Pulp Canal Obliteration Following Traumatic Dental Injury in an Upper Lateral Incisor: A Case Report with 3-year Follow-up.

Endodontic management of teeth afflicted with pulp canal obliteration faces a challenge due to the heightened risk of complications including excessive wear, perforation, and suboptimal chemomechanical preparation. This report aims to elucidate the clinical endodontic strategy employed in addressing pulp canal obliteration after a history of dental trauma and an associated periradicular lesion in an upper lateral incisor. A patient visited the dental emergency department with symptoms of apical swelling, acute persistent pain, and discoloration of tooth 22. Following comprehensive clinical evaluation and cone-beam computed tomography, the diagnosis of pulp canal obliteration involving the cervical and middle thirds of the tooth, alongside an acute periradicular abscess was established. Root canal was accessed using tomographic image planning, augmented by loupe magnification and ultrasonic instrumentation. Precise identification of the access cavity was radiographically confirmed, preceded by thorough irrigation with 2.5% sodium hypochlorite and subsequent cervical and middle third preparation. Verification of the working length by an electronic apex locator ensured precise apical preparation, followed by passive ultrasonic irrigation to optimize disinfection and to enhance penetrability of intracanal calcium hydroxide medication, administered for 15 days to eliminate microbial invasion. Upon resolution of symptoms, root canal obturation employing thermo-mechanical compaction and coronal sealing with composite resin was accomplished. Radiographic assessment after a one-year interval presented evidence of lesion regression and bone repair. Subsequent cone-beam computed tomography imaging at the three-year follow-up confirmed complete healing of the periradicular tissues, attesting to the efficacy of the endodontic intervention.

Age estimation by evaluation of obliteration of the palatine sutures: a scoping review.

The age estimation (AE) of human remains is a challenging task since it is dependent on the state in which these remains are found. Since the macroscopic evaluation of palatal sutures has been proposed as a method for AE, the aim of this study was to review the literature on this method, considering that the cases of edentulous elderly are among the greatest challenges in anthropological and forensic contexts. A scoping review was performed using a specific search strategy in PubMed, Web of Science, SciELO, LILACS, and Google Scholar. The search identified 13 articles, among which the USA yielded the most information with 3 articles. Only 1 study was identified in Latin America (Peru). There was great diversity regarding the origin of samples, and the studies were carried out on both historical and modern populations. Only 6 articles exceeded the average sample size (168.08) and 4 articles studied samples of fewer than 100 individuals. Although 6 different methods were identified, Mann et al.'s revised method was the most used. The selection of appropriate methods for AE depends on what skeletal elements are present and the general age of the specimens. Although evaluation of the obliteration of the palatal sutures has been found to be simple and promising for AE in individuals over 60 years of age, this method has been reported to have less precision than other more complex methods, which makes the use of a combination of methods necessary to increase the level of confidence and the percentage of success. Further research could resolve this weakness, and methodological refinement (perhaps the digitization and automation of processes, or the application of Bayesian methodology) could provide the necessary solidity to comply with international standards in the forensic scenario.

Guided Endodontic Approach in Teeth with Pulp Canal Obliteration and Previous Iatrogenic Deviation: A Case Series.

Pulp canal obliteration (PCO) is a challenging clinical scenario in which canals must be located in progressively narrowing roots. Recently, proof of concept papers have, in parallel, introduced the combination of cone-beam computed tomography and surface scans for the construction of guides to pilot the negotiation and preparation of partially or completely obliterated pulp chambers and canals in anterior and posterior teeth. Authors' purpose is to describe the treatment approach for teeth with PCO and previous iatrogenic deviation using guided endodontic technique. The clinical cases reported here show that technological evolutions should make guided endodontic procedures more widespread because their execution is relatively fast and safe even in the cases of root canal deviation. Treatment of teeth with pulp canal obliteration with deviations or perforation may be more effective with designed 3D printed access guides that seems to be a safe and clinically feasible method to locate root canals.

Limitations and Management of Static-guided Endodontics Failure.

