Sensitive nerve function measurement in facial trauma: An observational study.

BACKGROUND: Facial trauma is responsible for various types of health damage and may be functional or aesthetic. Depending on the degree of energy released in this type of trauma, sometimes an irreversibility degree is obtained. This study aimed to perform an objective evaluation of traumatic peripheral nerve injuries resulting from mandibular fractures and midface, using silicon monofilaments. MATERIAL AND METHODS: This was an observational, cross-sectional study. All patients with maxillofacial fractures, who were hospitalized by the department of Oral and Maxillofacial Surgery of Instituto Dr. José Frota Hospital, were randomly recruited and screened for inclusion in the present study. Sixty patients, victims of automobile accidents or firearms, were evaluated using Semmes Weinstein monofilaments in the regions corresponding to the mental and infraorbital nerves, right and left. RESULTS: The highest frequencies mandibular nerve changes were those that there was a loss protective sensation, but in which, the patient can feel deep pressure and pain; In which the worst sensory alterations occurred in patients' victims of firearm. In the middle third of the face, the worst alterations were those that there was a loss of the protective and discriminating sensation for hot and cold. CONCLUSIONS: The use of monofilaments is a support tool in oral and maxillofacial traumatology for the diagnosis and monitoring of peripheral sensory alterations. Key words:Peripheral nerve injuries, facial trauma, wounds and injuries, accidents, traffic, violence.

Fatores etiológicos e prevalência de lesões bucofaciais em surfistas de Fortaleza

RESUMO O estudo investigou fatores etiológicos e prevalência de lesões bucofaciais em surfistas profissionais e amadores em Fortaleza, Ceará. Aplicou-se um questionário em 150 surfistas homens e usaram-se testes estatísticos (qui-quadrado e teste t de Student) com nível de significância p < 0,05. Em 56% encontrou-se alguma lesão bucofacial. Queimaduras de lábio e de face, laceração de mucosa e fratura dentária foram as mais prevalentes. Comparando surfistas competidores com não competidores houve significância entre ocorrência de lesões com fundo de rocha (p = 0,032) e com prancha (p = 0,003) e maior presença de lesões entre os competidores (p = 0,003). Conclui-se que fraturas dentárias e queimaduras facial e labial são prevalentes em surfistas e que há mais chances de ocorrência de lesões quanto maiores forem a idade e o tempo de prática.

ABSTRACT The study investigated etiological factors and the prevalence of orofacial lesions in surfers professionals and amateurs in Fortaleza, Brazil. A questionnaire was applied to 150 male surfers and statistical tests (Chi-square and Student t) were used with significance level p <0.05. In 56%, there was some orofacial lesion. Lip and face burns, mucosal laceration and dental fracture were the most prevalent. Comparing competitive surfers with non-competitors there was significance between the occurrence of rock bottom injuries (p=0.032) and surfboard (p=0.003) and greater presence of injuries among competitors (p=0.003). It is concluded that dental fractures and facial and lip burns are prevalent in surfers and that there is a greater chance of occurrence of injuries the greater the age and the time of practice of them.

RESUMEN El estudio investigó factores etiológicos y prevalencia de lesiones bucofaciales en surfistas profesionales y aficionados en Fortaleza, Ceará. Se aplicó un cuestionario en 150 surfistas de sexo masculino y se utilizaron pruebas estadísticas (chi cuadrada y prueba de la t de Student) con un nivel de relevancia estadística de p <0,05. En el 56% se encontró alguna lesión bucofacial. Las más frecuentes fueron quemaduras del labio y de la cara, laceración de mucosa y fractura dental. Al comparar a surfistas competidores con otros no competidores hubo relevancia entre lesiones producidas por el fondo (p = 0,032) y por la tabla (p = 0,003), y mayor existencia de lesiones entre competidores (p = 0,003). Se concluye que las fracturas dentales y las quemaduras facial y labial son frecuentes en surfistas y hay más probabilidad de que se produzcan lesiones cuanto mayor es la edad y el tiempo de práctica.

