Comminuted mandibular fracture in child victim of dog bite.

Dog bites represent lesions commonly found in Hospital Emergency Clinic. This type of lesion may cause severe harm to patients, but it rarely affects the underlying bone structure causes facial fracture. This study aims to illustrate a rare clinical case in which a pediatric patient presented a comminuted fracture in the mandible which evolved into a unilateral avulsion of the mandibular condyle, body fractures as well as a mandibular ramus and hemiface that had been deformed, with multiple lacerations and loss of soft-tissue mass. Intermaxillary fixation was performed using the Ivy method, followed by internal rigid fixation using miniplates and screws in attempt to reconstruct the child's mandible. After 2 years of follow-up, a satisfactory esthetics and functional results could be observed.

Analgesia and Side Effects of Codeine Phosphate Associated with Paracetamol Versus Oxycodone After the Extraction of Mandibular Third Molars: A Randomized Double-Blind Clinical Trial Using the Split-Mouth Model.

Purpose: To assess the analgesia and side effects of 10 mg oxycodone as compared to 30 mg of codeine phosphate associated with 500 mg of paracetamol after bilateral lower third molar extraction. Methods: This is a prospective, randomized, double-blind study applied to a sample of 16 patients. They were evaluated for seven days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Wilcoxon distribution. The side effects of these medications were assessed by the Q Cochran test. A p value of < .05 was considered statistically significant. Results: The mean score of the VAS of pain was higher in the oxycodone side, where few patients reported the use of rescue analgesic. There was no report of rescue medication in codeine phosphate associated with paracetamol side. The most common side effects reported in both groups, predominantly in patients using the oxycodone, were drowsiness, dizziness, and headache. Conclusion: The use of codeine phosphate associated with paracetamol after the extraction of impacted mandibular third molars is a better choice than oxycodone for controlling postoperative pain. Trial Registration Number and Date of Registration: RBR-8ntwmyq 07/07/2021.

Reliability of panoramic radiography in predicting proximity of third molars to the mandibular canal: A comparison using cone-beam computed tomography.

PURPOSE: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. MATERIALS AND METHODS: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. RESULTS: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal (P<0.05). CONCLUSION: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

Intubação submentoniana para o manejo de vias aéreas em paciente com fratura panfacial: relato de caso

Introdução: As fraturas panfacias apresentam particularidades que exigem maior atenção e interação dos profissionais responsáveis pelo atendimento primário e secundário das vítimas. Nesse contexto, pode-se destacar o correto manejo das vias aéreas. Objetivo: Apresentar o caso clínico de um paciente com fraturas nos três terços da face onde optou-se pela utilização da intubação submentoniana para manejo da via aérea no transoperatório. Relato de caso: Paciente do gênero masculino, 38 anos de idade, vítima de acidente motociclístico, necessitando de abordagem cruenta para fixação das fraturas de face com possibilidade de abordagem em um único momento cirúrgico. Conclusão: A intubação submentoniana demonstrou ser uma técnica de fácil execução quando há conhecimento profundo da anatomia submandibular, devendo ser, portanto, mais difundida entre as equipes multiprofissionais.

An alternative technique using a gutta percha points and blue methylene to excision of congenital fistula of lower lip in patient with Van der Woude syndrome.

Van der Woude syndrome is a rare disorder of craniofacial development, characterized by the triad (congenital lip fistula, cleft lip and/or cleft palate). Discomfort caused by spontaneous or induced drainage of saliva/mucus when pressure is applied or during a meal as well as poor aesthetics match is one of the main complaints of patients with congenital lip fistula. This paper aims to describe an alternative technique for excision of the congenital fistula of lower lip in patient with Van der Woude syndrome, using gutta percha points and methylene blue for better identify the the fullest extent of the fistula. This approach aims to facilitate a dissection of fistula tissues providing better preservation of the tissues around the fistula, faster healing and better aesthetics lip of the patient.

[Prevalence and factors associated to overweight and obesity in public schools]. / Prevalência e fatores associados a sobrepeso e obesidade em escolares da rede pública.

This study assessed the association between environmental factors and the prevalence of overweight and obesity in public schools. It was studied 480 students, by means of anthropometric measurements evaluation, weight and height--BMI by sex and age and in accordance with the parameters of WHO and IOTF. Environmental information was obtained using a questionnaire applied to students. The Epi Info Program, version 3.3.2, was used to data collection and analysis. Prevalence rates of obesity varied according to the criteria it was used. According to the IOTF, prevalence of obesity was 7.1%, while, according parameters of the WHO, the prevalence was 18%. The significant risk factor for obesity was the father obesity (PR = 1.08; CI: 0.57-2.04). We concluded that the nutritional profile of the school serves as a subsidy for tracking trends of overweight in this group. This study could instruct the rationalization of the use of the time and public financial resources, proving the need to invest in the school feeding and in the health students.