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Purpose: Aiming to evaluate and study the epidemiological profile of frontal sinus fractures treated in the region of Ribeirão Preto-Brazil. Methods: Sixteen years of activity in the Oral and Maxillofacial service of the Faculty of Dentistry of Ribeirão Preto/SP (FORP/USP), totaling 9,736 consultations, 4,524 with facial fractures, those diagnosed with frontal sinus fracture (113) were evaluated and selected for the study. Results: Frontal sinus fractures accounted for 2.5% of facial fractures, the majority occurring in men (89.4%), concentrated in the age group 21-30 years old, with 52.2% of cases being caused by road traffic accidents (RTA). Associations with other facial fractures are common and appeared in 75.2% of cases. Treatment was followed either surgically, by open reduction internal fixation (52.2%) or conservatively (35.4%). Analyzing only the 28 isolated frontal sinus fractures, the most common treatment was conservative (46.4%). surgical treatment dropped to 25%. The most common postoperative complications were temporal branch paralysis and supraorbital nerve paresthesia, both occurring in 30.5% of surgical cases. Conclusion: The frequency of frontal sinus fractures may be decreasing, but the pattern of occurrence in young men due to road traffic accidents does not seem to change, fortunately the appearance of serious complications is not common and it is usually associated with more severe trauma.

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The prevalence of dentoalveolar injuries in children is approximately 25%, with falls from own height being one of the main etiologies. Diagnosis is based on the clinical evaluation associated with complementary imaging tests. The treatment of choice depends on the type of damage and structure affected. For alveolar process fractures, closed reduction and semi-rigid dental splinting for 4 to 6 weeks is generally satisfactory. However, some cases, such as severe segmental fractures, require open treatment to ensure adequate reduction and stabilization of the displaced alveolar segment, which is usually achieved by titanium miniplates and screws. Nevertheless, there are situations where this type of fixation is not possible, requiring alternative methods. Therefore, this article describes a surgical technique performed by open reduction, associating semi-rigid dental splint and circummandibular wiring in pediatric patient diagnosed with dentoalveolar fracture through clinical examination (with bone fracture displacement) and tomography. The technique promoted a good prognostic to the patient, proving to be a viable alternative for treating dentoalveolar fractures.

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Paracoccidioidomycosis is an infectious disease caused by Paracoccidioides brasiliensis and is endemic in South America. A patient can be infected via fungus inhalation in the mycelium phase. Oral manifestations of paracoccidioidomycosis are often the first clinical sign of disease, but their appearance can vary. As a result, many clinicians are unable to identify this infection early. Late diagnosis can result in serious complications, such as pulmonary changes, or even death. This article reports 2 cases of paracoccidioidomycosis with different oral manifestations, reviews the literature, and discusses the various appearances of this infection and its differential diagnoses in order to emphasize the importance of performing a detailed clinical examination to make an accurate diagnosis and refer the patient for appropriate treatment.

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The aim was to evaluate bone repair and gingival tissue repair in osteopenic rats. Fifteen female wistar rats were included; in all of them ovariectomy was realized to induce osteopenia; after 45 days, the animals were submitted to 2 surgical techinques 1) dental extraction of the upper central incisor with no socket preservation and 2) 5 mm cranial defect in the calvarium; 5 rats were included in the control group (G1) withput alendronate application; in the group 2 (G2) was used subcutenous alendronate (0.5 mg/kg) once for three weeks and then was realizd the both surgical techniques. In group 3 (G3), after ovariectomy was realized the both dental extraction and the calvarium defect and after that was realized the alendronate protocol. In each group, after six week was realized euthanasia and descriptive histological analysis of the surgical areas involved. In bone formation of the 5 mm cranial defect was observed with good progression in the 3 experimental models and no modification in quality of bone repair was observed. For the gingival tissue in the extraction socket, no differences were observed between G1 and G3. On other hand, in G2 a thinner and reduced gingival epithelium was found. Our results showed that alendronate was not an obstacle for bone repair; deficiencies in re-epithelialization of oral mucosa show the impact of alendronate before dental extraction.

