RESUMO
Aim: To investigate the bacteriological profile of oral and maxillofacial infections and the pattern of sensitivity to a specific group of antibiotics in a reference emergency hospital in Brazil. Methods: This is a prospective cohort institutional study that studied patients affected by oral and/ or maxillofacial infections in a Brazilian emergency hospital, over a 12-month period, of different etiologies, through data collection, culture and antibiogram tests, and monitoring of the process of resolution of the infectious condition. The variables were analyzed using the chi-square and Mann-Whitney tests, using a significance level of 5%. Results: The sample consisted of 61 patients, 62.3% male. The mean age of participants was 34.3 years. Odontogenic infection was the most frequent etiology and the submandibular space was the most affected. The bacterial species Streptococcus viridans was isolated in 21.6% of cases. Levofloxacin, vancomycin and penicillin were the antibiotics with the highest frequency of bacterial sensitivity, while clindamycin and erythromycin showed the highest percentages of resistance. Conclusions: The results suggest that, among the most used antibiotics for the treatment of these infections, penicillin remains an excellent option of choice for empirical therapy
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Infecção da Ferida Cirúrgica , Bactérias/efeitos dos fármacos , Resistência Microbiana a Medicamentos , Infecção Focal Dentária , AntibacterianosRESUMO
A Cirurgia e Traumatologia Buco-Maxilo-Facial (CTBMF) é uma especialidade da Odontologia que tem como objetivo o diagnóstico e o tratamento das doenças, traumatismos, lesões e anomalias, congênitas e adquiridas, do aparelho mastigatório e anexos, e estruturas crânio-faciais associadas. Metodologia: Estudo descritivo, tipo relato de experiência, realizado a partir das vivências dos alunos envolvidos no projeto. O projeto promove discussões sobre agravos de saúde comuns na comunidade via palestras nos ambulatórios de cirurgia da FOP/UPE, atua através de postagens nas redes sociais sobre temas de grande importância em cirurgia bucal e de reuniões com aulas ministradas que provêm fundamentação teórica para capacitação dos alunos. Resultados: Desde sua fundação, a LABMF promove ações ambulatoriais para promover troca de conhecimentos sobre a CTBMF, desmistificar e instruir a população sobre exodontias e a importância do autoexame bucal. Atua com mutirões para atender a população em espera, e promove encontros científicos, proporcionando integração com outras faculdades. Conclusão: O projeto proporciona ao aluno a oportunidade de aprofundar seus conhecimentos em CTBMF e a desenvolver e aprimorar competências relacionadas à educação em saúde, liderança, comunicação, e outros. Ainda, provém retorno à população geral, repassando informações e conhecimentos pertinentes à sua saúde, tornando-os multiplicadores do saber... (AU)
Oral and Maxillofacial Surgery and Traumatology (CTBMF) is a specialty of Dentistry that aims to diagnose and treat diseases, traumas, injuries, and anomalies, congenital and acquired, of the masticatory system and appendages, and craniofacial structures associated. Methodology: Descriptive study, experience report type, carried out based on the experiences of the students involved in the project. The project promotes discussions about common health problems in the community via lectures at the FOP/UPE surgery outpatient clinics, works through posts on social media on topics of great importance in oral surgery, and meetings with classes taught that provide theoretical foundations for training professionals. students. Results: Since its foundation, LABMF has promoted outpatient actions to promote the exchange of knowledge about CTBMF, demystify and educate the population about extractions and the importance of oral self-examination. It works with joint efforts to assist the waiting population and promotes scientific meetings, providing integration with other faculties. Conclusion: The project provides students with the opportunity to deepen their knowledge in CTBMF and to develop and improve skills related to health education, leadership, communication, and others. Furthermore, it provides feedback to the general population, passing on information and knowledge relevant to their health, making them multipliers of knowledge... (AU)
La Cirugía y Traumatología Oral y Maxilofacial (CTBMF) es una especialidad de la Odontología que tiene como objetivo diagnosticar y tratar enfermedades, traumatismos, lesiones y anomalías, congénitas y adquiridas, del sistema masticatorio y apéndices, y estructuras craneofaciales asociadas. Metodología: Estudio descriptivo, tipo relato de experiencia, realizado a partir de las vivencias de los estudiantes involucrados en el proyecto. El proyecto promueve discusiones sobre problemas de salud comunes en la comunidad a través de charlas en los ambulatorios de cirugía de la FOP/ UPE, trabaja a través de publicaciones en redes sociales sobre temas de gran importancia en cirugía bucal y encuentros con clases impartidas que brindan fundamentos teóricos a la formación de profesionales. Resultados: Desde su fundación, LABMF ha impulsado acciones ambulatorias para promover el intercambio de conocimientos sobre el CTBMF, desmitificar y educar a la población sobre las extracciones y la importancia del autoexamen bucal. Trabaja en conjunto para atender a la población en espera y promueve encuentros científicos, brindando integración con otras facultades. Conclusión: El proyecto brinda a los estudiantes la oportunidad de profundizar sus conocimientos en CTBMF, y desarrollar y mejorar habilidades relacionadas con la educación para la salud, el liderazgo, la comunicación y otros. Además, retroalimenta a la población en general, transmitiéndole información y conocimientos relevantes para su salud, convirtiéndola en multiplicadora de conocimientos... (AU)
Assuntos
Humanos , Masculino , Feminino , Faculdades de Odontologia , Estudantes de Odontologia , Cirurgia Bucal , Cirurgiões BucomaxilofaciaisRESUMO
Abstract This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.
