Benefits of Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-analysis.

PURPOSE: The purpose of this study was to measure and compare coronectomy versus extraction in patients at increased risk for inferior alveolar nerve (IAN) injuries associated with third molar removal in terms of IAN injury and other complications. METHODS: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. We conducted a comprehensive literature search across six databases and the gray literature from July 15 to August 01, 2022. We employed Rayyan software to identify and remove duplicate articles to ensure data integrity. Our research followed the strategy patient (P), intervention (I), comparison (C), outcome (O), and study (S): (P) patients needing lower third molar surgery at higher risk of IAN injury; (I) surgery options, coronectomy or complete extraction; (C) comparisons included reduced risks of nerve injuries, postoperative complications (pain, infection, alveolitis), and increased risks of reoperation, root migration, and extraction; (O) desired outcomes were preventing nerve injuries and reducing other surgical complications; and (S) observational study designs (cohort, case-control). Excluded from consideration were studies involving teeth other than lower third molars, as well as reviews, letters, conference summaries, and personal opinions. To gauge the certainty of evidence, we employed the Grading of Recommendation, Assessment, Development, and Evaluation instrument, selecting the most current papers with the highest levels of evidence for inclusion. The primary outcome variable of our study centered on evaluating the incidence of IAN injury, and secondly, the lingual nerve (LN) injury, the postoperative pain, infection, localized alveolitis, the necessity for surgical reintervention, root migration, and extraction. These assessments were carried out with respect to their chosen operative technique for managing third molars, either coronectomy or extraction, as predictor variables. We also considered covariates such as age, gender, and the presence of systemic diseases in our analysis to account for potential confounding factors. The pooled data underwent rigorous analysis utilizing an inverse variance method with both random and fixed effect models by the "metabin" function in the R program's meta-package. Additionally, we assessed the risk of bias in the selected studies by utilizing the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data and the Critical Appraisal Checklist for Case Reports. RESULTS: Of the 1,017 articles found, after applying the inclusion and exclusion criteria, 42 were included in this study (29 cohort and 13 case-control studies), including 3,095 patients from 18 countries. The meta-analysis showed that coronectomy reduced the risk of IAN injury [OR (Odds Ratio): 0.14; 95% CI (confidence intervals): 0.06-0.30; I2 (inconsistency index) = 0%; P = .0001], postoperative pain (OR: 0.97; 95% CI: 0.33-2.86; I2 = 81%; P = .01), and alveolitis (OR: 0.38; 95% CI: 0.13-1.09; I2 = 32.2%; P = .01) when compared to complete tooth extraction. However, it also highlighted a greater risk of reintervention (OR: 5.38; 95% CI: 1.14-25.28; I2 = 0.0%; P = .01). CONCLUSIONS: This study has demonstrated that coronectomy is associated with a decreased risk for IAN injury and decreased pain and localized alveolitis when compared to complete tooth extraction. However, it is essential to acknowledge the higher likelihood of requiring reintervention with coronectomy. Therefore, clinicians should carefully consider the advantages and potential drawbacks of both techniques and tailor their choices to the unique clinical circumstances of each patient.

Plication of the Suprahyoid Muscles Concomitant with Genioplasty to Improve the Aesthetics of the Submandibular Region / Plicatura de los Músculos Suprahioideos Concomitante con Genioplastia para Mejorar la Estética de la Región Submandibular

In addition to functionally correcting skeletal facial deformities, orthognathic surgery also has a great impact on aesthetics and facial proportions. However, patients who have soft tissue changes, such as tissue flaccidity, may not achieve an ideal result, and require complementary surgical techniques that promote aesthetic refinement. The literature on less invasive techniques is limited, and therefore, this work aims to report a surgical technique performed concomitantly with genioplasty to refine the harmony of the submandibular region, in a simple and effective way. Patient with skeletal class II deformity, with lack of mandibular definition and submandibular flaccidity, underwent bimaxillary advancement orthognathic surgery with advancement genioplasty to correct chin retrusion. Due to limited results with bone repositioning alone, plication of the suprahyoid musculature was performed in association with the same approach used in the genioplasty. As a result, there was traction in the cervical region, with a consequent decrease in the submental-cervical angle and improvement in submandibular aesthetics. Furthermore, there was no need for extensive surgical intervention and no impairment of the functional results of the orthognathic surgery itself. Therefore, it can be concluded that plication of the suprahyoid musculat ure concomitantly with genioplasty is a technique that promotes aesthetic gains in the cervical region.

