Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review.

BACKGROUND: The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS: Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION: Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.

Effect of simvastatin topical use on alveolar bone after tooth extraction: a scoping review.

OBJECTIVES: Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin's impact on alveolar bone regeneration and determine its level of support for clinical applications. MATERIALS AND METHODS: This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. RESULTS: Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. CONCLUSIONS: Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. CLINICAL RELEVANCE: This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF REGISTRY PROTOCOL: osf.io/q3bnf.

Limite ético para confirmar identidade pelos caracteres morfológicos / Ethical limits to confirming identity by morphological features / Límite ético para confirmar la identidad por caracteres morfológicos

Resumo O desenvolvimento de novas tecnologias fez nascer ferramentas que auxiliam no processo de identificação de indivíduos, possibilitando confirmar identidades e ajudando a solucionar crimes, ao permitir confirmar o encontro de pessoas desaparecidas ou vítimas de acidentes, por exemplo. Entretanto, um importante questionamento ético precisa ser observado: os fins sempre justificam os meios? A identificação facial a partir de imagens coletadas por câmeras de circuito fechado de televisão ou a análise de registros fotográficos são capazes de confirmar a identidade de alguém inequivocamente? Impressões digitais ou labiais podem ser utilizadas, em qualquer hipótese, em um confronto dactiloscópico? O conhecimento sobre as limitações dos métodos técnicos científicos utilizados em comparações de caracteres morfológicos permite que o resultado do perito papiloscopista atenda a dois princípios basilares constitucionais: a legalidade e o direito da pessoa humana. Ao respeitá-los, estará agindo conforme os limites éticos.

Abstract Technological advancements have generated tools to help with identifying individuals, allowing to verify identities and solve crimes by confirming found missing persons or accident victims, for example. An important ethical question, however, arises: do the ends always justify the means? Can facial identification from images collected by closed-circuit television cameras or analysis of photographic records confirm someone's identity unequivocally? Can fingerprints or lip prints be used for any dactyloscopy? Knowing the limitations of scientific technical methods used in morphological comparisons allows examiners to comply with two fundamental constitutional principles: that of legality and right of the human person. By respecting them, examiners will be acting according to ethical limits.

Resumen El desarrollo de nuevas tecnologías dio lugar a herramientas que ayudan en el proceso de identificación de personas, lo que posibilita la confirmación de identidades y contribuye a la resolución de delitos al permitir confirmar, por ejemplo, a personas desaparecidas o víctimas de accidentes. Sin embargo, es necesario observar una cuestión ética importante: ¿el fin siempre justifica los medios? ¿La identificación facial desde imágenes captadas por cámaras de circuito cerrado de televisión o el análisis de registros fotográficos puede confirmar inequívocamente la identidad de una persona? ¿Se pueden utilizar huellas dactilares o labiales, bajo cualquier circunstancia, en un enfrentamiento dactiloscópico? El conocimiento sobre las limitaciones de los métodos técnicos y científicos utilizados en las comparaciones de caracteres morfológicos permite que el resultado del perito en papiloscopía responda a dos principios constitucionales básicos: la legalidad y el derecho de la persona humana. Al respetarlos se estará actuando dentro de los límites éticos.

Tomographic evaluation of the effect of simvastatin topical use on alveolar bone microarchitecture, pain and swelling after mandibular third molar extraction: a randomized controlled trial.

OBJECTIVES: To evaluate the effect of a collagen sponge containing simvastatin on socket healing in terms of bone microarchitecture through tomographic analysis, pain, and swelling after impacted third molar extraction. MATERIALS AND METHODS: In this single-blind, split-mouth, randomized clinical trial, 29 patients undergoing impacted third molar extraction were allocated into two groups: (i) test group, a collagen sponge containing simvastatin was inserted within the sockets; and (ii) control group, in which sockets retained the clot. Bone volume (BV), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp), and gray scale were evaluated using cone beam computed tomography (CBCT) acquired immediately postoperative and 3 months after surgery. Pain, swelling, and wound healing were evaluated using the 10-point visual analogue scale, three extra-oral reference measurements, and the Landry index. RESULTS: In total, 22 participants remained in the study; no loss-to-follow-up was related to the intervention. BV and BV/TV were significantly higher at 3 months postoperatively in the test group compared with the control group and were correlated with greater bone trabeculation. Pain, edema, and the Landry index revealed a greater inflammatory response in the test group during early repair. Simvastatin contributed to bone healing, with no adverse effects or postoperative complications. CONCLUSIONS: The absorbable collagen sponge containing simvastatin improved BV, BV/TV, and trabecular bone, indicating the potential of this drug to induce the formation of autogenous bone. CLINICAL RELEVANCE: Intraosseous statins represent a promising, low-cost, and easy-to-use alternative for alveolar ridge preservation and bone regeneration. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (REBEC), No. RBR-523N7R.

