Influence of surgical ultrasound used in the detachment of flaps, osteotomy and odontosection in lower third molar surgeries. A prospective, randomized, and "split-mouth" clinical study

BACKGROUND: As third molar surgery is the most commonly procedure performed in Dentistry and has been accompanied by serious postoperative disorders such as pain, edema and trismus, the study aimed to evaluate if ultrasound device would be able to reduce such postoperative features. The aim of this study was to assess the effects of soft tissue flap elevation, osteotomy and odontosection using piezosurgery versus conventional technique in mandibular third molar extractions. MATERIAL AND METHODS: Twenty patients with impacted mandibular third molars underwent tooth extractions using two different methods. Ten patients were included in the Piezo Flap Group (PFG - the flap was elevated using piezosurgery) and ten patients were part of the Piezo Ostectomy Group (POG - osteotomy and odontosection were carried out with ultrasound tips). The contralateral tooth was included in the Control Group (CG - conventional technique). The patients were evaluated at postoperative periods of 1, 3, 7 and 14-days. The measured parameters were duration of surgery, pain, trismus and swelling. RESULTS: The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). There was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG (p > 0.05). There was a statistically significant difference in swelling between the PFG and POG, presenting less swelling at the 3-day postoperative period (p = 0.038; p < 0,05). However, for the remaining analyzed periods there was no difference (p > 0.05). CONCLUSIONS: Piezosurgery for tissue elevation of the surgical flap, osteotomy and dental sectioning in mandibular third molar extraction surgery promoted less edema in the early postoperative stages in mandibular third molar extractions despite the longer surgical duration

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Bone Repair Process in Defects of Diabetic Rats Filled with Autogenous Bone Graft and Covered with Homogenous Bone Matrix Membrane or Polytetrafluoroethylene Membrane.

PURPOSE: To analyze the process of repair of bone defects in diabetic rats filled with autogenous bone and covered with membranes of homogenous bone matrix or expanded polytetrafluoroethylene (ePTFE). MATERIALS AND METHODS: One hundred twenty male rats were divided into two groups: group 1 (IC), without systemic alterations (control), received an intravenous injection of citrate buffer at 0.01 M, pH 4.5; group 2 (IID) (diabetic) received an intravenous injection of streptozotocin (Sigma-Aldrich) dissolved in 0.01 M citrate buffer (pH 4.5) at a concentration of 35 mg/kg. After glycemic control was achieved, the rats were subdivided into three groups: SM (surgical cavity of the left tibia filled with autogenous bone graft, not covered by membrane); MH (surgical cavity filled with autogenous bone graft and covered with homogenous membrane); and MX (surgical cavity filled with autogenous bone graft and covered with synthetic ePTFE membrane). At 10 and 60 days, the defects in the tibiae were analyzed histologically and histometrically. RESULTS: At 10 days, no statistically significant differences were found between the groups. However, the bone tissue of the diabetic group was qualitatively worse than that of the control group. At 60 days, a delay was found in the bone-repair process in wounds covered by the membranes regardless of the systemic state, but the quality of the newly formed bone in the wounds covered by the membranes was better in both groups. At 60 days, the diabetic group treated with homogenous membrane experienced less bone formation when compared with the nondiabetic group, and this difference was statistically significant. Such differences were even greater between the groups treated without the membrane (P < .01). CONCLUSION: The homogenous membrane exhibited excellent biocompatibility and was incorporated into the newly formed bone in later periods, both in diabetic and nondiabetic rats.

Survival Without Neurological Impairment of a Patient With Rhino-Orbito-Cerebral Zygomycosis.

Rhinocerebral zygomycosis is a rare condition characterized by infection initially in the nose and paranasal sinuses with atypical symptoms consistent with sinusitis. Once established in the nasal sinuses, the infection can easily spread to the orbital region and brain. In the localized form of the infection, the mortality rate is approximately 10%, which increases in the occurrence of orbital involvement and survival in patients of cerebral dissemination is extremely rare. The present paper reports a patient of nasal zygomycosis with orbital and cerebral dissemination in an otherwise healthy patient who survived after 14 months of hospitalization with no neurological impairment. A review of the literature addressing aspects related to diagnosis, treatment, and complications of this fungal infection is also presented.

