Effect of surface roughness and low-level laser therapy on removal torque of implants placed in rat femurs.

The present study measured removal torque and bone-implant interface resistance of machined implants, acid-etched implants, or machined implants irradiated around the implant area with infrared low-level laser therapy (LLLT; 830 nm) immediately after surgery. There were statistically significant differences between Groups A (control) and B (rough surface) (P = .03). Implants with a rough surface seem to add resistance to the bone-implant interface compared with smooth titanium implants or implants treated with LLLT.

Sialolithiasis in the duct of submandibular gland: a case report in patient with epidermolysis bullosa.

AIM: To describe the options of treatment to remove a sialolith associated with the submandibular gland duct in a patient with epidermolysis bullosa (EB). BACKGROUND: Treatment of patients with EB is very complex and involves a multidisciplinary team. This condition is characterized by a spectrum of blistering and mechanical fragility of the skin. One main feature of this disease is the esophageal constriction and possible constriction to the submandibular duct. This alteration may induce the formation of calculi in this duct, which is called sialolith. Once the sialolith obliterates the trajectory of the duct this will lead to a sialolithiasis. The calculi have to be removed. CASE REPORT: Seventeen years old female patient with dystrophic EB developed a sialolith at the submandibular duct. She has a limited mouth opening and her tongue was collapsed with mouth floor. The first choice of treatment was the lithotripsy, once this procedure is less invasive and a surgical remove could worse the collapsed tongue. She was with acute pain and with a great augmentation in the submandibular area. Once the patient was debilitated and has difficult to swallow she invariably needed to be hospitalized in order to receive intravenous medication. During the hospitalization the sialolith could be seen through the opening of the duct and the calculi was removed with local anesthesia. CONCLUSION: The treatment of sialolithiasis usually does not present major challenges, nevertheless if the sialolithiasis is associated with EB, the treatment became an extremely challenge. In this particular case the option of treatment was the less invasive. CLINICAL RELEVANCE: This case report has an enormous clinical relevance once there is no protocol to treat patients with EB and buccal diseases.

Calcium phosphate cement in orbital reconstructions.

Treatment of facial trauma sequelae is a complex and challenging process. There is still controversy over suitable materials for orbital wall reconstruction. This study evaluated calcium phosphate cement (CPC) implants manufactured by rapid prototyping in the repair of orbital wall defects secondary to trauma. Computed tomographic scans of 5 patients were used for surgery planning and production of CPC implants. Implants were used to restore orbital wall anatomy, ocular alignment, and facial contour. Benefits resulting from the use of implants, such as a reduced operating time, patient response to biomaterial implantation, biomaterial integrity and stability, and patient satisfaction with treatment, were analyzed qualitatively. Our results suggest that CPC is an effective and safe material for orbital reconstruction because of its biocompatibility and easy production and placement.

Septic arthritis of the temporomandibular joint.

Septic arthritis of the temporomandibular joint is a rare acute infectious disease that requires attention from physicians and, once misdiagnosed, can have several implications for a patient. The most common microorganisms related to this disease are Staphylococcus aureus, Neisseria, Haemophilus influenzae, and Streptococcus. The infection of the joint may be caused by a direct spread of a local infection or by hematogenous inoculation from a distant focus. General predisposing factors, such as immunodepression, can eventually be found. The aim of the current study was to report a case in which a patient with an articular infection resulting from hematogenous dissemination from a distant site was successfully treated using joint drainage and systemic antibiotics. Secretion culture from the temporomandibular joint space was positive for S. aureus. After 1 month of antimicrobial therapy, the patient was asymptomatic and mandibular function was normal. Literature related to this topic was reviewed and discussed.

Effect of partially selective cyclooxygenase-2 inhibitor in the removal of third molars.

A randomized, double-blind clinical trial was carried out involving 25 patients scheduled for the removal of symmetrically positioned lower third molars in separate procedures. Either 100 mg of nimesulide or 7.5 mg of meloxicam was administered 1 hour before surgery and every 12 hours after surgery for 2 days. Evaluations were carried out in the preoperative period as well as on the second and seventh days after surgery. Objective and subjective parameters were recorded for comparison purposes. The patients having received nimesulide had less of a need for additional pain medication in the first 48 hours and had lower pain scale values (P < 0.05). There was less trismus in the meloxicam group (P > 0.05). Postoperative swelling was lower in the nimesulide group (P < 0.05). All measurements on the second day were lower in the nimesulide group (P < 0.001), and only one of these parameters was lower on the seventh day in the nimesulide group, distance from the lower edge of the tragus to the lip commissure on the operated side (P = 0.009, P < 0.001) compared with another group. Nimesulide proved effective in controlling pain and swelling after surgical removal of the lower third molars, with few adverse effects. Meloxicam proved effective in diminishing trismus.

