Infecções odontogênicas complexas e seu perfil epidemiológico / Severe odontogenic infections and its epidemiological profile

Infecções odontogênicas complexas são aquelas, que se disseminam para espaços faciais subjacentes, podendo provocar complicações graves, como a Angina de Ludwig. Seu diagnóstico precoce e uma avaliação precisa das complicações são extremamente importantes para o sucesso do tratamento. O objetivo deste estudo foi conhecer o perfil epidemiológico de 50 pacientes internados com infecção odontogênica complexa em um hospital público de Belo Horizonte-MG, no intervalo de um ano. Dentre eles, 26 eram mulheres e 24 homens, com a média de idade de 31,04 anos. O período de internação foi, em média, de 6,9 dias, e o intervalo entre o início da infecção e a internação foi de 4,80 dias em média. Apenas 6% eram portadores de Diabetes Mellitus. Em 56%, os dentes causadores foram segundos e terceiros molares inferiores. Um total de 54% possuía baixa renda, mas apenas 4% eram analfabetos. Dentre os pacientes, 47 fizeram uso de algum tipo de medicamento prévio ao momento da internação hospitalar e 32,0% relataram-se automedicado. Concluiu-se que a infecção odontogênica pode atingir indivíduos de variadas faixas etárias, independente do sexo, classe econômica ou nível de instrução. A prevenção e a abordagem precoce dos casos são a melhor estratégia de tratamento... (AU)

Severe odontogenic infections are those that spread to spaces underlying facial and may cause severe complications such as Ludwig's angina. Early diagnosis and precise evaluation of complications is extremely important for successful treatment. The objective of this study was to understand the epidemiology of 50 patients admitted with severe odontogenic infection in a public hospital in Belo Horizonte, Minas Gerais within one year. Among them, 26 were women and 24 men, with a mean age of 31.04 years. The hospital stay averaged 6.9 days and the interval between the onset of infection and hospitalization was 4.80 days on average. Only 6% were diabetic patients. In 56%, the causing teeth were second and third molars. A total of 54% had low income, but only 4% were illiterate. Among the patients, 47 had used some kind of drug prior to the time of hospitalization and 32.0% reported having self-medicated. It was concluded that the odontogenic infection can affect individuals of different age groups, regardless of gender, economic class or education level. The prevention and early treatment of cases are the best treatment strategy... (AU)

Osteonecrose de mandíbula associada ao uso de bisfosfonato após instalação de implantes: relato de caso / Osteonecrosis of the jaw associated with bisphosphonate use after implant placement: case report

A reabilitação bucal de pacientes com perdas dentárias múltiplas ou unitárias com implantes osseointegrados tem se tornado um tratamento com altas taxas de sucesso. Apesar disso, uma séria complicações pode afetar a sobrevida desses implantes, como a osteonecrose dos maxilares associada ao uso de bisfosfonatos. Os bisfosfonatos são uma classe de medicamentos que têm por função a inibição da atividade dos osteoclastos, interferindo na remodelação e no turnover ósseo. São indicados para retardar o envolvimento ósseo em algumas condições malignas, como em mielomas múltiplos e metástase do câncer de mama e próstata, no tratamento da doença de Paget e da osteoporose. Clinicamente, as BRONJ (Bisphosphonated Related Osteonecrosis of the Jaw) aparecem como perda da continuidade da mucosa bucal com exposição do osso subjacente, podendo ser extremamente dolorosas, persistentes e não responder aos tratamentos convencionais. Assim, o objetivo do presente trabalho é revisar a literatura sobre o tema apresentado e relatar um caso clínico de BRONJ em mandíbula após a fixação de implantes.

Oral rehabilitation of patients with unit or multiple tooth loss with dental implants has become a treatment with high success rates. Nevertheless, a serious complication can affect the survival of these implants: osteonecrosis of the jaws associated with the use of bisphosphonates. Bisphosphonates are a class of drugs that has the function of inhibiting the activity of osteoclasts, interfering with remodeling and bone turnover. Are shown to slow bone involvement in some malignancies such as multiple myeloma and metastatic breast cancer and prostate cancer, in the treatment of Paget's disease and osteoporosis. Clinically the BRONJ appear as loss of continuity of the oral mucosa with exposure of the underlying bone and can be extremely painful, persistent and do not respond to conventional treatments. The objective of this paper is to review the literature on the subject and report of a case in BRONJ after implant fixation.

Tratamento endodôntico transcirúrgico: uma opção para casos especiais / Trans-surgical endodontic treatment: an option for special cases

A cirurgia endodôntica é indicada quando perfurações, instrumentos fraturados, calcificações e anormalidades anatômicas são responsáveis pelo insucesso do tratamento endodôntico convencional. Dentre as modalidades cirúrgicas, a obturação do canal radicular simultânea ao ato cirúrgico é indicada, quando não se consegue conter o exsudato persistente por meio de medicação intracanal e medicação sistêmica. O propósito deste trabalho é o de descrever a técnica cirúrgica utilizada e apresentar três casos clínicos de apicectomia com tratamento endodôntico trans-cirúrgico, promovendo uma discussão sobre suas indicações dentro da moderna clínica odontológica.

Endodontic surgery is indicated when perforations, broken instruments, calcifications and anatomical abnormalities are responsible for the failure of conventional endodontic treatment. Among the surgical modalities the obturation of the root canal concomitantly with the surgical procedure is indicated when it is not possible to contain the persistent exsudate by means of intracanal medication and systemic medication. The purpose of this paper is to describe the surgical technique used and to present three clinical cases of apicectomy with trans-surgical endodontic treatment, discussing its indications in modern clinical dentistry.