Endodontic treatment in severely calcified canals is always a challenging task because it can result in accidents such as deviations or perforations. Recently, guided endodontics has become an alternative approach for pulp canal calcification, facilitating the location of root canals more predictably through the combined use of cone-beam computed tomographic imaging, oral scanning, and endodontic access guides. Although several reports have shown that guided endodontics is safer, faster and can be performed without an operating microscope and by less experienced operators, the technique has limitations, and iatrogenesis may occur. This article describes the limitations of static-guided endodontics and possible causes of failures. In the present case, not fixing the guide to the bone and inaccuracies generated by manually performing mesh merger software led to root perforation. Endodontic microsurgery was effective in resolving this case and should be considered the treatment of choice when guided endodontics cannot be used safely or when it fails.

Endodoncia guiada Para el manejo de Canales Obliterados, Reporte de Caso / Guided Endodontic Treatment for the Management of Obliterated Pulp Canals. A Case Report

RESUMEN: El objetivo: de este reporte es presentar el tratamiento endodóntico de un diente ante-rior con obliteración del canal radicular, con la ayuda de la endodoncia guiada. Paciente masculino sin antecedentes médicos relevante, y en tratamiento ortodóntico. Diente 2.1 con historia de traumatismo dento-alveaolar y presencia de dolor a la percusión. En la TCHC se observa obliteración total del canal radicular en el tercio cervical y medio y un área de radiolucidez apical. Diagnóstico: Periodontitis apical Sintomática. Tratamiento: Terapia de canal No vital, con planificación virtual y guía endodóntica. Se utilizó el programa de acceso gratuito, Bluesky Plan®, para la planifica-ción digital de la guía endodóntica. El tratamiento se realizó en dos citas. Conclusión: el uso de tecnología para la resolución de casos de alta complejidad en endodoncia, podría ayudar a mejorar el pronóstico de estos dientes y ser una alternativa más segura para reducir la posibilidad de perforación y preservar estructura dental.

ABSTRACT: The aim: of this case report is to present the endodontic treatment of an anterior tooth with an obliterated pulp canal, with the help of guided endodontics. Male patient with no relevant medical history, currently with orthodontic treatment. Tooth 2.1 had a history of dental trauma and presented tenderness to percussion. The CBCT exam showed a completely obliterated root canal in the cervical and middle third, and apical radiolucency. Diagnosis: Symptomatic Apical Periodontitis. Treatment: Root canal treatment with virtual planning and endodontic guide. Bluesky Plan® free access program was used for the digital planning of the endodontic guide. The treatment: was made in two sessions. Conclusion: the use of technology for the resolution of high complexity cases in endodontics could help improve the prognosis of these teeth and be a safer alternative to reduce the possibility of perforation and preserve more tooth structure.

Mastoid obliteration and reconstruction techniques: A review of the literature.

OBJECTIVE: To review the published literature related to the different obliteration and reconstruction techniques in the management of the canal wall down mastoidectomy. METHODS: A PubMed (Medline) and LILACS databases as well as crossed references search was performed with the following Mesh terms: "cholesteatoma", "cholesteatoma-middle ear", "otitis media", "otitis media, suppurative", "mastoiditis", "mastoidectomy", "canal wall down mastoidectomy", "radical mastoidectomy", "mastoid obliteration" and crossed references. Inclusion criteria were adult patients subject to mastoid cavity obliteration and posterior canal wall reconstruction. The technique and materials used, anatomic and functional results, complications, recurrence rates, and changes in quality of life, were analyzed. A total of 94 articles were screened, 38 were included for full-text detailed review. RESULTS: Twenty-one articles fulfilled the inclusion criteria. Techniques and materials used for canal wall reconstruction, tympanoplasty, and ossiculoplasty were varied and included autologous, biosynthetic, or both. Auditory results were reported in 16 studies and were inconsistent. Three studies reported improvement in the quality of life using the GBI scale. Follow-up time ranged from 1 to 83 months. Eleven articles used imaging studies to evaluate postoperative disease recurrence. The highest recurrence rate reported for cholesteatoma after obliteration was 19%. The most frequently reported complications were retraction pockets and transient otorrhea. CONCLUSION: Plenty of techniques combining grafts and other materials have been used to overcome mastoidectomy cavity problems. So far, it is still not possible to standardize an ideal procedure. The available level of evidence for this topic is low and limited.

Pulp healing in immature replanted permanent teeth: A competing risk analysis.

