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.

Data collection on bone density of mandibular alveolar bone on a Hounsfield scale of the dental apex of the cranial root of the first inferior molar in dogs using computed tomography at FMVZ-UNESP

The head is the most important and specialized region in the body because it contains a range of specialized organs and, because it has interconnections between specialized organs, there is a great overlap of images. Thus, computed tomography (CT) helps in diagnosing diseases in this region, such as oral conditions, as they provide millimetric slices or cuts and demonstrate the relationship between the various anatomical structures involved, in volume and depth. Within dentistry, CT helps in the identification of pathological processes such as infection, tumors, visualization of embedded teeth and bone bed. This study aimed to assess the density of the mandibular alveolar bone at a determined point to later predict how periodontal disease is involved in bone resorption. For this, we performed a blind retrospective study (n = 124) of the CT scan files of dog skulls at FMVZ-UNESP in order to determine the density of the jaw bone using a Hounsfield scale, in the region of the dental apex of the cranial root of the first molar tooth in dogs. The results obtained were evaluated using mean and standard deviation (27.28 +/- 9.53 HU) in order to predict the normal density of the mandibular alveolar bone in the studied region. Thus, this data analysis allows a more concise evaluation of bone resorption of mandibular alveolar bone and, therefore, provides an adequate surgical planning in cases of osteosynthesis given mainly by the presence of installed periodontal disease.

Comparison of compressive strength between three different plates for mandibular angle fractures fixation

The present study aims to compare three types of internal fixation for fractures of the mandibular angle. Mechanical testing was performed on replicas of polyurethane hemimandibles sectioned at the angle region to simulate a fracture and fixed with three different hardwares. Fixation devices enrolled on this survey included the grid plates with and without an intermediate bar and the method described by Champy and colleagues in 1978 and the sample consisted of 10 hemimandibles for each group. Vertical loadings were applied on each hemimandible and recorded after a vertical displacement of 3 and 5 mm. Statistical analysis was made by means of the variance analysis (ANOVA) and the Duncan test with a significance level of 5%. The Champy technique showed a statistically significant increased resistance when compared to the grid plates after vertical displacements of 3 and 5 mm. The results of this survey suggest that the Champy technique, when compared to the grid plate positioned at the middle of the mandibular bone (placement site selected for this study), is more resistant than the grid plate and that the inclusion or not of an intermediate bar to the grid plates does not improve its resistance after linear vertical loadings.

Estudo da assimetria da fossa mandibular, em crânios secos de crianças pelo método radiográfico

The Temporomandibular Joint is a noble structure of the complex mandibular, a lot of research was conducted on the to signs and symptoms of the alterations that attack those structures. ln spite of the high incidence of the DTM in children, there's little knowledge about it, wich makes difficult the treatment Desorders Craniomandibulares (DCM) or Desorders Temporomandibulars (DTM). The Temporomandibular Joint is composed basically by three elements: bones, muscles and disk, in relation to bony part, we have the fossae mandibular that is part of the temporary bone and wich houses the condyle mandibular, accomplishing the articulation among the cranium and the jaw (it leaves piece of furniture of the articulation). Our intention in that work was of verifying a possible asymmetry of the fossae mandibular on the left side and of the right side in relation to two straight line: a straight line that coincided with the plane medium sagittal and another perpendicular straight line to the plan medium sagittal. Analyzing, the fossae mandibular in 91 dry craniums of children, with age varying between four months of life intrauterina and five years, in x-rays in that the incidence was cranium-flow, we could end that: in spite of we find statistical significance in relation to that asymmetry, clinic cannot affirm that interferences on occlusion exists for that asymmetry

Parafunção severa: reabilitação oral com prótese total mandibular x overlay maxilar: relato de caso

In many oral rehabilitation professionals seeking venture renew people smile. However, these procedures have functional implications and aesthetic criteria which must be satisfied so that the final result is predictable. The restoration of relations intermaxillary, phonetics, masticatory function, esthetics and patient comfort are the goals to be achieved. An effective way to achieve these goals when immediate reconstruction with permanent dentures is not possible, make use of a type of partial denture called overlay. Bruxism is a manifestation of biopsychological imbalance that affects the stomatognathic system, characterized by clenching and / or attrition of teeth together so centric or eccentric, can be manifestation of nocturnal or diurnal. Its effects can manifest themselves in different parts of the stomatognathic system, varying the severity of the damage as the resistance of the structures affected, the time of existence, its regularity and the general state of the wearer. The description of the steps followed in solving this case, in which the patient edentulous mandibular arch while the maxillary arch showed absence of teeth 16 and 26 and, except for the teeth 17 and 27, all other teeth showed wear very sharp in the sense denoting incisal cervical, severe impairment of the vertical dimension, the quality of masticatory function and a marked impairment phonetic, this case report aims to guide the beginning of a rehabilitation, as well as the transitional phase of treatment for recovery of functional and aesthetic relationships intermaxillary .

