Avaliação cefalométrica do espaço aéreo posterior em pacientes com oclusão Classe II submetidos à cirurgia ortognática

OBJETIVO: o avanço maxilomandibular é um método cirúrgico comumente usado no tratamento de pacientes acometidos pela Síndrome da Apnéia Obstrutiva do Sono (SAOS) e portadores de anormalidades anatômicas identificáveis neste complexo, que estreitam e/ou obstruem o espaço aéreo. O intuito deste estudo foi analisar variações cefalométricas do espaço aéreo faríngeo em indivíduos Classe II de Angle, após a cirurgia ortognática. METODOLOGIA: a amostra consistiu de telerradiografias laterais equivalentes aos períodos pré e pós-operatório de 30 indivíduos, divididos no grupo com avanço cirúrgico mandibular (n=15) e no grupo com avanço maxilomandibular (n=15). Os parâmetros cefalométricos usados permitiram avaliar o espaço aéreo posterior em 3 níveis: a hipofaringe (PFI-V), a orofaringe (PFM-PM, PFM-PO, PFM-U, PFM-Up) e a nasofaringe (PFM-PN, pm-PFS). A análise esquelética foi na base do crânio (N-S-Ba) e na mandíbula (Ar-Go-Me). A média das diferenças entre os valores pré e pós-operatórios das mensurações lineares (mm) e angulares (graus) foi avaliada pelo teste t pareado. RESULTADOS E CONCLUSÕES: estatisticamente, não houve redução do espaço aéreo faríngeo pós-avanço cirúrgico. O que se observou foi que apenas PFM-PO e PFS-pM se mantiveram constantes e na maioria restante os valores aumentaram.

Mordida cruzada posterior: uma classificação mais didática

O objetivo deste trabalho é apresentar uma nova classificação de mordida cruzada posterior, sendo esta mais didática e de fácil entendimento, diferindo das demais em sua nomenclatura, preservando, no entanto, os princípios fundamentais que regem a Ortodontia. Essa classificação torna o processo de diagnóstico da mordida cruzada posterior sistematizado, tornando-o mais preciso, auxiliando o clínico na elaboração de um plano de tratamento adequado e, como conseqüência, levando a um prognóstico mais favorável dessa má oclusão.

Treatment of posterior crossbite in mixed dentition with a removable appliance: Reports of cases

A posterior crossbite malocclusion is defined as an abnormal buccolingual relationship. One or more maxillary teeth improperly occludes with one or more mandibular teeth in centric relation. This alteration develops early and is seldom self-correcting. This study is a report of the benefits of treating posterior crossbite malocclusions in mixed dentitions using removable appliances.

Anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide versus prednisolone acetate 1% eyedrops after pars plana vitrectomy

Purpose: To compare the safety and anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide (TA) with prednisolone acetate 1% eyedrops after pars plana vitrectomy (PPV).Methods: the study included 40 consecutive phakic eyes of 40 patients undergoing PPV for non-clearing vitreous haemorrhage with attached retina (verified by echography), epiretinal membrane or macular hole. At the end of the surgical procedure, eyes were randomized to receive either a single posterior subtenon injection of TA (40 mg in 1 ml) plus sham eyedrops (prednisolone acetate 1% vehicle) postoperatively (group TA), or a posterior subtenon sham injection (1 ml balanced salt solution) plus prednisolone acetate 1% eyedrops postoperatively (group ED).Results: There was no difference in the severity of anterior chamber cell and flare between the two groups at any time-point during the study period (p > 0.05). Separate within-group analysis revealed a significant decrease in anterior chamber cell and flare from postoperative day 1 to postoperative days 7, 14 and 28 in both groups (p < 0.05). There was no difference in pain, photophobia, conjunctival erythema, ciliary flush or chemosis scores between the two groups at any time-point during the study period (p > 0.05). Steroid-induced intraocular hypertension was not observed in either group.Conclusions: A single posterior subtenon injection of TA can be as effective and safe as a 4-week regimen of prednisolone acetate 1% eyedrops in controlling intraocular inflammation after PPV.

One-year clinical performance of self-etch adhesives in posterior restorations

Purpose: To evaluate the 1-year clinical performance of three self-etching adhesives (Adper Prompt L-Pop, Clearfil S-3 Bond, iBond) in posterior composite restorations using one etch&rinse adhesive (One-Step Plus) as control. Methods: Upon approval by the Institutional Review Board, 121 restorations were inserted in 38 subjects. The adhesives were applied as per manufacturers' instructions. Preparations were restored with a nanofilled resin composite (Filtek Supreme) and evaluated at baseline, 6 months, and 1 year. Statistical analyses included the Chi-square distribution with the McNemar non-parametric test (P< 0.05). Results: At 1 year, 111 restorations in 35 subjects were evaluated using the USPHS modified criteria. No significant changes were observed for the etch&rinse adhesive One-Step Plus. At 1 year the number of Alfa ratings decreased significantly for Clearfil S-3 Bond and for iBond in the categories color match, marginal staining, and marginal adaptation. For Adper Prompt L-Pop, marginal adaptation at 1 year was significantly worse than at baseline. Postoperative sensitivity to air improved significantly for Adper Prompt L-Pop, Clearfil S-3 Bond, and iBond. When the evaluation criteria were paired at 1 year, iBond resulted in a significantly lower number of Alfa ratings than any of the other adhesives for color match, marginal staining, and marginal adaptation. One-Step Plus resulted in a greater number of Alfa ratings for marginal adaptation than either Adper Prompt L-Pop or Clearfil S-3 Bond. Marginal adaptation was significantly better for Clearfil S-3 Bond than for Adper Prompt L-Pop. The post-operative sensitivity measured at 1 year for Adper Prompt L-Pop was statistically better than that for One-Step Plus.

Aggressive management of orbital meningeal melanocytoma

Objective. Meningeal melanocytoma generally occurs in the posterior fossa. Orbital manifestation is rarely encountered.Methods. A thirty-five year-old man presented with progressive proptosis of his right eye. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) of the brain showed an expansive intraconal mass lesion occupying the superior orbital compartment, the entire orbital apex, and the optic foramen. Histological analysis and Immunohistochical staining for S-100 and HMB-45 monoclonal antibodies confirmed melanocytoma.Findings. Microsurgical removal was accomplished through a fronto-orbital craniotomy. Chemotherapy and irradiation followed the initial intervention. The patient returned for follow up two years after surgery, complaining of headache and right visual loss. A subfrontal tumor with massive edema was found on follow up CT scan.Interpretation. Meningeal melanocytomas are rare benign pigmented tumors of the central nervous system. They are predominant in the posterior fossa and spinal cord and frequently mistaken for melanomas, especially on frozen sections. Orbital presentation is rare. The natural history is poorly defined.

Ultrastructure of the Spermatozoa of the Domestic Duck (Anas platyrhynchos sp.)

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

Contribution of the study of the styloid prominence in the posterior tympanic cavity

70 human temporal bones were analyzed with the aid of an otologic microscope. The styloid prominence was found to be extremely variable in shape, location and occurrence. Depending on the degree of development, the prominence establishes important relationships with the sinus tympani, with the fossula of the cochlear fenestra, and with the suprapyramidal recess. Serial sections were used to study the relationship of the styloid process with the facial nerve inside the bony mass of the mastoid portion of the temporal bone.