Factors Associated With Violence Against Women and Facial Trauma of a Representative Sample of the Brazilian Population: Results of a Retrospective Study.

STUDY DESIGN: Violence against women is a challenge in public health. It involves women of all ages, socioeconomic statuses, cultures, and religions. OBJECTIVE: The objective of this study was to perform an epidemiological survey of facial trauma among women who experienced physical aggression by an intimate partner. METHODS: Electronic medical records from a public tertiary referral hospital for trauma in the Brazilian state of Espírito Santo were analyzed between 2013 and 2018. RESULTS: Patients were most commonly between 20 and 29 years of age (33.9%), and 50% of the patients were of mixed race. When separated by days of the week, facial trauma was most commonly inflicted on Sundays (24.2%) and on Saturdays (22.6%). Of the 62 women included in the study, 47 had facial fractures, and 7 had more than 1 concomitant fracture. Forty of the total fractures (72.7%) were on the middle and upper thirds of the face, while 15 fractures (27.3%) were on the lower third of the face. The most commonly observed signs and symptoms of these injuries were edema (56.5%), periorbital ecchymosis (35.5%), deviated nasal dorsum (22.6%), and hematoma (16.1%). CONCLUSIONS: Facial trauma may be considered an important marker of attempted femicide. Health care professionals must be aware of and attentive to this correlation, since many cases of attempted femicide go unnoticed or are attributed to another etiology.

Epidemiological analysis of 736 patients who suffered facial trauma in Brazil / Análisis epidemiológico de 736 pacientes que sufrieron trauma facial en Brasil

The etiology of facial fractures is directly related to the studied country, varying according to the socioeconomic, cultural condition of the population, besides the period of investigation. The objective of the present study is to evaluate the epidemiological characteristics of the prevalence, treatment modalities and complications rates of maxillofacial fractures in a hospital in the state of Espírito Santo, over a period of 5 years. A total of 428 patients presented a facial fracture, with a prevalence of males (436), with a mean age of 40 years. Regarding the number of fractures, 291 individuals suffered fractures only in the fixed skeleton, 97 only in the mandible, and 48 suffered fractures in both fixed and mandibular skeletons. The predominant anatomical site in fixed skeletal fractures was zygomatic complex (56.6 %), orbit (31.9 %) and nose (29.2 %); while in the mandible the condyle (33.8 %), body (17.9 %) and angle (13.1 %). The frequent etiology was falls, physical aggression, sports accidents. Regarding the type of treatment, in fixed skeleton 192 fractures were treated conservatively and 303 by surgery. Already in the mandible, the numbers were 43 and 143, respectively. In addition, 24 patients progressed with some type of complication in one or more operated sites. It is worth mentioning that epidemiological assessments provide important support in the creation of legislation in the attempt to reduce important for the establishment of clinical and research priorities, since risk factors and patterns of presentation can be identified. Accordingly in an attempt to reduce these rates.

La etiología de las fracturas faciales está directamente relacionada con el país estudiado, variando según la condición socioeconómica y cultural de la población, además del período de investigación. El objetivo del presente estudio fue evaluar las características epidemiológicas de la prevalencia, las modalidades de tratamiento y las tasas de complicaciones de las fracturas maxilofaciales en un hospital en el estado de Espírito Santo, durante un período de 5 años. Un total de 428 pacientes presentaron fractura facial, con una prevalencia de varones (436), con una edad media de 40 años. Con respecto al número de fracturas, 291 individuos sufrieron fracturas solo en el esqueleto fijo, 97 solo en la mandíbula y 48 sufrieron fracturas tanto en el esqueleto fijo como en el mandibular. El sitio anatómico predominante en las fracturas esqueléticas fijas fue el complejo cigomático (56,6 %), la órbita (31,9 %) y la nariz (29,2 %); mientras que en la mandíbula el cóndilo (33,8 %), el cuerpo (17,9 %) y el ángulo (13,1 %). La etiología frecuente fue caídas, agresión física, accidentes deportivos. En cuanto al tipo de tratamiento, en el esqueleto fijo se trataron 192 fracturas de forma conservadora y 303 mediante cirugía. Ya en la mandíbula, los números eran 43 y 143, respectivamente. Además, 24 pacientes progresaron con algún tipo de complicación en uno o más sitios operados. Cabe mencionar que las evaluaciones epidemiológicas brindan un apoyo importante en la creación de legislación en estos casos, para establecer prioridades clínicas y de investigación, debido a que se pueden identificar factores de riesgo y patrones de presentación. En consecuencia, en un intento de reducir estas tasas.