Associação de hábitos parafuncionais e DTM em pacientes classe II / Association of parafunctional habits and TMD class II patients

Introdução: A Disfunção Temporomandibular (DTM) é a dor orofacial crônica mais comum, encontrada por dentistas e outros profissionais de saúde. Sua etiologia tem caráter multifatorial, e pode envolver, desde fatores hereditários, hábitos parafuncionais, maloclusões, até ansiedade e estresse. Objetivo: Este estudo investigou a frequência da DTM e a sua relação entre hábitos parafuncionais em uma população de pacientes classe II esquelética. Método: Uma amostra composta por pacientes classe II esquelética foi selecionada de forma não probabilística. Setenta e três indivíduos concordaram em participar da pesquisa, se submetendo ao exame físico que consistia na aplicação do Eixo I do (RDC/TMD). Resultados: Quarenta e seis por cento dos pacientes examinados apresentaram diagnóstico positivo. A média de idade dos pacientes foi de 27 anos+ 8,73 anos, 82% do gênero feminino e 80% brancos. Trinta e quatro pacientes referiram alguma atividade parafuncional. Desses a onicofagia representou o grupo com maior frequência, seguido pelo bruxismo, interposição de objetos entre os dentes e por último o apertamento. As variáveis não apresentaram associação estatisticamente significante com o desfecho primário estudado. Conclusão: Na amostra estudada não se observou associação entre a ocorrência de DTM e hábitos parafuncionais em pacientes classe II esquelética... (AU)

Introduction: Temporomandibular disorder (TMD) is the most common chronic orofacial pain, found by dentists and other health professionals. Its etiology has a multifactorial character, and may involve, from hereditary factors, parafunctional habits, malocclusions, to anxiety and stress. Objective: This study investigated the TMD frequency and its relationship among parafunctional habits in a population of skeletal class II patients. Method: A sample composed by a class II patients was selected in a non probabilistic manner. Seventy-three members agreed to participate in the research, submitting themselves to a physical examination that consists in the application of Axis I (RDC/TMD). Results: Forty-six percent of patients diagnosed with a positive diagnosis. The average age of the patients was 27 years ± 8.73 years, 82% female and 80% white. Thirty-four patients reported some parafunctional activity. Of these, biting nail represented the group most frequently, followed by bruxism, interposition of objects between the teeth and lastly clenching. As variables did not present a statistically significant association with the primary outcome studied. Conclusion: In the sample studied, it is observed that there is no association between TMD occurrence and parafunctional habits in skeletal class II patients... (AU)

Chondrosarcoma of the Temporomandibular Joint: Systematic Review and Survival Analysis of Cases Reported to Date.

The purpose of this systematic review was to summarize the available data on TMJ chondrosarcomas and to perform a survival analysis of cases reported to date. This review was conducted in accordance with the PRISMA. Two authors performed an electronic search of case reports of TMJ chondrosarcoma published until August 02, 2020. Forty-seven studies reporting 53 cases were included. Chondrosarcomas of the TMJ were more prevalent in women, with a male:female ratio of 1:1.4. Survival curves were significantly associated with histological diagnosis (p = 0.004), reconstructive surgery (p = 0.024), recurrence (p < 0.001), and distant metastasis (p = 0.001). Only distant metastasis was independently associated with survival (p = 0.017). TMJ chondrosarcomas presented with low recurrence and higher survival rates than other chondrosarcomas. Synovial subtype, absence of reconstructive surgery, and presence of local recurrence or distant metastasis were associated with poorer prognosis.