Además de corregir funcionalmente las deformidades faciales esqueléticas, la cirugía ortognática también tiene un gran impacto en la estética y las proporciones faciales. Sin embargo, los pacientes que tienen cambios en los tejidos blandos, como la flacidez, pueden no lograr un resultado ideal y requieren técnicas quirúrgicas complementarias que promuevan el refinamiento estético. La literatura sobre técnicas menos invasivas es limitada, por lo que este trabajo tiene como objetivo reportar una técnica quirúrgica realizada concomitantemente con la genioplastia para refinar la armonía de la región submandibular, de manera simple y efectiva. Se trató a un paciente con deformidad esquelética clase II, con falta de definición mandibular y flacidez submandibular, intervenida de cirugía ortognática de avance bimaxilar con genioplastia de avance para corregir la retrusión del mentón. Debido a los resultados limitados solo con el reposicionamiento óseo, se realizó la plicatura de la musculatura suprahioidea en asociación con el mismo abordaje utilizado en la genioplastia. Como resultado, hubo tracción en la región cervical, con la consiguiente disminución del ángulo submentoniano-cervical y mejoría en la estética submandibular. Además, no hubo necesidad de una intervención quirúrgica extensa ni deterioro de los resultados funcionales de la cirugía ortognática en sí. Por lo tanto, se puede concluir que la plicatura de la musculatura suprahioidea concomitantemente con la genioplastia es una técnica que promueve ganancias estéticas en la región cervical.

Multiple Gardner Syndrome Osteomas Mimicking Temporomandibular Ankylosis: Case Report.

Objectives: This study aims to report a delayed Gardner syndrome diagnosis mimicking temporomandibular ankylosis. Methods: An 11-year-old patient was treated at the Hospital Josina Machel, Luanda, Angola for severe chronic trismus without TMJ involvement. Some difficulties in diagnosis and final results were discussed. Case report: A delayed diagnosis of Gardner syndrome was treated by the authors. The delay was due to a lack of timely CT scans and some COVID-19 pandemic restrictions. This delay worsened the patient´s clinical condition for several months. Classic surgical gap arthroplasty has been used and considered successful, particularly when material is scarce. Conclusions: Classical surgical techniques are still very useful in some parts of the world that do not rely on modern technology. International collaboration through teledentistry, case review over the Internet, and humanitarian or educational missions are very helpful in low-income countries.

Evaluation of Influence of Arthroscopy on the Range of Mandibular Movements Based on Medical Records.

The Temporomandibular Joint Dysfunction Syndrome (TJDS) is a group of pathologies that affect the temporomandibular joint, mastication muscles, and attached structures, 1 of the leading causes of orofacial pain. Arthroscopy is a technique used as a method of treatment for TJSD. This was a retrospective cohort study, and data were collected from the medical records of patients with TJDS. The diagnosis of TJDS was established based on computed tomography and nuclear magnetic resonance imaging tests, and clinical examination. All patients, who underwent arthroscopy, were operated on by the same surgeon in 2020. The variables analyzed in this study were: maximum mouth opening, laterality, and protrusion of patients undergoing arthroscopy at time intervals of 30, 90 days, and 6 months after surgery. Data from anamnesis of the medical records and findings on clinical examination were used to verify whether there was any correlation with good postoperative evolution. Afterward, these data were compared and submitted to statistical analysis (Wilcoxon (nonparametric and paired) and Mann-Whitney (nonparametric, unpaired) tests) to verify the degree of correlation between them. It could be concluded that in this sample, arthroscopy reduced the degree of pain in patients, increased mouth opening amplitude, and did not influence laterality and protrusion. The use of previous medication was correlated with a slight decrease in postoperative pain; patients who had undergone previous orthodontic treatment showed better results regarding maximum mouth opening without pain; patients who had previously felt pain on professional palpation had greater maximum mouth opening with and without pain after arthroscopy, and patients with noise at professional auscultation had greater maximum mouth opening without pain. Further studies should be conducted, with larger samples, associated with complementary exams (computed tomography and nuclear magnetic resonance) before and after arthroscopy.

