Hyberbaric oxygen and bone reconstruction.

INTRODUCTION: The aim of this literature review was to determine the benefits of hyperbaric oxygen therapy after bone reconstruction procedures in humans and identify information that may be useful for the development of optimal protocols for hyperbaric oxygen therapy to stimulate bone healing. EVIDENCE ACQUISITION: We searched the electronic database PubMed/Medline for studies published between January 1999 and December 2018, using the key words: "bone" or "bone graft" and "mandible reconstruction" or "jaw reconstruction" and "hyperbaric oxygen" or "HBO." First, the titles and abstracts of the studies found were evaluated and those that corresponded to the aims of this review were pre-selected for analysis of the full text. Subsequently, the full texts were analyzed, and those that met the eligibility criteria were pre-selected for the review. The full texts of studies whose abstracts did not provide enough data for decision were also evaluated. Two examiners independently assessed eligibility, risk of bias and extracted data. EVIDENCE SYNTHESIS: A total of 2237 studies were found according to pre-established criteria for data collection, of which only 5 studies were included in this systematic review. Although we observed positive results in the included studies, there are still few standardized clinical studies in the literature, assessing hyperbaric oxygen therapy after extensive bone reconstructive procedures. CONCLUSIONS: It is difficult to compare results found in different studies due to the variety of methodological and clinical conditions assessed.

Utilização de alveoloplastia intrasseptal para correção de acentuada projeção maxilar: relato de caso / Use of intraseptal alveoloplaty for the correction of severe maxillary protrusion: case report

A alveoloplastia intrasseptal, também chamada de Técnica de Dean, é uma técnica cirúrgica utilizada na correção dos rebordos alveolares na qual envolve a remoção do osso intrasseptal e o reposicionamento do osso cortical vestibular. Esta técnica é utilizada em áreas nas quais o rebordo é de contorno relativamente regular e altura adequada, porém apresenta uma depressão no fundo de vestíbulo, devido à configuração do rebordo ósseo. Este trabalho consiste no relato de caso clínico no qual a alveoloplastia pela técnica de Dean foi utilizada na resolução da condição clínica de uma paciente do sexo feminino, que ao exame clínico observou-se a presença de incisivos superiores vestibularizados, grande trespasse horizontal, falta de selamento labial, perfil facial convexo e uma perda óssea visível. O plano de tratamento estabelecido foi a confecção de prótese parcial removível provisória instalada imediatamente após a realização da Alveoloplastia intrasseptal. O resultado obtido foi satisfatório, permitindo uma harmonia estética facial e o selamento labial antes inexistente, o que aumentou a autoestima da paciente, permitindo que o tratamento reabilitador definitivo possa ser realizado com mais tranquilidade.

The intraseptal alveoloplasty, also called Dean Technique, is a surgical technique utilized for the correction of the alveolar ridges, which involves removing the intraseptal bone and repositioning the vestibular cortical bone. This technique is used in areas where the rim is relatively regular and adequate height, but has a depression in the bottom of the vestibule, due to the bone ridge configuration. This paper is a report of clinical case of a alveoloplasty using the Dean technique, witch the purpose was to solve the clinical condition of a female patient, that the clinical examination the presence of maxillary incisors proclined, large overjet, deficiency lip closure, convex facial profile and a visible bone loss was observed. The treatment plan was established fabrication of temporary removable partial denture installed immediately after completion of intraseptal Alveoloplasty. The result was satisfactory, allowing a facial aesthetic harmony and lip seal before nonexistent, which increased the self-esteem of the patient, allowing the definitive rehabilitative treatment can be carried out more smoothly.

Mandibular dislocation after stroke: an uncommon sequelae / Luxação mandibular após acidente vascular cerebral: uma sequela incomum

Temporomandibular joint (TMJ) recurrent dislocation is usually associated with jaw hypermobility or articular eminence anatomy. Patients who have stroke experience (CVA) can present joint and muscle tone changes, as laxity ligamentous and appearance of spastic muscle patterns in different parts of the body such as shoulder, elbow, wrist, hip, knee and face. This study reported two cases of patients with stroke sequelae who developed chronic dislocation of the jaw. It was concluded that these two clinical conditions appear to have some correlation, further studies with more patients needed to confirm this correlation.

