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1.
J Craniofac Surg ; 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33027171

RESUMO

Facial asymmetry is a challenge for surgeons. Some surgical strategies could be used involved soft or hard tissue of the face. The aim of this report is to show the use of patient specific implants (PSI) in a puzzle strategy based on computer aided design/computer aided manufacturer to solve a complex structural facial asymmetry after orthognathic surgery. Twenty-five-year-old male patient complain for facial asymmetry after orthognathic surgery; main deformity was related to the shape of mandibular bone in the ramus, angle, and body. After mirror image, was chose an augmentation in the right side using 2-pieces patient specific implants and the bone reduction in the vertical high of the mandibular body in the left side. Surgical technique was realized by intra oral approach installing the ramus segment at first approach and the body segment as second to obtain stability in the fitting implant-bone-implant; the left side was treated using a guide for osteotomy; after 1-year follow-up no infection or complication was observed and facial symmetry was obtained. It is possible to conclude that the puzzle technique using polyetheretherketone can be applied to obtain predictable results in a simple strategy to solve a complex problem.

2.
J Craniofac Surg ; 31(6): e614-e617, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32871855

RESUMO

Total midface deficiency, to include the orbits, nose, zygomas, and maxilla, can occur in both syndromic and non-syndromic individuals. The treatment with combination of Le Fort III and I osteotomy could be used and it is few reported in the literature. The aim of the study is to present how technology can make the procedure for the correction of hypoplasia of the middle third more predictable and safer. The 2 clinical cases were managed under submental intubation and using VSP that generated 3D printing of oclusal splints and cutting guides. Modified oblique Le Fort III osteotomy (MOLFIIIO) and Le Fort I osteotomy were used due to patients present large sagittal discrepancy between maxilla and mandible (18 and 17 mm). The patients presented good outcomes without complications. In this study, the authors demonstrate that non-syndromic patient could be managed safety with MOLFIII and Le Fort I osteotomies for the correction of midfacial deformities using virtual surgical planning (VSP) associated with 3D printing technique and piezoelectric surgery.

3.
J Craniofac Surg ; 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32858611

RESUMO

Contour augmentation and mandibular angle modification surgery is becoming increasingly. The aim of this research is to compare technique and outcomes in augmentations done with standard implants or PEEK-based patient specific implants (PSI) in mandibular angle. Data from surgical planning, operative and post-operative of 6 months follow-up were revised for 21 patients who were submitted to facial surgery using a stock implant obtained from companies currently on the market or 3D implants created with CAD/CAM technology using PEEK 3D printing. Surgical time, intra-operative and post-operative complications were compared, analyzing the advantages and disadvantage of each technique. Statistical analyses using t-test and chi-squared were performed considering P value< 0.05 for statistical differences. Twelve patients were operated on with stock implants and nine patients with PSI. The surgical time was 15 minutes less for the 3D implant surgeries (P = 0.021) and intraoperatively only the stock implants needed modifications with wear and adaptation methods; post-operative infections were observed in both groups with no significant differences (P > 0.05). The 3D implants had greater levels of facial symmetry than the stock implants, although they did not present significant differences.Considering the limitations of this study, mandibular angle implants with a PEEK-based 3D CAD/CAM are efficient, stable and have a low complication rate; the CAD/CAM strategy is useful in facial surgery and can be integrated as a standard for surgical planning in facial makeover surgery.

4.
J Craniofac Surg ; 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32657992

RESUMO

Total midface deficiency, to include the orbits, nose, zygomas, and maxilla, can occur in both syndromic and non-syndromic individuals. The treatment with combination of Le Fort III and I osteotomy could be used and it is few reported in the literature. The aim of the study is to present how technology can make the procedure for the correction of hypoplasia of the middle third more predictable and safer. The 2 clinical cases were managed under submental intubation and using VSP that generated 3D printing of oclusal splints and cutting guides. Modified oblique Le Fort III osteotomy (MOLFIIIO) and Le Fort I osteotomy were used due to patients present large sagittal discrepancy between maxilla and mandible (18 and 17 mm). The patients presented good outcomes without complications. In this study, the authors demonstrate that non-syndromic patient could be managed safety with MOLFIII and Le Fort I osteotomies for the correction of midfacial deformities using virtual surgical planning (VSP) associated with 3D printing technique and piezoelectric surgery.