Alternative approach to treating dark circles: A case report.

OBJECTIVES: Dark circles under the eyes are a common condition worldwide with multiple treatment options. The aim of this paper is to report a case of dark circles treated with ozone therapy, which showed a very reasonable clinical improvement. CASE REPORT: A case of dark circles under the eyes treatment with ozone therapy concentrations and doses was reported. We searched MEDLINE treatment options for dark circles. Literature on this subject is scarce. CARE guidelines have been adopted for this case report. RESULTS: Ozone therapy is a really effective biostimulator, that reduces spots and wrinkles. In this case, the patient and healthcare professionals were satisfied with just two ozone therapy sessions. This is an interesting alternative treatment for this common condition. CONCLUSIONS: Ozone therapy is a safe, inexpensive, and quick treatment for dark circles under the eyes. It can be used alone or in combination with other methods.

Evaluation of the accuracy of virtual planning in bimaxillary orthognathic surgery: a systematic review.

The purpose of this research was to evaluate the accuracy of virtual planning in bimaxillary orthognathic surgery in bone by comparing the mean linear and angular measurements of the surgical plan with the actual surgical result. Electronic databases, MEDLINE via PubMed, Web of Science, SCOPUS, the Cochrane Library, grey literature, and the American clinical trials registry (www.ClinicalTrials.gov), were accessed as search engines. The studies consisted of publications on the assessment of accuracy in virtual planning in bimaxillary orthognathic surgery between 2010 and 2020. After application of the eligibility criteria, 26 articles were included, and their quality was evaluated using the methodological index for non-randomised studies (MINORS) tool and Cohen's kappa statistic in the MedCalc program (MedCalc Software Ltd). Evidence obtained by comparing the planning and surgical results, both in the maxilla and mandible, showed that there is great accuracy in virtual planning in bimaxillary orthognathic surgery.

Complications on maxilar impaction: A systematic review and meta-analysis.

OBJECTIVES: Maxillary impactions are seen as an orthognathic surgical movement that increases the number of complications. The aim of this paper is to research literature on this topic, with special attention to avoiding of complications. METHODS: A systematic review was carried out according to the PRISMA guidelines. The PROSPERO registration has been performed. A risk of bias assessment was carried out with RevMan and graphics were created. A total of 20 articles were included in this systematic review. RESULTS: Some interesting and conclusive facts about maxillary impactions. Relapses are not common due to the higher bone contact. Bleeding is a common complication due to the location of palatal artery. Aesthetic and functional complications can arise, especially in the nasal region. Bimaxillary orthognathic surgeries has a higher incidence of complications. CONCLUSIONS: Today it is not possible to confirm that maxillary impactions alone are responsible for a higher incidence of complications due to the complexity of the three-dimensional movements. Some surgical steps could be safer and cause fewer complications.