Queratocisto odontogênico em região anterior da maxila: relato de caso / Odontogenic keratocystic in the anterior region of the maxilla: case report

Introdução: O queratocisto odontogênico é uma lesão cística intra-óssea que se origina do resto celular da lâmina dentária. Possui crescimento lento, assintomático e é comumente encontrado em radiografias de rotina. É mais prevalente no sexo masculino entre a 2ª e 3ª décadas de vida e acomete preferencialmente a mandíbula. Objetivo: relatar um caso de queratocisto em região anterior da maxila e realizar uma revisão dos tratamentos que estão disponíveis para essa lesão. Relato de caso: paciente do sexo feminino, 46 anos de idade, durante exame radiográfico de rotina, exibiu área radiolúcida unilocular com borda esclerótica definida que se estendia do dente 11 ao 24. No exame clínico não foi possível notar nenhuma expansão da cortical óssea. Foi realizada biópsia e instalado, no mesmo momento cirúrgico, dispositivo para descompressão da lesão. Após análise histopatológica e confirmação diagnóstica, a paciente foi submetida a enucleação cirúrgica. Conclusão: o paciente permanece em acompanhamento há 3 anos sem sinais clínicos ou radiográficos de recidiva da lesão.

Introduction: The odontogenic keratocyst is an intraosseous cystic lesion that originates the cellular remnant of the dental blade. It has slow growth, asymptomatic and is commonly found in routine radiographs. It is more prevalent in males between the 2nd and 3rd decades of life and affects the mandible preferentially. Objective: to report a case of keratocystic in the anterior region ofthe maxilla and to review the available treatments for this lesion. Case report: A 46-year-old female patient, during the routine radiographicexamination, exhibited a unilocular radiolucent area with a sclerotic border according to the extension of tooth 11 to 24. Conclusion: the patient remained in follow-up for 3 years without clinical or radiographic signs of recurrence of the lesion.

Estudo comparativo entre dois programas de computador (Dolphin Imaging® e Nemotec®) e método manual para análises cefalométricas de pacientes com deformidade dentofacial Padrão II / Comparative study of two computer software programs (Dolphin Imaging® and Nemotec®) and a manual method of cephalometric analysis for patients with dentofacial deformity Class II

Este estudo analisou traçados digitais obtidos por dois programas de computador (Dolphin Imaging® e Nemotec®) em comparação aos obtidos pelo método manual nas análises cefalométricas SNA, SNB, Co-A, Co-Gn, altura facial anterior, A-Nperp, Pg-Nperp e plano mandibular. 30 pacientes leucodermas, portadores de retrognatismo mandibular, foram avaliados e submetidos à cirurgia ortognática para correção da deformidade por meio da osteotomia sagital do ramo mandibular. Os traçados cefalométricos foram realizados em telerradiografias laterais obtidas uma semana antes da cirurgia. O método Manual e o Nemotec® apresentaram excelente confiabilidade em todas as medidas. Por outro lado, o método Dolphin Imaging® apontou baixa confiabilidade nas medidas altura facial anterior, Co-A e Co-Gn. Nas medidas A-Nperp, Pg-Nperp, Plano md, SNA e SNB, não houve diferença entre três métodos estudados. Na medida altura facial anterior, houve diferença entre os métodos Dolphin Imaging® e Nemotec®, mas não foram observadas diferenças em relação ao método manual. Nas medidas Co-A e Co-Gn, foi observado que o método Dolphin Imaging® apresentou média significativamente inferior aos demais métodos estudados. No método manual, somente as medidas Co-Gn, Pg-Nperp e SNB confirmaram o diagnóstico de retrognatismo mandibular, tendo o programa Nemotec® apresentado resultados melhores que o programa Dolphin Imaging®... (AU)

