Intraoral approach for treatment of displaced condylar fractures: case report

Dislocated subcondylar fractures often require open reduction and internal fixation. This treatment modality results in better anatomy, early function, and facilitated physical therapy. Ideal stable fixation is obtained by use of two miniplates to control the tension zone in the sigmoid notch area and stabilize the posterior border region or, if there is not enough space, one stronger plate. That is most frequently achieved through extraoral approaches. Recently new instruments have facilitated the use of an intraoral approach, which is used usually with the aid of an endoscope. However, it is possible to perform the procedure without the endoscope if proper instruments and clinical mirrors for checking the posterior border reduction and fixation are used. A case of reduction and fixation of a medially dislocated condylar fracture is presented and discussed.

Leaf anatomy of rubber-tree clones

A seringueira é uma planta de fácil reconhecimento por ser lenhosa, de porte mediano a grande, que apresenta um padrão característico de desfolha e reenfolhamento e, sobretudo, pela produção de látex. O objetivo do trabalho foi efetuar um estudo anatômico e morfológico foliar, comparando os clones RRIM 600 e GT 1 de seringueira &91;Hevea brasiliensis (Wild. ex Adr. de Juss.) Muell.- Arg&93;, desenvolvidos sob as mesmas condições edáficas e climáticas, para obtenção de informações que possam fornecer subsídios para correlações com dados fisiológicos e também diferenciar os clones em relação ao conteúdo de fibras, espessamento de tecidos do parênquima paliçádico e do parênquima lacunoso, caracterização anatômica do pecíolo, número e tamanho de estômatos e fornecer dados referentes a morfologia foliolar. Foram realizadas secções transversais na região do mesófilo, nervura central e pecíolo, seguindo-se os métodos usuais de preparação de lâminas permanentes. Foram realizadas análises biométricas de extensões de tecidos dos parênquimas paliçádico e lacunoso e contagem do número de células do parênquima lacunoso. Paralelamente foram realizadas análises biométricas para aferições de estômatos. Não houve diferenças para a altura das células epidérmicas, altura e número de camadas do parênquima lacunoso e para o comprimento e para a maior largura do limbo foliolar. Porém houve variação para a espessura das células do parênquima paliçádico, sendo que GT 1 apresentou maior espessura em relação a RRIM 600. GT1 apresentou maior número de estômatos em relação a RRIM 600, porém com menor tamanho. GT1 apresentou maior diâmetro da nervura central da folha e do pecíolo e maior quantidade de fibras de esclerênquima que RRIM 600.

Seed anatomy and germination of Phoenix roebelenii O'Brien (Arecaceae)

O objetivo desse trabalho foi estudar a morfologia, anatomia e o processo germinativo de sementes de Phoenix roebelenii. Para o levantamento dos dados biométricos foram utilizadas 100 sementes de frutos recém-colhidos, deixados secar ao ar por um dia. Para a germinação, quatro repetições de 50 sementes tratadas com Vitavax-Thiran foram semeadas em bandejas de plástico, contendo Sphagnum sp. como substrato e mantidas sob condições ambientais de laboratório. Detalhes da morfologia da semente foram documentados com o uso de microscopia eletrônica de varredura e esquematizados com auxílio de câmara clara, acoplada ao estereomicroscópio. Foram confeccionadas lâminas permanentes com cortes do embrião, para o estudo de sua anatomia. As dimensões médias das sementes foram: 10,32mm comprimento, 5,21mm largura e 3,91mm espessura. O peso de 1000 sementes foi de 151,1g e 1kg continha 6600 unidades. O início da germinação variou entre 27 e 58 dias. As sementes são albuminosas, com endosperma duro e o embrião é pouco diferenciado, lateral e periférico. A germinação inicia-se pela abertura de um opérculo, através do qual é emitido o pecíolo cotiledonar com o eixo embrionário na extremidade. O pecíolo funciona, internamente, como um haustório, digerindo gradativamente o endosperma. Na sua parte posterior, desenvolve-se a plúmula, que emerge através de uma fenda. Nota-se o aparecimento de raízes secundárias na porção anterior da raiz primária.

Coffee leaf and stem anatomy under boron deficiency

A deficiência de B é muito comum nos cafezais brasileiros, mas as respostas do cafeeiro ao B têm sido erráticas, dependendo do ano, do modo e época de aplicação e, ainda, da fonte de B empregada. Um melhor entendimento dos efeitos do B na fisiologia e anatomia do cafeeiro é importante para o desenvolvimento de um programa racional de adubação boratada, uma vez que a anatomia da planta pode influenciar a translocação do nutriente. Neste experimento, plantas de dois cultivares foram cultivadas em soluções nutritivas com 0,0 (deficiente), 5,0 (adequado) e 25,0 µM (alto) de B. Quando os primeiros sintomas de deficiência apareceram, as folhas foram cortadas e tiveram suas paredes celulares isoladas e analisadas quanto aos teores de B e Ca. Cortes foram feitos em folhas novas e no ápice de ponteiros e fotografados em microscópio eletrônico de varredura. A resposta dos dois cultivares ao B foi semelhante, não tendo sido observados sintomas de toxidez. O teor de B nas paredes celulares foi aumentado com o incremento da concentração desse elemento na solução, enquanto o teor de Ca não foi afetado. A relação Ca/B decresceu com o aumento da concentração de B na solução. Com deficiência de B, os tecidos vasculares foram desorganizados e as paredes do xilema ficaram mais finas. Folhas de café com deficiência deste nutriente apresentaram menos estômatos, os quais se encontravam.

