Pilomatrixoma in the cheek: a clinical case report.

Pilomatrixoma is a follicular benign tumor of unknown etiology that originates in the matrix of a hair follicle. It develops more frequently in children and young adults, with a slight predominance in female patients. It is a slow-growing tumor that presents as a mobile nodule, firm, and with well-defined borders. The present study aimed to report the clinical, histopathologic, and radiographic aspects of pilomatrixoma in the cheek area of a 20-year-old female patient as the established treatment at an oral maxillofacial department. Pilomatrixoma is rarely included in the differential diagnosis of masses and nodules in the skin, and it is often confused with other nodular lesions, such as epidermoid cysts. The diagnostic method to identify this entity is an incisional biopsy. Because of its high incidence in the head and neck region, oral surgeons should be well-acquainted with this type of tumor so that it can be included as a diagnostic hypothesis of masses and nodules of the head and neck.

Pilomatrixoma in the cheek: a clinical case report

ABSTRACT Pilomatrixoma is a follicular benign tumor of unknown etiology that originates in the matrix of a hair follicle. It develops more frequently in children and young adults, with a slight predominance in female patients. It is a slow-growing tumor that presents as a mobile nodule, firm, and with well-defined borders. The present study aimed to report the clinical, histopathologic, and radiographic aspects of pilomatrixoma in the cheek area of a 20-year-old female patient as the established treatment at an oral maxillofacial department. Pilomatrixoma is rarely included in the differential diagnosis of masses and nodules in the skin, and it is often confused with other nodular lesions, such as epidermoid cysts. The diagnostic method to identify this entity is an incisional biopsy. Because of its high incidence in the head and neck region, oral surgeons should be well-acquainted with this type of tumor so that it can be included as a diagnostic hypothesis of masses and nodules of the head and neck.

Effectiveness of the Conservative Surgical Management of the Ameloblastomas: A Cross-Sectional Study.

Ameloblastoma is a benign, but locally aggressive odontogenic neoplasm, whose appropriate therapeutic management remains highly debatable. The aim of this study was to evaluate the reliability and effectiveness of the two conservative surgical therapeutic protocols (curettage with peripheral ostectomy only and curettage plus cryotherapy) for the management of ameloblastomas. About 53 cases of the ameloblastomas treated in 9 years were retrospectively analyzed regarding their clinical, histopathologic, radiographic, and therapeutic data. The results and the postoperative complications related to both the therapeutic protocols were also statistically investigated. A slight female preponderance was seen (1.12:1.0) with a mean age of 27.1 years. The posterior mandible was the most affected site and dental involvement was frequently found. Multilocular lesions causing the alterations of the bone cortices were the most common radiographic findings. Recurrences were seen in 9.4% of the cases and although the patients submitted to curettage plus cryotherapy have shown an increased incidence of wound dehiscence, infection, and paresthesia, only bone sequestration proved to be significantly more frequent in this group compared to the patients treated by curettage with peripheral ostectomy only. The incidence of the recurrences following the conservative management is low and cryotherapy use as an adjuvant tool must be rationally considered.

Odontogenic myxoma in a child treated with enucleation and curettage.

Odontogenic myxoma is an aggressive benign odontogenic tumor, accounting for 3-6% of all the odontogenic tumors in adults. The incidence among children is lower. Due to its clinical behavior, there is no consensus on the best treatment. In this paper, the authors report the case of a 9-year-old girl with the diagnosis of odontogenic myxoma. The panoramic X-ray showed an extensive radiolucent lesion involving the left mandibular body causing teeth displacement. The treatment consisted of tumor enucleation followed by vigorous curettage of the bone walls. Both the base of the mandible and the inferior alveolar nerve were preserved. The patient is asymptomatic after 6 months of surgery. The age of the patient and the radiographic features were taken into account when deciding in favor of the conservative treatment.

Analgesic and adjuvant anesthetic effect of submucosal tramadol after mandibular third molar surgery.

