Long-term airway evolution after orthognathic surgery: Systematic Review.

Orthognathic surgery is a procedure that consists of correcting the abnormalities of the maxilla, mandible or both. Maxillary movements have a direct effect on the upper airways. For this reason, in the preoperative period, bone movements should be carefully analyzed and planned to avoid causing any damages to the airways. The goal of this study was to discuss the long-term evolution of the airways after orthognathic surgery. In order to do that, a search was performed through the databases PubMed, Virtual Health Library (VHL) and Scopus, using the acronym PICO strategy and a guiding question to conduct the search. Through the keywords and boolean operators "and" and "or" we found 930 articles. After reading the titles, abstracts and application of inclusion and exclusion criteria, we had 21 articles that were studied in their integrity. At the end of the selection, only 8 studies were included in the review. The postoperative evaluations from the selected studies showed that the airways suffered variations, independently of the patient's facial pattern. In addition, the airways tend to return to initial volumes, but none of the included studies obtained a complete return to the initial airways, even 6 years after surgery. Therefore, more studies with controlled methodologies should be conducted in order to have a better understanding of the airways and their changes.

Cisto epidermoide no assoalho da boca: relato de caso / Epidermoid cyst in the floor of the mouth: case report

Introdução: Os cistos epidermoides são anomalias de desenvolvimento incomum na região de cabeça e pescoço. Possuem um crescimento lento progressivo, podendo atingir grandes proporções, contendo queratina em seu interior. A teoria mais aceita sobre a origem desses cistos afirma que eles são derivados dos restos epiteliais retidos na linha média, durante o fechamento dos 1° e 2° arcos branquiais, na terceira e na quarta semana de vida intrauterina. São lesões assintomáticas e, dependendo da extensão, podem causar alterações estéticas e funcionais. Relato de caso: Este artigo tem como objetivo relatar um caso clínico, tratado de maneira cirúrgica, de um cisto epidermoide localizado no assoalho da cavidade bucal. Considerações Finais: Apesar de ser uma entidade rara e benigna, esse tipo de doença não deve ser subestimado. Dada a sua relevância, é importante realizar o diagnóstico diferencial tanto clínico como anatomopatológico, uma vez que o conhecimento dessa lesão por parte do cirurgião-dentista é fundamental para um diagnóstico precoce e um tratamento adequado, garantindo a saúde do paciente... (AU)

Introduction: Epidermoid Cysts are an unusual development in the region of the head and neck. It develops slowly and can reach large proportions, and some of them can contain keratin in its interior. The most accepted theory about the origin of the cysts is that they are derived from epithelial debris retained in the midline. This happened at the closure of the 1st and 2nd gill arches, usually after the third and fourth week of intrauterine life. They are asymptomatic lesions, and depending on the extent, it can cause aesthetic and functional alterations. Case report: The purpose of this article is to discuss the origin, location, classification, clinical characteristics and surgical treatments of an epidermoid cyst in the floor of the mouth. Final considerations: This type of disease, despite being a rare and benign entity, should not be underestimated. It is interesting to make the differential diagnosis both clinical and anatomopathological. Therefore, it is of great importance the knowledge of this injury by the dental surgeon for an early diagnosis and an appropriate treatment, guaranteeing the health of the patient... (AU)

Ear pruritus: a new otologic finding related to temporomandibular disorder.

This prospective clinical study evaluated the correlation among temporomandibular disorder (TMD), otologic manifestations, and parafunctional habits in a sample of 100 patients with TMD. The subjects were evaluated by clinical examination, use of a simplified anamnestic questionnaire for TMD diagnosis, and the investigation of otologic manifestations and parafunctional habits of the stomatognathic system. The prevalence of TMD and correlations with otologic manifestations and parafunctional habits were calculated. Patients ranged in age from 13 to 70 years, and 79.0% of the patients were between the ages of 30 and 59 years. Women represented 88.0% of the sample. Otologic manifestations were found in 92.0% of patients with TMD. Sex showed a significant correlation with severity of TMD (P = 0.024). A significant correlation was observed between female patients and both otalgia (P = 0.036) and ear pruritus (P < 0.001). Otalgia showed a significant association with the symptoms of TMD (P = 0.003). Significant correlations between severe TMD and otalgia (P < 0.001), tinnitus (P = 0.010), ear pruritus (P < 0.001), and aural fullness (P = 0.014) were also observed. Ear pruritus, otalgia, and aural fullness are the most common otologic manifestations in patients with TMD, showing a significant correlation with the female sex, severity of TMD, and frequency of TMD symptoms.

