Autotransplante dentário: da previsibilidade à técnica cirúrgica e resultados do tratamento / Dental Autotransplantation: from predictability to surgical technique and treatment results

Objetivo: apresentar o relato de duas pacientes com agenesias dentárias em que cinco dentes autotransplantados foram utilizados como modalidade de tratamento. Além disso, objetiva-se mostrar questões sobre a técnica cirúrgica, suas indicações e previsibilidade. Relato de caso: Neste estudo, foram relatados 5 casos de autotransplante dentário em duas pacientes jovens, em que a equipe realizou os procedimentos e o acompanhamento clínico e radiográfico por 5 e 7 anos. Devido à alta sensibilidade da técnica, foram seguidos princípios previamente estabelecidos na literatura envolvendo o autotransplante dentário. Durante o período de acompanhamento, os dentes se mantiveram em posição e em função e as pacientes não apresentavam queixas associadas. Considerações finais: a técnica do autotransplante dentário, quando bem indicada e executada, é capaz de promover resultados bastante satisfatórios, sendo uma ótima alternativa reabilitadora, com taxas de sucesso elevadas e custos reduzidos. No entanto, critérios em relação aos sítios doadores e receptores e a habilidade do cirurgião devem ser levados em conta para o sucesso do técnica.

Objective: presenting the report of two patients with tooth agenesis in which five autotransplanted teeth were used as a treatment modality. Furthermore, the aim is to show questions about the surgical technique and its indications and predictability. Case report: In this study, 5 cases of dental autotransplantation were reported in two young patients, in which the team performed procedures and had clinical and radiographic follow-up for 5 and 7 years. Due to the high sensitivity of the technique, principles previously established in the literature involving dental autotransplantation were followed. During the follow-up period, the teeth remained in position and function and the patients had no associated complaints. Final considerations: the dental autotransplantation technique, when well indicated and executed, is capable of achieving very satisfactory results, being a great rehabilitative alternative, with high success rates and reduced costs. However, criteria regarding donor and receptor sites and the surgeon's skill must be taken into account for the success of the technique.

Retrospective Study of the Epidemiological Profile of Facial Trauma Related to Violence.

ABSTRACT: Facial trauma is now considered an epidemic due to its high incidence. This type of injury represents an impact on the social, psychological and professional life of the victim. It may be associated with poor protection and exposure of this region of the body, as well as with the attempt to disfigure the face of victims of aggression, to affect their identity and self-image. This study aims to carry out an epidemiological survey on the profile of facial trauma related to violence at the First Aid Hospital of Porto Alegre from November 2015 to July 2016. In this retrospective descriptive cross-sectional study, data such as age and sex of the patient, type of trauma, anatomical region, etiology, and reasons for the aggression of patients' records were analyzed using the Chi-Square test in Paws Statistics 18 software, evaluating P  < 0.05. During the period evaluated, 1224 cases were recorded. The most prevalent sex was male. The age group with the most injuries varied from 21 to 40. The most affected type of lesion was soft tissue injury. Scalp regions (parietal, occipital, temporal) and multiple regions were the most affected in males, differing from females, where the frontal and nasal regions were the most predominant. Violence is a major risk factor for facial trauma in adult patients and it is from epidemiological studies like this that we have the possibility to know the magnitude and severity of the results of violence, allowing the definition of public policies for coping.

Redução de dor, edema e trismo: benefícios do uso da dexametasona via intramuscular como medicação preemptiva na cirurgia oral / Reduction of pain, swelling and trismus: benefits of using intramuscular dexamethasone as preemptive medication in oral surgery / Reducción del dolor, edema y trismo: beneficios del uso de dexametasona intramuscular como medicación preventiva en cirugía oral