Peripheral ossifying fibroma on the mandible: report of atypical presentation case / Fibroma ossificante periférico na mandíbula: relato de caso atípico

ABSTRACT Peripheral ossifying fibroma (POF) is a benign lesion, nodular, firm on palpation; the base is sessile or pedunculated; similar in color to the mucosa and epithelium; it may be preserved or ulcerated. It is prevalent in female and exclusively affects the gingiva. It is usually associated with irritating factors such as caries, dental plaque, among others. The objective of the present study is to report the case of a 27-years-old female patient, presenting a lesion in the mandible, complaining of an increased volume. Surgical excision was the treatment of choice. The patient is 24 months postoperatively with no signs of relapse.

RESUMEN El fibroma osificante periférico es una lesión benigna, nodular, firme a la palpación, de base sésil o pediculada, de color similar a la mucosa y al epitelio; puede estar intacto o ulcerado. Se observa más en mujeres y acomete solamente la encía. La lesión se asocia a factores irritantes, como caries, cálculo dental, entre otros. El objetivo del presente estudio es reportar el caso de una paciente de 27 años de edad, que ha presentado lesión en la mandíbula, quejando-se de aumento de volumen. La escisión quirúrgica ha sido el tratamiento de elección. La paciente encuentra se con 24 meses de postoperatorio, sin señales de recidva.

RESUMO O fibroma ossificante periférico (FOP) é uma lesão benigna, nodular, firme à palpação, de base séssil ou pediculada, com coloração semelhante à mucosa e ao epitélio; pode estar íntegro ou ulcerado. Prevalece no gênero feminino e acomete exclusivamente a gengiva. Associa-se a fatores irritantes, como cárie, cálculo dentário, entre outros. O objetivo do presente estudo é relatar o caso de uma paciente de 27 anos de idade, que apresentou lesão em mandíbula, queixando-se de aumento de volume. A excisão cirúrgica foi o tratamento de escolha. A paciente encontra-se com 24 meses de pós-operatório, sem sinais de recidiva.

Avaliação de vídeos sobre Suporte Básico de Vida (SBV) publicados no Youtube / Evaluation of Basic Life Support (BLS) videos published on YouTube

O presente trabalho tratará de uma análise de vídeos do YouTube relacionada ao suporte básico de vida de acordo com as diretrizes da American HeartAssociation (AHA) de 2010. O trabalho em questão é uma pesquisa do tipo exploratória, com abordagem quantitativa, realizada no sítio de compartilhamento de vídeos do YouTube, cujo endereço é "www.youtube.com.br, um "site bastante acionado pelos usuários da "internet" para adquirir conhecimentos de qualquer área. Foram analisados 104 vídeos. A média de duração dos vídeos foi de 6 minutos e 21 segundos. Dos 104 vídeos, 40 (38%) estavam de acordo com AHA e 64 (62%) não estavam conforme as diretrizes AHA. Quanto ao número de erros por vídeos os resultados demonstraram que metade dos vídeos analisados apresentaram 3 erros de publicação de acordo com AHA de 2010. Os vídeos analisados perfizeram um total de 148 desconformidades. O não seguimento da sequência CABD foi o erro mais comum observado com 45 (30,4%) aparições. Em relação à autoria dos vídeos, estes foram publicados por organização/instituição, pessoa física e ONG. Os vídeos analisados apresentaram um grande número de visualizações obtendo uma média de 23.829 visualizações... (AU)

This research will deal with an analysis of YouTube videos related to basic life support according to the guidelines of the American Heart Association (AHA) 2010. These is an exploratory research with a quantitative approach, carried out at the site of sharing YouTube videos, whose address is "www.youtube.com.br " a " site " that is very driven by users internet " to acquire knowledge in any field . 104 videos were analyzed. The average length of the videos were 6 minutes and 21 seconds. Of the 104 videos analyzed, 40 (38 %) were in accordance with AHA and 64 (62%) were not in accordance with guidelines AHA. As for the number of errors per video results showed that half of the videos analyzed present 3 Mistakes of publication according to AHA 2010. Videos analyzed resulted in a total of 148 discontinuities in total. Failure to follow the sequence CABD was the most common error observed in 45 (30.4%) appearances. Regarding the authorship of the videos were posted by the same organization / institution, individuals and NGOs. The videos analyzed showed a large number of views getting an average of 23,829 views... (AU)

Sagittal osteotomy for the removal of deeply impacted mandibular molars: a presentation of series of cases.