OBJECTIVE: The aim of this study was to assess analgesic and adjuvant anesthetic effects of submucosal tramadol after third molar extraction. STUDY DESIGN: In this double-blind, split-mouth, placebo-controlled, single-dose, crossover investigation, 52 patients underwent mandibular third molar extraction under local anesthesia. Surgical side was randomly assigned to submucosal 2 mL 100 mg tramadol injection (group T) or normal saline solution (group P) immediately after surgery. Anesthetic blockade duration, time of intake and amount of analgesic rescue drug, and postoperative pain intensity were recorded immediately after anesthesia cessation and 4, 8, 24, 48, and 72 hours after surgery. Data were submitted to analysis of variance and Wilcoxon tests. RESULTS: Anesthetic blockade duration between groups was similar. Group T took significantly less rescue drug after 72 hours (P = .008). Time elapsed before first intake of rescue drug was longer (P = .006), and pain intensity was significantly lower (P = .001) in group T. CONCLUSIONS: Submucosal tramadol injection after oral surgery improved postoperative analgesia, but did not extend anesthetic action duration.

Uso do acesso intraoral para tratamento cirúrgico de hipertrofia bilateral do músculo masseter / Intraoral approach for surgical treatment of bilateral masseter muscle hypertrophy

A hipertrofia do músculo masseter é uma condição incomum, caracterizada pelo aumento do volume do músculo masseter, em grande parte dos casos está associado a um esporão ósseo na região do ângulo mandibular, causando a projeção deste. A etiologia de tal condição é desconhecida, podendo ser atribuída a hábitos parafuncionais, desordens psiquiátricas e da articulação temporomandibular. De diagnóstico clínico, exames complementares são indicados para excluir possíveis patologias que acometem a região parotídeo-massetérica. Diversas formas de tratamento são descritos na literatura como o tratamento clínico-medicamentoso e aplicações de toxina botulínica tipo A Em relação ao tratamento cirúrgico, várias técnicas foram propostas, diferenciando-se basicamente em relação ao tipo de tecido abordado: muscular, ósseo ou ambos e quanto ao acesso utilizado: intra ou extraoral.

The masseter muscle hypertrophy is arare condition characterized by a increased muscle size. In most cases is associated with abone spur leading to a prominent mandibular angle. The etiology is uncertain, usually associated with parafunctional habits, psychiatric illness and disorders of the temporomandibular joint. Diagnosis is clinic but complementary exams are necessary to exclude other pathologies frequent in parotid masseteric region. Many ways of treatment are described in the literature such as the clinic treatment, medicamentous treatment and botulinic toxin type A injection and finally the surgical treatment. This last therapeutic methoa has several techniques that basically differ from each other by the kind of tissue that is manipulated: muscle, osseous or both and about the approach: intra or extra oral may be chosen.

Maxillary reconstruction with particulate bone graft and titanium mesh: a treatment option for large complex odontoma of the maxilla.

Odontomas are the most common type of odontogenic tumor and are generally asymptomatic. The purpose of this paper was to describe the case of a complex odontoma in a patient who had asymptomatic swelling in the central maxillary region, along with unerupted central and lateral incisors. In this case, surgical excision of the lesion was performed and an iliac bone graft was introduced into the defect area with a titanium mesh covering up the grafted harvesting bone. After 2 years of followup, no recurrence was identified. Patient followup is still in progress to evaluate bone graft resorption, and the patient awaits complete bone development. Oral rehabilitation with an osseointegrated titanium implant is expected in the future. An option of the large complex odontoma treatment is discussed.

