RESUMO
Inferior alveolar nerve (IAN) injuries may occur during various dental routine procedures, especially in the removal of impacted lower third molars, and nerve recovery in these cases is a great challenge in dentistry. Here, the IAN crush injury model was used to assess the efficacy of photobiomodulation (PBM) in the recovery of the IAN in rats following crushing injury (a partial lesion). Rats were divided into four experimental groups: without any procedure, IAN crush injury, and IAN crush injury with PBM and sham group with PBM. Treatment was started 2 days after surgery, above the site of injury, and was performed every other day, totaling 10 sessions. Rats were irradiated with GaAs Laser (Gallium Arsenide, Laserpulse, Ibramed Brazil) emitting a wavelength of 904 nm, an output power of 70 mWpk, beam spot size at target â¼0.1 cm2, a frequency of 9500 Hz, a pulse time 60 ns, and an energy density of 6 J/cm2. Nerve recovery was investigated by measuring the morphometric data of the IAN using TEM and by the expression of laminin, neurofilaments (NFs), and myelin protein zero (MPZ) using Western blot analysis. We found that IAN-injured rats which received PBM had a significant improvement of IAN morphometry when compared to IAN-injured rats without PBM. In parallel, all MPZ, laminin, and NFs exhibited a decrease after PBM. The results of this study indicate that the correlation between the peripheral nerve ultrastructure and the associated protein expression shows the beneficial effects of PBM.
Assuntos
Terapia com Luz de Baixa Intensidade , Nervo Mandibular/metabolismo , Nervo Mandibular/patologia , Compressão Nervosa , Neuropeptídeos/metabolismo , Animais , Densitometria , Filamentos Intermediários/metabolismo , Laminina/metabolismo , Masculino , Nervo Mandibular/ultraestrutura , Proteína P0 da Mielina/metabolismo , Ratos WistarRESUMO
Orofacial pain is associated with peripheral and central sensitization of trigeminal nociceptive neurons. Nerve injury results in release of chemical mediators that contribute to persistent pain conditions. The activation of the transient receptor potential vanilloid 1 (TRPV1), promotes release of calcitonin gene-related peptide (CGRP) and substance P (SP) from trigeminal nerve terminals. CGRP and SP contribute to the development of peripheral hyperalgesia. The expression of SP and CGRP by primary afferent neurons is rapidly increased in response to peripheral inflammation. CGRP receptor activation promotes activation of AMPA receptors, leading to increased firing of neurons which is reflected as central sensitization. In this study we investigated whether inferior alveolar nerve (IAN) injury influences AMPA receptors, CGRP, SP and TRPV1 expression in the trigeminal ganglion (TG). The relative expression of the protein of interest from naive rats was compared to those from injured rats and animals that received low level laser therapy (LLLT). IAN-injury did not change expression of GluA1, GluA2 and CGRP, but increased the expression of TRPV1 and SP. LLLT increases GluA1 and GluA2 expression and decreases TVPV1, SP and CGRP. These results, together with previous behavioral data, suggest that IAN-injury induced changes in the proteins analyzed, which could impact on nociceptive threshold. These data may help to understand the molecular mechanisms of pain sensitization in the TG.
Assuntos
Traumatismos do Nervo Facial/radioterapia , Regulação da Expressão Gênica/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Nervo Mandibular/efeitos da radiação , Gânglio Trigeminal/efeitos da radiação , Animais , Peptídeo Relacionado com Gene de Calcitonina/genética , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Traumatismos do Nervo Facial/genética , Traumatismos do Nervo Facial/metabolismo , Traumatismos do Nervo Facial/patologia , Masculino , Nervo Mandibular/metabolismo , Nervo Mandibular/patologia , Neurônios Aferentes/metabolismo , Neurônios Aferentes/patologia , Neurônios Aferentes/efeitos da radiação , Estimulação Luminosa/métodos , Ratos , Ratos Sprague-Dawley , Receptores de AMPA/genética , Receptores de AMPA/metabolismo , Transdução de Sinais , Substância P/genética , Substância P/metabolismo , Canais de Cátion TRPV/genética , Canais de Cátion TRPV/metabolismo , Gânglio Trigeminal/lesões , Gânglio Trigeminal/metabolismoRESUMO
The aim of this study was to present and evaluate a modified technique to inferior alveolar nerve lateralization (IANL) that allows the placement of longer implants in the posterior mandibular region. One hundred and forty-three consecutive patients were enrolled in this study; these patients had between 1.8 and 8mm residual crestal height above the mandibular canal. Vertical splitting of the mandibular body was performed using piezoelectric surgery followed by bone expansion and insertion of special conical implants of 10 and/or 12mm in length. Two hundred and sixty-nine osteotomies were performed and 636 implants were inserted, with a survival rate of 99% at the end of 12 months. Immediately postoperative there was an alteration of sensation in the lip/chin area in 8.5% of cases; 4.1% regained full sensation within 10-14 days, 2.6% after 8 weeks, and 0.7% had persistent paresthesia that did not affect their daily activities. Progressively increasing pain and numbness was present in 1.1%; the implants were removed 6 months postoperatively. This is a relatively simple procedure that has no limitations in clinical situations with minimal bone height. It allows for greater implant stability, and the risk of neurological disturbance is minimal.