Complicações pós-operatórias como edema, dor e trismo são comuns em cirurgias orais. Terapias, como o uso de analgésicos e anti-inflamatórios, são indicadas para estas complicações. No entanto, intervenções pré-operatórias podem ser alternativas. Desta forma, o presente estudo avaliou o efeito da dexametasona no edema, intensidade de dor e abertura de boca (trismo) no pós-operatório de retirada de terceiros molares inferiores. Pacientes (n=14, 9 mulheres) foram incluídos em um estudo clínico, cruzado, cego, randomizado, placebo-controlado e boca dividida. Pacientes receberam aleatoriamente medicação preemptiva (dexametasona 8mg, intramuscular, músculo masseter) ou placebo (soro fisiológico) uma hora antes da primeira cirurgia. O procedimento contralateral foi realizado 21 dias após. Avaliou se o edema e a abertura bucal nos momentos pré-operatórios e no 3º e 7º dias pós-operatórios, além de dor espontânea (imediatamente, 2 e 24 horas, 3 dias e 7 dias). Os dados foram analisados usando anova de medidas repetidas seguida do teste post hoc LSD de Fisher. Comparado ao placebo, a medicação reduziu edema (3 dias), dor (2 e 24 horas) e trismo (3 dias). Os resultados sugerem que o uso preemptivo da dexametasona intramuscular é capaz de aumentar o bem-estar dos pacientes submetidos a cirurgias orais, tendo o potencial de reduzir os custos pós-operatórios... (AU)

Postoperative complications such as edema, pain, and trismus are common in oral surgery. Therapies, such as the use of painkillers and anti inflammatory drugs, are indicated for the reversal of these complications. However, preoperative (preemptive) interventions can be alternatives. Thus, the present study aimed to evaluate the effect of dexamethasone on edema, pain intensity, and mouth opening (trismus) in the postoperative period of removal of impacted lower third molars. Patients (n = 14, 9 women) were included in a clinical, crossover, blinded, randomized, placebo-controlled, and divided mouth study. Preemptive mediation (dexamethasone 8mg, intramuscular, masseter muscle) or placebo (saline) was randomly given before the first surgery. The contralateral procedure was performed 21 days later. In the postoperative period, edema, mouth opening (preoperative, 3 and 7 days), and spontaneous pain (immediately, 2 and 24 hours, 3 days and 7 days) were analyzed. The data were analyzed using the one-way repeated measures ANOVA followed by Fisher's LSD post hoc. Compared to placebo, the medication reduced edema (3 days), pain (2 and 24 hours), and trismus (3 days). The results suggest that the preemptive use of dexamethasone is able to increase the well-being of patients undergoing oral surgeries, with the potential to reduce postoperative costs... (AU)

Las complicaciones posoperatorias como hinchazón, dolor y trismo son comunes en las cirugías orales. Las terapias, como el uso de analgésicos y antiinflamatorios, están indicadas para estas complicaciones. Sin embargo, las intervenciones preoperatorias pueden ser alternativas. Así, el presente estudio evaluó el efecto de la dexametasona sobre el edema, la intensidad del dolor y la apertura de la boca (trismo) en el postoperatorio de remoción del tercer molar inferior. Los pacientes (n = 14, 9 mujeres) se incluyeron en un estudio clínico, cruzado, ciego, aleatorizado, controlado con placebo y de boca dividida. Los pacientes recibieron aleatoriamente medicación preventiva (8 mg de dexametasona, intramuscular, músculo masetero) o placebo (solución salina) una hora antes de la primera cirugía. El procedimiento contralateral se realizó 21 días después. Se evaluó el edema y la apertura de la boca en el preoperatorio y en el tercer y séptimo días postoperatorios, además del dolor espontáneo (inmediato, 2 y 24 horas, 3 días y 7 días). Los datos se analizaron utilizando anova de medidas repetidas seguido de la prueba post hoc de LSD de Fisher. En comparación con el placebo, el medicamento redujo el edema (3 días), el dolor (2 y 24 horas) y el trismo (3 días). Los resultados sugieren que el uso preventivo de dexametasona intramuscular puede aumentar el bienestar de los pacientes sometidos a cirugía oral, con el potencial de reducir los costos posoperatorios... (AU)

Management of excessive gingival display using botulinum toxin type A: a descriptive study.

