Laser for bone healing after oral surgery: systematic review.

The purpose of this study is to perform a systematic review on the use of lasers in oral surgery for bone healing. Selection of articles was carried out by two evaluators in Pubmed and Web of Science databases for published articles and OpenGray for gray literature. Search strategy was developed based on the PICO Question "Does the use of lasers after oral surgery improve bone healing?". Eligibility criteria were: being on laser; evaluate bone healing; involve oral surgery; do not be about implant, periodontics, orthodontics, osteonecrosis or radiotherapy, nor revisions, clinical cases, etc. Data were collected from each article in a structured spreadsheet and a descriptive analysis was performed. Risk assessment of bias of the articles was carried out through the tool elaborated by the Cochrane collaboration. A total of 827 potentially relevant references were identified. No articles were found in OpenGray. Eleven articles met the eligibility criteria and were included in the systematic review. Most of studies were in vivo and in jaw, being conducted with low-power lasers which were applied immediately after the surgical procedure of extraction. Neoformation and bone density were the outcomes of choice and there was a tendency of increase in bone density, neoformation, regeneration, mineralization, or bone condensation when laser was applied. Regarding the bias risk assessment, studies were not clear in reporting most of the parameters. Low-power laser therapy seems to reduce time of bone healing in oral surgery, although there are no defined protocols and the level of evidence is still considered weak.

Tratamento cirúrgico de fibroma ameloblático: relato de caso / Ameloblatic fibroma surgical treatment: case report

O Fibroma Ameloblático (FA) é um tumor odontológico benigno misto relativamente raro, cujos componentes epiteliais e ectomesenquimais são neoplásicos. O presente estudo teve como objetivo relatar um caso de FA, tratado de forma cirúrgica. Neste estudo um paciente do gênero feminino, 20 anos, foi encaminhado para avaliação de imagem radiolúcida e multilocular em região de mandíbula esquerda, com primeiro e segundo molares envolvidos na lesão. Após o diagnóstico de FA, o tratamento realizado foi a enucleação do tumor associado a uma ostectomia periférica da loja cirúrgica com broca multilaminada de grosso calibre. Após três anos de acompanhamento clínico e radiográfico não houve sinais de recidiva, obtendo-se, assim, um prognóstico favorável

Ameloblastoma sólido, diagnóstico e tratamento: relato de caso clínico / Solid ameloblastoma, diagnosis and treatment: clinical case report

O ameloblastoma é um tumor odontogênico de origem epitelial, que representa cerca de 10% a 30% dos tumores odontogênicos. Consiste em um tumor benigno que acomete frequentemente região posterior de mandíbula, com crescimento lento e localmente invasivo, muito embora possa ter altas taxas de recidivas. A ressecção de um segmento mandibular, sem reconstrução adequada, terá como consequência sequelas estéticas e funcionais. O objetivo deste artigo é abordar as condutas empregadas diante de um achado radiográfico de um paciente com ameloblastoma sólido, porém com aspecto unicístico e sem qualquer sintomatologia dada o tamanho da lesão. O relato do caso clínico mostra uma paciente de 65 anos de idade, com diagnóstico de ameloblastoma do tipo sólido em região de corpo mandibular esquerdo tratada com ressecção do segmento ósseo comprometido. Para a reconstrução mandibular utilizou-se placa reconstrutiva e parafusos de titânio do sistema 2.4mm. O caso clínico não apresentou recidiva em sete anos de acompanhamento. Conclui-se que o diagnóstico é soberano somente com o exame anatomopatológico, sendo as características clínicas e radiográficas dados auxiliares na hipótese diagnóstica da lesão e o tratamento com ressecção da lesão e sua reconstrução funcional garante baixas taxas de recidiva.

The ameloblastoma is an odontogenic tumor of epithelial origin, which represents about 10% to 30% of odontogenic tumors. It consists in a benign tumor that often affects the posterior mandible region, with slow-growing and locally invasive, although it may have high rates of recurrence. The resection of a mandible segment, without adequate reconstruction will result in aesthetic and functional sequelae as a consequence. The objective of this article is to broach the procedures used in front of a radiographic discovery of a patient with solid ameloblastoma, but with unicystic aspect and without any symptoms given the lesion size. The clinical case report shows a 65 years old patient, diagnosed with solid kind of ameloblastoma in the left mandible body region treated with resection of the implicated bone segment. For the mandibular reconstruction was used reconstructive plate and titanium screws system 2.4mm. The clinical case did not present recurrence in seven years of monitoring. We conclude that the diagnosis is only sovereign with anatomopathological examination, so that the clinical and radiographic characteristics data aids in the lesion diagnostic hypothesis and treatment with lesion resection and its functional reconstruction guarantees low recurrence rates.