Evaluation of calcium hydroxide mixed with propolis by ultrasonic activation as root canal dressing in delayed tooth replantation.

Background: In cases of tooth avulsion, in which the neurovascular bundle responsible for nourishing the dental pulp is break, endodontic treatment is necessary before proceeding with tooth replantation. In this process, various substances have been tested in combination with calcium hydroxide Ca(OH)2 in an attempt to improve its effectiveness. This study aimed to examine the effects of using a mixture of Ca(OH)2 and 10% propolis, with subsequent application of ultrasonic treatment, on the delayed replantation of teeth in rats. Material and Methods: Twenty-four rats underwent a surgical procedure to extract the upper right incisor, leaving it on a surface to dry for one hour. The pulp and periodontal ligament were removed and the teeth were submerged in a 2% sodium fluoride acidulated phosphate solution. The canals were dehydrated using paper cones and the teeth were divided into four groups, according to the type of intracanal dressing: Ca(OH)2 group, Ca(OH)2 group with ultrasonic agitation, Ca(OH)2 and propolis group, Ca(OH)2 and propolis group with ultrasonic agitation. The root canals were irrigated with saline solution and the teeth were reimplanted. Sixty days after reimplantation, the animals were euthanized. Results: With regard to the presence of acute and chronic inflammatory infiltrate in the periodontal ligament, there was no statistically significant difference among some of the groups. Root resorption was identified in all groups, and there was no significant difference between them. Conclusions: It is concluded that the application of intracanal dressing containing Ca(OH)2 associated with 10% propolis, followed by ultrasonic agitation, did not prove to be more effective than the use of Ca(OH)2 alone in the repair process in the delayed replantation of rat teeth. Key words:Tooth replantation, Calcium hydroxide, Propolis, Ultrasound, Intracanal dressing.

Ozone therapy effect in medication-related osteonecrosis of the jaw as prevention or treatment: microtomographic, confocal laser microscopy and histomorphometric analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS: Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS: Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS: Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE: Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.

Mechanical Comparison of Four Different Types of Osteosynthesis in a 11-mm Advancement Le Fort I Osteotomy.

OBJECTIVE: This study aimed to evaluate 4 methods of osteosynthesis in the maxilla after a linear advance of 11 mm. METHODOLOGY: Le Fort I osteotomies were performed on 24 resin models and different osteosynthesis were applied in the anterior region. Group I received Lindorf plates; group II, modified Lindorf plates; group III, inverted "T" plates; and group IV, "L" plates. All groups received "L" plates in the posterior region. Analysis were performed through universal mechanical testing machine with an axial linear load until 5-mm displacement. The data obtained about the force and the amount of deformation were computed, thus the energy required for displacement and stiffness was calculated. Statistical analysis was performed using 2-way analysis (Shapiro-Wilk, followed by Holm-Sidak) (P  < 0.05). RESULTS: Groups I and II showed greater resistance to displacement (P < 0.05) than the other groups. The largest amount of maximum force exerted for the 5-mm displacement was in group II (91.73 N), followed by group I (87.46 N), presenting the best values in comparison with the other groups (P < 0.001). Group III had less stiffness (P < 0.001) than the other groups. CONCLUSIONS: The use of preclinical methodologies to verify the mechanical stability of fixation models allows a prediction in the choice of greater resistance systems. The fixation type with greater resistance to deformation was achieved with modified Linford plates followed by Linford plates in the anterior region and plate "L" bilaterally in the posterior region.

Comparative Evaluation of Bone Repair with Four Different Bone Substitutes in Critical Size Defects.

