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1.
Br J Oral Maxillofac Surg ; 62(1): 15-22, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38101969

RESUMO

Numerous procedures can potentially injure the inferior alveolar nerve during oral and maxillofacial surgery, eventually causing loss or alteration of local sensitivity. When its total rupture occurs, a conduit, such as an autogenous graft, can be used to join it. Due to the morbidity resulting from this technique, alternative forms of sensorineural repair have been investigated. This systematic review includes an electronic search of PubMed, Embase, LILACS, and Web of Science databases, in addition to a grey literature and manual search. Article selection was performed by two independent researchers following a predetermined inclusion criterion: human studies evaluating the regression of sensorineural disorders after any form of grafting (autogenous, allogeneic, and synthetic). Of the 789 studies, 648 were analysed. Only 11 articles met the eligibility criteria. After analysing the results, it was noted that regaining normal sensitivity was uncommon, but the majority of reconstructed nerves recovered their protective abilities. Allografts showed success rates similar to autogenous grafts, making them a viable alternative. However, clinical trials are still needed to provide solid evidence. Prognosis for sensory recovery was impacted by grafting time and patient age.


Assuntos
Nervo Mandibular , Procedimentos Neurocirúrgicos , Humanos , Nervo Mandibular/cirurgia , Resultado do Tratamento , Transplante Homólogo , Procedimentos Neurocirúrgicos/métodos
2.
Br J Neurosurg ; : 1-6, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35708248

RESUMO

Surgery to expose the anterior occiptocervical junction (OCJ) is exacting, and optimal approaches are debatable. The close proximity of vital structures and difficult surgical access present a unique challenge to treat lesions in this area. Routine access to the upper anterior cervical spine remains limited. The authors present a modified retropharyngeal approach and instrumentation in order to resect an exceptionally rare atypical rhabdoid teratoid tumor involving the craniovertebral junction. The technical aspects of this approach in anatomical perspectives are discussed in this article.

3.
Dentomaxillofac Radiol ; 51(3): 20210340, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34520241

RESUMO

OBJECTIVES: A systematic review was performed to analyze the current evidence on three-dimensional (3D) computed tomography (CT) superimposition protocols used to assess dentomaxillofacial changes after orthognathic and orthofacial surgery. Accuracy, reproducibility, and efficiency were evaluated. METHODS: The search was divided into Main Search (PubMed, EMBASE, Cochrane Library, LILACS, and SciELO), Grey Literature search (Google Scholar and Open Grey), and Manual search. Thirteen studies were included. Of these, 10 reported data on accuracy, 10 on reproducibility and five on efficiency. Seven proposed or evaluated methods of voxel-based superimposition, three focused on the surface-based technique, one compared surface- and voxel-based superimposition protocols, one used the maximum mutual information algorithm, and one described a landmark-based superimposition method. Cone-beam computed tomography (CBCT) was the most common imaging technique, being used in 10 studies. RESULTS: The accuracy of most methods was high, showing mean differences smaller than voxels' dimensions, ranging between 0.05 and 1.76 mm for translational accuracy, and 0.10-1.09° for rotational accuracy. The overall reproducibility was considered good as demonstrated by the small mean error (range: 0.01-0.26 mm) and high correlation coefficients (range: 0.53-1.00). Timing to complete virtual superimposition techniques ranged between a few seconds up to 40 min. CONCLUSIONS: Voxel-based superimposition protocols presented the highest accuracy and reproducibility. Moreover, superimposition protocols that used automated processes and involved only one software were the most efficient.


