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1.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 29-33, jul.-set. 2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1253237

RESUMO

Introdução: O objetivo do presente estudo é apresentar um caso clínico de osteomielite como complicação de fratura mandibular não tratada. Relato do caso: Paciente de do gênero masculino, 32 anos, compareceu ao serviço de Cirurgia e Traumatologia Bucomaxilofacial relatando ter sido vítima de queda da própria altura após ingestão de bebida alcoólica há mais de dois meses, com queixa de secreção em face. No exame físico observou-se presença de fistula extra oral na região mentual à esquerda com débito ativo de secreção sero purulenta; dor local; febre; limitação de abertura oral; parestesia da região mentual à esquerda, edema significativo e pseudartrose. O exame tomográfico confirmou a presença de fratura cominutiva de mandíbula com sequestro ósseo na região basilar. Optou-se por procedimento cirúrgico sob anestesia geral, com remoção de sequestro ósseo e fixação interna rígida. Considerações finais: Houve boa evolução, com regressão dos sintomas apresentados... (AU)


Introduction: The aim of this study is to present a clinical case of osteomyelitis as a complication of untreated mandibular fracture. Case report: Male patient, 32 years old, attended the service of Buccomaxillofacial Surgery, reporting that he had fallen from his own height after drinking alcohol for more than two months, complaining of secretion in the face. In the physical examination there was presence of extra oral fistula in the left mental region with active discharge of purulent serus secretion; local pain; fever; oral opening limitation; paresthesia of the left mental region, significant swelling and pseudarthrosis. The tomographic examination confirmed the presence of a comminuted mandible fracture with bone sequestration in the basilar region. We opted for surgical procedure under general anesthesia, with removal of bone sequestration and rigid internal fixation. Final considerations: There was a good evolution, with regression of the presented symptoms... (AU)


Assuntos
Humanos , Masculino , Adulto , Osteomielite , Cirurgia Bucal , Fraturas Mandibulares , Procedimentos Cirúrgicos Operatórios , Osso e Ossos , Fraturas Ósseas
2.
Dent Mater ; 36(9): 1201-1213, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32576408

RESUMO

OBJECTIVE: To evaluate the influence of light emitted from two Polywave®, LED light-curing units (LCU) on in vivo pulp temperature (PT) rise and signs of acute inflammatory response in pulps of human premolar having deep Class V preparations. METHODS: Sixty intact, first premolars from 15 volunteers requiring extraction received infiltrative anesthesia. A sterile thermocouple probe was inserted within the pulp tissue through a minute occlusal pulp exposure in only 45 teeth (n = 9) to continuously monitor PT (°C). A deep buccal Class V preparation was created, and the surface was exposed to light from a commercial Polywave LCU (Bluephase 20i (20i), Ivoclar Vivadent) or from an experimental LCU (Exp) using the exposure modes (EM): 1s/Exp and 2s/Exp, 10s/20i, 20s/20i, and 60s/20i. Peak PT and PT rise values above baseline (ΔT) data were evaluated using a one-way ANOVA followed by Tukey's post-hoc test (α = 5%). Teeth used for histological and immunohistochemical analyses (n = 3) were extracted approximately 2 h after exposure to the LCU. RESULTS: No significant difference in peak PT and ΔT values was noted between 2s/Exp and 20s/20i groups, which both exhibited higher values than 1s/Exp and 10s/20i groups (p < 0.001). Dilated and congested blood vessels were seen after exposure to 1s/Exp, 2s/Exp, or 60s/20i EMs. The expression of IL-1ß and TNF-α tended to be more intense when higher irradiance was delivered. SIGNIFICANCE: Although higher irradiance delivered over a short exposure caused lower PT rise than 5.5 °C, such EMs should be used with caution, as they have more potential to harm the pulp tissue.


Assuntos
Luzes de Cura Dentária , Cura Luminosa de Adesivos Dentários , Dente Pré-Molar , Resinas Compostas , Polpa Dentária , Humanos , Temperatura
3.
Rev. cir. traumatol. buco-maxilo-fac ; 19(1): 41-44, jan.-mar. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1254152

RESUMO

A disfunção temporomandibular (DTM) pode acometer os músculos mastigatórios, articulação temporomadibular (ATM) e estruturas adjacentes. Os sintomas mais comuns são: dor na região da ATM e dos músculos da mastigação, mas, em casos mais graves, podem acometer outras regiões faciais, que afetam diretamente a qualidade de vida dos pacientes. Tanto as abordagens cirúrgicas como não cirúrgicas podem ser usadas dependendo da etiologia e gravidade da doença. O tratamento tem como objetivo aliviar os sintomas e, consequentemente, melhorar a qualidade de vida dos pacientes. Objetiva também descrever um caso no qual foi realizada a discopexia como alternativa cirúrgica em uma paciente que teve tratamentos conservadores mal sucedidos para aliviar a dor facial, discutindo as características dos distúrbios de articulação e as formas de tratamento. A paciente continuou com tratamento fisioterápico funcional e evoluiu sem queixas álgicas, relatando melhora na qualidade de vida. A abordagem cirúrgica não deve ser considerada a primeira escolha, quando houver dor facial, no entanto, sob condições de sintomas persistentes e crônicos, alternativas, como a discopexia e cirurgia na articulação temporomandibular, podem ser consideradas para benefício do paciente... (AU)