This study analyzed digital tracings obtained by two different computer software programs (Dolphin Imaging® and Nemotec®) and compare them to the manual method using cephalometric measurements SNA, SNB, Co-A, Co-Gn, anterior facial height, A-Nperp, Pg-Nperp and mandibular plane. Thirty Caucasian patients exhibiting mandibular retrognathia were analyzed and were submitted to orthognathic surgery to correct the deformity by bilateral sagittal split osteotomy. The cephalometric tracings were performed with lateral radiographs that were obtained a week prior to the surgery. The manual method and the Nemotec® software exhibited an excellent reliability in all measurements. However, the Dolphin Imaging® method exhibited low reliability in the anterior facial height, Co-A and Co-Gn measurements. For the measurements of A-Nperp, Pg-Nperp, Mandibular plan, SNA and SNB, there were no significant differences between the three methods studied. For the anterior facial height measurement, a statistically significant difference was found between the Dolphin Imaging® and Nemotec® methods, although not in relation to the manual method. For the Co-A and Co-Gn measurements, the Dolphin Imaging® method exhibited a significantly lower mean than the other methods studied. In manual method, only the Co-Gn, Pg-Nperp and SNB measurements confirmed the diagnosis of mandibular retrognathia and Nemotec® software provided better results than Dolphin Imaging®... (AU)

Estudo comparativo entre teleradiografias de perfil escaneadas e fotografadas para uso no software Dolphin Imaging / A Comparison of Scanned and Corresponding Photographed Cephalograms For Use in Dolphin Imaging Software

O objetivo deste estudo foi comparar teleradiografias de perfil escaneadas e fotografadas para uso no Software Dolphin Imaging. Dez teleradiografias de perfil foram fotografadas para uso nesse programa computacional. Medidas lineares e angulares foram traçadas cefalometricamente e analisadas. Cada traçado foi repetido, duas vezes, no intervalo de 1 semana, pelo mesmo operador. As medidas foram tabladas no Microsoft Excel, e os testes t de Student e Wilcoxon foram utilizados para comparar cada medida. O coeficiente de correlação intraclasse foi utilizado para se verificar a padronização intraexaminador, e os resultados >0.92 indicavam alta confiabilidade. Nenhuma diferença estatisticamente significante foi observada entre os 2 grupos em todas as medidas lineares e angulares. Pode-se concluir, então, que ambos os métodos (fotografias e scanner) podem ser realizados para a utilização no Software Dolphin Imaging... (AU)

The purpose of this study was to compare scanned cephalograms to photographed cephalograms for use in Dolphin Imaging Software. Ten lateral cephalograms were photographed and scanned to be used in Dolphin Imaging Software. Linear and angular measurements were tracing and analyzed. Each tracing was repeated twice with 1-week interval, by the same operator. The measures were tabulated at Microsoft Excel and Students-t and Wilcoxon tests were used to compare each measurement. The intraclass correlator coefficient was used to test the intraexaminer reability and was >0.92 and it featured a high reability. No statistically difference was observed between the two groups, in all of the linear and angular measurements. We concluded that for the use in the Dolphin Imaging Software both methods (photographs and scanner) can be used... (AU)

Hipertrofia unilateral do músculo master: relato de caso / Unilateral Masseter Muscle Hypertrophy: Case Repor

A hipertrofia do músculo masseter é um crescimento excessivo uni ou bilateral do músculo, de etiopatogenia ainda não definida que, na maioria das vezes, gera um desconforto estético e em alguns casos, funcional. Os indivíduos afetados frequentemente exibem um aumento em volume ósseo em região de ramo e ângulo mandibular e o tratamento pode ser através de métodos cirúrgicos ou não cirúrgicos. A abordagem cirúrgica envolve intervenções que são realizadas, apenas, na musculatura comprometida, na estrutura óssea do ângulo mandibular ou ambos. O presente artigo descreve um caso de hipertrofia unilateral do músculo masseter, onde optou-se pela intervenção cirúrgica intraoral com ressecção de fibras musculares e osteotomia do ângulo mandibular. Após um período de dois meses de acompanhamento, observa-se que a modalidade cirúrgica para tratamento de hipertrofia do masseter está bem indicada pois proporciona ótimo resultado estético... (AU)

Masseter muscle hypertrophy is a unilateral or bilateral enlargement of the masseter muscle, of undefined etiology, which in most cases generates an aesthetic discomfort, and in some cases a functional one as well. The affected individuals often exhibit an increase in bone mass in the region of the branch and mandibular angle, and the treatment can use surgical or nonsurgical methods. The surgical approach involves intervetions performed in either the compromised muscle or the mandibular angle bone structure, or in both. This article describes a case of unilateral masseter muscle hypertrophy, where the surgical resection of the muscle fibers in an intraoral approach and a osteotomy with a reciprocating saw were performed in the mandibular angle region. After a two-month follow-up, it was observed that the surgical approach for the treatment of masseter hypertrophy is well advised, since the aesthetic results are excellent, with similarity to the contralateral side of mandibular angle... (AU)

Surgical treatment of odontogenic myxoma and facial deformity in the same procedure.