This study evaluated the osteoconductive potential of four biomaterials used to fill bone defects. For this, 24 male Albino rabbits were submitted to the creation of a bilateral 8 mm calvarial bone defect. The animals were divided into four groups-bovine hydroxyapatite, Bio-Oss® (BIO); Lumina-Bone Porous® (LBP); Bonefill® (BFL); and an alloplastic material, Clonos® (CLN)-and were euthanized at 14 and 40 days. The samples were subjected to histological and histometric analysis for newly formed bone area. Immunohistochemical analysis for Runt-related transcription factor 2 (Runx2), vascular endothelial growth factor (VEGF), and osteocalcin (OC) was performed. After statistical analysis, the CLN group showed greater new bone formation (NB) in both periods analyzed (p < 0.05). At 14 days, the NB showed greater values in BIO in relation to LBP and BFL groups; however, after 40 days, the LBP group surpassed the results of BIO (p < 0.001). The immunostaining showed a decrease in Runx2 intensity in BIO after 40 days, while it increased for LBP (p < 0.05). The CLN showed increased OC compared to the other groups in both periods analyzed (p < 0.05). Therefore, CLN showed the best osteoconductive behavior in critical defects in rabbit calvaria, and BFL showed the lowest osteoconductive property.

Strategy for Optimizing Airway Volume With Genioglossal Advancement Using Cutting Guide in the Treatment of Obstructive Sleep Apnea.

The genioglossus advancement muscle is a technique used to treat obstructive sleep apnea and depends on the precise location of the muscle insertion into the geniotubercle. The aim of this article was to present a case report about a 38-year-old male patient with obstructive sleep apnea even after undergoing uvulopalatopharyngoplasty and mentoplasty. A maxillo-mandibular advancement and genioglossus was proposed, for this a virtual planning of the surgical guide was done using a specialized software. The great advantage is to reduce the osteotomy by focusing precisely on the insertion of the muscle. The cutting guide facilitated the surgical procedure in all aspects and brought safety.

Reparación Ósea en Alvéolos de Ratas Ovariectomizadas con Biosilicato Cristalizado. Análisis Histomorfométrico / Alveolar Bone Repair in Ovarictomized Rats with Crystallized Biosilicate. Histomorphometric Analysis

RESUMEN: Evaluar el proceso de reparación alveolar en ratas sometidas a cirugía de simulacro u ovariectomizadas tras el relleno alveolar con coágulo o con biosilicato cristalino. Sesenta ratas Wistar fueron divididas en cuatro grupos (n=15) de acuerdo con el tratamiento: Grupo 1- ratas sometidas a cirugía de simulacro con alveolos rellenados con coágulo; Grupo 2- ratas sometidas a cirugía de simulacro con alveolos rellenados con biosilicato cristalino; Grupo 3- ratas ovariectomizadas con alveolos rellenados con coágulo; Grupo 4- ratas ovariectomizadas con alveolos rellenados con biosilicato cristalino. Después de 7, 14 y 28 días, los animales fueron sacrificados, se tomaron muestras óseas que fueron teñidas con hematoxilina-eosina y analizadas al microscopio para realizar un análisis histomorfométricos. Los mayores porcentajes de formación de hueso se presentaron en los grupos 1 (32 % a los 7 días, 46 % a los 14 días y 83.5 % a los 28 días) y 4 (27,1 % a los 7 días, 41,1 % a los 14 días y 79,7 % a los 28 días). En los alveolos rellenados con coágulo, las ratas sometidas a cirugía de simulacro mostraron los mejores resultados, mientras que, en los alveolos rellenados con biosilicato, las ratas ovariectomizadas tenían porcentajes significativamente mayores. En este estudio, el biosilicato cristalino se comportó como un biomaterial adecuado para la reparación ósea, favoreciendo la osteoconducción.

ABSTRACT: The objective of this study was to assess the process of alveolar bone repair in rats subjected to sham surgery or ovariectomized rats, after alveolar filling with clot or with crystalline biosilicate. Sixty Wistar rats were divided into four groups (n = 15) according to the treatment: Group 1 - rats subjected to sham surgery with sockets filled with clot; Group 2- rats submitted to sham surgery with sockets filled with crystalline biosilicate; Group 3 ovariectomized rats with sockets filled with clot; Group 4 ovariectomized rats with sockets filled with crystalline biosilicate. After 7, 14 and 28 days, the animals were sacrificed, bone samples were taken, stained with hematoxylin-eosin and analyzed under a microscope to perform a histomorphometric analysis. The highest percentages of bone formation were presented in groups 1 (32 % at 7 days, 46 % at 14 days and 83.5 % at 28 days) and 4 (27.1 % at 7 days, 41.1 % at 14 days and 79.7 % after 28 days). In the sockets filled with clot, the rats subjected to sham surgery showed the best results, while in the sockets filled with biosilicate, the ovariectomized rats had significantly higher percentages. In this study, the crystalline biosilicate behaved as an adequate biomaterial for bone repair, favoring osteoconduction.