5.
Int. j. morphol ; 38(3): 570-577, June 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1098289

RESUMO

El ratón (Mus musculus) es un buen modelo animal de experimentación, donde sus glándulas salivales han sido utilizadas en estudios, especialmente de tipo preclínico. Sin embargo, las diferencias en la morfología de estas glándulas y, en particular de las submandibulares, entre humanos y roedores no son de conocimiento común. Por lo anterior, el objetivo de este estudio fue conocer las características morfocuantitativos de la glándula submandibular del ratón macho C57BL/6. Se utilizaron cinco ratones macho, cepa C57BL/ 6, de 11 a 13 semanas de nacidos, con un peso promedio de 30 g. Luego de su ambientación, los ratones fueron eutanasiados. Para el análisis histológico, las glándulas fueron extraídas y fijadas en formalina tamponada por 48 horas, procesada para su inclusión en paraplast y teñidas con hematoxilina y eosina, azul alcián pH 2,5, ácido peryódico de Schiff y Picrosirius Red. Se determinaron las características estereológicas de densidad de longitud (LVcond), de volumen (VVcond) y de superficie (SVcond) de los conductos. En las células acinares se evaluó la densidad de número (NVcel) y la densidad de volumen (VVcel). Para cada variable se obtuvo la media ± desviación estándar. La glándula submandibular se encontraba organizada de manera lobulada, cuyo parénquima era de tipo túbuloacinar mixto con predominio seroso, que se conectaba a través de conductos. Las células acinares presentaban reacción positiva para azul alcián y ácido peryódico de Schiff. El estroma de la glándula contenía principalmente colágeno tipo 1. Los resultados de las mediciones estereológicas fueron: LVcond = 220,02 ± 50,51 mm/mm3; VVcond = 50,48 ± 9,55 %; SVcond = 26,39 ± 5,45 mm2/mm3; NVcel = 16,85 x 104 ± 9,13 × 104/mm3; VVcel = 24,98 ± 6,22 %. Con los análisis presentados es posible realizar investigaciones experimentales, considerando las similitudes y diferencias morfocuantitativas que presenta la glándula submandibular de ratón macho, cepa C57BL/6 con la del humano.


The mouse (Mus musculus) is a good experimental animal model, where murine salivary glands have been widely used in research by their similarities with human glands. Stereology is a tool that has to demonstrated to be valuable in biomedical researc h. Therefore, the objective was to realize an analogy between morphology, function and morpho-quantitative characteristics of the C57BL/6 mouse submandibular gland. Five male mice, C57BL/6, from 11 to 13 weeks old were used, with an average weight of 30 g. After seven days, the mice were euthanized and the samples were extracted. Then, these were processed following the conventional histological processing protocol and stained with H&E, Picrosirius Red, AA and PAS. Finally, the histological and stereological analysis of the samples was performed. In the glandular ducts the length density (LVcond), volume density (VVcond) and surface density (SVcond) were determined; whereas, in the acinar cells the density of number (NVcel) and the density of volume (VVcel) were evaluated. For each stereological variable the mean ± standard deviation was obtained. The histological study revealed no discrepancies as previously described. Descriptive statistical analysis revealed the following: LVcond = 220.02 ± 50.51 mm/mm3; VVcond = 50.48 ± 9.55 %; SVcond = 26.39 ± 5.45 mm2/mm3; NVcel = 168467.38 ± 91288.67 /mm3 and VVcel = 24.98 ± 6.22 %. From this study, it will be possible to conduct comparative experimental research analyzing quantitative results from those presented in this research. From this study, it will be possible to carry out comparative experimental research, analyzing quantitative results from those presented in this investigation.


