Recurrent dislocation of the temporomandibular joint: a literature review and two case reports treated with eminectomy.

AIMS: Dislocation of the temporomandibular joint (TMJ) is a troublesome condition that occurs in a chronic or acute form. It is a distressing and highly embarrassing situation that may occur as a result of daily activities such as yawning, laughing, or during events that require keeping the mouth open for a long time. This review aims to present and discuss different conservative and surgical techniques to treat patients with a dislocated mandible, and to present two cases of surgical treatment. METHODOLOGY: A search of the literature was completed (Medline, PubMed) using the keywords TMJ dislocation, TMJ luxation, mandibular dislocation and surgical and non-surgical methods of treatment for this condition. RESULTS: Eminectomy (Myrhaug's surgery) has been used with satisfactory results. Most of reports present large series of patients with more than one year of follow-up and no recurrence of complications. Is less invasive and take a short operation time; need no bone transplantation or placing any kind of foreign body into the joint. CONCLUSION: Eminectomy results in long-term resolution of recurrent TMJ dislocations, when compared with others surgical techniques.

Horizontal and vertical maxillary osteotomy stability, in cleft lip and palate patients, using allogeneic bone graft.

OBJECTIVE: This study was carried out to evaluate maxillary stability after orthodontic-surgical treatment of patients with cleft lip and palate. Cephalometric analysis was applied to two different groups, with and without allogeneic bone graft. METHODS: The sample comprised 48 patients with cleft lip and palate. The test group comprised 25 patients who, after correction of maxillary position, received allogeneic bone graft at the gap created by Le Fort I osteotomy. The control group comprised 23 patients and its surgical procedures were similar to those applied to the test group, except for the use of bone graft. Manual cephalometric analysis and comparison between lateral teleradiographs, obtained at the preoperative phase, immediate postoperative phase and after a minimum period of six months, were carried out. RESULTS: An higher horizontal relapse was observed in the control group (p>0.05). There were no statistically significant differences in vertical relapses between test and control groups (p<0.05). CONCLUSION: The use of allogeneic bone graft in cleft lip and palate patients submitted to Le Fort I osteotomy contributed to increase postoperative stability when compared to surgeries without bone graft.

Horizontal and vertical maxillary osteotomy stability, in cleft lip and palate patients, using allogeneic bone graft

OBJECTIVE: This study was carried out to evaluate maxillary stability after orthodontic-surgical treatment of patients with cleft lip and palate. Cephalometric analysis was applied to two different groups, with and without allogeneic bone graft. METHODS: The sample comprised 48 patients with cleft lip and palate. The test group comprised 25 patients who, after correction of maxillary position, received allogeneic bone graft at the gap created by Le Fort I osteotomy. The control group comprised 23 patients and its surgical procedures were similar to those applied to the test group, except for the use of bone graft. Manual cephalometric analysis and comparison between lateral teleradiographs, obtained at the preoperative phase, immediate postoperative phase and after a minimum period of six months, were carried out. RESULTS: An higher horizontal relapse was observed in the control group (p<0.05). There were no statistically significant differences in vertical relapses between test and control groups (p>0.05). CONCLUSION: The use of allogeneic bone graft in cleft lip and palate patients submitted to Le Fort I osteotomy contributed to increase postoperative stability when compared to surgeries without bone graft.

OBJETIVO: avaliar a estabilidade maxilar após o tratamento ortodôntico-cirúrgico de pacientes portadores de fissura labiopalatal, por meio de análise cefalométrica, em dois diferentes grupos, com e sem utilização de enxerto ósseo alógeno. MÉTODOS: a amostra foi constituída de 48 pacientes portadores de fissura labiopalatal. O grupo teste foi composto de 25 pacientes que, após a correção da posição da maxila, receberam enxertia óssea alógena para preenchimento dos espaços gerados pelas osteotomias maxilares do tipo Le Fort I. O grupo controle foi composto por 23 pacientes, com os procedimentos cirúrgicos similares aos do grupo teste, com a diferença de que não se utilizou enxertia óssea. Realizaram-se traçados cefalométricos manuais e comparação entre as telerradiografias em perfil, obtidas no pré-operatório, no pós-operatório imediato e após o período mínimo de seis meses. RESULTADOS: ocorreu maior recidiva horizontal no grupo controle (p < 0,05). Não houve diferenças estatisticamente significativas nas recidivas verticais entre os grupos teste e controle (p > 0,05). CONCLUSÃO: a utilização de enxertos alógenos em pacientes portadores de fissura labiopalatal submetidos a osteotomias maxilares Le Fort I contribuiu para o aumento da estabilidade horizontal pós-operatória, quando comparada com cirurgias sem enxertia óssea.

