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.

Vacina de DNA: uma alternativa para o tratamento do melanoma canino: revisão de literatura

O melanoma é considerado um dos tumores cutâneos de maior importância em cães devido ao seu caráter agressivo, à capacidade de produzir metástases em estágios precoces e à baixa resposta aos tratamentos não cirúrgicos. Recentemente, as vacinas de DNA apresentam-se promissoras na terapêutica do melanoma canino. O objetivo deste trabalho é apresentar uma revisão bibliográfica sobre o assunto. As vacinas de DNA são baseadas em plasmídeos que contêm o gene codificante para o antígeno alvo, expressando-o na célula do hospedeiro e apresentando, assim, vantagens em relação às vacinas tradicionais, como: facilidade de produção, estabilidade térmica, baixo custo e estimulação da resposta imune celular (linfócitos T CD8+). Devido ao sucesso limitado das terapias padrões, o estabelecimento de uma vacina de DNA efetiva aumenta a possibilidade de uma terapia promissora para o melanoma canino, podendo trazer novas expectativas aos animais portadores dessa neoplasia.

Aumento de gengiva queratinizada em mucosa peri-implantar

Introduction: Recent studies have evaluated the relationship between the width of keratinized mucosa and peri-implant tissue health. Insufficiently wide keratinized tissue can be increased surgically, for example by free gingival grafting. The presence or reconstruction of keratinized tissue around the implant can facilitate restorative procedures, promote aesthetics and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. Objective: To describe a patient who underwent free gingival graft surgery to increase the width of keratinized tissue in the region of previously implants to support a type of prosthetic protocol. Case report: A patient who had received dental implants to support a type of prosthetic protocol presented with inflamed peri-implant mucosa, but with no keratinized tissue. Free gingival tissue was obtained from the palate and grafted into the anterior maxilla. Sixty days after muco-gingival surgery, we observed that the free gingival graft favored peri-implant health and prosthetic casting. Conclusion: The free gingival graft technique is both easy to perform and effective in increasing the width of keratinized mucosa following implantation.

Correção da deficiência transversa da maxila por meio da expansão rápida da maxila cirurgicamente assistida

Fundamentation: The correction of maxillary transverse deficiencies involves orthodontic and surgical procedures that can be performed before or after skeletal maturity. The surgically assisted rapid maxillary expansion (SAR ME) is performed by osteotomies through the lateral walls of the maxilla, zygomatic and canines buttresses, palatal and pterygomaxillary sutures, causing the maxillary disjunction. Followed by activation of the expander to the desired over-expansion in order to correct intercuspal later. Objective: The purpose of this study was to discuss the issues involved in the diagnosis of maxillary atresia, SAR ME indications, as well as surgical technique, through a case study. Methods: The male patient, 19 years old, had severe transverse maxillary deficiency with facial pattern III , Class III , with great lip incompetence. The patient underwent general anesthesia in a hospital environment, the osteotomies was done according to the technique described by Epker and Wolford (1980). Postoperatively, the patient underwent activations daily for 15 days and after 6 months, the orthodontist installed fixed orthodontic appliance to prepare the patient to orthognathic surgery later. Conclusion: The diagnosis by clinical evaluation and models study is essential for the indication of SAR ME and this procedure provides good predictability in the correction of transverse deficiency, with minimal morbidity.

O efeito do consumo abusivo de alvool no torque de remoção de implantes de titânio

Studies have reported that alcohol may lead to imbalance in bone formation and resorption, however, its effects on osseointegration of titanium implants continues to be an inconclusive subject. In this context, the aim of this study was to make a biomechanical evaluation of the effect of abusive alcohol consumption on the removal torque of osseointegrated titanium implants. Male Wistar rats (n=30) were divided into two experimental groups (15 each) receiving only water (Control) or 36% alcohol solution oral administration. Thirty days later, all animals were submitted to titanium implant (2.2 mm x 4 mm) placement in the right and left tibiae. The surgical alveoli were prepared with a 2 mm drill mounted in a counter-angle hand-piece (20:1 ratio, 35 Ncm torque at 1200 rpm) under abundant cooling. Five animals from each group were euthanized at 15, 30, and 60 days. Tibiae were submitted to reverse torque analysis. Data obtained were submitted to statistical analysis by the non-parametric Kruskal-Wallis and Dunn Tests (p < 0.05). Animals in the alcohol group presented lower removal torque values when compared with control group animals for all periods tested (p < 0.05). It can be concluded that abusive alcohol consumption can reduce the removal torque of titanium implants placed in rat tibiae, suggesting that alcohol may interfere in the osseointegration process of titanium implants.