Worldwide incidence of odontogenic tumors.

PURPOSE: The objective of the study was to determine the relative frequency of odontogenic tumors (OTs) in the world population, directing an epidemiologic profile to these lesions. METHODS: Was conducted a search in epidemiologic studies involving OTs that are listed by PubMed and Ovid, EMBASE, and Cochrane Library, embracing the period from January 1960 to January 2010, to verify their incidence worldwide. We identified 195 articles, of which 19 articles were selected, considering the location, age, sex, histologic type, and World Health Organization classification. RESULTS: A total of 8544 OTs were found. The results showed a low frequency of malignant OTs in selected works. The most frequent tumor was ameloblastoma (39.6%), followed by odontoma (20.1%) and the newly included keratocystic OT (13.8%). CONCLUSIONS: These OTs are uncommon lesions in world population, and malignant OTs are very rare. The relative frequency of different kinds of OTs, the age, and the sex distribution show a marked geographic variation in incidence of those lesions. This was particularly notable in the ameloblastomas and odontoma, with the incidences being relatively well and weighted showing similar values to an average when compared with previous studies.

Rehabilitation of the Edentulous Mandible with an Immediately Loaded Full-Arch Fixed Prosthesis Supported by Three Implants: A 5-Year Retrospective Analysis.

PURPOSE: To evaluate the clinical and radiographic outcomes of full-arch mandibular rehabilitation with fixed prostheses supported by three immediately loaded implants after at least 5 years of follow-up. MATERIALS AND METHODS: The sample comprised 58 patients who underwent treatment with immediate loading. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, and length of cantilever and resistance arms. RESULTS: Five implants in four patients failed, for an overall success rate of 97.13%. Mean bone loss was 2.65 ± 1.06 mm around central implants and 2.11 ± 0.84 mm around distal implants. The most common complication was loss of abutment torque. Half of all patients in the sample experienced some prosthetic complication. There was no evidence of a statistically significant relationship of cantilever length with bone loss or prosthetic complications. CONCLUSION: The immediately loaded three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular rehabilitation in edentulous patients, with favorable outcomes after 5 years of clinical and radiographic follow-up.

Clinical and Radiographic Assessment of Three-Implant-Supported Fixed-Prosthesis Rehabilitation of the Edentulous Mandible: Immediate Versus Delayed Loading.

PURPOSE: To evaluate and compare the clinical and radiographic outcomes of mandibular rehabilitation with fixed prostheses on three implants with immediate versus delayed loading. MATERIALS AND METHODS: The sample comprised 21 patients who underwent treatment with immediate loading and 23 who received delayed loading. All had worn their prostheses for at least 18 months. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, length of cantilever (effort) and resistance arms, presence of plaque on prosthetic abutments, and hygiene of the prosthesis. RESULTS: One implant failed in each group, resulting in a 95.23% treatment success rate with immediate loading and 95.65% with delayed loading (no statistically significant between-group difference). In the immediate-loading group, the mean bone loss was 1.96 ± 0.73 mm around central implants and 1.64 ± 0.84 mm at distal implants. In the delayed-loading group, the mean bone loss was 1.85 ± 0.67 mm around central implants and 1.70 ± 0.77 mm at distal implants. According to Student t test, there was no significant within-group difference in bone loss and no difference between the immediate-loading and delayed-loading groups. The only prosthesis-related complications that differed significantly between groups were "condition of the acrylic base," "occlusion," and "presence of right cover screw." There was no statistically significant association of lever arm ratio with peri-implant bone loss or bone loss on the mesial surfaces compared to the distal surfaces of the distal implants. CONCLUSION: The three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular edentulous patients with maxillary complete dentures, regardless of whether loading was immediate or delayed, with no difference in peri-implant bone loss.

Delayed removal of maxillary third molar displaced into the maxillary sinus.