Plataforma Switching: considerações atuais / Platform Switching: an update

A utilização de implantes na reabilitação dentária em associação a próteses torna-se um tratamento cada vez mais gradativo e eficiente para aqueles dispostos a recuperar a função mastigatória, fonética e estética de seus elementos dentários, conferindo-lhes naturalidade. O implante consiste num parafuso de titânio instalado através de cirurgia e submetido à osseointegração em maxila ou mandíbula. Sobre a plataforma do implante acopla-se um componente protético de mesmo diâmetro. Todavia, o conceito de Plataforma Switching referese ao uso do componente protético de diâmetro menor quando comparado ao diâmetro da plataforma do implante. Essa técnica faz com que a junção implante-pilar se direcione para a porção mais central distanciandoa da crista óssea alveolar. Esse aspecto tem gerado aceitação por parte dos tecidos duros e moles, evitando a formação de micro-espaços na crista do osso e reduzindo o estresse sobre ele. Estudos comprovam que o uso da plataforma switching em Implantodontia atua na manutenção dos níveis de osso minimizando sua perda e favorecendo a estabilidade primária, embora alguns autores afirmem que essa redução é insignificante. Esperase que esta revisão aflore o interesse de mais pesquisadores, de forma a ampliar o campo de estudo teórico, prático e clínico, a fim de garantir maiores evidências a respeito dos benefícios da plataforma switching e delimitar suas restrições para cada caso

The use of implants in dental rehabilitation in combination with prosthesis is becoming a more gradual and efficient treatment for those willing to recover the masticatory, phonetic and aesthetic functions of their teeth, providing them with naturalness. The implant consists of a titanium screw installed by means of surgery being submitted to osseointegration in the maxilla or mandible. Above the implant platform a prosthetic component of the same diameter is coupled. However, the concept of platform switching refers to the use of the prosthetic component with smaller diameter compared to the diameter of the implant platform. This technique allows the implant-abutment junction to orientate itself towards the more central portion, distancing itself from the bone alveolar crest. This process has generated adaptation by the hard and soft tissues, preventing the formation of micro-spaces in bone crest and reducing the stress on it. Some studies show that the use of platform switching in Implantology actuates in the maintenance of bone levels, minimizing the loss and favoring primary stability, although some authors state that this reduction is insignificant. It is expected that this review flourishes the interest of more researchers in order to increase the theoretical, practical and clinical of study, to ensure more evidence concerning the benefits of choosing platform switching and define the restrictions for each case

Delayed tooth replantation following root canal filling with calcium hydroxide and MTA: Histomorphometric study in rats.

OBJECTIVE: The aim of this study was to perform a histomorphometric evaluation of the repair process in rat teeth replanted after root canals were filled with calcium hydroxide (CH) and mineral trioxide aggregate (MTA). DESIGN: Upper right incisors were extracted from 30 rats divided into three groups (n=10). The teeth were stored dry for 60min, after which the pulp and periodontal ligament (PDL) were removed and immersed in acidulated-phosphate sodium fluoride solution. In Group I, the root canals were filled with saline; in Group II, they were filled with CH; and in Group III, they were filled with CH, and the foramen was sealed with an MTA plug. The teeth were replanted, and the animals were sacrificed after 60 days. The sections with teeth were removed for histological preparation (haematoxylin and eosin, H&E). The characteristics of the PDL, cementum, dentine, and alveolar bone, as well as the occurrence of inflammatory and replacement root resorption and apical sealing, were subjected to histological and morphometric analysis (P<0.05). RESULTS: Group I was the most affected by root resorption (mean=67.05%). In Groups II and III, the resorption averaged 42.2% and 11.7%, respectively. Group III was less affected by inflammatory resorption and presented more areas of apical sealing by mineralized tissue (P<0.05). CONCLUSION: An apical MTA plug improved the repair of the replanted tooth by decreasing surface resorption and repairing mineralized tissue in the periapical region.

Bone repair of surgical defects filled with autogenous bone and covered with demineralized bone matrix membrane or polytetrafluoroethylene membrane in rats.

