Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial.

The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.

Fibroma ossificante juvenil em mandíbula: relato de caso / Fibroma juvenile ossificans mandible: a case report

Lesões fibro-ósseas benignas são processos patológicos comumente encontrados em ossos do esqueleto maxilofacial. O fibroma ossificante verdadeiro é uma entidade rara, com muitos casos previamente relatados sendo reconhecidos hoje como displasia cemento óssea focal. O fibroma ossificante juvenil é uma variante dos fibromas ossificantes, tendo como características peculiares o crescimento rápido, entre 5 ­ 15 anos, e o comportamento clínico agressivo. O presente trabalho relata um caso de paciente jovem (15 anos), do sexo feminino, com diagnóstico de fibroma ossificante juvenil em região posterior de mandíbula, tratada com ressecção em bloco e reconstrução imediata com enxerto ósseo não vascularizado de crista ilíaca. A paciente encontra-se em acompanhamento ambulatorial sem indícios de recidiva da lesão. O fibroma ossificante juvenil que apresenta comportamento clínico agressivo merece atenção especial no seu tratamento, nos casos em que o crescimento é rápido e destrutivo uma abordagem mais agressiva se faz necessário

Fibro osseous lesions are pathological processes commonly found in cranial and facial bones. The real ossifying fibroma is a rare entity, with many previously reported cases being recognized today as cemento-ossifiying dysplasia. The juvenile ossifying fibroma is a variant of ossifying fibroma, with the peculiar characteristics rapid growth, between 5-15 years, and the aggressive clinical behavior. This paper reports a case of a young female patient (15 years) with diagnosis of juvenile ossifying fibroma in the posterior mandible, treated with bloc resection and immediate reconstruction with bone graft non vascularized of iliac crest. The patient is being followed up, without evidence of recurrence. The juvenile ossifying fibroma presenting aggressive clinical behavior deserves special attention in their treatment, where growth is fast and destructive a more aggressive approach is needed