INTRODUCTION: The present article reports the late removal of a wisdom tooth displaced into the maxillary sinus associated with the curettage of the adjacent infection tissue, under general anesthesia. CASE DESCRIPTION: A male patient, 42 years-old, was forwarded to remove a right wisdom tooth which was displaced into the right maxillary sinus for 10 months. The patient reported that the tooth was tried to be removed using odontosection in two moments without any success. Since then, the patient has been having (applicants) episodes of sinusitis. It had been planned to remove the tooth and the cleaning of the right maxillary sinus. The surgical procedure was done through the Caldwell-Luc access, followed by the removal of the dental fragments which were into the maxillary sinus and curettage of the cavity in order to remove the granulation tissue, associated to copious irrigation. CONCLUSION: The surgical removal of the tooth displaced into the maxillary sinus associated with the sinus curettage was successfully achieved, solving the patient complaints.

Bibliometric analysis of scientific articles published in Brazilian and international orthodontic journals over a 10-year period.

OBJECTIVE: This study aimed at describing the profiles of Brazilian and international studies published in orthodontic journals. METHODS: The sample comprised 635 articles selected from two scientific journals, i.e., Dental Press Journal of Orthodontics and American Journal of Orthodontics and Dentofacial Orthopedics, which were analyzed at three different intervals over a 10-year period (1999 - 2004 - 2009). Articles were described in terms of knowledge domain, study design, and country of origin (or state of origin for Brazilian papers). RESULTS: The most frequent study designs adopted in international studies were cohort (23.9%) and cross-sectional (21.7%) designs. Among Brazilian papers, cross-sectional studies (28.9%) and literature reviews (24.6%) showed greater frequency. The topics most often investigated in international articles were dental materials (17%) and treatment devices (12.4%), with the latter topic being addressed by 16% of the Brazilian publications, followed by malocclusion, with 12.6%. In all cases, the most frequent countries of origin coincided with the countries of origin of each journal. CONCLUSIONS: The majority of the studies analyzed featured a low level of scientific evidence. Moreover, the findings showed that journals tend to publish studies produced in their own country of origin, and that there are marked discrepancies in the number of papers published by different Brazilian states.

Evaluation of 1211 third molars positions according to the Classification of Winter, Pell & Gregory / Evaluación de posiciones de 1211 terceros molares acorde a la Clasificación de Winter, Pell & Gregory

Panoramic radiographs are important for the evaluation and classification of the third molars position, allowing the diagnosis and planning of extraction. The objective of this study is to evaluate upper and lower third molars positions in panoramic radiographs with the classification methods proposed by Pell and Gregory (1933) and Winter (1926) and the subsequent comparison of results with other authors. Panoramic radiographs of 310 patients were analyzed, 197 female and 113 male, totaling 1,211 third molars. In relation to the upper third molars, the most prevalent positions were: angle compared to the long axis of the second molar of Distoangular form (53.23 %) and the depth of impaction as Class C (48.25 %). In the lower third molars, the most prevalent positions were: angle to the long axis of the second molar in Mesioangular classification (52.96 %), the depth of impaction was B (46.54 %) and the tooth relationship with the mandibular ramus was identified as class I (55.26 %). These results provide information that can be utilized in predicting third molar development in terms of impaction or eruption, assisting dental surgeons in making decisions regarding surgical planning and treatment.

Las radiografías panorámicas son importantes para la evaluación y clasificación de la posición de los terceros molares, lo que permite el diagnóstico y la planificación de la extracción. El objetivo de este estudio fue evaluar terceros molares superiores e inferiores y posiciones en las radiografías panorámicas con los métodos de clasificación propuestas por Pell & Gregory, y Winter y la posterior comparación de los resultados con otros autores. Se analizaron las radiografías panorámicas de 310 pacientes, 197 mujeres y 113 hombres, con un total de 1.211 terceros molares. En relación con los terceros molares superiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar de forma distoangular (53,23 %) y la profundidad de la impactación como Clase C (48,25 %). En los terceros molares inferiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar en la clasificación mesioangular (52,96 %), la profundidad de impactación fue de B (46,54 %) y la relación de los dientes con la rama mandibular fue identificado como Clase I (55,26 %). Estos resultados proporcionan información que puede ser utilizada para predecir el desarrollo del tercer molar en términos de compactación o erupción, ayudando a los cirujanos dentistas en la toma de decisiones respecto a la planificación y el tratamiento quirúrgico.

Remoção cirúrgica de dentes impactados em posições atípicas / Surgical removal of atypically positioned impacted teeth

Removal of impacted teeth may pose major challenges to the dental surgeon and requires careful surgical planning. The present series describes three clinical cases subjected to surgical extraction of atypically positioned impacted teeth with successful outcomes and no complications. The approach adopted in each case is discussed (AU).