Intraoral Approach for Surgical Treatment of Psammomatoid Juvenile Ossifying Fibroma.

Psammomatoid juvenile ossifying fibroma (PJOF) is a rare benign tumor that usually affects the paranasal sinuses, orbit, and skull. In most cases, extensive incisions are necessary for full access to the tumor site. The aim of this paper is to report a case of extensive PJOF in which an intraoral surgical approach was performed with complete excision of the tumor. A female patient, 18-year old had a deforming volume increase in the region of the left facial middle third with an approximate evolution time of 2 years. She complained of headache, epiphora in the left eye, and total obstruction of the left nostril. Extraoral examination showed facial asymmetry with dystopia, ocular proptosis, and considerable sclera exposition of the left eye. Tomography examination showed a mixed aspect lesion on the left side of the face, well delimited. The intraoral surgical approach was chosen for the excision of the lesion. Under general anesthesia and nasotracheal intubation, total resection was performed, followed by exodontia of the directly involved teeth. In the definitive histopathological examination, the diagnosis was confirmed. The patient is currently with 2 years and 6 months of postoperative follow-up and has good healing of intraoral surgical wounds and stable occlusion. Extraoral examination showed harmonic projection of the facial middle third, but still with excessive exposure of the sclera of the left eye due to the defect in the orbital floor. The surgical treatment of PJOF was possible by intraoral approach, even taking into account the limitations of the access and the complexity of the anatomy of the facial bones involved.

Virtual Surgical Planning and One-Stage Treatment of Active Hemimandibular Hyperplasia.

Hemimandibular hyperplasia was first described in 1836 by Adams as a disorder that causes condylar hyperplasia, deforming facial asymmetry and has an unknown etiology. The objective of this study was to report a patient with surgical correction through orthognathic surgery and high condilectomy for the treatment of hemimandibular hyperplasia. The patient complained of pain and cracking in the right temporomandibular joint region and was dissatisfied with the aesthetic appearance of the face. Virtual planning was done for bimaxillary orthognathic surgery and preparation of prototyped surgical guides. Stereolithographic models were used for the preparation of the acrylic guides of the osteotomies for the high condilectomy and the contour of the mandibular base. Orthognathic surgery resulted in the maxillary repositioning with correction of the inclination of the occlusal plane, reduction of the height of the ramus and right mandibular body and class I dental attachment. Mandibular contour osteotomy was performed with acrylic guide in the basilar. The condilectomy was performed by endaural access. In 2-year follow-up, there are no signs of recurrence.

Pressure and resistance of the lips in subjects with and without occlusal change / Pressão e resistência dos lábios em sujeitos com e sem alteração oclusal

ABSTRACT Objective: to evaluate the resistance and pressure of the lips in Class I, II and III Angle's malocclusion subjects, in comparison to reference values and relate them with gender and age. Methods: a quantitative, descriptive and cross-sectional study. Participants included 40 subjects, 20 women and 20 men, average age 26.3 years, separated by occlusal classification. The volunteers answered on the self-reported performance of the stomatognathic functions and were submitted to the evaluation of the mobility and posture of the lips. Pressure and resistance were measured with the Iowa Oral Performance Instrument (IOPI) and the results compared to the reference values described in the instrument´s manual. The data were analyzed descriptively and, for inferential analysis, Pearson's Chi-Square test was used. The significance level was considered 5%. Results: a decrease in pressure and resistance values wasobserved in all patients, including Angle's class I group. There was an inverse relationship between the age of the subjects and the values of pressure of lips with statistical significance (p = 0.02). In general, women had lower pressure values than men. Conclusion: all study subjects had lower pressure of the lips than the reference values described in the literature.

