Which devices can be used to decompress odontogenic cystic lesions in the oral cavity? A systematic review.

Odontogenic cysts are bony lesions in the jaws that can reach large sizes. Decompression, a technique that helps in their surgical treatment, aims to reduce their size. We aimed to conduct a systematic review of the main types of device used for the decompression of odontogenic cysts and to analyse the indications, types, advantages, and disadvantages of the devices used. We searched PubMed, Science Direct, LILACS, EMBASE, and Web of Science until February 2023, with no time restriction. We considered studies with a minimum of 10 patients published only in English, those that reported cases and case series, randomised clinical trials of the decompression of odontogenic cysts, and the types of devices used during the decompression period. All reported odontogenic cysts had to have been confirmed by biopsy in their respective publications. We found 713 articles in the selected databases. After removing duplicates, 499 remained. After reading the titles and abstracts, we excluded 461 articles so 38 remained. Nine studies were selected for the review, totalling 244 patients. A total of 206 lesions were identified and confirmed by anatomopathological examination: 123 keratocysts, 40 dentigerous cysts, 34 radicular cysts, one cyst of epithelial origin but without specification, and eight unicystic ameloblastomas. Although we did not find out which device is best for the decompression of odontogenic cysts, our findings show that those that are most effective should be as comfortable as possible and should remain in place. They should have stability in the oral cavity and be easy for the patient to clean.

Risco de contaminação por príon e desenvolvimento da doença de Creutzfeldt- Jakob em cirurgias orais quando se utiliza enxerto ósseo bovino: uma revisão sistemática / Risk of prion contamination and development of Creutzfeldt-Jakob disease in oral surgeries when using bovine bone graft: a systematic review

A Doença Creutsfeldt- Jacob (DCJ) é caracterizada por alterações neurodegenerativas através do acúmulo da proteína príon codificada (PrPC), nos órgãos linfoides, músculos esqueléticos e no SNC, sua forma vDCJ é a única que apresenta evidências de transmissão dos príons a partir da ingestão de alimentos de origem bovina contaminados. Há possibilidade de transmissão de príons por meio da utilização de enxertos ósseos bovinos em pacientes que necessitam de reconstrução e aumento de dimensão óssea resultantes de perdas dentárias e procedimentos reabilitadores da cavidade oral com implantes dentários, sendo esses pacientes aptos pelos bancos de sangue a doar sangue, surgindo o risco de transmissão, o que propagaria a disseminação da doença. Esta revisão teve como objetivo avaliar o risco de contaminação por príons e o desenvolvimento da doença de Creutzfeldt-Jakob ao uso de enxerto ósseo xenógeno de origem bovina, utilizado em procedimento cirúrgico odontológico. As bases de dados Pubmed, Web of Science, Scopus, LILACS, EMBASE, Google Scholar e Open grey foram pesquisadas almejando trabalhos publicados na língua inglesa, até março de 2021. Dos 2518 artigos potencialmente relevantes, 6 foram selecionados, porém nenhum incluído para o trabalho final, pois avaliaram outras formas de abordagem, riscos através do processo de esterilização e uso de instrumentais contaminados. Portanto, conclui-se que atualmente não há evidências científicas na literatura sobre o risco de contaminação do uso de osso bovino em reabilitações odontológicas, existindo apenas uma plausibilidade biológica.

Surgical techniques for pleomorphic adenoma in the hard palate: A case report and literature review

Objective: To report a case of pleomorphic adenoma that was surgically removed and to describe the surgical technique available to remove this lesion. Case Report: A male patient, caucasian, 46 years old, with a 4-year history of pleomorphic adenoma. He mentioned that he went to other services for treatment, but without success. He came at our service for treatment with tumoral excision. Local anesthesia was performed with mepivacaine with a vasoconstrictor and tumoral excision was performed with the overlying mucosa and the periosteal region to avoid recurrence. The patient has been under postoperative follow-up for two years without recurrence. Conclusion: Pleomorphic adenoma is a benign tumor and presents as a submucosal mass of slow growth. The ideal treatment for the Pleomorphic Adenoma tumor is the total excision of the lesion with the removal of the mucosa covering the region to avoid recurrence. (AU)

Maintenance of the buccal fat pad (Bichat) as a resource for regional grafting: A case report and literature review

Objective: Report a case of pyogenic granuloma with two years of evolution, three previous removals with external oral and maxillofacial surgeons, and new recurrences. Case Report: A 25-year-old male patient with a history of a pyogenic granuloma with two years of evolution had three previous removals with external maxillofacial and had relapses. The treatment indicated after these relapses were the extraction of the involved teeth and the lesion, performing the closure with a buccal fat pad flap. The lesion underwent metaplasia, transforming into mucosa.Conclusion: This case emphasizes keeping the buccal fat pad as a possible future resource for regional grafting. (AU)

Retrospective study of gunshot wounds in the face in a large hospital in Latin America: a two-year analysis

Objective: This study aims to compare data relating to gender, age, etiology, fractured areas, procedures performed, follow-up and purpose from September 2013 to July 2015. This retrospective study included patients whose medical records were complete and who presented face fractures due to gunshot wounds. Results: A total of 1289 patients diagnosed with fractures in the head and neck region were evaluated, of which only 13 patients had facial fractures caused by firearms. Stabilization of facial fractures with rigid internal fixation should be performed as soon as possible to avoid sequelae to the patient, which was conduc-ted in 8 patients. Conclusions: The study found that male and young patients are the most affected by fire injuries to the face due to the high rate of violence, cultural and socioeconomic differences in the city of São Paulo. Fracture stabilization must be performed as soon as possible to avoid future sequelae. Therefore, the study found that the care of facial trauma by firearm does not have a strict protocol; it depends on the extent and severity of each case. (AU)