PURPOSE: The aim of this study was to evaluate the behavior of a demineralized bone matrix membrane and a polytetrafluoroethylene (PTFE) membrane in the process of bone repair of surgical defects filled with autogenous bone in rats. MATERIALS AND METHODS: Sixty rats weighing approximately 250 g each were selected and separated into three groups: control group without membrane, demineralized bone matrix membrane group, and PTFE membrane group. Bilaterally, surgical defects of 2 mm in diameter were prepared in the tibiae. The defect in the left tibia was filled with particulate autogenous bone collected during the creation of the two defects and was left uncovered (control) or was covered with the membranes investigated by the present study. At 10 or 60 days postoperatively, the rats were euthanized and the left tibiae were submitted to routine laboratory processing for histomorphometric analysis. All groups were evaluated separately on the 10th and 60th days after surgery. The Kruskal-Wallis test was used for group comparison. RESULTS: The membrane-treated defects showed a delay in healing. Sites treated with demineralized bone matrix membrane showed, as early as day 10, more newly formed bone and slow replacement until day 60. At day 60, the sites covered with demineralized bone matrix membrane and with synthetic membrane showed statistically significant results. CONCLUSION: The demineralized bone matrix membrane proved to be biocompatible. In terms of newly formed bone area, both membranes showed similar performance.

Reconstrução imediata de fenestração peri-implantar por meio de enxerto autógeno em bloco obtido do ramo mandibular / Immediate reconstruction of peri-implant fenestration with autogenous block grafts harvested from mandibular ramus

As fenestrações das paredes alveolares são relativamente comuns durante o procedimento cirúrgico para instalação de implantes. O objetivo do presente trabalho foi relatar um caso clínico de reconstrução de fenestração peri-implantar imediatamente após a instalação de implante osseointegrável, através de enxerto ósseo autógeno em bloco obtido do ramo mandibular. Paciente do sexo masculino procurou o Departamento de Cirurgia e Clínica Integrada para trocar sua prótese parcial removível classe IV de Kennedy por prótese parcial fixa implantossuportada. Foram instalados dois implantes nos espaços protéticos correspondente aos dentes 12 e 21. Houve uma fenestração peri-implantar da parede vestibular durante a instalação do implante correspondente ao dente 12, que foi reconstruídapor meio de enxerto autógeno em bloco obtido do ramo mandibular e fixado por meio de parafuso bicortical. Após seis meses de concomitante período de incorporação do enxerto ósseo autógeno e osseointegração, iniciou-se o processamento para confecção da prótese parcial fixa implantossuportada. Diante da reabilitação protética alcançada, concluiu-se que o enxerto ósseo autógeno obtido da área doadora ramo mandibular constitui uma alternativa segura e eficaz para reconstrução de defeitos peri-implantares em forma de fenestração óssea...

Alveolar wall fenestrations are common during implant placement. The aim of this paper is to report a case where a peri-implant bone fenestration was reconstructed immediately after implant placement by an autogenous mandibular bone block. A male patient was referred to the Department of Surgical and Integrated Clinics to substitute his Kennedy´s Class IV removable partial denture for an implantsupported fixed prosthesis. A peri-implant bone fenestration at the buccal wall was seen at the region of 12, being reconstructed by a mandibular bone block secured by a bicortical screw. Six months later the surgical procedures, an implant-supported complete fixed partial prosthesis was developed. The autogenous bone block harvested from the mandibular ramus was a safe alternative to reconstruct the peri-implant bone defect such as fenestration types...

O uso de ansiolítico no pré-atendimento em Odontologia: revisão de literatura / The use of anxiolytic in dentistry pre-attendant: a literature review

A ansiedade produzida perante o procedimento odontológico é um fator que deve ser sempre levado em consideração, principalmente antes de procedimentos cirúrgicos. O profissional deve estar preparado para controlar essa tensão e, dentre as opções existentes, está a utilização de ansiolíticos que promovem sedação consciente, como o Midazolam ou Diazepam. Com relação ao primeiro, um benzodiazepínico, apresenta rápida absorção quando administrado por via oral e extensa margem de segurança. Já o segundo, Diazepam, gera uma sedação de longa duração. Assim sendo, o presente trabalho tem a finalidade de fazer uma revisão da literatura acerca do uso prévio de ansiolítico em Odontologia

The anxiety produced during dental procedure is a factor that should be taken into consideration, especially before surgical procedures. With the aim of controlling it, in dentistry we have several alternatives, including a choice of using anxiolytic drugs: how Midazolam or Diazepam, which promote conscious sedation. With respect to the first, benzodiazepine, has rapid absorption when administered orally and extensive safety margin. The second, Diazepam, generates a long lasting sedation. Therefore, this study aims to do a review of the literature on previous use of oral anxiolytic in surgery, especially concerning the use of midazolam