Assuntos
Cirurgia Ortognática , Protocolos Clínicos , Tomografia Computadorizada de Feixe Cônico/métodos , Ossos Faciais , Humanos , Imageamento Tridimensional/métodos , Reprodutibilidade dos Testes
4.
5.
J Craniofac Surg ; 31(6): e546-e549, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32371687

RESUMO

The authors report a 25-year-old female who presented facial palsy after undergoing bimaxillary orthognathic surgery for retrognathism correction. Orthognathic surgery is a procedure used to treat dentofacial deformities which aims to achieve an adequate relationship between dental archs, improving function (such as chewing, breathing, and speaking) and facial aesthetics. Even though there are some complications that can occur during the intraoperative and postoperative periods like bleeding, tooth, soft-tissue damage, nerve damage, bad split, infection, and nonunion, facial nerve injuries are considered rare complications after this kind of surgical procedure. Despite being uncommon, rarely described, transient, and spontaneously resolved in almost all patients, facial nerve palsy is one of the most serious complications because it directly affects patient's quality of life and social interaction.


Assuntos
Nervo Facial , Paralisia Facial/etiologia , Procedimentos Cirúrgicos Ortognáticos/efeitos adversos , Adulto , Feminino , Humanos , Qualidade de Vida , Resultado do Tratamento
6.
J Craniofac Surg ; 31(1): e75-e78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31634309

RESUMO

OBJECTIVE: This article describes the case report of a prostate adenocarcinoma in the mandible. BACKGROUND: Prostate adenocarcinoma is a malignant tumor common in men from the fourth decade of life. The occurrence of oral metastatic lesions is rare. CASE REPORT: A 78-year-old male patient was referred to the oral and maxillofacial surgery service of the Pontifical Catholic University of Rio Grande do Sul for complaints of painless volume increase in the mandible. The diagnosis through the association of clinical, radiographic, and histopathological examination with the patient's health history determined that the lesion was prostatic adenocarcinoma metastasis. CONCLUSION: Despite the rare occurrence of metastases in the oral region, the dental surgeon should be aware of the possibility for correct diagnostic conduction and, subsequently, the institution of treatment in the early stages of disease.


Assuntos
Adenocarcinoma/secundário , Maxila/patologia , Neoplasias da Próstata/patologia , Idoso , Humanos , Masculino , Mandíbula/patologia
7.
RFO UPF ; 24(2): 309-315, maio/ago. 2 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1049684

RESUMO

Objetivo: demonstrar, por meio de uma revisão de literatura, a utilização do hormônio do crescimento (GH) e concentrados plaquetários e sugerir técnica de associação de uso para odontologia em processos de preservação de osso alveolar. Revisão de literatura: enxertos ósseos são uma necessidade na área da saúde, por diversas razões. A utilização de osso autógeno apresenta grande desvantagem em ter um segundo sítio cirúrgico, entretanto, os substitutos ósseos não possuem as características ideais. Assim, existe a busca por alternativas que otimizem a cicatrização e a incorporação dos substitutos ósseos, dentre elas os concentrados sanguíneos, ricos em fatores de crescimento derivados das plaquetas e o hormônio do crescimento. É possível encontrar uma vasta literatura utilizando os concentrados sanguíneos, inclusive utilizando esses como veículos para outras substâncias. Os concentrados sanguíneos são ricos em fatores de crescimento derivados das plaquetas, como fator de crescimento semelhante à insulina (IGF), Fator de crescimento derivado de plaquetas (PDGF) e outros. Além disso, também é possível encontrar, na literatura, o uso tópico de hormônio do crescimento em enxertos ósseos, fraturas e implantes dentários. Entretanto, o GH possui uma meia-vida de 20 minutos, assim, quando utilizado em conjunto com a I-PRF, espera-se um aumento no tempo de ação local. Considerações finais: é possível otimizar os enxertos ósseos utilizando-se L-PRF/I-PRF e hormônio do crescimento. Porém, são necessárias mais pesquisas.(AU)


Objective: this study aims to show through a literature review the use of the growth hormone and platelet concentrates and to suggest an association technique for dentistry use in alveolar bone preservation processes. Literature review: bone grafts are a health requirement for a number of reasons. The use of autogenous bone has the main disadvantage of a second surgical site, while bone substitutes do not present optimal characteristics. Thus, there is a search for alternatives that optimize the healing and incorporation of bone substitutes, which include blood concentrates that are rich in platelet-derived growth factors and the growth hormone. A vast literature can be found on blood concentrates, including their use as vehicles to other substances. Blood concentrates are rich in platelet-derived growth factors such as IGF, PDGF, and others. Moreover, the literature also shows the topical use of the growth hormone in bone grafts, fractures, and dental implants. However, the growth hormone presents a half-life of 20 minutes; therefore, when combined with I-PRF, an increased time in local action is expected. Final considerations: it is possible to optimize bone grafts by using L-PRF/I-PRF and the growth hormone. However, further research is required.(AU)