The Role of MicroRNAs in the Osseointegration Process.

Regulation of cellular function is key to bone formation at endosseous implant surfaces. Osseointegration was "discovered" prior to the discovery of genetic regulation of osteoinduction or characterization of mesenchymal stem cells. Understanding osseointegration in cellular and molecular terms has benefited from genome-wide characterization of this healing process at endosseous implants in vivo. These in vivo studies also demonstrate a role for osteoprogenitor cells and cells involved in immune regulation and osteoclastogenesis. The identification of noncoding RNAs, including microRNAs, as key factors controlling cell function has highlighted the role of microRNAs in cell differentiation control. This review summarizes emerging in vitro and in vivo investigations emphasizing the role of microRNAs in the osseointegration process. Many microRNAs influence key osteoinductive pathways controlling Osterix, runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein (BMP)/SMAD function. Others influence the monocyte/macrophage lineage. While significant progress has been made in elucidating the mechanisms associated with the regulation of surface modulation of osteoblast differentiation by microRNAs, knowledge gaps are evident in the identification and characterization of microRNAs linked to osseointegration. Given existing knowledge regarding the varied expression of microRNAs and their role in inflammation, it is important to understand how microRNA expression may influence the process of bone accrual at implant surfaces during osseointegration.

Cementoblastoma: relato de caso / Cementoblastoma: case report / Cementoblastoma: reporte de caso

O cementoblastoma é uma neoplasia odontogênica benigna, rara, responsável por 1% dos tumores odontogênicos. A localização mais comum é a região do primeiro molar inferior. Ela afeta principalmente a segunda e terceira décadas de vida, com crescimento lento, pode causar abaulamento cortical. Radiograficamente apresenta-se como uma lesão radiopaca, circunscrita por uma fina área radiolúcida, envolvendo a raiz dentária. Histologicamente, pode-se observar uma massa mineralizada, com aspecto cementóide, aderida às raízes do dente. Casos que apresentam expansão da cortical óssea aos exames clínico e imaginológico requerem tratamento cirúrgico por meio da curetagem da lesão e remoção do elemento dentário associado. Paciente do sexo feminino, leucoderma, 30 anos, procurou atendimento sem queixa de dor, apresentando abaulamento do osso cortical na região inferior esquerda do primeiro molar. Exames de imagem mostraram lesão radiopaca associada à raiz do elemento dentário 36, circunscrita com halo radiolúcido. A tomografia computadorizada mostra uma massa radiopaca na região apical do elemento. Biópsia excisional e exodontia do dente 46 foram realizadas. Material foi enviado para análise histopatológica e o diagnóstico foi cementoblastoma. A paciente está em proservação(AU)

Cementoblastoma is a benign, rare odontogenic neoplasm responsible for 1% of odontogenic tumors. The most common location is the lower first molar region. It mainly affects the second and third decades of life, with slow growth, can cause cortical bulging. Radiographically it presents as a radiopaque lesion, circumscribed by a thin radiolucent area, surrounding the dental root. Histologically, one can observe a mineralized mass, with cementoid aspect, adhered to the roots of the tooth. Cases that present expansion of the cortical bone to the clinical and imaging exams require surgical treatment by means of curettage of the lesion and removal of the associated dental element. A 30-year-old female patient, leucoderma, sought care without complaint of pain, showing bulging of the cortical bone in the lower left region of the first molar. Imaging studies showed radiopaque lesion associated with the root of the dental element 36, circumscribed with radiolucent halo. Computed tomography shows a radiopaque mass in the apical region of the element. Excisional biopsy and tooth extraction 46 were performed. Material was sent for histopathological analysis and the diagnosis was cementoblastoma. The patient is in proservation(AU)