Eagle's syndrome: treatment by intraoral bilateral resection of the ossified stylohyoid ligament. A review and report of two cases.

The complexities of Eagle's syndrome are examined according to anatomical, historical, clinical, and treatment aspects. There appears to be little correlation between the extent, form, and size of the anomalies of the styloid process and the stylohyoid ligament and the predictability of patients with related symptoms. Surgical treatment and the advantages and disadvantages of each surgical approach (intra- and extraoral) are discussed. The probable causes of enlargement of the styloid process and ossification of the stylohyoid ligament are addressed. Two cases of Eagle's syndrome are presented: one unilateral and the other bilateral. An intraoral modified surgical technique is presented.

Feasibility of using acetazolamide in thetreatment of tooth resorption / Viabilidade de uso da acetazolamida notratamento de reabsorções radiculares

Objective: Since acetazolamide is a carbonic anhydrase inhibitor, it presents relevant aspects with regardto the treatment of late reimplanted teeth, and therefore, this is the aim of the present literature review.Data Sources: The databases used were Pubmed and Bireme. Selection of works: was performed usingthe keywords Tooth reimplantation, Dental ankylosis, Acetazolamide and Carbonic anhydrase inhibitors.Conclusions: In spite of contemporary guidelines for the treatment of late reimplantation, there is still avery high loss of avulsed teeth due to resorption, particularly by replacement resorption, so that the searchfor new substances or means of treatment is of the utmost importance.

Objetivo: Uma vez que a acetazolamida é uma inibidora da anidrase carbônica, ela apresenta aspectos relevantesquanto ao tratamento de dentes reimplantados tardiamente, justificando assim o objetivo da presenterevisão de literatura. Fontes de dados: as bases de dados utilizados foram Pubmed e Bireme. Seleção dos damtrabalhos:foi realizada por meio das palavras-chave Reimplante dentário, Anquilose dentária, Acetazolamidae Inibidores da anidrase carbônica. Conclusões: Apesar das diretrizes atuais para o tratamento do reimplantetardio, ainda a perda de dentes avulsionados por reabsorção é muito alta, principalmente diante da reabsorçãopor substituição, sendo premente a busca por novas substâncias ou meios de tratamento.

Histomorphometric analysis of bone tissue repair in rabbits after insertion of titanium screws under different torque.

PURPOSE: To evaluate the inflammatory response of rabbit bone after insertion of titanium screws under different torque values. METHODS: Four holes were made in the back tibia of fifteen New Zealand male albino rabbits; three screws were placed in each animal and a control hole remained without a screw. The screws were inserted with 0, 5 or 10 N.cm of torque. The animals were assigned to five groups according to the day of sacrifice after surgery (2, 7, 14, 21 or 42 days). The inflammatory cells and the thickness of the bone tissue around the screws was count. RESULTS: The screws were associated with a larger number of inflammatory cells when compared to the control hole. There was no statistically significant difference when several comparisons were made among the groups with different torque intensity. CONCLUSIONS: The histological changes were not statistically significant. There was a trend toward an increase in inflammatory cells found in local bone tissue surrounding the titanium screws installed with the highest torque. There was a tendency toward the formation of a lower thickness of tissue surrounding those bone screws that were inserted with higher torque.