O uso de drogas anticoagulantes e antiplaquet rias orais em pacientes cir£rgico-ambulatoriais – revisÆo de literatura / The use of anticoagulants and oral antiplatelet drugs in outpatient surgical patients – literature review

Os anticoagulantes orais (AOC) e antiagregantes plaquet rios sÆo drogas utilizadas para a preven‡Æo de fen“menos tromboemb¢licos, como tromboembolismo pulmonar em pacientes com fibrila‡Æo atrial e/ou v lvulas card¡acas, trombose e embolismo pulmonar. Para pacientes submetidos a procedimentos cir£rgico-odontol¢gico eram solicitados a interromperem o uso dos anticoagulantes at‚ que o valor do INR se mantivesse ≤que 2.0, de modo a evitar hemorragias no trans e p¢s-operat¢rio. No entanto, a interrup‡Æo do AOC pode causar a forma‡Æo de um co gulo, levando a obstru‡Æo das vias sangu¡neas. Sendo assim, tornava-se duvidosa a interrup‡Æo do medicamento para a realiza‡Æo de cirurgias odontol¢gicas, em que medidas hemost ticas locais seriam suficientes para promover hemostasia. Deste modo, o objetivo da revisÆo foi avaliar o risco de hemorragia em pacientes usu rios de AOC que sÆo submetidos a procedimentos cir£rgicos, por meio de um levantamento bibliogr fico realizado em estudos cl¡nicos relevantes publicados entre 1990 e 2012, pela base Medline/PubMed. Nesta revisÆo de literatura concluiu- se que o benef¡cio da preven‡Æo de tromboembolismo supera o risco de hemorragia, assim sendo, recomenda-se manter a dose da terapia com anticoagulantes inalterada para pacientes submetidos … cirurgia oral menor e Implantodontia, utilizando n¡veis de INR adequado, com aux¡lio de hemost tico locais. Al‚m disto, uma t‚cnica cir£rgica apurada deve ser realizada nestes pacientes. Com rela‡Æo … cirurgia oral mais invasiva com risco de hemorragia, pode ser necess rio o tratamento em conjunto com a equipe m‚dica.

The oral anticoagulants (AOC) and platelet antiagregants are drugs used for the prevention of thromboembolic phenomena, such as pulmonary embolism in patients with atrial fribrilation heart valves, thrombosis and pulmonary embolism. For patients who are undergoing surgical procedures-dentistry were asked to discontinue the use of anticoagulants until the value of the INR remained≤2.0, that in order to avoid trans and hemorrhages in the postoperative period. However, the AOC can cause the formation of a clot, leading to obstruction of blood pathways. Thus, it became doubtful the medicine for surgery, in which local hemostatic measures would be sufficient to promote hemostasis. Thus, the objective of the review was to evaluate the risk of bleeding in patients AOC users that are subjected to surgical procedures, through a bibliographical survey carried out in relevant clinical studies published between 1990 and 2012, by the MedlinePubMed data. In this review of literature was concluded that the benefit of thromboembolism prevention overcomes the risk hemorrhage, therefore, it is recommended to keep the dose of anticoagulant therapy unchanged for patients undergoing oral surgery and implant dentistry, using appropriate INR levels with the assistance of local hemostatic. In addition, a refined surgical technique should be performed in these patients. With respect to the most invasive oral surgery, with a risk of bleeding, treatment may be necessary in conjunction with the medical staff.

Avaliação da satisfação de pacientes submetidos à cirurgia ortognática: análise qualitativa / Evaluation of the satisfaction of patients submitted to orthognathic surgery: qualitative analysis

Os profissionais da odontologia têm se tornado mais consciente da relação dentição com os ossos faciais e seu impacto sobre a aparência facial. Este trabalho tem o propósito de avaliar, de forma qualitativa, o grau de satisfação de pacientes submetidos à cirurgia ortognática. Foram selecionados cinco pacientes submetidos a este tipo de tratamento, os quais foram submetidos a uma entrevista oral, semi-estruturada e gravada. As entrevistas foram transcritas e submetidas à análise de conteúdo. Desta análise resultou um textosíntese, com a categorização dos resultados obtidos. Verificou-se que o principal motivo dos pacientes aderirem à cirurgia foi a estética da face, sendo o fator função observado, também, como decisivo ao paciente frente à escolha do tratamento. O tratamento ortodôntico-cirúrgico proporcionou melhoras, tanto de ordem estética, funcional, de elevação da auto-estima, e consequente qualificação positiva no relacionamento interpessoal dos pacientes pesquisados