Devido à complexidade para remoção que algumas impactações dentárias podem apresentar, o cirurgião deve estar atento no momento do planejamento cirúrgico. Esta série de 3 casos clínicos mostra o manejo cirúrgico de dentes impactados em posições atípicas que foram tratados com sucesso e sem complicações e discute a forma de abordagem de cada caso (AU).

Evaluation of optical density of bone defects filled with calcium phosphate cement and bioactive glass in rats.

PURPOSE: To evaluate new bone formation, by the analysis of optical density, in rat femoral defects filled with calcium phosphate cement (CPC) and bioactive glass (BG). METHODS: Twenty-one rats were divided into three groups, Group I (CPC), Group II (BG), and Group III (control), and assessed after 7, 15, and 30 days. Three bone cavities were made in the left femur and filled with CPC, BG, and no material (control). Digital images were obtained and the results were subjected to statistical analysis of variance (ANOVA), complemented by the Friedman and Kruskal-Wallis nonparametric tests, with a significance level of 5%. RESULTS: Regarding optical density, Group I showed statistical values significantly higher than Group III and also higher, although not statistically significant, than Group II, in all observation periods. When Groups II and III were compared, Group II showed higher optical density values, without statistically significant differences, in all periods. CONCLUSION: The biomaterials analyzed showed higher optical density in relation to the control group in all observation periods, calcium phosphate cement being the best option in the repair of bone defects, but without statistically significant differences in relation to bioactive glass.

Use of calcium phosphate cement scaffolds for bone tissue engineering: in vitro study.

PURPOSE: To evaluate the ability of macroporous tricalcium phosphate cement (CPC) scaffolds to enable the adhesion, proliferation, and differentiation of mesenchymal stem cells derived from human bone marrow. METHODS: Cells from the iliac crest of an adult human donor were processed and cultured on macroporous CPC discs. Paraffin spheres sized between 100 and 250µm were used as porogens. Cells were cultured for 5, 10, and 15 days. Next, we assessed cells' behavior and morphology on the biomaterial by scanning electron microscopy. The expression levels of the BGLA and SSP1 genes and the alkaline phosphatase (ALP) activity were quantified by the quantitative real-time polymerase chain reaction technique (QT-PCR) using the fluorophore SYBR GREEN(®). RESULTS: QT-PCR detected the expression of the BGLA and SSP1 genes and the ALP activity in the periods of 10 and 15 days of culture. Thus, we found out that there was cell proliferation and differentiation in osteogenic cells. CONCLUSION: Macroporous CPC, with pore sized between 100 and 250µm and developed using paraffin spheres, enables adhesion, proliferation, and differentiation of mesenchymal stem cells in osteogenic cells and can be used as a scaffold for bone tissue engineering.

Surgical Treatment of Condylar Hyperplasia Associated with Dentofacial Deformity: Low Condylectomy, Articular Disc Repositioning, and Orthognathic Surgery / Tratamiento Quirúrgico de Hiperplasia Condilar Asociado a la Deformidad Dentofacial: Condilectomía Baja, Reposicionamiento del Disco Articular y Cirugía Ortognática

Due to the complexity of the treatment of condylar hyperplasia associated with dentofacial deformities and its complications, if left untreated, the surgeon should be alert to these factors at the time of surgical planning to tailor the optimal therapy for an individual patient. This case report describes a patient with right condylar hyperplasia associated with dentofacial deformity who was treated surgically with low condylectomy, articular disc repositioning and anchoring, and orthognathic surgery, concomitantly, with stable results, satisfactory occlusion and facial harmony.

Debido a la complejidad del tratamiento de la hiperplasia condilar asociada con deformidades dentofaciales y sus complicaciones, si no se trata, el cirujano debe estar alerta ante estos factores en el momento de la planificación quirúrgica para adaptar la terapia óptima para cada paciente. Este caso describe un paciente con hiperplasia condilar derecha asociada con la deformidad dentofacial que fue tratado quirúrgicamente con condilectomía baja, reposicionamiento y anclaje del disco articular, y la cirugía ortognática, concomitantemente, con resultados estables, oclusión satisfactoria y armonía facial.

Alpha-tricalcium phosphate cement in the reconstruction of bone defects in rats.

