Prevalence of the systemic inflammatory response syndrome in patients who underwent orthognathic surgery.

PURPOSE: The systemic inflammatory response syndrome (SIRS) is the body's response to an insult, such as infection, trauma, burn, and surgical stress linked to several factors deemed potential for multiple organ failure if left untreated. Thus, the aim of this paper was a prospective study to examine the incidence of SIRS in postoperative patients who underwent orthognathic surgery from June/2013 to July/2016. METHODS: The sample consisted of 80 patients who underwent bimaxillary orthognathic surgery, with data on vital signs and white blood cell count collected preoperatively, and the same data collected in the immediate postoperative period, in addition to CO2 pressure in arterial blood by blood gas analysis. The data were tabulated and cases of SIRS (2 or more signs out of four pre-set signs) were identified within 24 h after surgery. RESULTS: From the sample of 80 patients, 26 (32.5% of total) patients had SIRS with higher incidence in females who are 40 years old. CONCLUSION: The incidence of patients who develop SIRS after orthognathic surgery is relatively high and we should pay attention to the possible complications that these cases can evolve.

In-vitro comparison of mechanical resistance between two straight plates and a Y-plate for fixation of mandibular condyle fractures.

OBJECTIVE: To compare the mechanical resistance of conventional plates with a modified Y-plate in mandibular condyle fracture. MATERIALS AND METHODS: 40 synthetic hemi-mandibular polyurethane replicates were used. Two groups of fixing materials were included: 20 mandibles fixed with 40 straight plates with four roles each (2.0 mm system) and 20 mandibles fixed with 20 Y-shaped plates (2.0 mm system and 1.5 mm thickness). The samples were submitted to linear loading in the following directions: 10 mandibles from each group from lateral to medial and 10 mandibles from each group from anterior to posterior. A universal loading machine, Instron Universal 4411, was used to performed the tests, and the resistance of each fixed mandible was assessed at displacements of 1 mm, 3 mm, and 5 mm. The t-test for independent samples was performed. The p value was set at <0.05. RESULTS: The worst mechanical resistance was found in the Y-plates loaded from anterior to posterior. The best mechanical resistance was in two straight hole plates loaded from lateral to medial. The Y-plates and two straight hole plates showed similar resistance when a lateral to medial load was applied. CONCLUSION: There was no difference between the plates when lateral to medial loading was tested.

Influence of degree of edentulism in mandible fractures / Influência do grau de edentulismo em fraturas mandíbulas

Objective ­ To characterize epidemiologically the aspects of incidence, treatment and complications of mandibular fractures in dentate, partially dentate and edentulous patients. Methods ­ Data were collected from medical records of patients seen by the department of Oral and Maxillofacial Surgery, Piracicaba School of Dentistry/UNICAMP, from January 1999 to October 2009. Results ­ Were selected 738 adult patients, grouped into three age groups (18 to 30 years, 31-64 years and over 64 years), whose degree of edentulism was informed, being 330 dentition (45%), 367 partially serrated (50%) and 41 edentulous (5%). The ratio between male and female was 4:1, mean age of 31 years, with higher incidence in caucasians, and 81% were economically active. The most common causes were traffic accidents (54%), followed by assault (20%), falls (15%), sports accidents (4%) and work (4%). Condylar fractures accounted for 29% of all fractures, followed by fractures of the body (25%), symphysis (24%) and angle (19%). The only significant difference between the sites of fracture was found in the edentulous, which presented a low incidence of angle fractures. Conclusions ­ It was observed that this population, homogeneous as to the cultural and socio-environmental factors, the dentate, partially dentate and edentulous behaved similarly as to the mandibular fractures resulting from trauma energies of similar intensities.

