Neuropeptide expression and morphometric differences in crushed alveolar inferior nerve of rats: Effects of photobiomodulation.

Inferior alveolar nerve (IAN) injuries may occur during various dental routine procedures, especially in the removal of impacted lower third molars, and nerve recovery in these cases is a great challenge in dentistry. Here, the IAN crush injury model was used to assess the efficacy of photobiomodulation (PBM) in the recovery of the IAN in rats following crushing injury (a partial lesion). Rats were divided into four experimental groups: without any procedure, IAN crush injury, and IAN crush injury with PBM and sham group with PBM. Treatment was started 2 days after surgery, above the site of injury, and was performed every other day, totaling 10 sessions. Rats were irradiated with GaAs Laser (Gallium Arsenide, Laserpulse, Ibramed Brazil) emitting a wavelength of 904 nm, an output power of 70 mWpk, beam spot size at target ∼0.1 cm2, a frequency of 9500 Hz, a pulse time 60 ns, and an energy density of 6 J/cm2. Nerve recovery was investigated by measuring the morphometric data of the IAN using TEM and by the expression of laminin, neurofilaments (NFs), and myelin protein zero (MPZ) using Western blot analysis. We found that IAN-injured rats which received PBM had a significant improvement of IAN morphometry when compared to IAN-injured rats without PBM. In parallel, all MPZ, laminin, and NFs exhibited a decrease after PBM. The results of this study indicate that the correlation between the peripheral nerve ultrastructure and the associated protein expression shows the beneficial effects of PBM.

Bilateral intraosseous lipoma of the maxillary tuberosity: A challenging entity.

Lipomas can occur anywhere in the body where fat cells are present; however, intraosseous lipomas are rare. Although solitary lesions have already been reported in the gnathic bones, to the best of our knowledge, this is the first case of bilateral intraosseous lipoma. A 62-year-old woman was referred for evaluation of a swelling on both maxillary tuberosities. The radiographic examination showed a mixed radiolucent-radiopaque image with ill-defined borders on the right side of the maxilla, and an ill-defined radiolucency on the left side. Histologically, both sides revealed numerous mature adipocytes surrounded by immature bone and dystrophic calcification. The patient remains under follow-up and free of disease for 8 months. Due to the rarity of the intraosseous lipomas in the jaws, a literature review of the published cases was performed jointly with this unique case report.

Pharmacological Treatment of Primary Chronic Osteomyelitis: A Case Report

Introduction: Chronic primary osteomyelitis (CPO) is a rare disease, defined as a chronic inflammatory process involving cortical and medullary bone. In the maxillofacial region, it mainly affects the mandible, with a predilection for females in a wide age range, with unknown etiology or defined treatment protocol. Objective: The objective of this article is to report a case of the rare disease Chronic Primary Osteomyelitis, focusing on its cli-nical, radiographic, and histopathological characteristics, and to discuss the nomenclature for differential diagnosis while comparing with other osteomyelitis. Case Report: MLP patient, 53 years old, female, leukoderma, was admitted at the Maxillofacial Surgery and Traumatology Service of the University Hospital of USP referred from another service and reported of severe pain and swelling in the face for approximately 1 .5 year. On cli-nical examination, he presented edema 1+/4+ in the lower third of the right hemiface, sensitive to palpation, trismus, lower lip paresthesia, no evidence of infectious odontogenic focus, increased volume or intraoral secretion. The patient was submitted to an incisional biopsy, computed tomography and scintigraphy, which showed an sclerotic pattern and increased uptake in the mandible, respectively. After months of antibiotic therapy with no results, the patient was initially submitted to 20mg of Prednisone with regression up to 5mg and two doses of 60mg of Pamidronate which resulted in remission of pain, edema and trismus. Until the publication of this article, the patient had no recurrence of the symptoms, totalizing 6 years of follow up. Conclusion: CPO is a rare and challenging diagnosis disease. Prednisone was effective to edema and trismus decreasement and Pa-midronate for pain control, however more studies are necessary to determine a definitive treatment for this condition. (AU)

[Total resection of the zygomatic arch in the growth period: experimental study in rats]. / Ressecção completa do arco zigomático na fase de crescimento: estudo experimental em ratos.

The results obtained after total unilateral resection of the zygomatic arch in Wistar rats were evaluated by means of cephalometric measurements. The resection of the right zygomatic arch was carried out in one-month-old rats, and the animals were sacrificed two months later. The skull and hemimandibles were submitted to axial and lateral radiographic incidences. Based on the obtained radiographs, measurements were carried out by means of a computer system, which compared both sides of the specimens. The obtained values were submitted to statistical analysis. There was significant difference as to the extent of the temporal fossa, but there was no significant difference as to other measures of the maxilla. There was significant difference between both sides regarding the height of the body and the length of the base of the mandible.

