RESUMEN

Introdução: A saúde bucal é um aspecto que não deve ser subestimado pelos pacientes, principalmente se considerar que as infecções odontogênicas podem levar a quadros graves, incluindo complicações cervicotorácicas, como Mediastinite e cervicofaciais, como Angina de Ludwig. Para tanto, é imprescindível que os profissionais da odontologia saibam reconhecer os principais sinais e sintomas dessas infecções, sua evolução, conhecer as complicações associadas e qual o manejo adequado. Objetivo: Assim, é objetivo deste trabalho, relatar, discutir um caso clínico de uma infecção odontogênica grave que acarretou em complicação cervical, com trajeto em direção ao mediastino, necessitando manejo multidisciplinar, e explorar os principais aspectos desse quadro e a conduta necessária, que exige, no mínimo, intervenção cirúrgica, antibioticoterapia e manutenção das vias aéreas. Relato de caso: O caso trata de um paciente com infecção odontogênica, iniciada como uma pericoronarite do dente 38 semieruptado, que evoluiu para a área cervical, demandando imediata drenagem nesta região pois encaminhava-se para uma mediastinite. Após a drenagem cervical e antibioticoterapia e, assim que houve redução do trismo, foi removido o dente 38, evoluindo para a cura.Conclusões:As infecções odontogênicas, principalmente as que acometem os espaços fasciais e cervicais profundos, são potencialmente graves e devem ter suas principais manifestações clínicas entre os domínios de conhecimento dos profissionais Bucomaxilofaciais, pois necessitam de diagnóstico preciso, manejo rápido e tratamento adequado e precoce, considerando a velocidade com que podem evoluir (AU).

Introduction: Oral healthis an aspect that should not be underestimated by patients, especially considering that dental infections can lead to serious symptoms, including cervicothoracic complications, such as Mediastinitis and cervicofacial complications, such as Ludwig's Angina. Therefore, it is essential that dental professionals know how to recognize the main signs and symptoms of these infections, their evolution, know the associated complications and appropriate management.Objective: Thus, this work aims to report and discuss a clinical case of a serious odontogenic infection that resulted in a cervical complication, with a path towards the mediastinum, requiring multidisciplinary management, and to explore the main aspects of this condition and the necessary conduct, which requires, at least, surgical intervention, antibiotic therapy and airway maintenance.Case report: The case concerns a patient with odontogenic infection, which began as pericoronitis of semi-erupted tooth 38, which progressed to the cervical area, requiring immediate drainage in this region as it was heading towards mediastinitis. After cervical drainage and antibiotic therapy and, as soon as the trismus was reduced, tooth 38 was removed, progressing towards healing.Conclusions: Odontogenic infections, especially those that affect the fascial and deep cervical spaces, are potentially serious and should have their main clinical manifestations among the domains of knowledge ofOral and Maxillofacial professionals, as they require accurate diagnosis, rapid management and adequate and early treatment, considering the speed at which they can evolve (AU).

Introducción: La salud bucal es un aspecto que los pacientes no deben subestimar, especialmente considerando que las infecciones odontógenas pueden derivar en afecciones graves, incluidas complicaciones cervicotorácicas, como la mediastinitis, y complicaciones cervicofaciales, como la angina de Ludwig.Para ello, es fundamental que los profesionales odontológicos sepan reconocer las principales señalesy síntomas de estas infecciones, su evolución, conocer las complicaciones asociadas y el manejo adecuado.Objetivo: Así,el objetivo de este trabajo es reportar y discutir un caso clínico de infección odontogénica grave que resultó en una complicación cervical, con trayecto hacia el mediastino, que requirió manejo multidisciplinario, y explorar los principales aspectos de esta condicióny las medidas necesarias, que requiere, como mínimo, intervención quirúrgica, terapia con antibióticos y mantenimiento de las vías respiratorias.Reporte de caso: El caso se trata de un paciente con una infección odontogénica, que comenzó como pericoronaritis del diente 38 semi-erupcionado, la cual progresó hacia la zona cervical, requiriendo drenaje inmediato en esta región ya que se encaminaba para una mediastinitis.Después del drenaje cervical y la terapia antibiótica y, una vez reducido el trismo, se extrajo el diente 38, evolucijjonando hacia la cura.Conclusiones: Las infecciones odontogénicas, especialmente aquellas que afectan los espacios fasciales y cervicales profundos, son potencialmente graves y deben tener sus principales manifestaciones clínicas entre los dominios del conocimiento de los profesionales Orales y Maxilofaciales, pues requieren de un diagnóstico certero, un manejo rápido y un tratamiento adecuado y temprano, considerando la velocidad a la que pueden evolucionar (AU).