Objetivo ­ Caracterizar epidemiologicamente os aspectos de incidência, tratamento e complicações de fraturas mandibulares em pacientes dentados, parcialmente dentados e edêntulos. Métodos ­ Os dados foram coletados de prontuários de pacientes atendidos pelo departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia de Piracicaba/UNICAMP, de janeiro de 1999 a outubro de 2009. Resultados ­ Foram selecionados 738 pacientes adultos, agrupados em três faixas etárias (18 a 30 anos, 31-64 anos e mais de 64 anos), cujo grau de edentulismo foi informado, sendo 330 dentições (45%), 367 parcialmente serrilhadas (50%) e 41 edêntulas (5%). A proporção entre homens e mulheres foi de 4:1, idade média de 31 anos, com maior incidência em caucasianos e 81% economicamente ativas. As causas mais comuns foram os acidentes de trânsito (54%), seguidos pelo assalto (20%), quedas (15%), acidentes esportivos (4%) e trabalho (4%). As fraturas condilares representaram 29% de todas as fraturas, seguidas de fraturas do corpo (25%), sínfise (24%) e ângulo (19%). A única diferença significativa entre os locais de fratura foi encontrada no edêntulo, que apresentou baixa incidência de fraturas angulares. Conclusões ­ Observou-se que esta população, homogênea quanto aos fatores culturais e socioambientais, dentada, parcialmente dentada e edêntula, comporta-se de forma semelhante às fraturas mandibulares resultantes de energias de trauma de intensidades semelhantes.

Evaluation of cyclic and linear mechanical resistance of prebent and manually-bent plates used for maxillary advancement in orthognathic surgery.

The aim of the present study was to compare prebent and manually-bent plates used in maxillary advancement. The prebent plates were fixed in polyurethane blocks for the linear test and aluminium blocks for the cyclic test, and the manually-bent plates were fixed in polyurethane and aluminium blocks. The linear load tests were done using an Instron® 4411 mechanical testing machine and the cyclic test with an Instron® E3000 testing machine. The linear mechanical test showed that there was no significant difference between the plates. In the cyclic test the prebent plates reached the limit of 500000 cycles without fracturing whereas the manually-bent plate group fractured before reaching the limit of cycles (p=0.008). The decision to use prebent or manually-bent plates during operations should be influenced by the production of the bends and their consequent brittleness.

Mechanical and microstructural properties of fixation systems used in oral and maxillofacial surgery.

OBJECTIVES: This paper aims to evaluate in vitro the mechanical and microstructural properties of internal fixation systems used in oral and maxillofacial surgeries. MATERIALS AND METHODS: Four brands of internal fixation systems (screws and 4-hole straight plates) were selected and assigned to four groups: G1 Leibinger®, G2 Tóride®, G3 Engimplan®, and G4 Medartis®. The systems were submitted to Vickers hardness testing, metallographic and interstitial elements chemical composition analyses. Data were submitted to ANOVA and Tukey's test for statistical analysis. RESULTS: Plates in groups 1, 2, and 3 showed similar microstructure and mechanical properties, different from those in G4 revealing larger grains. In all groups, the screws showed similar microstructure, with uniform arrangement and size of grains; the screws showed higher hardness values than those observed for the plates. CONCLUSIONS: The results indicate that all materials tested are adequate for use in oral maxillofacial surgeries.

Analysis of residual stress and hardness in regions of pre-manufactured and manual bends in fixation plates for maxillary advancement.

The aim of this study was to analyze, through Vickers hardness test and photoelasticity analysis, pre-bent areas, manually bent areas, and areas without bends of 10-mm advancement pre-bent titanium plates (Leibinger system). The work was divided into three groups: group I-region without bend, group II-region of 90° manual bend, and group III-region of 90° pre-fabricated bends. All the materials were evaluated through hardness analysis by the Vickers hardness test, stress analysis by residual images obtained in a polariscope, and photoelastic analysis by reflection during the manual bending. The data obtained from the hardness tests were statistically analyzed using ANOVA and Tukey's tests at a significance level of 5 %. The pre-bent plate (group III) showed hardness means statistically significantly higher (P < 0.05) than those of the other groups (I-region without bends, II-90° manually bent region). Through the study of photoelastic reflection, it was possible to identify that the stress gradually increased, reaching a pink color (1.81 δ / λ), as the bending was performed. A general analysis of the results showed that the bent plate region of pre-bent titanium presented the best results.

Mechanical and photoelastic analysis of four different fixation methods for mandibular body fractures.

OBJECTIVE: The aim of the present study was to compare four methods of fixation in mandibular body fractures. STUDY DESIGN: Mechanical and photoelastic tests were performed using polyurethane and photoelastic resin mandibles, respectively. The study groups contained the following: (I), two miniplates of 2.0 mm; (II) one 2.0 mm plate and an Erich arch bar; (III) one 2.4 mm plate and an Erich arch bar, and (IV) one 2.0 mm plate and one 2.4 mm plate. The differences between the mean values were analyzed using Tukey's test, the Mann-Whitney test and the Bonferroni correction. RESULTS: Group II recorded the lowest resistance, followed by groups I, IV and III. The photoelastic test confirmed the increase of tension in group II. CONCLUSION: The 2.4 mm system board in linear mandibular body fractures provided more resistance and the use of only one 2.0 mm plate in the central area of the mandible created higher tension.

