New Trends to Treat Muscular Atrophy: A Systematic Review of Epicatechin.

Epicatechin is a polyphenol compound that promotes skeletal muscle differentiation and counteracts the pathways that participate in the degradation of proteins. Several studies present contradictory results of treatment protocols and therapeutic effects. Therefore, the objective of this systematic review was to investigate the current literature showing the molecular mechanism and clinical protocol of epicatechin in muscle atrophy in humans, animals, and myoblast cell-line. The search was conducted in Embase, PubMed/MEDLINE, Cochrane Library, and Web of Science. The qualitative analysis demonstrated that there is a commonness of epicatechin inhibitory action in myostatin expression and atrogenes MAFbx, FOXO, and MuRF1. Epicatechin showed positive effects on follistatin and on the stimulation of factors related to the myogenic actions (MyoD, Myf5, and myogenin). Furthermore, the literature also showed that epicatechin can interfere with mitochondrias' biosynthesis in muscle fibers, stimulation of the signaling pathways of AKT/mTOR protein production, and amelioration of skeletal musculature performance, particularly when combined with physical exercise. Epicatechin can, for these reasons, exhibit clinical applicability due to the beneficial results under conditions that negatively affect the skeletal musculature. However, there is no protocol standardization or enough clinical evidence to draw more specific conclusions on its therapeutic implementation.

Cranial anatomical structures with high sexual dimorphism in metric and morphological evaluation: A systematic review.

The mastoid process has attracted the attention of several researchers due to its protected position at the base of the skull and the fact that it is relatively compact, in addition to being highly resistant and dimorphic, considered as a gold standard anatomical structure in the determination of the sexual dimorphism of skulls. However, intrinsic and extrinsic factors may influence this anatomical structure over time, providing contradictory and ambiguous data. Therefore, other anatomical structures need to be evaluated concurrently with the mastoid process to provide better accuracy and reliability of skull sexual dimorphism data. Thus, the objective of this systematic review was to evaluate the degree of reliability of the mastoid process to determine sexual dimorphism compared to other dimorphic structures, since there are still no systematic reviews on the subject in the literature. This review follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was recorded in the Prospective International Systematic Reviews Registry (PROSPERO) (CRD 42023395167 Systematic Registry) (CRD420223). The inclusion criteria for selecting the studies were based on the PICO question: "Are skull anatomical structures reliable as alternatives to determine sexual dimorphism compared to the mastoid process?". A literature search for studies was performed in the MEDLINE Scopus, Web of Science, LILACS, and Cochrane Library databases. The Kappa agreement presented an approval level of (k = 0.93). This systematic review analyzed 13 ex-vivo studies published between 2008 and 2023. The risk of bias was considered low in 12 of the studies, and high in 1 study. Based on the findings, it can be concluded that even with the limitations of this systematic review, quantitative and qualitative analyses are essential in sexual identification of human skulls, and different anatomical structures can be used as references in addition to the mastoid process, with high reliability and precision, among them the; glabella, frontal profile, superciliary arch, bizygomatic width, maximum cranial length, and nasal height.

A systematic review of photogrammetry as a reliable methodology in gender identification of human skull.

One of the most important parameters in the identification process in forensic Medicine and Dentistry is the determination of sex through the skull, based on morphological and metric dimorphism. Photogrammetry is an affordable option that allows the reconstruction of position, orientation, shape, and size, allowing the performance of quantitative and qualitative analyzes to identify the sex of the individual. However, there are few systematic reviews in the literature validating whether photogrammetry is a reliable methodology for sexual identification using human skulls. Therefore, the objective of the current systematic review was to validate whether photogrammetry of dry skulls is reliable as a method for calculating sex in human identification. This revision follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was recorded in the Prospective International Systematic Reviews Registry (PROSPERO) (CRD420223 Systematic Registry) (CRD420223). The inclusion criteria for selecting the studies were based on the PICO question: "Is test photogrammetry reliable as a method for estimating sex in human identification?". A literature search for studies was performed in the databases MEDLINE Scopus, Web of Science, LILACS, and the Cochrane Library. The Kappa agreement presented an approval level of (k = 0.93). This systematic review analyzed 11 ex-vivo studies published between 2001 and 2021. The risk of bias was considered low in 8 of the studies, and high in 3 studies. Based on this systematic review, it can be concluded that the photogrammetry method is viable and reliable in identifying sexual dimorphism.