BACKGROUND/AIM: Tooth displacement during avulsion causes total rupture of the pulp's neurovascular supply. Revascularization and pulp healing may occur in immature teeth, which gives rise to the recommendation that root canal treatment may not be required. The aim of this study was to evaluate the prognostic factors for the pulp's response after replantation of young permanent teeth. METHODS: Records from 117 patients with 133 replanted permanent immature teeth were reviewed, and pulp outcomes were classified as healing (hard tissue deposition on the dentinal walls followed by narrowing of the pulp lumen or ingrowth of bone-like tissue inside the pulp canal) or non-healing (pulp necrosis with infection). The effect of clinical and demographic co-variates on the hazards of both outcomes was assessed performing a competing risk model. RESULTS: Pulp necrosis with infection was diagnosed in 78.2% of the teeth, and healing was observed in 12.8% of the teeth. A total of 12 teeth (9.0%) were censored due to prophylactic removal of the pulp or severe external root resorption caused by eruption of adjacent canines. The cs-Cox model demonstrated that the hazards of pulp healing increased in teeth with extra-alveolar periods <15 min (csHR: 7.83, 95% CI 1.76-34.80, p = .01), while the hazards of pulp necrosis with infection decreased (csHR: 0.31, 95% CI: 0.10-0.92, p = .04). Teeth replanted with Moorrees' stages 4 and 5 of root development had higher hazards of pulp necrosis with infection than teeth with stage 2 of root development (csHR: 2.23, 95% CI 1.11-4.50, p = .03; csHR: 2.89, 95% CI: 1.40-5.95; p = .01). CONCLUSIONS: Pulp healing rarely occurred after replantation of young permanent teeth being associated with short extra-alveolar periods <15 min. Early stages of root development decreased the hazards of pulp necrosis with infection.

Tooth autotransplantation using an interdisciplinary approach to rehabilitation in a young patient: Case report with 7-year follow-up.

This case report demonstrates the possibility of functional and aesthetic rehabilitation using an interdisciplinary approach in a child following avulsion of a tooth. Autotransplantation after the development of calcific metamorphosis of the pulp and acute apical periodontitis provided satisfactory repair after root canal treatment. A 7-year-old white boy avulsed the right maxillary central incisor (tooth 11). The extra-alveolar time exceeded 60 minutes, and this triggered external replacement resorption of the avulsed tooth. At 11 years of age, the child underwent tooth autotransplantation. After 4 years of follow-up, intraoral clinical and radiographic examination led to the diagnosis of calcific metamorphosis of the pulp and acute apical periodontitis. The patient had minimally invasive root canal treatment, orthodontic treatment and esthetic rehabilitation with a porcelain crown. Control periapical radiography and tomography of the autotransplanted tooth after 7 years revealed bone repair in the periapical region. This case report indicates that tooth autotransplantation can be used to replace anterior teeth after avulsion followed by replacement resorption. Interdisciplinary management helped to maintain the esthetics and function of the rehabilitated area.

O Mapa de Ausências e Apagamentos em A Rua dos Crocodilos, de Bruno Schulz / The Map of Absences and Obliterations in Bruno Schulz's The Street Of Crocodiles / El Mapa de Ausencias y Eliminaciones en La Rua de Los Crocodilos, de Bruno Schulz

Este trabalho procura colocar em destaque, por meio da narrativa do escritor polonês Bruno Schulz, um operador possível para o enlace entre psicanálise e literatura: o texto (o romance literário ou uma vida narrada em análise) como resultante da impossibilidade de representar o real. A leitura de Schulz, guiada pela bússola da teoria psicanalítica de Freud e Lacan, permite com que se acentue o que chamamos de "mapa de ausências e apagamentos", elemento presente e transversalizador na compilação dos quinze contos que integram A rua dos Crocodilos. Esse mapa traça as linhas de um território no qual é possível realçar as reverberações do conceito de estranho de Freud e, com ele, refletir sobre os efeitos de leitura produzidos pela obra do escritor polonês. (AU)

This paper aims to highlight, trough the narrative of the polish writer Bruno Schulz, a possible operator for the link between psychoanalysis and literature: text (literary novel or a life narrated in analysis) as the result of the impossibility to represent real. The reading of Schulz with the guidelines from Freud's and Lacan's psychoanalytic theories let us examine what we have called "map of absences and obliterations" in the compilation of fifteen short stories The street of croocodiles. This map traces the lines of a territory in which is possible to highlight the reverberations of Freud's concept of strange, and enable us to reflect upon the effects of the reading Schulz's works. (AU)