Lipoma intraoral: relato de caso / Intraoral lipoma: case report

Os lipomas são as neoplasias mesenquimais mais frequentes do corpo humano, sendo raros na cavidade oral. No aspecto histopatógico, são constituídos basicamente de adipócitos maduros. Clinicamente, apresentam-se como massas nodulares, sésseis ou pedunculadas, de consistência amolecida, aspecto gelatinoso e de superfície lisa; frequentemente são assintomáticos e sem ulcerações. O presente artigo tem por objetivo relatar um caso de um lipoma na região do ventre da língua, que impedia a correta adaptação da prótese total inferior, além de trazer transtornos fonéticos à paciente, tendo sido proposto um tratamento cirúrgico através de uma biópsia excisional da lesão... (AU)

Lipomas are the most common mesenchymal neoplasms of the human body, being rare in the oral cavity. In histopatoógico aspect, consist primarily of mature adipocytes. Clinically, it presents as nodular masses, sessile or pedunculated, of soft consistency, gelatinous appearance and smooth surface; are often asymptomatic and without ulceration. This paper aims to report a case of a lipoma in the belly region of the tongue, which prevented accurate adaptation of the lower denture, and bring the patient phonetic disorders, surgical treatment was proposed through an excisional biopsy of the lesion... (AU)

Tratamento cirúrgico de assimetria facial associada ao alongamento hemimandibular: relato de caso / Surgical treatment of facial asymmetry associated with hemimandibular elongation: case report.

A hiperplasia condilar (HC) ou hiperatividade condilar é uma má condição patológica de supercrescimento no processo condilar, o que leva a uma assimetria facial anormal variável. A AH é um fenótipo da HC, caracterizada por um alongamento horizontal da hemimandíbula afetada e pode acometer o processo condilar da mandíbula, o ramo e o corpo mandibular. Métodos radiográficos e de cintilografia são comumente utilizados para o diagnóstico e o monitoramento de seus aspectos macroscópicos. Os pacientes apresentam baixa autoestima, e o desenvolvimento social é indesejável. Assim, as deformidades podem causar uma diminuição na qualidade de vida e o consequente surgimento de depressão. Diferentes tratamentos cirúrgicos são propostos na literatura, desde a simples baixa ou alta condilectomia até procedimentos mais complexos, combinando osteotomias em diferentes locais da mandíbula. O relato de caso descreve uma paciente do sexo feminino de 27 anos de idade, com alongamento hemimandibular no lado direito com a atividade do crescimento condilar. Inicialmente foi tratada com expansão rápida da maxila assistida cirurgicamente (ERMAC) e posteriormente submetida à condilectomia com plicatura do disco articular e cirurgia ortognática bimaxilar.

Condylar hyperplasia or condylar hyperactivity is a pathological overgrowth condition at the condylar process, which leads to variable abnormal facial asymmetry. HE is a phenotype of the HC characterized by a horizontal elongation of the affected hemimandible and may affect the condylar neck, the mandibular ramus and corpus. Radiological and scintigraphic methods are commonly used for diagnosis and monitoring of its macroscopic aspects. The patients present low self-esteem and social development is undesirable. Thus deformities can cause a decrease in quality of life and the consequent emergence of depression. Different surgical treatments are proposed in the literature, from simple low or high condylectomy to more complex procedures combining osteotomies in different sites of the mandible. The case report describes a 27-year-old woman patient with hemimandibular hyperplasia on the right side with activity of condylar growth, initially treated with rapid maxillary expansion surgically assisted (SARME) and subsequently submitted condylectomy with plication of the articular disc and bimaxillary orthognathic surgery.