Treatment of oral myiasis in a patient with implant-supported fixed prosthesis.

Oral myiasis is a rare parasitic disease that requires immediate treatment once diagnosed. However, no standard treatment protocol can be found in the literature. Through a clinical-surgical report, we present the case of an 82-year-old man with lesions extending through the vestibule and alveolar ridge of the maxilla on both sides, in addition to occupying a large part of the palate, with a considerable number of larvae. The patient was initially treated with a single dose of systemic ivermectin (6 mg orally) and topical application of a tampon soaked in ether. The larvae were then surgically removed and debridement of the wound was performed. A crushed tablet of ivermectin 6 mg was applied topically for 2 days, the remaining larvae were again mechanically removed, and the patient received intravenous antimicrobial therapy. Treatment with systemic and topical ivermectin combined with antibiotic therapy and debridement proved to be effective in treating oral myiasis.

Treatment of oral myiasis in a patient with implant-supported fixed prosthesis

ABSTRACT Oral myiasis is a rare parasitic disease that requires immediate treatment once diagnosed. However, no standard treatment protocol can be found in the literature. Through a clinical-surgical report, we present the case of an 82-year-old man with lesions extending through the vestibule and alveolar ridge of the maxilla on both sides, in addition to occupying a large part of the palate, with a considerable number of larvae. The patient was initially treated with a single dose of systemic ivermectin (6 mg orally) and topical application of a tampon soaked in ether. The larvae were then surgically removed and debridement of the wound was performed. A crushed tablet of ivermectin 6 mg was applied topically for 2 days, the remaining larvae were again mechanically removed, and the patient received intravenous antimicrobial therapy. Treatment with systemic and topical ivermectin combined with antibiotic therapy and debridement proved to be effective in treating oral myiasis.

Guided neural regeneration with autologous fat grafting and oxygen hyperbaric therapy.

The loss of continuity of the nerve structure interrupts the transmission of nerve impulses and leads to the disorganization of functional activities. Many methods, as the use of neurogenic factors, aid in the process of neural regeneration by accelerating or improving peripheral nerves neoformation. The adipose tissue is abundant in the human body, and it has presented promising results in the regeneration of peripheral nerves. We carried out a randomized controlled study in 9 months, using 45 male Wistar rats, 80 days old, and the sciatic nerve was chosen for analysis. The control animals were divided into three groups - Initial group (IG), Final group (FG), and denervated group (DG) - with seven animals each. The experimental groups, with twelve animals each, were polyethylene tube filled with fat (EGF) and polyethylene tube without filling (EGwf). All groups, except IG, were submitted to 10 sessions of hyperbaric oxygen treatment of 1h 45 min in alternating days. Functional evaluation by walking-track was assessed using the Catwalk XT® software and tissues were harvested and stained with 1% toluidine blue for histological analysis. Quantitative data were first analyzed with the Kolmogorov Smirnov normality test. Comparison between the four groups was analyzed by ANOVA followed by Tukey Test. We concluded that hyperbaric oxygen therapy had positive results on morphometric and functional parameters. However, no significant differences were found regarding the use of autologous fat graft.

Lack of 5-lipoxygenase in intramembranous and endochondral 129Sv mice skeleton and intramembranous healing.

