A Novel Analysis via Micro-CT Imaging Indicates That Chemically Modified Tetracycline-3 (CMT-3) Inhibits Tooth Relapse after Orthodontic Movement: A Pilot Experimental Study.

OBJECTIVE: To evaluate the effect of chemically modified tetracycline-3 (CMT-3) and simvastatin on tooth relapse after orthodontic movement in rats using a novel analysis method employing high-resolution micro-CT (Micro-CT) images. In addition, the correlation between bone density and orthodontic relapse was also evaluated for each experimental group. METHODS: Forty adult male Wistar rats had stainless steel springs installed on their left upper first molars in order to generate tooth movement for 18 days. After this initial period, the animals were divided into three groups: (1) 30 mg/kg of CMT-3; (2) 5 mg/kg of simvastatin; and (3) 0.5% carboxymethylcellulose, and each group was treated for 20 days. Micro-CT images were analyzed (conventional method and 3D reconstruction) on the 7th and 18th days following spring fixation and finally, 20 days after treatment either with CMT-3 or simvastatin (38th day). Bone mineral density (BMD) of the mesial and distal roots of the upper first molar was also analyzed. RESULTS: The difference was statistically significant between the groups as to recurrence (p=0.048), and the post hoc test identified the value of p=0.007 between the control group and the CMT-3 group. Simvastatin was not able to inhibit tooth relapse. The bone mineral densities of both the mesial and distal roots were different between the three groups, after the 20th day of drug use (p=0001 and p < 0001). CONCLUSION: Our findings support the initial evidence that CMT-3 is able to prevent relapse after tooth movement. Future trials in humans should evaluate such treatment as a promising approach to preventing this common phenomenon. CLINICAL RELEVANCE: Considering the results obtained, CMT-3 can be used to avoid relapse after tooth movement.

Avaliação dos efeitos da fibrina rica em plaquetas (FRP) comparada a um anti-inflamatório não esteroidal (AINE) na resposta inflamatória e reparadora de defeitos críticos em calota de ratos / Evaluation of the effects of Platelet Rich Fibrin (PRF) compared to an Non-Steroidal (NSAID) in the inflammatory and repair of critical defects in rat's calvaria

O objetivo deste estudo foi avaliar a influência da Fibrina Rica em Plaqueta (FRP) no processo inflamatório em defeitos críticos em calotas de ratos e sua consequente reparação tecidual. Foram utilizados 128 (cento e vinte e oito) ratos (Rattus norvegicus, albinus, Wistar), adultos, com peso corporal entre 450 e 500g. Os animais foram divididos aleatoriamente em 4 grupos equitativos que compuseram a amostra do trabalho, onde no grupo coágulo (GC) foi realizado o defeito ósseo de tamanho crítico preenchido com coágulo sanguíneo; grupo anti-inflamatório não esteroidal (AINE) que teve os defeitos de tamanho crítico preenchidos com coágulo sanguíneo e administrado cetoprofeno (10mg/kg dia); o grupo fibrina rica em plaquetas (FRP) com defeitos de tamanho crítico preenchidos com preparado de fibrina rica em plaquetas autóloga; e o grupo fibrina rica em plaquetas mais AINE (FRP + AINE) com defeitos de tamanho crítico preenchidos com preparado de fibrina rica em plaquetas autóloga e administrado cetoprofeno (10mg/kg dia). Cada grupo foi avaliado nos períodos de 2, 7, 14 e 28 dias e os espécimes analisados através da histometria, micro-CT e teste ELISA para presença de TNFα. Os dados quantitativos foram submetidos aos testes estatísticos ANOVA 1/2 fatores ou Kruskal-Wallis e pos Tukey e Dunn (p<0,01). Os resultados histométricos e microtomográficos evidenciaram maior formação óssea para o grupo PRF em comparação aos demais grupos (p<0,05) e menor presença de TNF-alfa no período inicial no grupo PRF comparado ao grupo controle (p<0,05). Conclui-se que o PRF foi favorável desde os períodos iniciais até os mas tardios, auxiliando na resposta inflamatória e neoformação óssea(AU)