El cementoblastoma es una neoplasia odontogénica benigna, rara, responsable del 1% de los tumores odontogénicos. La ubicación más común es la región del primer molar inferior. Se afecta principalmente a la segunda y tercera décadas de vida, con un crecimiento lento, puede causar abombamiento cortical. Radiograficamente se presenta como una lesión radiopaca, circunscrita por una fina área radiolúcida, envolviendo la raíz dental. Histológicamente, se puede observar una masa mineralizada, con aspecto celoide, adherida a las raíces del diente. Los casos que presentan expansión de la cortical ósea a los exámenes clínicos e imaginológico requieren tratamiento quirúrgico por medio del curetaje de la lesión y remoción del elemento dental asociado. El paciente de sexo femenino, leucoderma, 30 años, buscó atención sin queja de dolor, presentando abombamiento del hueso cortical en la región inferior izquierda del primer molar. Los exámenes de imagen mostraron lesión radiopaca asociada a la raíz del elemento dental 36, circunscrita con halo radiolúcido. La tomografía computarizada muestra una masa radiopaca en la región apical del elemento. Se realizó la biopsia excisional y la exodoncia del diente 46. El material fue enviado para análisis histopatológicos y el diagnóstico fue cementoblastoma. El paciente está en reposo(AU)

Evaluation of condylar resorption rates after orthognathic surgery in class II and III dentofacial deformities: A systematic review.

The purpose of this study was to perform a systematic review of morphological alterations in the condyles after orthographic surgery involving a sagittal split ramus osteotomy (SSRO), with or without surgery on the maxilla. Searches were performed on three databases and registered in the PROSPERO. The selected studies fulfilled the criteria established by the following PICO model: (1) population: individuals with skeletal dentofacial deformities (class II or III facial patterns), without asymmetry; (2) intervention: orthognathic surgery for mandibular setback using an SSRO, with or without a Le Fort I osteotomy, and fixed with bicortical screws or plates and screws; (3) comparison: orthognathic surgery for mandibular advancement using an SSRO, with or without a Le Fort I osteotomy, and fixed with plates and screws or bicortical screws; and (4) outcome: condylar resorption rate and relapse. Initially, 1,371 articles were identified and 636 articles were screened after elimination of duplicates, and 6 articles were selected for qualitative analysis based on the inclusion and exclusion criteria. Five studies had data regarding the rate of condylar resorption, varying from 0.0% to 4.2%. In conclusion, condylar resorption and relapses were present in a small percentage of patients studied.

Modulation of Micro RNA Expression and Osteoblast Differentiation by Nanotopography.

PURPOSE: This study evaluated the expression pattern of micro RNAs (miRNAs) on a surface with nanotopography compared with a smooth surface (control). MATERIALS AND METHODS: Human mesenchymal stem cells (hMSCs) were plated on different surfaces and compared at 3, 7, and 14 days for alkaline phosphatase (ALP) activity, expression of genes (osterix [OSX], runt-related transcription factor 2 [RUNX2], bone morphogenetic protein 2 [BMP2], and ALP), and expression of miRNAs. Western blot was also used to detect osteogenic proteins (BMP2, OSX, and osteocalcin [OCN]). Scanning electron microscopy of cells plated onto the surfaces was obtained. RESULTS: ALP activity on different surfaces was significantly greater in the nanotopography surface. At day 14, there was a 3.5-fold and a 9-fold increase for the RUNX2 and OSX genes, respectively. BMP2 and ALP also increased by fourfold and sevenfold compared with the control. Protein levels for OSX and BMP2 were also upregulated compared with the control group. Using RNA sequencing technology (RNA-Seq), a total of 117 miRNAs were found to be differentially expressed comparing the control (day 7) with the nanosurface (day 14). Forty-five miRNAs were upregulated, and 72 were downregulated. Several of the miRNAs that were differently expressed regulate osteogenic genes. For example, hsa-miR-135b-5p targets OCN, BSP, RUNX2, COL15A1, and OSX; hsa-miR-122-5p targets OPN; hsa-miR-196a-5p targets BMP4; hsa-miR-26b-5p targets BMP2; and hsa-miR-148b-3p targets OPN. CONCLUSION: Surfaces with nanotopography have the potential to improve the osseointegration response in order to reduce the osseointegration time and also increase bone formation around the implants, improving areas with low bone quality. Within the limitation of this study, nanotopography surfaces affected MSC differentiation to osteoblasts. Several miRNAs were differentially regulated by surface topography. These miRNAs could be related to the differentiation response to help control the osseointegration process.