Assuntos
Animais , Masculino , Camundongos , Glândula Submandibular/anatomia & histologia , Camundongos Endogâmicos C57BL/anatomia & histologia , Glândulas Salivares/anatomia & histologia , Modelos Animais
6.
Int. j. morphol ; 38(3): 683-688, June 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1098307

RESUMO

The aim was to evaluate bone repair and gingival tissue repair in osteopenic rats. Fifteen female wistar rats were included; in all of them ovariectomy was realized to induce osteopenia; after 45 days, the animals were submitted to 2 surgical techinques 1) dental extraction of the upper central incisor with no socket preservation and 2) 5 mm cranial defect in the calvarium; 5 rats were included in the control group (G1) withput alendronate application; in the group 2 (G2) was used subcutenous alendronate (0.5 mg/kg) once for three weeks and then was realizd the both surgical techniques. In group 3 (G3), after ovariectomy was realized the both dental extraction and the calvarium defect and after that was realized the alendronate protocol. In each group, after six week was realized euthanasia and descriptive histological analysis of the surgical areas involved. In bone formation of the 5 mm cranial defect was observed with good progression in the 3 experimental models and no modification in quality of bone repair was observed. For the gingival tissue in the extraction socket, no differences were observed between G1 and G3. On other hand, in G2 a thinner and reduced gingival epithelium was found. Our results showed that alendronate was not an obstacle for bone repair; deficiencies in re-epithelialization of oral mucosa show the impact of alendronate before dental extraction.


El objetivo fue evaluar la reparación ósea y gingival en ratas con osteopenia. Quince ratas wistar hembras fueron incluidas; en todas ellas se realizo ovarectomia y fue realizada la inducción de osteopenia; después de 45 días, los animales fueron sometidos a dos técnicas quirúrgicas 1) extracciones dentales del incisivo central superior sin preservación alveolar y 2) creación de un defecto craneano de 5 mm en la calota; 5 animales fueron incluidos como grupo control (G1) sin la aplicación de alendronato; en el grupo 2 (G2) se utilizó alendronato subcutáneo (0,5 mg/kg) una vez a la semana durante 3 semanas. En el grupo 3 (G3), después de la ovarectomia se realizó la exodoncia y el defecto en el cráneo y después de ello se inicio el protocolo con alendronato. En cada grupo, después de seis semanas se realizó la eutanasia con descripción histológica de los hallazgos. En el hueso formado en el defecto craneano de 5 mm se observó una adecuada progresión de reparación en los 3 modelos experimentales y no se observó cambios importantes en el modelo de reparación. Para el tejido gingival en el sitio de extracción, no se observaron diferencias entre el grupo G1 y G3. Por otra parte, el G2 presentó un tejido mas delgado con reducción del epitelio gingival; nuestros resultados demuestran que el alendronato no fue un obstáculo en la reparación ósea; deficiencias en la re epitelización de la mucosa oral muestran el impacto del alendronato después de la exodoncia.


Assuntos
Animais , Feminino , Ratos , Doenças Ósseas Metabólicas/tratamento farmacológico , Regeneração Óssea/efeitos dos fármacos , Alendronato/administração & dosagem , Gengiva/efeitos dos fármacos , Osteonecrose/tratamento farmacológico , Osteoporose/tratamento farmacológico , Doenças Ósseas Metabólicas/complicações , Ovariectomia , Ratos Wistar , Difosfonatos/administração & dosagem
7.
Int. j. odontostomatol. (Print) ; 14(2): 242-248, June 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1090681