Odontogenic myxoma (OM) is an uncommon benign tumor with aggressive and invasive behavior. Predominant symptoms are usually slow and painless swelling, sometimes resulting in perforation of the cortical borders of the affected bone. In this paper, a case report of a patient with an OM on the right maxillary sinus and a vertical excess of maxilla will be presented. The treatment chosen was tumor resection in association with orthognathic surgery with biomodels assessment for surgical planning. A 3-year follow-up showed disease free and stability of the new position of maxilla. The international literature is evaluated to discuss this case report.

Prospective study of postoperative sensory disturbances after surgical treatment of mandibular fractures.

INTRODUCTION: This present study's purpose is to evaluate the degree of paresthesia and recovery of inferior alveolar nerve in patients with mandible fractures who underwent surgical treatment. MATERIAL AND METHODS: Nineteen patients were evaluated (27 hemimandibles) at six different times: preoperative (T1), postoperative 1 week (T2), postoperative 1 month (T3), postoperative 3 months (T4), postoperative 6 months (T5), and postoperative 1 year (T6). Subjective and objective methods were used for this evaluation. RESULTS: The results were analyzed using likelihood ratio chi-square test for the hypothesis of no association between indicators of sensitivity and responses to the questionnaire, and the Cochran-Mantel-Haenszel test for equality hypothesis. All objective tests showed a statistically significant worsening in sensitivity at T2 (p < 0.0001) and a significant improvement after T4 (α < 0.05). The subjective tests showed an association with the objectives tests, and improvement in sensitivity after T4 (p < 0.0001) was noted. DISCUSSION: The first postoperative week is the period in which there are major changes with respect to sensitivity, and after 3 months postoperatively, the recovery reaches its apex with little difference observed after this period. In this research 100 % of the patients analyzed recovered all sensibility until T6.

Evaluation of the use of biomodels in sequelae of maxillofacial trauma / Evaluación de la utilización de biomodelo de secuelas de traumatismo maxilofacial

The use of rapid prototyping technology in Oral and Maxillofacial Surgery has been increasing in the last decade, allowing the management of biomodels from medical image processing as computed tomography in order to obtain a three dimensional model with the same geometric characteristics as the virtual one. The aim of this study is to present the use of biomodels for treatment of maxillofacial trauma sequelae with evaluation of clinical records in a period that varies from January 2000 to December 2010. For diagnosis and surgical planning of maxillofacial sequelae in this period, some 15 prototypes were used, allowing us to determine the treatment planning with more accuracy and to save operating room time.

El uso de tecnología de prototipado rápido en Cirugía Oral y Maxilofacial se ha incrementado en la última década, lo que permite la gestión de los biomodelos de procesamiento de imágenes médicas, como tomografía computarizada para obtener un modelo tridimensional con las mismas características geométricas del virtual. El objetivo de este estudio es presentar el uso de biomodelos para el tratamiento de las secuelas de un traumatismo maxilofacial con la evaluación de las historias clínicas en un período que varía entre enero de 2000 a diciembre de 2010. Para el diagnóstico y la planificación de la cirugía maxilofacial de las secuelas en este período, 15 prototipos fueron utilizados, lo que permite determinar la planificación del tratamiento con más precisión y para ahorrar tiempo de quirófano.

Recurrent mandibular dislocation treated by eminectomy.

Mandibular dislocations present with frequency; when they are recurrent and sustained over time, surgical treatment is indicated. Although different therapeutic techniques exist, the eminectomy is one of the most often applied. In this investigation, 3 cases are described where the bilateral eminectomy was performed for recurrent mandibular dislocation with 5 years of duration. No dislocation recurrence, postoperative pain, or functional alterations were observed in any of the patients. The bilateral eminectomy is a well-known procedure described in the literature, with good scientific support and constant modifications to optimize its indications and results. Compared with the results from other investigations, it is concluded that treatment with a bilateral eminectomy can be applied safely in cases of recurrent mandibular dislocations.

Cervicofacial pain associated with Eagle's syndrome misdiagnosed as trigeminal neuralgia.

