Surgical Treatment of Bilateral Atrophic Mandible Fracture.

Poor proprioception, weakness, and impaired reflexes increase the incidence of facial fracture in the elderly. Mandibular fractures in these people range from 10.1% to 56%. Fragment reduction and fracture consolidation are difficult due to bone atrophy, decreased capacity for bone regeneration, and lack of anatomical landmarks to guide the alignment of the fragments. This study reports 2 patients with different conducts regarding the treatment of bilateral fractures in atrophic mandible. The first patient refers to the removal of plates of the 2.4 mm system with low profile, which failed during the mandibular function, being replaced by the 2.4 mm system with high profile. The 2nd clinical reports the use of the 2.0 mm system only to simplify the mandibular fracture, and then reconstructing that with a 2.4-mm system with high profile, using the load bearing principles. Regarding mandibular fractures, an important goal is to neutralize the muscle action aiming the bone stability. There are several methods to treat that the indication should consider the load bearing and load sharing concepts. The incorrect fixation choice in these patients can result in complications as bad union, material failure, infection, and consequent treatment failure.

Reconstruction of Frontal Bone With Custom-Made Prosthesis Using Rapid Prototyping.

Frontal bone fracture treatment is still an issue of research in craniofacial surgery and neurosurgery. The aims of the treatment are to reduce the complication risks and to keep the aesthetic of the face. Before the management of this fracture type, it is necessary to consider the permanence or not of the frontal sinus function. Rapid prototyping has been an aid tool on planning and simulation of the surgical procedure, improving the diagnostic quality and the implant manufacture, beyond reducing the operative time. Among the used materials on treatment of these fractures, titanium mesh shows large versatility and ease of handling. Poly(methyl methacrylate) has been used in defects of partial thickness or irregularities on cranial surface. The aim of this study is to report a case of a patient presenting sequelae of large fracture of anterior wall of frontal bone, treated by a titanium mesh associated with the customized poly(methyl methacrylate) implant from the rapid prototyping. It could be concluded that the use of this technique showed itself effective on patient treatment, and rapid prototyping demonstrated being a valuable tool showing predictable and satisfactory results.

Adenoma pleomórfico em lábio inferior: relato de caso / Pleomorphic adenoma in lower lip: case report

O adenoma pleomórfico é o tumor benigno mais comum de glândulas salivares, acometendo, com mais frequência, as glândulas salivares maiores, especialmente a glândula parótida. Geralmente se apresenta como nódulo firme, indolor e de crescimento lento. Suas localizações mais comuns, em glândulas salivares menores, são o palato mole, duro e lábio superior, podendo ser encontrado em outras regiões com menos frequência. Essa lesão tem ligeira preferência pelo gênero feminino e seu tratamento consiste na excisão cirúrgica. O prognóstico é bom para as lesões benignas enucleadas. O objetivo deste trabalho é relatar o caso de um paciente portador de adenoma pleomórfico em lábio inferior. O paciente foi tratado sem intercorrências por meio da excisão cirúrgica da lesão e encontra-se em acompanhamento pós-operatório de um ano sem sinais de recidiva e sem queixas funcionais ou estéticas. No entanto, um acompanhamento mais prolongado se faz necessário para indicar cura do paciente... (AU)

Pleomorphic adenoma is a benign tumor most common of salivary glands, it usually occurs in major salivary glands, especially the parotid gland. Normally, it is seen as a firm nodule, painless with slow growth. Its locations most common, in minor salivary glands, are the soft and hard palate and upper lip, it can be found in other regions less frequently. This lesion has slight preference for females and its treatment consists on surgical excision. The prognosis is good to the removed benign lesions. The aim of this work is to report the case of a patient with the diagnosis of pleomorphic adenoma in lower lip. The case was treated without complications, and a year follow-up patient showed no recurrence, but longer follow is necessary to indicate patient's cure... (AU)

Prevalência de maloclusão e necessidade de tratamento ortodôntico em indivíduos adultos / Prevalence of malocclusion and orthodontic treatment needs in adult patients

Os objetivos desse estudo foram determinar a prevalência de maloclusão e a necessidade de tratamento ortodôntico em pacientes de 18 a 50 anos de idade atendidos nas clínicas odontológicas da Universidade Estadual da Paraíba. A amostra compreendeu 156 pacientes (65,4% mulheres e 34,6% homens). O diagnóstico da maloclusão foi feito com o uso do Índice de Estética Dental (DAI) por meio de dois examinadores calibrados (K = 0,71). A análise estatística utilizou os testes do Qui-quadrado e Exato de Fisher, com nível de significância de 5%. A prevalência de maloclusão foi 63,5%. Observou-se diferença estatisticamente significante entre a perda de elemento dentário na região anterior e a severidade da maloclusão (p = 0,000; OR = 21,06 [8,47-53,90]). Metade dos pacientes não estava satisfeita com o sorriso, existindo diferença estatisticamente significante entre a severidade da maloclusão e a satisfação ao sorrir (p = 0,015; OR = 2,23 [1,16-4,71]). Conclui-se que a prevalência de maloclusão foi alta, sendo mais frequente o apinhamento no segmento incisal. Um terço dos pacientes portava maloclusão muito severa/incapacitante, sendo verificada associação entre a severidade da maloclusão e a satisfação ao sorrir.

The objectives of this study were to determine the prevalence of malocclusion and the orthodontic treatment needs in patients aged 18 to 50 years attending the dental clinics of the State University of Paraíba, Brazil. The sample was composed of 156 patients (65.4% females and 34.6% males). The diagnosis of malocclusion was established by two calibrated examiners (K = 0.71) using the Dental Aesthetics Index (DAI). The Chi-square and Fisher's exact tests were used for statistical analysis of the data at 5% significance level. The prevalence of malocclusion was 63.5%. There was statistically significant difference between tooth loss in the anterior region and malocclusion severity (p = 0.000; OR = 21.06 [8.47-53.90]). Half of the patients were not satisfied with their smile, with statistically significant difference between malocclusion severity and satisfaction at smiling (p = 0.015; OR= 2.23 [1.16-4.71]). In conclusion, the prevalence of malocclusions was high, the most frequent being crowding in the incisal segment. One third of the patients presented very severe/incapacitating malocclusion, existing association between malocclusion severity and satisfaction at smiling.