Influencia del nivel de inserción ósea del diente soporte en el desplazamiento de PPR de extremidad libre mandibular asociada al implante oseointegrado

The rehabilitation with mandibular distal extension removable partial dentures (DERPD) is complex and the use of implants has been improving the functioning of this approach. The insertion bony level around of the last support tooth is an aggravating factor, since it can harm the longevity of the treatment. Thus, the aim of this research was to evaluate the displacement tendency of a mandibular DERPD associated to an implant, with different insertion bony levels and different connections between the RPD and the support tooth, by finite element analysis. Eight models were made: MA - DERPD, incisal rest, no bony loss; MB - DERPD, distal plate, no bony loss; MC - DERPD, incisal rest, no bony loss, with implant and ERA system; MD - DERPD, distal plate, no bony loss, with implant and ERA system; ME - DERPD, incisal rest, bony loss; MF - DERPD, distal plate, bony loss; MG - DERPD, incisal rest, bony loss, with implant and ERA system; MH - DERPD, distal plate, bony loss, with implant and ERA system. Loads of 50 N in each peak were applied. Displacement maps were obtained and showed that implant favors this association and the bony loss harms the prognostic of the prosthesis. It is concluded that: the introduction of the implant with ERA system reduced the displacement tendency of the tooth and supporting structures; introduction of distal plate reduced the movement tendency of the support tooth; the decrease of the periodontal support didn't influence significantly the displacement tendency of the models with distal plate distal, but it influenced the models with distal incisal rest.

Predicting the behaviour of structures under impact loads using geometrically distorted scaled models

When a scaled structure (model or replica) is used to predict the response of a full-size compound (prototype), the model geometric dimensions should relate to the corresponding prototype dimensions by a single scaling factor. However, owing to manufacturing technical restrictions, this condition cannot be accomplished for some of the dimensions in real structures. Accordingly, the distorted geometry will not comply with the overall geometric scaling factor, infringing the Pi theorem requirements for complete dynamic similarity. In the present study, a method which takes geometrical distortions into account is introduced, leading to a model similar to the prototype. As a means to infer the performance of this method, three analytical problems of structures subjected to dynamic loads are analysed. It is shown that the replica developed applying this technique is able to accurately predict the full-size structure behaviour even when the studied models have some of their dimensions severely distorted. (C) 2012 Elsevier Ltd. All rights reserved.

Correlation between mandibular gland secretion and cuticular hydrocarbons in the stingless bee Melipona quadrifasciata

We investigated whether Melipona quadrifasciata worker mandibular gland secretions contribute directly to their cuticular hydrocarbon profile. The mandibular gland secretion composition and cuticular surface compounds of newly emerged worker bees, nurse bees, and foragers were determined by gas chromatography and mass spectrometry and compared. Both the mandibular gland secretions and the cuticular surface compounds of all worker stages were found to be composed almost exclusively of hydrocarbons. Although the relative proportion of hydrocarbons from the cuticular surface and gland secretion was statistically different, there was a high similarity in the qualitative composition between these structures in all groups of bees.

In Vitro Macroscopic and Endoscopic Analysis of Three-Rooted Maxillary Premolars and Two-Rooted Mandibular Premolars in the Same Individual: a Case Report

The recent addition of endoscopy in dental practice has enabled clinicians to have an excellent view of the operative field, yielding highly successful visualization of anatomical structures that are difficult to access, both in oral surgery and endodontics. The purpose of this report is to provide an in vitro macroscopic, radiographic, and endoscopic description of the anatomic variation of the roots of maxillary and mandibular first premolars in the same patient. A 22-year-old patient was referred by an orthodontist for the extraction of all the first premolars. Once extracted, the premolars were examined macroscopically and then analyzed radiographically after trepanation and filled root canal systems. Subsequently, a diaphanization process was carried out and the samples were sectioned at the middle and apical third for observation by endoscope. It was found that both the maxillary first premolars had three roots, and mandibular first premolars had two roots, all with complete root formation. Apical deltas or accessory canals were not identified in the radiographic images; however, through endoscope at the middle third, it was possible to observe an accessory canal to the first maxillary and mandibular right premolars. Thus, it can be concluded that the view through the endoscope allows better identification of accessory canals than X-rays.