Fibrous Dysplasia treated with virtual planning ­ report of two cases

Fibrous dysplasia (FD) is part of a rare group of bone dysplasia. It exhibits benign behavior and can lead to osteolytic lesions, deformities, and fractures. The treatment is challenging, and accurate removal of the lesion is necessary to restore function and esthetics. Here we present two cases of FD where virtual planning with presurgical computed tomography (CT) was used for the production of a surgical guide for bone contouring. First, CT image reconstruction was performed to mirror the patient's original anatomy. Then, three surgical guides that determined the area and depth of bone wear were prepared and used in the relevant sequence during the actual surgeries, which were successfully performed in both patients. This technique is termed the template guide holes (TGH) technique. The findings from this report suggest that presurgical virtual planning and guide preparation allows direct and objective measurement of the level of bone wear and improves the functional and esthetic outcomes of surgery for FD. In particular, the TGH technique is safe and allows adequate preoperative surgical simulation, reduces the surgical duration, and increases the predictability of the final result.

Ressecçäo completa do arco zigomático na fase de crescimento. Estudo experimental em ratos / Total resection of the zygomatic arch in the growth period. Experimental study in rats

Foram avaliados, por meio de mensuraçöes cefalométricas, os resultados decorrentes da ressecçäo unilateral total do arco zigomático em ratos Wistar. As ressecçöes foram realizadas com um mês de idade e os animais foram sacrificados com três meses de idade. O crânio e as hemimandíbulas foram submetidos, respectivamente às incidências radiográficas axial e lateral e, com base nestas, foram feitas mensuraçöes por meio de um sistema de computador, comparando-se um lado com o outro, e os valores obtidos foram submetidos a análise estatística. Houve diferença significante na amplitude da fossa temporal mas näo houve diferença significante para as demais mensuraçöes da maxila. Houve diferença significante, a menor para a altura do corpo e comprimento da base da mandíbula no lado operado

Escalas subjetivas de dor: breve análise de literatura e considerações sobre seu uso em clínica e pesquisa odontológica / Brief review on subjective pain rating scales and discussion on their usage in dental research and clinics

A avaliação da dor é de grande importância na prática clínica e em pesquisa. Como ferramentas úteis para tais fins, as escalas subjetivas de dor são de uso corrente. Contudo, existe a crítica de que muitos profissionais delas se utilizam sem o conhecimento de suas características e analisam e comparam os dados obtidos, também, de forma equivocada, pois a complexidade sensorial da experiência dolorosa e sua característica multidimensionalidade, dificultam o relato do doente e a compreensão do examinador. As escalas subjetivas de dor possibiltam a avaliação da dor promovendo um meio de comunicação entre ambos. Entre as escalas mais utilizadas, a escala analógica visual (VAS), a escala numérica (NRS), e escala comportamental (BRS), a escala descritiva verbal (VDS) e o questionário de dor McGill (MGPQ) têm em comum a praticidade de baixo custo e tempo de aplicação. Diversos estudos comprovam sua eficácia e validade em diversas áreas; entretanto ainda há dificuldade na escolha, uso e análise dos resultados destas escalas. Este trabalho busca apresentar, brevemente, as características das escalas citadas e analisar os fatores importantes na escolha e no uso das mesmas

Freqüência de hábitos parafuncionais e suas manifestaçöes clínicas em pacientes com disfunçöes da articulaçäo temporomandibular / Frequency of parafunctional habits and their clinical manifestations in patients with temporomandibular joint dysfunctions

Os hábitos parafuncionais säo considerados um fator importante na gêneses das disfunçöes da articulaçäo temporomandibular. Entretanto, poucos estudos os têm relacionado com disfunçöes temporomandibulares. Foi avaliada a freqüência de hábitos parafuncionais e suas manifestaçöes clínicas num grupo de 43 pacientes com disfunçöes temporomandibulares. Destes, 32 (74,4 por cento) relataram hábitos parafuncionais durante o exame subjetivo. Houve uma predominância do gênero feminino (87,5 por cento) e da faixa etária de 21-40 anos (65,6 por cento). Os hábitos parafuncionais foram, em ordem decrescente, briquismo, isolado ou associado a outros hábitos, apertamento dentário, onicofagia, morder objetos e morder a língua. Sinais comuns às disfunçöes temporomandibulares predominaram, havendo dor em músculos como masseter, temporal e cervicais, bem como sinais articulares representados por estalos e dor articular. Amplitudes normais foram verificadas na maioria dos movimentos mandibulares máximos. Sinais clínicos como hipertrofia da linea alba jugal (43,7 por cento) e língua crenada (37,5 por cento) foram obseravdos. Facetas de desgaste foram freqüêntes em dentes anteriores (65,8 por cento do total), em especial caninos (37,6 por cento do total). Concluiu-se que a freqüência de hábitos parafuncionais em disfunçöes temporomandibulares é alta, com predomínio do briquismo, enquanto que evidências clínics destes säo observadas apenas em parte dos pacientes

Prótese complementar da cirurgia e traumatologia BMF / Complementary prosthesis in oral maxilo facial surgery and traumatology

Os autores apresentam revista da literatura quanto a necessidade de utilização de aparelhos protéticos diante de procedimentos cirúrgicos maxilo-faciais. Descrevem os tipos básicos de aparelhos e suas indicações