Asunto(s)

RESUMEN

Currently, there is growing interest in the potential use of lactoferrin (LTF), a member of the transferrin family, for the improvement of tissue healing. In this sense, a literature search was conducted to integrate data published on the effect of LTF on jawbone repair. PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, and Cochrane databases were retrieved according to the PRISMA 2020 statement. Articles in English, Spanish, and Portuguese were recovered, with no year restriction. In vitro, in vivo, and clinical studies were selected. A total of 742 articles were retrieved, 11 of which met the inclusion criteria (5 in vitro and 5 in vivo studies, and one clinical trial). The included data demonstrated wide variations in study design and LTF therapy protocols. Cell proliferation and viability were the primary outcomes evaluated in the in vitro studies, all of which reported a potential effect of LTF on the repair process. Of three in vivo studies, one reported a reduction in the overall healing rate, whereas the other two showed that LTF inhibited bone resorption and increased bone formation. The clinical trial's findings showed that LTF is a potential promoter of wound repair in patients with medication-related osteonecrosis of the jaws. Overall, data from the studies support a potential effect of LTF therapy on the process of jawbone repair.

Asunto(s)

RESUMEN

Objetivo: elaborar e testar uma Escala de Triagem Odontológica para Pacientes com Necessidades Especiais (PNEs). Métodos: a escala foi elaborada a partir da experiência clínica de um centro de referência para aten-dimento odontológico a PNEs e de evidências científicas. Foi construída utilizando cinco critérios principais: comportamento, necessidade e possibilidade de estabilização protetora, urgência odontológica (dor), núme-ro e complexidade de procedimentos odontológicos e local do atendimento (acessibilidade). O instrumento foi testado em 14 PNEs, que participaram de uma triagem no Centro de Especialidades Odontológicas (CEO) Jequitibá, na Faculdade de Odontologia da Universidade Federal de Pelotas (UFPel). Estudantes de gradua-ção a partir do oitavo semestre fizeram a aplicação, e o resultado da escala foi comparado ao parecer clínico realizado pelos pesquisadores experientes no atendimento a esses pacientes. Resultados: foi observada uma concordância em 85% dos casos. Conclusão: o instrumento apresentou desempenho comparável à avalia-ção de profissionais com expertise, e a escala pode ser um instrumento útil para ser empregado em serviços odontológicos que oferecem atendimento aos PNEs. A sua utilização em meio acadêmico também pode pro-porcionar o empoderamento dos critérios de avaliação pelos estudantes, proporcionando maior segurança em acolher, atender ou encaminhar esse público no seu futuro profissional. (AU)

Objective: to develop and test a dental screening scale to be used of patients with special needs (PSN). Method: the scale was developed based on the clinical experience of a reference center for dental care for PSN and scientific evidence. It was built using 5 main criteria: behavior, need and possibility of protective stabilization (PE), dental urgency (pain), number and complexity of dental procedures and place of care (accessibility). The instrument was tested on 14 PSN who participated in a screening at the Center for Dental Specialties (CEO) Jequitibá, Faculty of Dentistry, UFPEL. Undergraduate students from the eighth semester onwards applied and the result of the scale was compared to the clinical opinion carried out by experienced researchers in the care of these patients. Results: agreement was observed in 85% of cases. Conclusion: the instrument presented performance comparable to the evaluation of professionals with expertise and the scale can be a useful instrument to be used in dental services that offer care to PSN. Its use in academia can also provide the empowerment of assessment criteria by students, providing greater security in welcoming, serving or referring this audience in their professional future.

Asunto(s)

RESUMEN

Fibrous dysplasia is a benign fibroosseous disorder that can affect the maxillary bones, causing aesthetic deformity and functional impairment. This article reports the case of a 13-year-old male patient at the time of diagnosis. The patient showed increased facial volume with relevant asymmetry, having reported the onset of the condition 12 months before. Upon examination, the patient presented an 8-mm mouth opening and an acute inflammatory process associated with tooth 37 pericoronal hood. Upon imaging exam, exuberant bone growth in the left mandibular ramus area of ground glass aspect was observed. After incisional biopsy, fibrous dysplasia was diagnosed and sequentially treated with osteoplasty and coronoid process removal. The patient evolved to a 43-mm mouth opening and favorable aesthetics without recurrence in a 3-year follow-up period. In this case, coronoidectomy and bone plasty proved to be effective, returning aesthetics and function. The patient is supposed to be followed up in the long term.