Assuntos
Humanos , Hormônio do Crescimento/uso terapêutico , Processo Alveolar/fisiopatologia , Aumento do Rebordo Alveolar/métodos , Fibrina Rica em Plaquetas , Terapia Combinada
8.
RFO UPF ; 24(2): 273-278, maio/ago. 2 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1049671

RESUMO

Objetivo: o transplante dentário é uma técnica cirúrgica que consiste na movimentação cirúrgica de um dente, podendo ser vital ou tratado endodonticamente, o qual é submetido a uma avulsão do seu local de origem e implantado em outro alvéolo. Relato de caso: paciente do sexo masculino, 18 anos, normossistêmico, buscou atendimento no Serviço de Cirurgia e Traumatologia Bucomaxilofacial da Pontífica Universidade Católica do Rio Grande do Sul (PUCRS) apresentando cárie no dente 26. O plano de tratamento consistiu em realizar um autotransplante do dente 28 para o alvéolo do dente 26. Após 8 meses do transplante, o dente apresentava em boas condições periodontais avaliadas clinicamente e em exame radiográfico. Considerações finais: o transplante dentário autógeno pode ser uma opção viável para a substituição de molares ausentes ou com cáries extensas, como mostrado no presente caso clínico. (AU)


Objective: Dental transplantation is a surgical technique that consists of the surgical movement of an either vital or endodontically treated tooth, which is subjected to an avulsion from its place of origin and implanted in another socket. Case report: An 18-year-old male patient, normosystemic, attended the Oral and Maxillofacial Traumatology Surgery Service of PUCRS presenting a decayed tooth 26. The treatment plan consisted of the autotransplantation of tooth 28 to the alveolus of tooth 26. Eight months after the transplantation, the tooth presented satisfactory periodontal conditions by clinical and radiographic assessments. Final considerations: The autogenous dental transplantation may be a viable option for replacing absent molars or with extensive caries, as shown in the present clinical case. (AU)


Assuntos
Humanos , Masculino , Adolescente , Dente/transplante , Reimplante Dentário/métodos , Cárie Dentária/cirurgia , Transplante Autólogo , Radiografia Dentária , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Alvéolo Dental/cirurgia
10.
RFO UPF ; 24(1): 38-43, 29/03/2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1048401

RESUMO

Introdução: o odontoma é um tipo de tumor do epitélio odontogênico com ectomesênquima, podendo estar relacionado à presença de dentes não irrompidos. O tratamento consiste em excisão cirúrgica da lesão. Nor-malmente, dentes impactados são assintomáticos, sendo descobertos em radiografias de rotina. A impactação é causada por fatores sistêmicos ou etiológicos locais. Objetivo: reportar um caso clínico de uma criança com impactação dentária de um incisivo central superior esquerdo associado a um odontoma, enfatizando e discutindo a técnica cirúrgica e o planejamento realizado. Relato de caso: paciente de 13 anos de idade, do gênero feminino, com a não erupção do incisivo central superior esquerdo, ao exame clínico, apresentou ausência clínica do dente 21, persistência do dente 61 e um discreto aumento de volume entre os elementos 61 e 22. Foi solicitada uma tomografia computadorizada de feixe cônico (cone beam) da região, na qual se diagnosticou a presença de uma massa radiopaca envolta por um halo radiolúcido sugestivo de odontoma composto, alterando a posição e impedindo a erupção do dente 21, que se encontrava em posição transal-veolar. O plano de tratamento proposto foi remoção cirúrgica do odontoma e tracionamento do dente não irrompido. Conclusão: a remoção cirúrgica de patologias associadas e as manobras referentes aos dentes envolvidos devem ser realizadas no momento mais oportuno e com adequado planejamento, evitando lesões a estruturas nobres e permitindo, assim, um processo de reparo adequado e uma completa restauração da saúde bucal do paciente. (AU)