Histomorphometric analysis of bone tissue repair in rabbits after insertion of titanium screws under different torque / Estudo histomorfométrico do reparo tecidual ósseo de coelhos com parafusos de titânio inseridos sob diferentes intensidades de torques

PURPOSE: To evaluate the inflammatory response of rabbit bone after insertion of titanium screws under different torque values. METHODS: Four holes were made in the back tibia of fifteen New Zealand male albino rabbits; three screws were placed in each animal and a control hole remained without a screw. The screws were inserted with 0, 5 or 10 N.cm of torque. The animals were assigned to five groups according to the day of sacrifice after surgery (2, 7, 14, 21 or 42 days). The inflammatory cells and the thickness of the bone tissue around the screws was count. RESULTS: The screws were associated with a larger number of inflammatory cells when compared to the control hole. There was no statistically significant difference when several comparisons were made among the groups with different torque intensity. CONCLUSIONS: The histological changes were not statistically significant. There was a trend toward an increase in inflammatory cells found in local bone tissue surrounding the titanium screws installed with the highest torque. There was a tendency toward the formation of a lower thickness of tissue surrounding those bone screws that were inserted with higher torque.

OBJETIVO: Avaliar em variados períodos de tempo a resposta inflamatória do tecido ósseo de coelhos nos quais foram instalados parafusos de titânio com variadas intensidades de torque. MÉTODOS: 15 coelhos Nova Zelândia receberam três parafusos de titânio instalados em cada tíbia traseira e uma perfuração sem parafuso. Foram inseridos os parafusos com 0, 5 e 10 N.cm de torque. A eutanásia ocorreu 2, 7, 14, 21 e 42 dias pós-operatórios e foram analisados a em microscopia óptica a quantidade de células inflamatórias e espessura do tecido ósseo formado. RESULTADOS: Observou-se que a presença de parafusos apresentou uma quantidade significantemente maior de células inflamatórias quando comparado às perfurações controle. Houve um aumento na formação de tecido ósseo adjacente aos parafusos dos grupos 14, 21 e 42 dias quando comparados aos demais. CONCLUSÕES: Quanto maiores foram os torques de instalação dos parafusos de titânio, maiores foram as quantidades de células inflamatórias locais observadas nos tecidos ósseos circundantes e que com o passar dos períodos de tempo, foram diminuindo gradativamente. As espessuras de tecidos ósseos formadas observadas ao redor dos parafusos inseridos foram proporcionalmente menores quando a intensidade dos torques aplicados foram cada vez maiores.

Clinical oral findings in dialysis and kidney-transplant patients.

OBJECTIVES: Oral lesions secondary to chronic renal failure or related to immunosuppressive therapy after transplant are reported in the literature, but their prevalence is still obscure. The aim of this study was to investigate oral clinical findings in patients undergoing renal dialysis and renal transplant recipients. METHOD AND MATERIALS: Forty-six patients treated with dialysis (DL), 33 kidney-transplant (KT) patients, and 37 control (C) patients were examined intraorally. Oral clinical findings were diagnosed and treated. RESULTS: The results showed that 95.6% (44/46) of the DL group, 93.9% (31/33) of KT patients, and 56.7% (21/37) of the control group presented at least one pathological entity in the oral mucosa. A high prevalence of oral lesions, such as saburral tongue and xerostomia, was found in the DL and KT groups. Certain oral lesions demonstrated a predisposition toward one type of group, such as a higher prevalence of metallic taste in the DL group and gingival overgrowth in the KT group. CONCLUSION: The prevalence of oral lesions was significantly higher in renal patients (DL and KT groups). The most prevalent oral clinical findings were saburral tongue and xerostomia for both groups. Metallic taste was more prevalent in the DL group. Although geographic tongue was more frequent in KT patients and melanin pigmentation in the control group, the number of lesions was low for all groups. In addition, gingival overgrowth was more prevalent in the KT group; however, the difference was not significant (P = .06).