RESUMO Objetivo: avaliar a pressão e resistência dos lábios em sujeitos com má oclusão classe I, II e III de Angle, comparativamente a valores de referência e relacioná-las com sexo e idade. Métodos: estudo quantitativo, descritivo e transversal. Participaram 40 sujeitos, 20 mulheres e 20 homens, idade média 26,3 anos, separados pela classificação oclusal. Os voluntários responderam sobre queixa autorreferida de desempenho das funções estomatognáticas e foram submetidos à avaliação da mobilidade e postura dos lábios. Pressão e resistência foram aferidas com Iowa Oral Performance Instrument(IOPI) e os resultados comparados aos valores de referência descritos no manual do referido equipamento. Os dados foram analisados descritivamente e, para análise inferencial, utilizou-se o teste Qui-Quadrado de Pearson. Considerou-se nível de significância de 5%. Resultados: foi possível observar diminuição dos valores de pressão e resistência em todos os participantes, inclusive no grupo classe I de Angle. Foi encontrada uma relação inversa entre a idade dos sujeitos e os valores de pressão de lábios com significância estatística (p=0,02). De uma maneira geral, as mulheres apresentaram valores de pressão mais baixos que os homens. Conclusão: todos os sujeitos do estudo apresentaram valores de pressão labialinferiores aos de referência, descritos na literatura.

O impacto da dor crônica por disfunção temporomandibular nas atividades laborais / Chronic temporomandibular disorder pain impact on work activities

Objetivo: Avaliar se a disfunção temporomandibular (DTM) crônica esteve associada ao absenteísmo laboral. Métodos: O estudo foi realizado com dados secundários de um ensaio clínico randomizado conduzido em um centro de referência terciária. Foram selecionados os pacientes que apresentaram diagnóstico de DTM segundo o Research Diagnostic Criteria/Temporomandibular Disorders (RDC/TMD), e que exerciam atividade profissional. O grau de dor crônica foi relacionado com o absenteísmo laboral relatado. Resultados: Dos 106 pacientes selecionados, a maioria registrou níveis altos de intensidade da dor e baixos de interferência na capacidade de trabalhar. Entretanto, quanto maior a classificação do grau de dor crônica, mais dias de falta ao trabalho foram relatados (p<0,001). Houve ainda uma correlação positiva de média a forte entre ausência do trabalho, a interferência nas atividades diárias e a mudança na capacidade laboral. Conclusão: A dor crônica por DTM esteve associada ao absenteísmo laboral, e os pacientes com maior grau de dor crônica relataram mais dias de ausência ao trabalho.

Purpose: Evaluate if TMD chronic pain had been associated to work absenteeism. Methods: A study using secondary data obtained from a randomized clinical trial of patients seeking for TMD treatment at a tertiary center. Worker patients with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were selected. Mean degree of chronic pain severity was compared with number of days of work absenteeism. Results: Of 106 selected patients, majority reported high levels of pain intensity and low disability. However, the greater pain severity degree, the greater the number of days of sick leave reported (p<0,001). There was also a positive correlation between work absenteeism, disability and daily activities impairment. Conclusion: TMD chronic pain has been associated to work absenteeism, and patients with severe degree of chronic pain reported more days of sick leave.

Demineralized bone matrix and calcium-phosphate cement in bone regeneration in rats.

PURPOSE: To compare bone regeneration in critical-sized defects in rat calvarium using demineralized bone matrix and calcium phosphate cement. METHODS: Thirty Wistar rats were divided into 3 groups of 10 animals each. Two defects of 5-mm were made in the parietal bones of each animal. Group I had calcium phosphate cement placed in the experimental defect, Group II had filled with demineralized bone matrix and Group III had with the combination of the matrix and cement in equal parts. All animals had one defect left unfilled to serve as controls. Five animals in each group were sacrificed at 4 and 8 weeks. Histomorphometric analysis was used to quantify the amount of new bone within the defects. RESULTS: The results showed that demineralized bone matrix-treated defects had significantly more new bone at 4 weeks compared to calcium phosphate cement-treated defects (p=0.03) and also had significantly more new bone at 8 weeks compared to unfilled defects (p=0.04). CONCLUSIONS: The demineralized bone matrix was superior to calcium phosphate cement in bone regeneration. It seems that calcium phosphate cement acted by inhibiting the osteogenesis when associated with a demineralized bone matrix and this combination should not be recommended.