Use of retinoids in the treatment of oral leukoplakia: a review / Uso de retinoides no tratamento de leucoplasias bucais: revisão

OBJECTIVE: The purpose of this paper is to review the literature regarding the topical use of the retinoids in the treatment of oral leukoplakia, discussing their mechanisms of action, indications, effectiveness, and adverse effects. DISCUSSION: Leukoplakia is defined as white lesion in oral mucous membrane that cannot be characterized as any other entity and it has potential for malignancy. It does not present specific histological pattern. Due to its potential for malignancy and high prevalence, dentists should know how to diagnose and treat it correctly. The retinoids are chemopreventive agents derived from the vitamin A. They could be either natural or synthetic and their main role is to suppress cellular mitosis. Retinoid derivatives have been used as agents for chemoprevention of malignant transformation of leukoplakias due to its potential effect on the control of the differentiation and proliferation of the epithelial cells, as well as their induction of apoptosis. CONCLUSION: The topical use of retinoids to treat oral leukoplakia is safe, convenient and effective, with minor side effects than the systemic administration.

OBJETIVO: A proposta deste artigo é revisar a literatura referente ao uso de retinoides no tratamento de lecoplasiasbucais e discutir o mecanismo de ação, indicações, efetividade e efeitos adversos. DISCUSSÃO: Leucoplasia é definida como lesão branca na mucosa bucal que não pode ser caracterizada como qualquer outra entidade e tem potencial de malignização. Não apresenta padrão histológico específico e, por causa de seu potencial de malignização e alta prevalência, os cirurgiões-dentistas devem conhecer como diagnosticá-la e tratá-la corretamente. Os retinoidestêm sido usados como agentes quimio-profiláticos para a transformação maligna das leucoplasias por seu efeito potencial no controle da diferenciação e proliferação da células epiteliais, bem como capazes de indução de apoptose. CONCLUSÃO: O uso tópico de retinoides para tratar leucoplasias é seguro, conveniente e efetivo, com efeitos colaterais menores do que na administração sistêmica.

Cistos ósseos simples atípicos / Atypical simple bane cysts

O cisto ósseo simples, lesão incomum dentre as patologias da cavidade oral, apresenta uma etiologia ainda inconclusiva, o que se pode constatar frente à variedade de termos que têm sido utilizados para descrever tal condição. Clinicamente, este se apresenta de forma assintomática, sendo na grande maioria dos casos, diagnosticado a partir de um achado ra- diográfico. Apresenta uma predileção pela mandíbula, em regiões dentadas, caracterizando-se radiograficamente como uma lesão unilocular sem expansão das paredes ósseas circundantes. Este artigo visa relatar dois casos clínicos de cistos ósseos simples diagnosticados como atípicos devido ao acometimento do osso mandibular em regiões edêntulas, sendo que em um dos casos apresentou expansão das paredes ósseas; aspecto que, diverge do comumente encontrado na literatura. Ambos os casos clínicos foram submetidos à curetagem e promoção do sangramento das paredes ósseas, com subseqüente formação de um coágulo sanguíneo estável. Como visto na maioria dos casos relatados na literatura, a curetagem da região acometida pelo cisto ósseo traumático apresenta-se como uma alternativa terapêutica extremamente eficaz, devendo o paciente ser periodicamente monitorado, através de exames radiográficos, ate que haja a completa formação do tecido ósseo, já que a recorrência local, apesar de raramente relatada, pode ocorrer.

The sim pie bone cyst is not an ordinary lesion among the oral cavity pathologies and still does not present a conclusive etiology. This can be very well noticed when we face the many terms that have been used to describe it. Clinically speaking, it is not presented in a symptomatic way, being diagnosed, mostly, from X-ray exams. It happens preferably in the teeth regions of the mandible, and can be identified through radiographic exams as an unilocular lesion with no expansion of the surround bone walls. This article aims to relate two clinical cases in which the simple bone cysts have been diagnosed as atypical because of the damage caused on the mandible bone at edentulous regions, considering that in one of them there has been an expansion of the bone walls. Such aspects are not in accordance with what has been described at the common literature. Both clinical cases have been submitted to a curettage proceeding, what developed the bleeding of the bone walls, with subsequent formation of a stable blood coagulum. According to the literature, in most cases, the curettage proceeding at the affected region with the traumatic bone cyst is a very effective therapeutic alternative, in which the patient should be monitored periodically, through radiographic examination, until the bone texture is completely rebuilt, since although it is rare, the local reincidence may occur.

