Postoperative nausea and vomiting in orthognathic surgery: systematic review and meta-analysis.

PURPOSE: Postoperative nausea and vomiting (PONV) is a frequently reported adverse event following orthognathic surgery. The aim of this work is to conduct a systematic review of the literature on the subject, and to discuss the role of maxillofacial surgeons and the steps that can be taken to prevent or control PONV in orthognathic surgery. METHODS: A systematic review was conducted according to the PRISMA guidelines, using the search strategy: (orthognathic AND (nausea OR vomiting)). The authors searched PubMed, Embase, Dimensions, Web of Science and Google Scholar databases, without any language restrictions. RevMan 5.4 was used to create a risk of bias graph and a forest plot. RESULTS: The included articles were classified as having a low risk of bias, despite the limited literature on the subject. Various measures have been reported to be beneficial in preventing or managing PONV, such as the use of dexamethasone, antiemetic drugs, gastric aspiration, and anesthetic blocks. Effective bleeding control and faster surgeries can also be helpful. CONCLUSIONS: Throat packs have not been found to be effective in preventing PONV. Although no definitive protocol has been established in the literature, the Enhanced Recovery After Surgery (ERAS) protocol could be a useful approach. Overall, a multimodal approach may be taken to prevent PONV, and further research is needed to establish definitive protocols.

Optimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide.

OBJECTIVE: This study aimed to comprehensively review the literature and provide a practical guide for optimizing drug regimens and supplementation related to orthognathic surgery. METHODS: The authors conducted a thorough review of the existing literature, following the PRISMA-ScR guidelines. Various types of studies except case reports and reviews were included. The study applied specific inclusion criteria, focusing on perioperative and/or postoperative drugs, medications, or supplementation related to orthognathic surgery. RESULTS: This guide included 78 studies on various medications in orthognathic surgery. It encompasses clinical trials, cohort studies, cross-sectional studies, prospective and retrospective studies. The topics covered include antibiotics, analgesics, corticosteroids, antiemetics, hemostatic agents, local anesthetics, herbal medicine, and botulinum toxin. Pain and edema control involved specific medications, while local anesthesia utilized ropivacaine and bupivacaine. The guide also discusses mineral and vitamin supplementation. The effectiveness of hemostatic agents and antiemetics was highlighted. CONCLUSION: Pain management, reduced swelling, enhanced wound healing, and faster recovery are among the advantages. In addition to the standard drugs and medications, the inclusion of vitamin and mineral supplements, tranexamic acid, postoperative anesthetic blocks, and preemptive antiemetics is anticipated to offer various benefits in orthognathic surgery, despite the limited available evidence.

Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study.

OBJECTIVE: We analyzed the quality and quantity of systematic reviews (SRs) of orthognathic surgery, the most frequently published topic in maxillofacial surgery. STUDY DESIGN: We searched the PubMed database for SRs of orthognathic surgery with no restriction on the language of publication date. We assessed the certainty of evidence presented according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and the Leiden Manifesto using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed the data using descriptive statistics, Pearson´s correlation test, and linear regression. RESULTS: Of the 171 SRs evaluated, approximately one fifth presented evidence with a high level of certainty. The number of orthognathic surgery SRs has been increasing, and many SRs were published after very similar topics had already been published. There is no relationship between the impact factor and the certainty of evidence. CONCLUSIONS: An excessive number of SRs of orthognathic surgery are published, and many SRs are superfluous, simply reporting previous findings. Clinicians should not base treatment decisions solely on the evidence presented in SRs, and journal editors and reviewers should evaluate these SRs more critically, particularly when they address topics that have already been covered in the literature.

Science mapping analysis of maxillofacial reconstruction over the last four decades.

PURPOSE: This paper aims to provide a bibliometric analysis of the maxillofacial reconstruction literature over 40 years and to compare the data with previous studies. METHODS: A bibliographical search for oral and maxillofacial surgery literature in maxillofacial reconstruction was conducted on Wef of Science. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95 % confidence interval, which was considered significant. RESULTS: A total of 7417 articles from specialized journals were included in the study. These articles received 138,493 citations from 63,390 other studies, with an average citation count of 18.67, and a very high H-index. A total of 2375 specific keywords were analyzed, covering a wide range of topics, with two noteworthy MeSH keywords that have recently gained prominence. A total of 33 journals were included in the study, with a mean Impact Factor of 2.404, indicating a relatively high influence in the subject area. CONCLUSION: The high h-index reflects abundant and high-quality literature on maxillofacial reconstruction, with the United States leading in publication quantity. Emerging topics in maxillofacial reconstruction were discussed. These areas shape the discipline, driving advancements and offering opportunities for researchers and clinicians to contribute to progress and improve patient outcomes.