The dental professionals have become more aware of the relationship with dentition, facial bones and their impact on facial appearance. This work has the purpose of evaluating, in a qualitative way, the degree of patients’ satisfaction submitted to orthognathic surgery. Five patients were selected submitted to this treatment type, which they were submitted to an oral interview, semi-structured and recorded. The interviews were transcribed and submitted to the content analysis. Of this analysis it resulted a text-synthesis, with the categorization of the obtained results. It was verified that the patients’ main reason to adhere to the surgery it was the aesthetics of the face, being the factor function observed, also, as decisive to the patient front to the choice of the treatment. It was verified, likewise, that the orthodontic-surgical treatment provided improvements, so much of order aesthetic, functional, of elevation of the self-esteem, and consequent positive qualification in the researched patients interpersonal relationship

Utilization of ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives for autogenous bone graft fixation: histomorphometric study in rats.

The present study analyzes the repair process of autogenous bone graft in a block fixed with ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives in rat calvaria. Forty-eight rats, divided into 3 groups, received round osteotomies at the right parietal bone for the attainment of autogenous bone graft fragment, which was fixed at the opposite side to the donor site with ethyl cyanoacrylate (ethyl group) and 2-octyl cyanoacrylate (octyl group) adhesives. In the control group, bone fragment was only juxtaposed at the parietal bone surface without any fixation material. The animals were euthanized after 10 and 60 postoperative days. The calvariae were processed in a laboratory for the attainment of slides stained through the hematoxylin and eosin technique for histological and histometric analysis. The qualitative analysis showed a discrete inflammatory infiltrate in the control group and moderate inflammatory infiltrate in the ethyl and octyl groups at the 10-day period, which remained at the 60-day period, mainly in the octyl group. The bone fragment remained bonded to the recipient site through the adhesive, but graft incorporation was not observed in any of the specimens. Resorption was higher in the octyl group followed by the ethyl and control groups, both at the 10- and 60-day periods, but with no statistical significance (P < .05). Although promoting graft fixation and its maintenance at the recipient site, both studied adhesives did not allow the graft incorporation, producing a localized and discrete inflammatory reaction, which persisted at 60 days, being more intense in the octyl cyanoacrylate group.

Central giant cell granuloma in pediatric maxilla: surgical management.

Central giant cell granuloma (CGCG) is an intraosseous lesion consisting of fibrous cellular tissue that contains multiple foci of hemorrhage, multinucleated giant cells, and occasional trabeculae of woven bone. An 8-year-old boy presented himself complaining of a painless swelling in the left maxilla that had started 1 year. Computed tomography (CT) scan confirmed a poorly defined multilocular radiolucent lesion in the left maxilla crossing the midline. The patient underwent enucleation through an intraoral approach of the lesion. The biopsy revealed multinucleated giant cells in a fibrous stroma. A CT was taken approximately 1 year postoperatively. There was no clinical or radiographic evidence of recurrence. Therefore, surgical treatment of CGCG can be performed, trying to preserve the surrounding anatomic structures, which can be maintained in case the lesion does not show an aggressive clinical behavior, avoiding large surgical defects which are undesirable in children.

Isolated bilateral blowout fracture with extensive pneumatization of the maxillary sinuses.

The blowout fracture injuries are often associated with fractures of the zygomatic complex and other facial structures but can also occur in an isolated fashion. Isolated bilateral blowout fractures are uncommon and constitute a challenge with regard to both assessment and reconstruction. This article describes an uncommon case of isolated bilateral blowout fracture in a patient with extensive pneumatization of the maxillary sinuses.

Grau de conhecimento dos cirurgiões-dentistas sobre Odontologia Hospitalar / Level of knowledge of dentists about Hospital Dental Care

O objetivo desta pesquisa foi analisar o conhecimento, opinião, acompanhamento e a execução do cirurgião-dentista na Odontologia Hospitalar. Foram aplicados 500 questionários a cirurgiões-dentistas na cidade de Araçatuba do estado de São Paulo. Os resultados demonstraram que 49% dos profissionais nunca tiveram a experiência no âmbito hospitalar e 64% afirmaram que este conteúdo é carente como parte integrante do currículo de graduação. Outro resultado foi de que 46% dos entrevistados não têm interesse ou não acham necessário atuar dentro do hospital e 24% acreditam que esse atendimento seja feito somente por especialistas. Pode-se sugerir que há carência de conhecimento sobre Odontologia Hospitalar, assim o cirurgião-dentista deve ser instruído desde a sua formação acadêmica para a inserção na equipe hospitalar.