Assuntos
Mandíbula/cirurgia , Nervo Mandibular/patologia , Osteotomia/métodos , Piezocirurgia/métodos , Idoso , Processo Alveolar/inervação , Queixo/inervação , Implantação Dentária Endóssea/métodos , Implantes Dentários , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Remoção de Dispositivo , Feminino , Seguimentos , Humanos , Hipestesia/etiologia , Lábio/inervação , Masculino , Mandíbula/inervação , Pessoa de Meia-Idade , Osteotomia/instrumentação , Parestesia/etiologia , Estudos Prospectivos , Análise de SobrevidaRESUMO
Neurofibroma is a benign neoplasm derived from peripheral nerves whose etiology is still unclear. It may present as a solitary lesion or be associated with other diseases such as neurofibromatosis type I and II syndrome. This paper aims to report an extremely rare case of a solitary giant neurofibroma of the mental nerve whose etiology was related to a local trauma. A 14-year-old female patient presented an extensive left facial mass with a size of 7 × 5 × 4 cm, located between the teeth 33 and 37 in the mandible region. It has begun to grow 3 months after a local trauma. Imaging studies were suggestive of a soft-tissue lesion, with minimal bone changes and maintaining the integrity of the mandibular canal and mental foramen. Histopathological tests showed spindle cells with undulated and hyperchromatic nuclei, and sparse cytoplasm in a stroma composed of dense fibrous connective tissue. Immunohistochemistry revealed positive expression for the proteins S-100 and vimentin, confirming the diagnosis of neurofibroma. The patient underwent surgical removal of the lesion by intraoral approach and evolved with an excellent cosmetic result and no signs of recurrence after 2 years of follow up. We report a rare case of solitary giant neurofibroma whose etiology was related to a local trauma. To our knowledge, this is the first report of a mental nerve neurofibroma. Although the etiology remains unclear, we suggest the investigation of local trauma as a possible etiologic factor for solitary neurofibromas of the jaw.
Assuntos
Queixo/inervação , Neoplasias dos Nervos Cranianos/diagnóstico , Traumatismos Faciais/complicações , Neurofibroma/diagnóstico , Adolescente , Núcleo Celular/patologia , Queixo/lesões , Tecido Conjuntivo/patologia , Neoplasias dos Nervos Cranianos/etiologia , Citoplasma/patologia , Feminino , Seguimentos , Humanos , Nervo Mandibular/patologia , Neurofibroma/etiologia , Proteínas S100/análise , Lesões dos Tecidos Moles/complicações , Vimentina/análiseRESUMO
Simple bone cysts are well-defined intraosseous radiolucencies that often extend between the roots and appear clinically like empty cavities. This article aims to provide more information about this lesion with limited prominence in academic literature, to illustrate atypical cases, and to provide a review of the current literature. A series of six atypical cases of simple bone cysts is presented and their clinical, radiographic and microscopic characteristics, differential diagnosis, treatment and follow-up are discussed. Correct diagnosis of this entity is of key importance, since it presents with clinical & radiographic similarities to other bone lesions, some exhibiting more aggressive behaviour.
Assuntos
Cistos Maxilomandibulares/diagnóstico , Doenças Mandibulares/diagnóstico , Adolescente , Adulto , Ameloblastoma/diagnóstico , Diagnóstico Diferencial , Feminino , Seguimentos , Tecido de Granulação/patologia , Humanos , Masculino , Nervo Mandibular/patologia , Pessoa de Meia-Idade , Cistos Odontogênicos/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Cicatrização/fisiologia , Adulto JovemAssuntos
Implantação Dentária Endóssea/métodos , Endoscopia/métodos , Procedimentos Cirúrgicos Bucais/métodos , Adulto , Perda do Osso Alveolar/diagnóstico , Processo Alveolar/inervação , Processo Alveolar/patologia , Endoscópios , Feminino , Humanos , Nervo Lingual/patologia , Masculino , Nervo Mandibular/patologia , Microcirurgia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Dente Serotino/cirurgia , Planejamento de Assistência ao Paciente , Cisto Radicular/cirurgia , Extração Dentária , Alvéolo Dental/patologia , Adulto JovemRESUMO
The aim of this study was to precise the relationships of the auriculotemporal nerve in the infratemporal and parotid regions. We realized micro-dissections of thirty-two infratemporal and parotid regions of human cadaver's formol-fixed. The pattern of origin was: one root: 15.4%, two roots: 73.1%, three roots: 11.5%. In all cases, the lateral root present the major diameter (2-2.5 mm). In those cases with two roots, these formed a neural loop round the middle meningeal artery in the 89.4% of the cases. The origin of the medial root was the posterior border of the inferior alveolar nerve. The median distance between the lateral root and the temporomandibular joint capsule was 1.5 mm, with asymmetric pattern: right: 2 mm (rank: 0-7 mm; ED: 1.90 mm); left: 1.25 mm (rank: 0-3 mm; ED: 0.88 mm). In 10 cases (31.3%) the lateral root was in direct contact with the articular capsule, with asymmetric pattern: left: 46.1%; right: 21%. The median distance between the superior aspect of the articular disk and the trunk of the auriculotemporal nerve in the posterior aspect of the temporomandibular joint was 10,5 mm (ED: 4.06 mm), with asymmetric pattern: right: 9 mm (rank: 5-18.0 mm; ED: 3.70 mm); left: 11.0 mm (rank: 3.0-20 mm; ED: 4.41 mm). We discussed the rol of this findings in the etiology of the Frey's syndrome.