Diagnosis of ameloblastic fibro-odontoma: case report / Diagnóstico de fibro-odontoma ameloblástico: relato de caso

Objective: the present report describes the clinical, radiographic, and histopathological features of an ameloblastic fibro-odontoma (AFO) lesion. Case report: we report a clinical case of a 14-year-old boy with asymptomatic edema. Panoramic radiography detected a unilocular lesion with defined margins located in the posterior region of the mandible. The internal structure of the lesion presented several degrees of radiopacity with the involvement of the third molar. Cone-beam computed tomography revealed expanded buccal and lingual cortical bones, perforation of the lingual cortical bone, and displacement of the mandibular canal. AFO was suspected based on the radiographic and clinical characteristics. Total excision was performed and histologically examined, confirming the diagnosis of AFO. No recurrence occurred during a 24-month follow-up period. Final considerations: the evaluation of the clinical, radiographic, and histopathologic findings needs to be accurate for a correct diagnosis and appropriate treatment for case of AFO since the presentation is often asymptomatic.(AU)

Objetivo: o presente relato descreve as características clínicas, radiográficas e histopatológicas de uma lesão de fibro-odontoma ameloblástico (FOA). Relato de caso: relatamos o caso clínico de um menino de 14 anos com edema assintomático. A radiografia panorâmica detectou lesão unilocular com margens definidas e localizada na região posterior da mandíbula. A estrutura interna da lesão apresentava vários graus de radiopacidade com envolvimento do terceiro molar. A tomografia computadorizada de feixe cônico revelou as corticais ósseas vestibular e lingual expandidas, perfuração da cortical óssea lingual e deslocamento do canal mandibular. FOA foi a hipótese diagnóstica com base nas características radiográficas e clínicas. A excisão total foi realizada e examinada histologicamente, confirmando o diagnóstico de FOA. Nenhuma recorrência ocorreu durante um período de acompanhamento de 24 meses. Considerações finais: a avaliação das características clínicas, radiográficas e histopatológicas contribuíram para um diagnóstico correto e o tratamento adequado para o caso de FOA, uma vez que a lesão é frequentemente assintomática.(AU)

Jacob's Disease: case report / Doença de Jacob: relato de caso

ABSTRACT Jacob's disease or osteochondroma is a rare disease that presents as a pseudo-joint between the coronoid process of the mandible and the posterior surface of the zygomatic bone. The present case report is of an 11-year-old female patient with a maximum mouth opening of 2mm. When evaluating computed tomography with three-dimensional reconstruction, a mushroom-shaped increase in the coronoid process of the mandible on the left side was observed, intimately connected to the zygomatic bone (inferoposterior region of the body of the zygoma), which suggests a pseudoarticulation. Surgical removal of the tumor mass was performed under general anesthesia via intraoral access and is called coronoidectomy. Histopathological, the presence of hyaline cartilage was observed, a condition that is pathognomonic for Jacob's Disease. Jacob's disease case reports are still rare in the literature, with mushroom shape and histopathological confirmation due to the presence of hyaline cartilage.

RESUMO A Doença de Jacob ou osteocondroma é uma doença rara que se apresenta como uma pseudoarticulação entre o processo coronóide da mandíbula e a superfície posterior do osso zigomático. O presente relato de caso é de um paciente, do sexo feminino, com 11 anos de idade e com 2mm de abertura máxima de boca. Ao se avaliar exame de tomografia computadorizada com reconstrução tridimensional foi observado um aumento volumétrico no processo coronóide da mandíbula do lado esquerdo em formato de cogumelo, intimamente ligado ao osso zigomático (região inferoposterior do corpo do zigoma), o que sugere uma pseudoarticulação. A remoção cirúrgica da massa tumoral foi realizada sob anestesia geral por acesso intraoral e é denominada coronoidectomia. Histopatologicamente, observou-se presença de cartilagem hialina, condição é que patognomônica da Doença de Jacob. Ainda são raros os relatos de casos de Doença de Jacob na literatura, com formato de cogumelo e confirmação histopatológica devido à presença de cartilagem hialina.