OBJECTIVE: To analyze the lack of 5-lipoxygenase (5LO) on dental socket healing and post-natal phenotype of intramembranous and endochondral bones. DESIGN: Wild type (WT) 129/SvEv (n = 20) and 5LO knockout (5LOKO) (n = 20) male mice underwent tooth extraction of the upper right incisor and were euthanized after 7, 14, and 30 day time points for the evaluation of dental socket healing and histological phenotyping of intramembranous (IM) and endochondral (EC) bones. Microscopic analysis of alveolar sockets included histopathological description, histomorphometry, and immunohistochemistry for 5LO, cyclooxygenase 2 (COX2), and tartrate resistant acid phosphatase (TRAP). RESULTS: Histological phenotyping revealed thicker cortical bone in EC bones (femur and vertebra) of 5LOKO mice compared to WTs, with no differences in collagenous content. Although dental socket healing was similarly observed in both groups, WT mice revealed increased numbers of COX-2+ and 5LO+ cells during bone maturing stage, with a decrease of TRAP+ cells at day 30. On the other hand, an increased quantity of fibroblasts was observed at day 7 in 5LOKO group, as well as increased inflammatory infiltrate and significantly decreased TRAP+ cells at final stages of alveolar socket healing in comparison to WTs. CONCLUSIONS: The lack of 5LO in 5LOKO mice resulted in thicker cortical of EC, but not of IM post natal bones. Furthermore, genetic deletion of 5LO in the 5LOKO mice directly affected the inflammatory response during socket healing, influencing initial and late phases of bone repair in a model of post-tooth extraction in 129Sv WT and 5LOKO mice.

New Surgical Model for Bone-Muscle Injury Reveals Age and Gender-Related Healing Patterns in the 5 Lipoxygenase (5LO) Knockout Mouse.

Signaling lipid mediators released from 5 lipoxygenase (5LO) pathways influence both bone and muscle cells, interfering in their proliferation and differentiation capacities. A major limitation to studying inflammatory signaling pathways in bone and muscle healing is the inadequacy of available animal models. We developed a surgical injury model in the vastus lateralis (VL) muscle and femur in 129/SvEv littermates mice to study simultaneous musculoskeletal (MSK) healing in male and female, young (3 months) and aged (18 months) WT mice compared to mice lacking 5LO (5LOKO). MSK defects were surgically created using a 1-mm punch device in the VA muscle followed by a 0.5-mm round defect in the femur. After days 7 and 14 post-surgery, the specimens were removed for microtomography (microCT), histopathology, and immunohistochemistry analyses. In addition, non-injured control skeletal muscles along with femur and L5 vertebrae were analyzed. Bones were microCT phenotyped, revealing that aged female WT mice presented reduced BV/TV and trabecular parameters compared to aged males and aged female 5LOKO mice. Skeletal muscles underwent a customized targeted lipidomics investigation for profiling and quantification of lipid signaling mediators (LMs), evidencing age, and gender related-differences in aged female 5LOKO mice compared to matched WT. Histological analysis revealed a suitable bone-healing process with osteoid deposition at day 7 post-surgery, followed by woven bone at day 14 post-surgery, observed in all young mice. Aged WT females displayed increased inflammatory response at day 7 post-surgery, delayed bone matrix maturation, and increased TRAP immunolabeling at day 14 post-surgery compared to 5LOKO females. Skeletal muscles of aged animals showed higher levels of inflammation in comparison to young controls at day 14 post-surgery; however, inflammatory process was attenuated in aged 5LOKO mice compared to aged WT. In conclusion, this new model shows that MSK healing is influenced by age, gender, and the 5LO pathway, which might serve as a potential target to investigate therapeutic interventions and age-related MSK diseases. Our new model is suitable for bone-muscle crosstalk studies.

Evaluation of the Use of an Inorganic Bone Matrix in the Repair of Bone Defects in Rats Submitted to Experimental Alcoholism.