Botulinum toxin is a protease used by the bacterium Clostridium botulinum that causes chemical denervation of skeletal muscles, producing a temporary weakening of muscle activity. Despite having a transitory effect, the application of botulinum toxin has been identified as an alternative for correcting an excessive gingival display (EGD). However, studies evaluating the maintenance of long-term results of botulinum toxin remain scarce. This study aimed to evaluate the effectiveness and duration of botulinum toxin type A in the treatment of anterior EGD. Botulinum toxin Type A was applied to 15 patients with EGD. The measurement was performed in triplicate, using a Castro Viejo dry point compass, between the central cervical portion of the upper lateral incisors to the lower portion of the upper lip, bilaterally. The measurements were performed before the application of the toxin and repeated on days 7, 14, 90, 120, and 180 after the procedure. The data were analyzed using repeated-measures ANOVA, followed by a Bonferroni. There was a statistically significant reduction between the measurements performed on the Baseline and seven days after the application of the botulinum toxin. After 180 days, approximately one-quarter of the patients in the sample did not presented EGD. Mild adverse effects were reported by 46.7% of the patients. The use of botulinum toxin type A was effective to treat EGD. After 180 days, it was still possible to observe a significant effect compared to the initial gingival exposure.

Perfil epidemiológico dos pacientes e dos atendimentos realizados no ambulatório de exodontia (FO-UFRGS) / Epidemiological survey of patients seeking dental care in the tooth extraction outpatient clinic (FO-UFRGS)

Objetivo: Realizar um levantamento epidemiológico dos pacientes que buscaram atendimento no ambulatório de Exodontia da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS).Métodos: Estudo descritivo retrospectivo no qual foram reunidos e tabulados 1905 relatórios cirúrgicos preenchidos pelos alunos da graduação nas atividades referentes à disciplina de Exodontia, entre os anos de 2011 e 2015.Resultados: Os pacientes eram na maioria mulheres, entre 30 e 59 anos, cor de pele branca, com ensino fundamental incompleto e renda familiar entre 2 e 3 salários mínimos, 30,9% dos pacientes relatavam fumar e 27,8% disseram consumir bebidas alcoólicas pelo menos uma vez por semana. Quanto à história clínica, 24,4% dos pacientes relataram sofrer de hipertensão, 7,9% eram diabéticos. Em relação aos procedimentos, 24,9% estavam indicados por serem restos radiculares, 9% dos procedimentos foram suspensos, sendo a hipertensão a principal razão para tal (42,6%). Em 59,8% dos procedimentos não houve nenhum tipo de complicação pós-operatória. Conclusão: A partir dos dados obtidos foi possível conhecer o perfil epidemiológico e a situação de saúde da população atendida, identificando suas principais necessidades, fornecendo informações estratégicas para a organização e qualificação do serviço. (AU)

Aim: To conduct an epidemiological study of patients seeking dental care in the Tooth Extraction Outpatient Clinic, School of Dentistry, Federal University of Rio Grande do Sul (FO-UFRGS). Methods: This research was a retrospective descriptive study on 1,905 surgical reports filled out by undergraduate students during the activities related to the Exodontics (Tooth Extraction) classes held between 2011 and 2015.Results: Patients were mostly women from 30 to 59 years of age, white, with an incomplete elementary school education, and a household income between 2 and 3 minimum salaries; 30.9% of the patients claimed to be smokers and 27.8% reported that they consumed alcohol at least once a week. In relation to the clinical history, 24.4% of the patients reported suffering from hypertension, and 7.9% were diabetic. Regarding the procedures, 24.9% had been referred due to the existence of root fragments; in 9% of the cases, procedures were suspended, mainly due to hypertension (42.6%). In 59.8% of the procedures, no postoperative complications were observed.Conclusion:From the obtained data, it was possible to access the epidemiological profile and the health status of the population who received dental care, identifying their main needs and providing strategic information for the organization and qualification of the service and the health care of these patients. (AU)

Dental consultation requests to oral and maxillofacial surgery in a hospital in Brazil