The objective of this study was to evaluate the influence of Platelet Rich Fibrin (PRF) on the inflammatory process in critical defects in rat calvaria and its consequent tissue repair. One hundred twenty-eight adult rats (Rattus norvegicus, albinus, Wistar) with body weight between 450 and 500g were used for the study. The animals were randomly divided into 4 equitable groups that composed the work sample. In the clot group (GC) the critical size defect was filled with blood clot; the non-steroidal anti-inflammatory group (NSAID) had the critical size defects filled with blood clot and ketoprofen was given pos-operatively (10mg / kg day); the platelet-rich fibrin group (FRP) had the critical-size defects filled with autologous platelet-rich fibrin preparation; and platelet-rich fibrina group plus NSAIDs (FRP + NSAID) had the critical-size defects filled with autologous platelet-rich fibrin preparation and administered ketoprofen post-operatively (10mg / kg day). Each group was evaluated at 2, 7, 14 and 28 days after the surgical procedures. The samples were evaluated through histometry, micro-CT and ELISA for the presence of TNFα. The quantitative data were submitted to the statistical test ANOVA 1/2 factors or Kruskal-Wallis and post Tukey and Dunn (p <0.01). The histometric and microtomographic results showed higher bone formation for the PRF group compared to the other groups (p <0.05) and lower TNF-alpha in the initial period in the PRF group compared to the control group (p <0.05). It was concluded that the PRF was favorable since the beginning through the later periods, aiding in the inflammatory response and bone neoformation(AU)

Bone regeneration with recombinant human bone morphogenetic protein 2: a systematic review.

AIM: The aim of this work was to perform a systematic literature review on the clinical application of rhBMP-2 in bone reconstruction prior to placing implants. MATERIALS AND METHODS: A PUBMED search was made about the subject and nine clinical trials were selected according to strict inclusion criteria. RESULTS: Overall success rates of bone regeneration with rhBMP-2 was 81.4% and success of implants placed was 87.4%. Most frequent adverse events were pain, edema and erythema. CONCLUSION: It was concluded that the treatment with rhBMP-2 foi satisfactory in most cases and the placement of dental implants in the bone regenerated with rhBMP-2 is feasible.

Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child.

Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.

Retrieval of a Broken Dental Needle Close to the Facial Artery After Cervical Migration.

Use of imaging tools like digital C-arm, tridimensional tomography, and navigational surgery has proven its value to the surgical removal of broken needles. A 32-year-old patient was referred for evaluation of a fractured needle during inferior alveolar nerve block attempt few days before. The patient complained of a pricking sensation at the injured area while moving the neck. A contrasted computed tomography was performed for further evaluation of the needle toward the vascular network of the neck, showing a close location by the left facial artery, parallel to the styloid process of the temporal bone. The needle was then released from the underlying tissues and retrieved. Although considered a rare intercurrence, there are still reports of breaking needles during dental anesthesia. Such reports are almost always related to inferior alveolar nerve blocks, associated with the use of short, thin needles, and after multiple bending movements before the insertion of the needle in the tissues. Accurate image examinations such as contrasted computed tomography are of great importance for planning the surgical removal, especially in patients of migration next to important vessels of the neck.

The Use of Foley Catheter for Treatment of Unstable Fracture Zygomatic Arch.

The isolated zygomatic arch fractures represent 21% of zygomatic-maxillary fractures and the falls is the main etiology. This type of fracture is easily reduced through several methods and the most used is the reduction through the surgical temporal approach of Gillies. The present patient illustrates the success treatment of a patient with isolated zygomatic arch fracture which a Foley catheter was used to stabilize the fracture reduction.

Bilateral Incomplete Cleft Lip.

Patients with cleft palate and cleft lip have severe functional and aesthetic problems, if this deformity is not treated properly and in time, can also cause psychological and aesthetic problems to the patients. This study reports a case of a 22-year-old patient with incomplete bilateral cleft lip, addressing aspects related to the diagnosis, treatment planning, surgical technique, and postoperative follow-up of the patient. Surgical treatment of cleft lip and cleft palate consists of suturing the lip and the palate, and aims not only the aesthetic restoration, but also the recovery of the phonation, mastication and respiration, as well as a normal psychosocial development.