El objetivo fue evaluar la reparación ósea y gingival en ratas con osteopenia. Quince ratas wistar hembras fueron incluidas; en todas ellas se realizo ovarectomia y fue realizada la inducción de osteopenia; después de 45 días, los animales fueron sometidos a dos técnicas quirúrgicas 1) extracciones dentales del incisivo central superior sin preservación alveolar y 2) creación de un defecto craneano de 5 mm en la calota; 5 animales fueron incluidos como grupo control (G1) sin la aplicación de alendronato; en el grupo 2 (G2) se utilizó alendronato subcutáneo (0,5 mg/kg) una vez a la semana durante 3 semanas. En el grupo 3 (G3), después de la ovarectomia se realizó la exodoncia y el defecto en el cráneo y después de ello se inicio el protocolo con alendronato. En cada grupo, después de seis semanas se realizó la eutanasia con descripción histológica de los hallazgos. En el hueso formado en el defecto craneano de 5 mm se observó una adecuada progresión de reparación en los 3 modelos experimentales y no se observó cambios importantes en el modelo de reparación. Para el tejido gingival en el sitio de extracción, no se observaron diferencias entre el grupo G1 y G3. Por otra parte, el G2 presentó un tejido mas delgado con reducción del epitelio gingival; nuestros resultados demuestran que el alendronato no fue un obstáculo en la reparación ósea; deficiencias en la re epitelización de la mucosa oral muestran el impacto del alendronato después de la exodoncia.

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Resumo Introdução: O tratamento das fraturas condilares causadas por um projétil de arma de fogo possui controvérsias na literatura. Objetivo: Descrever um caso clínico de fratura do côndilo mandibular causado por ferimento de arma de fogo que foi tratado com elasticoterapia e fisioterapia. Discussão: A região maxilofacial tem sido alvo constante desse tipo de trauma, refletindo a alta violência urbana. Frequentemente, esses traumas envolvem fraturas cominutivas na região e a abordagem terapêutica para esses casos depende do deslocamento, grau de cominação da fratura e cooperação do paciente. Apesar das diferentes possibilidades de tratamento das fraturas mandibulares, o tratamento não cirúrgico é uma opção válida como primeira escolha, principalmente nos casos de fraturas favoráveis, sem grandes deslocamentos ósseos e associadas à adesão do paciente ao tratamento. Considerações finais: A combinação de bloqueio maxilo-mandibular e elasticoterapia como tratamento conservador é preconizada para a restauração da funcionalidade estomatognática, seguida de acompanhamento periódico. (AU)

Abstract Introduction: The treatment of condylar fractures caused by firearm projectile has controversies in the literature. Objective: This study aimed to describe a clinical case of mandibular condyle fracture caused by firearm injury and treated with elastic therapy and physiotherapy. Discussion: The maxillofacial region has been a constant target for this type of trauma, reflecting the high urban violence. Frequently these traumas involve comminuted fractures in the region and the therapeutic approach for these cases depends on the displacement, degree of fracture comminution and patient cooperation. Despite the different possibilities for treatment of mandibular fractures, non-surgical treatment is a valid option as first choice, especially in cases of favorable fractures, without large bone displacements and associated with patient adherence to treatment. Final considerations: The combination of maxillo-mandibular block and elastic therapy as a conservative treatment is recommended for the restoration of stomatognathic functionality, followed by periodic follow-up (AU)