Sagittal osteotomy was primarily described as a treatment for prognathism and retrognathia. It has been rarely reported as an option for the removal of deeply impacted tooth. The principal indication of this approach is when the tooth is deeply impacted on the mandibular ramus or body and it presents intimate relationship between its root and inferior alveolar neurovascular bundles. In this article the author related three rare cases of lower third molar included. Because of the unusual deeply position of these, the SRRO surgery technique was realized to remove them. Sagittal split ramus osteotomy (SSRO) is technically safe and allows the removal of teeth in situations of deeply impacted mandibular ramus, angle or body with minimal trauma in a short time.

Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

INTRODUCTION: This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. MATERIALS AND METHODS: Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. RESULTS: Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). DISCUSSION: Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

Distrator palatal de Rotterdam: uma opção para expansão cirúrgica de maxila / Rotterdam palatal distractor: an option for surgically assisted rapid maxillary expansion

Existem diversos aparelhos que podem ser utilizados para a expansão, sendo classificados em distratores de ancoragem dentária, e os mais utilizados e difundidos são o Haas e Hyrax e distratores de ancoragem óssea somente. Vários aparelhos de ancoragem óssea têm sido desenvolvidos, sendo o expansor palatal de Rotterdam um dos mais utilizados. Este artigo tem como objetivo relatar um caso de expansão cirurgicamente assistida de maxila com o distrator palatal Rotterdam (KLS Martin) e discutir as principais indicações, vantagens e desvantagens desse aparelho bem como o protocolo de utilização.

There are several devices that can be used for maxillary expansion. They can be classified as follows: toothanchored distractors (the most frequently used being the Haas and the Hyrax) and bone anchor distractors only. Several bone anchorage devices have been developed, with the Rotterdam palatal expander being the one most commonly used. This article sets out to report a case of surgically assisted maxillary expansion with the Rotterdam palatal distractor (KLS Martin) and to discuss indications, advantages and disadvantages of this device and the protocol used.

Reabilitação de maxilas atróficas com implantes zigomáticos em carga imediata: estudo retrospectivo de 22 casos / Rehabilitation of atrophic maxilla with immediate loading through zigomatic implants: review of 22 cases

Realizou-se uma análise retrospectiva de 22 casos de maxilas atróficas, reabilitadas proteticamente com carga imediata, por meio de implantes cônicos na região anterior de maxila em conjunto com dois implantes zigomáticos bilateralmente. Objetivamos discutir a efetividade deste método a partir de informações relativas à técnica empregada (tipo de implante, quantidade, comprimento e torque de inserção) e da taxa de sucesso durante o tempo de acompanhamento da pesquisa. Os pacientes apresentaram-se com média de idade de 57,3 anos, variando de 39 a 76, sendo 6 do gênero masculino e 16 feminino. A média do torque de inserção foi de 47,75N.cm para os implantes cônicos anteriores (n = 68) e de 68,5N. cm para os zigomáticos (n = 44), ambos apresentaram taxa de sucesso de 100% durante o período de acompanhamento médio de 34,7 meses

The present study evaluated retrospectively 22 atrophic maxilla cases treated by prosthodontic rehabilitation with immediate loading using conic implants in the pre-maxilla with two zigomatic implants bilaterally disposed. We aimed at discussing the effectiveness of this treatment through information on the applied method (type of implant, quantity, length and placement torch) and on the success rate during follow-up period. The average age of the patients was 57.3 years old, varying from 39 to 76 and six of them were males and sixteen females. The insertion torch average was of 47.75N.cm for anterior conic implants (n = 68) and 68.5Ncm on the right and left zigomatic implants (n = 44), both with success rate of 100% during a 34.7 months follow-up period

A comparison of motorcycle and bicycle accidents in oral and maxillofacial trauma.