Introduction: Odontoma is a type of tumor of the odontogenic epithelium with ectomesenchyme and it may be related to the presence of unerupted teeth. The treatment consists of surgical excision of the lesion. Usually, unerupted teeth are asymptomatic and discovered in routine radiographs. Impaction is caused by local systemic or etiological factors. Objective: The present study aims to report a clinical case of a child with an impacted upper central incisor associated with an odontoma, highlighting and discussing the surgical technique and treatment planning. Case report: A 13-year-old female patient without eruption of the left upper central incisor. After clinical examination, the absence of tooth 21, persistence of tooth 61, and a discrete volume increase between elements 61 and 22 were observed. A cone beam computed tomography of the region was requested, which diagnosed the presence of a radiopaque mass involved by a radiolucent halo suggestive of compound odontoma. This condition changed the position and prevented the eruption of tooth 21, which was found in a transalveolar position. The treatment plan proposed was the surgical removal of the odontoma and orthodontic traction of the unerupted tooth. Conclusion: The surgical removal of associated pathologies and maneuvers related to the teeth involved should be performed in a timely manner, with adequate planning, preventing lesions in noble structures, thus allowing an adequate repair process and a complete restoration of the oral health of the patient. (AU)


Assuntos
Humanos , Feminino , Adolescente , Dente Impactado/cirurgia , Neoplasias Maxilares/cirurgia , Odontoma/cirurgia , Incisivo/cirurgia , Dente Impactado/complicações , Neoplasias Maxilares/complicações , Odontoma/complicações , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico
11.
J Craniofac Surg ; 29(7): 1934-1938, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30204726

RESUMO

Cases of severely atrophic edentulous maxilla require reconstruction techniques employing bone grafts to promote adequate bone dimension for the successful placement of dental implants for prosthetic rehabilitation that reestablishes the patient's function and aesthetics. This study aims to present a severely atrophic edentulous maxilla reconstruction with the off-label use of recombinant human bone morphogenetic protein type 2 (rhBMP-2) associated with lyophilized particulate bovine bone xenograft for the prosthetic rehabilitation with osseointegrable dental implants. The paper describes a case of severely atrophic edentulous maxilla in a 42-year-old woman referred to the dental school with complaint of failure in adaptating to the dentures. The patient reported 27 years of maxilla edentulism and consecutive treatment failures, so the proposed therapy was the reconstruction of the maxilla with an association of rhBMP-2 and lyophilized bovine bone xenograft for increasing bone volume and further prosthetic rehabilitation with osseointegrated dental implants. The present report illustrates a case of atrophic edentulous maxilla in which the off-label use of rhBMP-2 was successful and the patient's prosthetic rehabilitation could be concluded. The 8 dental implants received prosthetic functional load during 1 year of follow-up with no complications. Based on the case presented, the association between rhBMP-2 and a bovine bone xenograft could be considered a viable option for the reconstruction of atrophic edentulous maxilla. After a year of functional prosthetic load follow-up, the patient is asymptomatic and satisfactorily adaptated to the prosthesis, which restored her functional and aesthetic demands.


Assuntos
Proteína Morfogenética Óssea 2/uso terapêutico , Transplante Ósseo/métodos , Implantação Dentária Endóssea/métodos , Arcada Parcialmente Edêntula/cirurgia , Maxila/cirurgia , Fator de Crescimento Transformador beta/uso terapêutico , Adulto , Animais , Atrofia/cirurgia , Bovinos , Prótese Dentária Fixada por Implante , Estética Dentária , Feminino , Liofilização , Humanos , Maxila/patologia , Proteínas Recombinantes/uso terapêutico
12.
J Craniofac Surg ; 29(6): e598-e603, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29877980