Síndrome de Sjögren Primária: relato de caso / PrimarySjögren'ssyndrome: a reported case

A Síndrome de Sjögren(SS) primária é uma desordem autoimune crônica dos tecidos exócrinos, com comprometimento funcional importante das glândulas lacrimais e salivares. Essa doença poliglandular é frequentemente associada a manifestações sistêmicas extraglandulares, como secura ocular e bucal, propiciando alterações fisiológicas locais. O entendimento da fisiopatologia e a evolução da SS primária favorecem o correto diagnóstico e a terapêutica apropriada. Este artigo tem por objetivo descrever os principais sinais e sintomas clínicos da SS primária, os critérios para correto diagnóstico e relatar um caso clínico clássico da doença.

Sjögren's syndrome (SS) is a primary chronic autoimmune disorder of exocrine tissue with significant functional impairment of the salivary and lacrimal glands. This polyglandular disease is often associated with extraglandular systemic manifestations such as dryeyes and mouth providing physiological sites. The understanding of the pathophysiologyand progression of primary SS favor the correct diagnosis and appropriate therapy. This article aim to describe the main clinical signs and symptoms of primary SS, the criteria for correct diagnosis and a case report of classic disease.

Granuloma Piogênico Com Características Clínicas Atípicas: Relato de Caso / Pyogenic Granuloma With Atypical Clinical Features: a Case Report

O Granuloma Piogênico, conhecido também como tumor gravídico, é mais prevalente em indivíduos do gênero feminino na segunda década de vida, especialmente durante a gravidez. Manifesta-se como uma massa firme, nodulada ou plana e, frequentemente indolor, com presença de sangramento espontâneo, principalmente ao toque. Geralmente, não atinge grandes proporções. A gengiva do maxilar é o sítio mais comum na maioria dos casos. O tratamento mais recorrente é a excisão completa da lesão acompanhada de medidas profiláticas de higiene. Este trabalho tem como objetivo relatar um caso clínico de granuloma piogênico que apresentou características clínicas pouco usuais. Por ser uma lesão de prevalência comum na clínica Odontológica, destaca-se a importância de conhecimentos mais aprofundados sobre as suas possíveis apresentações clínicas, contribuindo para um correto diagnóstico.

Pyogenic granuloma, also known as pregnancy tumor, is more prevalent in females in the second decade of life, especially during pregnancy. It manifests as a firm mass, nodular or flat, often painless, with the presence of spontaneous bleeding, especially when palpated. It usually does not attain large proportions. The maxillary gingiva is the commonest site in most cases. The most frequently used treatment is the complete excision of the lesion, accompanied by preventive measures relating to hygiene. This aim of this paper is to report a case of pyogenic granuloma that presented some unusual clinical features. The fact that it is a lesion commonly found in dental practice highlights the need for a deeper insight into its possible clinical presentations, thereby contributing to a correct diagnosis.

An impressive case of complete traumatic maxillofacial degloving.

By definition, degloving is skin and subcutaneous tissue detachment, most often affecting the limbs and extremities and occasionally the scalp. Degloving generally stems from high-energy trauma, but can also be intentional, such as in the case of planned surgical access in the anterior region of the mandible in oral-maxillofacial surgery. This paper describes an extreme case of complete traumatic maxillofacial degloving that caused partial avulsion of the soft tissues and maxilla. This is an extremely rare condition that has not previously been described in the literature, as the patient survived despite the risk of imminent death. This case report addresses the decisions made regarding the prevention of necrosis and infection that guided the emergency care and subsequent elective steps.

Reconstrução nasal parcial com retalho frontal oblíquo: relato de caso / Partial nasal reconstruction partial with an oblique frontal flap: a case report

Os ferimentos avulsivos na região nasal podem ser de origem traumática ou patológica. A reconstrução desses defeitos apresenta grande complexidade devido à região nasal ser importante do ponto de vista funcional e estético. A escolha do método reconstrutivo é baseada no tamanho, na localização e na profundidade do defeito a ser corrigido. O objetivo deste trabalho é relatar o caso de uma paciente que apresentou avulsão parcial de nariz cujo tratamento cirúrgico proposto foi a reconstrução nasal por meio de retalho frontal oblíquo.

The avulsive wound of the nose may be of traumatic or pathological origin. The reconstruction of these wounds is difficult because the nasal region is functionally and aesthetically important. The method of treatment is based on size, localization and depth of the defect to be corrected. The aim of this study is to present a case report of a partial avulsive wound of the nose treated surgically by nasal reconstruction using an oblique frontal flap.