To assess the effects of chronic alcoholism on the repair of bone defects associated with xenograft. Forty male rats were distributed in: control group (CG, n = 20) and experimental group (EG, n = 20), which received 25% ethanol ad libitum after a period of adaptation. After 90 days of liquid diet, the rats were submitted to 5.0-mm bilateral craniotomy on the parietal bones, subdividing into groups: CCG (control group that received only water with liquid diet and the defect was filled with blood clot), BCG (control group that received only water with liquid diet and the defect was filled with biomaterial), CEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with blood clot), and BEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with biomaterial). In the analysis of body mass, the drunk animals presented the lowest averages in relation to non-drunk animals during the experimental period. Histomorphologically all groups presented bone formation restricted to the defect margins at 60 days, with bone islets adjacent to the BCG biomaterial particles. CEG showed significant difference compared to BEG only at 40 days (17.42 ± 2.78 vs. 9.59 ± 4.59, respectively). In the birefringence analysis, in early periods all groups showed red-orange birefringence turning greenish-yellow at the end of the experiment. The results provided that, regardless of clinical condition, i.e., alcoholic or non-alcoholic, in the final period of the experiment, the process of bone defect recomposition was similar with the use of xenograft or only clot.

Fibrin Sealant Derived from Human Plasma as a Scaffold for Bone Grafts Associated with Photobiomodulation Therapy.

Fibrin sealants derived from human blood can be used in tissue engineering to assist in the repair of bone defects. The objective of this study was to evaluate the support system formed by a xenograft fibrin sealant associated with photobiomodulation therapy of critical defects in rat calvaria. Thirty-six rats were divided into four groups: BC (n = 8), defect filled with blood clot; FSB (n = 10), filled with fibrin sealant and xenograft; BCPBMT (n = 8), blood clot and photobiomodulation; FSBPBMT (n = 10), fibrin sealant, xenograft, and photobiomodulation. The animals were killed after 14 and 42 days. In the histological and microtomographic analysis, new bone formation was observed in all groups, limited to the defect margins, and without complete wound closure. In the FSB group, bone formation increased between periods (4.3 ± 0.46 to 6.01 ± 0.32), yet with lower volume density when compared to the FSBPBMT (5.6 ± 0.45 to 10.64 ± 0.97) group. It was concluded that the support system formed by the xenograft fibrin sealant associated with the photobiomodulation therapy protocol had a positive effect on the bone repair process.

Usefulness of Cone-Bean Computed Tomography Exams to Detect Foramen of Huschke in Diverse Age Group.

The foramen of Huschke (FH) is present in the early stages of the temporal bone tympanic portion development. The literature shows that FH may persist in adult individuals and several authors acknowledge its clinical importance, reporting being associated with the dissemination of diseases. Some authors believe that FH presents importance in archeology and forensic situations.Considering that the identification of FH by conventional imaging methods is extremely impaired or impossible due to overlapping bone structures and that cone-bean computed tomography presents quality in the evaluation of this structure, the authors conducted this research to determine the FH prevalence and dimensions through the Invivo5 software, and correlated its size with age.The foramen was present in 19 scans (12.7%), 6 (8.8%) were present among male and 13 (15.8%) among female. The χ test was performed, with no statistically significant difference for gender and age. Considering the age, in individuals aged 7 to 18 years, 16.4% of persistent FH was found compared with 10.5% in individuals over 18 years of age. The diameter ranged from 2.58 to 3.28 mm. No correlation was found between size and age (p between 0.25 and 0.88).The authors conclude that the cone-bean computed tomography is an examination that allows the correct evaluation of the FH and, although the persistence of this unusual anatomical variation presents different frequencies in the different populations and age groups, it can have clinical consequences, so that the professionals who work in the area must be aware of its existence.

Effects of photodynamic therapy on the adhesive interface using two fiber posts cementation systems.