PURPOSE: The aim of this study was to present a large series of motorcycle- and bicycle-related traumas to the face in an attempt to identify the injury pattern in motorcyclists and bicyclists. PATIENTS AND METHODS: Data were collected from patients during a 10-year period (1999 through 2009), which included demographic data, diagnosis of facial fractures, use of protective devices, dentoalveolar trauma, and facial soft tissue injuries. RESULTS: There were 556 patients with bicycle accidents and 367 with motorcycle accidents. Men were involved in 79% (436) of bicycles accidents and 82% (299) of motorcycle accidents. Young male patients were more frequent in bicycle and motorcycle accidents. Two hundred fifty bicyclists showed 311 maxillofacial fractures. Two hundred twenty-one motorcyclists showed 338 maxillofacial fractures. Motorcycle accidents caused multiple fractures in more patients. Seventy-six percent of motorcyclists were using helmets at the time of the accidents, whereas 6% of cyclists were using helmets. Motorcyclists showed a larger number of lacerations, whereas bicyclists showed a larger number of abrasions. Avulsion was the most common dentoalveolar injury for these accident types. Hospital stays were 3.8 days for motorcyclists and 1.3 days for bicyclists. CONCLUSIONS: The high-impact collisions typically observed in motorcycle accidents is directly related to larger percentages of soft tissue lacerations and facial fractures. The low-impact trauma that is observed in bicycle accidents is more commonly associated with soft tissue abrasion, hematoma, and dentoalveolar fractures. This stresses the need for compulsory legislation for helmet use with face-guards for cyclists and motorcyclists. It is important to take measures to alert the public regarding the severity of injuries likely to occur in bicycle- and motorcycle-related accidents and ways to prevent them.

Mandibular buccal bifurcation cyst: a case report and literature review.

The mandibular buccal bifurcation cyst is a cystic lesion occurring on the buccal surface of the permanent mandibular first molar in 6- to 8-year-old children. The purpose of this article was to present a case report of an 8-year-old with a radiolucent area on the permanent mandibular left first molar, with clinical, radiological, and histological characteristics compatible with the pathological entity mentioned. The treatment adopted in this case was enucleation without extraction. The patient is still under observation without any sign of recurrence.

A 9-year retrospective study of dental trauma in Piracicaba and neighboring regions in the State of São Paulo, Brazil.

PURPOSE: The purpose of this study was to evaluate the occurrence of dentoalveolar trauma during a 9-year period in the Oral and Maxillofacial Surgery Division at Piracicaba Dental School, State University of Campinas in patients from the Piracicaba municipality and neighborhood regions in São Paulo, Brazil. PATIENTS AND METHODS: This retrospective epidemiologic study from January 1999 to December 2007 evaluated all patients who presented at the Oral and Maxillofacial Surgery Division at Piracicaba Dental School with sustained oral and maxillofacial traumatic injuries associated with dentoalveolar trauma. Information regarding age, gender, etiology, use of protective devices such seatbelts, crash helmets, and presence of facial fractures and general trauma, oral condition, stage of dentition, date of trauma, drug abuse, type, teeth affected, and classification of the trauma were gathered from the medical files. Descriptive analysis was conducted. RESULTS: In total, 2,785 patients were analyzed and 542 (19.46%) were included in this study. The male to female ratio was 2.81:1. Most patients presented with oral hygiene as regular (51.85%). Friday, Saturday, and Sunday were the most prevalent days. Smoking was the most common harmful habit analyzed (16.05%) followed by alcohol use (15.87%). Bicycle accidents (26.94%) were the most common cause, followed by falls (22.69%). With regard to protective devices, 31.51% of drivers were wearing seatbelts during the accidents and helmets were used by 84.38% of motorcycle drivers at the moment of injury. One hundred thirty-five facial fractures were associated with dental and dentoalveolar traumas, and the mandible was the facial bone most associated with dentoalveolar trauma. Upper and lower limbs were most frequently associated with general trauma, accounting for 140 (38.78%) and 111 (30.75%), respectively. CONCLUSION: This study shows that dentoalveolar trauma rates and patterns in the Piracicaba municipality and neighborhood regions in São Paulo are similar to other populations. The weekend is the period with the major incidence of dentoalveolar trauma. Alcohol consumption was linked with this type of trauma. Dentoalveolar trauma is involved in and closely related to severe maxillofacial trauma. The use of a helmet is as important as that of a seatbelt. More studies are necessary for a better knowledge and understanding when considering protocols and organization charts in emergency rooms.

