Sverzut Nasotracheal Tube Support Device: Ergonomic Management and Airway Safety in Cervicomaxillofacial Surgery.

Nasotracheal intubation is the preferred route for general anesthesia maintenance in patients undergoing maxillofacial surgery or dental procedures. However, compression of the tracheal tube may cause superficial necrosis of the nasal wing and deformation of the external nose. Thus, proper fixation of the tracheal tube during nasotracheal intubation is important for the patient's safety as well as that of the medical staff. Recently, a nasotracheal tube support device has been developed; thus, in this study, the aim was to present and describe the Sverzut nasotracheal tube support device and discuss the advantages of its use during nasal intubation in cervicomaxillofacial surgery. Findings from this study show that the Sverzut nasotracheal tube support device can contribute to the stabilization of the nasotracheal tube and all its connectors, aiding in the maintenance of the airway patency and minimizing the complications related to this type of intubation.

Exuberant hypercementosis mimicking cementoblastoma / Hipercementose exuberante simulando cementoblastoma

RESUMEN La hipercementosis se clasifica como una proliferación no neoplásica que implica un depósito excesivo de cemento a lo largo del cemento radicular normal. Presentamos el caso de un paciente masculino de 77 años que acude al dentista por una lesión supurativa en la encía que evoluciona desde hace varios meses. El examen radiográfico mostró una gran área radiopaca involucrando la raíz del diente 46, que estaba completamente rodeada por un área radiolúcida, sugiriendo un cementoblastoma asociado con el proceso infeccioso. El examen histopatológico del diente afectado reveló hipercementosis extensa asociada con inflamación supurativa crónica, además de osteomielitis crónica localizada. Esta presentación es infrecuente y, debido a los hallazgos clínico-patológicos, se propone el término "hipercementitis crónica". Los dentistas, especialmente los patólogos orales y endodoncistas, deben estar tener conocimiento de esta inusual presentación para establecer el diagnóstico correcto.

Gingival carcinoma cuniculatum mimicking a reactive/inflammatory process / Carcinoma cuniculado gengival mimetizando um processo inflamatório/reativo

ABSTRACT Carcinoma cuniculatum (CC), a rare variant of oral squamous cell carcinoma, presents well-differentiated neoplastic epithelial cells infiltrating the underlying submucosal or bone tissues, forming the so-called "rabbit burrows" filled with keratin. A 67-year-old female patient was referred complaining of a painless tumoral mass in the left mandibular body, with several months of evolution. Previous history indicated extraction of the teeth #37 and #38 and diagnosis of chronic suppurative osteomyelitis. A deep incisional biopsy revealed CC. Due to its microscopic features, suggesting an inflammatory or reactive process, strict clinicopathological correlation is necessary for the correct diagnosis of CC.

RESUMEN El carcinoma cuniculatum (CC), una variante del carcinoma de células escamosas oral, presenta células epiteliales neoplásicas bien diferenciadas que se infiltran en la submucosa o en el tejido óseo subyacente, formando la llamada "madriguera de conejo", rellenada con queratina. Reportamos el caso de una paciente de 67 años con quejas de una masa tumoral asintomática en el cuerpo mandibular izquierdo con varios meses de evolución. La historia previa apuntó exodoncia de los dientes 37 y 38 y diagnóstico de osteomielitis supurativa crónica. Una biopsia incisional profunda reveló CC. Debido a las características microscópicas, que sugirieron un proceso inflamatorio o reactivo, es necesaria una estrecha correlación clinicopatológica para el diagnóstico correcto del CC.

RESUMO O carcinoma cuniculado (CC), uma rara variante do carcinoma espinocelular oral, apresenta células epiteliais neoplásicas bem diferenciadas que se infiltram na submucosa ou no tecido ósseo subjacente, formando a chamada "toca de coelho", preenchida por queratina. Relatamos o caso de uma paciente de 67 anos que foi encaminhada apresentando uma massa tumoral assintomática no corpo mandibular esquerdo com vários meses de evolução. A história prévia indicou exodontia dos dentes 37 e 38 e diagnóstico de osteomielite supurativa crônica. Uma biópsia incisional profunda revelou CC. Devido às características microscópicas, as quais sugeriram um processo inflamatório ou reativo, é necessário estrita correlação clinicopatológica para o correto diagnóstico do CC.

Effect of surgically assisted rapid maxillary expansion on masticatory muscle activity: A pilot study.

BACKGROUND: The aim of the present study was to analyze the electromyographic (EMG) activity of masseter and temporal muscles of adult patients submitted to surgically assisted rapid maxillary expansion (SARME) before and after the surgery. MATERIALS AND METHODS: The sample consisted of 19 adults, with ages ranging from 20 to 47 years (mean 25.4 years), with bilateral posterior cross bite requiring SARME treatment. The electromyographic activity of masseter and temporal muscles was analyzed before treatment (T1) and after the surgical procedure (T2). The mean interval between the two electromyographic analyses was 15 days. RESULTS: The muscular active was electromyographically analyzed during the clinical situation of habitual gum chewing (10 sec), dental clenching (4 sec), mouth opening and closing (10 sec), rest (10 sec), protrusion (10 sec), and right and left laterality (10 sec). The measured differences between T1 and T2 data were evaluated using the paired t-test (SPSS 17.0 for Windows). The electromyographic analysis showed that the activity of the masseter and temporal muscles decreased significantly after the SARME in all the clinical situations after the surgery. CONCLUSION: According to the results of the present study, individuals after SARME surgery presented patterns of electromyographic contraction similar to those developed by dentate individuals during the movements of mandibular excursion.

Reconstruction of mandibular segmental defects using the guided-bone regeneration technique with polylactide membranes and/or autogenous bone graft: a preliminary study on the influence of membrane permeability.

PURPOSE: Bone maintenance after mandibular reconstruction with autogenous iliac crest may be disappointing due to extensive resorption in the long term. The potential of the guided-bone regeneration (GBR) technique to enhance the healing process in segmental defects lacks comprehensive scientific documentation. This study aimed to investigate the influence of polylactide membrane permeability on the fate of iliac bone graft (BG) used to treat mandibular segmental defects. MATERIALS AND METHODS: Unilateral 10-mm-wide segmental defects were created through the mandibles of 34 mongrel dogs. All defects were mechanically stabilized, and the animals were divided into 6 treatment groups: control, BG alone, microporous membrane (poly L/DL-lactide 80/20%) (Mi); Mi plus BG; microporous laser-perforated (15 cm(2) ratio) membrane (Mip), and Mip plus BG. Calcein fluorochrome was injected intravenously at 3 months, and animal euthanasia was carried out at 6 months postoperatively. RESULTS: Histomorphometry showed that BG protected by Mip was consistently related to larger amounts of bone compared with other groups (P