RESUMEN

Introdução: Traumatismos buco-maxilo-faciais apresentam alta prevalência na população e resultam em comprometimento estético e funcional. Fatores sociodemográficos influenciam no tipo, na severidade e etiologia dessas lesões. O objetivo deste estudo foi identificar o perfil dos traumatismos buco-maxilo-faciais atendidos em um serviço de urgência e emergência. Métodos: Foi realizada a análise retrospectiva dos prontuários atendidos em um período de 10 anos, coletando-se as variáveis: idade, gênero, diagnóstico, etiologia e sítio anatômico. Os dados foram avaliados pelo teste qui-quadrado (p≤0,05). Resultados: Foram incluídos 11.779 prontuários, verificando-se prevalência de pacientes do gênero masculino (69,3%) entre 0 e 9 anos (29,8%) e entre 20 e 29 anos (19,8%). Ainda, lacerações representaram 59,8% dos casos; o sítio acometido foi perióbita (18,6%), e a principal etiologia quedas, 30,9%. O teste qui-quadrado demonstrou associação entre todos os pares de variáveis. É verificada a associação de quedas e colisões em crianças, agressão e acidentes de trânsito em adultos e quedas em idosos. Ainda, observaram-se traumatismos alvéolo dentários em crianças e fraturas em adultos. Conclusão: O perfil dos atendimentos é representado por homens, crianças vítimas de quedas e colisões com lacerações em terço médio e adultos, vítimas de agressão ou acidente de trânsito com lacerações ou fraturas em terço médio facial... (AU)

Introduction: Maxillofacial injuries have high prevalence in the population and may result in aesthetic and functional impairment. Sociodemographic factors may influence the type, severity and etiology. The aim of this study is to identify the maxillofacial trauma profile in an Urgency and Emergency Service. Methods: A 10-year retrospective analysis was performed and the variables age, gender, diagnosis, etiology and anatomical site were collected. The data was evaluated by chi-square test (p≤0,05). Results: 11.779 records were included and was observed prevalence of male patients (69,3%) between 0 and 9 years (29.8%) and 20 and 29 years (19.8%). Lacerations represented 59.8% of cases, the most affected site was periorbital region (18.6%), and the main etiology was falls (30.9%). Chi-square test demonstrate correlation between all variables. There were association of falls and collisions in children, aggression and traffic accidents in adults, and falls in elderly. Dental trauma occurred in children and facial fractures in adults. Conclusion: The profile of maxillofacial trauma is represented by men, children with lacerations in midface due falls and collisions, and adults with lacerations or fractures due to aggression or traffic accident... (AU)

Asunto(s)

RESUMEN

PURPOSE: Odontogenic infections are a common problem in dentistry, and their treatment often requires the use of antibiotics besides the removal of the source of infection, which frequently makes it more difficult for clinicians to make a decision regarding the choice of antibiotic. This study aimed to answer the following questions through the Patient, Intervention, Comparison, Outcome (PICO) format: When should antibiotics be used in dental infections (DIs)? Which are the most effective drugs? How long should antibiotics be administered? MATERIALS AND METHODS: This was a systematic review using the PubMed, Scopus, and Cochrane databases without restriction as to the period researched. The variables analyzed in each article were the number of odontogenic infections in each study, type of study, surgical intervention performed, antibiotics administered, statistical differences between groups studied, and patients' evolution after treatment. RESULTS: The search included 1,109 articles. After the full reading of 46 articles, 16 were included in the final review and 30 were excluded. A sample of 2,197 DI cases was obtained, in which 15 different antibiotics were used, with a 98.2% overall cure rate. CONCLUSIONS: The studies showed that antibiotics were prescribed only in situations of regional and/or systemic body manifestations. In the case of DIs, once drainage has been performed and/or the cause of infection has been removed, all antibiotics tested are equally effective with respect to clinical cure, and the choice of antibiotics is not as successful as the local intervention treatment procedure. When the real need for antibiotic therapy is detected, antibiotics should be used for the shortest time possible until the patient's clinical cure is achieved.

Asunto(s)

RESUMEN

Aim: This study aimed to evaluate through a specific survey the knowledge of dentists on dental trauma in Southern Brazil regarding their conduct facing some dental trauma injuries. Methods: A survey with five personal and five specific questions on knowledge about dental trauma was carried out with all dentists regularly registered in Pelotas, Brazil (n=276). The data was submitted to descriptive statistical analysis and associations were tested by Chi-square test (p≥0.05). Results: There were a higher number of dentists with up to 10 years since graduation (45.4%) who worked in private dental office (66.1%) and with some specialization (63.7%). Dentists with more years since graduation were associated to less knowledge on dental trauma management (p<0.001). Conclusions: The knowledge of the dentists related to dento-alveolar trauma is lowered with higher time in clinical practice. Continuing education courses should be offered to the dentists by educational institutions (AU)

Asunto(s)

RESUMEN

Osteomas são tumores benignos compostos de osso maduro compacto ou esponjoso, podendo apresentar-se clinicamente na periferia, intraósseo, ou no interior dos tecidos moles. São essencialmente restritos ao esqueleto craniofacial, ocorrendo com maior frequência na mandíbula, sendo raramente diagnosticados em outros ossos. A variável osteoma periférico apresenta-se como uma massa óssea pediculada, de crescimento lento, assintomática, isolada e unilateral. Sua frequência é maior em homens, entre a segunda e quinta décadas de vida, sendo sua etiopatogenia amplamente discutida, podendo ser de origem reacional, traumatológica, inflamatória, ou alteração na fisiologia óssea. Comumente esta lesão está associada a pacientes portadores da Síndrome de Gardner. Objetiva-se, através de relato de caso clínico, discutir a causa, aspectos clínicos, radiográficos e histológicos desta neoplasia, assim como seu tratamento.