Relationship between body size and flying-related structures in Neotropical social wasps (Polistinae, Vespidae, Hymenoptera)

Body size influences wing shape and associated muscles in flying animals which is a conspicuous phenomenon in insects, given their wide range in body size. Despite the significance of this, to date, no detailed study has been conducted across a group of species with similar biology allowing a look at specific relationship between body size and flying structures. Neotropical social vespids are a model group to study this problem as they are strong predators that rely heavily on flight while exhibiting a wide range in body size. In this paper we describe the variation in both wing shape, as wing planform, and mesosoma muscle size along the body size gradient of the Neotropical social wasps and discuss the potential factors affecting these changes. Analyses of 56 species were conducted using geometric morphometrics for the wings and lineal morphometrics for the body; independent contrast method regressions were used to correct for the phylogenetic effect. Smaller vespid species exhibit rounded wings, veins that are more concentrated in the proximal region, larger stigmata and the mesosoma is proportionally larger than in larger species. Meanwhile, larger species have more elongated wings, more distally extended venation, smaller stigmata and a proportionally smaller mesosoma. The differences in wing shape and other traits could be related to differences in flight demands caused by smaller and larger body sizes. Species around the extremes of body size distribution may invest more in flight muscle mass than species of intermediate sizes.

Numerical combination for nonlinear analysis of structures coupled to layered soils

This paper presents an alternative coupling strategy between the Boundary Element Method (BEM) and the Finite Element Method (FEM) in order to create a computational code for the analysis of geometrical nonlinear 2D frames coupled to layered soils. The soil is modeled via BEM, considering multiple inclusions and internal load lines, through an alternative formulation to eliminate traction variables on subregions interfaces. A total Lagrangean formulation based on positions is adopted for the consideration of the geometric nonlinear behavior of frame structures with exact kinematics. The numerical coupling is performed by an algebraic strategy that extracts and condenses the equivalent soil's stiffness matrix and contact forces to be introduced into the frame structures hessian matrix and internal force vector, respectively. The formulation covers the analysis of shallow foundation structures and piles in any direction. Furthermore, the piles can pass through different layers. Numerical examples are shown in order to illustrate and confirm the accuracy and applicability of the proposed technique.

Dynamic identification of structures: experimental assessment of modal parameteres through methods in frequency domain, in time-frequency domain and model updating

Among the experimental methods commonly used to define the behaviour of a full scale system, dynamic tests are the most complete and efficient procedures. A dynamic test is an experimental process, which would define a set of characteristic parameters of the dynamic behaviour of the system, such as natural frequencies of the structure, mode shapes and the corresponding modal damping values associated. An assessment of these modal characteristics can be used both to verify the theoretical assumptions of the project, to monitor the performance of the structural system during its operational use. The thesis is structured in the following chapters: The first introductive chapter recalls some basic notions of dynamics of structure, focusing the discussion on the problem of systems with multiply degrees of freedom (MDOF), which can represent a generic real system under study, when it is excited with harmonic force or in free vibration. The second chapter is entirely centred on to the problem of dynamic identification process of a structure, if it is subjected to an experimental test in forced vibrations. It first describes the construction of FRF through classical FFT of the recorded signal. A different method, also in the frequency domain, is subsequently introduced; it allows accurately to compute the FRF using the geometric characteristics of the ellipse that represents the direct input-output comparison. The two methods are compared and then the attention is focused on some advantages of the proposed methodology. The third chapter focuses on the study of real structures when they are subjected to experimental test, where the force is not known, like in an ambient or impact test. In this analysis we decided to use the CWT, which allows a simultaneous investigation in the time and frequency domain of a generic signal x(t). The CWT is first introduced to process free oscillations, with excellent results both in terms of frequencies, dampings and vibration modes. The application in the case of ambient vibrations defines accurate modal parameters of the system, although on the damping some important observations should be made. The fourth chapter is still on the problem of post processing data acquired after a vibration test, but this time through the application of discrete wavelet transform (DWT). In the first part the results obtained by the DWT are compared with those obtained by the application of CWT. Particular attention is given to the use of DWT as a tool for filtering the recorded signal, in fact in case of ambient vibrations the signals are often affected by the presence of a significant level of noise. The fifth chapter focuses on another important aspect of the identification process: the model updating. In this chapter, starting from the modal parameters obtained from some environmental vibration tests, performed by the University of Porto in 2008 and the University of Sheffild on the Humber Bridge in England, a FE model of the bridge is defined, in order to define what type of model is able to capture more accurately the real dynamic behaviour of the bridge. The sixth chapter outlines the necessary conclusions of the presented research. They concern the application of a method in the frequency domain in order to evaluate the modal parameters of a structure and its advantages, the advantages in applying a procedure based on the use of wavelet transforms in the process of identification in tests with unknown input and finally the problem of 3D modeling of systems with many degrees of freedom and with different types of uncertainty.

