Treatment of Dentofacial Deformity Associated with Temporomandibular Joint Ankylosis Through Vertical and Sagittal Osteotomies of the Mandibular Ramus.

ABSTRACT: Ankylosis of the temporomandibular joint is a disorder resulting from fibrous, osseous, or fibro-osseous adhesion that directly affects the quality of life of the individual. The authors present a case of unilateral temporomandibular joint ankylosis treated by condilectomy and ipsilateral sliding vertical ramus osteotomy associated with contralateral sagittal osteotomy aiming to restore function and to correct dentofacial deformity class II. A 31-year-old female patient presented with a history of facial trauma and major complaint of oral opening limitation. Physical examination revealed hypoplasia of the lower third of the face, facial pattern type II, anterior open bite, and maximum mouth opening of 22.5 mm. Computed tomography showed an ankylotic mass in the right mandibular condyle with deformity of the condylar structure and fusion to the right zygomatic arch and a contralateral condylar fracture sequel. It was proposed to perform a condilectomy of the right mandibular condyle for the removal of the bone mass concomitant to the sliding vertical ramus osteotomy of the mandibular ramus for condylar reconstruction by rhytidectomy approach and the sagittal osteotomy of the left mandibular aiming the reestablishment of occlusion and the correction of dentofacial deformity. The condylar fracture was not operated because the condyle was remodeled. The patient is in her fourth year postoperative presenting satisfactory esthetic-functional re-stabilization, without clinical signs of recurrence. In conclusion, the authors believe that combined sliding vertical ramus osteotomy and sagittal osteotomy can bring satisfactory results in complex cases.

Is Bilateral Sagittal Split Osteotomy of the Mandible With no Step Possible? A Modification in the Technique.

The mandibular ramus sagittal osteotomy is a usual procedure used to correct deformities of the lower third of the face. Modifications of the procedure will be presented to avoid the presence of palpable gap at mandibular body, easily seen in greater movements.

Surgical Treatment of Polyostotic Craniomaxillofacial Fibrous Dysplasia Associated With Acromegalia: The McCune - Albright Syndrome.

INTRODUCTION: The McCune-Albright syndrome (MAS) is a complex congenital disorder caused by the embryonic post-zygotic somatic activating mutations in the GNAS1 gene. In such syndrome, phenotypes are heterogeneous and comprised polyostotic/monostotic fibrous dysplasia, café au lait macules, and hyperfunctioning endocrinopathies as the excess growth hormone. Likewise, acromegaly, as a manifestation of the endocrine hyperfunction, is unusual and affects about 20% of patients with MAS. CASE PRESENTATION: This research study describes a case of a 31-year-old female subject presenting polyostotic fibrous dysplasia with severe facial involvement, along with acromegaly and the MAS. The case was satisfactorily managed by surgical re-alignment and presented no clinical signs of relapse in a 12-year follow-up period. Finally, a literature review was conducted to discuss the standard protocols and the controversies when treating such cases. CONCLUSION: Patients with craniomaxillofacial fibrous dysplasia associated with acromegaly may present significant facial deformities that can be satisfactorily treated by cosmetic treatment, especially in patients with psychological problems and severe social acceptance.

Atuação odontológica na Unidade de Terapia Intensiva (UTI) do Hospital Geral de Fortaleza (HGF) / Dentistry performance in the Intensive Care Unit of Fortaleza's General Hospitais(HGF)

O Setor de Odontologia do HGF (Hospital Geral de Fortaleza) visa atender os pacientes provenientes dos seus diversos setores, principalmente os que buscam procedimentos de alta complexidade. 0 tratamento odontológico em pacientes hospitalizados se faz necessário tanto para evitar o desenvolvimento de doenças sistêmicas, como para diminuir as consequências daquelas já instaladas, resultando em um relacionamento direto entre cirurgião-dentista, paciente, equipe e instituição. Alunos do curso de Odontologia da Universidade de Fortaleza realizaram visitas semanais à UTI (Unidade de Terapia Intensiva) do HGF, com a finalidade de aperfeiçoar a técnica de higienização bucal desenvolvida pelos auxiliares de enfermagem nos pacientes e diagnosticar doenças bucais, com o objetivo de realizar o tratamento adequado. Este trabalho teve o propósito de mostrar a importância da presença do cirurgião-dentista na UTI de um hospital do Sistema Único de Saúde (SUS), a fim de contribuir para a melhora tanto das condições bucais como sistêmicas dos pacientes. Unitermos - UTI; Higiene bucal; Unidade hospitalar de Odontologia; Estudantes de Odontologia.

Tratamento de hemangioma por escleroterapia com oleato de etanolamina: relato de dois casos clínicos / Treatment of hemangioma by sclerotherapy with ethanolamine oleate: report of two clinical cases

Os hemangiomas representam a maior parte das afecções de crescimento tecidual envolvendo tecidos moles da cavidade oral durante a infância e a adolescência. Por tratar-se de uma lesão que, apesar de benigna, possui origem vascular, a escolha da melhor forma de abordagem nesses casos parece muitas vezes ser um desafio para os cirurgiões. Neste trabalho descrevemos a apresentação clínica de dois casos, onde foi optado pela utilização de substância esclerosante oleato de etanolamina 5% (Ethamolin@) para o tratamento de lesões angiomatóides em língua e mucosa jugal de pacientes em idade adulta e juvenil, respectivamente.

Hemangiomas represent the majority of disorders of tissue growth surrounding soft tissuesof the oral cavity during childhood and adolescence. As this is an injury that, although benign, have vascular origin, the choice of the better way to treat these cases often seems to be a challenge for surgeons. Here we describe the clinical presentation of two cases, where we choose the use of the sclerosing substance ethanolamine oleate 5% (Ethamolin@) for treatment of tongue and oral mucosa angiomatoid lesions of patients with adult and juvenile age, respectively.

Treatment of pseudoaneurysm of internal maxillary artery: a case report.

Pseudoaneurysms are rare lesions secondary to blunt or penetrating trauma, temporomandibular joint surgery, or orthognathic surgery. Nonsurgical interventions are the treatment of choice for pseudoaneurysms. In the case reported here, endovascular injection of acrylic glue was successful in the treatment of a pseudoaneurysm of the internal maxillary artery secondary to fracture of the zygomatic bone.

Síndrome de Melkersson-Rosental: relato de caso / Melkersson-Rosental syndrome: a case report

A Síndrome de Melkersson-Rosenthal é uma desordem rara caracterizada por edema orofacial recorrente, paralisia facial e língua fissurada. A patogênese dessa condição é incerta, fazendo com que seja limitado o sucesso do tratamento. O objetivo deste trabalho é o de relatar um caso da referida síndrome bem como discutir o uso do corticóide intralesional como modalidade terapêutica