RESUMO
This study reports the case of a patient with a severely resorbed mandible who was treated without a bone graft, using short implants, internal rigid fixation, rhBMP-2 and ß-tricalcium phosphate. A 76-year-old woman, with a severely resorbed mandible (less than 3mm), reported a history of nearly 25 years of complete edentulism and consecutive treatment failures, with total bilateral exposed inferior alveolar nerves and complete bone resorption of the inferior border in some areas. The treatment of choice was the placement of a 2.0mm thick unilock bone plate (MatrixMandible, Synthes Maxillofacial, Paoli, PA, USA), to reinforce the mandible. Eight short implants with a regular platform (Nobel Biocare, Goteborg, Sweden) were placed: three on the external oblique line on both sides and two on the symphysis. In order to augment mandible height and coat the exposed thread of the anterior implants, rhBMP-2 (Infuse Bone, Meditronic Sofamor Danek, Memphis, TN, USA) and ß-tricalcium phosphate (Cerasorb; Curasan, Kleinostheim, Germany) were used. Four 1.3 mmL miniplates were placed to support the graft. 14 months after surgery, the patient was satisfied and had excellent function without complications.
Assuntos
Proteína Morfogenética Óssea 2/uso terapêutico , Doenças Mandibulares/tratamento farmacológico , Idoso , Proteína Morfogenética Óssea 2/administração & dosagem , Implantes Dentários , Feminino , Humanos , Doenças Mandibulares/patologia , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêuticoRESUMO
OBJECTIVE: The purpose of the present study was to assess the knowledge regarding emergency management of tooth avulsion among elementary schoolteachers in the city of Jaboatão dos Guararapes, Pernambuco, Brazil. MATERIALS AND METHODS: A total of 338 teachers answered a questionnaire with items on emergency procedures following tooth avulsion. RESULTS: The majority of teachers (89.1%) had received no previous orientation regarding management of dental trauma and 81.4% had not witnessed an accident in which tooth avulsion had occurred. If an avulsed tooth had fallen to the ground, 84.3% of the teachers said they would pick it up, and 67.8% of them stated that they would clean it with water or some other liquid. A total of 33.1% said that they would take the student with the tooth in hand to a dental office. Of the respondents 88.5% would seek professional help immediately; 85.2% stated they would be unable to reimplant the avulsed tooth; and 39.3% would store the tooth in water. CONCLUSIONS: A lack of technical information was observed among teachers regarding management of tooth avulsion. Educational campaigns at schools are necessary to modify the behavior of the teachers with regard to management of tooth avulsion. Further studies should be carried out for the assessment of teachers who have participated in educational campaigns to make the treatment of dental trauma a matter of public interest.