El presente trabajo forma parte de una investigación más amplia, inspirada en la vida y obra de Bruno Schulz, que se propone pensar el proyecto artístico y literario del escritor norteamericano Jonathan Safran Foer, llamado Tree of codes (2010). En este artículo, partiendo de la obra de Schulz La calle de los cocodrilos, nos dedicamos a reflexionar sobre la relación entre el psicoanálisis y lo que denominamos "mapa de ausencias y eliminaciones", presente en esa compilación de 15 cuentos del escritor polaco. Esa relación nos permitirá establecer un operador posible para el enlace entre psicoanálisis y literatura: el texto (la novela literaria o una vida narrada en análisis) como resultante de la imposibilidad de representar lo real. (AU)

Case Reports in Maxillary Posterior Teeth by Guided Endodontic Access.

The localization of partial or completed root canal obliteration is a challenging task in endodontic practice. Recently, guided endodontics has become an alternative solution for those cases. Although this technique has already been used clinically in managing anterior teeth, in this report, we describe 3 complex clinical scenarios of calcified root canals of 1 molar and 2 premolars using guided endodontics. The clinical cases reported here show that technological evolutions should make guided endodontic procedures more widespread because their execution is relatively fast and safe even in the case of the upper molar. Additionally, 12-month clinical follow-up visits showed the effectiveness of the guided endodontic procedures.

Clinical Approach to Pulp Canal Obliteration: A Case Series.

This article describes four cases with safe and feasible clinical treatment strategies for anterior teeth with pulp canal obliteration (PCO) using cone-beam computed tomography (CBCT), digital radiography (DR), dental operating microscopy (DOM) and ultrasonic tips (US). Four anterior teeth with PCO were chosen. DR was taken with different angulations and analyzed with different filters. Subsequently, the access cavity was performed with the aid of DOM. If the canal was not identified, CBCT was requested. Sagittal and axial slices guided the direction of the ultrasonic tips. After identification of the canal, it was then negotiated and instrumented with the rotary instruments. All four canals were successfully identified, with no complications. In case 1, the canal was identified using DR, DOM and US tips. In cases 2, 3 and 4, the canals were identified with DR, DOM, US tips and CBCT. Complete root canal obliteration identified in radiography did not necessarily mean that pulp tissue was not visible clinically, either. The clinical evaluation of the access cavity with the aid of MO was crucial. If the canal was not identified, CBCT was mandatory in order to show more detailed view of the precise position of the canals, their directions, degrees of obstruction and dimensions. It served as a guide for the direction of the ultrasonic tips to keep them within the pulp chamber safely, with a low risk of iatrogenic injury.

Importancia del método clínico en el diagnóstico de la fístula carótido-cavernosa / Importance of the clinical method in the diagnosis of the carotid-cavernous fistula

Se describe el caso clínico de un paciente de 49 años de edad, que a causa de una crisis hipertensiva presentó una proptosis con enrojecimiento en el ojo derecho, por lo cual recibió diferentes diagnósticos y tratamientos. Debido a que el paciente no mejoraba y aparecían otras manifestaciones clínicas, fue remitido a las consultas de Glaucoma y Neuroftalmología del Centro Oftalmológico de Santiago de Cuba, donde se le realizaron estudios que condujeron al diagnóstico definitivo de fístula arteriovenosa cavernosa carotídea en el lado derecho, indirecta y de bajo flujo. Se indicó compresión manual externa de la carótida, con lo cual se logró la obliteración de la fístula y la mejoría del afectado

The case report of a 49 years patient that presented a proptosis with right eye reddening due to a hipertensive crisis is described, reason why he received different diagnosis and treatments. As the patient didn't improve and other clinical features appeared, he was referred to the Glaucoma and Neurophthalmology Service of the Ophthalmologic Center in Santiago de Cuba, where some studies were carried out which lead to the definitive diagnosis of indirect and of low flow carotid cavernous arteriovenous fistula in the right side. External manual compression of the carotid was indicated and the obliteration of the fistula and improvement of the affected patient was achieved

Mastoid Obliteration with Autologous Bone in Mastoidectomy Canal Wall Down Surgery: a Literature Overview