Osteochondroma of the temporomandibular joint: a case report.

Osteochondroma of the mandibular condyle has been found in the oral and maxillofacial region rarely. This paper describes a case of osteochondroma of the mandibular condyle in a 20-year-old woman, who was referred to our service with facial asymmetry, prognathic deviation of chin, cross-bite to the contralateral side, changes in condylar morphology, limited mouth opening, and malocclusion. Computed tomography (CT) was performed for better evaluation to the pathological conditions on the temporomandibular joint. Based on the clinical examination, patient history, and complementary exams, the hypothesis of osteochondroma was established. Condylectomy was performed using a preauricular approach with total removal of the lesion. After 3 years of postoperative follow up and orthodontic therapy, the patient is symptom-free, and has normal mouth opening with no deviation in the opening pattern.

Eficácia analgésica pós-operatória e ação anestésica adjuvante do cloridrato de tramadol utilizado localmente após exodontias de terceiros molares inferiores impactados / Efficacy of postoperative analgesia and adjuvant anesthetic action of local tramadol hydrochloride injection after impacted third molar extraction

Foi estudado o efeito analgésico e anestésico adjuvante do cloridrato de tramadol aplicado localmente, após extração do terceiro molar inferior impactado. Um total de 52 pacientes foi submetido à exodontia sob anestesia local (mepivacaína 2% 1:20 000 corbadrina), em estudo duplo-cego, dose única, cruzado, controlado por placebo. Pacientes e os lados dos procedimentos foram distribuídos aleatoriamente para receberem 2 ml de tramadol (100%) (grupo T) ou 2 ml de solução salina 0,9% (grupo P). Ambas as soluções foram injetadas na submucosa gengival e alvéolo, imediatamente após as cirurgias realizadas por um mesmo cirurgião. Impacção dental e quantidade anestésica foram pareadas. Dados do consumo e a hora de uso de analgésico de resgate (dipirona 500 mg) foram utilizados para avaliar o efeito analgésico de tramadol. Uma Escala Analógica Visual (EAV) de dor foi aplicada após término da anestesia, 4, 8, 24, 48 e 72 horas após cirurgia, com os dados submetidos ao teste de Wilcoxon (p < 0,05). Não houve diferença no bloqueio anestésico e efeitos adversos entre os grupos. O grupo T requisitou um número significativamente menor (p = 0,008) de comprimidos de dipirona durante o período de avaliação (3,37 ± 4,65) do que o grupo P (4,4 ± 3,71). O grupo T levou mais minutos para usar a dipirona após a primeira cirurgia (303,72 ± 416,01) do que o grupo P (185,4 ± 59,4) (p = 0,006). O grupo T apresentou menor média de dor na EAV após término da anestesia (3,55 ± 2,27) do que no grupo P (5,26 ± 2,49) (p = 0,001). O tramadol administrado localmente após exodontia de terceiros molares inferiores melhora a qualidade da analgesia pós-operatória, porém não prolonga a duração da anestesia local com mepivacaína.

The present study sought to assess the analgesic and adjuvant anesthetic effects of surgical site administration of tramadol hydrochloride immediately after extraction of impacted mandibular third molars. In this double-blind, placebo-controlled, singledose, crossover investigation, 52 patients underwent bilateral extraction of impacted mandibular third molars under local anesthesia (mepivacaine 2% with levonordefrin 1:20 000). Patients and procedures, by side of intervention, were randomly assigned to receive either 2 mL of tramadol (100%) (Group T, n = 52) or 2 mL of normal saline, 0.9% (Group P, n = 52). Medications were administered by submucosal injection at the level of the third molar immediately after surgery. All patients were operated on by the same surgeon; patients were paired for technical difficulty and amount of anesthetic solution. Use of supplementary analgesics (500 mg metamizole) and time to first postoperative use of a rescue drug were used to assess the analgesic effect of tramadol. Pain level on both sides (Group T and P) was recorded on a visual analog scale (VAS 010 cm) immediately after cessation of anesthetic effect and at 4, 8, 24, 48, and 72 hours postoperatively. Data were compared using the Wilcoxon test (p < 0.05). There was no difference in anesthetic blockade between groups. There were no differences in reported adverse effects. In the 72 hours following surgery, patients in group T took significantly fewer (p = 0.008) metamizole tablets (3.37 ± 4.65) than did those in group P (4.4 ± 3.71). Time to first dose of a rescue drug (in minutes) was longer in Group T (303.72 ± 416.01) than in Group P (185.4 ± 59.4) (p = 0.006). Tramadol reduced pain intensity values (VAS) significantly in Group T (3.55 ± 2.27) as compared to Group P (5.26 ± 2.49) after anesthetic effect had worn off (p = 0.001)...