Tongue pressure and endurance in patients with Class II and Class III malocclusion / Pressão da língua em pacientes com má oclusão Classe II e III

ABSTRACT Objective: to evaluate pressure and endurance exerted by the tongue and their association with malocclusion, gender and age in orthognathic surgery candidates. Method: a cross-sectional, descriptive observational study, performed with 34 subjects, i.e., 18 women and 16 men, in the average age 28.7 years, sorted by Angle's classification. Self-reported complaint of tongue mobility and stomatognathic functions was assessed and the evaluation of tongue mobility carried out. Tongue pressure and endurance were measured with the Iowa Oral Performance Instrument (IOPI). The data were analyzed descriptively and, for inferential analysis, the Pearson Chi-Square test was used. A 5% significance level was considered. Results: the assessed pressure and tongue endurance values of patients with malocclusion were lower than the reference ones, indicating a statistical significance in class II female patients. There was an association between inadequate pressure and tongue endurance in women with class II malocclusion. Pressure and tongue endurance in females were slightly higher than in males and a gradual decrease in averages of pressure and tongue endurance with advancing age was seen. Conclusion: pressure and tongue endurance values in women presented with class II malocclusion were lower than the reference ones, an association between inadequate pressure and tongue endurance being found.

RESUMO Objetivo: avaliar pressão e resistência exercidas pela língua e associação com má oclusão, sexo e idade em candidatos à cirurgia ortognática. Métodos: estudo observacional transversal descritivo. Participaram 34 sujeitos, 18 mulheres e 16 homens, idade média 28,7 anos, separados pela classificação de Angle. Verificou-se queixa autorreferida de mobilidade de língua e funções estomatognáticas. Avaliou-se mobilidade de língua. Pressão e resistência foram aferidas com Iowa Oral Performance Instrument (IOPI). Os dados foram analisados descritivamente e, para análise inferencial, utilizou-se Qui-Quadrado de Pearson. Considerou-se significância de 5%. Resultados: valores de pressão e resistência da língua dos pacientes com má oclusão apresentaram-se inferiores aos valores de referência, apontando significância nos pacientes Classe II do sexo feminino. Foi encontrada associação entre a inadequação da pressão e resistência da língua em mulheres com má oclusão Classe II. Verificou-se que pressão e resistência de língua no sexo feminino foram ligeiramente maior que a do masculino e uma gradativa diminuição das médias de pressão e resistência de língua, com avançar da idade. Conclusão: pressão e resistência da língua em mulheres com má oclusão classe II foram inferiores aos valores de referência, tendo sido verificada associação entre inadequação da pressão e resistência da língua.

Demineralized bone matrix and calcium-phosphate cement in bone regeneration in rats

Abstract Purpose: To compare bone regeneration in critical-sized defects in rat calvarium using demineralized bone matrix and calcium phosphate cement. Methods: Thirty Wistar rats were divided into 3 groups of 10 animals each. Two defects of 5-mm were made in the parietal bones of each animal. Group I had calcium phosphate cement placed in the experimental defect, Group II had filled with demineralized bone matrix and Group III had with the combination of the matrix and cement in equal parts. All animals had one defect left unfilled to serve as controls. Five animals in each group were sacrificed at 4 and 8 weeks. Histomorphometric analysis was used to quantify the amount of new bone within the defects. Results: The results showed that demineralized bone matrix-treated defects had significantly more new bone at 4 weeks compared to calcium phosphate cement-treated defects (p=0.03) and also had significantly more new bone at 8 weeks compared to unfilled defects (p=0.04). Conclusions: The demineralized bone matrix was superior to calcium phosphate cement in bone regeneration. It seems that calcium phosphate cement acted by inhibiting the osteogenesis when associated with a demineralized bone matrix and this combination should not be recommended.

Suitability of Wrist External Fixator for Treatment of Mandibular Fracture.

The mandibular fracture is one of the most commonly fractures of the facial bones. In high-energy traumas, a comminuted mandible fracture may occur. The closed reduction with external fixator is an interesting alternative for these types of fractures. The aim of this article is to report the case of a patient with comminuted fracture in the right mandibular body, whose surgical treatment was the noninvasive reduction of fracture and stabilization using a Colles' wrist external fixator. After 1 year of follow-up, the patient is without complaints, with satisfactory dental occlusion, adequate contour, and mandibular alignment. External fixation with wrist orthopedic fixators adapted to the mandible provides many advantages owing to its versatility and simplicity of use. Therefore, this method should be remembered as a valid and affordable option for the treatment of complex lesions when indicated correctly.