O efeito do consumo abusivo de álcool no torque de remoção de implante de titânio

Studies have reported that alcohol may lead to imbalance in bone formation and resorption, however, its effects on osseointegration of titanium implants continues to be an inconclusive subject. In this context, the aim of this study was to make a biomechanical evaluation of the effect of abusive alcohol consumption on the removal torque of osseointegrated titanium implants. Male Wistar rats (n=30) were divided into two experimental groups (15 each) receiving only water (Control) or 36% alcohol solution oral administration. Thirty days later, all animals were submitted to titanium implant (2.2 mm x 4 mm) placement in the right and left tibiae. The surgical alveoli were prepared with a 2 mm drill mounted in a counter-angle hand-piece (20:1 ratio, 35 Ncm torque at 1200 rpm) under abundant cooling. Five animals from each group were euthanized at 15, 30, and 60 days. Tibiae were submitted to reverse torque analysis. Data obtained were submitted to statistical analysis by the non-parametric Kruskal-Wallis and Dunn Tests (p < 0.05). Animals in the alcohol group presented lower removal torque values when compared with control group animals for all periods tested (p < 0.05). It can be concluded that abusive alcohol consumption can reduce the removal torque of titanium implants placed in rat tibiae, suggesting that alcohol may interfere in the osseointegration process of titanium implants.

Fratura do seio frontal: relato de caso

The frontal sinus fractures are derived from accidents of great intensity. Are usually associated with fractures of the midface, including the naso-orbital fractures and zygomatic ethmoid. Several treatment modalities have been proposed. In this case it was used to access bicoronal reconstruction of the anterior frontal sinus, and restore contour fronto-naso-orbital-ethmoid with satisfactory results.

Aspectos clínicos influentes no planejamento das próteses sobre implantes tipo overdenture e protocolo

The aim of his study was to review the current scientific literature in order to discuss the surgical, prosthetics and psychological/psychosocial aspects during the treatment planning of edentulous patients, when a total fixed prosthesis or overdenture is indicated. To identify studies to take part in this review, a search was conducted for the following databases: PubMed, Dentistry and Oral Sciences Source, Journals@Ovid, SpringerLink, Wiley Online Library, Nature (NPG), Oxford Journals. It was used as descriptors: total fixed prostheses and overdentures. Inclusion criteria were: clinical articles, clinical case reports, case series, literature reviews and systematic reviews that addressed the study and comparison of total fixed prostheses and overdentures for a surgical- prosthetic planning. Exclusion criteria were: laboratory and in vitro studies and those whose first language was not English or Portuguese. Of a total of 454 articles, after an analysis according to inclusion and exclusion criteria, 76 articles were selected. During an implantsupported prosthesis rehabilitation with dental in edentulous patients, the use of alternative procedures appear to be effective when compared to more invasive surgical techniques, and thus, the amount of dental implants possible to install associated with prosthetic issues such as lip support, smile line, quantity and quality of mucosa, phonetics, etc., will allow an appropriate treatment planning to each clinical case

Implantes osseointegrados: evolução e sucesso

Introduction: The oral rehabilitation with dental implants is a very viable treatment modality for patients. Therefore the discovery of osseointegration, dentistry has reached the trigger with respect to treatment with a high predictability of success. For this various principles, since the surgical protocols, the choice of material and even the technique for the manufacture of implant-supported prosthesis influence a good prognosis for treatment. Objective: Therefore, it is proposed this study a literature review of the fundamentals of osseointegration, explaining the historical and technical parameters of implantology, focusing in what the literature currently is studying with more intensity, the acceleration of osseointegration. Conclusion:well conducted procedures promotes the best aimed success in implantology. Rough surfaces shows great are for implant-bone contact and better mechanical results. The bone quality is fundamental in results foresigh.