Introduction: This study analyzed dental consultation requests to the division of oral and maxillofacial surgery in a Brazilian tertiary hospital. Methods: A cross-sectional study with data collected retrospectively from inpatients' electronic medical records containing dental consultation requests made between January 2013 and December 2017. Results: 327 consultation requests were analyzed. Mean (SD) patient age was 38.71 (24.4) years; 164 (50.2%) were male and 267 (81.7%) were Caucasian. Regarding systemic conditions, 34 (10.4%) were classified as ASA I, 86 (26.3%) as ASA II, 182 (55.7%) as ASA III, and 25 (7.6%) as ASA IV. Dental consultations were mostly requested by the internal medicine team (n = 42, 12.8%). The most common reason for consultation was septic teeth (n = 131, 40.1%). Complementary tests were required in 188 (57.5%) cases. Surgical intervention was required in 82 (25.0%), with tooth extraction as the most prevalent procedure (20.2%). The most demanding service was inpatient care, with 276 (84.4%) requests. Cases were resolved in 249 (76.1%). Conclusions: The division of oral and maxillofacial surgery in our hospital deals with a great amount of consultations, contributing with surgical procedures to the adequacy of patients' oral health with a high effectiveness rate. Our data illustrate the contribution of dentists in a hospital setting, assisting the medical team in providing comprehensive care for inpatients. (AU)

Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial.

The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.

Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial

Abstract The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.

Efetividade de agentes químicos na desinfecção de tubetes anestésicos

Avaliar a efetividade da desinfecção de tubetes anestésicos, in vitro, para procedimentos cirúrgicos ambulatoriais, utilizando álcool 70% (A), composto de iodo (I) solução aquosa de digluconato de clorexidina 0,12% (CA 0,12%), solução aquosa de digluconato de clorexidina 2% (CA 2%), solução alcoólica de digluconato de clorexidina 0,12% (CAL 0,12%), solução alcoólica de digluconato de clorexidina 2% (CAL 2%). Materiais e método: como grupos controle utilizou-se a água destilada (D) e nenhum agente (SN). Após os tempos de exposição de 5, 10 e 15 minutos aos agentes desinfetantes realizou-se coleta das amostras com swab que foram embebidas em caldo de tripticase de soja (TSB) e os tubos incubados a 37°C por 24 horas. As amostras foram inoculadas em placas de Petri contendo meio tripticase de soja ágar (TSA) e incubadas a 37°C por 48 horas, verificando a presença ou ausência de Unidades Formadoras de Colônias (CFU). Resultados: o estudo revelou que A e CA 0,12% foram efetivos apenas após 15 minutos de exposição. As soluções CA 2%, CAL 0,12%, CAL 2% e I foram efetivos nos tempos experimentais de 5, 10 e 15 minutos. Nos grupos controles (D e SN) houve crescimento bacteriano em todos os tempos experimentais. Conclusões: os agentes testados que demonstraram eficácia de desinfecção já em 5 minutos, associada ao baixo custo e facilidade de manipulação, foram: I, CA 2%, CAL 0,12%, CAL 2%. O resultado do grupo controle evidencia a necessidade de desinfecção dos tubetes previamente ao seu uso.

Influence of a Magnetic Field and Laser Therapy on the Quality of Mandibular Bone During Distraction Osteogenesis in Rabbits.

PURPOSE: This study evaluated the use of low-level laser therapy (LLLT) and exposure to a magnetic field (MF) during distraction osteogenesis. MATERIALS AND METHODS: The sample consisted of 18 rabbits divided into 3 groups of 6 animals each: control, MF exposure (briefly, magnetized gold-coated washers were placed next to the distractor device), and LLLT exposure (830 nm applied every 48 hours over 4 points [dose, 5 J/cm2] during the consolidation period). The same distraction osteogenesis protocol was used in all 3 groups (0.5 mm every 12 hours for 1 week). RESULTS: Quantitative microscopic analysis of sections stained with hematoxylin and eosin showed a statistically significant difference in the amount of newly formed bone in the MF group compared with the LLLT group (P = .006). The number of cells with more than 3 argyrophilic nucleolar organizer regions also was significantly different between the LLLT and control groups (P = .038). CONCLUSION: Distraction osteogenesis effectively promoted bone lengthening. The LLLT group exhibited a larger amount of newly formed bone and a larger number of osteoblasts in the cell division phase, but the difference was not statistically relevant compared with the control group.

