RESUMEN
Background: Osteoradionecrosis (ORN) of the jaws is a late complication after radiotherapy to head and neck cancer. Objective: To describe a rare case of ORN of the torus mandibularis that was successfully managed exclusively with antimicrobial photodynamic therapy (aPDT). Case report: A 72-year-old man presented an exposed necrotic bone observed in the torus mandibularis, extending to the lingual alveolar ridge with no edema nor suppuration. The treatment provided a noninvasive treatment leading to spontaneous sequestrectomy of the torus in 2 weeks with complete mucosal repair in 5 weeks and absence of lesion signs and/or symptoms even after 6 months of follow-up. Conclusions: The aPDT indicated to be a satisfactory treatment for ORN affecting torus mandibularis, a region with surgical limitations, avoiding surgery.
Asunto(s)
Osteorradionecrosis , Fotoquimioterapia , Humanos , Masculino , Anciano , Osteorradionecrosis/etiología , Osteorradionecrosis/terapia , Osteorradionecrosis/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Enfermedades Mandibulares/etiología , Enfermedades Mandibulares/terapia , Enfermedades Mandibulares/tratamiento farmacológicoRESUMEN
ABSTRACT Purpose: to verify if there is an electromyographic difference during maximal (maximum) voluntary contraction of the masseter and temporalis muscles in patients with temporomandibular disorders, before and after speech therapy intervention with and without the use of therapeutic elastic bandages. Methods: an analysis of secondary data from a clinical intervention study, carried out with 17 adult volunteers, diagnosed with temporomandibular muscle dysfunction with or without disc displacement with reduction. The Bandage Group received manual therapy associated with elastic bandages and the No Bandage Group received only manual therapy. Surface electromyography was performed to record the Maximum Voluntary Contraction before and after four weeks of speech therapy intervention. For exploratory analysis, the Mann Whitney and Wilcoxon paired tests were used, with P<0.05. Results: in the Bandage Group, there was a statistically significant decrease in electrical activity during Maximum Voluntary Contraction in the masseter and temporalis muscles on the left side at the post-therapeutic moment. Comparing the pre- and post-intervention between Bandage Group and No Bandage Group, a statistical difference was found in the electrical activity values of the Maximum Voluntary Contraction in the left temporal muscle. Conclusion: manual myofunctional speech therapy, associated or not with the use of therapeutic elastic bandages, impacts the muscle activity of the masseter and temporal muscles during Maximum Voluntary Contraction, whether the values demonstrate relaxation and/or equivalence of the electromyographic values of the masticatory muscles.
RESUMO Objetivo: verificar se há diferença eletromiográfica durante contração voluntária máxima dos músculos masseter e temporal de pacientes com disfunção temporomandibular, antes e após intervenção fonoaudiológica com e sem uso de bandagem elástica terapêutica. Métodos: foi realizada a análise de dados secundários de estudo do tipo intervenção clínica, com 17 voluntárias, adultas, com diagnóstico de disfunção temporomandibular muscular com ou sem deslocamento de disco com redução. O Grupo Bandagem recebeu terapia manual associada à bandagem elástica e o Grupo Sem Bandagem recebeu apenas terapia manual. Foi realizada eletromiografia de superfície para registro da contração voluntária máxima antes e após quatro semanas de intervenção fonoaudiológica. Para análise exploratória foram utilizados os testes: Mann Whitney e Wilcoxon Pareado, com p<0,05. Resultados: no Grupo Bandagem, houve diminuição estatisticamente significante da atividade elétrica durante a Contração Voluntária Máxima nos músculos masseter e temporal do lado esquerdo no momento pós-terapêutico. Na comparação do pré e pós-intervenção entre Grupo Bandagem e Grupo Sem Bandagem, constatou-se diferença estatística nos valores da atividade elétrica de Contração Voluntária Máxima no músculo temporal esquerdo. Conclusão: a terapia fonoaudiológica miofuncional manual, associada ou não ao uso da bandagem elástica terapêutica, impacta a atividade muscular dos músculos masseter e temporal durante a Contração Voluntária Máxima, sejam os valores demonstrando relaxamento e/ou equivalência dos valores eletromiográficos da musculatura mastigatória.