Bloco xenógeno para aumento do rebordo e colocação de implante dentário com finalidade estética na região anterior da maxila – relato de caso com dois anos de acompanhamento / The use of xenogeneic blocks for ridge augmentation and implant placement with esthetic purposes in the anterior maxillary region – a case report with 2 years of follow-up

Este artigo ilustra um caso clínico com aplicação de enxerto xenógeno e implantes dentários para aumento do rebordo na zona estética. Um paciente de 41 anos de idade apresentava perdas unitárias nas regiões 13 e 15. Após os exames iniciais e com TCFC, um bloco ósseo xenógeno foi colocado apenas na região do elemento 13 em função do defeito ósseo encontrado. Os implantes utilizados foram de 3,75 mm por 13,5 mm. Oito meses depois, os implantes foram expostos para os procedimentos protéticos. As coroas definitivas metalocerâmicas foram colocadas dez meses depois da cirurgia inicial. O controle tomográfico após dois anos e quatro meses demonstrou integridade do enxerto xenógeno com manutenção do volume inicialmente obtido na área do rebordo.

This article illustrates a clinical case with the use of xenogeneic graft and dental implants for ridge augmentation in the esthetic zone. A 41 years-old patient presented with two tooth loses at the regions 13 and 15. After initial and CBCT exams, a xenogeneic bone block was installed only at the 13 due to a bone defect. The implants used had 3.75 mm x 13.5 mm. Eight months later, the dental implants were exposed for prosthodontic procedures. Definitive metalloceramic crowns were delivered 10 months after the initial surgeries. The last CBCT has 2 years and 4 months and shows integrity of the xenogeneic block with the initial volume obtained still observed at the ridge augmentation area.

Sialolito gigante em ducto de Wharton: um caso distinto e revisão da literatura / Giant sialolith in Wharton's duct: case report and literature review

A sialolitíase é uma condição clínica relativamente comum, caracterizada pela obstrução da glândula salivar ou de seu ducto excretor por um cálculo, o qual recebe a denominação de sialolito. Pode ocorrer em qualquer faixa etária, apresentando leve predileção pelo gênero masculino e afeta, principalmente, a glândula submandibular. O diagnóstico é realizado pela correlação entre achados clínicos e radiográficos, sendo as radiografias oclusal e panorâmica as mais adequadas para este fim. Os sialolitos geralmente apresentam tamanho menor que 1 cm, mas raramente podem medir mais que 1,5 cm, os quais são denominados de sialolitos gigantes. O presente artigo relata um caso raro de sialolito gigante situado na região anterior do ducto de Wharton, o qual foi removido cirurgicamente por via intraoral, através de incisão no soalho bucal. O tratamento instituído mostrou-se adequado visto que após 8 meses de acompanhamento, o paciente evoluiu de maneira satisfatória... (AU)

The sialolithiasis is a relatively common clinical condition characterized by obstruction of the salivary gland or its excretory duct by a calculus, which receives the name of sialolith. It can occur in any age group, with a slight predilection for masculine gender and affects mainly the submandibular gland. The diagnosis is made by the correlation between clinical and radiographic findings, and occlusal and panoramic radiographs are the most suitable for this purpose. The sialoliths usually feature size less than 1 cm, but can rarely measure more than 1.5 cm, which are called giant sialoliths. This article reports a rare case of giant sialolith located in the anterior region of Wharton's duct, which was removed surgically by intraoral via through of incision in the mouth floor. The treatment was adequate because after 8 months follow up, the patient progressed satisfactorily... (AU)

Ulcerated anterior maxillary swelling showing radiopaque bodies on cone beam computed tomography.

The calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a rare benign tumor of epithelial origin of locally aggressive behavior, which represents less than 1% of all odontogenic tumors affecting the oral cavity. The lesion usually presents as a nonulcerated painless mass of slow growth, commonly affecting the posterior region of the mandible. Depending on the stages of development, CEOTs may present variable radiographic appearances. To date, a few number of cases affecting the anterior maxillary region have been published in the English-language literature. This article describes an interesting and rare case of an anterior ulcerated maxillary swelling diagnosed as a CEOT based on clinical, cone beam computed tomography and pathologic findings. Functional results were obtained with the surgical approach, and no recurrence of the lesion during a 2-year follow-up period was observed.

Submandibular-space abscess from loss of a bonded molar tube during orthognathic surgery.