RESUMO

The purpose of this study was to evaluate cervical lordosis and head posture changes using lateral cephalographs after bimaxillary orthognathic surgery for mandibular prognatism by null hypothesis. Twenty-five patients with skeletal class III dentofacial deformities (10 men, 15 women; mean age, 29.28 ±â€Š8.23 years; range 18-48 years) were included in this prospective clinical study. Lateral cephalographs were taken in natural head position (NHP) 2 weeks before and 6 months after orthognathic surgery. The reproducibility of the radiographer's technique of taking radiographs in NHP was investigated using a photographic method and found to be acceptable. All measurements for cervical lordosis (CV1/CV2; CV3/CV7; CV1/CV7), head posture (NSL/OPT; NSL/VER), and other cephalometric values (NSL/Go-Gn; NSL/OCL; Overjet) were repeated 3 times by the same blinded investigator at 2-week intervals and the average values of the 3 measurements were calculated to use in statistical analysis. Intraclass correlation coefficients (ICC) ranged between 0.996 and 1.000, demonstrating a high reliability of the measures. Statistically significant differences were found for CV3/CV7 (P = 0.006) and CV1/CV7 (P = 0.005) and no significant differences were identified in head posture for both cranio-cervical and cranio-vertical angles. The null hypothesis was rejected. Orthognathic surgery resulted in significant cervical lordosis extension, and a tendency for head extension could also be observed.


Assuntos
Lordose/cirurgia , Cirurgia Ortognática/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Adolescente , Adulto , Cefalometria/métodos , Vértebras Cervicais , Feminino , Humanos , Lordose/diagnóstico , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Postura , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
13.
Oral Maxillofac Surg ; 22(2): 143-150, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29442244

RESUMO

PURPOSE: This study aimed to assess body posture before and after bimaxillary orthognathic surgery by photogrammetry in skeletal class III patients. METHODS: Thirty-one patients with skeletal class III dentofacial deformities (14 men, 17 women) who underwent orthodontic preparation for surgery were included in this non-randomized controlled trial. Of these, 15 who did not undergo orthognathic surgery during the period of this study served as controls. Postural assessment was performed by photogrammetry using SAPO® (Postural Assessment Software) based on anterior-, posterior-, and lateral-view images taken 1 month before and 4 months after bimaxillary orthognathic surgery with internal rigid fixation (or 4 months after the initial assessment, for the control group). The study was approved by PUCRS Research Ethics Committee, and written informed consent was obtained from all individual participants prior to their inclusion in the study. RESULTS: There was no significant difference between groups for age, gender, and GAP. In the intervention group, the right leg/hindfoot angle, which initially indicated a valgus deformity, normalized after intervention (P < 0.048). Posterior displacement of the head (P < 0.005) and trunk (P < 0.004) were observed after intervention. CONCLUSIONS: These results suggest that correction of class III dentofacial deformities by bimaxillary orthognathic surgery can produce systemic postural adjustments, especially posterior displacement of the head and trunk and knee and ankle valgus.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Cirurgia Ortognática/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fotogrametria/métodos , Adolescente , Adulto , Pontos de Referência Anatômicos , Deformidades Dentofaciais/cirurgia , Feminino , Humanos , Masculino , Mandíbula/anatomia & histologia , Mandíbula/cirurgia , Maxila/anatomia & histologia , Maxila/cirurgia , Adulto Jovem
14.
J Oral Maxillofac Surg ; 76(2): 426-435, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28822721