Idiopathic thrombocytopenic purpura and oral surgery: case report / Púrpura trombocitopênica idiopática e cirurgia bucal: relato de caso

OBJECTIVES: To review the function of platelets in the blood clotting mechanism. To address,conceptualize and classify thrombocytopenic purpura, especially idiopathic thrombocytopenic purpura (ITP),emphasizing the immunological aspects involved in the etiology of the disease. To address the clinicalmanifestations of the disease and the appropriate therapy. To present the case study of a patient with ITPwho requires oral surgical intervention. DISCUSSION: Leukopenia in ITP can be subclinical. The firstmanifestation of the disease can be severe hemorrhaging due to small lacerations or minor medical anddental surgical procedures. The cause of the platelet reduction is idiopathic; an autoimmune reaction in whichthe antibodies destroy the platelets appears to participate in the process. A variety of situations can occur,leading to mild to severe thrombocytopenia. One frequent aspect is the instability of the platelet count,which oscillates inconsistently and may be related to infections and other factors that have not been clearlydetermined, including stress. In the case presented here, the leukopenia in the patient was mild in presentation.However, it was decided that the patient should be referred to a hematologist for preparation and clearance.Oral surgery that compromises the bone, such as exodontia, can present significant difficulties in localizingand clamping intraosseous vessels, which does not only occur in small soft tissue surgeries. CONCLUSIONS:Platelet destruction in ITP occurs from a complex process that is comprised of multiple components of theimmune system. The platelets are prematurely destroyed by antibodies that are aimed at the platelet glycoprotein,which can results in serious, even fatal consequences. It is important to emphasize the significance of themedical history and the appropriate physical examination during the diagnostic process, as well as collaborationwith the patient’s medical...

OBJETIVOS: Revisar a função das plaquetas no mecanismo de coagulação sanguínea. Conceituare classificar a púrpura trombocitopênica, especialmente a púrpura idiopática, enfatizando osaspectos imunológicos envolvidos na etiologia da doença. Enfocar as manifestações clínicas dadoença e a terapia apropriada. Apresentar um caso de manifestação clínica da doença e a terapiaapropriada. Apresentar o caso de uma paciente com púrpura que necessitava de intervençãocirúrgica bucal. DISCUSSÃO: A leucopenia na púrpura trombocitopênica idiopática pode sersubclínica. A primeira manifestação da doença pode ser uma hemorragia severa por causa depequenas lacerações ou pequenos procedimentos médicos e odontológicos. A causa da reduçãodas plaquetas é idiopática; uma reação autoimune na qual os anticorpos destroem as plaquetasparece participar do processo. Uma variedade de situações pode ocorrer, levando àtrombocitopenia discreta a severa. Um aspecto frequente é a instabilidade da contagem plaquetária,que oscila inconsistentemente e pode relacionar-se com infecções e outros fatores ainda nãoclaramente determinados, incluindo estresse. No presente caso, o paciente apresentava discretaleucopenia. Entretanto, decidiu-se que o paciente deveria ser avaliado por um hematologista,para preparação e liberação para cirurgia, pois a cirurgia bucal que compromete osso, como aexodontia, pode apresentar dificuldades significativas na localização e pinçamento de vasosintraósseos, o que não acontece em pequenas cirurgias de tecidos moles. CONCLUSÕES: Adestruição plaquetária na púrpura trombocitopênica ocorre por meio de um complexo processo,com múltipos componentes do sistema imune. As plaquetas são destruídas prematuramente poranticorpos dirigidos contra as glicoproteínas plaquetárias, o que pode resultar em sérias – emesmo fatais – consequências. É importante enfatizar o significado da história médica e o examefísico adequado no processo diagnóstico...

Cirurgia ortognática: estética e/ou função / Ortognatic surgery: aesthetic and/or function

Esta revisão tem como objetivo trazer informações a respeito das indicações e planejamento, bem como das técnicas cirúrgicas usadas para tratamento das deformidades dentofaciais. A relação multidisciplinar não apenas do planejamento ortocirúrgico, mais do preparo psicológico e da oportunidade do procedimento, pois as mudanças faciais relativas à busca deste equilíbrio e estabilidades oclusal pela movimentação dos ossos da face repercutiram intensamente na vida pessoal e social do indivíduo.