Asunto(s)
Enfermedades Mandibulares/terapia , Electromiografía , Terapéutica , SaludRESUMEN
ABSTRACT: Radiotherapy applies ionizing radiation at predetermined doses for a limited period of time in order to destroy tumors. The oral cavity, which has a high rate of cell renewal, is affected by the side effects of radiotherapy including osteoradionecrosis (ORN). This condition occurs due to irradiated bone tissue that becomes devitalized and exposed in the oral cavity. Conservative therapies are recommended for ORN lesions that are not extensive or in an early stage. Surgical intervention is necessary for extensive areas affected by necrosis. This study reports a case of ORN in the left mandibular body which resulted in a pathological fracture. The treatment consisted of segmental mandibulectomy and the use of a reconstruction plate. Also, low-level laser therapy around bone exposure was performed. After surgery, the patient underwent 6 months of follow-up and was satisfied with the outcome. However, the patient died before control of ORN was achieved due to a heart attack.
RESUMEN: La radioterapia aplica radiación ionizante a dosis predeterminadas durante un período de tiempo limitado para destruir tumores. La cavidad oral, que tiene una alta tasa de renovación celular, se ve afectada por los efectos secundarios de la radioterapia, incluida la osteorradionecrosis (ORN). Esta condición se produce debido al tejido óseo irradiado que se desvitaliza y expone en la cavidad oral. Se recomiendan terapias conservadoras para las lesiones de ORN que no son extensas o en una etapa temprana. La intervención quirúrgica es necesaria para áreas extensas afectadas por necrosis. Este estudio reporta un caso de ORN en el cuerpo mandibular izquierdo que resultó en una fractura patológica. El tratamiento consistió en mandibulectomía segmentaria y el uso de una placa de reconstrucción. Además, se realizó una terapia con láser de bajo nivel alrededor de la exposición ósea. Después de la cirugía, el paciente se sometió a 6 meses de seguimiento y quedó satisfecho con el resultado. Sin embargo, el paciente falleció antes de que se lograra el control de ORN debido a un ataque cardíaco.
Asunto(s)
Humanos , Masculino , Adulto , Osteorradionecrosis/diagnóstico , Osteorradionecrosis/terapia , Enfermedades Mandibulares/terapia , Osteotomía Mandibular/métodos , Neoplasias de Cabeza y Cuello/radioterapia , Radiografía Dental/métodos , Radiografía Panorámica , Mandíbula/cirugíaRESUMEN
ABSTRACT: Florid osseous dysplasia (FOD) is an extensive form of osseous dysplasia where normal trabecular bone is substituted by fibrous connective tissue and amorphous mineralized tissue. Usually, the lesions are mainly asymptomatic and the patients should be followed with clinical and imaging examination, requiring no intervention. Nevertheless, due to the poor vascularization of the lesion and to local trauma, secondary infections and osteomyelitis may occur. Patients may present with pain, mucosal ulceration, lesion exposure in the oral cavity, fistula and swelling. In such cases, the correct diagnosis and management of the lesion is decisive to reestablish patient's health and quality of life. The aim of this article is to present a case of complicating secondary chronic osteomyelitis treated successfully with conservative intervention. A 68-year-old black female patient reported a "swelling of the gums" that was present for eleven years, with episodes of periodic pain and swelling. On physical examination, a papule with suppuration in the alveolar mucosa in the right side of the mandible was observed. Panoramic radiography and CBCT showed a mixed lesion surrounded by sclerotic bone. The patient was diagnosed with chronic osteomyelitis in association with FOD and treated with antibiotic therapy together with surgical curettage. The incidence, etiophatology, differential diagnosis, treatment and prevention of secondary osteomyelitis associated with FOD are discussed in the light of literature. This information might assist the dentists while choosing the best treatment options for similar cases.