Osteochondroma of the temporomandibular joint: a case report

Osteochondroma of the mandibular condyle has been found in the oral and maxillofacial region rarely. This paper describes a case of osteochondroma of the mandibular condyle in a 20-year-old woman, who was referred to our service with facial asymmetry, prognathic deviation of chin, cross-bite to the contralateral side, changes in condylar morphology, limited mouth opening, and malocclusion. Computed tomography (CT) was performed for better evaluation to the pathological conditions on the temporomandibular joint. Based on the clinical examination, patient history, and complementary exams, the hypothesis of osteochondroma was established. Condylectomy was performed using a preauricular approach with total removal of the lesion. After 3 years of postoperative follow up and orthodontic therapy, the patient is symptom-free, and has normal mouth opening with no deviation in the opening pattern.

Osteocondroma de côndilo mandibular é raro na região craniofacial. Este artigo descreve um caso de osteocondroma de côndilo mandibular em uma mulher de 20 anos que foi encaminhada ao nosso serviço apresentando assimetria facial, desvio de mento, mordida cruzada para o lado contralateral, alterações na morfologia condilar, limitação de abertura bucal e maloclusão. Tomografia computadorizada foi realizada para melhor avaliação da condição patológica da ATM. Devido à base no exame clínico, histórico do paciente e exames complementares, foi estabelecida uma hipótese de osteocondroma. Um procedimento de condilectomia utilizando abordagem preauricular com uma total remoção da lesão foi executado. Após três anos de acompanhamento pós-operatório e ortodôntico, o paciente está livre dos sintomas e tem uma abertura normal sem desvio de padrão durante a abertura.

Eficácia analgésica pós-operatória e ação anestésica adjuvante do cloridrato de tramadol utilizado localmente após exodontias de terceiros molares inferiores impactados / Efficacy of postoperative analgesia and adjuvant anesthetic action of local tramadol hydrochloride injection after impacted third molar extraction

Foi estudado o efeito analgésico e anestésico adjuvante do cloridrato de tramadol aplicado localmente, após extração do terceiro molar inferior impactado. Um total de 52 pacientes foi submetido à exodontia sob anestesia local (mepivacaína 2% 1:20 000 corbadrina), em estudo duplo-cego, dose única, cruzado, controlado por placebo. Pacientes e os lados dos procedimentos foram distribuídos aleatoriamente para receberem 2 ml de tramadol (100%) (grupo T) ou 2 ml de solução salina 0,9% (grupo P). Ambas as soluções foram injetadas na submucosa gengival e alvéolo, imediatamente após as cirurgias realizadas por um mesmo cirurgião. Impacção dental e quantidade anestésica foram pareadas. Dados do consumo e a hora de uso de analgésico de resgate (dipirona 500 mg) foram utilizados para avaliar o efeito analgésico de tramadol. Uma Escala Analógica Visual (EAV) de dor foi aplicada após término da anestesia, 4, 8, 24, 48 e 72 horas após cirurgia, com os dados submetidos ao teste de Wilcoxon (p < 0,05). Não houve diferença no bloqueio anestésico e efeitos adversos entre os grupos. O grupo T requisitou um número significativamente menor (p = 0,008) de comprimidos de dipirona durante o período de avaliação (3,37 ± 4,65) do que o grupo P (4,4 ± 3,71). O grupo T levou mais minutos para usar a dipirona após a primeira cirurgia (303,72 ± 416,01) do que o grupo P (185,4 ± 59,4) (p = 0,006). O grupo T apresentou menor média de dor na EAV após término da anestesia (3,55 ± 2,27) do que no grupo P (5,26 ± 2,49) (p = 0,001). O tramadol administrado localmente após exodontia de terceiros molares inferiores melhora a qualidade da analgesia pós-operatória, porém não prolonga a duração da anestesia local com