Reconstrução de sequela facial por prótese interna acrílica / Reconstruction of facial sequela by internal acrylic prothesis

As sequelas faciais decorrentes do trauma representam grande desafio para o cirurgião buco-maxilo-facial e exigem que este tenha em mente o conhecimento anatômico, cirúrgico, do acervo material, bem como do aporte tecnológico que lhe assiste a prática cirúrgica. Frente aos biomateriais utilizados na confecção protética, a resina acrílica aparece como uma possibilidade amplamente vantajosa para o profissional e para o paciente, e, uma vez somada às técnicas de prototipagem, se tornam ainda mais eficientes e eficazes. O presente trabalho objetiva discutir o uso da resina acrílica no tratamento das sequelas faciais após o trauma por meio da apresentação de um caso clínico... (AU)

As the facial sequelae resulting from trauma represent a great challenge for the maxillo-facial surgeon, and require that keep in mind the knowlodge about anatomical, surgical, material assets and the technological support that assists you to surgical practice. In view of the prosthetic biomaterials used in making the acrylic resin appears as a widely advantageous possibility for professional and patient, and once added to the prototyping techniques become more efficient and effective. This paper aims to discuss the use of acrylic resin in the treatment of facial sequelae after trauma by presenting a clinical case... (AU)

Application of Dexamethasone in the Masseter Muscle During the Surgical Removal of Lower Third Molars.

PURPOSE: The aim of the present study was to analyze the effect of the application of dexamethasone in the masseter muscle during third molar surgery. METHODS: This randomized, clinical trial used dependent samples and the split-mouth method. A sample of 30 patients, with impacted or semi-impacted third molars, as well as vertical and mesioangular positions of a similar surgical difficulty (on both sides), was subjected to 2 operations: an experimental operation and a control procedure, with a 30-day wash-out. The choice of which group would be experimental or control was random. The experimental group received 8 mg of dexamethasone, which was applied directly to the masseter muscle immediately after surgery. The control group did not receive corticosteroids. Seven and 15 days after the surgery, the patients were assessed in relation to their levels of pain, trismus, and edema. RESULTS: Concerning edema and trismus, there was a significant difference (P <0.05) between the control and experimental groups. As for the pain scale, no significant differences were found between the presence or absence of corticoids. CONCLUSION: The present study concluded that the application of dexamethasone in the masseter muscle effectively reduces edema and trismus, but does not affect pain.

Treatment of Large Thyroglossal Duct Cyst.

The thyroglossal duct cyst is the neck congenital abnormality most common in the childhood. Clinically, it shows itself as a solitary neck mass in the region of hyoid bone, it is painless and can be dislocated during de physical examination and tongue protrusion. The most common treatment is its removal through the Sistrunk technique. Patient with diagnosis of thyroglossal duct cyst in neck region with extension to the mouth floor was treated by total surgical removal through intraoral access. The intraoral approach to the treatment of the thyroglossal duct cyst showed itself practicable and permitted the total removal of the lesion with no recurrence signs.

Cryosurgery with refrigerant gas as a therapeutic option for the treatment of leukoplakia: a case report.

Leukoplakia is a nondetachable, potentially malignant, white lesion that is commonly found in smokers of advanced age. Leukoplakia occurs more frequently in men; however, there is a higher index of dysplastic changes and malignant transformation in women. The proposed treatments for this disease range from monitoring to surgical excision. Cryosurgery has been reported as an alternative to conventional surgery. Cryosurgery destroys the tissues of a potentially malignant lesion through the application of low temperatures. This technique offers a low rate of postsurgical infection, absence of hemorrhage, and ease of application, and it is widely accepted by patients. The most commonly used cryogenic agent, liquid nitrogen, is costly and difficult to use. The objective of this article is to suggest the use of a combination of refrigerant gases (propane and butane), commonly employed in pulp sensitivity tests, for cryosurgery of potentially malignant lesions of the oral cavity and to report a case of leukoplakia treated with this approach.