RESUMEN: La displasia ósea florida (DOF) es una forma de displasia ósea donde el hueso trabecular normal es sustituido por tejido conectivo fibroso y tejido mineralizado amorfo. En general, las lesiones son de origen asintomático y los pacientes deben ser seguidos con el examen clínico. Sin embargo, debido a la pobre vascularización de la lesión y al trauma local, pueden producirse lesiones secundarias y osteomielitis. Los pacientes pueden presentarse con dolor, ulceración mucosa, lesión de exposición en la cavidad oral, fístula y edema. En estos casos, el correcto diagnóstico y tratamiento de la lesión es decisivo para reestabilizar la salud y la calidad de la vida. El objetivo de este artículo consistió en presentar un caso de complicación secundaria crónica de osteomielitis tratados con tratamiento conservador. El paciente, negro, de 68 años de edad, consulta por "hinchazón de las encías" que se presentó durante once años, con episodios de dolor. En el examen intraoral, se observó una pápula con supuración en la mucosa alveolar en el lado derecho de la mandíbula. La radiografía panorámica y CBCT mostraron una lesión mixta rodeada de hueso esclerótico. El paciente fue diagnosticado con osteomielitis crónica en asociación con DOF y fue tratado con tratamiento antibiótico junto con curetaje quirúrgico. La incidencia, la etiopatología, el diagnóstico diferencial, el tratamiento y la prevención de la osteomielitis secundaria asociada con DOF se discuten a la luz de la literatura. Esta información puede ayudar a los dentistas a elegir las mejores opciones de tratamiento para casos similares.
Asunto(s)
Humanos , Anciano , Osteomielitis/terapia , Osteomielitis/diagnóstico por imagen , Enfermedades Mandibulares/terapia , Tratamiento Conservador/métodos , Radiografía Panorámica , Enfermedades Mandibulares/diagnóstico por imagen , Displasia Fibrosa Ósea/terapia , Displasia Fibrosa Ósea/diagnóstico por imagenRESUMEN
PURPOSE: The aims of the present study were to discuss the demographic distribution and clinical characteristics of patients with pycnodysostosis (PYCD) and the onset of osteomyelitis and its treatment using a literature review. The authors also report on an update of treatment of mandibular osteomyelitis in a patient with PYCD using a buccal fat pad (BFP) as a free graft. PATIENTS AND METHODS: The study was carried out in 2 steps. In the first step, an electronic search was undertaken in PubMed in March 2018, with 17 articles being included. In the second step, the authors present a case of mandibular osteomyelitis in a 30-year-old woman with PYCD treated by sequestrectomy and a BFP as a free graft (follow-up, 24 months). RESULTS: Twenty-one cases of osteomyelitis of the jaws in patients with PYCD were included. Dental extraction, mandibular fracture, and 1 case of facial trauma represented the causes of mandibular osteomyelitis. Treatments included resection associated with antibiotics and sequestrectomy alone or associated with antibiotics. CONCLUSIONS: Despite the good results of the present case, further studies using the BFP as an adjuvant for jaw osteomyelitis are necessary to elucidate its clinical efficiency and safety.
Asunto(s)
Tejido Adiposo/trasplante , Antibacterianos/uso terapéutico , Enfermedades Mandibulares/terapia , Procedimientos Quirúrgicos Orales , Osteomielitis/terapia , Picnodisostosis/complicaciones , Adulto , Femenino , HumanosRESUMEN
BACKGROUND: Tuberculosis is considered an emerging disease worldwide; in the last 10 years, its incidence has increased to more than 9.6 million cases of active tuberculosis. In 2014, it resulted in 1.5 million patient deaths. However, oral presentation with bone involvement occurs in less than 3% of all reported cases and rarely arouses clinical suspicion on initial presentation. CASE PRESENTATION: A 15-year-old Mexican girl who had a previous diagnosis of neurofibromatosis presented to our hospital with pain and swelling in the region of the left mandibular body since November 2011. A clinical examination revealed pain in the mandibular region, a mass of soft consistency that seemed to involve bone, and a fistula with discharge of intraoral purulent material. Additionally, tachycardia and hyperthermia were observed. The left submental and submandibular regions had a 12-cm-diameter swelling, which was well-delineated and nonerythematous. The final diagnosis was established by real-time polymerase chain reaction. CONCLUSIONS: The final diagnosis of rare cases of tuberculous osteomyelitis in the jaw can be established by deoxyribonucleic acid (DNA) identification of Mycobacterium tuberculosis in the lesion. Simple and fast complementary diagnosis by real-time polymerase chain reaction is a fundamental approach to establishing early and effective pharmacological and surgical treatment.