Autonomia profissional versus autinomia do paciente: casos de extrações de dentes recuperáveis / Autonomy of the professional versus autonomy of the patient: cases of extraction of teeth that could be treated conservatively

OBJETIVOS: Revisar a literatura concernente às relações éticas entre cirurgiões-dentistas e pacientes,especialmente nos casos de extrações dentárias em regime de urgência ou emergência, em prontosocorrosodontológicos. Discutir a validade de documentos assinados pelo paciente ou responsável,autorizando ao cirurgião-dentista a extração de dente passível de tratamento conservador. Discutiras autonomias do profissional e do paciente frente a essa circunstância. METODOLOGIA: Analisouse4.973 prontuários de pacientes atendidos no último trimestre de 2001 no Pronto-SocorroOdontológico do Hospital Universitário Cajuru, da PUCPR, Curitiba, PR, Brasil. Avaliou-se asindicações das exodontias, pelo reexame das radiografias, observando-se a possibilidade de tratamentoconservador dos dentes extraídos, bem como a existência do documento de consentimento informadoassinado pelo paciente. RESULTADOS: Foram realizadas 961 extrações dentárias, em 902 pacientes.748 procedimentos (77,84%) tinham indicação radiográfica para extração e 213 (22,16%) não tinham.Somente para esses últimos havia o consentimento informado assinado pelos pacientes.CONCLUSÃO: Considerando os resultados e as condições do presente estudo, é lícito concluirque os pacientes foram adequadamente informados das situações em que os dentes poderiam serconservados, bem como tiveram oportunidade de optar pela cirurgia. Discute-se no presente artigoas implicações éticas e legais desta situação, muitas vezes frustrante e constrangedora para osprofissionais cirurgiões-dentistas.

OBJECTIVES: To review the literature of the ethical relations between dentist and patients,especially in the cases of urgency dental extrations in hospitals and emergency services. Todiscuss the validity of the document signed by the patient or his responsible person, authorizingthe professional to extract a tooth that the possible could be saved by a conservative treatment.To analyse the autonomies of the professional and the patient considering this circumstance.METHODOLOGY: 4,973 files of patients taken care of in the last trimester of 2001 in theEmergency Service of the University Hospital Cajuru, PUCPR, Curitiba, PR, Brazil. Theindications for tooth extractions were re-evaluated bye re-examination of the X-rays images,as well as the existence of the informed consent document signed by the patients. RESULTS:961 dental extrations had been carried through in 902 patients. 748 procedures (77.84%)had radiographic indication for extration and 213 (22.16%) did not have. For these last onesit only had the informed assent signed for the patients. CONCLUSION: Considering theresults and the conditions of the present study, it is possible to conclude that the patientsadequately had been informed of the situations where the teeth could be conserved, as well ashad had chance to opt to the surgery.

Osteogenic sarcoma of the maxilla: case report

Osteosarcoma (OS) is one of the most common primary malignant bone neoplasms, which predominantly occurs in the long bones and rarely in the maxillofacial area. We present a rare case of maxillary OS early diagnosed in a 17-year-old girl through clinical, radiological and histological examination. The treatment involved surgical resection of the tumor followed by radiation therapy and chemotherapy. The patient was much younger than the average age of presentation of a jaw tumor, which typically presents in the third to fourth decades of life. Although there is a consensus in the literature that OS of the jaws is less aggressive and less prone to metastasis than OS of the long bones, that was not true in this case, where in spite of early diagnosis and treatment the patient died due to brain metastasis.

Análise radiográfica da proximidade das raízes dos molares com o nervo alveolar inferior / Radiographic analysis of the proximity of the molar roots to the inferior alveolar nerve

O canal da mandíbula tem a direção ínfero-lateral descrita como uma curva descendente de concavidade ântero-superior havendo assim uma relação muito próxima entre o mesmo e os ßpices dos molares inferiores. Esta pesquisa tem como objetivo analisar radiograficamente a relação de proximidade dos molares inferiores com o canal da mandíbula bem como observar a dificuldade de remoção do terceiro molar inferior em função de sua posição no arco dental. Foram avaliadas cento e cinqüenta radiografias panorâmicas pertencentes à Clínica Odontológica da PUCPR, nas quais foi mensurada a distância do teto do canal da mandíbula aos ßpices dos molares inferiores com auxílio de um paquímetro. Aplicando-se o teste de Correlação de Amostras Pareadas e o teste de Wilcoxon para amostras dependentes (p > 0,05) constatou-se uma correlação positiva significativa quando as raízes dos molares foram analisadas independentemente e comparadas com suas homônimas contralaterais. Na amostra pesquisada, pôde-se concluir que a dificuldade cirúrgica na remoção dos terceiros molares se dß em função do tipo de inclusão dentßria, pois o trajeto do canal da mandíbula é simétrico bilateralmente.