RESUMO

Los aumentos óseos previo a la instalación de implantes son cada vez mas utilizados y el diseño de nuevas estrategias para disminuir la morbilidad deben ser considerados. El objetivo de esta investigación fue definir el aumento óseo generado con la técnica "tent pole" en sector de mandíbula posterior. Se diseño un estudio longitudinal, prospectivo para estudiar la técnica. Se incluyeron sujetos con ancho óseo no mayor a 4 mm en el sector posterior y con altura no menor a 9 mm desde el margen superior del conducto alveolar inferior. Se realizaron cirugías bajo anestesia local realizando un acceso quirúrgico; se instalaron de 2 a 4 tornillos de osteosíntesis manteniendo 4 mm del tornillo extraóseo para luego reconstruir con biomaterial alógeno y L-PRF en conjunto con una membrana biológica absorbible; después de 4 meses se realizaron las re entradas estableciendo con tomografía computadorizada de haz cónico las ganancias óseas generadas. Fueron operados 14 sujetos con 27 sitios quirúrgicos; en todos los casos se pudo realizar la instalación de implantes a los 4 meses. En la evaluación inicial, el ancho óseo observado estaba entre 1,2 y 4,0 mm (promedio de 2,95 ± 0,75 mm); después de 4 meses de realizado el aumento horizontal el ancho observado fue de 3,79 y 10,05 mm (promedio de 7,15 mm ± 1,87 mm), confirmando una ganancia ósea promedio de 4,2 ± 1,26 mm. La diferencia obtenida fue significativa (p< 0,05). Se puede concluir que la técnica "tent pole" aplicada en esta investigación es predecible en el aumento óseo y aplicable para la rehabilitación sobre implante.


Bone augmentation prior to implant placement, is among strategies that should be considered to reduce morbidity rates in these procedures. The objective of this research was to define bone augmentation generator using the "tent pole " technique in the posterior jaw. A longitudinal, prospective study was designed, and subjects were included with ridge width no greater than 4 mm, height no less than 9 mm from the upper margin of the inferior alveolar canal. Surgeries were performed under local anesthesia for surgical approach; 2 to 4 osteosynthesis screws over ridge with 4 mm of the extra osseous screws were installed and were then regenerated, using allogeneic biomaterial and L-PRF together with an absorbable biological membrane. Re-entry was performed after four months and cone beam computed tomography analysis was used to confirm bone gain. Fourteen subjects were operated with 27 surgical sites; in all the cases, implant installation was possible at 4 months. In the initial evaluation, bone width observed was between 1.2 and 4.0 mm (average of 2.95 ± 0.75 mm); after 4 months of the horizontal increase, width was recorded at 3.79 and 10.05 mm (average of 7.15 mm ± 1.87 mm), confirming an average bone increase of 4.2 ± 1.26 mm. The difference obtained was significant (p <0.05). It can be concluded that the "tent pole" technique applied in this analysis is predictable in bone augmentation and applicable for implant rehabilitation.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Implantação Dentária Endo-Óssea/métodos , Aumento do Rebordo Alveolar , Mandíbula/cirurgia , Estudos Prospectivos , Estudos Longitudinais , Transplante Ósseo , Substitutos Ósseos , Tomografia Computadorizada de Feixe Cônico
8.
Am J Orthod Dentofacial Orthop ; 157(5): 662-667, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32354439

RESUMO

INTRODUCTION: The purpose of this research was to prospectively determine the ratio of 2 soft-tissue landmarks, pogonion (sPg) and menton (sMe), to their hard-tissue counterparts (Pg and Me) in the sagittal and vertical directions for mandibular lengthening surgeries. METHODS: We drew a sample from the prospective Orthognathic and Orthofacial Surgery Research study, consisting of patients who underwent surgical mandibular lengthening (alone or in combination with maxillary osteotomy) without genioplasty. We digitized landmarks using Facewizz software and determined the relationships between the hard- and soft-tissue changes by correlation analysis. RESULTS: Pearson correlation test showed a significant correlation between the type of surgery and the sPg:Pg and sMe:Me ratios. The sPg:Pg ratio was 87% for mandibular lengthening only and 102% for mandibular lengthening in combination with maxillary surgery. The sMe:Me ratio was 85% and 96% for upward and downward movements, respectively. CONCLUSIONS: The average ratios presented in this study for the pogonion and menton can aid in preoperative planning by providing estimates for soft-tissue behavior. Further stratifications will be possible after the Orthognathic and Orthofacial Surgery Research database is enriched with more inclusions.