Introduction The objectives of mastoidectomy in cholesteatoma are a disease-free and dry ear, the prevention of recurrent disease, and the maintenance of hearing or the possibility to reconstruct an affected hearing mechanism. Canal wall down mastoidectomy has been traditionally used to achieve those goals with greater or lesser degrees of success. However, canal wall down is an aggressive approach, as it involves creating an open cavity and changing the anatomy and physiology of themiddle ear andmastoid. A canal wall up technique eliminates the need to destroy the middle ear and mastoid, but is associated with a higher rate of residual cholesteatoma. The obliteration technics arise as an effort to avoid the disadvantages of both techniques. Objectives Evaluate the effectiveness of the mastoid obliteration with autologous bone in mastoidectomy surgery with canal wall down for chronic otitis, with or without cholesteatoma. Data Synthesis We analyzed nine studies of case series comprehending similar surgery techniques on 1017 total cases of operated ears in both adults and children, with at least 12 months follow-up. Conclusion Mastoid Obliteration with autologous bone has been utilized for many years to present date, and it seems to be safe, low-cost, with low recurrence rates - similar to traditional canal wall down procedures and with greater water resistance and quality of life improvements.

[Difficulties in the percutaneous approach of the acute coronary syndrome with associated axillobifemoral bypass]. / Dificultades en el abordaje percutáneo del síndrome coronario agudo con bypass axilobifemoral.

BACKGROUND: Peripheral arterial disease and coronary artery disease are frequently associated. The percutaneous approach may sometimes involve additional difficulties to the coronary artery disease. CLINICAL CASE: The case is presented on an 82 year-old male patient with multiple cardiovascular risk factors, a Leriche syndrome and axillobifemoral bypass, who was admitted to hospital due to an inferior myocardial infarction. The procedure approach (radial, brachial, or femoral access routes for percutaneous coronary treatment) and associated complications from the procedure are discussed. CONCLUSION: Although technical improvements and/or treatment of peripheral vascular lesions may allow percutaneous coronary intervention, individual risk and benefit in each patient must be assessed.

Mastoid Obliteration with Autologous Bone in Mastoidectomy Canal Wall Down Surgery: a Literature Overview.

Introduction The objectives of mastoidectomy in cholesteatoma are a disease-free and dry ear, the prevention of recurrent disease, and the maintenance of hearing or the possibility to reconstruct an affected hearing mechanism. Canal wall down mastoidectomy has been traditionally used to achieve those goals with greater or lesser degrees of success. However, canal wall down is an aggressive approach, as it involves creating an open cavity and changing the anatomy and physiology of the middle ear and mastoid. A canal wall up technique eliminates the need to destroy the middle ear and mastoid, but is associated with a higher rate of residual cholesteatoma. The obliteration technics arise as an effort to avoid the disadvantages of both techniques. Objectives Evaluate the effectiveness of the mastoid obliteration with autologous bone in mastoidectomy surgery with canal wall down for chronic otitis, with or without cholesteatoma. Data Synthesis We analyzed nine studies of case series comprehending similar surgery techniques on 1017 total cases of operated ears in both adults and children, with at least 12 months follow-up. Conclusion Mastoid Obliteration with autologous bone has been utilized for many years to present date, and it seems to be safe, low-cost, with low recurrence rates - similar to traditional canal wall down procedures and with greater water resistance and quality of life improvements.

Stereotactic radiosurgery for pediatric patients with intracranial arteriovenous malformations: variables that may affect obliteration time and probability.

INTRODUCTION: It is debatable whether pediatric patients diagnosed with arteriovenous malformations (AVMs) should be treated as adults. Several indexes to classify AVMs have been proposed in the literature, and most try to predict the outcome for each specific treatment. The indexes differ in the variables considered, but they are all based in adult populations. In this study, we analyzed the variables that influence the obliteration time and probability of occurrence in a Mexican pediatric population diagnosed with an AVM and treated with stereotactic radiosurgery (SRS). METHODS: We analyzed 45 pediatric patients (<18 years) with a minimum follow-up of 10 months and a maximum of 112 months. We used logistic regression analysis and Kaplan-Meier curves to evaluate the influence of age, AVM volume, prescribed dose, minimum dose, maximum dose, time of follow-up, sex, previous hemorrhage, venous drainage, treatment technique, previous treatment and location. We also evaluated the predictive power of the following indexes: Spetzler-Martin, RBAS, or K index dose deviation. RESULTS: We found that the radiation technique used may influence the obliteration occurrence (p=0.057). The data suggests that circular arcs are a more efficient treatment technique than dynamic arcs. However, no relationship of dose or volume with treatment technique could be found. Obliteration was also dependent on follow-up time and after three years of follow-up, the obliteration probability decreases (p=0.024). According to Kaplan-Meier analysis, the nidus obliteration time was related with the location according to the Spetzler-Martin index. If the nidus was located in a non-eloquent region, there was a tendency of a shorter obliteration time (p=0.071). CONCLUSION: None of the previously proposed indexes for adults predict obliteration in this pediatric population. Treatment technique, eloquence and follow up time were the only variables that showed influence in obliteration. Since the highest probability of obliteration occurs during the first three years, if the nidus has not been obliterated after this time then another treatment option could be considered.