The importance of written informed consent in facial cosmetic surgery litigation.

It is the aim of the study to discuss litigation related to facial cosmetic surgery with a particular focus on written consent, in order to prevent unfortunate outcomes for the surgeon and patient alike. A 10-year online search for facial cosmetic surgery litigation in Brazil was conducted from 2012 to 2022. Statistical analyzes were performed using RStudio, and the results were considered significant with a 95% confidence interval. A total of 992 litigations were identified through the search. Of these, 122 articles met our inclusion criteria. The number of legal disputes on this subject has been increasing for years. Female patients are more prone to litigation. Financial damage ranged from $75 to $500,000 (mean: $59,536). Many of the lawsuits that had appropriate written consent have had a favorable outcome for the defendant. The primary specialty was the most common plastic surgery (67%), followed by maxillofacial surgery (9%). Surgeons engaged in facial cosmetic surgery should protect themselves legally from litigation. Written consent significantly reduces both litigation losses and financial damage. Some details on the preparation of this consent form have been discussed.

Global network mapping research findings on orthognathic surgery and temporomandibular disorder.

OBJECTIVES: The objective of this work is to assess the relationship between orthognathic surgery and temporomandibular disorders literature through a bibliometric analysis. METHODS: A bibliographic search in line with the STROBE guidelines and the concepts of the Leiden Manifesto was performed on the Web of Science using the terms orthognathic surgery AND temporomandibular. A citation analysis and establishment of the more cited articles were performed. A graphical representation of the keywords was created with VOSviewer. RESULTS: A total of 810 articles were analyzed in this study. The research revealed a significant increase in publications on this topic, particularly in English language articles and a high H-index. The publications represented 55 nations, with the highest number of articles coming from the USA. The discussion of highly cited articles covered various aspects such as the relationship between orthognathic surgery and TMD, including condylar resorption or displacement, predisposing factors, dentoskeletal and occlusion patterns, anatomical factors, osteotomy techniques, condylar positioning techniques, and emerging technologies for improved TMJ stability. CONCLUSION: The analysis reveals an increasing research interest in this field, with a significant number of publications in English and a high citation rate per article, indicating the impact of the research. Various factors associated with TMD in orthognathic surgery are explored, including condylar alterations, predisposing factors, occlusion patterns, and surgical techniques. The study underscores the importance of thorough assessment, treatment, and monitoring of TMD in orthognathic surgery patients, while acknowledging the need for further research and consensus in management strategies.

A global science mapping analysis on odontogenic infections.

OBJECTIVES: Odontogenic infections are common and a topic of core interest for dentists, and maxillofacial surgeons. The aim of this study was to conduct a bibliometric analysis of the global literature on odontogenic infection and explore the top 100 most cited papers to identify the common causes, sequelae and management trends. METHODS: Following a comprehensive literature search, a list of top 100 most cited papers was created. The VOSviewer software (Leiden University, The Netherlands) was used to create a graphical representation of the data, and statistical analyses were performed to analyze the characteristics of the top 100 most cited papers. RESULTS: A total of 1,661 articles were retrieved with the first article published in 1947. There is an exponential upward trend on the number of publications (R2 = 0.919) and a majority of papers are in English language (n = 1,577, 94.94%). A total of 22,041 citations were found with a mean of 13.27 per article. The highest number of publications were recorded from developed countries. There was a male predilection in the reported cases and the most common sites included the submandibular and parapharyngeal spaces. Diabetes mellitus was identified as the commonest co-morbidity. Surgical drainage was ascertained to be the preferred method of management. CONCLUSIONS: Odontogenic infections remain prevalent and have a global distribution. Although prevention of odontogenic infection through meticulous dental care is ideal, early diagnosis and prompt management of established odontogenic infections is important to avoid morbidities and mortality. Surgical drainage is the most effective management strategy. There is lack of consensus regarding the role of antibiotics in the management of odontogenic infections.

Predictors of complication for alveolar cleft bone graft.