Assuntos
Avanço Mandibular , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Queixo/anatomia & histologia , Humanos , Mandíbula , Estudos Prospectivos
9.
Int. j. morphol ; 38(2): 423-426, abr. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1056457

RESUMO

The aim of this investigation was to define the volume and area of the airway in subjects with Class II and Class III skeletal deformity. A cross-sectional study was designed including subjects with facial deformity defined by Steiner's analysis in subjects with indication of orthognathic surgery who presented diagnosis by cone beam computerised tomography. We determined the measurements of maximum area, minimum area and volume of the airway. The data were compared using Spearman's test, with statistical significance defined as p<0.05. 115 subjects were included: 61.7 % Class II and 38.3 % Class III, mean age 27.8 years (± 11.6). A significant difference was observed in the area and volume measurements in the groups studied, with significantly smaller measurements found in Class II (p=0.034). The minimum area was 10.4 mm2 smaller in Class II patients than in Class III, while the general volume of the airway was 4.1 mm3 smaller in Class II than in Class III. We may conclude that Class II subjects present a smaller airway volume than Class III subjects.


El objetivo de esta investigación de definir el volumen y área de vía aérea en sujetos con deformidad esqueletal clase II y III. Se diseñó un estudio de corte transversal incluyendo sujetos con deformidad facial definida según análisis de Stainer en sujetos con indicación de cirugía ortognática que presentaran una tomografía computadorizada de haz cónico como elemento diagnóstico; en este examen se determinaron medidas de área mayor, menor de vía aérea y volumen presente; los datos fueron comparados utilizando pruebas estadísticas con el test de spearman considerando el valor de p<0,05 para definir significancia estadística. 115 sujetos fueron incluidos, siendo 61,7 % de tipo clase II y 38,3 % de sujetos clase III, con una edad promedio de 27,8 años (± 11,6). Se observó una diferencia significativa en mediciones de area y volumen en los grupos estudiados, siendo el grupo de clase II significativamente menor (p=0,034). El área de menor tamaño fue 10,4 mm2 en pacientes clase II que en pacientes clase III, mientras que el volumen general de la vía área fue 4,1 menor en los clase II que en los clase III. Es posible concluir que los sujetos de clase II presentan menor volumen de vía área que los sujetos clase III.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Sistema Respiratório/diagnóstico por imagem , Anormalidades Craniofaciais/diagnóstico por imagem , Faringe/diagnóstico por imagem , Sistema Respiratório/anatomia & histologia , Nariz/diagnóstico por imagem , Imageamento Tridimensional
10.
Int. j. morphol ; 38(2): 309-315, abr. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1056440

RESUMO

Stability is necessary to ensuring proper bone repair after osteotomies and fractures. The aim of this research was to analyze how the repair of pseudoarthrosis sites was affected by different conditions in related to soft tissue. An experimental study was designed with 18 New Zealand rabbits. Six study groups were formed. An osteotomy was performed on the mandibular body of each animal and muscle was installed at the osteotomy site to model pseudoarthrosis. Fixation by surgery was then carried out, using plates and screws. The animals were submitted to euthanasia after 21, 42 and 63 days to make a descriptive comparison of the histological results. No animal was lost during the experiment. In all the samples, bone formation was observed with different degrees of progress. Defects treated with or without removal of the tissue involved in pseudoarthrosis presented comparable bone repair, showing that stability of the bone segments allows the repair of adjacent tissue. In some samples cartilaginous tissue was associated with greater bone formation. Stabilization of the fracture is the key in bone repair; repair occurs whether or not the pseudoarthrosis tissue is removed.