Osteomas are benign tumors composed of compact or cancellous mature bone, which may present clinically in the periphery, intra-bone or inside soft tissues. They are essentially restricted to craniofacial skeleton, occurring more frequently in the jaw, rarely diagnosed in other bones. The variable peripheral osteoma usually presents as a pedicled bone mass, of slow growth, asymptomatic, isolated, and unilateral. It is more frequently found in men, between the second and fifth decades of life, being its etiopathogenesis widely discussed, its origin may be reactive, inflammatory, from trauma or physiological bone changes. These lesions are commonly associated with patients with GardnerÆs Syndrome. Through a case report this study aims to discuss cause, clinical, radiographic and histological aspects of this neoplasm, as well as its treatment.

Asunto(s)

RESUMEN

Infecções focais dentárias podem causar complicações sistêmicas e resultar em internação hospitalar. Conduziu-se estudo descritivo de casos de infecções focais dentárias, perfil dos pacientes internados no Pronto-Socorro de Pelotas-RS, e estimativa dos custos dessas internações no período de 2008/2013 com dados provenientes da Faculdade de Odontologia da UFPel. A descrição das variáveis foi realizada por frequências absolutas e relativas, mediana, média/desvio-padrão. A estimativa do custo foi realizada por meio da média dos valores das Autorizações de Internações Hospitalares com CID K04/K05, repassados pela SMS-Pel. Dos 417 registros coletados, 52,8% eram mulheres, tinham entre 18-39 anos de idade (55,9%) e eram oriundos de Pelotas-RS (95%). A média etária foi de 25,5 anos (± 13,7 anos). Dos 417 indivíduos atendidos, 88,5% foram medicados, prevalecendo combinações de medicamentos (67,6%). A falta de registros foi observada para todas as variáveis, exceto sexo. Foram identificadas 63 internações. O custo médio para o município foi de R$ 347,67. Das urgências observadas, 6,9% eram decorrentes de infecções focais dentárias, sensíveis a intervenções na Atenção Básica. Considerando custos em internações de urgências odontológicas, e, sendo possível preveni-las, sugerem-se novas abordagens sobre o tema. É necessário qualificar registros para adequado monitoramento dessa demanda, verificando seu impacto na redução das internações... (AU)

Dental focal infections can cause systemic complications and result in hospitalization. We conducted a descriptive case study of dental focal infections, patients characteristics admitted to the Emergency Room of Pelotas, and estimated costs of hospital admissions in the period 2008/2013 with data from the School of Dentistry Federal University of Pelotas. The description of the variables was performed by absolute and relative frequencies, median, mean and standard deviation. The cost estimate was performed using average values of Authorizations Hospitalizations with ICD K04 / K05, provided by the SMS-Pel. Of the 417 selected records, 52.8% were women, aged between 18-39 years old (55.9%) and originating from Pelotas (95%). Mean age was 25.5 years (± 13.7 years). Of total 417 individuals, 88.5% were prescribed, whichever drug combinations (67.6%). The lack of records was found for all variables except sex. Were identified 63 hospitalizations. The average cost for the city was (R$ 347.67). Of the emergencies observed, 6.9% were due to sensitive interventions in primary care dental focal infections. Considering costs for dental emergencies admissions, and prevent thembeing possible, were suggest new approaches to the topic. It is necessary to qualify records for proper monitoring of this demand, checking its impact in reducing hospitalizations... (AU)

Asunto(s)

RESUMEN

Os profissionais da odontologia têm se tornado mais consciente da relação dentição com os ossos faciais e seu impacto sobre a aparência facial. Este trabalho tem o propósito de avaliar, de forma qualitativa, o grau de satisfação de pacientes submetidos à cirurgia ortognática. Foram selecionados cinco pacientes submetidos a este tipo de tratamento, os quais foram submetidos a uma entrevista oral, semi-estruturada e gravada. As entrevistas foram transcritas e submetidas à análise de conteúdo. Desta análise resultou um textosíntese, com a categorização dos resultados obtidos. Verificou-se que o principal motivo dos pacientes aderirem à cirurgia foi a estética da face, sendo o fator função observado, também, como decisivo ao paciente frente à escolha do tratamento. O tratamento ortodôntico-cirúrgico proporcionou melhoras, tanto de ordem estética, funcional, de elevação da auto-estima, e consequente qualificação positiva no relacionamento interpessoal dos pacientes pesquisados