We have analysed the predictors of postoperative complications and the need for reoperation after grafting of the alveolar cleft from one specialised cleft centre. The data were obtained from hospital casenotes of patients operated on from December 2004 to April 2010, with a minimum one-year follow-up from the final operation. Independent variables included postoperative complications and the need for reoperation. Conditional variables were sex, age, type of cleft, sides affected, donor area, type of graft material, and the presence of an erupted tooth in contact with the cleft. A total of 71 patients had bone grafted on to the alveolar cleft. The following associations were found to be significant: postoperative complications and need for reoperation (p=0.003); age and complications (p=0.002); affected side and complications (p=0.006); age and reoperation (p=0.000); sex and reoperation (p=0.001); and type of cleft and reoperation (p=0.001). Proper attention should be given to all the variables and risk factors to overcome the many obstacles that might have an adverse influence on a successful outcome of alveolar bone grafting for patients with clefts.

Efeito da laserfototerapia sobre a viabilidade de diferentes tipos celulares em cultura submetidos a diferentes concentrações do alendronato sódico e ácido zoledrônico / Effect of low level laser therapy on viability of different cell types submitted to different concentrations of sodium alendronate and zoledronic acid

Os bisfosfonatos (BFs) têm sido amplamente utilizados para o tratamento de doenças do metabolismo ósseo, principalmente na prevenção de metástases ósseas e na prevenção e tratamento da osteoporose. No entanto, existem efeitos colaterais indesejáveis sendo um deles, a indução da Osteonecrose dos Maxilares (Medication-Related Osteonecrosis of the Jaws - MRONJ), uma complicação de difícil tratamento e solução. Até o presente momento, não foi definida a fisiopatologia da MRONJ e nem estabelecido protocolo de tratamento eficaz para esta doença. Diversas terapias vem sendo descritas na literatura para o tratamento da MRONJ dentre elas a laserfototerapia. Assim sendo, os objetivos deste estudo foram: inicialmente avaliar in vitro o efeito de diferentes concentrações dos BFs mais empregados na atualidade (alendronato e ácido zoledrônico) na viabilidade de células envolvidas na reparação de lesões MRONJ (osteoblastos e fibroblastos); secundariamente estudar o efeito da fototerapia com laser de baixa potência sobre estas células previamente induzidas pelos BFs. Foram utilizados osteoblastos-símile da linhagem OSTEO 1 e fibroblastos de mucosa bucal humana da linhagem FMM1. Após terem sido submetidos aos testes de citotoxicidade expondo as células as concentrações de 1?M, 10?M e 100?M de alendronato sódico e 3?M, 5?M e 10?M de ácido zoledrônico por 24 horas, os grupos testes foram irradiados com laser de diodo no modo contínuo, puntual e de contato (InGaAIP, 660nm, 30mW, spot 0,028cm2 ) com duas densidades de energia diferentes 5J/cm2 (4,5s) e 10J/cm2 (9s)

Duas irradiações com intervalo de 6 horas entre cada uma delas foram executadas. A viabilidade celular foi determinada utilizando o ensaio de redução do MTT, e a atividade de fosfatase alcalina dos osteoblastos foi avaliada utilizando ensaio de ponto final. Os resultados obtidos foram submetidos à análise estatística ANOVA 1 critério complementado por Tukey (p<0,05). Foi possível concluir que: as concentrações de 100?M e 10?M do alendronato sódico foram tóxicas para os osteoblastos e fibroblastos em cultura. As concentrações de 3?M, 5?M e 10?M do ácido zoledrônico foram tóxicas para os osteoblastos e fibroblastos a longo prazo (48h e 72h). A atividade da fosfatase alcalina nos osteoblastos foi afetada por todas as concentrações de ácido zoledrônico testadas (3?M, 5?M e 10?M). Nos parâmetros aqui aplicados a LPT não teve efeito sobre a atividade da fosfatase alcalina das células tratadas com o alendronato de sódio ou ácido zoledrônico. E a laserfototerapia de baixa potência nos parâmetros utilizados nesse estudo não foi capaz de reverter a toxicidade dos bisfosfonatos testados, independentemente das concentrações destas substâncias