Dolphin software accuracy in soft tissue facial profile prediction of Class II patients in orthognathic surgery / Precisão de software Dolphin na predição do perfil facial de tecidos moles de pacientes Classe II submetidos a cirurgia ortognática

ABSTRACT Objective: The present study aimed to analyze the accuracy of the Dolphin Imaging 11.9® computer program in the surgical prediction of the soft tissue facial profile. Methods: The investigators designed and implemented a retrospective study. It was used a sample of 55 patients, being 14 males and 41 females, aged from 19 to 55 years old. All patients were subjected to surgery orthognathic bimaxillary combined with mentoplasty, in Class II facial profile - Angle. Patients' actual results were compared to the obtained up to a year and a half after the surgery procedure. The study was delineated in three phases. In the first phase, cephalometric preoperative radiographs were performed; in the second phase the postoperative cephalometries were made; in the third phase, the measurements of the soft profile of the virtual analysis were compared with the real post-surgical profile. The data was collected and subjected to statistical analysis in the "R" program, using the t test and ANOVA. Results: The results demonstrated that measures A' and Eis were underestimated in -0.15 ± 0. 52 mm and -0.47 ± 1.05 mm, respectively, while measures Pg' and ANL were overestimated at 0.76 ± 1.98 mm and 3.31 ± 3.60° respectively. There was no evidence of measures, Ls, Li and B', being different between real and virtual. Conclusions: The results of this study suggest that Dolphin 11.9® computer program complies with the function of preserving with reliability virtual surgical planning.

RESUMO Objetivo: O presente estudo teve como objetivo analisar a precisão do programa de computador Dolphin Imaging 11.9® na predição cirúrgica do perfil facial dos tecidos moles. Métodos: Os pesquisadores projetaram e implementaram um estudo retrospectivo. Utilizou-se uma amostra de 55 pacientes, sendo 14 do sexo masculino e 41 do sexo feminino, com idades entre 19 e 55 anos. Todos os pacientes foram submetidos à cirurgia ortognática bimaxilar combinada com mentoplastia, no perfil facial Classe II de Angle. Os resultados reais dos pacientes foram comparados com os obtidos até um ano e meio após o procedimento cirúrgico. O estudo foi delineado em três fases. Na primeira fase, foram realizadas radiografias cefalométricas pré-operatórias; na segunda fase, foram realizadas cefalometrias pós-operatórias; na terceira fase, as medidas do perfil mole da análise virtual foram comparadas com o perfil pós-cirúrgico real. Os dados foram coletados e submetidos à análise estatística no programa "R", utilizando o teste t e ANOVA. Resultados: Os resultados demonstraram que as medidas A 'e Eis foram subestimadas em -0,15 ± 0, 52 mm e -0,47 ± 1,05 mm, respectivamente; enquanto as medidas Pg' e ANL foram superestimadas em 0,76 ± 1,98 mm e 3,31 ± 3,60°, respectivamente. Não houve evidência de medidas, Ls, Li e B', sendo diferentes entre real e virtual. Conclusão: Os resultados deste estudo sugerem que o programa de computador Dolphin 11.9® cumpre a função de preservar com confiabilidade o planejamento cirúrgico virtual.

Transmigrated teeth / Transmigração dentária

Pre-eruptive migration of a tooth across the midline is called transmigration. This article reviews the literature on tooth transmigration. In the literature there is no consensus on the definition of true cases of transmigration and impacted teeth. Transmigration is a rare phenomenon that typically affects the mandibular canines. There is no known etiology for its occurrence, however, there are many and varied etiological factors involved in transmigrated teeth, such as ectopic growth of the tooth bud, retention or premature loss of a primary tooth, inadequate eruption space and excessive length of crown. Genetic factors, endocrine disorders and trauma have also been also proposed as etiological factors. In most clinical reports, transmigrated teeth were found in a horizontal position, below the apices of the erupted teeth and in the majority of cases, such a migrated tooth remains impacted; however, it may sometimes erupt later in its new position. When it is diagnosed in radiographic exams, careful evaluation is necessary in order to establish the most adequate treatment. Extraction of the transmigrated tooth appeared to be the only choice of treatment.

