Restoring Facial Contour and Harmony Using Biphasic Calcium Phosphate Bioceramics.

BACKGROUND: The restoration of facial contour is one of the pillars for the treatment of facial disharmonies and deformities. Fat transplantation and fillers have been widely used to improve the positioning of soft tissues, which are, however, directly related to the conditions and positioning of the underlying bone tissue. Recontouring of the latter has been performed using osteotomies and several types of bone grafts or biomaterials, as inlay or onlay grafts/implants. Here, biphasic calcium phosphate bioceramics were applied in a series of cases, their long-term results are shown, and their advantages, discussed. METHODS: A retrospective analysis of 20 patients, who were subjected to facial recontour with onlay implants of biphasic calcium phosphate bioceramics, is reported. Patients were seeking to improve facial harmony due to congenital deformities, trauma, tumor resection or signs of aging, and were followed for up to 16 years. Clinical data, radiographic images, and information regarding pain and other findings were retrieved from medical records. RESULTS: Six patients were men and 14 were women. Their ages ranged from 19 to 64 years. Bioceramics were implanted under the periosteum through external or intraoral incisions. Some patients underwent combined procedures, such as rhinoplasties or facial lifting. None of the patients presented exacerbated inflammation or pain. One of them had infection in the intraoral incision, which was resolved with medication. CONCLUSION: All patients had improved facial contours following the use of bio-ceramics to augment bone tissue and presented stable results at long-term evaluation.

Quantification of bone mass gain in response to the application of biphasic bioceramics and platelet concentrate in critical-size bone defects.

Biphasic bioceramics have been widely indicated for bone reconstruction; however, the real gain in bone mass due to the presence of such biomaterials has not been established yet nor the advantages of its association with platelet concentrate. This study aims at quantifying the volume of bone matrix, osteoblasts, osteocytes, blood vessels and adipose tissue after the application of a biphasic bioceramics composed of 65% hydroxyapatite and 35% beta-tricalcium phosphate. Critical-size bone defects were produced in rabbit femora and reconstructed with bioceramics only, with bioceramics combined with platelet concentrate, with platelet concentrate alone, and with no treatment (blood clot). The quantitative evaluation was performed on histological sections using histomorphometry. Our data provide original evidence that consolidates the indication of bioceramics for clinical bone loss reconstruction. The application of biphasic bioceramics alone led to major bone mass gain and was followed by its association with platelet concentrate. On the other hand, platelet concentrate can contribute to the augmentation and maintenance of the adipose tissue, representing a new field for future applications in plastic surgery.

Estudio comparativo del análisis de la estética facial en cirugía ortognática / A comparative study of facial aesthetic analysis in orthognatic surgery

Los autores realizan un estudio comparativo entre procedimientos de diagnóstico estéticos que fueron realizados en los pacientes sometidos a cirugía ortognática, en el Centro Médico Nacional ®20 de Noviembre¼ del ISSSTE, en el periodo comprendido entre enero de 1993 a junio de 1997. En un grupo de pacientes se realizó el diagnóstico de manera convencional y al otro grupo se le anexó el análisis de la estética facial proporcional, obteniendo diferencias en la profundidad del diagnóstico y como resultado, la necesidad de incrementar procedimientos estéticos faciales en los pacientes con deformidades dentofaciales

Incidência e tratamento de fraturas do côndilo da mandíbula no Serviço de Cirurgia e Traumatologia Bucomaxilofacial da Faculdade de Odontologia de Bauru da Universidade de Säo Paulo e Associaçäo Hospitalar de Bauru, no período de 1991 a 1995 / Incidence and tratment of condilar fractures in the bucomaxillofacial surgery and traumatology service of the Bauru Dental School - USP and Bauru Hospitalar Association, in the period of 1991 to 1995

Pela alta incidência de traumas faciais, escassez de trabalhos nacionais publicados e, diversidade de tratamentos instituídos para as fraturas do côndilo da mandíbula, fez-se levantamento estatístico de 4792 pacientes atendidos no Serviço de Cirurgia e Traumatologia Bucomaxilofacial da Faculdade de Odontologia de Bauru da Universidade de Säo Paulo e Associaçäo Hospitalar de Bauru, no período de 1991 a 1995. Deu-se ênfase às fraturas do côndilo mandibular, que foram analisadas sob vários aspectos e estudadas estatisticamente. Resultados permitiram concluir que, o número de pacientes portadores de fraturas faciais e condilares atendidos na cidade de Bauru, durante 05 anos, somam 1492 e 113 respectivamente; os homens na segunda e terceira décadas de vida säo os mais atingidos; as fraturas isoladas e as unilaterais säo as mais frequentes; as quedas acidentais constituem a etiologia mais comum; o tratamento cirúrgico fechado é o mais utilizado, sendo a prevençäo de fundamental importância

Clinical evaluation of novocol anesthesic efficiency

This research had as main objectives evaluate NOVOCOL anaesthesic efficiency in odontological surgical proceedings and the occurrence of adverse reactions decurrent from its utilization. A total of 150 patients were included in the research, having the evaluation the following patterns: patient's age, his emotional condition before surgery, pre-anaesthesic medication, blood pressure, king of surgery, anaesthesic technique, time of induction and duration, anaesthesic volume and, finally, patient's opinion about anaesthesic efficiency. Results showed that NOVOCOL was efficient in most of surgical proceedings (74,5%), induction time is satisfactory and duration time is sufficient to surgical manouvres. It wasn't observed efficiency in patients who had taken pre-anaesthesic medication and a better effect in calm or normotense ones. No adverse reaction was found in the patients who were tested. It was concluded that NOVOCOL fits into necessary patterns to the realization of surgical manouevres reported here as a safe and efficient anaesthesic

Displasia fibrosa dos maxilares / Fibrous dysplasia of the jaws: presentation of two surgical cases

Os autores tecem algumas consideraçöes a respeito da displasia fibrosa dos maxilares, juntamente com a descriçäo de dois casos clínicos, um ocorrido na mandíbula e outro, na maxila, que apresentavam aspectos radiográficos diversos

Avaliação clínica da eficácia do anestésico NOVOCOL / Clinical evaluation of NOVOCOL anesthetic solution

Este trabalho teve como objetivo avaliar a eficácia do anestésico NOVOCOL em manobras cirúrgicas odontológicas, assim como a ocorrência de reações adversas recorrentes da sua utilização. Foram incluídos na pesquisa 150 pacientes, sendo que a avaliação seguiu os seguintes padrões: idade do paciente, seu estado emocional antes da anestesia, medicação pré-anestésica, pressão arterial, tipo de cirurgia, técnica anestésica, tempos de indução e duração, volume anestésico e finalmente, a opinião do paciente sobre a eficácia do anestésico. Os resultados mostraram que o NOVOCOL foi eficiente na maioria dos procedimentos cirúrgicos (74,5 por cento), o tempo de indução é satisfatório, e o tempo de duração é suficiente para realização das manobras cirúrgicas. Não se observou aumento da eficácia em pacientes que receberam medicação pré-anestésica, nem um melhor efeito em pacientes calmos ou normotensos. Entre aqueles pacientes avaliados, nenhuma reação adversa foi observada. Concluiu-se que o NOVOCOL encontra-se dentro dos padrões necessários para a realização das manobras cirúrgicas aqui relatadas, sendo um anestésico seguro e eficaz