Perfil sociodemográfico, epidemiológico e comportamental dos pacientes atendidos no ambulatório de exodontia da FO-UFRGS e a efetividade dos atendimentos realizados / Sociodemographic, epidemiological and behavioral profile in patients attended at the tooth extraction outpatient clinic, School of Dentistry, UFRGS, and the effectiveness of dental care provided

Objetivo: Identificar o perfil sociodemográfico, epidemiológico, comportamental e de utilização dos serviços dos pacientes atendidos no ambulatório de exodontia da Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul (FO-UFRGS), bem como os principais tipos de procedimentos, técnicas e condutas empregadas e intercorrências trans/pós-operatórias mais comuns. Material e Métodos: Estudo descritivo retrospectivo. Foram tabulados 877 relatórios cirúrgicos preenchidos pelos alunos da graduação nas atividades das disciplinas de Exodontia e Anestesiologia e Introdução à Exodontia, entre 2011/2 e 2013/1. As informações foram analisadas pelo programa Software Package for Social Sciences (SPSS for Windows, version 18.0, SPSS Inc, Chicago, IL), sendo calculadas as distribuições de frequência das variáveis investigadas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade. Resultados: Os pacientes eram, na maioria, mulheres, entre 30-59 anos, cor de pele branca, ensino fundamental incompleto, além de possuírem uma renda familiar entre 2 e 3 salários mínimos. Em relação aos hábitos comportamentais, 34,4% dos pacientes relatavam fumar e 31,1% disseram consumir bebidas alcoólicas pelo menos uma vez por semana. Quanto à história clínica, 25,1% dos pacientes relataram sofrer de hipertensão, 33,3% eram diabéticos ou tinham algum parente próximo com diabetes, 36,3% estavam em tratamento médico e 54,8% utilizavam um ou mais medicamentos. Em relação aos procedimentos, 39,5% estavam indicados por serem restos radiculares, sendo que em 30,1% dos casos os pacientes já chegavam com a queixa principal de extração. Conclusão: Foi possível conhecer o perfil sociodemográfico da população estudada ­ sexo feminino, 30-59 anos, cor de pele branca, ensino fundamental incompleto, renda familiar entre 2-3 salários mínimos ­ e sua situação de saúde (dados epidemiológicos-comportamentais). A maior parte dos pacientes não fumava, não consumia bebidas alcoólicas e não sofria de hipertensão ou diabetes, porém relatou estar usando um ou mais medicamentos. As intercorrências mais comuns foram hemorragia e lipotímia.(AU)

Aim: To identify the sociodemographic, epidemiological, behavioral and service utilization profiles of the patients who received dental care at the Tooth Extraction Outpatient Clinic, School of Dentistry, Federal University of Rio Grande do Sul (FO-UFRGS), as well as the main types of procedures, together with the most commonly employed procedures, techniques, and conducts, and the most common trans and postoperative complications. Methods: This was a retrospective descriptive study, in which 877 surgical reports, filled out by undergraduate students during the activitiesrelated to the Exodontics and Anesthesiology, as well as Intro to Exodontics, classes between the second semester of 2011 and the first semester of 2013, were gathered and tabulated. The collected data were analyzed using Software Package for Social Sciences (SPSS for Windows, version 18.0, SPSS Inc, Chicago, IL), calculating the frequency distribution of investigated variables. This study was approved by the University's Research Ethics Committee. Results: Patients were mostly women, from 30 and 59 years of age, of white ethnicity, with an incomplete elementary school education, and a household income of between 2 and 3 minimum wages. Regarding behavioral habits, 34.4% of the patients reported being smokers and 31.1% reported alcohol consumption at least once a week. Regarding the clinical history, 25.1% of patients reported suffering from hypertension, 33.3% were diabetic or had a close relative with diabetes, 36.3% were under medical treatment, and 54.8% used one or more types of medicine. Regarding the procedures, 39.5% were indicated because they were root fragments, while 30.1% of the patients had arrived with the main complaint of tooth extraction. Conclusion: It was possible to access the sociodemographic profile ­ women, between 30-59 years of age, of white ethnicity, incomplete elementary school education, household income between 2 and 3 minimum wages ­ and the health status of the population (epidemiological and behavioral data). Most of the patients were not smokers, did not consume alcoholic beverages, and did not suffer from hypertension or diabetes, but they did report the use of one or more types of medicine. The most common complications were bleeding and fainting.(AU)

Finite element analysis of masticatory stress on neoformed bone tissue after distraction osteogenesis and low-level laser therapy: a pilot study.