A migração pré-eruptiva de um dente através da linha média é chamada de transmigração. O objetivo deste artigo é apresentar uma revisão da literatura sobre a transmigração dentária. Na literatura não há consenso sobre a definição de casos de verdadeiros de transmigração e dentes impactados. Transmigração é um fenômeno raro, que normalmente afeta os caninos inferiores e a sua etiologia é desconhecida, porém vários fatores etiológicos podem estar envolvidos nos casos de transmigração, tais como o crescimento ectópico da raiz do dente, retenção ou perda prematura de um dente decíduo, espaço insuficiente erupção e comprimento excessivo da coroa. Fatores genéticos, doenças endócrinas e trauma também foram citados como possíveis fatores etiológicos. Nos relatos clínicos os dentes transmigrados foram encontrados em posição horizontal, abaixo os ápices dos dentes irrompidos e na maioria das vezes, um dente com transmigração permanece impactado; no entanto, posteriormente, pode irromper em sua nova posição. Quando diagnosticado, por exames radiográficos, é necessário um planejamento criterioso para o estabelecimento do tratamento mais adequado. A exodontia é o tratamento de escolha para os casos de transmigração dentária.

Transplante dental bilateral: relato de caso clínico com acompanhamento de 9 anos / Bilateral transplantation of teeth: a case report with a 9-year follow-up

O transplante e reimplante dentário é um procedimento comum na Odontologia moderna,como grande alternativa às próteses convencionais e até mesmo aos implantes dentários metálicospara correção de perdas dentárias precoces em pacientes adolescentes e adultos jovens.A etiologia dessas perdas dentárias pode ser variada, como cáries extensas, que resultaram emfraturas dentárias patológicas e consequente condenação do elemento dental, problemas endodônticosinsolúveis, como perfurações e fraturas de assoalho pulpar, em que a resolução sedeu por exodontia do elemento dental e traumatismos e avulsões de dentes permanentes emque se faz necessário o reimplante dental. Nessa faixa etária é possível realizar os autotransplantesdentários devido ao fato da cronologia de erupção dos dentes permanentes, sobretudoaos terceiros molares, terem sua fase final de formação radicular propícia para a realização dotransplante dental autógeno. O objetivo deste trabalho é relatar um caso clínico de autotransplantedentário bilateral em um adulto jovem que se apresentou com as raízes residuais dosdentes 36 e 46 indicadas para exodontias devido a lesões de cárie extensas. Os terceiros molaressuperiores apresentavam-se radiograficamente inclusos, com o terço final radicular em início deformação, propício para o transplante autógeno e reposição dos molares inferiores condenados.O prognóstico foi favorável no momento da avaliação e no pós-operatório imediato da cirurgia.Após o período de acompanhamento de 9 anos observou-se excelentes resultados funcionais eestéticos, com vitalidade pulpar dos elementos transplantados.

Tooth transplantation is a common procedure in modern dentistry, as important alternative toconventional dentures and even to dental metallic implants for correction of early dental lossesinpatients as teenagers and young adults. The etiology of these dentallosses can be varied as extendeddental caries, which resulted in pathological dental fractures and consequent condemnation of thedental element; endodontic insoluble problems, such as fractures and perforations of pulp floar,where the resolution made by exodontics of the dental element and trauma and avulsions of permanentteeth in that it is necessaryto reimplant the teeth.ln this age, it is possible to achieve the dentalautotransplantation due to the fact that the eruption chronology of the permanent teeth, especiallythe third molars, have their root phase in final development, conducive to the achievement of dentalautogenous transplantation. The objective of this study is to present a report a case of self-dentalbilateral transplantation in a young adult who, because of extensive caries injuries presented withresidual roots of the teeth 36 and 46, indicated for tooth extractions. The upper third molars had tobe included radiographically, with the root on top of development, conducive to the autogenoustransplantation and replacement of lower molars convicted. The prognosis was favorable at the timeof evaluation and performs the surgery, with a 9 years follow-up, showing excellent results functionallyand aesthetic as pulpar vitallity of the transplanted teeth.