Comparação dos padrões istopatológicos de casos em pacientes diagnosticados com Schwannoma/Neurilemmoma bucal em relação a localização acometida da lesão / Comparison of histopathological patterns of cases in patients diagnosed with Schwannoma / Neurilemmoma buccal in relation to lesion location: a review of the literature

Introdução: Revisão da literatura comparando padrões histopatológicos e localização, em casos de Schwannoma e Neurilemmoma bucal. Metodologia: A base de dados utilizada foi Pubmed / Medline. Incluídos relatos de casos de Schwannoma e Neurilemmoma, os quais estivessem completos, contendo a idade, localização, gênero, aspectos histopatológico e imunoistoquimico. Resultados: Com a análise dos dados encontrados, constatamos que o gênero Feminino foi mais acometido, região mais afetada foi a língua, a média de idade encontrada foi de 33,46 anos, o padrão histopatológico encontrado com maior frequência foi a presença de padrões Antoni A e Antoni B juntos (38 casos). Conclusão: Observamos a importância da confirmação com imunoistoquimica positiva para S-100.(AU)

Introduction: Literature review comparing histopathological patterns and location in cases of Schwannoma and / or oral Neurilemmoma. Methods: The database used was Pubmed / Medline. Including reports of Schwannoma ou Neurilemmoma cases, which were complete, containing age, location, gender, histopathology and immunohistochemistry. Results: With the analysis of the data found, we found that the female gender was more affected, the region more affected was the tongue, the mean age was 33.46 years, the most frequently found histopathological pattern was the presence of Antoni A and Antoni B patterns together (38 cases). Conclusion: We observed the importance of the confirmation with immunohistochemistry + S-100.(AU)

Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child.

Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.

The Use of Foley Catheter for Treatment of Unstable Fracture Zygomatic Arch.

The isolated zygomatic arch fractures represent 21% of zygomatic-maxillary fractures and the falls is the main etiology. This type of fracture is easily reduced through several methods and the most used is the reduction through the surgical temporal approach of Gillies. The present patient illustrates the success treatment of a patient with isolated zygomatic arch fracture which a Foley catheter was used to stabilize the fracture reduction.

Retrieval of a Broken Dental Needle Close to the Facial Artery After Cervical Migration.

Use of imaging tools like digital C-arm, tridimensional tomography, and navigational surgery has proven its value to the surgical removal of broken needles. A 32-year-old patient was referred for evaluation of a fractured needle during inferior alveolar nerve block attempt few days before. The patient complained of a pricking sensation at the injured area while moving the neck. A contrasted computed tomography was performed for further evaluation of the needle toward the vascular network of the neck, showing a close location by the left facial artery, parallel to the styloid process of the temporal bone. The needle was then released from the underlying tissues and retrieved. Although considered a rare intercurrence, there are still reports of breaking needles during dental anesthesia. Such reports are almost always related to inferior alveolar nerve blocks, associated with the use of short, thin needles, and after multiple bending movements before the insertion of the needle in the tissues. Accurate image examinations such as contrasted computed tomography are of great importance for planning the surgical removal, especially in patients of migration next to important vessels of the neck.

Evaluation of Patients' Satisfaction after Class III Orthognathic Surgery.