INTRODUCTION: Photodynamic therapy (PDT) can be employed for prosthetic space decontamination; however, its effects on adhesion of glass-fiber posts cementation systems are still unclear. PURPOSE: The aim of this study was to evaluate the effects of photodynamic therapy (PDT) on the adhesive interface between the dentin and different glass-fiber post cementation systems using a self-adhesive resin cement (RelyX U200) or a glass ionomer cement (Gold Label 1). METHOD: Forty human canine roots were endodontically-treated and prepared for fiber post. The roots were divided into four groups (n = 10), according to the PDT use and cementation protocol, as follow: G1- RelyX U200; G2: Gold Label 1; G3: PDT + RelyX U200; and G4: PDT + Gold Label 1. Afterwards, the roots were cross-sectioned and specimens from the cervical, middle and apical thirds of the post space were obtained and submitted to the push-out test. After that, the dentinal penetrability of the cementation protocol was assessed using laser confocal microscopy. CURRENT RESULTS: No significant differences were found in the bond strength values among the groups in all thirds (P > 0.05). G2 and G4 presented lower dentinal penetrability than the other groups, only in the cervical third (P < 0.05). CONCLUSION: Photodynamic therapy didn't present effects on the bonding interface between root dentin and fiber post cementation systems in both RelyX U200 and Gold Label 1, which were similar to each other.

Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve.

OBJECTIVE: Evaluate the efficacy of low-level laser therapy (LLLT) on qualitative, quantitative, and functional aspects in the facial nerve regeneration process. MATERIALS AND METHODS: Forty-two male Wistar rats were used, randomly divided into a control group (CG; n = 10), in which the facial nerve without lesion was collected, and four experimental groups: (1) suture experimental group (SEG) and (2) fibrin experimental group (FEG), consisting of 16 animals in which the buccal branch of the facial nerve was sectioned on both sides of the face; an end-to-end epineural suture was performed on the right side, and a fibrin sealant was used on the left side for coaptation of the stumps; and (3) laser suture experimental group (LSEG) and (4) laser fibrin experimental group (LFEG), consisting of 16 animals that underwent the same surgical procedures as SEG and FEG with the addition of laser application at three different points along the surgical site (pulsed laser of 830 nm wavelength, optical output power of 30 mW, power density of 0.2586 W/cm2, energy density of 6.2 J/cm2, beam area of 0.116 cm2, exposure time of 24 sec per point, total energy per session of 2.16 J, and cumulative dose of 34.56 J). The animals were submitted to functional analysis (subjective observation of whisker movement) and the data obtained were compared using Fisher's exact test. Euthanasia was performed at 5 and 10 weeks postoperative. The total number and density of regenerated axons were analyzed using the unpaired t-test (p < 0.05). RESULTS: Laser therapy resulted in a significant increase in the number and density of regenerated axons. The LSEG and LFEG presented better scores in functional analysis in comparison with the SEG and FEG. CONCLUSIONS: LLLT enhanced axonal regeneration and accelerated functional recovery of the whiskers, and both repair techniques allowed the growth of axons.

PPE tube filled with autologous fat in the repair of peripheral nerve: a new proposal / Tubo PPE relleno con grasa autóloga en la reparación de los nervios periféricos: una nueva propuesta

This study proposes the use of a porous polyethylene (PPE) tube as the conductive element in the regeneration in the sciatic nerve sectioning and evaluates the use of fill with autologous fat. The subject was divided randomly into five groups, 3 control and 2 experimental (PPE tube graft with/ without autologous fat). Each group was selected for functional, histological and morphometric evaluation of the sciatic nerve. Functional analysis of the sciatic nerve occurred through the "footprint" values near -100 refer sectioned sciatic nerve, near 0 (zero) refer to control group. On histological analysis of the experimental groups lots of dense connective tissue replacing nerve tissue was observed. In morphometric analysis the group EGPGf got higher performance in all of variables. The use of PPE has shown promise in nerve regeneration with favorable results when associate with fat as a trophic factor in the regeneration.