PURPOSE: To evaluate the ability of a mixture of α-TCP and autogenous bone (AB) vs. α-TCP alone and AB alone to promote new bone formation and tissue repair in bone defects. METHODS: Bone defects surgically created in 15 male Wistar rats were divided into four groups: Group I (AB), Group II (α-TCP), Group III (α-TCP+AB assessed by light microscopy), and Group IV (α-TCP+AB assessed by scanning electron microscopy). Bone repair findings were assessed at 30, 60, and 120 days postoperatively. RESULTS: The histological findings obtained in Groups I (p=0.459), II (p=0.368), and III (p=0.459) and at 30 days (p=0.717), 60 days (p=0.717), and 120 days (p=0.779) did not show statistically significant differences. Scanning electron microscopy revealed direct contact between the α-TCP+AB implant and the bone tissue at 120 days. CONCLUSION: The α-TCP implant is effective alternative bone substitutes for the treatment of critical size bone defects.

Bibliometric analysis of scientific articles published in Brazilian and international orthodontic journals over a 10-year period

Objective: This study aimed at describing the profiles of Brazilian and international studies published in orthodontic journals. Methods: The sample comprised 635 articles selected from two scientific journals, i.e., Dental Press Journal of Orthodontics and American Journal of Orthodontics and Dentofacial Orthopedics, which were analyzed at three different intervals over a 10-year period (1999 - 2004 - 2009). Articles were described in terms of knowledge domain, study design, and country of origin (or state of origin for Brazilian papers). Results: The most frequent study designs adopted in international studies were cohort (23.9%) and cross-sectional (21.7%) designs. Among Brazilian papers, cross-sectional studies (28.9%) and literature reviews (24.6%) showed greater frequency. The topics most often investigated were dental materials (17%) and treatment devices (12.4%) in international articles, with the latter topic being addressed by 16% of the Brazilian publications, followed by malocclusion, with 12.6%. In all cases, the most frequent countries of origin coincided with the countries of origin of each journal. Conclusions: The majority of the studies analyzed featured a low level of scientific evidence. Moreover, the findings showed that journals tend to publish studies produced in their own country of origin, and that there are marked discrepancies in the number of papers published by different Brazilian states. .

Objetivo: determinar o perfil das publicações nacionais e internacionais nos periódicos de Ortodontia. Métodos: foram avaliados 635 artigos da Revista Dental Press de Ortodontia e Ortopedia Facial e American Journal of Orthodontics and Dentofacial Orthopedics, em três tempos distintos, dentro de um intervalo de 10 anos (1999, 2004 e 2009), caracterizando as áreas de conhecimento, os delineamentos utilizados e identificando países e estados brasileiros com maior produção científica. Resultados: os delineamentos dos estudos internacionais mais utilizados foram estudos de coorte (23,9%) e transversal (21,7%). Em estudos nacionais, destacam-se os delineamentos transversais (28,9%) e revisão de literatura (24,6%). Nas publicações internacionais, as categorias temáticas mais pesquisadas foram materiais dentários (17%), além de dispositivos de tratamento (12,4%); essa mesma categoria esteve presente em 16% das publicações nacionais, e a má oclusão dentária em 12,6%. A nacionalidade das publicações mais observada foi a do próprio país de origem do periódico. Conclusões : a maioria dos artigos publicados refere-se a estudos de menor potencial para estabelecer evidências científicas. Além disso, a situação detectada ilustra a propensão das revistas publicarem os artigos produzidos dentro de seu país de origem, bem como as disparidades entre os estados do Brasil quanto ao número de publicações. .

Teeth in the line of mandibular fractures: epidemiology, management and complications / Dentes em linhas de fraturas mandibulares: epidemiologia, manejo e complicações

Objetivo: avaliar a incidência, as regiões mais afetadas, o manejo bem como as complicações encontradas em dentes envolvidos em linhas de fraturas mandibulares. Métodos: Os dados foram coletados a partir de prontuários de pacientes tratados com fraturas mandibulares. Foram incluídas informações como dados demográficos, localização da fratura, presença de dentes na linha de fratura e complicações. Resultados: a amostra apresentou um total de 310 linhas de fratura, e destas 144 tinham dentes envolvidos. a região mais afetada foi o ângulo, seguido da parassínfise, pelo corpo, pelo processo alveolar e pela sínfise. Observaram-se 196 dentes nas linhas de fraturas, 60 dos quais tinham sido retirados. Complicações pós-operatórias ocorreram em 8,6% da amostra. Dos casos que apresentaram complicações, pacientes sem dentes envolvidos na linha de fratura corresponderam a 43,75%, e os pacientes com dentes envolvidos na linha de fratura foram de 56,25%. Quando o dente foi removido, 8,47% dos pacientes apresentaram complicações, e, quando o dente foi mantido, 2,85%. Conclusão: este estudo demonstrou que a presença de dentes da linha de fratura não é um fator limitante para o tratamento. As complicações são mais frequentemente relacionadas com o método de tratamento escolhido do que para o envolvimento de dentes na linha de fratura.