Tratamento compensatorio da má oclusnao de classe lll: revisão de literatura

Class III malocclusion is less common occlusal relationship, covering less than 5% of the population. There are various forms of treatment in Class III malocclusion. Depending on how the form is expressed Class III and age of the patient, the therapy may be orthopedic and orthodontic surgical orthodontics. The objective was to review the literature of the last 10 years about ways to compensatory treatment of Class III malocclusion. Several articles were published between 04/2003 and 04/2013 in the Pubmed database from the keyword "Class III malocclusion". However, only 19 articles that addressed the compensatory treatment of Class III were selected. Based on the selected items it was concluded that the treatment of Class III malocclusions in children before the peak of pubertal growth has better prognosis with greater effects orthopedic and orthodontic minor effects. The ideal treatment option for this condition is the Rapid maxillary expansion associated with maxillary protraction of the same. The treatment of Class III malocclusion in young people after the peak of pubertal growth is doubtful prognosis. You can opt to treat rapid maxillary expansion and maxillary protraction of the same or fixed appliance, however, orthopedic effects can be the same or smaller than the orthodontic effects, depending on the age of the patient. Depending on the degree of Class III malocclusion in adults, the treatment will consist of dental compensations or orthognathic surgery.

Protocolo radiográfico para a instalação de mini-implantes: descrição da técnica

In the last decade mini-screws have gained popularity in orthodontics field and a correct placement of mini-screws is a critical point to the success of the skeletal anchorage. A careful clinical and radiographic diagnostic before insertion mini-screw is an essential requirement to achieve the central point of the radicular septum. The correct application of these pre-surgical procedures should avoid possible iatrogenic damages in periodontal ligament, dental roots, nasomaxillary cavities, or even important vascular tissues. As of today, periapical radiographs is a regular pre surgical procedure during mini-screw insertion technique. Nevertheless, accurate execution of the radiographic parallax technique can offer to us useful and precise radiographic images, to decide the right local insertion of mini-screws in to the septum bone. The purpose of this paper is to describe the ¬application of new positioning circular guides in conjunction with a ¬parallax radiographic protocol before placement of orthodontic mini-screws.

Emprego de técnica cirúrgica e materiais adesivos diretos no fechamento de diastema

The following is a clinical case report of a patient whose main complaint was the presence of a generalized spacing in the anterior maxillary segment. After meticulous clinical analysis and discussions of the clinical procedures to be adopted, a labial frenectomy was our first choice, so that we could reduce the diastemas directly using composite resin. It was observed that the association of clinical and restorative procedures was capable of giving back shape, function and dental aesthetics, allowing to the young patient the satisfaction of smiling without any fear.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Bone defect repair on the alveolar wall of the maxillary sinus using collagen membranes and temporal fascia: an experimental study in monkeys

Few studies has been done using guided bone regeneration in maxillary sinus defects. AIM: To assess the bone repair process in surgical defects on the alveolar wall of the monkey maxillary sinus, which communicates with the sinus cavity, by using collagen membranes: Gen-derm - Genius Baumer, Pro-tape - Proline and autologous temporal fascia. MATERIALS AND METHODS: In this prospective and experimental study, orosinusal communications were performed in four tufted capuchin monkeys (Cebus apella) and histologic analysis was carried out 180 days after. RESULTS: In the defects without a cover (control), bone proliferation predominated in two animals and fibrous connective tissue predominated in the other two. In defects repaired with a temporal fascia flap, fibrous connective tissue predominated in three animals and bone proliferation predominated in one. In the defects repaired with Gen-derm or Pro-tape collagen membranes there was complete bone proliferation in three animals and fibrous connective tissue in one. CONCLUSIONS: Surgical defect can be repaired with both bone tissue and fibrous connective tissue in all study groups; collagen membranes was more beneficial in the bone repair process than temporal fascia or absence of a barrier.

Implantes pós-exodônticos: relato de caso

With the search for treatments faster and aesthetic improvement of materials and surgical techniques, immediate implants have become a clinical reality increasingly practiced. Thus, based on literature the specific purpose of this study was to address critically the concepts of immediate implants, discussing issues related to dental extraction, milling technique, care of the periodontal tissues support and protection, prosthetic replacement, benefits, indications and contraindications. To this end, from Pubmed electronic crawler Medline, 54 articles published between 1990 and 2009, over 4 items classics, all in English were selected. The Studies have shown success rates for this technique Conventional techniques like two-stage surgery, many different techniques and planning are present among these techniques, and implants more immediate subject to failures.