Este estudio propone el uso de un tubo de polietileno poroso (PPE) como elemento conductor en la regeneración del nervio ciático seccionado y evaluar el uso de relleno con grasa autóloga. Al azar se formaron cinco grupos, 3 y 2 de control experimental (PPE prótesis tubular con / sin grasa autóloga). Cada grupo fue seleccionado para estudiar la forma funcional, histológica y evaluación morfométrica del nervio ciático. Un análisis funcional del nervio ciático se produjo a través de los valores de "huella", cerca de -100 se refiere al nervio ciático seccionado; cerca de 0 (cero) se refiere al grupo control. En el análisis histológico de los grupos experimentales se observó una gran cantidad de tejido conjuntivo denso que sustituye el tejido nervioso. En el análisis morfométrico, el grupo experimental de injerto de polietileno lleno de grasa (EGPGf) obtuvo un mayor rendimiento en todas las variables. El uso de PPE ha mostrado ser prometedor en la regeneración del nervio, con resultados favorables cuando se asocia con la grasa como un factor trófico en la regeneración.

Identification of the bony canal of the posterior superior alveolar nerve and artery in the maxillary sinus: tomographic, radiographic, and macroscopic analyses.

The aim of this study was to identify the shape and route of the bony canal of the posterior superior alveolar artery (PSAA) and posterior superior alveolar nerve (PSAN) using different identification methods, including computed tomography (CT), panoramic radiograph, and macroscopic evaluation (corpse and dry skull). Twenty-four patients were analyzed by CT and panoramic and posterior anterior (PA) radiographs; additionally, 90 dry skulls and 21 dissected anatomical specimens were examined. Three-dimensional-CT revealed that the lateral wall of the maxillary sinus resembled a tunnel format in 60% of the treated patients. Out of all 24 patients, the panoramic radiograph identified the bony canal in only one patient; whereas the PA radiograph identified it in 80% of the patients. The dry skulls showed tunnellike routes of the PSAA and PSAN in 65% of the cases. Moreover, the pathway was also visibly observed in the dissected anatomical specimens as a straight shape in 85% of the cases. Thus, our results demonstrated that the most common shape of the bony canal of the PSAA and PSAN is the tunnel format with a straight route by 3D-CT, posterior anterior radiography, and macroscopic evaluation. However, in the panoramic radiographs, it was difficult to identify this canal.

Ipsilateral supplementary lateral incisors: a case report

Supernumerary teeth are one of the dental anomalies which occur due to the developmental disturbances in teeth. They can be seen in various shape and form. They can occur in both the deciduous and permanent dentition and can impose aesthetic and occlusion problems. Morphologically the supernumerary teeth exhibit various forms ranging from conical to tuberculate and supplemental types. Supplemental teeth as the name suggests are similar in shape to that of the normal prototype. In this particular case, we are reporting a case of ipsilateral supplemental permanent lateral incisors and the treatment approach which would subsequently facilitate the patient to undergo orthodontic treatment.

Comparison of results obtained with standard and inside out vein graft techniques and their implication on neurotrophin expression in repair of nerve defect: an experimental study.