The aim of this research was to investigate the knowledge, judgment, monitoring and execution of the dentists regarding Hospital Dental Care. Five hundred dentists from Araçatuba (São Paulo state) answered a questionnaire. The results showed that 49% of professionals have never had experience at hospitals and 64% affirmed that this content is poorly approached in graduation. Also 46% of respondents have no interest or don’t think necessary acting in a hospital and 24% believe that this care is done by specialists only. It can be suggested that there is a lack of knowledge about Hospital Dental Care, thus the dentist shall be instructed since academic training for insertion into the hospital team.

Tumor odontogênico queratocístico - relato de caso / Odontogenic keratocyst tumor - a case report

Introdução: O Tumor Odontogênico Queratocístico (TOQ)deriva dos restos lâmina dentária com particularidades easpectos histológicos específicos, com alto índice de recidiva ecomportamento clínico agressivo. Apresenta certa predileçãopara o sexo masculino, acometendo a mandíbula de 60% a 80%dos casos, podendo estar relacionado a dente incluso de 25 a45% dos casos. Objetivo: evidenciar as características clínicas,imaginológicas e histopatológicas do TOQ, bem como discutirsobre o tratamento desta lesão. Relato de Caso: Paciente de 10anos de idade que ao procurar o ortodontista para correção demordida aberta anterior, observou-se na ortopantomografia árearadiolúcida, na região do corpo de mandíbula, associada à inclusãopatológica do pré-molar inferior. Foi realizada biópsia incisionalda lesão e o laudo histopatológico foi de tumor odontogênicoqueratocístico. Realizou-se uma tomografia computadorizadapara avaliar a extensão da lesão e sua relação com as estruturasanatômicas. Como conduta, optou-se pela extração do molarinferior decíduo e enucleação da lesão, preservando o pré-molarincluso. O mesmo segue em controle clínico-radiográfico de 18meses, após a remoção do TOQ obtendo-se a erupção do prémolarque estava envolvido na lesão. Comentários Finais: Épreciso adotar protocolos de atenção odontológica que incluemo conhecimento de diagnóstico bucal, anamnese e avaliaçãoclínica criteriosa sem esquecer a necessidade de confirmaçãohistopatológica.

Reabilitação protética de mandíbula atrófica por meio de implantes curtos. Relato de caso clínico com oito anos de acompanhamento / Complete, fixed prosthetic rehabiliation over short dental implants in the atrophic mandible: 8-year follow-up

Este relato de caso mostra como o prognóstico da atrofia mandibular severa pode ser melhorado pelo uso dos implantes dentários curtos. Um paciente leucoderma do sexo masculino, 54 anos de idade, recebeu quatro implantes na região mandibular anterior. A prótese definitiva foi entregue quatro meses depois. Após oito anos de acompanhamento, não foram registradas queixas ou perda de osseointegração. Implantes dentários curtos com próteses fixas implantossuportadas podem ser um tratamento bem-sucedido na arcada mandibular atrófica.

This case report shows how the prognosis of severe mandibular atrophy can be improved with the use of short dental implants. A Caucasian 54 years-old male patient received four dental implants in the anterior mandibular region. Four months later, the definitive prosthesis was delivered. At the 8-year follow-up period, no complaints or loss of integration were reported. Short dental implants with complete, fixed definitive prosthesis can be a successful treatment in the mandibular arch.

Qual a importância da Odontologia Hospitalar? / What is the importance of Hospital Dentistryn

Odontologia Hospitalar pode ser compreendida por cuidados das alterações bucais que exigem intervenções de equipes multidisciplinares nos atendimentos de alta complexidade. A Odontologia integrada ao hospital permite melhor desempenho no compromisso de assistência ao paciente e expandiu o atendimento de saúde bucal à população. No entanto, mesmo entre os dentistas, as opiniões divergem sobre o assunto. A participação do cirurgião-dentista em nível ambulatorial ou baixa hospitalar tem o objetivo de colaborar, oferecer e agregar mais força ao que caracteriza a nova identidade do hospital. O objetivo deste trabalho foi realizar uma revisão da literatura quanto à importância de se ministrar conceitos sobre a Odontologia Hospitalar para o exercício da profissão odontológica e como se encontra a situação a respeito atualmente.

