What is the Effectiveness of Premaxilla Surgical Repositioning and its Stabilization Methods in Mixed Dentition Patients With Bilateral Cleft Lip and Palate?

OBJECTIVE: Verify the effectiveness of surgical repositioning of the premaxilla and its stabilization methods in patients with bilateral cleft lip and palate during mixed dentition. DESIGN: Systematic review. MATERIAL AND METHODS: The search was conducted in 7 databases (eg, Medline via PubMed; Scopus; Central Cochrane; LILACS; Embase, Web of Science; and Sigle via OpenGrey until August 2021), using the descriptors "premaxilla", "cleft Palate", and "bone transplantation". INCLUSION CRITERIA: Clinical trials and observational studies that have patients with bilateral cleft who had a need for superior/posterior repositioning of the premaxilla on mixed dentition; Studies in any language was evaluted whitout time restriction of publication. RESULTS: From 5572 records, 6 studies were included in the review with a total sample of 212 patients. Regarding the type of stabilization used in the premaxilla, the hybrid method (rigid and complementary semi-rigid stabilization) predominated, being observed in 184 patients (86.8%). A total of 17 failures were identified related to the surgical repositioning of the premaxilla, corresponding to 8% of the total number of surgeries. A meta-analysis of prevalence was performed, only with the retrospective studies. It was observed that the effectiveness rate of premaxilla repositioning was 92%, with a CI between 0.04 and 0.13, with all included studies showing a similar failure rate (0.08-0.09). The included studies also showed great homogeneity in this analysis (I2 = 0%; P = .75). CONCLUSION: Although there are several alternatives and techniques for repositioning and stabilizing the premaxilla, the statistical result did not differ between the different techniques.

Surgical Treatment of Aggressive Intraosseous Cavernous Hemangioma in Maxilla Through Surgical Resection.

Hemangiomas are benign vascular lesions characterized by endothelial vascular proliferation and may demonstrate aggressive clinical features. Intraosseous hemangiomas are uncommon and the maxillary location rare, with few cases described in the literature. The treatment of these lesions varies, however they have a better prognosis when a surgical treatment through resection is performed. The aim of this study is to report a case of right maxillary cavernous intraosseous hemangioma treated by surgical resection with previous embolization. The diagnosis was made through incisional biopsy and immunohistochemical examination. An aggressive lesion profile was observed through the Ki67 marker. During surgery, a temporary ipsilateral external carotid artery ligation was performed to minimize possible bleeding. Weber-Fergson surgical access was performed and total surgical resection through hemi-maxillectomy. The patient is stable after 30 months of follow-up without relapses. In suspected cases of intraosseous hemangiomas, accurate diagnosis and total surgical resection of the lesion is essential. The use of therapeutic mammoths that minimize sagging during and after the procedure such as embolization and arteriography should always be performed.

Tratamento cirúrgico de anquilose temporo-mandibular utilizando o disco articular como material de interposição / Ankylosis temporomandibular surgical treatment using disc as joint filing of material

A anquilose da articulação temporomandibular (A.T.M) é à união do complexo disco-côndilo à superfície articular do osso temporal. A anquilose da A.T.M possui etiologia multifatorial, sendo trauma associada a fratura condilar a causa mais comum. A anquilose causa diversos distúrbios funcionais nos pacientes acometidos, principalmente limitação de abertura bucal reduzindo a capacidade de mastigar. O diagnóstico é feito pela correlação dos aspectos clínicos e imaginológicos. Existem diversos relatos na literatura sobre o tratamento e a abordagem cirúrgica para anquilose da A.T.M, porém o primordial é remover totalmente a massa anquilótica. O objetivo do presente artigo é relatar um caso de tratamento cirúrgico da anquilose da ATM, com interposição do próprio disco articular, devolvendo ao paciente as funções importantes relacionadas à movimentação mandibular

The ankylosis of the temporomandibular joint (TMJ) is the union of the complex disk-condyle to the articular surface of the temporal bone. Ankylosis of the TMJ has a multifactorial etiology, trauma associated with condylar fractures the most common cause. The ankylosis cause various functional disorders in affected patients, especially mouth opening limitation reducing the ability to chew. The diagnosis is made by the correlation of clinical and imaging aspects. There are several reports in the literature on the treatment and surgical approach for ankylosis of TMJ, but the primary is fully remove the anquilótica mass. The objective of this study is to report a case of surgical treatment of TMJ ankylosis, with interposition of the articular disc itself, returning to the patient the important functions related to mandibular movement

Cisto dermóide sublingual (30 anos de evolução): relato de caso / Subligal Dermoid Cyst ( 30 years Evolution): Case Report

O Cisto Dermóide é uma condição rara em região de cabeça e pescoço, caracterizado por apresentar um epitélio que contém estruturas anexas em sua parede, glândulas sebáceas, sudoríparas, folículos pilosos ou unhas. Quando em localização supra-milohióidea, o cisto dermóide pode causar deslocamento ântero-posterior da língua, causando transtornos fonéticos e respiratórios. O seu tratamento é a exérese cirúrgica, sendo a escolha do acesso cirúrgico dependente da localização da lesão e da experiência do cirurgião. Este trabalho descreve os aspectos clínicos, imagenológicos e anatomopatológicos, assim como o tratamento cirúrgico desta patologia e proservação do caso. Paciente, gênero feminino, 36 anos de idade, cursando com lesão em assoalho bucal, decorrendo em elevação da língua, dislalia e disfagia, com 30 anos de evolução. Foi realizada exérese da lesão por acesso intra-oral, com diagnóstico anatomopatológico de Cisto Dermóide... (AU)

Dermoid Cyst is a rare condition in head and neck area, histologically characterized by epithelium containing structures attached on its wall, sebaceous glands, sweat glands, hair follicles or nails. When located in upper-mylohyoid muscle area, the Dermoid Cyst can cause displacement of the tongue, respiratory and phonetic disorders. Its treatment is surgical excision, being the choice of surgical approach related to the lesion location and the surgeon's experience. This paper describes the clinical, pathological and imaging aspects as well as surgical treatment and follow up of this pathology. Female patient, 36 years old, showing lesions on the mouth floor, elevation of the tongue, dyslalia, dysphagia and 30 years of evolution. Excision of the lesion was performed by intraoral access, with histopathological diagnosis of Dermoid Cyst... (AU)