Standard vein graft (SVG) and inside out vein graft (IOVG) techniques to promote peripheral nerve regeneration have been widely studied since last two decades. In this experimental study, we attempted to compare these two techniques and analyze the differences in the expression of the neurotrophins during peripheral nerve regeneration. Thirty-six male Wistar rats were used in this sciatic nerve transection model and were divided into two experimental groups (SVG and IOVG) and one sham operated control group. An overall defect of 10 mm was made in the sciatic nerve of the animals in the experimental groups. Each group consisted of two time intervals of 6 and 12 weeks (n = 6). After each experimental interval, sciatic functional index (SFI) along with area and diameter of the axons and fibers of each group were calculated. Muscle mass measurements were also evaluated to see any functional recovery in the groups. Expression of neurotrophins in the graft and distal stump were analyzed with the help of RT-PCR. SFI obtained from walking track analysis showed poor motor recovery in the experimental groups during both time intervals. No significant differences in the histological, morphometric (P > 0.05), and muscle mass measurements (P > 0.05) between the two experimental groups were observed. Analysis of RT-PCR data exhibited an increase in the expression of NT-3 with time in both the grafts (6 weeks 0.428 ± 0.392, 12 weeks 1.089 ± 0.455, P < 0.05) and distal stump (6 weeks 0.411 ± 0.306, 12 weeks 0.807 ± 0.303, P < 0.05) of the SVG group. The study concludes that there is no substantial difference in the nerve regeneration ability between both the techniques. Also, the difference in the level of NT-3 between SVG and IOVG suggests a distinct regulation of NT-3 in peripheral nerve regeneration.

Anatomical, clinical and radiographic characteristics of styloid syndrome (Eagle syndrome): a case report / Características anatómicas, clínicas y radiográficas del síndrome Estiloide (síndrome de Eagle): un caso clínico

Styloid syndrome is characterized by an elongated styloid process or calcification of the stylomandibular and stylohyoid ligament. This study describes a case of a 65-year-old woman who presented to the Stomatology Clinic, University of Marilia with temporomandibular joint pain, ear ringing and a reduced ability to open the mouth. Panoramic and posteroanterior digital radiographs showed bilateral elongation of the styloid processes, especially of the right side, whose length extended beyond the mandible angle. The diagnosis was confirmed with the association of clinical data and image examinations. The treatment options for styloid Syndrome include clinical follow-up, surgical removal of the styloid process or fracture of the elongated process. The case was managed by providing prosthetic rehabilitation and clinical follow-up, observing the level of discomfort and the benefit that could be achieved by the therapy, and avoiding surgical intervention.

El síndrome estilode (Síndrome de Eagle) se caracteriza por un proceso estiloides alargado o calcificación de los ligamentos estilohioideo y estilomandibular. Este estudio describe el caso de una mujer de 65 años de edad que concurrió a la Clínica Estomatológica de la Universidad de Marilia con dolor de la articulación temporomandibular, zumbido en los oídos y una disminución de la capacidad de abrir la boca. Las radiografías digitales panorámica y posteroanterior mostraron alargamiento bilateral de los procesos estiloides, especialmente del lado derecho, cuya longitud se extendió más allá del ángulo de la mandíbula. El diagnóstico se confirmó con la asociación de los datos clínicos y los exámenes de imagen. Las opciones de tratamiento para el síndrome estiloide incluyen el seguimiento clínico, la extirpación quirúrgica del proceso estiloides o la fractura del proceso alargado. El caso fue tratado con rehabilitación protésica y seguimiento clínico, observando el nivel de molestia y el beneficio que se podría lograr mediante la terapia, evitando la intervención quirúrgica.

Surgical anatomy of the human middle ear: an insight into cochlear implant surgery.

PURPOSE: This research was designed to aid practical otologic studies of the human middle ear. The topographic anatomy access of the middle ear was described with special focus to the cochlear implant procedure. It was conducted in an attempt to elucidate factors that would ultimately determine the ease of insertion of an electrode array. METHODS: Fifteen right and 12 left temporal bones were dissected under the surgical microscope. After performing appropriate incisions, the distances between the stapedius muscle tendon, incus long crus and the cochleostomy were measured with the help of a digital microscope (Dino-Lite plus(®)). RESULTS: After performing statistical analysis, we found that strong relationship exists in the distances between the measured anatomical landmarks. CONCLUSION: Microscopic anatomical studies of the temporal bone are essential to safely perform surgical intervention within the middle ear. The results shows that morphometric data concerning different anatomical structures inside the middle ear, particularly distances, is an important contribution towards the planning of safe surgical procedures.

Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls.

THE AIM OF THIS STUDY: was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File) in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000). The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05).