Evaluation of the Anatomic Position of the Mandibular Canal Regarding to the Segments of the Mandibular Sagittal Split Ramus Osteotomy to Diminish the Possibility of Injuries: a Pilot Study.

Objectives: This pilot study evaluated the relationship between inferior alveolar nerve location through computed tomography scan and intraoperative inferior alveolar nerve entrapment after bilateral sagittal split osteotomy. Material and Methods: Overall, 20 helicoidal computed tomography scans were evaluated in patients with facial deformities who underwent to bilateral sagittal split osteotomy (BSSO). The distance from the mandibular canal to the internal surface of the buccal and lingual cortical bone, mandibular thickness, bone density and proportion of medullary and cortical bone in 3 regions were evaluated. During the intraoperative period, the segment to which the nerve remained adhered after performing BSSO was analysed, and the data correlated. Results: The distance from the mandibular canal to the buccal cortical bone showed a mean of 2.6 mm when the inferior alveolar nerve was adhered to the distal segment and mean of 0.7 mm when the nerve was adhered to the proximal segment. The thickness was 11.2 mm and 9.8 mm when the nerve was adhered the distal the proximal segments respectively. Mandibular thickness, distance from the mandibular canal to the buccal and lingual cortical were statistically related to intraoperative nerve entrapment (P < 0.05). Conclusions: Narrow jaws and the distance from the mandibular canal to buccal cortical bone less than 2 mm increases the risk of the inferior alveolar nerve entrapment in bilateral sagittal split osteotomy.

Laser Therapy in the Treatment of Paresthesia: A Retrospective Study of 125 Clinical Cases.

OBJECTIVE: The aim of this retrospective study was to evaluate the effectiveness of laser therapy for acceleration and recovery of nerve sensitivity after orthognathic or minor oral surgeries, by analysis of clinical records of patients treated at the Special Laboratory of Lasers in Dentistry (LELO, School of Dentistry, University of São Paulo), throughout the period 2007-2013. BACKGROUND DATA: Nerve tissue lesions may occur during various dental and routine surgical procedures, resulting in paresthesia. Laser therapy has been shown to be able to accelerate and enhance the regeneration of the affected nerve tissue; however, there are few studies in the literature that evaluate the effects of treatment with low-power laser on neural changes after orthognathic or minor oral surgeries. METHODS: A total of 125 clinical records were included, and the data on gender, age, origin of the lesion, nerve, interval between surgery and onset of laser therapy, frequency of laser irradiation (one or two times per week), final evolution, and if there was a need to change the irradiation protocol, were all recorded. These data were related to the recovery of sensitivity in the affected nerve area. Descriptive analyses and modeling for analysis of categorical data (α=5%) were performed. RESULTS: The results from both analyses showed that the recovery of sensitivity was correlated with patient age (p=0.015) and interval between surgery and onset of laser therapy (p=0.002). CONCLUSIONS: Within the limits of this retrospective study, it was found that low- power laser therapy with beam emission band in the infrared spectrum (808 nm) can positively affect the recovery of sensitivity after orthognathic or minor oral surgeries.

Tooth fragment embedded in the lower lip after dental trauma: case reports.

Dental traumas are reasonably common, especially in children and adolescents. This report describes two cases in which dental fragments were embedded in the lip soft tissue. Radiographs confirmed the presence of this foreign-body, which were surgically removed under a local anesthesia. Early diagnosis and surgical removal of theses fragments could prevent undesirable foreign-body reaction and scarring. The need in such cases for taking routine facial soft tissue radiographs and chest rx-ray before stating treatment is emphasized.

Incidence of dental trauma associated with facial trauma in Brazil: a 1-year evaluation.

Dental trauma occurs frequently in young people, and mostly occurs in conjunction with facial trauma. In the literature, there are still few reports relating dental trauma, facial trauma, and soft-tissue injuries. This research aimed to evaluate: (i) the overall incidence of dental trauma in 340 patients who presented with facial trauma over a 1-year-period, (ii) the epidemiology of these related diseases, and (iii) the most common dental trauma when a facial trauma was present. Of all facial trauma, 15.29% presented dental trauma, of which luxations and avulsions were the most frequent injuries (40.30% each), occurring mainly on weekends (38.46%) and in October (15.38%), followed by March and June (13.46% each). The sex ratio presented the proportion of 3.3:1 (M:F). Trauma occurred mainly in the second decade (44.23%). These results highlight the high incidence of dental and facial trauma, and suggest the importance of the adoption of appropriate prevention protocols and effective therapeutic methods.