RESUMO
A infecção pelo novo Coronavírus (SARS-CoV-2), caracterizada por um conjunto de alterações que podem evoluir para síndrome respiratória aguda grave, teve início na China, no final de 2019, sendo assim denominada de doença pelo coronavírus 2019 (COVID-19). Além de danos físicos, que em alguns casos leva à morte, a COVID-19 tem impactado na forma de atuação de diversos profissionais de saúde em relação a sua conduta com os pacientes. O objetivo desse estudo foi avaliar a percepção e conduta dos Cirurgiões Dentistas da área de Cirurgia e Traumatologia Bucomaxilofaciais frente à pandemia de Covid-19. Foi realizada uma entrevista semiestruturada de abordagem qualitativa com os profissionais atuantes desta especialidade, pertencentes a um grupo de aplicativo de mensagens (WhatsApp), para melhor compreensão da percepção relacionada à sua rotina odontológica durante a pandemia do COVID-19. Após a transcrição das falas, na íntegra, foi realizada a leitura criteriosa do material coletado seguido da análise de conteúdo, segundo a teoria helleriana em seu referencial teórico do cotidiano, para interpretar as memórias relatadas dos participantes. A amostra do estudo foi constituída por 9 especialistas, sendo 6 do sexo masculino com idade média de 34,8 anos e variando de 30 a 41 anos. Quatro temas foram identificados: percepção dos profissionais sobre a odontologia, biossegurança, impressões psicossociais dos profissionais e impacto no atendimento. O desconhecimento da doença e o medo de se contaminar durante o atendimento foram as principais causas de alterações no ritmo de trabalho. Houve um pensamento comum sobre aumento de barreiras de biossegurança e maior sensação de segurança. A necessidade de isolamento social para contenção do vírus determinou o afastamento, em grande parte, entre profissionais e seus familiares ocasionando altos níveis de ansiedade. Houve repetitivos relatos sobre lentidão e diminuição nos atendimentos com relação direta à perda financeira, agravando o estresse. Em conclusão, foi possível perceber que os profissionais desta especialidade tiveram suas vidas profissionais e pessoais afetadas em relação aos hábitos diários, convívio familiar e desgaste financeiro capazes de alterar de maneira impactante seus níveis de estresse e ansiedade.
Infection by the new Coronavirus (SARS-CoV-2), characterized by a set of changes that can progress to a severe acute respiratory syndrome, began in China in late 2019, thus being called coronavirus 2019 disease (COVID-19). In addition to physical damage that in some cases leads to death, COVID-19 has had an impact on the way many health professionals act and their conduct with patients. This study aimed to assess the perception and conduct of Dentists of Oral and Maxillofacial Surgeons regarding the Covid-19 pandemic. A semi-structured interview with a qualitative approach was carried out with professionals working in this specialty belonging to a messaging application group (WhatsApp), to better understand the perception related to their dental routine during the COVID-19 pandemic. After transcribing the speeches in full, collected material was carefully read, followed by content analysis according to the Hellerian theory in its daily theoretical framework, to interpret the participants' reported memories. The study sample consisted of 9 specialists, 6 males with a mean age of 34.8 years and ranging from 30 to 41 years. Four themes were identified, such as professionals' perception of dentistry, biosafety, professionals' psychosocial impressions, and impact on care. The lack of knowledge about the disease and the fear of being contaminated during care were the main causes of changes in the work routine. There was common thinking about increasing biosafety barriers and a greater sense of security. The need for social isolation to contain the virus determined the distance, in large part, between professionals and their families, causing high levels of anxiety. Repetitive reports of slowness and decrease in attendance as a direct relationship of financial loss, aggravating stress. In conclusion, it was possible to notice that professionals in this specialty had their professional and personal lives affected concerning daily habits, family life, and financial strain, impacting their levels of stress and anxiety.
Assuntos
Medidas de Segurança , Clínicas Odontológicas , Pesquisa Qualitativa , Odontólogos , Cirurgiões Bucomaxilofaciais , SARS-CoV-2RESUMO
ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.
RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Fraturas Orbitárias/cirurgia , Fraturas Cranianas/cirurgia , Fraturas Zigomáticas/cirurgia , Ossos Faciais/lesões , Fixação Interna de Fraturas , Fraturas Mandibulares/cirurgia , Fraturas Maxilares/cirurgia , Osso Nasal/cirurgia , Fraturas Orbitárias/etiologia , Fraturas Orbitárias/epidemiologia , Fraturas Cranianas/etiologia , Fraturas Cranianas/epidemiologia , Fraturas Zigomáticas/etiologia , Fraturas Zigomáticas/epidemiologia , Brasil/epidemiologia , Análise de Sobrevida , Estudos Retrospectivos , Recuperação de Função Fisiológica , Ossos Faciais/cirurgia , Fraturas Mandibulares/etiologia , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/etiologia , Fraturas Maxilares/epidemiologia , Pessoa de Meia-Idade , Osso Nasal/lesõesRESUMO
The Pterygospinous Ligament (PSL) extends from the Pterygospinous process of the lateral Pterygoid plate to the spine of the sphenoid bone. Sometimes, it may be ossified forming a bar of bone bounding the pterygospinous foramen to which mandibular nerve and its branches are variably related. Mandibular and chorda tympani nerves may get compressed depicting various clinical symptoms, which in turn depend upon dimensions of the foramen and grades of compression. Therefore, knowledge of the position and extent of ossification of PSL and its relation to the important structures in the deep infratemporal fossa is important for radiologists, neurologists, maxillofacial surgeons, dental surgeons and anesthesiologists during various anesthetic and surgical procedures.
El ligamento Pterigoespinoso (LP) se extiende desde el proceso Pterigoespinoso de la placa Pterigoideo lateral a la espina etmoidal del hueso esfenoides. A veces, se puede osificar formando un puente de hueso que une el foramen espinoso con el cual el nervio mandibular y sus ramas están relacionados de manera variable. Los nervios mandibulares y el cordón timpánico se pueden comprimir resultando en diversos síntomas clínicos, que a su vez dependen de las dimensiones del foramen y los grados de compresión. Por lo tanto, el conocimiento de la posición y el grado de osificación del ligamento pterigoespinoso y su relación con las estructuras importantes en la fosa infratemporal profunda es importante para radiólogos, neurólogos, cirujanos maxilofaciales, cirujanos dentales y anestesistas durante diversos procedimientos anestésicos y quirúrgicos.
Assuntos
Humanos , Osso Esfenoide , Ligamentos/anatomia & histologia , Nervo Mandibular , Edificação em Ponte , Forame Oval , Fossa InfratemporalRESUMO
ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%), followed by motor vehicle accidents (14.2%), motorcycle accidents (13.4%), falls (9%), road accidents (6.7%), sports accidents (5.2%), work accidents (5.2%), firearm injuries (4.5%) and cycling accidents (3%). The most frequent fractures were those of the zygomatic complex (44.5%), followed by fractures of the mandible (42.5%), maxillary bone (5.2%), nasal bones (4.5%) and zygomatic arch (3.3%). Conclusion: the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.
RESUMO Objetivos: pesquisar a incidência e etiologia dos traumas de face com diagnóstico de fratura facial atendidos no Serviço de Cirurgia e Traumatologia Bucomaxilofacial do Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre. Métodos: estudo epidemiológico, transversal, retrospectivo de 134 pacientes vítimas de trauma com 153 fraturas faciais. Resultados: o gênero mais acometido foi o masculino (86,6%) e sua incidência foi maior na faixa etária dos 21 aos 30 anos. A principal etiologia foi a agressão (38,8%), seguida de acidentes automobilísticos (14,2%), acidentes motociclísticos (13,4%), quedas (9%), atropelamentos (6,7%), acidentes esportivos (5,2%), acidentes de trabalho (5,2%), ferimentos por arma de fogo (4,5%) e acidentes ciclísticos (3%). As fraturas mais frequentes foram as do complexo zigomático (44,5%), seguidas das fraturas da mandíbula (42,5%), osso maxilar (5,2%), ossos próprios nasais (4,5%) e arco zigomático (3,3%). Conclusões: as fraturas do complexo zigomático e da mandíbula foram as de maior incidência nos traumas de face, e tiveram como principal causa as agressões físicas.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Idoso , Adulto Jovem , Fraturas Ósseas/etiologia , Fraturas Ósseas/epidemiologia , Ossos Faciais/lesões , Brasil/epidemiologia , Incidência , Estudos Transversais , Estudos Retrospectivos , Hospitais , Pessoa de Meia-IdadeRESUMO
Aim: to evaluate, using the Scopus database, the input and output citation pattern in the year 2015 for documents published in the five main oral and maxillofacial (OMS) journals. Methods: All document types published over the 20132015 period by the five main OMS journals: BJOMS, JOMS, IJOMS, JCMFS and JCFS were included. Citation and referencing data were extracted from the advanced search of Scopus. Results: A total of 2303 documents were published by the journals in 2015, and 3253 documents published in 2015 cited documents published by the journals in 2013 and 2014. Self-citation was 13.19 percent for the five journals as a whole, and 1024 (31.49 percent) documents cited journals from within the group. A total of 36,972 references were included in documents published in 2015 in the journals. Self-referencing was 6.56 percent for all journals as a group, and 7524 (20.35 percent) documents were from the group itself. From the top-20 referenced and citing journals, the presence of plastic and reconstructive surgery, and head and neck (otolaryngology) surgery journals is clear. This pattern was not the same across all the journals under study. Conclusion: There appears to be a medical versus dental fragmentation of research in the specialty, over a fragmentation by regions or countries.