergoing surgical procedures-dentistry were asked to discontinue the use of anticoagulants until the value of the INR remained = 2.0, that in order to avoid trans and hemorrhages in the postoperative period. However, the AOC can cause the formation of a clot, leading to obstruction of blood pathways. Thus, it became doubtful the medicine for surgery, in which local hemostatic measures would be sufficient to promote hemostasis. Thus, the objective of the review was to evaluate the risk of bleeding in patients AOC users that are subjected to surgical procedures, through a bibliographical survey carried out in relevant clinical studies published between 1990 and 2012, by the MedlinePubMed data. In this review of literature was concluded that the benefit of thromboembolism prevention overcomes the risk hemorrhage, therefore, it is recommended to keep the dose of anticoagulant therapy unchanged for patients undergoing oral surgery and implant dentistry, using appropriate INR levels with the assistance of local hemostatic. In addition, a refined surgical technique should be performed in these patients. With respect to the most invasive oral surgery, with a risk of bleeding, treatment may be necessary in conjunction with the medical staff.