OBJECTIVE: This study aimed to understand the action of masticatory forces on an implant virtually introduced into the sheep mandible after distraction osteogenesis and low-level laser therapy (LLLT) by using finite element analysis. BACKGROUND DATA: Distraction osteogenesis as an alternative for bone reconstruction that may be used in the treatment of deformities. METHODS: Four ewes underwent distraction osteogenis to elongate the left mandibular body by 15 m, and three of them underwent LLLT with the purpose of improving bone properties. After death, animals were scanned by computed tomography and their mandibles were tridimensionally reconstructed by computer programs. The physical properties related to hardness and modulus of elasticity of each animal were obtained from the dissected mandibles, and data were transferred to Femap software for finite element analysis. RESULTS: Animals exposed and not exposed to LLLT irradiation showed remarkably similar values for superficial hardness and modulus of elasticity, without statistically significant difference (p>0.05), between the values observed for the cortical bone and the cancellous bone among the groups. The neoformed mandible, after a brief period for bone healing, was able to promote stability for implant placement and proper distribution of masticatory forces. CONCLUSIONS: An implant introduced virtually into the site of bone neoformation did not suffer any micromotions relevant to osteointegration. Furthermore, finite element analysis showed that the neoformed portion of the mandible was able to absorb and distribute masticatory forces throughout its structure, even after a brief period for bone maturation.

Avaliação do efeito biomodulatório local e à distância por laserterapia infravermelha e vermelha na cicatrização de feridas cutâneas em dorso de ratos / Analysis of local and distant biomodulatory effects by red and infrared lasertherapy on cutaneous wounds healing on the dorsum of rats

Objetivos: Este estudo tem por objetivo verificar se os lasers vermelho e infravermelho podem, ou não, interferir no processo cicatricial de ferimentos localizados no ponto de aplicação e a distância deste. Materiais e métodos: Foram realizados três ferimentos circulares em dorso de ratos, na região cranial, na região medial e na região caudal. Para este estudo experimental foram analisados 45 animais, divididos em três grupos, onde 15 animais não sofreram irradiações, em 15 animais foi aplicado laser infravermelho e em 15 animais foi aplicado laser vermelho. O período de observação foi de três, cinco e sete dias. Assim, cada grupo foi dividido em três subgrupos (A; B; C), de acordo com período de observação. Para os grupos II e III a dose de energia das irradiações foi de 8J/cm2, aplicados após o término da cirurgia e a cada 48 horas, totalizando, na dependência da época da morte do animal, duas, três ou quatro irradiações. Resultados: Houve maior presença de edema e processo inflamatório agudo nos primeiros dias avaliados e quantitativamente não houve diferença estatisticamente significante no percentual de redução das feridas intra e inter-grupos. Conclusões: A fototerapia por laser de baixa potência infravermelha apresentou um efeito biomodulatório positivo nos períodos iniciais de cicatrização e reparo em feridas no dorso de ratos. A fototerapia por laser de baixa potência vermelha apresentou, nos períodos iniciais analisados, maior processo inflamatório agudo, o que pode ser devido ao menor comprimento de onda que atinge as camadas mais superficiais da ferida.

Objectives: This study aims to verify whether red and infrared lasers can interfere with the healing process ofwounds located at the point ofapplication and at distance. Materials and methods: Three circular wounds were conducted on the dorsum of rats, being one in the cranial region, another one in the medial reg ion, and a third one in the caudal region. For thisexperimental study, 45 animals wereinvestigated and divided into threegroups, to which 15 animals weresubmitted to no laser of any kind, 15 animals were submitted to infrared laser, and 15 animals were submitted tored laser. The observation periodwas of three, five, and seven days.Thus, each group was divided into three subgroups (A, B,C) based on the observation period. For groups II andIII the amount of energy during theirradiation was 8J/cm 2, appliedafter the surgery and then every 48hours, totalizing, depending on thetime of death of the animal, two,three or four irradiations. Results: There was higher presence of edema in among 3 and 5 day period of analysis and acuteinflammatory proces s were found in red laser irradiation study group.Quantitatively, there was no statistically significant difference in the percentage of reduction of wounds in and among the groups. Conclusions: There is no statistical difference were found by thetherapy with low power red and infra-red laser in the wound sizes during all period of analysis.