The present study sought to assess the analgesic and adjuvant anesthetic effects of surgical site administration of tramadol hydrochloride immediately after extraction of impacted mandibular third molars. In this double-blind, placebo-controlled, singledose, crossover investigation, 52 patients underwent bilateral extraction of impacted mandibular third molars under local anesthesia (mepivacaine 2% with levonordefrin 1:20 000). Patients and procedures, by side of intervention, were randomly assigned to receive either 2 mL of tramadol (100%) (Group T, n = 52) or 2 mL of normal saline, 0.9% (Group P, n = 52). Medications were administered by submucosal injection at the level of the third molar immediately after surgery. All patients were operated on by the same surgeon; patients were paired for technical difficulty and amount of anesthetic solution. Use of supplementary analgesics (500 mg metamizole) and time to first postoperative use of a rescue drug were used to assess the analgesic effect of tramadol

Pain level on both sides (Group T and P) was recorded on a visual analog scale (VAS 010 cm) immediately after cessation of anesthetic effect and at 4, 8, 24, 48, and 72 hours postoperatively. Data were compared using the Wilcoxon test (p < 0.05). There was no difference in anesthetic blockade between groups. There were no differences in reported adverse effects. In the 72 hours following surgery, patients in group T took significantly fewer (p = 0.008) metamizole tablets (3.37 ± 4.65) than did those in group P (4.4 ± 3.71). Time to first dose of a rescue drug (in minutes) was longer in Group T (303.72 ± 416.01) than in Group P (185.4 ± 59.4) (p = 0.006). Tramadol reduced pain intensity values (VAS) significantly in Group T (3.55 ± 2.27) as compared to Group P (5.26 ± 2.49) after anesthetic effect had worn off (p = 0.001). Local administration of tramadol after oral surgery improves the quality of postoperative analgesia, but does not extend the duration of anesthetic action

Estudo epidemiológico de 829 casos de fratura de mandíbula / epidemiological study of 829 cases of jaw fracture

A meta deste estudo epidemiológico foi analisar os dados dos registros de 829 casos de fratura de mandíbula tratadas cirurgicamente no Serviço de Cirurgia Traumatologia Buco-Maxilo-Facila do Hospital das Clínicas-FMUSP entre os anos de 1990 a 2002. Métodos: foram revisados os prontuários de 915 pacientes, classificados como tendo o diagnóstico de fratura de mandíbula, que sofreram tratamento cirurgico, ocorridos a partir de janeiro de 1990 a dezembro de 2002. Dentre 915 prontuários, 829 prontuários foram incluídos no estudo...

The goal of this study was to analyze records of 829 cases of mandible fractures surgically treated at the Oral and Maxiillo-Facial Service of the Hospital das Clínicas-FMUSP between 1990 and 2002. Records of 915 patients classified as having diagnosis of mandible fracture underdoing surgical treatment from january/1990 to december/2002 were reviewed. Among 9115 records, 829 were incluid inthe study...

Correção cirúrgica da deficiência transversal da maxila: relato de caso / Surgery correction of the maxillary transverse deficiency: case report

A deficiência transversal da maxila ou atresia maxilar é deformidade dento-facial, caracterizada pela presença de mordida cruzada posterior uni ou bilateral, palato ogival, apinhamentos dentários, dificuldade de respiração nasal, hipoplasia zigomática, base nasal estreita e sulco nasolabial profundo. O tratamento baseia-se na expansão rápida maxilar por meio de tratamento ortopédico-ortodôntico em pacientes jovens com uso de disjuntores (expansores) e a associação cirúrgica-ortodôntica em pacientes adultos, realizando osteotomias para a fragilização das zonas de resistência óssea a disjunção. O objetivo deste trabalho é relatar uma breve revisão de literatura e um caso submetido à disjunção maxilar cirurgicamente assistida complementar ao tratamento ortodôntico.