Validação de técnica hemostática do complexo arteriovenoso ovariano na ovariosalpingohisterectomia de gatas / Hemostasis technique validation of ovarian arterial venous complex in queens ovariosalpingohisterectomy

The present study aimed at describing ovarian arterial venous complex (OVAC) obliteration technique consisting in tying a knot over its own axis. It also aimed at evaluating the efficacy of this hemostatic technique in queens ovariosalpingohisterectomy, as well as checking partial OVAC obliteration time and total procedure time. After previous training based on alternative methods for the demanded surgical skills acquisition, in vivo surgical procedures were conducted. Once gathered the necessary skills, an experimental study was carried in order to compare this technique with the linking technique in which three hemostatic clamps are used. In vivo training, firstly applied in healthy queens, and later in uterine affection carriers, helped consolidating the dexterity previously acquired through alternative practice methods, and also contributed to the feasibility verification of the described technique, which showed to be effective. Comparative study did not reveal any significant statistic difference between both groups on total surgical elapsed time (p =0.2848) and time spent for the right OVAC obliteration (p=0.1036), however significant difference was observed on the left OVAC obliteration (p=0.0001). The results obtained during trans-operatory observation led to the conclusion that the described technique is feasible and provides appropriate OVAC hemostasis.(AU)

O estudo objetivou descrever a técnica de obliteração do complexo arteriovenoso ovariano (CAVO) por meio da confecção de um nó sob seu próprio eixo, além de avaliar a eficácia desta técnica hemostática na ovariosalpingohisterectomia de gatas, bem como averiguar os tempos parciais de obliteração dos CAVOs e o tempo total do procedimento. Após treinamento prévio, com auxílio de métodos alternativos para ganho de habilidade cirúrgica, foram realizados procedimentos cirúrgicos in vivo. Realizou-se estudo experimental com finalidade de comparar a técnica proposta com a técnica de ligadura com três pinças hemostáticas. O treinamento in vivo, inicialmente em gatas hígidas e, posteriormente, em portadoras de afecções uterinas, serviu para consolidar a destreza adquirida por meio de métodos alternativos e para averiguar a exequibilidade da técnica descrita, que se mostrou eficaz. No estudo comparativo não houve diferença estatística significativa entre o tempo cirúrgico (p=0,2848) e a obliteração do CAVO direito (p=0,1036) entre os dois grupos, porém foram observadas diferenças significativas no tempo de obliteração do CAVO esquerdo (p=0,0001). Diante dos resultados obtidos a partir das avaliações realizadas no período de observação transoperatória, podemos inferir que a técnica descrita é exequível e promove adequada hemostasia do CAVO.(AU)

Validação de técnica hemostática do complexo arteriovenoso ovariano na ovariosalpingohisterectomia de gatas / Hemostasis technique validation of ovarian arterial venous complex in queens ovariosalpingohisterectomy

The present study aimed at describing ovarian arterial venous complex (OVAC) obliteration technique consisting in tying a knot over its own axis. It also aimed at evaluating the efficacy of this hemostatic technique in queens ovariosalpingohisterectomy, as well as checking partial OVAC obliteration time and total procedure time. After previous training based on alternative methods for the demanded surgical skills acquisition, in vivo surgical procedures were conducted. Once gathered the necessary skills, an experimental study was carried in order to compare this technique with the linking technique in which three hemostatic clamps are used. In vivo training, firstly applied in healthy queens, and later in uterine affection carriers, helped consolidating the dexterity previously acquired through alternative practice methods, and also contributed to the feasibility verification of the described technique, which showed to be effective. Comparative study did not reveal any significant statistic difference between both groups on total surgical elapsed time (p =0.2848) and time spent for the right OVAC obliteration (p=0.1036), however significant difference was observed on the left OVAC obliteration (p=0.0001). The results obtained during trans-operatory observation led to the conclusion that the described technique is feasible and provides appropriate OVAC hemostasis.