Implant migration into maxillary sinus: description of two asymptomatic cases.

BACKGROUND: Rehabilitation of edentulous jaws with dental implants has become a usual practice around the world. A very low incidence of complications is associated with this therapy. One of them is migration of dental implants into maxillary sinus. Foreign bodies inside maxillary sinus should be removed because they can cause sinusitis, but if any symptoms are present, preservation alone can be indicated. Implant removal and bone reconstruction on the same procedure reduce treatment time and allow rehabilitation with implant-supported prosthesis. METHODS: In the present study, we report two cases of dental implants displaced into maxillary sinus that receive different treatment. RESULTS: In one of them, implant removal and sinus lift were carried out on same procedure while on the other preservation alone was advocated. CONCLUSION: Both treatment modalities treatments allowed installation of implant-supported prosthesis.

Fratura de ângulo mandibular após tentativa de exodontia de 3º molar incluso: relato de um caso / Treatment of a Mandibular Angle Fracture by Champy?s Method after Removal of Contralateral Impacted Third Molar: Case Report

As fraturas de ângulo mandibular durante ou após a exodontia dos terceiros molares inferiores são raras. Vários fatores podem estar associados a um maior acometimento deste local como presença do terceiro molar, corte seccional na região de ângulo mandibular mais fino que na região dos dentes e por ser considerada uma região de alavanca. Este tipo de fratura apresenta uma das maiores taxas de complicações dentre as fraturas mandibulares. Inúmeros tratamentos são propostos na literatura, como: 1) Utilização de bloqueio maxilo-mandibular associado ou não à fixação não rígida 2) Utilização de placas de reconstruções através de acesso extraoral 3) Técnica de Lag Screw 4) Utilização de duas miniplacas 2,0mm uma na zona de tensão com parafusos monocorticais e outra na zona de compressão, com a utilização de parafusos bicorticais 5) Método de Champy, que se baseia na utilização de apenas uma miniplaca na zona de tensão (linha oblíqua), com a utilização de parafusos monocorticais e por acesso intrabucal. O presente trabalho relata uma rara fratura de ângulo mandibular esquerdo após a tentativa de exodontia do dente 48, que foi tratado pelo método de Champy, que se mostrou eficaz e seguro neste tratamento. Um resultado pós-operatório de 3 meses é apresentado.

Mandibular angle fractures during or following mandibular third molar surgery are rare. There are various associated factors, such as the presence of a lower third molar, a cross-sectional area thinner than the tooth-bearing region and the fact that the angle can be considered an area of ?levering?. The mandibular angle fracture shows a greater incidence of complications than other mandibular fractures. Many treatments are reported in the literature, such as: 1) Closed reduction or intraoral open reduction whether or not associated with non-rigid internal fixation; 2) Extraoral open reduction and internal fixation using reconstruction plates; 3) Lag- screw technique; 4) Open reduction and internal fixation using two noncompression miniplates; 5) Champy`s method, by means of which, via the intraoral approach, a single miniplate is fixed with monocortical screws on the tension zone (oblique ridge). This case report shows a rare fracture of the left mandibular angle after an attempt to remove the contralateral impacted third molar. Champy`s method proved to be efficient and safe in treating this fracture. The result of a three -month- follow-up is reported.

Oral myiasis caused by Cochliomyia hominivorax treated with ivermectin and nitrofurazone: case report.

Myiasis is the infestation of tissues and organs of animals and humans by certain dipteran fly larvae. This phenomenon is well-documented, especially among animals and people in tropical and subtropical areas. Oral myiasis is a rare condition that can be caused by several species of dipteran fly larvae. When the larvae are removed from the mouth, the tissues seem to recover with no subsequent complications and no need for further treatment. This article presents a case involving a patient with oral myiasis caused by Cochliomyia hominivorax and treated with ivermectin and nitrofurazone.