Temporomandibular dysfunction (TMD) can affect the masticatory muscles, temporomandibular joint (TMJ) and adjacent structures. The most common symptoms are pain in the TMJ region and chewing muscles, but in more severe cases can affect other facial regions that directly affect the quality of life of patients. Both surgical and non-surgical approaches may be used depending on the etiology and severity of the disease and the goal of treatment is to alleviate symptoms and thereby improve patients' quality of life. The aim of the present article is to describe a case where discopexy was performed as a surgical alternative in a patient who had unsuccessful conservative treatments to relieve facial pain, discussing the characteristics of joint disorders and treatment modalities. The patient continued with functional physiotherapeutic treatment and evolved without pain complaints, reporting improvement in quality of life. The surgical approach should not be considered the first choice when there is facial pain. However, under conditions of persistent and chronic symptoms, alternatives such as discopexy and temporomandibular joint surgery may be considered for the benefit of the patient... (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Dor , Articulação Temporomandibular , Dor Facial , Transtornos da Articulação Temporomandibular , Disco da Articulação Temporomandibular , Tratamento Conservador , Mastigação , Qualidade de Vida , Sinais e Sintomas , Articulações , Músculos da Mastigação
4.
ROBRAC ; 27(83)out./dez. 2018. ilus
Artigo em Português | LILACS-Express | LILACS | ID: biblio-997283

RESUMO

Objetivo: Relatar um caso de fixação de zigoma em ponto único "single point". Relato do caso: Paciente do gênero masculino, 58 anos, saudável, pardo, foi encaminhado ao Pronto Socorro Municipal do município de Osasco/SP relatando ter sido assaltado, sofrendo trauma facial. Ao exame físico específico observou-se perda de projeção zigomática direita, degrau palpável na sutura fronto zigomática, degrau mínimo no rebordo infra orbital e movimentação ocular normal, sem perda de sensibilidade na porção infra orbital. O paciente foi informado do diagnóstico e necessidade de tratamento cirúrgico. Após exames laboratoriais e consentimento, foi submetido a procedimento composto por: acesso supratarsal, exposição da fratura, redução, checagem da projeção e fixação utilizando miniplaca 2.0 mm. Procedeu-se a nova checagem da posição do zigoma onde verificou-se a resolução do degrau na margem infraorbital. No controle pós-operatório, observou-se abertura bucal normal e restauração da projeção zigomática. Conclusão: Quando corretamente indicadas, as fixações em ponto único trazem benefícios como menores custos, menor morbidade, melhora da estética facial e redução do risco de ocorrer lesões sensoriais e o incômodo quando são utilizadas as miniplacas e parafusos.


Aim: To report a case of single-point zygoma fixation. Case report: A 58-year-old male, healthy, brown patient was referred to the Municipal Emergency Room in the city of Osasco / SP, reporting that he had been assaulted, suffering facial trauma. At the specific physical examination, there was loss of right zygomatic projection, palpable step in the zygomatic frontal suture, minimal step in the infraorbital border and normal ocular movement, without loss of sensitivity in the infra-orbital portion. The patient was informed of the diagnosis and the need for surgical treatment. After laboratory tests and consent, the patient was submitted to a procedure consisting of: supratarsal access, fracture exposure, reduction, check of the projection and fixation using mini-plate 2.0 mm. A new check of the zygoma position was performed, where the resolution of the step in the infraorbital margin was verified. Postoperative control revealed a normal oral opening and restoration of the zygomatic projection. Conclusion: When correctly indicated, single-point fixations bring benefits such as lower costs, lower morbidity, improved facial aesthetics and reduced risk of sensory lesions, and discomfort when using miniplates and screws.

5.
Dent Mater ; 34(6): 901-909, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29606368

RESUMO

OBJECTIVE: This in vivo study evaluated pulp temperature (PT) rise in human premolars having deep Class V preparations during exposure to a light curing unit (LCU) using selected exposure modes (EMs). METHODS: After local Ethics Committee approval, intact first premolars (n=8) requiring extraction for orthodontic reasons, from 8 volunteers, received infiltrative and intraligamental anesthesia and were isolated using rubber dam. A minute pulp exposure was attained and sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted into the coronal pulp chamber to continuously monitor PT (°C). A deep buccal Class V preparation was prepared using a high speed diamond bur under air-water spray cooling. The surface was exposed to a Polywave® LED LCU (Bluephase 20i, Ivoclar Vivadent) using selected EMs, allowing 7-min span between each exposure: 10-s in low (10-s/L), 10-s (10-s/H), 30-s (30-s/H), or 60-s (60-s/H) in high mode; and 5-s-Turbo (5-s/T). Peak PT values and PT increases over physiologic baseline levels (ΔT) were subjected to 1-way, repeated measures ANOVAs, and Bonferroni's post-hoc tests (α=0.05). Linear regression analysis was performed to establish the relationship between applied radiant exposure and ΔT. RESULTS: All EMs produced higher peak PT than the baseline temperature (p<0.001). Only 60-s/H mode generated an average ΔT of 5.5°C (p<0.001). A significant, positive relationship was noted between applied radiant exposure and ΔT (r2=0.8962; p<0.001). SIGNIFICANCE: In vivo exposure of deep Class V preparation to Polywave® LED LCU increases PT to values considered safe for the pulp, for most EMs. Only the longest evaluated EM caused higher PT increase than the critical ΔT, thought to be associated with pulpal necrosis.


Assuntos
Luzes de Cura Dentária , Preparo da Cavidade Dentária/métodos , Polpa Dentária/efeitos da radiação , Dente Pré-Molar , Temperatura Alta , Humanos , Extração Dentária
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