The dental professionals have become more aware of the relationship with dentition, facial bones and their impact on facial appearance. This work has the purpose of evaluating, in a qualitative way, the degree of patients’ satisfaction submitted to orthognathic surgery. Five patients were selected submitted to this treatment type, which they were submitted to an oral interview, semi-structured and recorded. The interviews were transcribed and submitted to the content analysis. Of this analysis it resulted a text-synthesis, with the categorization of the obtained results. It was verified that the patients’ main reason to adhere to the surgery it was the aesthetics of the face, being the factor function observed, also, as decisive to the patient front to the choice of the treatment. It was verified, likewise, that the orthodontic-surgical treatment provided improvements, so much of order aesthetic, functional, of elevation of the self-esteem, and consequent positive qualification in the researched patients interpersonal relationship

Asunto(s)

RESUMEN

Avulsion injuries of facial bones are rare, as well as accounts regarding the management of these lesions. This study describes a facial trauma that resulted from a bull gore, which caused the avulsion of the zygomatic bone, which was left hanging by only a small pedicle. The case study involved a 36 year old male leukoderma patient who sought the Maxillo-Facial Surgery and Trauma Department at the Emergency Unit in Pelotas-RS (Brazil). Clinical examination showed extensive laceration of the face in the middle third area on the left side, with the avulsion of the zygomatic body, causing the displacement of the eyeball towards the maxillary sinus. Treatment included bone and eyeball repositioning, zygoma fixation and suture, yielding good aesthetic and functional results. The peculiarity of the etiology and the particular features of the trauma are highlighted... (AU)

Lesões avulsivas dos ossos faciais são raras, assim como descrições quanto ao manejo dessas injúrias. Este estudo descreve um traumatismo facial decorrente de uma chifrada de um boi, que ocasionou a avulsão do osso zigomático, restando preso apenas por um pequeno pedículo. Trata-se de um paciente gênero masculino, 36 anos, leucoderma, que procurou o serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital de Pronto-Socorro da cidade de Pelotas-RS (Brasil). Ao exame clínico observava-se extensa laceração na face, em área de terço médio, lado esquerdo, com avulsão do corpo do zigoma, determinando o deslocamento do globo ocular em direção ao seio maxilar. O tratamento constou de reposicionamento ósseo e do globo ocular, fixação do zigoma e sutura, obtendo-se um bom resultado estético e funcional. Destaca-se a peculiaridade da etiologia e características únicas deste trauma... (AU)

Asunto(s)

RESUMEN

Este caso clínico descreve a situação de uma paciente parcialmente desdentada com má oclusão esquelética classe III de Angle que apresentava pobre função mastigatória e desagradável aparência estética, originada pela grave discrepância anteroposterior entre as arcadas dentárias e pela perda de dimensão vertical de oclusão. Sua reabilitação funcional e estética foi realizada através de cirurgia ortognática e tratamento protético mediante a instalação de uma prótese parcial removível tipo overlay. Ao final do tratamento, a paciente foi reabilitada funcionalmente e esteticamente com sucesso através do restabelecimento da dimensão vertical de oclusão e correção da discrepância anteroposterior entre os arcos dentários. A prótese parcial removível tipo overlay é uma alternativa simples e rápida para o tratamento de pacientes parcialmente desdentados com má oclusão esquelética classe III e pequena discrepância anteroposterior entre os arcos dentários. Neste caso clínico, foi obtido de forma satisfatória o restabelecimento estético e funcional do sistema estomatognático através da combinação de cirurgia ortognática e tratamento protético...

This clinical report discusses the case of a partially edentulous patient with class III skeletal malocclusion, suffering from poor masticatory function and esthetic appearance caused by severe anteroposterior discrepancy between the dental arches and loss of occlusal vertical dimension. The functional and esthetic rehabilitation was performed with orthognathic surgery followed by prosthetic treatment using an overlay removable partial denture. At the end of the treatment, the patient was successfully rehabilitated, both functionally and esthetically, through reestablishment of the occlusal vertical dimension and correction of the anteroposterior discrepancy between the dental arches. The overlay removable partial denture is a simple and time-efficient alternative in the treatment of partially edentulous patients with class III skeletal malocclusions and small anteroposterior discrepancies between dental arches. Additionally, an esthetic smile and functional rehabilitation of the stomatognathic system was satisfactorily obtained with orthognathic surgery followed by prosthetic treatment...