RESUMO

PURPOSE: To determine the postural characteristics of patients with Class III dentofacial deformities before orthognathic surgery by photogrammetry using SAPO postural assessment software. MATERIALS AND METHODS: This was a cross-sectional study. Eligible participants were adult patients who had an indication for orthognathic surgery to correct skeletal Class III dentofacial deformities and were undergoing orthodontic preparation for surgery. Patients were recruited at the outpatient clinic for dentofacial deformities of the authors' institution from March to November 2015. Postural assessment was performed by photogrammetry based on anterior, posterior, and lateral images, which were analyzed using SAPO software. RESULTS: The sample consisted of 40 patients with a mean age of 28.7 years; 55% were men. Postural changes were found in most anatomic structures, and the main changes were anterior displacement of the center of gravity (sagittal plane asymmetry, 43.77%) and a tendency to left lateral deviation (frontal plane asymmetry, -3.89%). The anterior view showed a pattern of head tilt to the left (measured value minus reference value [Δ], -0.22), elevation of the left acromion (Δ, 2.31), elevation of the right anterior superior iliac spine (Δ, -0.56), right knee with genu varum (Δ, 1.25), and left knee with genu valgum (Δ, -1.55). The posterior view displayed scapular asymmetry with abduction of the right scapula (Δ, 7.54) and valgus foot deformity (Δright, 8.35; Δleft, 11.60). The lateral view depicted decreased cervical lordosis (Δright, 22.63; Δleft, 19.98), pelvic anteversion (Δright, -0.56; Δleft, -0.26), and genu flexum at the right (Δ, 6.85) and left (Δ, 4.40) knees. Twenty-seven patients (67.5%) reported temporomandibular joint pain. CONCLUSIONS: Postural assessment by photogrammetry showed that most anatomic structures were outside the normal range in patients with skeletal Class III dentofacial deformities before orthognathic surgery. These results suggest that dentofacial abnormalities can lead to postural disorders in this population.


Assuntos
Má Oclusão Classe III de Angle/fisiopatologia , Postura/fisiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Ortognáticos , Fotogrametria , Software
15.
Int J Oral Maxillofac Implants ; 32(3): e183-e189, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28494049

RESUMO

PURPOSE: Biomaterials, as an alternative to autogenous bone and other biologic tissues, have been widely used in oral and maxillofacial surgery. In this context, a biomaterial that functions as a scaffold (osteoconductor), combined with a growth factor (osteoinductor), would be of great interest for clinical application. Biodegradable polymers used for slow drug release have been investigated, demonstrating good results and interesting potential. Growth hormone (GH) may be released by incorporating it into these polymers. This study aimed to evaluate cell adhesion and proliferation of a polymeric biomaterial for slow release of recombinant human GH (rhGH). MATERIALS AND METHODS: Poly(lactic-co-glycolic acid) (PLGA) and PLGA/polycaprolactone (PCL) (at a 70/30 ratio of PLGA to PCL) matrices were prepared by the solvent evaporation method, combined or not with GH. Biomaterials were tested for cell adhesion and proliferation by culture in mesenchymal stem cells derived from Wistar rat bone marrow, 4',6-diamidino-2-phenylindole (DAPI) staining, and subsequent cell counting, in addition to scanning electron microscopy. Cell adhesion and proliferation was assessed at 24 and 72 hours of biomaterial exposure to culture medium. RESULTS: All tested polymers exhibited cell adhesion and proliferation. However, PLGA-based biomaterials, especially when combined with GH, showed greater cell proliferation when the difference in growth from 24 to 72 hours was evaluated. GH appeared to modify the polymer surface, with increased roughness and microporosity. This feature was more evident in the PLGA + GH combination. CONCLUSION: The biomaterials tested showed pronounced cell adhesion in all test groups, and GH appeared to contribute to the increase in cell proliferation, especially when combined with PLGA as compared with pure PLGA. Further studies are required to clarify this potential for development of new biomaterials.


Assuntos
Materiais Biocompatíveis , Células da Medula Óssea/citologia , Adesão Celular/fisiologia , Proliferação de Células/fisiologia , Hormônio do Crescimento Humano/administração & dosagem , Células-Tronco Mesenquimais/fisiologia , Tecidos Suporte/química , Animais , Sistemas de Liberação de Medicamentos , Humanos , Ácido Láctico/química , Poliésteres/química , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Ratos , Ratos Wistar , Proteínas Recombinantes/administração & dosagem
16.
J Craniofac Surg ; 28(2): 492-495, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28045827

RESUMO

Maxillary advancement by Le Fort I osteotomy has become the standard procedure to restore function and facial esthetics, correct skeletal and occlusal discrepancies, and treat obstructive sleep apnea in patients with facial deformities. Incomplete ossification between the bone segments at the jaw osteotomy site has proven to be a major problem in these patients. There are several studies in the literature that address orthognathic surgery, but only a limited number that discuss the use of graft materials in maxillary osteotomy. Bone grafts were introduced in recent decades in order to promote and improve bone union and prevent the formation of gaps. This study will discuss the results obtained using bone substitutes in orthognathic surgery for maxillary advancement and maxillary repositioning with Le Fort I osteotomy, in a clinical report and a literature review, covering the main indications and specifying the type of material used and the stability of the surgical procedure postoperatively.