Development plates for stable internal fixation: Study of mechanical resistance in simulated fractures of the mandibular condyle.

OBJECTIVE: To develop Y-shaped plates with different thicknesses to be used in simulated fractures of the mandibular condyle. Ten plates were developed in Y shape, containing eight holes, and 30 synthetic polyurethane mandible replicas were developed for the study. MATERIAL AND METHODS: The load test was performed on an Instron Model 4411 universal testing machine, applying load in the mediolateral and anterior-posterior positions on the head of the condyle. Two-way ANOVA with Tukey testing with a 5% significance level was used. RESULTS: It was observed that when the load was applied in the medial-lateral plate of greater thickness (1.5 mm), it gave the highest strength, while in the anteroposterior direction, the plate with the highest resistance was of the lesser thickness (0.6 mm). A plate with a thickness of 1.5 mm was the one with the highest average value for all displacements. In the anteroposterior direction, the highest values of resistance were seen in the displacement of 15 mm. CONCLUSION: After comparing the values of the biomechanical testing found in the scientific literature, it is suggested that the use of Y plates are suitable for use in subcondylar fractures within the limitations of the study.

Cephalometric evaluation of preoperative incisor inclination in patients with class II dentofacial deformities treated with mandibular advancement / Avaliação cefalométrica da inclinação de incisivos em pacientes com deformidade dentofacial classe II e que foram tratados com avanço de mandíbula

Avaliar cefalometricamente a inclinação dos incisivos de 30 pacientes com maloclusão Classe II que foram tratados com avanço de mandíbula Material e Métodos: Trinta teleradiografias de perfil do pré-operatório imediato foram fotografadas para serem utilizadas no Software Dolphin Imaging. Medidas lineares e angulares foram traçadas e analisadas. Cada traçado foi realizado repetido duas vezes em um intervalo de uma semana pelo mesmo operador. As medidas foram tabuladas no Microsoft Excel e submetidas ao teste estatístico t- Studen e as médias das medidas foram comparadas aos valores normais. O coeficiente de correlação intraclasse foi utilizado para avaliar a confiabilidade intra-examinador. Resultados: O coeficiente intraclasse foi >0.9 o que certifica uma alta confiabilidade. Os incisivos inferiores obtiveram médias diferentes dos valores normais, apresentando-se mais vestibularizados. Conclusão: Nesse estudo, os resultados demonstraram que pacientes Classe II submetidos a cirurgia ortognática de avanço de mandíbula apresentam compensações dentárias, sendo que os incisivos inferiores estão mais vestibularizados quando comparados aos valores normais...

To evaluate cephalometrically the preoperative incisor inclination of 30 patients with Class II malocclusion, who were treated with mandibular advancement. Material and Methods: Thirty immediate preoperative lateral cephalograms were photographed to be used in Dolphin Imaging Software. Linear and angular measurements were traced and analyzed. Each tracing was repeated twice with 1-week interval by the same operator. The measures were tabulated at Microsoft Excel and submitted to Student’s-t test and mean measures were compared with the normal values. The intraclass correlator coefficient was used to test the intraexaminer reliability. Results: The intraclass correlation coefficient was >0.9 and it featured a high reliability. Mean values of lower incisors differed from normal values, presenting labial inclination compared to normal values. Conclusion: In this study, the results showed that Class II patients that will be submitted a mandibular advancement (orthognathic surgery) had dental compensations and the lower incisors are more proclined comparing to the standard values...

Bilateral alloplastic prostheses for temporomandibular joint reconstruction in a patient with ankylosing spondylitis.

Ankylosing spondylitis (AS) or Bechterew disease is a chronic, usually progressive, systemic inflammatory joint disease, which predominantly affects the spine and sacroiliac joints. In these joints, early inflammatory changes are followed by lumbosacral pain and progressive restriction of spinal movement associated with radiologically visible intervertebral ossification. Peripheral joint involvement occurs in 10 to 30% of patients and shows a predilection for the shoulders, knees, ankles, feet, and wrists. Temporomandibular joint (TMJ) involvement has been described, and its reported frequency varies from 11 to 35%. However, ankylosis is uncommon with a single documented case utilizing an alloplastic prosthesis for total joint replacement. A case report of bilateral ankylosis of the jaw treated with alloplastic prostheses for total TMJ replacement using a Brazilian system in a patient with AS is presented.