Asunto(s)
Antituberculosos/uso terapéutico , Enfermedades Mandibulares/microbiología , Osteotomía Mandibular , Reconstrucción Mandibular , Mycobacterium tuberculosis/aislamiento & purificación , Tomografía Computarizada por Rayos X , Tuberculosis Osteoarticular/microbiología , Adolescente , Femenino , Humanos , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/terapia , Reconstrucción Mandibular/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa , Resultado del Tratamiento , Tuberculosis Osteoarticular/diagnóstico por imagen , Tuberculosis Osteoarticular/patología , Tuberculosis Osteoarticular/terapiaRESUMEN
BACKGROUND: Chorea acanthocytosis is an extremely rare neurodegenerative condition characterized by neuropsychiatric disturbances, movement disorders, neuropathy, seizures, and acanthocytosis. In this case report, the authors will present the management of the oromandibular movement disorders associated with this disease. CASE DESCRIPTION: This case report describes the focal management of the severe orofacial manifestations associated with this condition. The therapeutic approach adopted to reduce the severe oromandibular movements, dysphagia, and the numerous oral ulcers was selective electromyography (EMG)-guided botulinum toxin application to the inferior head of the lateral pterygoid muscles and masseters. This would be applied to control severe and sudden oromandibular dystonia. RESULTS: Through this procedure, the authors were able to reduce these severe oral manifestations, which had a major impact on the patient's quality of life, and temporarily improve vital functions, such as mastication, deglutition, and speech articulation. CONCLUSIONS: Electromyography-guided botulinum toxin application may be a useful tool in the multimodal management of this condition.
Asunto(s)
Toxinas Botulínicas/administración & dosificación , Distonía/terapia , Electromiografía , Enfermedades Mandibulares/terapia , Neuroacantocitosis/terapia , Adulto , Distonía/diagnóstico , Electromiografía/efectos de los fármacos , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intramusculares , Enfermedades Mandibulares/diagnóstico , Músculo Masetero/efectos de los fármacos , Neuroacantocitosis/diagnóstico , Úlceras Bucales/diagnóstico , Úlceras Bucales/terapia , Músculos Pterigoideos/efectos de los fármacosRESUMEN
BACKGROUND: This study evaluates the influence of platelet-rich plasma derived from bone marrow aspirate (PRP-BMA) on the healing of periodontal fenestration defects in rats. METHODS: Periodontal fenestration defects were surgically created in the mandibles of 40 rats. The animals were randomly divided into two groups, control and PRP-BMA, in which defects were filled with blood clot or PRP-bma, respectively. Animals were euthanized at either 10 or 30 days post-surgery. Histologic, histometric, and immunohistochemical analyses were performed. Percentage of new bone area (NBA), area of bone trabeculae (ABT), new cementum (NC), and extension of remaining defect were histometrically evaluated. Proliferating cell nuclear antigen (PCNA), bone sialoprotein (BSP), osteocalcin (OCN), and tartrate-resistant acid phosphatase (TRAP) immunohistochemical staining were performed. Immunolabeled cells were quantified. Data were statistically analyzed (analysis of variance; Tukey, P <0.05). RESULTS: At 10 days, control and PRP-BMA groups presented similar amounts of NBA and ABT; NC formation was not observed. At 30 days, control and PRP-BMA groups presented similar amounts of NBA and ABT; the PRP-BMA group showed NC formation with collagen fibers inserted obliquely or perpendicularly to the root surface. NC formation was not observed in any control group specimen. PRP- BMA presented higher numbers of PCNA-positive and BSP-positive cells than control at 10 and 30 days post-surgery. No significant differences in the number of either OCN-positive or TRAP-positive cells were observed between groups at 10 or 30 days. CONCLUSION: PRP-BMA promoted NC formation with a functional periodontal ligament when applied at experimental periodontal fenestration defects.