Geometric and Combinatorial Aspects of NonEquilibrium Statistical Mechanics

Non-Equilibrium Statistical Mechanics is a broad subject. Grossly speaking, it deals with systems which have not yet relaxed to an equilibrium state, or else with systems which are in a steady non-equilibrium state, or with more general situations. They are characterized by external forcing and internal fluxes, resulting in a net production of entropy which quantifies dissipation and the extent by which, by the Second Law of Thermodynamics, time-reversal invariance is broken. In this thesis we discuss some of the mathematical structures involved with generic discrete-state-space non-equilibrium systems, that we depict with networks in all analogous to electrical networks. We define suitable observables and derive their linear regime relationships, we discuss a duality between external and internal observables that reverses the role of the system and of the environment, we show that network observables serve as constraints for a derivation of the minimum entropy production principle. We dwell on deep combinatorial aspects regarding linear response determinants, which are related to spanning tree polynomials in graph theory, and we give a geometrical interpretation of observables in terms of Wilson loops of a connection and gauge degrees of freedom. We specialize the formalism to continuous-time Markov chains, we give a physical interpretation for observables in terms of locally detailed balanced rates, we prove many variants of the fluctuation theorem, and show that a well-known expression for the entropy production due to Schnakenberg descends from considerations of gauge invariance, where the gauge symmetry is related to the freedom in the choice of a prior probability distribution. As an additional topic of geometrical flavor related to continuous-time Markov chains, we discuss the Fisher-Rao geometry of nonequilibrium decay modes, showing that the Fisher matrix contains information about many aspects of non-equilibrium behavior, including non-equilibrium phase transitions and superposition of modes. We establish a sort of statistical equivalence principle and discuss the behavior of the Fisher matrix under time-reversal. To conclude, we propose that geometry and combinatorics might greatly increase our understanding of nonequilibrium phenomena.

A soft-tetramer model for diblock copolymer melts: structure formation and geometric characterization

The ability of block copolymers to spontaneously self-assemble into a variety of ordered nano-structures not only makes them a scientifically interesting system for the investigation of order-disorder phase transitions, but also offers a wide range of nano-technological applications. The architecture of a diblock is the most simple among the block copolymer systems, hence it is often used as a model system in both experiment and theory. We introduce a new soft-tetramer model for efficient computer simulations of diblock copolymer melts. The instantaneous non-spherical shape of polymer chains in molten state is incorporated by modeling each of the two blocks as two soft spheres. The interactions between the spheres are modeled in a way that the diblock melt tends to microphase separate with decreasing temperature. Using Monte Carlo simulations, we determine the equilibrium structures at variable values of the two relevant control parameters, the diblock composition and the incompatibility of unlike components. The simplicity of the model allows us to scan the control parameter space in a completeness that has not been reached in previous molecular simulations.The resulting phase diagram shows clear similarities with the phase diagram found in experiments. Moreover, we show that structural details of block copolymer chains can be reproduced by our simple model.We develop a novel method for the identification of the observed diblock copolymer mesophases that formalizes the usual approach of direct visual observation,using the characteristic geometry of the structures. A cluster analysis algorithm is used to determine clusters of each component of the diblock, and the number and shape of the clusters can be used to determine the mesophase.We also employ methods from integral geometry for the identification of mesophases and compare their usefulness to the cluster analysis approach.To probe the properties of our model in confinement, we perform molecular dynamics simulations of atomistic polyethylene melts confined between graphite surfaces. The results from these simulations are used as an input for an iterative coarse-graining procedure that yields a surface interaction potential for the soft-tetramer model. Using the interaction potential derived in that way, we perform an initial study on the behavior of the soft-tetramer model in confinement. Comparing with experimental studies, we find that our model can reflect basic features of confined diblock copolymer melts.

New Application of Piezoelectric Ultrasounds in Maxillo-facial bone surgery

Background: Piezoelectric instrumentation seems to offer 3 important advantages for cutting bone structures. Be more precise because it is produced by micro-vibrations from the cutting insert. Be safer because the ultrasonic frequency used does not affect soft tissue. Thirdly, the less invasive cutting action produces minor tissue damage and consequently probably a better healing Aim of the Study: The aim of this study is to evaluate the effectiveness of piezoelectric device capability in maxillo-facial surgery, in order to take advantage of these favourable capacity. Material and Methods: Considering the several potential application of the piezoelectric technology in Orthognathic, Oncologic and Extractive surgery, we would like to design protocols in order to verify how this new device can modify the surgical technique, the surgical time, the patients healing and its quality of life. Results: Due to the precise Piezosurgery cut, we can manage the Cad-Cam-Custom Made plates protocol in Oncologic Surgery and in Orthognatic Surgery increasing our percentage of comparison between the 3D preoperative plan and the surgical execution. We also found a better quality of life impaction in Patient who underwent and extractive surgery Conclusion: Piezosurgery device seems to be a strong surgical aid were safe and precise cut are needed and its capability to reduce the discomfort Patients need to be study in deep also in major surgery like Orthognatic and Oncologic surgery.