Asunto(s)

RESUMEN

PURPOSE: The aim of this paper is to briefly review and discuss the literature about KA and present a case report with a 2-year follow-up of the removal of a KA lesion in the upper lip. CASE DESCRIPTION: A 53-year-old woman complained of a painless, aesthetically unpleasant brownish, hard lesion in the cutaneous area of the upper lip. The lesion had grown rapidly in the last 30 days (size: ~10×5 mm), and was associated with a hot waxing hair removal. Surgical excision was the treatment chosen in order to differentiate the lesion from squamous cell carcinoma (SCC). An oval-shaped incision was created with an in-depth wedge shape for the removal of the lesion and better approximation of the edges after synthesis. Histopathological analysis confirmed the diagnosis of KA. After 2 years, the patient was completely satisfied with the treatment, and no scar was evident. CONCLUSION: Due to the clinical difficulty in differentiating KA from SCC and the risk for formation of an aesthetically unpleasant scar upon spontaneous resolution of KA, surgical removal might be considered the treatment of choice for a solitary KA.

OBJETIVO: O objetivo deste trabalho é revisar e discutir brevemente a literatura sobre CA e apresentar o relato de um caso da remoção de CA em lábio superior com 2 anos de acompanhamento. DESCRIÇÃO DO CASO: Mulher com 53 anos queixava-se de lesão indolor, esteticamente desagradável, dura e de coloração marrom na área cutânea do lábio superior. A lesão havia crescido rapidamente nos últimos 30 dias (tamanho: ~10×5 mm), e estava associada à remoção de pêlos com cera quente. Excisão cirúrgica foi o tratamento escolhido para diferenciar a lesão de carcinoma espinocelular (CEC). Uma incisão em forma oval aprofundada em forma de cunha foi realizada para remoção da lesão e melhor aproximação das bordas após a síntese. A análise histopatológica confirmou o diagnóstico de CA. Após 2 anos, a paciente estava completamente satisfeita com o tratamento, e nenhuma cicatriz era evidente. CONCLUSÃO: Devido à dificuldade na diferenciação clínica entre CA e CEC, e o risco de formação de cicatriz esteticamente desagradável quando da resolução espontânea do CA, a remoção cirúrgica pode ser considerada o tratamento de escolha para CA solitário.

Asunto(s)

RESUMEN

PURPOSE: The aim of the present study was to relate the use of 5% monoethanolamine oleate in sclerotherapy for vascular malformations and to suggest a protocol for its use. PATIENTS AND METHODS: A total of 53 patients with 66 vascular malformation lesions were treated with an intralesional injection of 5% monoethanolamine oleate at 0.1 mL/cm of lesion with at least a 15-day interval and as many as 4 applications. A descriptive statistical analysis was performed using SigmaPlot, version 9.0, software. RESULTS: The treatment with the protocol suggested was effective in 65 cases, and in 1 case, surgical intervention was required. CONCLUSIONS: Sclerotherapy was effective in the treatment of vascular malformations, and the method chosen was adequate for lesion resolution without complications.

Asunto(s)

RESUMEN

Um material adequado para a reconstrução óssea craniofacial deve ser simples de implantar, possuir forma adequada, resistência à fratura e à deformação similares ao osso original, ser eventualmente substituído por osso natural, ser largamente disponível e não possuir um custo muito elevado. Baseado no fato de que um material com todas estas características ainda não está disponível atualmente, torna-se importante buscar novos materiais, novas composições e novas conformações. Diferentes biomateriais são utilizados atualmente para cirurgias de reconstrução craniofacial, cada um apresentando suas vantagens e limitações. Entre eles destacam-se o titânio, o polimetilmetacrilato e os cimentos de fosfato de cálcio. O titânio apresenta difícil conformação; o polimetilmetacrilato polimeriza-se por meio de uma reação exotérmica, podendo causar necrose de tecidos adjacentes ao implante; o cimento de fosfato de cálcio, por sua vez apresenta certa fragilidade, característica de alguns materiais cerâmicos. Neste sentido, este estudo examinou diferentes materiais utilizados para reconstrução craniofacial e suas propriedades mecânicas quando submetidos a ensaios de flexão, como o polimetilmetacrilato, o cimento de fosfato de cálcio e o cimento de fosfato de cálcio reforçado com titânio. Foi verificada a melhoria de propriedades mecânicas do cimento de fosfato de cálcio quando reforçado com malha de titânio. Além disso, este estudo apresenta uma técnica para o projeto e fabricação de implantes craniofaciais personalizados utilizando cimento de fosfato de cálcio reforçado com titânio, validada através de quatro casos de indicação cirúrgica de reconstrução craniofacial.