A comparison of the wood anatomy of 11 species from two cerrado habitats (cerrado s.s. and adjacent gallery forest)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

STEM ANATOMY and DEVELOPMENT of SUCCESSIVE CAMBIA IN THE NEOTROPICAL LIANA SECURIDACA RIVINIFOLIA (POLYGALACEAE)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Handgrip strength predicts pressure ulcers in patients with hip fractures

Objective: Pressure ulcer (PU) is a frequent complication of hip fracture. Studies were carried out to identify the risk factors of PU development after hip fractures. The objective of the study was to determine the role of anthropometric measurements and handgrip strength as predictors of PUs in patients with hip fractures during their hospital stay and 30 d after discharge, which has not yet been established.Methods: Ninety-two consecutive patients with hip fractures who were older than 65 y old and admitted to an orthopedic unit were prospectively evaluated. Within the first 72 h of admission, each patient's characteristics were recorded, anthropometric measurements were taken (circumferences of the arm, waist, thigh, calf, triceps, and biceps and subscapular and suprailiac skinfolds), handgrip strength was measured, and blood samples were collected. PU evaluations were performed during the hospital stay and 30 d after hospital discharge.Results: Three patients were excluded because of PUs before hospitalization. Eighty-nine patients (average age 80.6 +/- 7.5 y) were studied; 70.8% were women, and 49.4% developed PUs during their hospital stay. In a univariate analysis, length of hospital stay (P = 0.001) and handgrip strength (P = 0.02), but not body circumferences and skinfolds, were associated with PUs during a hospital stay. Only handgrip strength (P = 0.007) was associated with PUs 30 d after hospital discharge. In a multivariate analysis, only handgrip strength was found to predict PU development at these points.Conclusion: Handgrip strength was found to predict PU development in patients with hip fractures during their hospital stay and 30 d after discharge. (C) 2012 Elsevier B.V. All rights reserved.

Submental Endotracheal Intubation: A Valuable Resource for the Management of Panfacial Fractures

Modern techniques for surgical treatment of midfacial and panfacial fractures in maxillofacial trauma lead to special problems for airway management. Usually, in perioperative management of panfacial fractures, the surgeon needs to control the dental occlusion and nasal pyramid assessment. For these reasons, oral and nasal endotracheal intubations are contraindicated for the management of panfacial fractures. Tracheotomy is considered by many as the preferred route for airway management in patients with severe maxillofacial fractures, but there are often perioperative and postoperative complications concerning this technique. The submental route for endotracheal intubation has been proposed as an alternative to tracheotomy in the surgical management of patients with panfacial fractures, besides it is accompanied by low morbidity. Thus, this paper aimed to describe the submental endotracheal intubation technique in a patient experiencing panfacial fracture. The subject was well treated using the submental endotracheal intubation to get good reconstruction of the fractures because the authors obtained free access of all facial fractures.

Crown and crown-root fractures: an evaluation of the treatment plans for management proposed by 154 specialists in restorative dentistry

Traumatic tooth injuries involve function and aesthetics and cause damage that range from minimal enamel loss to complex fractures involving the pulp tissue and even loss of the tooth crown. Technical knowledge and clinical experience are essential to establish an accurate diagnosis and provide a rational treatment. The purpose of this study was to evaluate the knowledge of Restorative Dentistry specialists about the management of crown and crown-root fractures based on treatment plans proposed by these professionals for these cases. A descriptive questionnaire was mailed to 245 Restorative Dentistry specialists with questions referring to their professional profile and the treatment plans they would propose for the management of crown and crow-root fractures resulting from dental trauma. One hundred and fifty-four questionnaires were returned properly filled. The data were subjected to descriptive statistics and the chi-square test was used to determine the frequency and the level of the significance among the variables. The analysis of data showed that in spite of having a specialist title, all interviewees had great difficulty in planning the treatments. As much as 42.8% of the participants were unable to treat all types of dental trauma. Complicated and uncomplicated crown-root fractures posed the greatest difficulties for the dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis.

