Ocular Reconstruction After Zygomatic Complex Fracture With Retention of a Foreign Body

Facial injuries with the retention of foreign bodies inside the tissues, both in soft and hard ones, can cause major functional and aesthetic damage. Among the different etiological agents, cutting tools, fragments of a firearm, the splinter of wood, steel, or iron, launched by misuse, or even caused by defects in equipment, are the main cause of these injuries. The aim of this study was to discuss the peculiarity of the multidisciplinary approach in caring of a 33-year-old man, victim of an accident at work, by the rupture of an emery disc and consequent penetration of the fragments in violation of the tissues in the orbital and zygomatic region of the left side, with perforation of the eyeball and orbital-zygomatic fracture. Urgent treatment consisted of debridement of wounds, bleeding control, removal of foreign bodies, fracture reduction with rigid internal fixation, and suture, performed by the oral and maxillofacial surgical team. Reconstruction of orbital tissues by the ophthalmology team consisted of suture of the injuries. About 1 month after the trauma, phthisis bulbi was noted, and the patient underwent a new procedure under general anesthesia for eye evisceration and installation of an alloplastic prosthesis associated with the homogenous sclera. Facial harmony was restored, especially in aesthetics and function of the zygomatic-orbital complex.

Evaluation of dental pulp repair using low level laser therapy (688 nm and 785 nm) morphologic study in capuchin monkeys

The aim of this study was to evaluate the hypothesis that low-level laser therapy (LLLT) 688 nm and 785 nm accelerate dentin barrier formation and repair process after traumatic pulp exposure. The sample consisted of 45 premolars of capuchin monkeys (Cebus apella) with pulp exposure Class V cavities. All premolars were treated with calcium hydroxide (Ca(OH)(2)), divided in groups of 15 teeth each, and analyzed on 7(th), 25(th), and 60(th) day. Group GI - only Ca(OH)(2), GIF- laser 688 nm, and GIII - laser 785 nm. Laser beam was used in single and punctual dose with the parameters: continuous, 688 nm and 785 nm wavelength, tip's area of 0.00785 cm(2), power 50 mW, application time 20 s, dose 255 J/cm(2), energy 2 J. Teeth were capped with Ca(OH)(2), Ca(OH)(2) cement and restored with amalgam. All groups presented pulp repair. on 25(th) day the thickness of the formed dentin barrier was different between the groups GI and GII (p < 0.05) and between groups GI and GIII (p < 0.01). on 60(th) day there was difference between GI and GIII (p < 0.01). It may be concluded that, LLLT 688 nm and 785 nm accelerated dentin barrier formation and consequently pulp repair process, with best results using infrared laser 785 nm. (c) 2009 by Astro Ltd. Published exclusively by WLLEY-VCH Verlag GmbH & Co. KGaA

Osseointegrated Implant Fracture: Causes and Treatment

Despite its high success rate, therapy with osseointegrated dental implants is not free of complications. Among the problems that may occur is fracture of implants, which, albeit a rare phenomenon, may lead to unpleasant clinical outcomes for the patient, as well as for the clinician. Thus, it is paramount to know the factors related to the biological processes involved in maintenance of osseointegration and biomechanics applied to dental implants to prevent such complications, as well as treatment options available to deal with the problem. Therefore, the objectives of this work were to investigate the literature to identify causative factors that may lead to fracture of dental implants and to discuss available procedures.

Composite Resin to Yttria Stabilized Tetragonal Zirconia Polycrystal Bonding: Comparison of Repair Methods

Purpose: The purpose of the current study was to evaluate different approaches for bonding composite to the surface of yttria stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics.Methods: One hundred Y-TZP blocks were embedded in acrylic resin, had the free surface polished, and were randomly divided into 10 groups (n=10). The tested repair approaches included four surface treatments: tribochemical silica coating (TBS), methacryloxydecyldihidrogenphosphate (MDP)-containing primer/silane, sandblasting, and metal/zirconia primer. Alcohol cleaning was used as a "no treatment" control. Surface treatment was followed by the application (or lack thereof) of an MDP-containing resin cement liner. Subsequently, a composite resin was applied to the ceramic surface using a cylindrical mold (4-mm diameter). After aging for 60 days in water storage, including 6000 thermal cycles, the specimens were submitted to a shear test. Analysis of variance and the Tukey test were used for statistical analyses (alpha=0.05).Results: Surface treatment was a statistically significant factor (F=85.42; p<0.0001). The application of the MDP-containing liner had no effect on bond strength (p=0.1017). TBS was the only treatment that had a significantly positive effect on bond strength after aging.Conclusion: Considering the evaluated approaches, TBS seems to be the best surface treatment for Y-TZP composite repairs. The use of an MDP-containing liner between the composite and Y-TZP surfaces is not effective.

Osteointegration of poly(L-lactic acid)PLLA and poly(L-lactic acid)PLLA/poly(ethylene oxide)PEO implants in rat tibiae

Natural or synthetic materials may be used to aid tissue repair of fracture or pathologies where there has been a loss of bone mass. Polymeric materials have been widely studied, aiming at their use in orthopaedics and aesthetic plastic surgery. Polymeric biodegradable blends formed from two or more kinds of polymers could present faster degradation rate than homopolymers. The purpose of this work was to compare the biological response of two biomaterials: poly(L-lactic acid)PLLA and poly(L-lactic acid)PLLA/poly(ethylene oxide)PEO blend. Forty four-week-old rats were divided into two groups of 20 animals, of which one group received PLLA and the other PLLA/PEO implants. In each of the animals, one of the biomaterials was implanted in the proximal epiphysis of the right tibia. Each group was divided into subgroups of 5 animals, and sacrificed 2, 4, 8 and 16 weeks after surgery, respectively. Samples were then processed for analysis by light microscopy. Newly formed bone was found around both PLLA and PLLA/PEO implants. PLLA/PEO blends had a porous morphology after immersion in a buffer solution and in vivo implantation. The proportion 50/50 PLLA/PEO blend was adequate to promote this porous morphology, which resulted in gradual bone tissue growth into the implant.

