Avaliação cefalométrica do perfil mole de pacientes face longa submetidos à cirurgia ortognática: estudo retrospectivo

OBJETIVO: o presente trabalho propôs-se a comparar o perfil tegumentar pós-operatório de pacientes Classe II, Padrão Face Longa, submetidos ao tratamento ortodôntico-cirúrgico, com os parâmetros descritos na análise cefalométrica de Legan e Burstone. METODOLOGIA: 32 telerradiografias pós-cirúrgicas, com um mínimo de 6 meses de acompanhamento, foram submetidas a traçado manual (repetido 4 vezes) e digitalização (também repetida 4 vezes) no programa DFPlus para análise cefalométrica. RESULTADOS: os resultados permitiram verificar que 9 das 11 medidas avaliadas encontravam-se estatisticamente diferentes da norma avaliada; contudo, ao se verificar o desvio padrão permitido na norma, os achados deste trabalho situam-se dentro da mesma, com exceção do ângulo mentocervical. CONCLUSÃO: as condições experimentais deste estudo permitiram concluir que, embora a população estudada tenha obtido resultados estéticos-funcionais satisfatórios, não se enquadrou nas normas da análise de Legan e Burstone, o que indica que a avaliação após a cirurgia ortognática deve ser principalmente clínica e que a estética facial não está totalmente relacionada com as medidas préestabelecidas na análise cefalométrica.

Alterações tridimensionais dos arcos dentários de pacientes submetidos à cirurgia ortognática

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Cirurgia ortognática associada á cirurgia das ATMs acometidas por artrite reumatóide ou osteocondroma

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação cefalométrica do perfil mole de paciente face longa submetido à cirurgia ortognática: estudo retrospectivo

Pós-graduação em Odontologia - FOA

Estabilidade sagital da condiloplastia associada à cirurgia ortognática para o tratamento do osteocondroma mandibular

The aim of this study was to evaluate the stability of the conservative condylectomy technique and articular disc repositioning as the surgical treatment approach for management of mandibular condylar osteochondroma, with appropriate Orthognathic surgery. Fifteen patients (12 females and 3 males), average age of 32.3 years (range, 13 to 56 years), with unilateral active osteochondroma of the mandibular condyle were analyzed. All patients underwent conservative condylectomy, recontouring of the remaining condylar neck stump and articular disc repositioned and indicated orthognatic surgical procedures. Average post surgical follow-up was 19 months. Each patient's lateral cephalograms were traced at 3 intervals (presurgery, immediate post surgery and long-term follow-up). Immediate after surgery the oclusal plane angle decreased -2.8 ± 4.5o, the maxillomandibular complex rotated counter-clockwise with advancement at menton 5.3 ± 5.6 mm, pogonion 5.0 ± 5.1 mm, B point 3.4 ± 4.2 mm and A point 1.0 ± 1.5 mm. The long-term follow-up showed significant changes in overbite (-0.6 ± 0.5 mm) and SNGoMe (0,93° ± 1,53°). Horizontally and vertically small instabilities occurred in Me (-1.21 ± 1.94 mm) and PNS (-1.48 ± 1.67 mm) respectively. The treatment protocol studied produced counterclockwise rotation and maxillofacial mandibular advancement. The long-term follow-up showed solid dental and skeletal stability with horizontal instability of Me and PNS in the vertical direction.

Cirurgia estética para remoção de hiperplasia gengiva: granuloma piogênico

The pyogenic granuloma, a lesion considered hyperplastic regenerative inflammatory reaction is a finding commonly found in the oral cavity, affecting large numbers of individuals, being more prevalent in females. But its pathogenesis is not well defined and may be associated with numerous factors that stimulate tissue proliferation. Correct diagnosis and treatment plan are essential for success in approach, restoring function and aesthetics to the periodontal tissues. In agreement with the literature, the most common treatment and greater predictability is surgical removal, which involves resection of the lesion, together with its base inserted into the underlying tissue, periosteum and bone tissue. However, the excision can promote aesthetic defects, particularly in anterior regions where it is most affected. This article reports on the importance of a correct surgical approach for removal of pyogenic granuloma in the region of the interdental papilla between teeth 42 and 43, resulting in a good anatomical result and aesthetic.