Perception of oral and maxillofacial surgeons, orthodontists and laypersons in relation to the harmony of the smile.

OBJECTIVE: Harmony is one of the main objectives in surgical and orthodontic treatment and this harmony must be present in the smile, as well as in the face. The aim of the present study was to assess the perceptions of professionals and laypersons in relation to the harmony of the smile of patients with or without vertical maxillary alterations. MATERIALS AND METHODS: Sixty observers (oral and maxillofacial surgeons, orthodontists and laypersons) reported the degree of harmony of six smiles using an objective questionnaire and the participants indicated if there was a need for corrective surgery or not. The classification of observers was recorded on a Likert scale from 1 to 5. Mixed regression was used to determine differences between the three groups. RESULTS: Statistically significant differences were found only for the harmony of the smile between the oral and maxillofacial surgeons and laypersons, with laypersons being more critical when assessing the smile. There was no statistical difference between the other groups for the harmony of the smile or the indication of corrective surgery. The patterns of greater or lesser harmony determined by observers during the smile were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. CONCLUSIONS: Laypersons had a tendency to be more critical in relation to facial harmony than surgeons, although no statistical differences were found in the other groups in relation to the harmony of the smile or indication for the corrective surgery. In addition, the patterns of greater or lesser harmony of the smile determined by the participants were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Overall, the present study demonstrates that adequate interaction between surgeons, orthodontists and laypersons is essential in order to achieve facial harmony with orthodontic and/or surgical treatment. CLINICAL RELEVANCE: Opinion of specialists and laypersons about the smile in relation to the vertical positioning of the maxilla.

Estudo comparativo entre teleradiografias de perfil escaneadas e fotografadas para uso no software Dolphin Imaging / A Comparison of Scanned and Corresponding Photographed Cephalograms For Use in Dolphin Imaging Software

O objetivo deste estudo foi comparar teleradiografias de perfil escaneadas e fotografadas para uso no Software Dolphin Imaging. Dez teleradiografias de perfil foram fotografadas para uso nesse programa computacional. Medidas lineares e angulares foram traçadas cefalometricamente e analisadas. Cada traçado foi repetido, duas vezes, no intervalo de 1 semana, pelo mesmo operador. As medidas foram tabladas no Microsoft Excel, e os testes t de Student e Wilcoxon foram utilizados para comparar cada medida. O coeficiente de correlação intraclasse foi utilizado para se verificar a padronização intraexaminador, e os resultados >0.92 indicavam alta confiabilidade. Nenhuma diferença estatisticamente significante foi observada entre os 2 grupos em todas as medidas lineares e angulares. Pode-se concluir, então, que ambos os métodos (fotografias e scanner) podem ser realizados para a utilização no Software Dolphin Imaging... (AU)

The purpose of this study was to compare scanned cephalograms to photographed cephalograms for use in Dolphin Imaging Software. Ten lateral cephalograms were photographed and scanned to be used in Dolphin Imaging Software. Linear and angular measurements were tracing and analyzed. Each tracing was repeated twice with 1-week interval, by the same operator. The measures were tabulated at Microsoft Excel and Students-t and Wilcoxon tests were used to compare each measurement. The intraclass correlator coefficient was used to test the intraexaminer reability and was >0.92 and it featured a high reability. No statistically difference was observed between the two groups, in all of the linear and angular measurements. We concluded that for the use in the Dolphin Imaging Software both methods (photographs and scanner) can be used... (AU)

Biomechanical strength analysis of mini anchors for the temporomandibular joint.

INTRODUCTION: The usage of mini anchors for the treatment of internal derangements of the temporomandibular joint (TMJ) is considered an innovative treatment, and it has presented excellent clinical results in the stabilization of the articular disc. This study aimed to evaluate, through mechanical tensile testing, the resistance of mini anchors for TMJ articular disc repositioning. MATERIALS AND METHODS: Ten thermoplastic polymer poly-ether-ether-ketone (PEEK) mini anchors were tested in artificial polyurethane blocks with a pullout test in a mechanical Instron™ machine, model 4411. The mini anchors were pulled out until failure and the force and displacement were recorded for each specimen. A small standard deviation was noted, which indicated reproducibility. RESULTS: The findings indicate that Cillen™ mini anchors presented a mean force at failure up to 46.1 N with similar values in the scientific literature. Nevertheless, further studies should be conducted for a comparison of PEEK mini anchors with other commercially available anchors, in addition to studies related to PEEK, a scarcely known material in the dentistry field.