A material suitable for craniofacial reconstruction must be easy to implant, have the appropriate shape, have the strength and deformation similar to the original bone, be eventually substituted for natural bone, be widely available and present affordable costs. As such as material, with all theses characteristics is still not available, it is important to search for new materials, new compositions and new design. Different biomaterials are used nowadays for craniofacial reconstruction surgeries, each one presenting its advantages and limitations. Among these materials are the titanium, the poli(methilmetacrilate) and the calcium phosphate cements. Titanium presents hard conformation; poli(methilmetacrilate)’s polymerization reaction is exothermic, which may cause necrosis of the adjacent tissues; calcium phosphate cement is brittle, an usual characteristic of ceramic materials. In this way, this study evaluated different materials used for craniofacial reconstruction and its mechanical properties when submitted to bending test, such as poli(methilmetacrilate), calcium phosphate cement and calcium phosphate cement reinforced with titanium. It was verified the improvement in the mechanical properties of the calcium phosphate cement when reinforced with titanium mesh. In addition, this study presents a method for design and manufacturing of customized craniofacial implants using calcium phosphate cement reinforced with titanium mesh, validated through four cases of craniofacial reconstruction surgery indication.

Asunto(s)

RESUMEN

Purpose: This paper reports the procedure used to close a late oroantral fistula using rotating flaps of the pedicled buccal fat pad. Case description: A 66-year-old, male patient with leukoderma, in good general health, was referred for closure of an extensive late oroantral communication. Upon clinical examination, an approximately 10-mm fistula was observed connecting the oral cavity to the maxillary sinus. An outpatient surgical procedure was performed with the use of local anesthetics to close the oroantral fistula with a rotating pedicled buccal fat pad flap. The healing of the wound and closure of the defect could be seen after a 30-day postoperative period, with complete epithelialization. Conclusion: Grafting of the pedicled buccal fat pad is thought to be an efficient, safe and easy alternative to a larger oroantral fistula closure. Pedicled buccal fat pad grafting corrected the defect without generating any sequelae and/or great postoperative discomfort to the patient.

Objetivo: O objetivo deste artigo foi relatar um caso clínico de fechamento de fístula buco-sinusal tardia utilizando rotação de enxerto de tecido adiposo pediculado do corpo adiposo da bochecha. Descrição do Caso: Paciente do sexo masculino, 66 anos, leucoderma, em boas condições de saúde geral, foi encaminhado para fechamento de extensa comunicação buco-sinusal. Ao exame clínico, observou-se uma fístula de aproximadamente 10 mm de diâmetro comunicando a cavidade oral com o seio maxilar. A cirurgia foi realizada em nível ambulatorial, sob anestesia local, para fechar a fístula buco-sinusal com um enxerto de tecido adiposo pediculado do corpo adiposo da bochecha. A reparação da ferida e o fechamento do defeito foram observados no pós-operatório de 30 dias, com completa epitelização. Conclusão: O enxerto pediculado de tecido do corpo adiposo da bochecha mostrou-se uma alternativa simples, eficaz e segura no fechamento mediato da fístula buco-sinusal apresentada neste caso clínico.

Asunto(s)

RESUMEN

The purpose of the present article was to report a case of central giant cell granuloma (CGCG) associated with intralesional corticosteroid injections. Although benign, the CGCG may be locally aggressive, causing extensive bone destruction, tooth displacement, and root resorption. The common therapy is surgery, which may result in important facial deformity and loss of teeth or dental germs. In this article, an 8-year-old girl who presented with maxillary CGCG was treated with a solution of equal parts of triamcinolone actinide (10 mg/ml) and 0.5% bupivacaine injected into the lesion for a period of 11 weeks. The osseous neoformation was gradual. After 6-years follow-up, clinical and radiographic success of treatment were observed. Based on our results and the literature available, the administration of intralesional corticosteroid injections is an alternative in CGCG treatment, especially in children.

Asunto(s)

RESUMEN

Objetivos: Analisar os dados existentes na literatura, que mostra uma alta incidência de fraturas mandibulares e elucidar o contexto de sua ocorrência no universo dos pacientes atendidos pelo Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, Brasil. Métodos: A partir dos registros referentes ao período de junho de 2001 a agosto de 2007, obtivemos 1 345 pacientes com fraturas faciais. Foram selecionados para este estudo 116 pacientes com fraturas mandibulares, nos quais os itens analisados foram: faixa etária, sexo, sítio mandibular fraturado, etiologia e período do ano. Resultados: Assim, encontramos 86,2% de indivíduos do sexo masculino. A faixa etária mais atingida foi a dos 20 aos 29 anos, com 36,2%, e os sítios mandibulares mais afetados foram o corpo com 29 casos (25%) e o côndilo com 26 casos (22,4%). As causas mais comuns destas fraturas foram as agressões físicas, com 37,1%. O verão foi o período do ano com a maior incidência de fraturas mandibulares, com 38 casos (32,8%). Conclusão: Observou-se, então, que os pacientes com fratura mandibular, atendidos no Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, geralmente são homens, na faixa etária dos 20 aos 29 anos, com fratura do corpo mandibular e que foram vítimas de agressão física.