BACKGROUND: Eagle's syndrome is characterized by the symptoms of recurrent throat pain, pharyngeal foreign body sensation, dysphagia, referred otalgia, and neck pain. The treatment for Eagle's syndrome can be pharmacologically, surgically, or both. The surgical management consists of two major procedures: the transoral approach or the extraoral-cervical approach. CASE REPORT: A 64-year-old patient with a severe cervical pain on the left side was evaluated with no defined diagnosis. During physical examination, an elongated styloid process could be palpated and with CT scan image, the Eagle's syndrome diagnosis was done. The patient was successfully submitted to surgical resection of the elongated styloid process on the left side by an extraoral-cervical approach. After 6 months follow-up, the patient referred no symptom after the surgical treatment. CONCLUSION: The extraoral/cervical approach is a safe alternative that achieves adequate treatment of Eagle's syndrome.

Using biomodels for maxillofacial surgeries: 10 years of experience in a Brazilian public service

Aim: To evaluate 10 years of experience of use of biomodels at the Department of Oral andMaxillofacial Surgery of the Piracicaba Dental School, University of Campinas (UNICAMP),Brazil, showing the difficulties and importance of using biomodels in a public oral and maxillofacialsurgery service. Methods: The records of all patients treated at the referred Department of Oraland Maxillofacial Surgery between January 2000 and December 2010 were reviewed. Results:Biomodels were used in 63 cases, including pathologies (47%), trauma sequelae (23%),dentofacial deformities (8%), temporomandibular joint anomalies (8%), implant surgery (8%)and maxillofacial prosthesis (6%). These cases were performed in a partnership with RenatoArcher Information of Technology Center – CTI, Campinas, Brazil. Conclusions: The partnershipwith CTI enables the use of prototypes for treatment planning of patients of a public health systemusing selective laser sintering, a cheaper prototyping method. The patients can benefit from thistechnology, without any costs for them.

Comparative study between 2 methods of mounting models in semiadjustable articulator for orthognathic surgery.

PURPOSE: Compare the traditional method of mounting dental casts on a semiadjustable articulator and the new method suggested by Wolford and Galiano, 1 analyzing the inclination of maxillary occlusal plane in relation to FHP. MATERIALS AND METHODS: Two casts of 10 patients were obtained. One of them was used for mounting of models on a traditional articulator, by using a face bow transfer system and the other one was used to mounting models at Occlusal Plane Indicator platform (OPI), using the SAM articulator. After that, na analysis of the accuracy of mounting models was performed. The angle made by de occlusal plane and FHP on the cephalogram should be equal the angle between the occlusal plane and the upper member of the articulator. RESULTS: The measures were tabulated in Microsoft Excell(®) and calculated using a 1-way analysis variance. Statistically, the results did not reveal significant differences among the measures. CONCLUSION: OPI and face bow presents similar results but more studies are needed to verify its accuracy relative to the maxillary cant in OPI or develop new techniques able to solve the disadvantages of each technique.

Correção de deformidade transversa de maxila associada à cirurgia ortognática: um ou dois tempos cirúrgicos? / Correction of maxillary transverse deficiency combined with orthognathic surgery: a single or 2-stage surgical approach?

A deficiência transversa de maxila é uma das deformidades maxilofaciais mais comumente encontradas. Seu tratamento pode ser realizado apenas com uso da ortodontia, se o paciente ainda estiver em fase de crescimento (expansão rápida de maxila). Após a maturação óssea, as opções de tratamento são a expansão rápida de maxila assistida cirurgicamente (ERMAC) ou a osteotomia segmentada da maxila, cada uma com suas indicações, vantagens e desvantagens. O objetivo deste trabalho é o de relatar um caso de ERMAC prévia à cirurgia ortognática e discutir sobre as vantagens em realizar esse procedimento em um ou dois tempos cirúrgicos, além de tecer importantes considerações sobre a técnica.

Transverse maxillary deficiency is one of the most common maxillofacial deformities. Its treatment can be conducted 33 only with the use of orthodontics if the patient is still in the growth phase (rapid maxillary expansion). After skeletal maturation, treatment options are surgically assisted rapid maxillary expansion (SARME) or segmented maxillary osteotomy, each with its indications, advantages and disadvantages. This paper reports a case of SARME prior to orthognathic surgery and discusses the advantages of performing this procedure in one or two surgical steps, as well as addressing a number of important considerations regarding the technique.