Asunto(s)
Pérdida de Hueso Alveolar/terapia , Células de la Médula Ósea/fisiología , Cementogénesis/fisiología , Enfermedades Mandibulares/terapia , Plasma Rico en Plaquetas/fisiología , Fosfatasa Ácida/análisis , Pérdida de Hueso Alveolar/patología , Animales , Coagulación Sanguínea/fisiología , Regeneración Ósea/fisiología , Colágeno/ultraestructura , Tejido Conectivo/patología , Cemento Dental/patología , Inflamación , Sialoproteína de Unión a Integrina/análisis , Isoenzimas/análisis , Masculino , Enfermedades Mandibulares/patología , Necrosis , Osteocalcina/análisis , Osteogénesis/fisiología , Ligamento Periodontal/patología , Recuento de Plaquetas , Antígeno Nuclear de Célula en Proliferación/análisis , Distribución Aleatoria , Ratas , Ratas Wistar , Fosfatasa Ácida Tartratorresistente , Factores de TiempoRESUMEN
BACKGROUND: This study histomorphometrically analyzes the influence of platelet-rich plasma (PRP), low-level laser therapy (LLLT), or their combination on the healing of periodontal fenestration defects (PFDs) in rats. METHODS: PFDs were surgically created in the mandibles of 80 rats. The animals were randomly divided into four groups: 1) C (control) and 2) PRP, defects were filled with blood clot or PRP, respectively; 3) LLLT and 4) PRP/LLLT, defects received laser irradiation, were filled with blood clot or PRP, respectively, and then irradiated again. Animals were euthanized at either 10 or 30 days post-surgery. Percentage of new bone (NB), density of newly formed bone (DNB), new cementum (NC), and extension of remaining defect (ERD) were histomorphometrically evaluated. Data were statistically analyzed (analysis of variance; Tukey test, P <0.05). RESULTS: At 10 days, group PRP presented ERD significantly lower than group C. At 30 days, group PRP presented NB and DNB significantly greater than group C. Groups LLLT, PRP, and PRP/LLLT showed significant NC formation at 30 days, with collagen fibers inserted obliquely or perpendicularly to the root surface. NC formation was not observed in any group C specimen. CONCLUSIONS: LLLT, PRP, or their combination all promoted NC formation with a functional periodontal ligament. The combination PRP/LLLT did not show additional positive effects compared to the use of either therapy alone.
Asunto(s)
Pérdida de Hueso Alveolar/terapia , Regeneración Ósea/fisiología , Terapia por Luz de Baja Intensidad/métodos , Plasma Rico en Plaquetas/fisiología , Pérdida de Hueso Alveolar/radioterapia , Proceso Alveolar/patología , Proceso Alveolar/efectos de la radiación , Animales , Coagulación Sanguínea/fisiología , Densidad Ósea/fisiología , Densidad Ósea/efectos de la radiación , Regeneración Ósea/efectos de la radiación , Colágeno/química , Colágeno/efectos de la radiación , Terapia Combinada , Cemento Dental/patología , Cemento Dental/efectos de la radiación , Fibroblastos/patología , Fibroblastos/efectos de la radiación , Masculino , Enfermedades Mandibulares/radioterapia , Enfermedades Mandibulares/terapia , Osteogénesis/fisiología , Osteogénesis/efectos de la radiación , Distribución Aleatoria , Ratas , Ratas Wistar , Factores de Tiempo , Raíz del Diente/patología , Raíz del Diente/efectos de la radiaciónRESUMEN
Coronoid hyperplasia is a rare entity of unknown etiology due to increased and persistent bone growth that has been associated with trauma, inflammation, hormonal influence and hypervascularization. A case of coronoid hyperplasia in a pediatric patient with restriction in mandibular movements and an absence of painful symptoms initially misdiagnosed as a functional temporomandibularjoint (TMJ) abnormality is presented. Causative factors and management strategies are emphasized to enhance the recognition and understanding of mandibular hypomobilities.