Assuntos
Substitutos Ósseos , Má Oclusão Classe III de Angle/cirurgia , Maxila/cirurgia , Osteotomia de Le Fort/métodos , Transplante Ósseo , Humanos , Má Oclusão Classe III de Angle/diagnóstico por imagem , Maxila/fisiologia , Adulto Jovem
17.
Rev. odontol. UNESP (Online) ; 44(4): 218-225, jul.-ago. 2015. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-755986

RESUMO

Objetivo: Incorporar o hormônio de crescimento recombinante humano em um polímero biodegradável (PLGA). Material e método: As matrizes foram confeccionadas através da técnica de evaporação de solventes. Foi feita uma mistura do polímero (poli ácido glicólico lático) e do hormônio do crescimento humano recombinante (Saizen® Merck Serono S.A. Aubonne, Suíça). Essa mistura foi vertida em moldes de silicone circulares de 1 cm de diâmetro e aproximadamente 2 mm de espessura, e levada para secagem em uma câmara de evaporação de solvente por 48 horas. Após esse período, as matrizes foram imersas em PBS e passaram por um banho termostatizado (ensaio de degradação hidrolítica), in vitro, à temperatura de 37°C. As amostras foram retiradas do banho no intervalo de 1, 2, 3, 4, 7, 10 e 14 dias. Foram aferidas a perda de massa, a variação do pH e a concentração do hormônio liberado em função do tempo. Resultado: A concentração do hormônio liberado em função do tempo foi aumentando até o terceiro dia. No quarto dia, houve uma queda e, no sétimo, ocorreu um aumento do hormônio liberado, estendendo-se até o décimo dia; no 14° dia, houve queda novamente. O pH teve uma queda brusca de 7,4 para 3,2 no primeiro dia, mantendo uma pequena queda até o 14° dia. A perda de massa foi gradual em relação ao tempo, como já era esperado. Conclusão: O PLGA é um bom biomaterial para confecção de matrizes com hormônio do crescimento. Revelou-se possível incorporar o rhGH nessa matriz, de modo a, então, desenvolver-se um substituto ósseo.


Objective: Incorporate recombinant human growth hormone in a biodegradable polymer (PLGA). Material and method: The arrays were fabricated by solvent evaporation technique. A mixture of polymer (poly lactic glycolic acid) and recombinant human growth (Saizen® Merck Serono SA Aubonne, Switzerland) was performed hormone. This mixture was poured into circular molds silicone 01cm in diameter and about 02mm thick, and carried into a drying chamber for evaporation of solvent for 48 hours. After this period, the matrices were immersed in PBS and passed through a constant temperature bath (test for hydrolytic degradation) in vitro, at a temperature of 37°C. The samples were removed from the bath in the range of 01, 02, 03, 04, 07, 10, 14 days. Mass loss, pH and concentration of hormone released as a function of time was measured. Result: The concentration of hormone released versus time was increased until the third day. On the fourth day had a fall and on the seventh day there have been increased hormone released by the tenth day, the fourteenth day was falling again. The pH had a sharp drop from 7.4 to 3.2 on the first day and keeping a small drop until the fourteenth day. The mass loss was a gradual loss in relation to time as was to be expected. Conclusion: PLGA is a good biomaterial for making breeders of growth hormone. It has proved possible to incorporate the rhGH in the array so as to then develop a bone substitute.


