961 resultados para Traumatismo dento-alveolar


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Dento-alveolar process fracture is an important and common event in the dental office practice usually managed under the well-established protocols, but sometimes this kind of lesion is evaluated in the hospital emergency rooms without attention to the dental injuries. In this type of trauma, the time between the injury and the definitive resolution is essential for the treatment success, usually 1 h in cases of dento-alveolar fractures (tooth and alveolar bone). This paper describes the management of a patient with unusual dento-alveolar fracture caused by gunshot and treated using screw fixation.

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Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

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Background: Paediatric dento-alveolar trauma is a common event. Delays in treatment can have adverse effects on long term outcomes and the aim of this study was to quantify the treatment delays in paediatric dento-alveolar trauma in a tertiary referral hospital. Methods: All cases of paediatric dento-alveolar trauma over a two-year period from July 2000 to June 2002 were identified and the charts were reviewed retrospectively. All children presenting the emergency department with dento-alveolar trauma within 48 hours of injury during the time period were included. Results: Forty-three patients were identified. The average age was 5.51 years, though there was a bias towards one and two year olds. Males were injured 1.5 times more frequently than females. There was an average delay of 9.6 hours between injury and treatment for all patients. Transit time from outside practitioners to hospital and waiting times in hospital made up the greatest delays. Children injured an average of 2.37 teeth and only 14 per cent were uncomplicated crown fractures. Conclusions: Children who present to children's hospitals for treatment of dento-alveolar trauma have more severe injuries than those treated elsewhere. They have large but potentially reducible delays between injury and treatment.

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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

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Objectif : Récemment, un nouvel appareil issu de la technologie du Forsus™ et visant à corriger les malocclusions de classe III a été mis sur le marché et se popularise dans la pratique orthodontique : le Tandem Forsus Maxillary Corrector (TFMC). L’objectif de la présente étude est de mesurer les effets squelettiques, l’influence réelle sur la croissance, et les effets dento-alvéolaires du port du TFMC. Matériel et méthodes : 14 patients présentant une malocclusion de classe III (âge moyen de 9 ans 6 mois) traités par le même orthodontiste ont participé à cette étude prospective. Le groupe consiste en 10 garçons et 4 filles. Le Tandem Forsus Maxillary Corrector est porté de 12 à 14 heures par jour jusqu’à l’obtention d’une surcorrection du surplomb horizontal et une relation dentaire de classe I. Le traitement est généralement d’une durée de 8 à 9 mois. Des radiographies céphalométriques latérales prises avant (T1) et après (T2) le traitement ont été analysées afin de déterminer les changements dentaires et squelettiques. Les résultats ont été comparés à un groupe contrôle composé de 42 enfants provenant du Centre de croissance de l’Université de Montréal. Les radiographies ont été tracées et analysées de manière aveugle à l’aide du logiciel Dolphin Imaging (ver 11.0, Patterson Dental, Chatsworth, California). L’erreur sur la méthode a été évaluée avec la formule de Dahlberg, le coefficient de corrélation intra-classe et l’indice de Bland-Altman. L’effet du traitement a été évalué à l’aide du test t pour échantillons appariés. L’effet de la croissance pour le groupe contrôle a été calculé à l’aide d’un test t pour échantillons indépendants. Résultats : L’utilisation du TFMC produit un mouvement antérieur et une rotation antihoraire du maxillaire. De plus, il procline les incisives supérieures et rétrocline les incisives inférieures. Une rotation antihoraire du plan occlusal contribue aussi à la correction de la malocclusion de classe III. Par contre, le TFMC ne semble pas avoir pour effet de restreindre la croissance mandibulaire. Conclusion : La présente étude tend à démontrer que le port de l’appareil TFMC a un effet orthopédique et dento-alvéolaire significatif lors du traitement correctif des malocclusions modérées de classe III.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The ability to tridimensionally evaluate pathological and anatomical areas, in apical surgery planning, presents a number of advantages. Cone beam computed tomography (CBCT) was developed for dental applications. This paper aims to present a literature review on CBCT, highlighting its advantages over both conventional computed tomography (CT) and radiography. Moreover, its clinical applications in apical surgery are discussed. LITERATURE REVIEW AND CONCLUSION: Unlikely CT, CBCT captures a volume of data in a single 360º rotation, providing benefits such as higher accuracy, better resolution, reduced scanning time and reduced radiation dose. In the maxillofacial region, CBCT has been mainly used in the assessment of dento-alveolar pathology and oral traumatology. CBCT provides a better diagnosis and quantitative information on periodontal bone levels than conventional radiography. It has also been used for patients requiring surgical facial reconstruction, orthognathic surgery, dental implants, and more complex tooth extractions. Besides that, it seems to be a significant tool in modern endodontic practice, presenting useful applications in apical surgery.