La estabilidad de las osteotomías y de las fracturas son fundamentales para asegurar la adecuada reparación ósea; el objetivo de esta investigación fue analizar la reparación presente en sitios de pseudoartrosis realizando la limpieza de la zona previo a la fijación o manteniendo el tejido de la nounión en el mismo lugar durante la osteosíntesis. Se diseñó un estudio experimental incluyendo 18 conejos de raza Neozelandesa. Se formaron 6 grupos de estudios a quienes se relizó una osteotomía en el cuerpo mandibular y posterior instalación de músculo en el lugar de la osteotomía para fabricar un modelo de pseudoartrosis. En cirugía posterior se fijó con placa y tornillos. Se realizaron eutanasias a los 42 y 63 días para comparar los resultados de forma descriptiva mediante estudio histológico. No fue perdido ningún animal durante el experimento. En todas las muestras evaluadas se observó formación ósea en diferentes niveles de avance; defectos tratados con o sin el retiro del tejido involucrado en la pseudoartrosis presentaron una condición de reparación ósea comparables, determinando que la estabilidad de los segmentos óseos permite la reparación del tejido adyacente. El tejido cartilaginoso se presentó en algunas muestras asociadas a sectores con mayor presencia de formación ósea. La estabilización de la fractura es clave en la reparación ósea; la reparación se produce manteniendo o retirando el tejido presente en la pseudoartrosis.


Assuntos
Animais , Coelhos , Consolidação da Fratura , Fraturas Mal-Unidas/terapia , Fraturas Mandibulares/terapia , Osteotomia/efeitos adversos , Fraturas Mandibulares/cirurgia
11.
Int. j. morphol ; 38(2): 316-321, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1056441

RESUMO

La regeneración de defectos óseos críticos requiere la utilización de biomateriales óseos. Así, se han utilizados agentes osteogénicos como la proteína morfogenética (rhBMP-2). El objetivo fue describir la formación ósea de defectos óseos críticos en calota de ratas utilizando rhBMP-2 con distintos biomateriales. Se realizaron dos defectos óseos críticos de 5 mm en 15 calotas de ratas machos adultas divididos en grupo control (sin tratamiento) (C); autoinjerto + rhBMP-2 (A); fosfato tricálcico + rhBMP-2 (BTCP); xenoinjerto de bovino + rhBMP-2 (B) y hidroxihapatita + rhBMP-2 (HA). A las ocho semanas post tratamiento, se realizó la eutanasia y posterior análisis histológico de los defectos. El grupo C no presentó formación de tejido óseo en el defecto. En el resto de los grupos, se formó abundante tejido óseo en los márgenes, por lo tanto, el defecto presentó menor tamaño. El grupo HA presentó formación ósea trabecular con amplios espacios medulares y abundante tejido adiposo. El grupo B-TCP también presentó formación ósea trabecular y la mayoría de las muestras presentaron puente óseo en el defecto. El grupo B presentó partículas de material injertado rodeado por trabéculas óseas y tejido conectivo. En el grupo A, todas las muestras presentaban puente óseo formado por bloques de autoinjerto rodeado por tejido conectivo y óseo. Es posible concluir que los defectos óseos de 5 mm en calota de rata son defectos críticos que requieren utilizar biomateriales para la reparación del defecto. El grupo B-TCP presentó características histológicas más próximas a la regeneración ósea lograda con el Grupo A.