Diagnóstico e planejamento em cirurgia parendodôntica: utilização da tomografia cone beam

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.

Estudo comparativo entre traçados cefalométricos predictivo e pós operatório imediato de pacientes que foram submetidos à cirurgia ortognática para correção da síndrome da face longa

The aim of this research was to verify the accuracy of the prediction trace. Records in 15 patients admitted for orthognathic surgical treatment were analysed. Predictive and postoperative positíons of maxilla were compared with linear measurements. Statistically significant difference between predicted and postoperative position were demonstrated, but the prediction trace revealed to be very useful to help in decision of direction of movements, easy to do at low cost

Avaliação clínica e da qualidade de vida utilizando dois protocolos para recuperação miofuncional em pacientes que se submeteram à cirurgia ortognática: resultados preliminares

The objective of this randomized, blind and prospective clinical trial was to compare the pain, the edema, the mandibular movements, the masticatory efficiency and life quality, in the first 60 days after surgery using 2 different clinical protocols for myofunctional recovery, in patients who underwent orthognathic surgery. A sample of 19 patients was used and divided into 2 groups. The control group (CG) consisted of 10 patients who had postoperative rehabilitation guided by a standard protocol, conducted by the Service of Surgery and Traumatology Oral and Maxillofacial. In other hand, the experimental group (EC) totaled 9 patients who received the speech therapy rehabilitation protocol specialized, by professionals in the area. The variables pain, edema and mandibular movements were analyzed during 48h, 96h, 7 days, 14 days, 30 and 60 days post-surgery. The masticatory efficiency and the quality of life were classified with 60 days after surgery . The data were submitted an analysis of variance, Student's t-test and Fisher's independence, at the level of 5% probability. It was identified that patients of GE have benefited in the first 14 days(p<0,001), as they have had reported less pain than those in the CG. Significant statistics differences between groups for pain parameters (after 14 days) (p=0,065), edema(p=0,063), mandibular movements(p=0,068), masticatory efficiency(p=0,630) and the impact on quality of life (p=0,813) were not observed on this study. The speech therapy protocol for myofunctional recovery (EG), although it has not obtained statistical results superiors than the CG in the general context, presents itself as a viable alternative to conventional therapy assumed by many maxillofacial surgeons, allowing the surgeon to optimize time with patients in the period postoperatively.

Complicações em cirurgia oral menor: caso clínico

Um paciente chega a UBS queixando-se de dor espontânea no lado direito da mandíbula após extração dentária, secreção purulenta no local e sensação de 'buraco' no dente.

Patologia e cirurgia oral em odontopediatria

Revisar o conhecimento de patologia bucal, erupção dentária, características do sistema estomatognático na primeira infância e cirurgia bucal em odontopediatria

Lipoidoproteinose

OBJETIVO: Apresentar as características clínicas, tratamento cirúrgico e achado histológico de um caso de lipoidoproteinose. DESCRIÇÃO DO CASO: Criança do sexo masculino, cinco anos de idade, branco, que procurou atendimento odontológico na Universidade. A mãe da criança relatou presença de intensa halitose e dificuldade na alimentação e higienização bucal, decorrentes de crescimento gengival generalizado nos arcos dentários superior e inferior. No exame clínico, verificaram-se comprometimento funcional e estético generalizado (rouquidão, artralgia bilateral no joelho e tornozelo, lesões tumorais nas orelhas, entre outros), além de extensa hiperplasia gengival em ambos os arcos dentários. Optou-se pelo tratamento cirúrgico, com remoção do tecido hiperplásico e exodontia de todos os dentes decíduos e de dois permanentes. O exame histopatológico da peça cirúrgica confirmou o diagnóstico de lipoidoproteinose. COMENTÁRIOS: A lipoidoproteinose é uma doença rara caracterizada pela deposição da substância hialina na pele, membranas mucosas e nos órgãos internos. Os sinais que podem surgir após o nascimento, são: rouquidão; lesões pápulo-nodulares na cabeça, pescoço e membros; lesões papulares amareladas nas margens das pálpebras. O curso desta doença é benigno e crônico.