Osteochondroma of the mandibular condyle: literature review and report of a case.

AIM: The intent of this report is to present a brief review of the literature on osteochondroma and to present a case involving the surgical removal and replacement of a major portion of the condyle and angle of the mandible using free autogenous mandibular bone. BACKGROUND: While osteochondroma is the most common tumor of skeletal bones, it is relatively uncommon in the jaws occurring at the condyle or the tip of the coronoid process. This benign cartilage-capped growth is usually discovered incidentally on radiographic examination or on palpation of a protruding mass in the affected area. Malocclusion and progressive facial asymmetry are common findings in most cases of condylar osteochondroma. REPORT: A case of a 29-year-old woman with an osteochondroma of the mandibular condyle is presented. Surgical treatment was tumor resection, grafting, and reshaping of the mandibular angle and ramus. As this lesion is usually asymptomatic and discovered incidentally on radiographic examination, the general practitioner usually is the first professional to make the diagnosis. SUMMARY: Condylectomy cannot be recommended as routine in all cases.37 Common surgical treatments include condylectomy and reconstruction.24 If the tumor involves only a limited area of the condylar surface, then preservation of the remaining portion of the condyle and reshaping should be done. Reasons for not taking such a conservative approach are the possibilities of malignancy and the risk of recurrence. In this case report the extraoral vertical ramus osteotomy, associated with free autogenous mandibular bone, presented several advantages.

Traumatic pseudolipoma of the oral cavity: report of a case.

An uncommon traumatic pseudolipoma of the oral cavity is presented. In this particular case there was evidence of previous trauma to the buccal fat pad during a difficult extraction of a maxillary premolar. Evidence is presented that iatrogenic trauma resulting in foreign body introduction might produce traumatic pseudolipoma in the oral cavity. The morphology of the buccal fat pad, the possible pathogenisis of the condition, as well as the diagnostic and the management of the case are presented.

Efeito da Schinus terebinthifolius raddi sobre o processo de reparo tecidual das lesões ulceradas induzidas na mucosa bucal do rato / Effect of the Schinus terebinthifolius raddi in the process of tissular repair in ulcers induced in mucosa oral of the rat

A aroeira (Schinus terebinthifolius Raddi) uma planta nativa da região Sul do Brasil, Argentina, Uruguai, Paraguai, Chile, Peru e Bolívia, está distribuída por todo o litoral paranaense. A aroeira tem vários nomes tais como: aroeira-vermelha, aroeira mansa, aroeira branca, aroeira da praia, aroeira do brejo, aroeira rasteira, aroeira do campo, coração de bugre, bálsamo, fruta do sablá, aroeira de sabiá, aguaraíba, aroeira do sertão, cabuí e cambuí. Floresce em novembro até março, às vezes irregularmente, frutifica em seguida. Os frutos podem permanecer até a próxima floração. O objetivo foi estudar o modo de ação e os efeitos terapêuticos da aroeira, no combate ao processo inflamatório, no processo de reparo do tecido sobre as lesões ulceradas da mucosa bucal do rato. Foram utilizados cinqüenta ratos machos do tipo Rattus norvegicus albinus, Rodentia, Mammalia da linhagem Wistar com idade aproximada de 45 a 50 dias e alimentados com ração e água ad libitum, os quais foram divididos em 2 grupos: 1 experimental de 25 animais e 1 grupo controle de 25 animais. Em seguida foram induzidas na língua dos animais as lesões ulceradas através da aplicação tópica diária de hidróxido de sódio a 40%. As lesões foram tratadas pela aplicação tópica do extrato da aroeira e foram sacrificados com a anestesia inalatória, utilizando éter etílico a 97% no 2°, 7°, 14°, 21 ° e 42° dias após o início do tratamento. Os grupos controles não receberam nenhum tipo de tratamento e os grupos experimentais foram tratados com o extrato da folha de Schinus terebinthifolius Raddi. As informações obtidas foram analisadas estatisticamente através do teste de Kruskal-Wallis e comparações múltiplas, utilizando probabilidade de p>0,05. Na análise dos resultados obtidos do efeito do extrato, observou-se que as úlceras nos grupos experimentais, quando comparadas às dos grupos controles, mostraram fechamento epitelial acelerado, maior proliferação vascular e fibroblástica. A Schinus terebenthifolius...