O estudo objetivou descrever a técnica de obliteração do complexo arteriovenoso ovariano (CAVO) por meio da confecção de um nó sob seu próprio eixo, além de avaliar a eficácia desta técnica hemostática na ovariosalpingohisterectomia de gatas, bem como averiguar os tempos parciais de obliteração dos CAVOs e o tempo total do procedimento. Após treinamento prévio, com auxílio de métodos alternativos para ganho de habilidade cirúrgica, foram realizados procedimentos cirúrgicos in vivo. Realizou-se estudo experimental com finalidade de comparar a técnica proposta com a técnica de ligadura com três pinças hemostáticas. O treinamento in vivo, inicialmente em gatas hígidas e, posteriormente, em portadoras de afecções uterinas, serviu para consolidar a destreza adquirida por meio de métodos alternativos e para averiguar a exequibilidade da técnica descrita, que se mostrou eficaz. No estudo comparativo não houve diferença estatística significativa entre o tempo cirúrgico (p=0,2848) e a obliteração do CAVO direito (p=0,1036) entre os dois grupos, porém foram observadas diferenças significativas no tempo de obliteração do CAVO esquerdo (p=0,0001). Diante dos resultados obtidos a partir das avaliações realizadas no período de observação transoperatória, podemos inferir que a técnica descrita é exequível e promove adequada hemostasia do CAVO.

VALIDAÇÃO DE TÉCNICA HEMOSTÁTICA DO COMPLEXO ARTERIOVENOSO OVARIANO NA OVARIOSALPINGOHISTERECTOMIA DE GATAS

The present study aimed at describing ovarian arterial venous complex (OVAC) obliteration technique consisting in tying a knot over its own axis. It also aimed at evaluating the efficacy of this hemostatic technique in queens ovariosalpingohisterectomy, as well as checking partial OVAC obliteration time and total procedure time. After previous training based on alternative methods for the demanded surgical skills acquisition, in vivo surgical procedures were conducted. Once gathered the necessary skills, an experimental study was carried in order to compare this technique with the linking technique in which three hemostatic clamps are used. In vivo training, firstly applied in healthy queens, and later in uterine affection carriers, helped consolidating the dexterity previously acquired through alternative practice methods, and also contributed to the feasibility verification of the described technique, which showed to be effective. Comparative study did not reveal any significant statistic difference between both groups on total surgical elapsed time (p =0.2848) and time spent for the right OVAC obliteration (p=0.1036), however significant difference was observed on the left OVAC obliteration (p=0.0001). The results obtained during trans-operatory observation led to the conclusion that the described technique is feasible and provides appropriate OVAC hemostasis.

O estudo objetivou descrever a técnica de obliteração do complexo arteriovenoso ovariano (CAVO) por meio da confecção de um nó sob seu próprio eixo, além de avaliar a eficácia desta técnica hemostática na ovariosalpingohisterectomia de gatas, bem como averiguar os tempos parciais de obliteração dos CAVOs e o tempo total do procedimento. Após treinamento prévio, com auxílio de métodos alternativos para ganho de habilidade cirúrgica, foram realizados procedimentos cirúrgicos in vivo. Realizou-se estudo experimental com finalidade de comparar a técnica proposta com a técnica de ligadura com três pinças hemostáticas. O treinamento in vivo, inicialmente em gatas hígidas e, posteriormente, em portadoras de afecções uterinas, serviu para consolidar a destreza adquirida por meio de métodos alternativos e para averiguar a exequibilidade da técnica descrita, que se mostrou eficaz. No estudo comparativo não houve diferença estatística significativa entre o tempo cirúrgico (p=0,2848) e a obliteração do CAVO direito (p=0,1036) entre os dois grupos, porém foram observadas diferenças significativas no tempo de obliteração do CAVO esquerdo (p=0,0001). Diante dos resultados obtidos a partir das avaliações realizadas no período de observação transoperatória, podemos inferir que a técnica descrita é exequível e promove adequada hemostasia do CAVO.