The use of bonded orthodontic molar tubes is becoming more prevalent in orthodontics because they have some advantages over conventional bonding. However, a bonded apparatus can become detached, leading to complications. This article presents the case of a submandibular-space abscess associated with a molar tube that detached during orthognathic surgery and became embedded in the soft tissues. The site became infected, and antibiotics were prescribed. Eventually, the molar tube migrated and could be removed under local anesthesia.

Proteínas morfogenéticas ósseas (BMPs): conceitos, funções e aplicaçÕes clínicas / Bone morphogenetics proteins (BMPs): concepts, functions and clinical applications

As proteínas morfogenéticas ósseas (BMPs) são potentes agentes osteoindutores que pertencem à superfamília do fator de crescimento transformador beta (TGF-b). Atualmente, mais de 15 tipos de BMPs são estabelecidas e diversas perspectivas de emprego são possíveis, seja na área odontológica seja na área médica. O presente trabalho tem como objetivo realizar uma revisão da literatura abordando vários aspectos relacionados as BMPs, desde sua descoberta, funções, mecanismo de ação, assim como enfatizar sua principais aplicações terapêuticas e futuras perspectivas

Hiperplasia do côndilo mandibular - dados epidemiológicos, manejo clínico e modalidades terapêuticas / Mandibular condyle hyperplasia - epidemiology, clinical management and therapeutic approaches

A hiperplasia do côndilo mandibular (HCM) representa uma má formação de desenvolvimento causada por um crescimento condilar excessivo e autolimitado. Embora, ainda não esteja elucidada a sua etiologia, vários fatores têm sido relacionados com o surgimento da HCM, desde alterações circulatórias e trauma, até distúrbios hormonais. Diversas classificações podem ser encontradas na literatura e as características clínicas e radiográficas são variadas. Além disso, a HCM muitas vezes mimetiza outras patologias orofaciais e, portanto, a sua distinção é essencial para a instituição de um correto plano de tratamento. O propósito do presente trabalho é realizar uma objetiva revisão da literatura acerca da HCM, enfatizando os aspectos epidemiológicos, diagnóstico e as formas de tratamento

Manifestações bucofaciais iniciais em paciente com síndrome do carcinoma nevóide basocelular / Initial facial and oral manifestations in patient with nevoid basal cell carcinoma syndrome

A síndrome do carcinoma nevóide basocelular (SCNB), também conhecida como síndrome de Gorlin-Goltz, representa uma condição autossômica dominante de penetrância completa e expressividade variada, caracterizada por alterações cutâneas, ósseas e dentárias, além de poder afetar o sistema nervoso central e estruturas oculares. O desenvolvimento de múltiplos carcinomas basocelulares em idade precoce, costela bífida ou costelas alargadas, presença de ceratocistos maxilares, sinais palmares e plantares além de calcificações ectópicas da foice cerebral normalmente representam os achados mais freqüentes. O presente trabalho relata o caso de uma jovem paciente portadora da SCNBC discutindo a importância do CD no seu diagnóstico e a necessidade de um acompanhamento multidisciplinar

Líquen plano oral em paciente diabética associado a carcinoma mucoepidermóide / Oral lichem planus in diabetic's patient associated to mucoepidermoid carcinoma

O líquen plano constitui um enfermidade mucocutânea de ocorrência relativamente comum e etiologia desconhecida. Esta condiçäo é de grande interesse para o cirurgiäo-dentista, pois pode apresentar manifestaçöes na mucosa bucal. Existem vários relatos descrevendo um possível potencial de transformaçäo maligna a partir de lesöes orais de liquen plano, o que tem sido objeto de grande controvérsia. Os autores relatam um caso de múltiplas lesöes de líquen plano oral em paciente diabética associado a carcinoma mucoepidermóide

Osteomielite de Garré: relato de um caso de inusitada dificuldade diagnóstica / Garré's osteomyelitis: a case report with an unusual difficulty diagnosis

A osteomielite de Garré constitui um tipo específico de osteomielite crônica, caracterizada por um espessamento reparativo do periósteo, com deposiçäo de osteóide e formaçäo de uma nova cortical óssea, em resposta a uma infecçäo persistente. Neste artigo, os autores relatam um caso clínico de uma paciente do gênero feminino, de 11 anos de idade, que apresentava assimetria facial em regiäo mandibular posterior direita, de consistência endurecida. A evoluçäo inusitada do caso determinou uma incomum dificuldade diagnóstica