Asunto(s)
Mandíbula/patología , Enfermedades Mandibulares/patología , Niño , Tomografía Computarizada de Haz Cónico , Errores Diagnósticos , Terapia por Ejercicio , Humanos , Hiperplasia/diagnóstico por imagen , Hiperplasia/patología , Masculino , Mandíbula/diagnóstico por imagen , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Mandibulares/terapia , Síndrome de la Disfunción de Articulación Temporomandibular/diagnósticoRESUMEN
INTRODUCTION: Keratocystic odontogenic tumours raise particular interest, because of their high recurrence rate and association with nevoid basal cell carcinoma syndrome. OBJECTIVE: To analyze the clinical and histopathological features of all cases diagnosed as keratocystic odontogenic tumour in a Brazilian population. METHODS: A total of 64 keratocystic odontogenic tumours, arising in forty-six patients, were evaluated using the following parameters: association with nevoid basal cell carcinoma syndrome, gender, age at first diagnosis, race, anatomical location, symptoms, radiographic features, history of recurrence, association with teeth, and treatment. RESULTS: Keratocystic odontogenic tumours were more frequent among women than men (1:0.84). The mean patient age was 31.5 years (SD: +/- 16.6). Ten tumours (16.4%) involved the maxilla and 51 (83.6%) the mandible. Swelling (n = 12; 46.1%), followed by pain and swelling (n = 4; 15.3%), were most common clinical manifestations. A unilocular radiotransparency with well-defined margins was the main radiographic finding (n = 29; 87.8%). A significant association was observed between the multilocular radiographic pattern and recurrence (p < 0.05, Fisher's Test). Sixty-one (95.3%) tumours were treated by surgical enucleation followed by bone curettage, and the recurrence rate was 13% (n = 6). This study showed that the keratocystic odontogenic tumours relapsed within a mean period of 25-36 months. CONCLUSION: Despite the results of this study being similar to previous reports found in the literature, it provides an important insight about keratocystic odontogenic tumours in a Brazilian population.
Asunto(s)
Enfermedades Mandibulares , Neoplasias Mandibulares , Enfermedades Maxilares , Quistes Odontogénicos , Tumores Odontogénicos , Adolescente , Adulto , Brasil , Niño , Femenino , Humanos , Masculino , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Mandibulares/terapia , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/terapia , Enfermedades Maxilares/diagnóstico por imagen , Enfermedades Maxilares/terapia , Persona de Mediana Edad , Quistes Odontogénicos/diagnóstico por imagen , Quistes Odontogénicos/terapia , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/terapia , Radiografía , Adulto JovenRESUMEN
PURPOSE: This study describes the technique of lesion enucleation without capsule disruption combined with liquid nitrogen cryotherapy in the surgical treatment of keratocystic odontogenic tumors (KOTs). PATIENTS AND METHODS: Eight patients (9 KOTs) were included in the study. After enucleation, liquid nitrogen was applied twice for 1 minute, with 5-minute intervals between applications. The patients were followed up for 3 to 9 years. RESULTS: There were no recurrences during the follow-up of 9 KOTs for up to 9 years. Only 1 patient had temporary reversible loss of lip sensation after treatment. There were no pathologic fractures. In all cases bone height at the surgical site was restored, and no patients needed bone reconstruction for post-treatment rehabilitation. CONCLUSIONS: This study confirmed the efficiency of KOT treatment enucleation without fragmentation combined with liquid nitrogen cryotherapy at the surgical site.
Asunto(s)
Crioterapia , Enfermedades Mandibulares/terapia , Neoplasias Mandibulares/terapia , Nitrógeno/administración & dosificación , Quistes Odontogénicos/terapia , Tumores Odontogénicos/terapia , Adolescente , Adulto , Niño , Terapia Combinada , Femenino , Humanos , Masculino , Enfermedades Mandibulares/cirugía , Neoplasias Mandibulares/cirugía , Quistes Odontogénicos/cirugía , Tumores Odontogénicos/cirugía , Adulto JovenRESUMEN
PURPOSE: The purpose of this study is to report a case of a patient with a severely atrophic mandible (less than 5 mm) who was treated without bone graft using short implants and internal rigid fixation. PATIENT AND METHODS: A 61-year-old woman was referred to a private clinic in the city of Recife (Brazil) with a severely resorbed mandible (less than 5 mm). The patient reported a history of nearly 15 years of complete edentulism and consecutive treatment failures. Cone beam tomography was performed and severe atrophy was confirmed, revealing total bilateral exposed inferior alveolar nerves. There was a high risk of pathologic mandible fracture, since bone density in critical areas was very low. Treatment of choice was the placement of 4 Shorty (3.75 x 5.5 mm) implants (Nobel Biocare, Göteborg, Sweden) at the symphysis for immediate functional reasons and a 2.0-mm large profile Unilock bone plate (Synthes Maxillofacial, Paoli, PA) to reinforce the mandible. A rapid prototype model was made to help precontour the plate, enabling the insertion of the plate through the transoral approach. RESULTS: A week after surgery, a Brånemark prosthesis protocol was performed and the patient was satisfied with the result. At 29 months after surgery, the patient was still satisfied and had excellent function without complications. CONCLUSIONS: Because of the reported advances in implantology and internal rigid fixation, more patients would be able to improve their severe dental condition without the use of more invasive techniques.