The maxillary transverse deficiency or atresic maxilla is dentofacial deformity characterized by presence of posterior bilateral or unilateral crossbite, deep ogival palate, nasal breathing difficulty, zigomatic hipoplasic, narrow nasal base and deep nasolabial sulcus. The treatment is based on rapid maxillary expansion through orthodontic-orthopedic treatment in young patients and the orthodontic-surgery association in adults patients, performing osteotomies for fragilization of the bone resistance zones in maxillary disjunction. The purpose of this work is to report a brief review of the literature and a case submitted to surgically assisted rapid maxillary disjunction for complement of orthodontic treatment.

Osteonecrose bilateral na maxila induzida por zolendronato / Zoledronate-induced maxillary bilateral osteonecrosis

Os bifosfonatos são drogas utilizadas com diversas finalidades, dentre elas, o tratamento da hipercalcemia secundária a neoplasias malignas. Embora sua eficácia médica seja comprovada, o número de pacientes que apresentam osteonecrose nos maxilares vem aumentando devido ao uso desse medicamento. Este relato mostra o tratamento de um paciente que desenvolveu osteonecrose de maxila após fazer uso crônico de bifosfonato, enfatizando o surgimento de lesões maxilares agressivas concomitantes à piora do estado geral do paciente.

Bisphosphonates are drugs used to treat malignat hypercalcemia in certain types of cancer. Although this drug has clear evidence of medical efficacy, there are an increasing number of patients that develop bisphosphonate associated osteonecrosis of the jaws. This report show the treatment of a patient that present osteonecrosis subsequent the cronic use of bisphosphonate showing a strong correlation between the aggressive aspect of the lesion and general health patient.

Prevalência das lesões diagnosticadas no Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial (CTBMF) da USP / Prevalence of the lesions diagnosed at the Service of the CTBMF from USP

A meta deste estudo foi analisar os dados dos registros de pacientes atendidos com lesões da cavidade bucal no serviço de Cirurgia e Traumatologia Buco-maxilofacial do HCFMUSP no período de maio a dezembro de 2004. Foram levantadas as seguintes variáveis em 98 prontuários: gênero, raça, idade, tipo de lesão, quantidade e localização anatômica da lesão. Um total de 98 pacientes foi analisado e foram encontrados 40 tipos de lesões. Houve predomínio de pacientes do sexo feminino, brancos, entre 30 a 40 anos. A região anatômica mais frequente foi a mandíbula. As lesões mais prevalentes foram querocisto, hiperplasia fibrosa inflamatória e carcinoma epidermóide.

Adesivos teciduais de cianoacrilato em cirurgia e traumatologia buco-maxilo-facial / Cyanoacrylate tissue adhesives in oral and maxillofacial surgery

Os adesivos teciduais à base de cianoacrilato são utilizados há mais de 40 anos como alternativa à sutura convencional ou à osteossíntese. Cianoacrilatos de última geração suscitam menos histotoxicidade, são passíveis de uso em pele, mucosas e ossos, além de possuir certo efeito bactericida. Assim, avaliamos a utilidade desses materiais para estabelecimento de limitações, vantagens, e de protocolos de utilização e técnicas de manuseio que possibilitem as menores complicações possíveis. Este estudo mostra que a sutura química de ferimentos bucais e maxilofaciais é amplamente aceita, com vantagens como propriedades hemostáticas e de proteção à ferida. A utilização para fixação óssea e outras aplicações são reservadas para casos selecionados, pois os resultados são ainda pobres, se comparados aos das maneiras tradicionais de tratamento.