Assuntos
Nervo Mandibular/anatomia & histologia , Sudorese Gustativa , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Masculino , Nervo Mandibular/patologia , Pessoa de Meia-Idade , Glândula Parótida/anatomia & histologia , Sudorese Gustativa/patologia , Articulação Temporomandibular/anatomia & histologiaRESUMO
Este trabajo fue escrito por el primer profesor de la Escuela Dental de Buenos Aires en 1910. Relata un caso clínico interesante que él considera como aneurisma.
Assuntos
Humanos , Masculino , Adolescente , Aneurisma/cirurgia , Aneurisma/diagnóstico , Aneurisma/patologia , Nervo Mandibular/patologia , Argentina , Aneurisma/história , Faculdades de Odontologia/história , Unidade Hospitalar de Odontologia/históriaRESUMO
Este trabajo fue escrito por el primer profesor de la Escuela Dental de Buenos Aires en 1910. Relata un caso clínico interesante que él considera como aneurisma.(AU)
Assuntos
Humanos , Masculino , Adolescente , Aneurisma/diagnóstico , Aneurisma/patologia , Aneurisma/cirurgia , Nervo Mandibular/patologia , Argentina , Unidade Hospitalar de Odontologia/história , Faculdades de Odontologia/história , Aneurisma/históriaAssuntos
Mandíbula/diagnóstico por imagem , Neoplasias Mandibulares/patologia , Dente Molar/cirurgia , Osteoma Osteoide/patologia , Doenças Periapicais/cirurgia , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula/patologia , Mandíbula/cirurgia , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/cirurgia , Nervo Mandibular/patologia , Osteoma Osteoide/diagnóstico por imagem , Osteoma Osteoide/cirurgia , Doenças Periapicais/diagnóstico por imagem , Radiografia , Odontalgia/diagnóstico por imagem , Odontalgia/etiologia , Odontalgia/cirurgia , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this article is to evaluate the bone healing around 2 different dental implant surfaces after the lateralization surgery of the inferior alveolar nerve (IAN) during an 8-week healing period in rabbits, and to check if there is any interaction between the implants and the nerve. MATERIALS AND METHODS: The IAN lateralization was performed in an experimental rabbit model. Eight adult female rabbits (Oryctolagus cuniculus) underwent the surgical procedure, and 1 implant was placed on each side of the mandible while the nerve was lateralized. On both sides, the nerve was repositioned directly in contact with the implant surface. With the intention of obtaining comparative results, smooth titanium implants were installed on the right side, and blasted Al2O3 ones were placed on the left. During the healing period, bone tracers were administered subcutaneously to check different periods of bone ingrowth. RESULTS: Histologic section, regardless of the studied surface, showed bone remodeling around the nerve, without contact between the nerve and the implanted surface. The bone blocks containing implants were histomorphometrically examined through computerized analysis, and the results obtained showed that the bone remodeling around the nerve occurred during the first weeks of healing. Through analysis of variance, the blasted Al2O3 implants showed at least 2.5-fold greater bone neoformation compared with the smooth titanium implants. CONCLUSIONS: Our results showed that there was no significant difference in the healing process concerning the nerve between the 2 studied surfaces. No interaction was detected between the nerve and the implants.
Assuntos
Implantes Dentários , Mandíbula/cirurgia , Nervo Mandibular/cirurgia , Abrasão Dental por Ar , Óxido de Alumínio/química , Análise de Variância , Animais , Remodelação Óssea/fisiologia , Planejamento de Prótese Dentária , Feminino , Processamento de Imagem Assistida por Computador , Mandíbula/patologia , Nervo Mandibular/patologia , Modelos Animais , Osseointegração , Coelhos , Propriedades de Superfície , Titânio/química , Cicatrização/fisiologiaRESUMO
A case is reported in which mental nerve paresthesia was associated with an adhesive resin restoration placed in direct contact with the pulp of a mandibular molar. The restoration was removed, and the paresthesia had completely resolved after nonsurgical endodontic therapy. Epicutaneous patch testing response indicated a possible causal relationship between the filling material and paresthesia.