Hospital Dentistry can be understood by the care of the oral abnormalities that require intervention of multidisciplinary team for highly complex treatment. Dentistry integrated into the hospital, allows a better performance in the commitment to patient care and also expanded oral health care to the population. However, even among dentists, opinions differ on the subject. The participation of the dentist in an outpatient or in hospital, aims to collaborate, deliver and add more strength to what characterizes the new identity of the hospital. The aim of this study was to review the literature about the importance of ministering concepts of Hospital Dentistry for the exercise of this profession and how the situation is nowadays.

Condutas terapêuticas para caninos inclusos / Therapeutic behavior for impacted canines

Normalmente, os últimos dentes a erupcionar são os que permanecem inclusos ou semi-inclusos, como é o caso dos caninos. O estudo teve como objetivo relatar algumas opções de tratamento a fim da manutenção estética e funcional da área atuada diante de um canino incluso, discutindo as suas indicações, contra-indicações, vantagens e desvantagens. Este trabalho também busca enfatizar a acessibilidade que o paciente teria caso a sua opção ideal fosse uma das formas de tratamento abordadas. Para a identificação dos estudos incluídos ou considerados nesta revisão, foi realizada uma estratégia de busca detalhada para os bancos de dados pesquisados: Pubmed, Bireme, Scielo, Cochrane e Dentistry Oral Science até o ano de 2011. Foram utilizados como descritores: dente não-erupcionado, canino e terapêutica. Os critérios de inclusão foram: artigos clínicos e de revisão que abordavam o tema. Foi constatado mediante esta revisão que a falta do conhecimento técnico-científico por parte do cirurgião-dentista e a impossibilidade financeira da maioria da população são alguns dos empecilhos para o estabelecimento do correto planejamento para o canino incluso.

Normally, the last teeth to erupt are the ones which remain impacted or semi-impacted, and that is the case of the canines. This study aimed to report a few options of treatment, aiming at esthetic and functional maintenance of the affected area before a impacted canine, discussing its indications, contraindications, advantages and disadvantages. This study also aims to emphasize the accessibility the patient would have in case his/her option were one of the approached ways of treatment. In order to identify the studies included or analyzed in this review, a detailed search strategy was performed for the database used: Pubmed, Bireme, Scielo, Cochrane, and Dentistry Oral Science up to 2011. We used non-erupted teeth, canine, and therapeutics as descriptors. The criteria of inclusion were clinical and review articles that approached the theme. Through this review, it was found that the surgeon dentist?s lack of technical and scientific knowledge and the financial impossibility of most population are some hindrances for the establishment of the right planning for the impacted canine.

Periapical tissue reactions to calcium hydroxide and MTA after external root resorption as a sequela of delayed tooth replantation.

Clinical experience has shown that most avulsed teeth are replanted after a long extra-alveolar time and dry or inadequate wet storage, causing necrosis of periodontal ligament cells. This condition invariably leads to development of external root resorption, leaving the filling material in contact with the periapical connective tissues. In this study, the periapical tissue reactions to calcium hydroxide (CH) and mineral trioxide aggregate (MTA) were evaluated after occurrence of external root resorption as an expected sequela of delayed tooth replantation. Twenty male Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. Then, the dental papilla, enamel organ, pulp tissue, and periodontal ligament were removed, and the teeth were immersed in a 2% acidulated phosphate sodium fluoride solution, pH 5.5, for 10 min. The teeth were randomly assigned into two groups (n = 10), in which the canals were filled with either a CH and saline paste (CH group) or MTA (MTA group). The sockets were irrigated with saline, and the teeth were replanted. After 80 days, it was possible to observe large areas of replacement root resorption and some areas of inflammatory root resorption in both groups. More severe inflammatory tissue reaction was observed in contact with calcium hydroxide compared with the mineral trioxide aggregate. New bone formation was more intense at the bottom of the socket in the MTA group. In conclusion, as far as periapical tissue compatibility is concerned, intracanal MTA can be considered as a viable option for root canal filling in delayed tooth replantation, in which external root resorption is an expected sequela.