Comparative study of chronological, bone, and dental age in Fanconi's anemia.

Fanconi's anemia (FA) is a genetic autosomal recessive disorder, characterized by progressive bone marrow failure, congenital abnormalities, growth retardation, and predisposition to leukemia and solid tumors. The purpose of this study was to compare the chronological age (CA), bone age (BA), and dental age (DA) of FA patients and to determine whether the therapy received influenced the BA or DA. Thirty FA patients were evaluated and divided into three groups according to the therapy received. Hand and wrist radiographs for BA estimation and panoramic radiographs for DA estimation were taken. Statistical analysis demonstrated that mean values for CA, BA, and DA were 8.91 years old, 7.90 years old, and 7.75 years old, respectively, indicating low mean values for BA and DA in comparison with CA (P<0.01). The therapy given to the patient did not influence the BA or DA. BA and DA are delayed and are not influenced by the therapy given.

Dentoalveolar and mandibular body fractures caused by a horse kick: report of a case.

A rare case of multiple mandibular fractures and severe facial laceration is presented. The cause was a horse hoof kick to an unmounted equestrian. The pertinent literature is reviewed and the maxillofacial injuries associated with animal interaction are discussed.

Cirurgia ortognática: orientações legais aos ortodontistas e cirurgiões bucofaciais / Orthognathic surgery: legal orientations to orthodontists and bucomaxilofacial surgeons

Os autores entrevistaram especialistas em Ortodontia e em Cirurgia Bucomaxilofacial, elaboraram uma lista de ocorrências específicas do dia-a-dia do exercício da especialidade, redigindo, com base na legislação vigente e na literatura, uma série de orientações, atitudes e comportamentos que sugerem como rotina aos profissionais.

Estudo experimental do efeito dos clareadores dentais sobre úlceras induzidas com NaoH na mucosa bucal de ratos / The experimental study tooth-whitening agents effect on ulcers induced with naoh on the oral mucous of mice

Objetivo: Verificar as alterações microscópicas decorrentes da aplicação tópica dos dentrifícios clareadores e dos geis clareadores contendo peróxido de carbamida e carbopol nas concentrações 10 porcento, 16 porcento e 35 porcento, em úlceras no dorso da língua de rato. Método: Foram utilizadas 150 Rattus norvegicus albinus machos com idade de 45 a 50 dias e peso corporal de 250g a 350g, alimentados com ração e água ad libitum. Os mesmos foram divididos em 6 grupos com tratamentos diferenciados e com datas de morte de 2,7,14,21,42 dias. Os grupos de tratamento foram os de gel clareador 10 porcento, 16 porcento, 35 porcento: WHITENESS; o dentrificio clareador 1: COLGATE BICARBONATO DE SÓDIO & PERÓXIDO; dentrificio clareador 2: CONFIDENT, e o Grupo Controle tratado com água destilada. Na mucosa que reveste o dorso da língua de cada animal, na porção mais anterior foram induzidas as lesões ulceradas, por meio da aplicação diária de hidróxido de sódio (NaOH) a 40 porcento, por 7 dias. Após constatada a presença da úlcera foi iniciada a aplicação tópica dos produtos clareadores e a água destilada no grupo controle. Resultados: As úlceras tratadas com os géis clareadores estavam presentes ainda no sétimo dia, porém as tratadas com os dentifrícios clareadores, principalmente o CONFIDENT, persistiam por mais tempo, eram maiores e com o fundo esbranqueçado, havendo maior número de mortes entre os ratos tratados com o CONFIDENT. Conclusão: Pacientes portadores de aftas e outros tipos de úlceras devam ser aletardos sobre o risco de aumentar o período de cicatrização e de ter uma infecção sucundária, quando estiveram utilizando os produtos odontológicos clareadores