BACKGROUND: Well-planned orthognathic surgery improves psychological health, aesthetics and function of patients. AIM: The present study aimed to investigate patients' satisfaction after orthognathic surgery by means of a satisfaction questionnaire before and after surgery. MATERIALS AND METHODS: A total of 29 patients was selected (17 women and 12 men), with a mean age of 28 years, randomly selected from a private clinic at Araçatuba - São Paulo by two investigators. Anamnesis and clinical examination were performed. Subjects with facial deformities submitted to orthodontic treatment before and after orthognathic surgery with a minimum post-surgery period of 6 months, answered a satisfaction questionnaire composed of 10 questions regarding dental and facial aesthetics. In this study, the maximum satisfaction score was 10. RESULTS: Regarding aesthetics, two satisfaction parameters were investigated: dental and facial. For all indices, the average satisfaction was up to score 7. CONCLUSION: According to the results, it can be concluded that orthognathic surgery has been an effective treatment for dentofacial deformities, aesthetics and functional problems, what was verified by pre and postoperative questionnaire application.

Bloco xenógeno para aumento do rebordo e colocação de implante dentário com finalidade estética na região anterior da maxila – relato de caso com dois anos de acompanhamento / The use of xenogeneic blocks for ridge augmentation and implant placement with esthetic purposes in the anterior maxillary region – a case report with 2 years of follow-up

Este artigo ilustra um caso clínico com aplicação de enxerto xenógeno e implantes dentários para aumento do rebordo na zona estética. Um paciente de 41 anos de idade apresentava perdas unitárias nas regiões 13 e 15. Após os exames iniciais e com TCFC, um bloco ósseo xenógeno foi colocado apenas na região do elemento 13 em função do defeito ósseo encontrado. Os implantes utilizados foram de 3,75 mm por 13,5 mm. Oito meses depois, os implantes foram expostos para os procedimentos protéticos. As coroas definitivas metalocerâmicas foram colocadas dez meses depois da cirurgia inicial. O controle tomográfico após dois anos e quatro meses demonstrou integridade do enxerto xenógeno com manutenção do volume inicialmente obtido na área do rebordo.

This article illustrates a clinical case with the use of xenogeneic graft and dental implants for ridge augmentation in the esthetic zone. A 41 years-old patient presented with two tooth loses at the regions 13 and 15. After initial and CBCT exams, a xenogeneic bone block was installed only at the 13 due to a bone defect. The implants used had 3.75 mm x 13.5 mm. Eight months later, the dental implants were exposed for prosthodontic procedures. Definitive metalloceramic crowns were delivered 10 months after the initial surgeries. The last CBCT has 2 years and 4 months and shows integrity of the xenogeneic block with the initial volume obtained still observed at the ridge augmentation area.

Estudo clínico retrospectivo da taxa de sucesso precoce de implantes osseointegrados / A retrospective clinical trial of the earlysuccess rate of osseointegrated implants

Introdução: os implantes se consolidaram como alternativa no tratamento do edentulismo, porém, algumas variantes envolvendo, por exemplo, o implante e o leito receptor podem interferir negativamente no sucesso do tratamento. As falhas dos implantes dentários podem ser classificadas como tardias ou precoces, dependendo do momento em que ocorreram. Objetivo: estabelecer o índice de sucesso precoce dos implantes realizados em um curso de especialização em Implantodontia no período de 2009 a 2012. Métodos: foram analisados os prontuários de pacientes tratados em um curso de especialização entre 2009 e 2012. O critério de inclusão empregado foi a instalação de implantes da marca P-I Brånemark Philosophy, utilizando-se da técnica cirúrgica de duas etapas para sua realização, sendo que esses permaneceram submersos por um período mínimo de três meses. Os pacientes selecionados receberam implantes em maxila e mandíbula, submetidas ou não a enxertos ósseos. A avaliação foi efetivada no momento da cirurgia de reabertura, não sendo levada em consideração a sobrevida dos implantes após o carregamento protético. Resultados: a taxa de sucesso foi de 97%, e os fatores que alteraram significativamente os resultados foram a presença ou não de enxerto ósseo e a localização do implante. Conclusões: o índice de sucesso obtido corrobora a literatura e evidencia que a experiência do operador não interfere, necessariamente, no resultado final do tratamento. Os achados demonstram, ainda, que a área de maior falha foi a região posterior, e que os sítios com enxerto ósseo apresentaram taxa de sucesso maior que os citados em outros estudos.