Descompressão de cisto dentígero na maxila / Decompression of a maxillary dentigerous cyst

This study describes the case of a dentigerous cyst in a six-year-old patient treated by decompression of the lesion. The patient?s main clinical complaint was facial asymmetry with displacement of the nasal cavity. Clinical examination showed an extensive lesion in the left side of maxilla invading the nasal cavity. An interdisciplinary course of treatment for this patient was indicated to preserve the impacted permanent tooth inside the lesion. A panoramic radiograph and computed tomography scan were requested for planning the surgery. A decompression surgery was performed and an incisional biopsy revealed the presence of a dentigerous cyst in the maxilla. A second operation was performed two years later to disimpact the permanent incisor and promote its eruption by means of orthodontic traction. The patient was thoroughly followed for a few years. Bone repair at the dentigerous cyst site was perfect.

Este artigo relata o caso de um cisto dentígero em um paciente de seis anos de idade em que a técnica utilizada para tratamento foi a de descompressão. A queixa clínica principal do paciente era assimetria facial e deslocamento da cavidade nasal. Ao exame clínico pôde-se constatar uma lesão extensa na maxila, do lado esquerdo que invadia a cavidade nasal. Foi planejado um tratamento interdisciplinar com a finalidade de preservar o dente permanente impactado que se localizava no interior da lesão. Foram requisitadas para o diagnóstico e planejamento cirúrgico uma radiografia panorâmica e uma tomografia computadorizada. A cirurgia de descompressão foi inicialmente realizada e a biópsia incisional revelou a presença de um cisto dentígero na maxila. A segunda intervenção cirúrgica foi realizada após dois anos, com a finalidade de tracionar o incisivo permanente para permitir que o mesmo pudesse irromper na cavidade bucal por meio de tração ortodôntica. O paciente foi rigorosamente acompanhado por alguns anos e pôde-se observar uma perfeita reparação óssea na área em que havia o cisto dentígero.

Fechamento de fístula buco-sinusal com enxerto de tecido conjuntivo sub-epitelial (ETCSE) / . Oro-sinusal fistula closed with subepithelial connective tissue graft (SECTG)

O objetivo deste trabalho foi descrever um caso clínico com o emprego de uma técnica cirúrgica para fechamento de fístula buco-sinusal, através da utilização de enxerto de tecido conjuntivo sub-epitelial (ETCSE), utilizando conceitos de cirurgia plástica periodontal. O resultado obtido foi considerado satisfatório. Mostrou-se evidente o estudo da possível indicação da técnica de ETCSE para outras situações de grandes comprometimentos funcionais.

The aim of this present study was to describe the use of a surgical technique for closing oroantral communications, by using sub-epithelial connective tissue graft (SECTG), associating concepts of periodontal plastic surgery. The result was satisfactory. This study showed that the SECTG may be used in other situations where major functional impairments is necessary.

Análise da concordância intra e inter-observadores na detecção das fraturas da face por meio da tomografia computadorizada / Intra and interobservers concordance analysis of face fractures detection through computed tomography

