Hyberbaric oxygen and bone reconstruction.

INTRODUCTION: The aim of this literature review was to determine the benefits of hyperbaric oxygen therapy after bone reconstruction procedures in humans and identify information that may be useful for the development of optimal protocols for hyperbaric oxygen therapy to stimulate bone healing. EVIDENCE ACQUISITION: We searched the electronic database PubMed/Medline for studies published between January 1999 and December 2018, using the key words: "bone" or "bone graft" and "mandible reconstruction" or "jaw reconstruction" and "hyperbaric oxygen" or "HBO." First, the titles and abstracts of the studies found were evaluated and those that corresponded to the aims of this review were pre-selected for analysis of the full text. Subsequently, the full texts were analyzed, and those that met the eligibility criteria were pre-selected for the review. The full texts of studies whose abstracts did not provide enough data for decision were also evaluated. Two examiners independently assessed eligibility, risk of bias and extracted data. EVIDENCE SYNTHESIS: A total of 2237 studies were found according to pre-established criteria for data collection, of which only 5 studies were included in this systematic review. Although we observed positive results in the included studies, there are still few standardized clinical studies in the literature, assessing hyperbaric oxygen therapy after extensive bone reconstructive procedures. CONCLUSIONS: It is difficult to compare results found in different studies due to the variety of methodological and clinical conditions assessed.

Effect of low-level laser therapy on repair of the bone compromised by radiotherapy.

Radiotherapy (RDT) is commonly used for cancer treatment, but high doses of ionizing radiation can directly affect healthy tissues. Positive biological effects of low-level laser therapy (LLLT) on bone repair have been demonstrated; however, this effect on surgical defects of bone previously compromised by radiotherapy has not been evaluated. The aim of this study was to investigate the influence of LLLT (λ = 830 nm) in femur repair after ionizing radiation. Twenty Wistar rats were divided into four groups: control group (GC, n = 5) creation of bone defects (BDs) only; laser group (GL), with BD and LLLT (n = 5); radiotherapy group (GR), submitted to RDT and BD (n = 5); and radiotherapy and laser group (GRL), submitted to RDT, BD, and LLLT (n = 5). GL and GRL received punctual laser application (DE = 210 J/cm(2), P = 50 mW, t = 120 s, and beam diameter of 0.04 cm(2)) immediately after surgery, with 48-h interval during 7 days. Animals were euthanized at 7 days after surgery, and bone sections were evaluated morphometrically with conventional microscopy. Bone repair was only observed in nonirradiated bone, with significant improvement in GL in comparison to GC. GR and GRL did not present any bone neoformation. The result demonstrated a positive local biostimulative effect of LLLT in normal bone. However, LLLT was not able to revert the bone metabolic damage due to ionizing radiation.

Tratamento de fratura mandibular em paciente gestante: relato de caso / Treatment of mandibular fractures in pregnancy: case report

As fraturas mandibulares são as mais frequentes envolvendo o complexo bucomaxilofacial. Fraturas simples de mandíbula com pouco deslocamento tornam-se favoráveis ao tratamento, facilitando o acesso cirúrgico e a instalação do material de osteossíntese. No presente relato, apresentamos um caso clínico de tratamento de fratura mandibular em paciente gestante, sob anestesia local, discutindo a indicação dessa abordagem terapêutica e as suas vantagens.

Mandible fractures are the most common involving the maxillofacial complex. Simple fractures of the mandible with little displacement offers a favorable treatment, facilitating surgical access and installation of the osteosynthesis material. In this report, we present a case of mandibular fracture treatment in a pregnant patient under local anesthesia, discussing the indication for this therapeutic approach and its advantages.