Oral myiasis.

Human myiasis results from parasitic tissue infestation by maggots. It often develops in open or necrotic wounds and has its highest prevalence among poor populations in tropical regions. This study reports 2 cases of human myiasis in the oral cavity and describes its clinical aspect and treatment.

A preliminary study of hardness and modulus of elasticity in sheep mandibles submitted to distraction osteogenesis and low-level laser therapy

Objectives: To investigate the quality of newly formed bone in sheep mandibles submitted to distraction osteogenesis and low-level laser therapy (LLLT), based on hardness and modulus of elasticity values. The ideal moment for laser application (during the latency/activation period vs. during the bone consolidation period) was also evaluated. Computed tomography imaging was used to assess relapse as a result of early device removal. Study design: Extraoral distraction devices were placed in five sheep so as to achieve 1.5 cm of lengthened bone in 60 days. Distraction devices were removed 50, 40, and 33 days after surgery. Four animals were treated with LLLT, at different times, and one was used as control (no LLLT).Results: When applied during the bone consolidation period, LLLT caused an increase in hardness and modulus of elasticity values. On the other hand, animals irradiated with LLLT during the latency/activation period presented adelay in bone healing. A period of consolidation of 13 days (early device removal) was associated with relapse. Conclusions: Nanoindentation tests were able to detect slight abnormalities in bone metabolism and proved to be important tools for the assessment of bone quality following distraction osteogenesis. LLLT provided increased benefits when applied during the bone consolidation period, once it promoted an increase in hardness and modulus of elasticity values. According to our results, the bone consolidation period should be of at least 3 weeks, so as to prevent relapse (AU)

A preliminary study of hardness and modulus of elasticity in sheep mandibles submitted to distraction osteogenesis and low-level laser therapy.

OBJECTIVES: To investigate the quality of newly formed bone in sheep mandibles submitted to distraction osteogenesis and low-level laser therapy (LLLT), based on hardness and modulus of elasticity values. The ideal moment for laser application (during the latency/activation period vs. during the bone consolidation period) was also evaluated. Computed tomography imaging was used to assess relapse as a result of early device removal. STUDY DESIGN: Extraoral distraction devices were placed in five sheep so as to achieve 1.5 cm of lengthened bone in 60 days. Distraction devices were removed 50, 40, and 33 days after surgery. Four animals were treated with LLLT, at different times, and one was used as control (no LLLT). RESULTS: When applied during the bone consolidation period, LLLT caused an increase in hardness and modulus of elasticity values. On the other hand, animals irradiated with LLLT during the latency/activation period presented a delay in bone healing. A period of consolidation of 13 days (early device removal) was associated with relapse. CONCLUSIONS: Nanoindentation tests were able to detect slight abnormalities in bone metabolism and proved to be important tools for the assessment of bone quality following distraction osteogenesis. LLLT provided increased benefits when applied during the bone consolidation period, once it promoted an increase in hardness and modulus of elasticity values. According to our results, the bone consolidation period should be of at least 3 weeks, so as to prevent relapse.

Displasia fibrosa monostótica: um desafio terapêutico / Monostotic fibrous Dyspalsia: a therapeutic challenge

A displasia fibrosa monostótica é uma condição benigna que se caracteriza pela proliferação e substituição do tecido ósseo por tecido fibroso. Essa doença geralmente inicia-se na infância e progride até a puberdade e adolescência. Relata-se um caso de Displasia Fibrosa Monostótica em um paciente de 15 anos de idade, com aumento de volume assintomático no lado esquerdo do corpo da mandibular que foi tratado cirurgicamente. Por meio de revisão de literatura procurou-se estabelecer critérios de diagnóstico, planejamento e tratamento cirúrgico que norteassem a exérese da displasia fibrosa monostótica nos ossos maxilares.