Introdução: A face está sujeita a agressões externas, encontrando-se em uma região propícia a ferimentos leves e graves, através de acidentes automobilísticos, esportivos, além de agressões, sendo a primeira zona de impacto do organismo a sofrer determinadas injúrias. A Traumatologia apresentou um importante desenvolvimento na área diagnóstica, com grandes avanços na tecnologia de obtenção de imagens para diagnóstico das fraturas faciais, como o desenvolvimento de novas técnicas de tomografia computadorizada como exame complementar no tratamento dos pacientes vítimas de traumas faciais. Objetivos: Avaliar a importância da tomografia computadorizada de face como meio diagnóstico dos traumatismos faciais através da análise de concordância intra e inter-observadores na detecção de fraturas da face por em pacientes vítimas de traumatismos faciais. Métodos: Para realização da análise de concordância foram utilizados 40 exames de tomografias computadorizadas de 40 pacientes vítimas de trauma facial atendidos entre os anos de 2000 e 2006. Os exames foram apresentados a dois observadores, em duas películas tomográficas para cada paciente observado, sendo uma contendo apenas cortes coronais e a outra com cortes axiais e foram interpretadas, com o objetivo de identificar a concordância intra e inter-observadores para a detecção das fraturas da face em dois intervalos diferentes (inicial e final ou A e B), com diferença de 30 dias do período inicial (A) para o período final(B). Para a análise da concordância intra e inter-observadores foi empregado o Índice Kappa (K) de Cohen (1960). Resultados: A eqüidade de valores encontrados nos dois intervalos de observação (A e B) reproduziu uma concordância considerada excelente para os observadores 1 e 2. Devido ao fato de que todos os valores serem exatamente iguais nos dois intervalos para o observador 1 e 2, mas diferentes entre eles, não se aplicou o índice Kappa para a análise intra-observadores 1 e 2. Na análise de...

Introduction: The face is subject to external aggressions since it is very liKely to minor as well as serious injuries. Such injuries can happen in a car accident or when practicing sports besides aggressions, because it is the first zone of impact of the organism bound to suffer certain injuries. The Traumatology presented an important development in the diagnostic area by achieving a significant breaKthrough in obtaining images for diagnosis of facial fractures, such as the development of new computerized tomography techniques as a complementary examination in the treatment of patients suffering from facial trauma. Objectives: To assess the importance of computed tomography of face as a means of diagnosing facial injuries through the analysis of concordance intra and inter-observers in the detection of fractures of the face of patients suffering from facial injuries. Methods: In order to do the concordance analysis 40 computed tomography scans were used from 40 patients victims of facial trauma attended between 2000 and 2006. The 40 computed tomography of face were presented to 2 observers, in two tomographic films for each patient observed, one containing only coronal sections and the other with axial images. Then they were interpreted, to identify the intra and inter observers concordance for the detection of fractures of the face in two different intervals (initial and final or A and B), with a thirty-day difference of the initial period (A) and the final period (B). For the analysis of the inter and intra-observers? concordance, the index Kappa (K) form Cohen (1960) was used. Results: The equality of values found in both intervals of observation (A and B) reproduced a concordance considered excellent for the observers 1 and 2. Due to the fact that all values are exactly equal in both intervals for observer 1 and 2, but different between them, the Kappa index was not applied for the analysis intra-observer 1 and 2. In the analysis of inter-observer...

Transmigração de caninos mandibulares impactados: relato de sete casos e revisão de literatura / Transmigration of mandibular canines: a review of the literature and report of seven cases

Os caninos impactados podem migrar da sua posição original, bem como os incisivos laterais e os segundos pré-molares. Entretanto, quando a coroa do dente ultrapassar a linha média, este fenômeno é conhecido como transmigração, fato que só acontece com os caninos retidos, tendo uma discreta predileção por mulheres, podendo este fenômeno acontecer bilateralmente. A sua incidência é maior na mandíbula, porém um caso de transmigração na maxila foi recentemente publicado. Não se sabe até o momento a causa deste fenômeno, porém duas hipóteses são mais aceitas: a primeira é que devido a um trauma na fase embrionária, o dente se deslocaria ou daria origem a algum processo patológico responsável pelo deslocamento dele e a segunda hipótese estaria relacionada a determinantes genéticos. A maioria dos pacientes é assintomática e o fenômeno da transmigração é descoberto nos exames de rotina, pela solicitação de uma radiografia panorâmica devido à ausência clínica do canino ou por documentações ortodônticas. O tratamento consiste na sua remoção, porém quando fatores contra-indicarem o procedimento cirúrgico, tais como: dificuldade de acesso, idade do paciente e doenças sistêmicas, deverá ser realizada preservação. Neste artigo, são apresentados sete casos de caninos transmigrados na mandíbula, em que os autores apresentam fotos clínicas, radiográficas e a conduta adotada para cada caso.