Laser 904 nm action on bone repair in rats with osteoporosis

The aim of the present study was to determine the action of AsGA laser irradiation on bone repair in the tibia of osteopenic rats. The animals were randomly divided into eight experimental groups according to the presence of ovarian hormone (sham group) or the absence of the hormone (OVX group), as well as being irradiated or non-irradiated. Low-level 904-nm laser (50 mJ/cm(2)) accelerated the repair process of osteopenic fractures, especially in the initial phase of bone regeneration.Introduction The development of new techniques to speed the process of bone repair has provided significant advances in the treatment of fractures. Some attention recently focused on the effects of biostimulation on bone.Methods Forty-eight adult rats were randomly divided into eight experimental groups (six animals in each group) according to the presence of ovarian hormone (sham group) or absence of the hormone (ovariectomized (OVX) group) as well as being irradiated or non-irradiated. For the application of low-level laser therapy, the animals were anesthetized with one third of the dose sufficient to immobilize the animal and irradiated with AsGa laser (904 nm, 50 mJ/cm(2) for 2s, point form and in contact). The control animals received the same type of manipulation as the irradiated animals, but with the laser turned off. Half of the animals were killed 7 days following the confection of the bone defect, and the other half were killed 21 days after the surgery. After complete demineralization, the tibias were cut cross-sectionally in the central region of the bone defect and embedded in paraffin blocks. The blocks were then cut in semi-seriated slices and stained with hematoxylin and eosin.Results There was new bone formation in the animals in the OVX group with laser treatment killed after 7 days (p<0.001). The lowest percentage of bone formation was observed in the OVX without laser killed after 7 days (p>0.05). All animals killed after 21 days exhibited linear closure of the lesion.Conclusion Low-level 904-nm laser (50 mJ/cm(2)) accelerated the repair process of osteopenic fractures, especially in the initial phase of bone regeneration.

Shear strength evaluation of composite-composite resin associations

Objective: The aim of this study was to investigate the shear strength between distinct associations of different commercial composite resins and their fracture modes.Methods: Nine composite-composite associations (n = 90) were prepared for shear strength evaluation and separated into the following groups: Z/Z (Filtek Z250 UD + Filtek Z250 A2); Z/ D (Filtek Z250 UD + Durafill VS A2); Z/S (Filtek Z250 UD + Filtek Supreme YT); C/C (Charisma OA2 + Charisma A2); C/D (Charisma OA2 + Durafill VS A2); C/S (Charisma OA2 + Filtek Supreme YT); H/H (Herculite XRV B2D + Herculite XRV B2E); H/D (Herculite XRV B2D + Durafill VS A2); H/S (Herculite XRV B2D + Filtek Supreme YT). Shear tests were carried out using universal mechanical test equipment with a load of 200 kgf and speed of 0.5 mm/min. Ultimate shear strength data (MPa) from all tested groups were submitted to analysis of variance (one-way ANOVA) and the Tukey test. The fractured surfaces of the test samples were visually evaluated by binocular stereomicroscope at 20 times magnification. Fractures were classified as either adhesive or cohesive or mixed.Results: The highest ultimate shear strength observed for composite-composite associations was found for the groups: Z/Z, C/S, H/H, H/S, Z/S and C/C. Those associations containing the Durafill resin were weaker than the others.Conclusion: Microparticle RBC associations presented lower shear strength than hybrid and/or nanoparticle RBC associations, once the only significant difference was found when the Durafill resin was involved. (c) 2008 Elsevier Ltd. All rights reserved.

Bone repair using mineral trioxide aggregate combined to a material carrier, associated or not with calcium hydroxide in bone defects

Mineral trioxide aggregate (MTA) is a powder aggregate containing mineral oxides with a good biological action and may facilitate the regeneration of the periodontal ligament and formation of bone. Calcium hydroxide demonstrates antibacterial properties, enhances tissue dissolution, and induces bone formation. The objective of this study was to evaluate the MTA in the bone healing process and verify if the calcium hydroxide P.A. can improve and accelerate this process. It was used forty rnale Wistar rats, which were divided into two groups, considering or not the use of calcium hydroxide P.A. solution before treatment. Thus, each one of these groups was divided in four groups with five animals each, according to the treatment and the defect filled by: animal's coagulum, monoolein gel, MTA in aqueous solution, and MTA combined with monoolein gel. After 10 days, the animals were perfused and the right hemimandibles removed for histological analysis. Statistical analysis of the data showed significant difference between all analyzed groups when it was made comparisons using or not calcium hydroxide P.A. (p < 0.0001). There was found statistical difference between the groups that was inserted or not MTA, independently the calcium hydroxide application (p < 0.05). Results showed that the MTA used was able to induce bone regeneration and had its action optimized when combined to calcium hydroxide P.A. (C) 2007 Elsevier Ltd. All rights reserved.