Hipertrofia unilateral do músculo master: relato de caso / Unilateral Masseter Muscle Hypertrophy: Case Repor

A hipertrofia do músculo masseter é um crescimento excessivo uni ou bilateral do músculo, de etiopatogenia ainda não definida que, na maioria das vezes, gera um desconforto estético e em alguns casos, funcional. Os indivíduos afetados frequentemente exibem um aumento em volume ósseo em região de ramo e ângulo mandibular e o tratamento pode ser através de métodos cirúrgicos ou não cirúrgicos. A abordagem cirúrgica envolve intervenções que são realizadas, apenas, na musculatura comprometida, na estrutura óssea do ângulo mandibular ou ambos. O presente artigo descreve um caso de hipertrofia unilateral do músculo masseter, onde optou-se pela intervenção cirúrgica intraoral com ressecção de fibras musculares e osteotomia do ângulo mandibular. Após um período de dois meses de acompanhamento, observa-se que a modalidade cirúrgica para tratamento de hipertrofia do masseter está bem indicada pois proporciona ótimo resultado estético... (AU)

Masseter muscle hypertrophy is a unilateral or bilateral enlargement of the masseter muscle, of undefined etiology, which in most cases generates an aesthetic discomfort, and in some cases a functional one as well. The affected individuals often exhibit an increase in bone mass in the region of the branch and mandibular angle, and the treatment can use surgical or nonsurgical methods. The surgical approach involves intervetions performed in either the compromised muscle or the mandibular angle bone structure, or in both. This article describes a case of unilateral masseter muscle hypertrophy, where the surgical resection of the muscle fibers in an intraoral approach and a osteotomy with a reciprocating saw were performed in the mandibular angle region. After a two-month follow-up, it was observed that the surgical approach for the treatment of masseter hypertrophy is well advised, since the aesthetic results are excellent, with similarity to the contralateral side of mandibular angle... (AU)

Biomechanical analysis on diferente fixation techniques for treatment of mandibular body fractures

Aim: To biomechanically analyze two fixation techniques in polyurethane hemi-mandibular bodyfractures, using a universal testing machine. Methods: The study employed 10 polyurethanehemi-mandible replicas, which simulated simple fractures of the mandibular body, divided into twogroups: one group comprised 5 hemi-mandibles with two 2.0 mm system plates in the tension andcompression zones, while the other group contained 5 hemi-mandibles with an Erich bar and a2.0 mm system plate in the tension and neutral zones, respectively. Data were analyzed statisticallyby the Student’s t-test (α=0.05) Results: The test results indicated that the fixation using 2.0 mmsystem plates offered significantly more resistance to the loads and presented significantly largerdisplacement compared to the fixation using just one 2.0 mm system plate and the Erich bar.Conclusions: It may be concluded that the use of two plates in the 2.0 mm system had greatermechanical strength than a single 2.0 mm plate combined with an Erich bar. Clinically, it is knownthat both techniques can provide good results, but patients receiving the combination of Erich barand one plate are required to be more cooperative during the postoperative period, especiallywith respect to the prescribed diet in order to avoid failures in this system.

Importance of occlusal plane reproduction on the semi-adjustable articulator in planning maxillary impactions for orthognathic surgery.

INTRODUCTION: The aim of this study was to evaluate whether a 6° counterclockwise change in occlusal plane inclination would produce significant modifications on the final result of a maxillary impaction and mandible advancement model surgery. MATERIALS AND METHODS: Four groups were used in this study, with ten identical maxillary casts and one mandibular cast mounted on the same semi-adjustable articulator, with the same malocclusion. The occlusal plane of the two control and study groups had an inclination of 13° and 7°, respectively. Preoperative and postoperative measures were performed using the Erickson platform and impactions of 6 and 10 mm were tested. To control these movements during model surgery, two splints were fabricated using another two maxillary and mandibular casts mounted with occlusal plane of 13°, simulating the proposed movement. RESULTS: The results were compared using the t test. Only the antero-posterior movement of the upper incisor was statistically significant for both study groups (p < 0.05), with a mean of 0.48 and 0.94 mm in the 10 and 6 mm impaction groups, respectively. DISCUSSION: This information means that if an error in the occlusal plane transference occur, it will not be clinically significant, because differences smaller than 1 mm does not have influence on soft and hard tissue final result.

Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

INTRODUCTION: This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. MATERIALS AND METHODS: Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. RESULTS: Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). DISCUSSION: Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

Prospective study of postoperative sensory disturbances after surgical treatment of mandibular fractures.

INTRODUCTION: This present study's purpose is to evaluate the degree of paresthesia and recovery of inferior alveolar nerve in patients with mandible fractures who underwent surgical treatment. MATERIAL AND METHODS: Nineteen patients were evaluated (27 hemimandibles) at six different times: preoperative (T1), postoperative 1 week (T2), postoperative 1 month (T3), postoperative 3 months (T4), postoperative 6 months (T5), and postoperative 1 year (T6). Subjective and objective methods were used for this evaluation. RESULTS: The results were analyzed using likelihood ratio chi-square test for the hypothesis of no association between indicators of sensitivity and responses to the questionnaire, and the Cochran-Mantel-Haenszel test for equality hypothesis. All objective tests showed a statistically significant worsening in sensitivity at T2 (p < 0.0001) and a significant improvement after T4 (α < 0.05). The subjective tests showed an association with the objectives tests, and improvement in sensitivity after T4 (p < 0.0001) was noted. DISCUSSION: The first postoperative week is the period in which there are major changes with respect to sensitivity, and after 3 months postoperatively, the recovery reaches its apex with little difference observed after this period. In this research 100 % of the patients analyzed recovered all sensibility until T6.

Evaluation of the use of biomodels in sequelae of maxillofacial trauma / Evaluación de la utilización de biomodelo de secuelas de traumatismo maxilofacial

The use of rapid prototyping technology in Oral and Maxillofacial Surgery has been increasing in the last decade, allowing the management of biomodels from medical image processing as computed tomography in order to obtain a three dimensional model with the same geometric characteristics as the virtual one. The aim of this study is to present the use of biomodels for treatment of maxillofacial trauma sequelae with evaluation of clinical records in a period that varies from January 2000 to December 2010. For diagnosis and surgical planning of maxillofacial sequelae in this period, some 15 prototypes were used, allowing us to determine the treatment planning with more accuracy and to save operating room time.

El uso de tecnología de prototipado rápido en Cirugía Oral y Maxilofacial se ha incrementado en la última década, lo que permite la gestión de los biomodelos de procesamiento de imágenes médicas, como tomografía computarizada para obtener un modelo tridimensional con las mismas características geométricas del virtual. El objetivo de este estudio es presentar el uso de biomodelos para el tratamiento de las secuelas de un traumatismo maxilofacial con la evaluación de las historias clínicas en un período que varía entre enero de 2000 a diciembre de 2010. Para el diagnóstico y la planificación de la cirugía maxilofacial de las secuelas en este período, 15 prototipos fueron utilizados, lo que permite determinar la planificación del tratamiento con más precisión y para ahorrar tiempo de quirófano.

Distrator palatal de Rotterdam: uma opção para expansão cirúrgica de maxila / Rotterdam palatal distractor: an option for surgically assisted rapid maxillary expansion

Existem diversos aparelhos que podem ser utilizados para a expansão, sendo classificados em distratores de ancoragem dentária, e os mais utilizados e difundidos são o Haas e Hyrax e distratores de ancoragem óssea somente. Vários aparelhos de ancoragem óssea têm sido desenvolvidos, sendo o expansor palatal de Rotterdam um dos mais utilizados. Este artigo tem como objetivo relatar um caso de expansão cirurgicamente assistida de maxila com o distrator palatal Rotterdam (KLS Martin) e discutir as principais indicações, vantagens e desvantagens desse aparelho bem como o protocolo de utilização.

There are several devices that can be used for maxillary expansion. They can be classified as follows: toothanchored distractors (the most frequently used being the Haas and the Hyrax) and bone anchor distractors only. Several bone anchorage devices have been developed, with the Rotterdam palatal expander being the one most commonly used. This article sets out to report a case of surgically assisted maxillary expansion with the Rotterdam palatal distractor (KLS Martin) and to discuss indications, advantages and disadvantages of this device and the protocol used.