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In a fraction of patients surgically treated for cleft lip/palate, excessive scarring disturbs maxillary growth and dento-alveolar development. Since certain genes are involved in craniofacial morphogenesis as well as tissue repair, a primary defect causing cleft lip/palate could lead to altered wound healing. We performed in vitro wound healing assays with primary lip fibroblasts from 16 cleft lip/palate patients. Nine foreskin fibroblast strains were included for comparison. Cells were grown to confluency and scratch wounds were applied; wound closure was monitored morphometrically over time. Wound closure rate showed highly significant differences between fibroblast strains. Statistically, fibroblast strains from the 25 individuals could be divided into three migratory groups, namely "fast", "intermediate", and "slow". Most cleft lip/palate fibroblasts were distributed between the "fast" (5 strains) and the "intermediate" group (10 strains). These phenotypes were stable over different cell passages from the same individual. Expression of genes involved in cleft lip/palate and wound repair was determined by quantitative PCR. Transforming growth factor-α mRNA was significantly up-regulated in the "fast" group. 5 ng/ml transforming growth factor-α added to the culture medium increased the wound closure rate of cleft lip/palate strains from the "intermediate" migratory group to the level of the "fast", but had no effect on the latter group. Conversely, antibody to transforming growth factor-α or a specific inhibitor of its receptor most effectively reduced the wound closure rate of "fast" cleft lip/palate strains. Thus, fibroblasts from a distinct subgroup of cleft lip/palate patients exhibit an increased migration rate into wounds in vitro, which is linked to higher transforming growth factor-α expression and attenuated by interfering with its signaling.

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O presente trabalho tem o objetivo de verificar as angulações e as inclinações dentárias obtidas no final do tratamento ortodôntico, em casos tratados com aparelho ortodôntico fixo e prescrição MBT e compará-las com os valores encontrados por Andrews para a oclusão normal natural. Foram utilizados 30 pares de modelos de gesso finais, de 30 pacientes, tratados, na faixa etária de 13 a 23 anos. Como pré-requisitos, estes pacientes não deveriam ter sido submetidos a qualquer tipo de intervenção ortopédica, uso de elásticos intermaxilares, compensações dento-alveolares e tratamentos realizados com extração. Para a mensuração da angulação mésio-distal e da inclinação vestíbulo-lingual utilizou-se um dispositivo, desenvolvido em pesquisa anterior, capaz de realizar tais medições. De acordo com a metodologia empregada e diante dos resultados obtidos, pôde-se concluir que as angulações das coroas dentárias tanto superiores quanto inferiores apresentaram valores positivos. Quanto às inclinações das coroas dentárias, em ambos os arcos dentários, foram encontrados valores positivos para os incisivos centrais e laterais, ao passo que caninos, pré-molares e primeiros molares apresentaram valore s negativos. Variações individuais estiveram presentes nas duas mensurações realizadas. Ao comparar nossos resultados com os de Andrews, obtivemos diferenças estatisticamente significantes para a maioria dos dentes, em ambas as medidas efetuadas.