Monostotic Fibrous Dysplasia is a benign fibro-osseous developmental anomaly where only one bone is involved. This disease usually begins in childhood and progresses throughout puberty and adolescence. The present case is a 15 years-old male patient. The patient was concerned about asymptomatic swelling in his left mandible body. The literature review was used to establish diagnostic criteria, planning and treatment in order to guide the monostotic fibrous dysplasia exeresis in the jaws.

Effect of low-level laser therapy after implantation of poly-L-lactic/polyglycolic acid in the femurs of rats.

This study evaluated the use of red and infrared lasers on tissue surrounding the femurs of 60 rats randomly divided into three groups after implantation of bioabsorbable plates. The control group were not subjected to laser irradiation; group A was treated with red laser [indium-gallium-aluminum-phosphide (InGaAlP) laser, wavelength 685 nm, 35 mW, continuous wave (CW), Ø = 0.06 cm, 2.23 min], and group B was subjected to infrared laser [gallium-aluminum-arsenium (GaAlAs) laser, wavelength 830 nm, 50 mw, CW, Ø = 0.06 cm, 1.41 min], both at 10 J/cm(2). Samples were stained with hematoxylin and eosin (H&E) and examined microscopically. Results showed that the laser irradiation had had a positive photobiomodulation effect on inflammation, confirmed by a better histologic pattern than that of the control group at 3 days and 7 days. Semiquantitative analysis revealed that groups A and B had a histologic score significantly greater than that of the control group at 3 days. At 21 days, histomorphometric analysis revealed a more intense inflammation in the red laser group than in the other groups. We concluded that low-level laser therapy (LLLT) has positive effects on the photobiomodulation of inflammation in the tissues surrounding the poly-L-lactic/polyglycolic acid (PLLA/PGA) bioabsorbable plate. It stimulated vascularization, fibroblast proliferation, and collagen deposition.

Vermilionectomy: a treatment alternative for actinic cheilitis / Vermelhectomia: uma opção de tratamento para queilite actínica

Purpose: Ultraviolet radiation is the main etiological agent associated with the development of actinic cheilitis, a premalignant irreversible disease that frequently affects the vermilion border of the lower lip. This paper aimed to describe the case of a patient with actinic cheilitis and treated with scalpel vermilionectomy. Case Description: A male, Caucasian, 66 year-old subject sought dental treatment complaining of "wounds on the lip that not heal" for approximately 15 years. The patient reported that he had worked in farms since the age of 5 year-old and was a frequent user of alcohol and tobacco. Atrophic and erosive areas associated with many ulcers covered with eschars were observed throughout the length of the lip. Based on the patient history and clinical exam, scalpel vermilionectomy was proposed. The histopathological analysis revealed a superficially invasive squamous cell carcinoma with free borders. The patient was monitored for two years with no relapse. Conclusion: Scapel vermilionectomy was chose to treat this case due to its low cost, relatively short time for repair, and possibility of histopathological analysis of the removed tissue.

Objetivo: A radiação ultravioleta é o principal agente etiológico associado ao desenvolvimento da queilite actínica, uma lesão pré-maligna que afeta o lábio inferior. Este trabalho descreveu o caso clínico de um paciente que apresentava várias ulcerações recobertas por crosta no lábio inferior e foi tratado pela técnica da vermelhectomia. Descrição do caso: Um sujeito do sexo masculino, Caucasiano, de 66 anos de idade, procurou tratamento odontológico com queixa de "feridas no lábio que não cicatrizavam" por 15 anos. O paciente relatou que tinha trabalhado em fazendas desde os 5 anos de idade e fazia uso frequente de tabaco e álcool. Áreas erosivas e atróficas associadas a múltiplas úlceras cobertas com escaras foram observadas em todo o lábio. Com base na história do paciente e exame clínico, foi proposto tratamento por vermelhectomia. O diagnóstico histopatológico foi de carcinoma espinocelular superficialmente invasivo, com margens livres, e o paciente foi acompanhado por um período de 2 anos sem recidiva. Conclusão: A técnica da vermelhectomia foi a escolha preferencial de tratamento por ser de baixo custo, ter um tempo cicatricial relativamente curto e, especialmente, permitir que o tecido removido possa ser examinado histopatologicamente.