Purpose: To examine the incidence, the regions most affected, the management as well as the complications found in teeth involved in the line of mandibular fractures. Methods: Data were collected from patients records treated of mandibular fractures. It was included information such as demographic data, fracture location, presence of teeth in the line of fracture, treatment and complications. Results: The sample has presented a total of 310 lines of fracture, from these, 144 had teeth involved. The most affected area was the angle, followed by the parasymphysis, body, alveolar process and symphysis. There were 196 "fracture line" teeth, 60 of which had been removed. Postoperative complications occurred in 8.6% of the sample. From the cases that presented complications, patients without teeth involved in the fracture line ranged 43.75% and patients with teeth involved in the fracture line reached 56.25%. When the tooth was removed 8.47% of the patients presented complications and when the tooth was retained 2.85%. Conclusion: This study demonstrated that the presence of teeth in the line of fracture is not a limiting factor for the treatment. The complications are more frequently related to the chosen method of treatment than to the involvement of teeth in the line of fracture.

Estudo comparativo sobre a eficácia de duas drogas de ação anti-inflamatória (Etoricoxib e Diclofenaco) após exodontia de terceiros molares inferiores inclusos. / Comparative study of the efficacy of two different anti-inflammatory drugs (Etoricoxib and Diclofenac) following removal of impacted lower third molars.

Neste trabalho, os autores compararam clinicamente a eficácia de duas drogas de ação anti-inflamatória: o Etoricoxib (Arcoxia®) e Diclofenaco (Olfen®) no controle da dor pós-operatória, na exodontia de terceiros molares inclusos. Foram selecionados 15 pacientes adultos da Disciplina de Cirurgia e Traumatologia Buco-Maxilo-Facial da Faculdade de Odontologia de Araraquara - Unesp que necessitavam de extrações de terceiros molares inferiores bilateralmente. As drogas foram administradas na primeira e na segunda cirurgia aleatoriamente. A dor foi avaliada por meio de escala analógica visual, por 72 horas pós-operatórias. Concluiu-se, após a análise dos resultados, que não houve diferenças estatísticas significantes entre as duas drogas no controle da dor pós-operatória.

In this article the authors clinically compare the efficacy of two different anti-inflammatory drugs - Etoricoxib (Arcoxia®) and Diclofenac (Olfen®) - in the control of postoperative pain resulting from the surgical removal of impacted lower third molars. Fifteen patients requiring the extraction of bilaterally impacted lower third molars were selected at the Department of Oral and Maxillofacial Surgery at the Araraquara School of Dentistry - UNESP. The drugs were randomly administered during the first and second surgical procedures. Pain was evaluated by means of a visual analogic scale for 72 hours following the surgical procedure. After statistical analysis of the results, the authors concluded that there were no significant differences in terms of postopoerative pain control between the two drugs studied.

Fratura do corpo da mandíbula após exodontia de 2º molar inferior em paciente HIV positiva: relato de caso clínico / Mandibular body fracture after the extraction of the second lower molar in a HIV Positive patient: Case Report

Objetivo: relatar um caso clínico no qual uma fratura de corpo da mandíbula após exodontia do dente 37 em paciente soro positiva foi diagnosticada e tratada com sucesso por meio de redução cruenta com fixação interna estável. Relato de caso: a paciente foi submetida a procedimento cirúrgico sob anestesia geral, acesso cirúrgico submandibular tipo Risdon para exposição do traço de fratura. Para redução dos cotos ósseos foi instituído bloqueio maxilomandibular por meio de parafusos de bloqueio intermaxilar. A fixação interna estável da fratura foi realizada com placas e parafusos de titânio do sistema 2,0 mm (banda de tensão) e 2,3 mm (banda de compressão). Após, o bloqueio maxilo-mandibular foi removido e a oclusão checada. Considerações finais: as complicações ou acidentes em exodontias são sempre um fator que se deve ponderar ao planejar uma cirurgia. As fraturas mandibulares, apesar de raras, normalmente estão relacionadas ao emprego de forças excessivas durante o ato operatório, mas também podem ocorrer no pós-operatório, principalmente em decorrência do enfraquecimento ósseo na região da exodontia, não tendo a mandíbula força para suportar as cargas mastigatórias naquela região, levando à fratura.