Tratamento endodôntico transcirúrgico: uma opção para casos especiais / Trans-surgical endodontic treatment: an option for special cases

A cirurgia endodôntica é indicada quando perfurações, instrumentos fraturados, calcificações e anormalidades anatômicas são responsáveis pelo insucesso do tratamento endodôntico convencional. Dentre as modalidades cirúrgicas, a obturação do canal radicular simultânea ao ato cirúrgico é indicada quando não se consegue conter o exsudato persistente por meio de medicação intracanal e medicação sistêmica. O propósito deste trabalho é o de descrever a técnica cirúrgica utilizada e apresentar três casos clínicos de apicectomia com tratamento endodôntico transcirúrgico, promovendo uma discussão sobre suas indicações dentro da moderna clínica odontológica.

The endodontic surgery is indicated when perforations, instruments broken, anatomical calcification and abnormalities are responsible for the failure of the conventional endodontic treatment. Among the surgical modalities the obturation of the canal to radicular simultaneous to the surgical act is indicated when it is not obtained to contain the persistent exsudate by means of intracanal medication and systemic medication. The intention of this work is to describe the surgical technique used and to present three clinical cases of apicectomy with trans-surgical endodontic treatment, making a discussion on its indications in of the clinical modern.

Analgesic efficacy of Lysine Clonixinate, paracetamol and dipyrone in lowerthird molar extraction. A randomized controlled trial

Objective: The purpose of this study is to compare the analgesic effect of lysine clonixinate, paracetamol anddipyrone after lower third molar extraction.Material and Methods: The sample consisted of 90 individuals, with clinical indication for inferior third molarsextraction. The mean age of the sample was 22.3 years (DP±2.5). The individuals received the medication in unidentifiedbottles along with the intake instructions. The postoperative pain parameters were measured accordingto Visual Analogical Scale (VAS) and the data was evaluated using the Kruskal-Wallis Test and Friedman Test,with the latter used to test different time intervals for each one of the drugs.Results: The final sample consisted of 64 individuals, including 23 males (45.9%) and 41 females (64.1%) Themean age of the entire sample was 22.3 years (±2.5). The average length of the procedures was 33.9 minutes (±9.8).The distribution of mean values for this variable showed little variance for the different drugs (p=0.07).Conclusion: Lysine Clonixinate did not show any substantial impact on the postoperative pain control when comparedto other drugs (AU)

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Analgesic efficacy of lysine clonixinate, paracetamol and dipyrone in lower third molar extraction: a randomized controlled trial.

OBJECTIVE: The purpose of this study is to compare the analgesic effect of lysine clonixinate, paracetamol and dipyrone after lower third molar extraction. MATERIAL AND METHODS: The sample consisted of 90 individuals with clinical indication for inferior third molar extraction. The mean age of the sample was 22.3 years (DP +/-2.5). The individuals received the medication in unidentified bottles along with the intake instructions. The postoperative pain parameters were measured according to the Visual Analogical Scale (VAS) and the data was evaluated using the Kruskal-Wallis Test and Friedman Test, with the latter used to test different time intervals for each one of the drugs. RESULTS: The final sample consisted of 64 individuals, including 23 males (45.9%) and 41 females (64.1%) The mean age of the entire sample was 22.3 years (+/-2.5). The average length of the procedures was 33.9 minutes (+/-9.8). The distribution of mean values for this variable showed little variance for the different drugs (p=0.07). CONCLUSION: Lysine Clonixinate did not show any substantial impact on the postoperative pain control when compared to other drugs.

Oral myiasis: a case report.

Oral Myiasis is a rare pathology in humans and is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis and others conditions. The treatment is a mechanical removal of the maggots one by one but a systemic treatment with Ivermectin, a semi-synthetic macrolide antibiotic, have been used for treatment for oral myiasis. We present a case report of a 32-year-old man indigent, alcohol-dependent with an extensive necrotic area and acute swelling in upper lip and fetid odor. The patient's management included topic use of gentian violet, oral therapy with ivermectin (6 mg orally), surgical exploration to remove the larvae and necrotic tissue. After the complete larvae removal the swelling and the wounds were healing normally, the patients was referred to plastic surgery to repair tissue damage. The prevention of human myiasis is by education, but unfortunately in the developing countries some people live in low social condition, predisposing the occurrence of the infestation.

Levantamento sobre os atendimentos de trauma facial - Realizado em Hospital de Pronto Socorro / Research about facial trauma attempt

O trauma de face tem sido o objetivo de uma série de pesquisas e levantamentos estatísticos em diversos hospitais do mundo. Resultados semelhantes foram encontrados, mesmos em países com diferentes situações culturais e sócio-econõmicas. O presente trabalho consistiu-se em desenvolver um levantamento de todos os pacientes com trauma facial atendidos pelos alunos do curso de Especialização em Cirurgia e Traumatologia Buco-Maxilo-Facial da Faculdade de Odontologia da UFMG, no Pronto Socorro do Hospital Municipal Odilon Behrens de Belo Horizonte no período de novembro de 1997 a julho de 1999. Neste levantamento, foram avaliados no paciente: o sexo, a faixa etária, o fator etiológico e o tipo de atendimento realizado.