Asunto(s)
Pérdida de Hueso Alveolar/terapia , Placas Óseas , Implantación Dental Endoósea/métodos , Implantes Dentales , Enfermedades Mandibulares/terapia , Procedimientos de Cirugía Plástica/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/instrumentación , Prótesis Dental de Soporte Implantado , Dentadura Completa , Femenino , Humanos , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/rehabilitación , Enfermedades Mandibulares/diagnóstico por imagen , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
A haemophilic pseudotumour is basically an encapsulated haematoma. It is an infrequent complication, estimated to affect 1-2% of severe haemophiliacs, although it has also been reported in patients with mild and moderate haemophilia. A history of trauma is reported in most cases, and the onset of symptoms varies from months to years. The majority of haemophilic pseudotumours are seen in adults and occur in long bones (femur, pelvis, tibia). Here are reported three cases of pseudotumour of the mandible in young patients with mild haemophilia A.
Asunto(s)
Hematoma/etiología , Hemofilia A/complicaciones , Enfermedades Mandibulares/etiología , Adolescente , Niño , Coagulantes/uso terapéutico , Diagnóstico Diferencial , Factor VIII/uso terapéutico , Hematoma/patología , Hematoma/terapia , Humanos , Masculino , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/terapiaRESUMEN
Quantification and assessment of the evolution of painful symptomology in patients with temporomandibular disorders, during the pre-, trans- and post-therapeutic stages is one of the greatest difficulties found by dental surgeons. Various authors have studied and discussed the use of verbal and non-verbal scales for this purpose. Therefore, this study aimed, by means of a combined experimental scale, to assess the evolution of painful symptomology in patients with completely edentulous maxilla and partly edentulous mandible, with Class I or Class II Kennedy prosthetic spaces, treated with flat occlusal appliances, before, during and after 150 of starting treatment. A selection was made of 16 patients with a mean age of fifty-two years, with signs and symptoms of temporomandibular disorders and diminished vertical occlusion dimension. The patients were submitted to treatment with flat occlusal appliances and fortnightly consultations for a period of 150 days. During these consultations, patients recorded their painful symptomology on a combined experimental pain scale. The results obtained were grouped into tables and submitted to the Friedman Test at a level of 5% probability. These revealed statistically significant differences between the values obtained at each assessment made. According to the methodology used and the results obtained, it was concluded that the therapy used was effective and that the experimental scale was efficient for registering the evolution of the symptoms initially detected.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Dimensión del Dolor , Trastornos de la Articulación Temporomandibular , Enfermedades Mandibulares/terapia , Cirugía BucalRESUMEN
Dentre os pacientes portadores de infecções odontogênicas internados no HGJAF (1999-2004), foram analisados dados tais como: sexo, idade, procedência, diagnóstico, tratamento, uso de antibiótico, período de internação e evolução. Houve predomínio de pacientes do sexo masculino (57,32%) entre 21 e 30 anos (32,92%, procedentes do interior (54,88%). Abscesso foi a infecção mais frequente (51,22%). O tratamento medicamentoso predominou (62,20%), com uso de antibióticos (100%), mais frequentemente a penicilina (39,71%). Cinco dias foi o período médio de internação, evoluindo para alta hospitalar (98,78%). O tratamento terapêutico-cirúrgico, apesar de não ter sido o mais frequente, é o de escolha, por obter resultados satisfatórios em menor período
Asunto(s)
Humanos , Masculino , Femenino , Absceso/terapia , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/terapia , Enfermedades Maxilares/patología , Enfermedades Maxilares/terapia , Infecciones Bacterianas/terapia , Distribución por Edad y Sexo , Estudios RetrospectivosRESUMEN