Bisphosphonates (BPs) have been widely used for treating bone metabolism diseases, especially for prevention of bone metastasis and osteoporosis. However, there are undesirable side effects and one of them, the induction of Osteonecrosis of the Jaw (Medication-Related Osteonecrosis of the Jaws - MRONJ), a complication of difficult treatment and solution. Until now the pathophysiology and an effective treatment protocol for MRONJ have not been established. Various therapies have been described in the literature for the treatment of MRONJ including laserphototherapy. The objectives of this study were to evaluate the effect of different concentrations of two BPs used today (alendronate and zoledronic acid) on the viability of cells involved in the repair of MRONJ lesions (osteoblasts and fibroblasts); and to study the effect of phototherapy with low power laser on these cells previously treated with referred BPs. After being submitted to cytotoxicity testing by exposing the cells to concentrations of 1?M, 10?M and 100?M of sodium alendronate and 3?M, 5?M and 10?M of zoledronic acid for 24 hours, the test groups were irradiated with diode laser in continuous mode, punctual and contact (InGaAIP, 660nm, 30mW, spot 0,028cm2) with two different energy densities 5 J/cm2 (4,5s) and 10J/cm2 (9s)

Two irradiations with an interval of 6 hours between each of them were performed. Cell viability was determined using the MTT reduction assay, and the alkaline phosphatase activity of osteoblasts was evaluated using the end point assay. The results were submitted to statistical analysis using ANOVA 1 criteria complemented by Tukey (p <0.05). It was possible to conclude that: concentrations of 100?M and 10?M of alendronate were toxic to osteoblasts and fibroblasts in culture. The concentrations of 3?M, 5?M and 10?M of zoledronic acid was toxic to osteoblasts and fibroblasts in long-term (48h and 72h). The activity of alkaline phosphatase in osteoblasts was affected by all the zoledronic acid concentrations tested (3?M, 5?M and 10?M). In the LPT parameters applied here had no effect on alkaline phosphatase activity of the cells treated with the sodium alendronate or zoledronic acid. And low power laserphototherapy, in the parameters used in this study, was unable to reverse the toxicity of bisphosphonates tested, irrespective of the concentrations of these substances

Coronectomia de terceiro molar inferior / Inferior third molar coronectomy

A técnica da coronectomia, também conhecida como odontectomia parcial intencional, foi 9 desenvolvida para minimizar o risco de lesão ao nervo alveolar inferior quando o terceiro molar a incluso e impactado apresenta raízes em relação de proximidade com o canal mandibular. É uma técnica controversa e tem ganhado muito espaço na literatura contemporânea da especialidade, com estudos clínicos randomizados e revisões sistemáticas que consigam comprovar a n evidência de sucesso na prevenção de traumatismos nervoso. O artigo apresenta um caso clínico s que descreve o diagnóstico radiográfico e tomográfico, a técnica da coronectomia utilizada, o controle pós-operatório e uma breve discussão da literatura.

Coronectomy or intentional partial odontectomy is an operatory maneuver developed to minimize traumatisms to the mandibular nerve when an impacted or non erupted third molar's presents great proximity to the alveolar nerve. It is a controversial technique although literature a has been increasing its attention in the last few years. Many randomized clinical studies and systematic reviews have been published in order to state clinical evidence on trauma prevention of e the alveolar nerve. This article presents a case report describing the radiographic and tomography diagnoses, coronectomy technical details, postoperative follow-up and a brief literature discussion.

Can the use of antibiotics interfere with the success of dental osseointegrated implants in diabetic patients?

AIM: The present review aims to discuss the last 10 years published data on the topic of the use of osseointegrated implants in diabetic subjects, particularly regarding the influence of antibiotics administration in the perioperative period. BACKGROUND: In the last decades, oral rehabilitation significantly has evolved particularly with the use of osseointegrated implants. Increased life expectation of population is reflecting in a greater number of diabetic patients who might require dental osseointegrated implants rehabilitation. Diabetes was considered for a long time as a contraindication for oral implant placement. In this context, the use of antibiotics is still a controversial factor when we correlate it to implant success rate. REVIEW RESULTS: Although 228 articles were initially selected for evaluation of proposed criteria, only 16 articles were considered valid. Among the 16 selected articles, only six articles represented clinical research that discussed the influence of the antibiotic in the success of osseointegration of dental implants in diabetic subjects. Five were retrospective studies and one a prospective research. CONCLUSION: Data favors the use of antibiotics without significant side effects but clinical investigations of the need of prophylaxis antibiotic or therapeutic antibiotics are still scarce. The lack of adequate methodology is one of the main problems of the current articles. It is important to emphasize that studies should present detailed methodology in order to allow reproducibility. CLINICAL SIGNIFICANCE: Permanent tooth loss is a pathological condition that affects millions of people worldwide. The possibility of successful treatment of edentulous areas through osseointegrated implants in those systemic compromised patients is a matter of scientific discussion. Although antimicrobial agents must be used rationally and carefully to avoid development of bacterial resistance, more studies are needed in order to support evidence regarding the influence of antibiotics in the success of dental implant surgery in diabetic patients.

