Treatment and complications of orbito-zygomatic fractures

The aim of the present study was to analyze the etiology, type and treatment employed in the orbito-zygomatic fractures (OZ). Also, postoperative complications are described and correlated with the type of treatment used. Fifty patients with OZ fractures were evaluated. Orbital fractures in which the zygomatic bone was not involved were excluded. Epidemiologic data and characteristics of treatment such as the type of material used for osteosynthesis, number of anatomical sites on which rigid internal fixation (RIF) was applied, surgical approaches and associated complications were recorded. The main causes of trauma were motorcycle and bicycle accidents, constituting 52% of the sample. The osteosynthesis system used was the 2.0 mm, except in four patients in whom the 1.5mm system was used for fixation at the infra-orbital rim. A total of 18% of the patients required reconstruction of the internal orbit and in all cases titanium mesh was used. 46% of the patients received RIF in three anatomical sites, most in the fronto-zygomatic suture, infra-orbital rim and zygomatic-maxillary buttress. The most frequent complication was paresthesia of the infra-orbital nerve (34 patients, 68%). Other findings were also discussed with the intent of better understanding the treatment of the OZ fractures.

Evaluación de la deformación de dos siliconas para prótesis faciales, influencia de la pigmentación y desinfección química

The purpose of present study was to analyze the effect of pigmentation and chemical disinfection on the initial and the permanent deformation of two silicones (Silved Selant and Brascoved) for facial prosthesis. Initial and permanent deformation tests samples (20 mm × 12.5 mm) were made following the manufacturer's instructions. For each silicone (n= 40), ten samples were used for pigmentation with make up power, ten with iron oxide, ten with ceramics power and tem were tested without pigmentation. Five samples of each group were submitted to chemical disinfection using a 2 % Chlorhexidine spray. All samples were immersed in physiological saline and stored in an oven at 35 ° ± 1 °C. After 90 days, the samples were submitted to initial and permanent deformation tests using a dial indicator. For both properties, data were analyzed by Tukey's test (a= 0.05). The results showed that all the materials had initial and permanent deformation regardless of pigmentation and chemical disinfection. The groups were used for pigmentation with iron oxide showed less initial and permanent deformation when were submitted to the chemical disinfection regardless the silicone used.

Radiographic and clinical evaluation of zygomatico-maxillary complex fractures treated by 2.0 miniplates system

The zygomaticomaxillary complex (ZMC) is the second highly incidental of facial fractures. According to the anatomical complexity, there are many reports in the literature about this trauma, mainly related to treatment for these fractures. With the purpose of evaluating clinically and radiographically the stability of unilateral zygomatic fractures treated by surgical reduction and fixed in two points by stable internal fixation, this research was proposed. Twenty patients with zygomatic fractures were evaluated and compared with twenty nonfractured patients. The results showed that there were no statistically significant differences among the obtained data, perimeter and area, of the treated and contra-lateral sides of the experimental group. When compared to the control group the differences were not statistically significant. We also performed a comparison of the distance between the nasal bone and zygomatic prominence in all groups the results were also satisfactory.

Efecto del blanqueamiento dental con peroxido de hidrógeno al 35% en la resistencia de unión de dientes restaurados con resina compuesta

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

Supratarsal approach to treatment of zygomatic complex fractures

Many incisions have been described for approaches to zygomatic fractures. Precise repositioning of zygomatic complex fractures is difficult. The traditional approach is through an eyebrow incision, but it can produce a scar that causes aesthetic and psychological problems for the patient. We describe the supratarsal fold approach to expose the frontozygomatic suture and to reduce small displacements of frontal sinus anterior wall; it gives good access and excellent aesthetic results.

Case report: Cornelia de Lange Syndrome (CDLS)

The Cornélia of Lange´s syndrome is a genetic anomaly, described and published by Cornelia Catharina of Lange in 1933, however, their aspects were described previously by Winfried Robert Clemens Brechmann in 1916, that’s why it is also known as Brachmann of Lange’s syndrome. The most frequent clinical characteristics include typical face dismorfia, variable degree of mental delay, anomalies of the hands and feet, multiple malformations, retardation of the pre and postnatal physical development and microcephaly variable intellectual compromising. Some facial characteristics are peculiar and they are mixed with the inherited lines of their own family, the united brows, the long lashes, the small nose, the round face, the fine lips and lightly inverted. As oral manifestations they present micrognathia, dental crowding, periodontal disease, delayed dental eruption, enamel hypoplasia, erosion of the enamel and dentine caused by stomach acids of the gastroesophageal reflux and atresia of the dental arches. The purpose of this paper is to present a clinical report of a boy bearer of this syndrome assisted at CAOE - FOA - UNESP, emphasizing the importance of multiprofessional team for the diagnosis and treatment of this syndrome.

Analysis of association between posterior crossbite, median line deviation and facial asymmetry

Facial asymmetry is a common human characteristic and can occur on many levels, originate of genetic factors, and can be caused by traumas or due to cross bite and/or muscular disability. The aim of this study was to evaluate the relation between posterior crossbite, median line deviation and facial asymmetry. For this study 70 children aged between 3 and 10 years-old were examined and photographed. Using Microsoft Office Power Point 2007, horizontal lines and one vertical line on median line were drawn, to subjectively analyze facial discrepancies. In relation to overjet, the majority of children (78.6%) showed normal relation, followed by high overjet (17.1%), anterior crossbite (4.3%). In relation to overbite, the majority of children (60%) showed normal relation, 27.1% anterior opened bite (negative overbite), and 12.9% showed high overbite. Posterior crossbite was present in 27.1% of children. Among them, 68.4% showed unilateral crossbite on right side, 21.1% bilateral crossbite and 10.5% unilateral crossbite on left side. The relation between posterior crossbite and facial asymmetry, according to Fisher´s Exact Test (p=0.0970), there was no statistically significant association. In relation to median line, the association was statistically significant with posterior crossbite (p=0.0109) and with facial asymmetry (p=0.0310). There was association between posterior crossbite and median line deviation. There was no association between posterior crossbite and facial asymmetry.