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PURPOSE: In clinical prosthetics procedures, including endodontics and post fixation, the presence of a smear layer can reduce the post bond strength. An Er,Cr:YSGG laser, which emits at 2780 nm, can promote a smear-layer-free surface due to the ablation process. Considering these aspects, the purpose of this work was to evaluate the influence of Er,Cr:YSGG laser irradiation using either a radial or an axial fiber tip on the bond strength of three resin cements to the fiber-reinforced composite posts. MATERIALS AND METHODS: Ninety recently extracted single rooted human teeth had their root canal instrumented and were randomly distributed into nine experimental groups, in which three resin cements (total-etching Variolink II, self-etching Panavia F, and self-adhesive RelyX Unicem Aplicap) and three root canal treatments (no treatment, laser irradiation using the radial fiber tip, laser irradiation using the axial fiber tip) were used. Specimens were then sectioned into three sections (cervical, middle, and apical thirds) with two slices on each section. A push-out test was performed on each slice, and the values were recorded as MPa. The push-out data were analyzed by a Ryan-Joiner normality test followed by a two-way ANOVA test and Tukey pairwise comparison. The statistical analysis was performed on each third section separately, with a 5% significance level. RESULTS: Laser irradiation with axial fiber tip significantly increased the post bond strength of RelyX Unicem Aplicap on middle third of specimens (p < 0.001) when compared to other root canal treatments (unlased or irradiated with radial tip). Considering the Panavia resin cement, laser irradiation with either axial or radial tips promoted a significant increase on the post bond strength of middle third when compared to unlased specimens (p < 0.001); however, laser irradiation did not influence the post bond strength of Variolink resin cement. CONCLUSIONS: The use of the Er,Cr:YSGG laser for clinical prosthetics procedures enhances the post bond strength of Panavia and RelyX Unicem Aplicap resin cements, mainly at middle third of roots, and does not interfere with the bond strength of Variolink resin cement. For the RelyX Unicem Aplicap system, the use of axial tip is most advantageous and can be recommended for future clinical application.

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Infecções agudas bucomaxilofaciais podem ser condições clínicas graves e de ocorrência comum, caracterizadas pela disseminação do processo infeccioso a tecidos adjacentes e espaços faciais da região de cabeça e pescoço, podendo resultar em várias complicações, até mesmo em óbito, embora seja raro. Objetivo: realizar uma análise epidemiológica de infecções maxilofaciais, relacionando os dados ao tratamento instituído e à sua efetividade, bem como analisar dados referentes a idade, sexo, principais dentes envolvidos e tempo total de internação. Sujeito e método: foram analisados retrospectivamente 240 prontuários de pacientes admitidos no Hospital Universitário de Maringá com infecção odontogênica, atendidos pela equipe de Cirurgia e Traumatologia Bucomaxilofacial no período de janeiro de 2009 a janeiro de 2017. Resultados: a média de idade dos pacientes foi de 38 anos, com 57 mulheres e 54 homens. A média de temperatura de admissão foi 38,5°C. A região mais acometida foi o ramo posterior da mandíbula, tendo uma média de duração de infecção e hospitalização de 6,1 dias. A principal conduta foi drenagem e antibioticoterapia, sendo que cerca de 13 pacientes não precisaram desse tipo de intervenção, e um paciente evoluiu a óbito. Conclusão: com base nestes resultados e na literatura, infecções odontogênicas merecem atenção, pois podem ser fatais e requerem internação rápida e tratamento adequado. Esse, portanto, é um assunto de grande importância para o cirurgião- -dentista, que exerce papel fundamental na prevenção e no tratamento. A resolução precoce ainda é a forma mais adequada para evitar complicações mais graves. (AU)

Acute Oral maxillofacial infections can be serious and relatively common clinical conditions, characterized by the spread of the infectious process to adjacent tissues and facial spaces of the head and neck region, which can result in several complications and lead to even death, although it is rare. Objective: the objective of this study was to perform an epidemiological analysis of maxillofacial infections and relate their data to the treatment instituted and the effectiveness of the same, as well as to analyze data regarding the age, sex, main teeth involved and total time of hospitalization. Subjects and method: in order to carry out study, 240 medical recordswere analyzed retrospectivelyat the University Hospital of Maringá of the patients with odontogenic infection attended by the Oral Maxillofacial Surgeon in the period of January 2009 to January 2017. Results: as a result, mean age was 38 years, with 57 women and 54 men and mean intake temperature was 38.5 °. The most affected region was the posterior branch of the mandible, with a mean duration of infection and hospitalization of 6.1 days. The main conduct was drainage and antibiotic therapy, and about 13 patients did not need this intervention and only 1 died. Conclusion: Based on these results and in literature, attention should be paid to odontogenic infections, which can be fatal and require proper treatment. This is a subject of great importance for the dentist, who plays a key role in prevention and proper treatment, its early resolution is still the most appropriate way to avoid serious complications. (AU)