Se realizó un estudio prospectivo durante el año 1999 en 16 niños con maloclusión de clase II división I de Angle, escogidos entre los que acudieron en busca de tratamiento a la Clínica Docente de Santa Clara en el año 1998. Todos usaron el activador abierto elástico de Klammt, pero con diferente magnitud en el avance mandibular: el grupo 1 quedó conformado por pacientes con avance total de la mandíbula y el grupo 2 con un adelantamiento por etapas. Las telerradiografías iniciales y al año, permitieron conocer que en el grupo 1 hubo cambios significativos en la posición mandibular, longitud mandibular y posición de incisivos superiores (p<0,05). En el grupo 2 se observaron estos cambios, pero más marcados (Z con mayor valor absoluto), y aparecen otros como la relación maxilomandibular, la posición del incisivo superior, así como la inclinación y la posición de los incisivos inferiores con respecto a la mandíbula. Concluimos que en ambos grupos hubo cambios significativos en variables esqueléticas y dentarias, pero más marcados y extensos en el grupo con un avance mandibular por etapas(AU)
Asunto(s)
Humanos , Masculino , Femenino , Niño , Aparatos Activadores , Maloclusión Clase II de Angle/terapia , Enfermedades Mandibulares/terapia , Cefalometría/métodosRESUMEN
Se realizó un estudio prospectivo durante el año 1999 en 16 niños con maloclusión de clase II división I de Angle, escogidos entre los que acudieron en busca de tratamiento a la Clínica Docente de Santa Clara en el año 1998. Todos usaron el activador abierto elástico de Klammt, pero con diferente magnitud en el avance mandibular: el grupo 1 quedó conformado por pacientes con avance total de la mandíbula y el grupo 2 con un adelantamiento por etapas. Las telerradiografías iniciales y al año, permitieron conocer que en el grupo 1 hubo cambios significativos en la posición mandibular, longitud mandibular y posición de incisivos superiores (p<0,05). En el grupo 2 se observaron estos cambios, pero más marcados (Z con mayor valor absoluto), y aparecen otros como la relación maxilomandibular, la posición del incisivo superior, así como la inclinación y la posición de los incisivos inferiores con respecto a la mandíbula. Concluimos que en ambos grupos hubo cambios significativos en variables esqueléticas y dentarias, pero más marcados y extensos en el grupo con un avance mandibular por etapas(AU)
A prospective study was conducted during 1999 among 16 children with class II division 1 Angle's maloclussion that were selected among those who seeked treatment at the Dental Teaching Clinic of Santa Clara, in 1998. All of them used the open elastic Klammt's activator-appliance, but with a different magnitude in the mandibular advance. Group 1 was composed of patients with total mandibular advance, whereas patients in group 2 presented an advance by stages. The initial teleradiographies and at a year allowed to know that in group 1 there were significant changes in the mandibular position, mandibular length and the position of upper incisors (P<0.05). These changes were more marked in group 2 (Z with a higher absolute value) and there were others as the maxillomandibular relationship, the position of the upper incisor and the inclination and position of the lower incisors in relation to the mandible. It was concluded that in both groups there were significant changes in skeletal and dental variables, but they were more marked and extensive in the group with a mandibular advance by stages(AU)
Asunto(s)
Humanos , Masculino , Femenino , Niño , Aparatos Activadores/efectos adversos , Enfermedades Mandibulares/terapia , Maloclusión Clase II de Angle/terapia , Cefalometría/métodos , Estudios ProspectivosRESUMEN
The objective of this publication is the description of a clinical case of long evolution that presented the following symptoms: dizziness and transient syncope, and in occasions, it anguishes and sensation of imminent death. The same one was diagnosed as Syndrome of Eagle. It is important to clarify that this pathology presents different clinical variants, belonging one to them those related with the artery carotid what would explain the sensation of eminent death. (AU)