Importância dos tratamentos complementares na terapêutica cirúrgica do tumor odontogênico queratocísitico / Importance of complementary treatment for the surgical therapy of the keratocystic odontogenic tumor

Tratamentos complementares como excisão tegumentar; ostectomia periférica e aplicação da solução de Carnoy minimizam a recorrência do tumor odontogênico queratocístico após a ecérese conservadora por enucleação ou curetagem, embora sejam desconsiderados por alguns cirurgiões. O artigo revisa as técncias citadas e relata a combinação delas em dois casos dessa neoplasia odontogência, mostrando resultado efetivo em acompanhamento mínimo de cinco anos.

Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up.

Dentigerous cyst (DC) is one of the most common odontogenic cysts of the jaws and rarely recurs. On the other hand, keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst (OKC), is considered a benign unicystic or multicystic intraosseous neoplasm and one of the most aggressive odontogenic lesions presenting relatively high recurrence rate and a tendency to invade adjacent tissue. Two cases of these odontogenic lesions occurring in children are presented. They were very similar in clinical and radiographic characteristics, and both were treated by marsupialization. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. At 7-years of follow-up, none of the cases showed recurrence.

Osteonecrose maxilar associada ao uso de bisfosfonatos / Bisphosphonate-related osteonecrosis of the jaw

Os bisfosfonatos (BFs) têm sido indicados para o tratamento de doenças do metabolismo ósseo. Atualmente, seu emprego terapêutico aumentou e, com ele, os efeitos adversos, dos quais um dos mais importantes é a indução da osteonecrose dos maxilares, uma complicação de difíceis tratamento e solução. Até o presente, não se sabe ao certo qual é o mecanismo de desenvolvimento da osteonecrose dos maxilares induzida por bisfosfonatos (ONMB), nem qual deve ser o tratamento estabelecido perante essa manifestação. Apesar de a literatura apresentar formas variadas de tratamento, não existe um protocolo definido. Apresentamos uma revisão sobre a ONMB, enfocando sua etiopatogenia e as formas reportadas de tratamento.

Bisphosphonates (BPs) have been used for the management of bone metabolic diseases. Currently their therapeutic use has increased, as also have their adverse effects, one of the most important being the bisphosphonate-related osteonecrosis of the jaw (BRONJ), a complication of difficult treatment and solution. Until now, the physiopathology of BRONJ remains unclear, and its treatment is uncertain. Although the literature provides several treatment options, there is no defined protocol. We present a review about BRONJ, focusing on its pathogenesis and its reported forms of treatment.

Surgical management of dentigerous cyst and keratocystic odontogenic tumor in children: a conservative approach and 7-year follow-up

Dentigerous cyst (DC) is one of the most common odontogenic cysts of the jaws and rarely recurs. On the other hand, keratocystic odontogenic tumor (KCOT), formerly known as odontogenic keratocyst (OKC), is considered a benign unicystic or multicystic intraosseous neoplasm and one of the most aggressive odontogenic lesions presenting relatively high recurrence rate and a tendency to invade adjacent tissue. Two cases of these odontogenic lesions occurring in children are presented. They were very similar in clinical and radiographic characteristics, and both were treated by marsupialization. The treatment was chosen in order to preserve the associated permanent teeth with complementary orthodontic treatment to direct eruption of the associated permanent teeth. At 7-years of follow-up, none of the cases showed recurrence.

Bisphosphonate-related osteonecrosis of the jaw.

Bisphosphonates (BPs) have been used for the management of bone metabolic diseases. Currently their therapeutic use has increased, as also have their adverse effects, one of the most important being the bisphosphonate-related osteonecrosis of the jaw (BRONJ), a complication of difficult treatment and solution. Until now, the physiopathology of BRONJ remains unclear, and its treatment is uncertain. Although the literature provides several treatment options, there is no defined protocol. We present a review about BRONJ, focusing on its pathogenesis and its reported forms of treatment.

Nodular lymphocyte predominance Hodgkin lymphoma of the parotid gland: a case report.