Tratamento de fístula bucossinusal com o uso de retalho do corpo adiposo de Bichat û relato de caso / Treatment of oroantral communications using pedicled buccal fat pad graft û case report

Fístulas bucossinusais são comunicações epitelizadas entre o meio oral e o seio maxilar. Ocorrem principalmente como complicação de intervenções cirúrgicas orais e maxilofaciais. Pequenas comunicações geralmente são autorresolutivas, porém nas comunicações maiores, um tecido epitelial pode desenvolver-se em torno do seu trajeto, configurando, assim, uma fístula bucossinusal. Vários métodos de tratamento para fístula bucossinusal têm sido descritos na literatura. Devido à facilidade de acesso e rico suprimento sanguíneo, o corpo adiposo bucal é adequado para obliteração de defeitos posteriores da maxila, tanto na região de palato duro e mole, como na região alveolar e retromolar. Este trabalho objetiva relatar o caso clínico de uma fístula bucossinusal na região de rebordo alveolar maxilar esquerdo proveniente de um procedimento cirúrgico para levantamento de seio maxilar realizado há dois meses. Foi realizada antibioticoterapia para controle da infecção sinusal e tratamento cirúrgico da fístula pela técnica de retalho pediculado do corpo adiposo de Bichat, onde o mesmo foi dissecado, fracionado para a área comprometida e estabilizado à mucosa adjacente. A paciente encontra-se em acompanhamento há um ano sem queixas e/ou sinais de recidiva...

Oroantral fistula are epithelized communications between the oral environment and the maxillary sinus. They occur mainly as a complication of oral and maxillofacial surgery. Small communications are usually self resolving, but in major communications, an epithelial tissue can develop around your path, so setting a oroantral fistula. Various methods of treatment for buccal sinus fistula have been described in literature. Due to the ease of access and rich blood supply, the buccal fat pad is suitable for obliteration of later defects of the jaw, both in the area of hard and soft palate, as in alveolar and retromolar region. This is a case report of a oroantral fistula on the left maxillary alveolar region from a surgical procedure to maxillary sinus survey conducted two months ago. Antibiotic therapy was performed to control sinus infection and surgical treatment of fistula by pedicle flap technique of the fat pad of Bichat, where it was dissected, split to the affected area, and stabilized to the adjacent mucosa. The patient has been followed for a year without complaints and/or signs of recurrence...

Abordagem cirúrgica de abscesso orbitário subperiosteal associado à fratura de órbita / Surgical approach of orbitalsubperiosteal abscess associated with the orbital fracture

As cavidades orbitárias com os espaços aéreos da face e a ocorrência de infecções advindas de sinusites para a órbita são frequentes especialmente devido à proximidade. Acometem mais comumente crianças com estado nutricional debilitado. Clinicamente apresentam os sinais flogísticos, além de deficit visual, diplopia, oftalmoplegia e proptose. Podem evoluir com complicações graves, como trombose do seio cavernoso e abscesso intracraniano. Estas infecções podem ser classificadas de acordo com sua gravidade. Os exames de imagem de escolha para o diagnóstico e planejamento dos casos são cortes axiais e coronais de tomografia computadorizada. O tratamento deve ser compatível com a gravidade do caso e reação do organismo à antibioticoterapia. O objetivo deste artigo é relatar um caso clínico de paciente pediátrico que após trauma em face foi acometido por fratura em rebordo orbitário superior e desenvolveu posteriormente abscesso orbitário subperiosteal, discutindo os critérios clínicos e imaginológicos para o diagnóstico e a devida condução do caso.

The proximity of the orbital cavities to the air spaces of the face results in the occurrence of orbital infections resulting from sinusitis. Children with debilitated nutritional status are especially vulnerable. Clinically presents the inflammatory signs, and visual acuity deficit, diplopia, ophthalmoplegia and proptosis. Might also lead to severe complications such as cavernous sinus thrombosis and intracranial abscess. These infections can be classified according to their severity. Imaging tests of choice for the diagnosis and planning of cases include axial and coronal cuts of computed tomography. Treatment should be compatible with the severity of the case, taking into account the side effects of the antibiotics used. The objective of this paper is to report a case of a pediatric patient who sustained facial trauma resulting in fracture of the upper orbital rim and subsequently developed orbital subperiosteal abscess. We discuss the clinical and imaging criteria for successful diagnosis and treatment.