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OBJECTIVE AND BACKGROUND: The correct selections of the cementing agent, the endodontic post material and placement protocol are critical to provide an increased longevity of the teeth that went through endodontic treatment. The irradiation with diode laser before post cementation, can promote an antimicrobial effect. However, there is a lack of information about the effect of 830 nm diode laser on the post bond strength. This study analyzed the effect of dentin root canal irradiation with high-intensity diode laser, at 830 nm, operating in continuous or pulsed mode, on the retention of metal or fiber posts, cemented with self-etching resinous composite (Panavia F) and zinc phosphate cement (ZnPO4). MATERIALS AND METHODS: Human roots were irradiated with diode laser (continuous and pulsed mode). The fiber posts were luted with Panavia F and the metal posts with Panavia F or ZnPO4 cement. Specimens were sectioned into three sections (cervical, middle, and apical). The bond strength was measured by a push-out mechanical analysis. For the statistical analysis, a three-way ANOVA test was applied following a Tukey's pairwise comparison with a significance level of p = 0.05. RESULTS: The irradiated groups presented higher bond strength compared with nonirradiated group (p < 0.05), and the cervical and middle thirds presented higher on bond strength than the apical. The association of metal post and Panavia F presented higher bond strength when irradiated on continuous mode (p < 0.05). Fiber post and Panavia F presented higher bond strength associated to pulsed mode. The mode seems not to make a significant difference. CONCLUSIONS: These results corroborate the importance of the post bond to dentin and root canal debris removal to increase the tooth longevity. It was shown that the dentin to post bond strength were enhanced by the diode laser irradiation either on continuous or pulsed modes.

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El liquen plano oral (LPO) es una enfermedad mucocutánea inflamatoria más común en las mujeres. Su etiología aún no es bien definida y esta condición puede estar relacionada, por ejemplo, a la ansiedad, estrés, diabetes, las enfermedades autoinmunes, infecciones y predisposición genética. El LPO se manifiesta en dos formas principales: reticular y erosivo. El objetivo de esta investigación es, a través de un estudio retrospectivo, analizar el posible potencial maligno del LPO. Se analizaron los registros de los pacientes atendidos en dos proyectos de lesiones bucales de dos diferentes instituciones en el período de 1995 a 2014. Se recogieron datos como género, edad, presencia de enfermedad sistémica, presencia de lesiones en la piel, tabaquismo, duración de la lesión, localización, síntomas, tratamiento, proservación y transformación maligna. Los resultados mostraron que, de los 3488 analizados, 85 (2,4%) tuvieron un diagnóstico confirmado de LPO, que afecta fundamentalmente a pacientes de sexo femenino (85%) siendo el LP reticular más común. En relación a la transformación maligna del LPO, 1 paciente (0,85%) tenía carcinoma de células escamosas 4 años después del diagnóstico inicial de LPO. Además, 3 pacientes mostraron atipia celular moderada en el diagnóstico. Los resultados refuerzan el potencial de transformación maligna del LPO. Aunque esta asociación es especulativa, la posibilidad debe ser considerada por los profesionales, que deben presentar estos pacientes a largos periodos de preservación.

Oral lichen planus (OLP) is an inflammatory mucocutaneous disease, more common in females. Its etiology is not yet well defined; this condition may be related, for example, to anxiety, stress, diabetes, autoimmune diseases, infections and genetic predisposition. The OLP manifests itself in two main forms: reticular and erosive. This work aims to perform a retrospective study analyzing the possible malignant potential of OLP. Records of the patients were analyzed in two projects of oral lesions in two different institutions in the period from 1995 to 2014. Data as gender, age, presence of systemic disease, presence of skin lesions, smoking, duration of the injury, location, symptoms, treatment, follow-up time and malignant transformation were collected. The results showed that, of the 3488 analyzed, 85 (2.4%) had a confirmed diagnosis of OLP, which mainly affected female patients (85%) being the most common the reticular LP. Regarding the malignant transformation of OLP, one patient (0.85%) had squamous cell carcinoma 4 years after the initial diagnosis of OLP. In addition, 3 patients showed moderate cellular atypia. The results reinforce the potential of malignant transformation of OLP. Although this association is speculative, this possibility must be considered by the dental practitioners, who must submit these patients to long periods of monitoring.

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