876 resultados para Radius fractures
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Investigamos a estimativa da orientação de fratura; mergulho e direção, através da análise de AVO multiazimutal de ondas qP e de suas convertidas qS1 e qS2. Assumimos fraco contraste de impedância, fraca anisotropia e ainda que, o meio fraturado comporta-se efetivamente como um meio transversalmente isotrópico (TI). Dentro destas hipóteses, a estimativa da orientação de fratura reduz-se a estimativa da orientação do eixo de simetria a partir de dados de refletividade de ondas qP. Aproximações lineares da refletividade da onda qP são utilizadas na inversão.
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The surgical treatment of mandibular condyle fractures currently offers several possibilities for stable internal fixation. In this study, a finite element model evaluation was performed of three different methods for osteosynthesis of low subcondylar fractures: (1) two four-hole straight plates, (2) one seven-hole lambda plate, and (3) one four-hole trapezoidal plate. The finite element model evaluation considered a load applied to the first molar on the contralateral side to the fracture. Results showed that, although the three methods are capable of withstanding functional loading, the lambda plate displayed a more homogeneous stress distribution for both osteosynthesis material and bone and may be a better method when single-plate fixation is the option.
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The aim of this study was to perform a physicochemical and morphological characterization and compare the mechanical behavior of an experimental Ti-Mo alloy to the analogous metallic Ti-based fixation system, for mandibular angle fractures. Twenty-eight polyurethane mandibles were uniformly sectioned on the left angle. These were divided into 4 groups: group Eng 1P, one 2.0-mm plate and 4 screws 6 mm long; group Eng 2P, two 2.0-mm plates, the first fixed with 4 screws 6 mm long and the second with 4 screws 12 mm long. The same groups were created for the Ti-15Mo alloy. Each group was subjected to linear vertical loading at the first molar on the plated side in a mechanical testing unit. Means and standard deviations were compared with respect to statistical significance using ANOVA. The chemical composition of the Ti-15Mo alloy was close to the nominal value. The mapping of Mo and Ti showed a homogeneous distribution. SEM of the screw revealed machining debris. For the plates, only the cpTi plate undergoes a surface treatment. The metallographic analysis reveals granular microstructure, from the thermomechanical trials. A statistically significant difference was found (P < 0.05) when the comparison between both internal fixation techniques was performed. The 2P technique showed better mechanical behavior than 1P.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Horizontal root fractures (HRF) usually affect the anterior teeth as a result of trauma, and generally heal spontaneously, depending on the vitality of the pulp. Diagnosis based on clinical findings, sensitivity tests, and radiographic examination is important to determine the presence of a root fracture and to prevent a root fracture from passing unnoticed. Cone-beam computed tomography (CBCT) has been used successfully for diagnosis and prognosis imaging of root fractures and has proved to be superior to other radiographic methods. This study reports two cases of dental trauma caused by a collision and a sports accident. The patients suffered horizontal root fractures in the maxillary left central incisor and in the mandibular left central incisor. The diagnosis of root fracture was confirmed by cone-beam computed tomography (CBCT) images, which also demonstrated spontaneous healing of the fracture line. The repair occurred by interposition of connective tissue in the former case and by interposition of bone and connective tissue in the latter case. The final diagnoses of both cases were based on CBCT images, indicating the importance of a CBCT examination to reach a firm diagnosis and to follow the healing process of root fracture cases, avoiding unnecessary radical endodontic treatment.
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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.
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Objective: this study aimed to present the causes and prevalence of maxillofacial fractures that occurred in the region of Araraquara-SP – Brazil, during a 6-year period. Methods: information regarding age, gender, etiology, and maxillofacial fracture site, as well as type of radiographic examination were evaluated. Data were gathered from the radiographic examination and radiographic report of the Division of Dentomaxillofacial Radiology, and from charts of the Division of Oral and Maxillofacial Surgery of patients attending for maxillofacial fractures from 2004 to 2009. A descriptive statistical analysis was developed using Epi-Info 3.5.1. Results: from a total of 11,728 patients assisted, 407 patients presented maxillofacial fractures. The prevalent age ranged from 21 to 30 years old. From the total patients, 322 were men and 85 were women (ratio of men to women was 3.8:1). Panoramic radiography (n = 306) was most frequently used to observe maxillofacial fractures. Mandibular fractures were frequent in the body of the mandible (n = 127), followed by symphysis (n = 102), and the prevalent cause was traffic accidents (n = 161). Conclusion: more than half of affected individuals were younger than 40 years of age. The body of the mandible was the most common fracture location visualized by panoramic radiography for traffic accidents and fights.
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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.
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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.
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Background This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach. Methods Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up. Results The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement. Conclusion Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.
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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.
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Objective The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (<10 mm) after rigid internal fixation of fractures. Patients and method Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. Results In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. Conclusion With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.
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Crowns made from an yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP) core with a porcelain veneer have shown high clinical failure rates. Manifestations of clinical failure in veneering ceramic ranges from a single chip to an extended fracture. Core failures are uncommon but usually are catastrophic. This article examines the possible causes of failure in zirconia systems and presents a case report involving the diagnosis and repair of three different types of failure in six 3Y-TZP/porcelain crowns.
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Background: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach.Methods: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up.Results: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 +/- 16.60 years. The median duration of postoperative follow-up was 24.39 +/- 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement.Conclusion: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.