The parotid is the most frequent site of primary salivary gland tumors. Lymphomas represent 0.2 to 0.8% of all malignant parotid tumors. Primary Hodgkin lymphoma of the parotid gland is rare with few cases reported in literature. The nodular lymphocyte predominance Hodgkin lymphoma (HL) is considered a particular clinical and histopathological subtype of HL. It has never been reported in the parotid gland since its incorporation in the 2001 World Health Organization Classification. The authors describe a case of a 32-year-old male who sought medical attention because of a one-year history of right cheek enlargement. A parotid nodule was submitted to a fine needle aspiration biopsy which disclosed a suspected lymphoproliferative disorder. A surgical dissection of the parotid gland was performed and an enlarged intraparotid lymph node measuring 4cm in its longest axis was excised, preserving the parotid gland integrity as well as the facial nerve. The pathological examination disclosed the diagnosis of nodular lymphocyte predominance Hodgkin lymphoma in this lymph node within the parotid gland. The treatment was completed with local radiotherapy and the 5-year follow up was uneventful.

Ocorrência de acidentes pérfuro-cortantes em um Curso de Odontologia / Accidents cutting and piercing in a School of Dentistry

Objetivo: Avaliar o índice de ocorrências e as características dos acidentes, notificados, envolvendo materiais pérfuro-cortantes em alunos, funcionários e professores, no período entre 2000 e 2005 na Clínica Odontológica da Faculdade de Odontologia da Universidade de São Paulo. Métodos: Foi realizado levantamento das fichas de notificações de ocorrências de acidentes, considerando o material que provocou oacidente, o período do dia da ocorrência, a disciplina em que ocorreu e a conduta clínica executada no pronto atendimento. Foram ainda considerados, quando disponíveis, os resultados dos exames laboratoriais do acidentado e do paciente fonte. Resultados: Os dados avaliados mostraram 40 notificações de acidentes, sendo que 39 notificações foram envolvendo alunos de graduação e um funcionário. O instrumento que mais provocou acidente foi a agulha de anestesia e o maior número desses acidentes aconteceu na disciplina de Cirurgia. Entretanto, 50% das fichas não apresentavam as informações completas o que impediu uma avaliação epidemiológica mais apurada. Conclusão: Os dados obtidos permitiram concluir que o índice de ocorrência de acidentes foi extremamente baixo considerando o número de atendimentos clínicos realizados no período e levanta-se a hipótese de que muitos casos não foram notificados.

Objective: To assess the occurrence and characteristics of the reported accidents with perforating-cutting materials involving students, staff and faculty members, between 2000 and 2005 at the Dental Clinic of the School of Dentistry of the University of São Paulo. Methods: A survey of the records of reported occurrences of accidents was made, considering the material that caused the accident, time of day of the occurrence, the discipline in which it occurred, and clinical conduct adopted in the emergency room. When available, the results of the laboratory exams of the accident victim and the source patient were also taken into consideration. Results: The data assessed showed there were 40 accident reports, of which 39 reports involved undergraduate students and 1 staff member. The instrument that caused most accidents was the anesthetic needle and largest number of these accidents occurred in the Surgery discipline. However, 50% of the records did not present complete information, which prevented a more accurate epidemiological assessment. Conclusion: The data obtained led to the conclusion that the rate of accidents is extremely low considering the number of clinical attendances provided in the period and raises the hypothesis that many cases were not reported.

Correlação da impactação de terceiros molares com a ausência de dentes / Relationship of third molar impaction with the absence of teeth

A literatura relata que a freqüência de impactação dos terceiros molares vem aumentando na população. Este trabalho teve como objetivo pesquisar, por meio de radiografias panorâmicas, o estado de impactação óssea dos terceiros molares com relação a ausência ou não de outros dentes no hemiarco correspondente. Foram incluídas radiografias que apresentassem pelo menos um terceiro molar, que foram classificados em dentes com ou sem impactação óssea, e divididos em: Grupo 1, terceiros molares que apresentavam ausência de um ou mais dentes no seu hemiarco; e Grupo 2, que não apresentavam ausência de dentes. O Grupo 1 também foi subdividido de acordo com o tipo de dente ausente (segundo molar, primeiro molar e pré-molar e/ou dente anterior). Ao total, foram incluídas 802 radiografias com 2.219 terceiros molares. As análises estatísticas dos resultados revelaram que os terceiros molares do Grupo 1 apresentaram menor freqüência de impactação óssea quando comparados aos do Grupo 2. Além disso, foi observado que quanto mais próximo do terceiro molar estava localizada a ausência, maior foi a influência dessa no estado de impactação. Foi possível concluir que a ausência de dentes foi correlacionada à diminuição de impactação dos terceiros molares.