A luxação recorrente da articulação temporo-mandibular ocorre quando o côndilo mandibular move-se para fora da cavidade glenóide e permanece travado anteriormente à eminência articular de forma repetitiva. Pacientes com histórico de acidente vascular cerebral podem apresentar alterações articulares e de tonicidade muscular. O presente estudo relatou dois casos clínicos de pacientes com seqüela de AVC, que desenvolveram luxação crônica da mandíbula. Concluiu-se que essas duas condições clinicas parecem apresentar alguma correlação clínica, sendo ainda necessário estudos com mais pacientes para confirmar tal correlação.

Síndrome da combinação: diagnóstico, prevenção e considerações sobre o tratamento / Combination Syndrome: diagnosis, prevention and treatment considerations

A síndrome da combinação, descrita por Kelly em 1972, apresenta-se a partir de um conjunto de características marcantes que ocorrem quando uma maxila desdentada se opõe a dentes anteriores inferiores naturais. Essa condição clínica é mais comumente encontrada em pacientes que fazem uso de prótese total superior que oclui com dentes naturais anteriores inferiores e prótese parcial removível bilateral inferior. Também conhecida por Síndrome de Kelly, é caracterizada pela perda óssea da região anterior do rebordo superior, extrusão dos dentes naturais anteriores, aumento das tuberosidades maxilares, perda óssea da região posterior do arco inferior sob a base da PPR e hiperplasia papilar da mucosa do palato duro. O correto diagnóstico e tratamento da síndrome são imprescindíveis na obtenção de resultado que, no mínimo, impeça o avanço do quadro. O presente trabalho consiste no relato de caso clínico de uma paciente diagnosticada com Síndrome da Combinação, no qual, além de importantes considerações acerca do diagnóstico, prevenção e tratamento reabilitador dos pacientes portadores dessa síndrome, chama-se atenção para os cuidados cirúrgicos e protéticos específicos que devem estar envolvidos na reabilitação dos pacientes portadores dessa condição.

The combination syndrome, as described by Kelly in 1972, is presented as a set of characteristics that occur when an toothless maxilla is opposed to natural mandibular anterior teeth. This clinical condition is more commonly found in patients who use dentures that occludes with natural lower anterior teeth and bilateral removable partial dentures. Also known as kelly syndrome is characterized by loss of bone anterior region of the upper lip, extrusion of lower natural teeth remaining, increased jaws tuberosities, bone loss of support from the base of removable partial dentures and papillary hyperplasia of the mucosa of the palate hard. Proper diagnosis and treatment of syndrome are essential in achieving a result which at least impedes the progress of the condition. This work is a case report of a patient diagnosed with the combination syndrome, in which, in addition to important considerations about the diagnosis, prevention and rehabilitation treatment of patients with this syndrome, called attention to the specific surgical and prosthetic care that should be involved in the rehabilitation of patients with this condition.

Effect of low-level laser therapy on repair of the bone compromised by radiotherapy.

Radiotherapy (RDT) is commonly used for cancer treatment, but high doses of ionizing radiation can directly affect healthy tissues. Positive biological effects of low-level laser therapy (LLLT) on bone repair have been demonstrated; however, this effect on surgical defects of bone previously compromised by radiotherapy has not been evaluated. The aim of this study was to investigate the influence of LLLT (λ = 830 nm) in femur repair after ionizing radiation. Twenty Wistar rats were divided into four groups: control group (GC, n = 5) creation of bone defects (BDs) only; laser group (GL), with BD and LLLT (n = 5); radiotherapy group (GR), submitted to RDT and BD (n = 5); and radiotherapy and laser group (GRL), submitted to RDT, BD, and LLLT (n = 5). GL and GRL received punctual laser application (DE = 210 J/cm(2), P = 50 mW, t = 120 s, and beam diameter of 0.04 cm(2)) immediately after surgery, with 48-h interval during 7 days. Animals were euthanized at 7 days after surgery, and bone sections were evaluated morphometrically with conventional microscopy. Bone repair was only observed in nonirradiated bone, with significant improvement in GL in comparison to GC. GR and GRL did not present any bone neoformation. The result demonstrated a positive local biostimulative effect of LLLT in normal bone. However, LLLT was not able to revert the bone metabolic damage due to ionizing radiation.

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.

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.