Influence of impacted canines on the stress distribution during dental trauma with and without a mouthguard.

BACKGROUND/AIM: Maxillary canines have a high incidence of impaction which may be associated with unexpected damage during maxillofacial trauma. The aim of this study was to evaluate how an impacted canine could influence the stress distribution in the dentoalveolar complex during a simulated impact before and after surgical removal plus the protective effect offered by a mouthguard. MATERIALS AND METHODS: Cross-sectional finite element models of the central incisor and support structures of a patient with an impacted canine in a transverse position were made using ImageJ and Marc/Mentat software. The following impact conditions were simulated: (a) incisor with impacted canine; (b) incisor with surgical socket after impacted canine extraction; and (c) incisor after bone healing. The impacts were also simulated with a 3 mm custom-fitted ethylene vinyl acetate mouthguard. A non-linear dynamic impact finite element analysis was performed in which a rigid object hit the model at 1 m/s. Maximum and minimum principal stresses as well as von Mises stresses were analyzed. RESULTS: Higher values of compressive and tensile stresses occurred on the cortical bone in the models after impacted canine extraction. The highest stress concentrations in the enamel and dentin structures were observed after bone healing. The mouthguard reduced the stress in the alveolar bone and dental structures. CONCLUSIONS: Use of mouthguards during impact reduced the compressive and tensile stresses in the alveolar bone, mainly in the fragile regions of the impacted canine or surgical socket.

Are insertion torque and early osseointegration proportional? A histologic evaluation.

OBJECTIVES: The objective of this histologic study was to determine the effect of three drilling protocols (oversized, intermediate, and undersized) on biologic responses to a single implant type at early healing periods (2 weeks in vivo) in a beagle dog model. MATERIALS AND METHODS: Ten beagle dogs were acquired and subjected to surgeries in the tibia 2 weeks before euthanasia. During surgery, each dog received three Unitite implants, 4 mm in diameter by 10 mm in length, in bone sites drilled to 3.5, 3.75, and 4.0 mm in final diameter. The insertion torque was recorded during surgery, and bone-to-implant contact (BIC), and bone area fraction occupied (BAFO) measured from the histology. Each outcome measure was compared between treatment conditions with the Wilcoxon signed-rank test. Bonferroni-corrected statistical significance was set to 95%. RESULTS: Insertion torque increased as an inverse function of drilling diameter, as indicated by significant differences in torque levels between each pair of conditions (P = 0.005). BIC and BAFO levels were highest and statistically similar in the recommended and undersized conditions and significantly reduced in the oversized condition (P < 0.01). CONCLUSIONS: Reduced drilling dimensions resulted in increased insertion torque (primary stability). While BIC and BAFO were maximized when drilling the recommended diameter hole, only the oversized hole resulted in evidence of statistically reduced integration.

Fratura mandibular durante remoção do terceiro molar: fatores de risco, medidas preventivas e métodos de tratamento / Mandibular fracture during third molar removal: risk factors, preventive measures and treatment methods

Fraturas mandibulares durante à extração do terceiro molar é uma complicação incomum, com consequências graves. Ocorrem quando a força de resistência do tecido ósseo e menor que as forças aplicadas durante o procedimento. O objetivo deste trabalho consiste em apresentar um caso clínico de fratura mandibular durante a exodontia do terceiro molar e também discutir os riscos, medidas preventivas e métodos de tratamento.

Mandibular fracture during third molar removal is an uncommon complication, with serious consequences. This occurs when the forces applied during surgery exceeds the strength of bone. The objective of this work is present a clinical case of mandibular fracture during third molar removal and also, discuss the risks, preventive measures and treatment methods.

Fratura mandibular após ferimento por arma branca: diagnóstico e conduta clínica / Mandibular fracture after stab wounds: diagnosis and clinical conduct

INTRODUÇÃO - Os ferimentos em face por armas brancas são raros, mas quando ocorrem, o cirurgião Buco-Maxilo-Facial deve estar apto a tratar esse tipo de lesão, haja vista que os insucessos podem resultar em alterações estético-funcionais que podem ser prejudiciais tanto funcional como psicologicamente. OBJETIVO - O artigo em questão buscou relatar um caso clinico de um paciente vitima de agressão física com extensa laceração em face por arma branca. CONCLUSÃO - O conhecimento dos princípios básicos de tratamento de lesões nos tecidos moles da face por arma branca é de suma importância para o alcance a resultados estéticos e funcionais satisfatórios.

INTRODUCTION - Facial stab wounds are rare but when occurs, the Maxillo-Facial surgeon should be able to treat this injury, given that failures can result in aesthetic and functional changes that can be functionally and psychologically harmful. OBJECTIVE - The article in question report a clinical case of a patient victim of assault with extensive facial laceration by a knife. CONCLUSION - Treatments knowledge about soft tissue injuries by facial stab wounds has a great importance to achievinga satisfactory aesthetic and functional result.

Tratamento de fratura mandibular em paciente gestante: relato de caso / Treatment of mandibular fractures in pregnancy: case report

As fraturas mandibulares são as mais frequentes envolvendo o complexo bucomaxilofacial. Fraturas simples de mandíbula com pouco deslocamento tornam-se favoráveis ao tratamento, facilitando o acesso cirúrgico e a instalação do material de osteossíntese. No presente relato, apresentamos um caso clínico de tratamento de fratura mandibular em paciente gestante, sob anestesia local, discutindo a indicação dessa abordagem terapêutica e as suas vantagens.

Mandible fractures are the most common involving the maxillofacial complex. Simple fractures of the mandible with little displacement offers a favorable treatment, facilitating surgical access and installation of the osteosynthesis material. In this report, we present a case of mandibular fracture treatment in a pregnant patient under local anesthesia, discussing the indication for this therapeutic approach and its advantages.