In vitro evaluation of conventional and locking miniplate/screw systems for the treatment of mandibular angle fractures

This in vitro study evaluated the influence of the type of miniplate and the number of screws installed in the proximal and distal segments on the stability and resistance of Champy's osteosynthesis in mandibular angle fractures. Sixty polyurethane hemimandibles with bone-like consistency were randomly assigned to four groups (n = 15) and sectioned in the mandibular angle region to simulate fracture. The bone segments were fixed by different osteosynthesis methods using 2.0 mm miniplates and 2.0 mm x 6 mm rnonocortical screws. In groups 1 and 2, two conventional (G1) or locking (G2) screws were installed in each bone segment using a conventional (G1) or a locking (02) straight miniplate; in groups 3 and 4, three conventional (03) or locking (04) screws were installed in the proximal segment and four conventional (G3) or locking (04) screws were installed in the distal segment using a conventional (G3) or a locking (G4) seven-hole straight miniplate. The hemimandibles were loaded in compressive strength until a 4 mm displacement occurred between the segments, vertically or horizontally. Locking plate/screw systems provided significantly greater resistance to displacement than conventional ones (p < .01). Locking miniplates offered more resistance than conventional miniplates. Long locking miniplates provided greater stability than short ones.

Morphometric study of the root anatomy in furcation area of mandibular first molars

Furcation involvement in periodontal disease has been a challenge for the dentist. Objective: The aim of this study was to investigate root dimensions in the furcation area of 233 mandibular first molars. Material and Methods: Digital photomicrographs were used to obtain the following measurements on the buccal and lingual surfaces of each tooth: root trunk height (RT), horizontal interadicular distance obtained 1 mm (D1) and 2 mm (D2) below the fornix and interadicular angle (IA). Results: Mean standard deviation of buccal and lingual furcation measurements were, respectively, 1.37 +/- 0.78 mm and 2.04 +/- 0.89 mm for RT; 0.86 +/- 0.39 mm and 0.71 +/- 0.42 mm for D1; 1.50 +/- 0.48 mm and 1.38 +/- 0.48 mm for D2; 41.68 +/- 13.20 degrees and 37.78 +/- 13.18 degrees for IA. Statistically significant differences were found between all measured parameters for buccal and lingual sides (p<0.05, paired t test). Conclusions: In conclusion, the lingual furcation of mandibular first molars presented narrower entrance and longer root trunk than the buccal furcation, suggesting more limitation for instrumentation and worse prognosis to lingual furcation involvements in comparison to buccal lesions.

Clinical evaluation of the bicoronal flap in the treatment of facial fractures. Retrospective study of 132 patients

The aim of the present study was to evaluate the postoperative complications of bicoronal flaps used to treat facial fractures. One hundred and thirty two patients that received bicoronal flaps for the treatment of upper and middle third facial fractures were called for clinical and radiographic examination. Minimum follow-up was 1 year and all patients had charts with adequate information about their perioperative care pertinent to the study. Results showed as complications hypoesthesia (17%), partial unilateral frontal motor deficit (11%), infection (3%), hypertrophic scars (3%), varying degrees of alopecia (18%), seroma or hematoma in the immediate postoperative period (5%). The flap provided wide surgical access to the upper and middle facial thirds with very few serious complications, most frequently allowing good aesthetic results. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.

Immediate reconstruction of frontal sinus fractures: review of 26 cases

Purpose: the purpose of this study was to evaluate complications occurring after immediate reconstruction of severe frontal sinus fractures, including cases where the fracture was not limited to the anterior wall and also involved the posterior wall and/or sinus floor.Patients and Methods: the records of twenty-six patients presently undergoing follow-up for frontal sinus fracture reconstruction were reviewed. Information regarding demographics, fracture characteristics and causes, associated facial fractures, use of grafts or implants, type of fixation used, nasofrontal duct management, use of antibiotics, and complications were noted. Patients were asked to return for clinical and radiographic follow-up to access late complications.Results: the average age of patients with frontal fractures was 29.1 years and 92.3% were male. Mean follow-up was 3.6 years. The most common causes of fracture were motor vehicle accidents and physical aggression. All patients presented with comminuted and dislocated anterior wall fractures, 34.6% presented with posterior wall fractures, and 46% had sinus floor fractures. Complications occurred in 7 patients (26.92%) and included pneumoencephalus, frontal cutaneous fistula, frontal bone irregularity, and sinusitis.Conclusions: Frontal sinus reconstruction is a good procedure for immediate fracture treatment if there is not excessive comminution, dislocation, or instability of the posterior wall and if the frontonasal duct area is intact or can be repaired. Most complications result from incorrect indication for reconstruction. (C) 2004 American Association of Oral and Maxillofacial Surgeons.

Comparative bark anatomy of root and stem in Styrax camporum (Styracaceae)

The bark of Styrax camporum Pohl (Styracaceae) differs anatomically in the root and stem. Roots have layered secondary phloem; short sieve tubes with simple, transverse or more or less inclined sieve plates; fibres in tangential bands; astrosclereids; wide rays, and a poorly developed periderm. Stems have non-layered secondary phloem; longer sieve tubes with compound, scalariform, inclined sieve plates; sclerified cells and brachyselereids; a developed periderm, and a non-persistent rhytidome. Prismatic crystals, starch grains, phenolic compounds and lipidic contents were observed in root and stem bark cells. The differences between the secondary phloem of root and stem are discussed.