Objectives: To analyze the data in the literature, which show a high incidence of mandibular fractures. The aim of this research was to elucidate the context in which these fractures occur among patients attended at the first aid center of "Pronto Socorro Municipal de Pelotas", Rio Grande do Sul, Brazil. Methods: From the records referring to the period of June, 2001 to August, 2007, there were 1 345 patients with facial fractures. Of this total, 116 patients with mandibular fracture were selected for this study and the items analysed were: age, gender, mandibular fracture site, etiology and period of the year. Results: It was found that 86.2% of the sample were men. The most prevalent age was 20 to 29 years old representing 36.2%, and the most affected mandibular sites were the body, with 29 cases (25%), and the condyle, with 26 cases (22.4%). The most common cause of fractures was the physical aggression representing 37.1%. The period of the year with the highest incidence of mandibular fractures was the summer, with 38 cases (32.8%). Conclusion: It was therefore observed that the patients with mandibular fracture assisted at Pronto-Socorro Municipal de Pelotas, Rio Grande do Sul, Brazil, were generally men, 20 to 29 years old with mandibular body fracture and they were victims of physical aggression.

Asunto(s)

RESUMEN

Purpose: Ultraviolet radiation is the main etiological agent associated with the development of actinic cheilitis, a premalignant irreversible disease that frequently affects the vermilion border of the lower lip. This paper aimed to describe the case of a patient with actinic cheilitis and treated with scalpel vermilionectomy. Case Description: A male, Caucasian, 66 year-old subject sought dental treatment complaining of "wounds on the lip that not heal" for approximately 15 years. The patient reported that he had worked in farms since the age of 5 year-old and was a frequent user of alcohol and tobacco. Atrophic and erosive areas associated with many ulcers covered with eschars were observed throughout the length of the lip. Based on the patient history and clinical exam, scalpel vermilionectomy was proposed. The histopathological analysis revealed a superficially invasive squamous cell carcinoma with free borders. The patient was monitored for two years with no relapse. Conclusion: Scapel vermilionectomy was chose to treat this case due to its low cost, relatively short time for repair, and possibility of histopathological analysis of the removed tissue.

Objetivo: A radiação ultravioleta é o principal agente etiológico associado ao desenvolvimento da queilite actínica, uma lesão pré-maligna que afeta o lábio inferior. Este trabalho descreveu o caso clínico de um paciente que apresentava várias ulcerações recobertas por crosta no lábio inferior e foi tratado pela técnica da vermelhectomia. Descrição do caso: Um sujeito do sexo masculino, Caucasiano, de 66 anos de idade, procurou tratamento odontológico com queixa de "feridas no lábio que não cicatrizavam" por 15 anos. O paciente relatou que tinha trabalhado em fazendas desde os 5 anos de idade e fazia uso frequente de tabaco e álcool. Áreas erosivas e atróficas associadas a múltiplas úlceras cobertas com escaras foram observadas em todo o lábio. Com base na história do paciente e exame clínico, foi proposto tratamento por vermelhectomia. O diagnóstico histopatológico foi de carcinoma espinocelular superficialmente invasivo, com margens livres, e o paciente foi acompanhado por um período de 2 anos sem recidiva. Conclusão: A técnica da vermelhectomia foi a escolha preferencial de tratamento por ser de baixo custo, ter um tempo cicatricial relativamente curto e, especialmente, permitir que o tecido removido possa ser examinado histopatologicamente.

Asunto(s)

RESUMEN

AIM: The aim of this report is to present a clinical case of impaction of a maxillary left central incisor in a mixed dentition caused by the presence of an odontoma as well as a review of the pertinent dental literature. BACKGROUND: Knowledge of the normal tooth eruption patterns is essential for the identification and appropriate treatment of deviations in eruption that may endanger physiologic development. A delay in time between the exfoliation of a deciduous tooth and the eruption of its permanent successor may be related to a disorder known as dental retention. This occurs when tooth eruption does not occur within a normal time frame, the tooth is not present in the dental arch, and there is no potential for eruption due to the presence of a completely formed root or when the homologous tooth has been erupted for at least six months with complete root formation. REPORT: A 10-year-old boy in the mixed dentition stage presented with an impacted maxillary left central incisor due to the presence of an odontoma. Treatment included the surgical removal of the lesion and the follow up of the spontaneous eruption while a partial fixed appliance was used to recover the space of the missing tooth. Since spontaneous eruption failed to occur within the expected time frame, surgical exposition of the crown and bonding of an orthodontic appliance for traction was done to facilitate eruption. SUMMARY: The incisor was integrated to the dental arch without any root or periodontal sequelae. The treatment was considered a success, since both health and aesthetics of the smile were recovered. The importance of the clinical and radiographic diagnosis of the retention of a permanent tooth associated with a pathological entity should be emphasized. The participation of a multidisciplinary team to accomplish the appropriate treatment of such patients is extremely relevant because of the esthetic and functional ramifications of a missing anterior tooth as well as the psychological well-being of the individual.

Asunto(s)