Introduction: Dental implants have become an alternative to treat edentulism, however, some variants involving theimplant itself and the receptor site can hinder treatment success. Dental implant failure is classified into late or early,depending on when it occurs. Objective: To determine the early success rate of implants installed during a specializationcourse in Implantodontics carried out between 2009 and 2012. Methods: The records of patients treatedbetween 2009 and 2012 were analyzed. The following inclusion criteria were applied: P-I Brånemark Philosophyimplants installed by means of the two-stage surgical technique, with implants submerged for a minimum period ofthree months. The selected patients underwent implant placement in the maxilla and mandible, subjected or not tobone graft. Evaluation was implemented at implant reopening. Implant survival after prosthetic loading was not considered.Results: The success rate was of 97%, with the presence or absence of bone graft, with implant positioningsignificantly influencing the final results. Conclusions: The success rate observed by this study not only corroboratesthe literature, but also reveals that the operator’s experience does not necessarily interferes in treatment outcomes.The findings also show that the posterior region had the highest number of failures, whereas bone graft sites had ahigher success rate in comparison to other studies.

Sialolito de grandes proporções localizado no ducto da glândula submandibular: diagnóstico e tratamento cirúrgico / Extensive sialolit located at submandible gland ducts: diagnosis and surgical treatment

A sialolitíase é caracterizada pela formação de cálculos (sialolitos) no sistema de ductos das glândulas salivares, provocando estase salivar e podendo acarretar a subseqüente dilatação da glândula salivar envolvida. Os sialolitos são formados por substâncias orgânicas e inorgânicas e sua patogênese permanece desconhecida, sendo duas hipóteses propostas. A primeira baseia-se na existência de microcálculos intracelulares que se acumulam com o passar do tempo e obstruem o ducto salivar. A segunda sugere que restos alimentares e bactérias presentes na cavidade oral migrariam para dentro dos ductos salivares causando a obliteração dos mesmos. Atualmente, existem várias formas de diagnóstico e tratamento dos episódios de sialolitíase, incluindo a excisão cirúrgica e a sialoendoscopia intervencional. O objetivo deste trabalho é apresentar a excisão cirúrgica de um cálculo de grandes proporções localizado no ducto da glândula submandibular em um paciente com queixa de dores constantes na região mandibular direita, elevação do assoalho bucal, diminuição da secreção de saliva e discreto desvio da língua. O procedimento cirúrgico foi o tratamento de escolha com total excisão do cálculo e posterior reconstrução do ducto. O pós-operatório de 18 meses mostrou fluxo salivar normal e ausência de recidiva.

Sialolithiasis is characterized by the formation of calculi (sialoliths) inside salivary glands duct system resulting in salivary ectasia and subsequent salivary gland dilation. Calculi are composed of organic and inorganic substances with its pathogenesis remaining unknown. Two main hypotheses are proposed: one consists of accumulation of pre existence intracellular micro calculi that accumulates in the course of time. The second theory suggests that aliments and bacteria presents inside the oral cavity migrate into the salivary ducts cause its obstruction. After clinical and/or radiographic sialolithiasis diagnosis different treatment modalities may be performed to treat this condition including surgical excision followed by ductal reconstruction or interventional sialendoscopy. The aim of this presentation is to demonstrate surgical excision of a large submandibular duct calculus in a patient complaining of constant pain at right mandible region, mouth floor elevation, diminish of salivary secretion, and slight tongue deviation. Surgical excision was conduct with totally calculi extirpation and submandibular duct reconstruction. Normal submandibular salivary flow was observed after 18 months of follow-up with no recurrence episodies.