Assuntos
Polímeros , Espectrofotometria , Materiais Biocompatíveis , Técnicas In Vitro , Hormônio do Crescimento , Microscopia Eletrônica de Varredura , Transplante Ósseo , Osteogênese , Cicatrização , Regeneração Óssea , Concentração de Íons de Hidrogênio
18.
Lasers Med Sci ; 30(5): 1569-74, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25975746

RESUMO

The biological effects of local therapy with laser on bone repair have been well demonstrated; however, this possible effect on bone repair outside the irradiated field has not been evaluated. The aim of this study was to investigate the effect of low-level laser therapy (LLLT) (λ = 830 nm) on repair of surgical bone defects outside the irradiated field, in rats. Sixty Wistar rats were submitted to osteotomy on the left femur and randomly separated into four groups (n = 15): group I, control, bone defect only; group II, laser applied on the right femur (distant dose); group III, laser applied locally on the bone defect and also on the right femur (local and distant doses); and group IV, laser applied locally on the left femur (local dose). Laser groups received applications within a 48-h interval in one point per session of density energy (DE) = 210 J/cm(2), P = 50 mW, t = 120 s, and beam diameter of 0.028 cm. Five animals of each group were euthanized 7, 15, and 21 days after surgery. Histologic analysis in all groups showed new bone formation in the region of interest (ROI) at 7 days. After 15 days, bone remodeling with a decrease of bone neoformation in the marrow area was observed in all groups. After 21 days, advanced bone remodeling with new bone mostly located in the cortical area was observed. The histomorphometric analysis showed at 7 days a significant increase of bone formation in groups III and IV compared to groups I and II. At days 15 and 21, histomorphometric analysis showed no significant differences between them. Laser therapy presented a positive local biostimulative effect in the early stage of bone healing, but the LLLT effect was not observed a long distance from the evaluated area.


Assuntos
Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Animais , Regeneração Óssea , Osso e Ossos/patologia , Osso e Ossos/efeitos da radiação , Fêmur/fisiopatologia , Fêmur/efeitos da radiação , Masculino , Ratos Wistar , Cicatrização/efeitos da radiação
19.
J Dent Child (Chic) ; 82(1): 47-52, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25909843

RESUMO

Hereditary gingival fibromatosis (HGF), also known as hereditary gingival hyperplasia, idiopathic gingival fibromatosis, and hereditary gingival overgrowth, is a rare condition but the most common form of gingival hyperplasia. Overgrowth of gingival tissue is usually slow and progressive and may delay or prevent tooth eruption, resulting in cosmetic and functional impairments. Hypertrichosis, epilepsy, and intellectual disability may be associated with HGF, which can occur in isolation or as part of a syndrome. The purpose of this case report is to describe a diode laser resection of gingival hyperplasia in a seven-year-old patient with nonsyndromic HGF and hypertrichosis. The diode laser enabled efficient removal of hypertrophic gingival tissue with good healing and minimal postoperative discomfort.


Assuntos
Fibromatose Gengival/cirurgia , Lasers Semicondutores/uso terapêutico , Criança , Feminino , Humanos
20.
Artigo em Inglês | MEDLINE | ID: mdl-25577591

RESUMO

Several vascular lesions are related to the lip area. There is no universally accepted protocol for the treatment of hemangiomas and vascular malformations. In the oral cavity, high-power lasers represent an excellent therapeutic option for this type of lesion. Their coagulative properties allow for the performance of procedures without the risk of bleeding, which promotes a better healing pattern and a differentiated postoperative appearance. This study describes three cases of lip hemangioma treated with forced dehydration with induced photocoagulation (FDIP) via diode laser. All the reported cases were followed up until complete healing of the operated area had total remission of lesions, with no complications or adverse effects. The findings of the present study suggest that FDIP is effective and useful in the treatment of hemangiomas in the oral cavity. Laser treatment of these lesions prevents their recurrence and is well tolerated by patients.


Assuntos
Hemangioma/cirurgia , Lasers Semicondutores/uso terapêutico , Fotocoagulação/métodos , Neoplasias Labiais/cirurgia , Idoso , Desidratação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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