The regeneration of bone critical size defects requires the use of bone biomaterials. Therefore, an osteogenic agent such as bone morphogenetic protein (rhBMP-2) has been used. The objective was to describe the bone formation of bone critical size defects in the rat calvaria using rhBMP-2 with different biomaterials. Two critical bone defects of 5 mm were made in 15 calvaria of adult male rats divided into a control group (without treatment) (C); autograft + rhBMP-2 (A); tricalcium phosphate + rhBMP-2 (B-TCP); bovine xenograft + rhBMP-2 (B) and hydroxyhapatite + rhBMP-2 (HA). At eight weeks post treatment, euthanasia and subsequent histological analysis of the defects were performed. Group C did not show bone tissue formation in the defect. In the rest of the groups, abundant bone tissue formed in the margins, therefore, the defect was smaller. The HA group presented trabecular bone formation with large medullary spaces and abundant adipose tissue. The B-TCP group also presented trabecular bone formation and most of the samples formed a bone bridge across the defect. Group B presented grafted material particles surrounded by bone trabeculae and connective tissue. In group A, all samples presented a bone bridge formed by autograft blocks surrounded by connective and bone tissue. It is possible to conclude that 5 mm bone defects in rat calvaria are critical size defects that require the use of biomaterials for defect repair. The B-TCP group presented histological characteristics similar to the bone regeneration achieved with Group A.


Assuntos
Animais , Masculino , Ratos , Regeneração Óssea/efeitos dos fármacos , Proteína Morfogenética Óssea 2/farmacologia , Materiais Biocompatíveis , Ratos Sprague-Dawley
12.
Int. j. odontostomatol. (Print) ; 14(1): 117-123, mar. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1056510

RESUMO

RESUMEN: El Leiomioma es una neoplasia benigna originada en el tejido muscular liso por lo que puede manifestarse en cualquier región del cuerpo humano que contenga músculo liso, siendo el sitio más común el útero, la piel y en el tracto gastrointestinal. La escasa cantidad de tejido muscular liso en boca hace que su manifestación oral sea infrecuente, representando solo 0.06 % del total de este tipo de tumores. Los sitios más afectados suelen ser los labios, las mejillas, el paladar, la lengua y encías. Histológicamente se distinguen tres tipos: el Leiomioma Sólido, Angioleiomioma (Vascular) y Leiomioma Epitelioide (Leiomioblastoma). El origen de esta neoplasia en boca suele ser la túnica media de los vasos sanguíneos. El Leiomioma intraóseo suele ser aún menos frecuente, y con un diagnóstico diferencial complejo, con histopatología que en varias ocasiones no suele ser fácil de clasificar. Si bien es definida como un tumor benigno, su manifestación intraósea puede llegar a ser localmente agresiva y con un diagnóstico controversial, debiendo abordarse muchas veces como una neoplasia maligna. El objetivo de este artículo es presentar una revisión de la literatura de esta variante intraósea de Leiomioma situada en mandíbula, sus consideraciones clínicas y un algoritmo de tratamiento.


ABSTRACT: Leiomyoma is a benign neoplasm, the origin is the smooth muscle tissue that can be found in any area of the human body, which contains smooth muscle tissue. The most common regions it can be located, are the uterus, the skin and the gastrointestinal tract. The low quantity of muscle tissue in the mouth leads to infrequent oral manifestation, representing only 0.06 % of these tumors. The most affected regions are the lips, cheeks, palate, tongue and gums. The Histologic classification is: Solid Leiomyoma, Angioleiomyoma (vascular) and Epithelioid Leiomyoma (Leiomyoblastoma). The origin of this tumor in the mouth is the tunica media of the blood vessels. Nevertheless, and in spite of being defined as a benign tumor, it can be extremely aggressive, be subject to controversial diagnosis, and must often be treated as a malign neoplasm. The Intraosseous Leiomyoma is infrequent and presents a complicated differential diagnosis, with a histopathology that many times cannot be easily classified. The aim of this article is to present a review of intraosseous variant Leiomyoma in the mandible, the clinicians´ considerations and a treatment algorithm.

13.
Cleft Palate Craniofac J ; 57(5): 589-598, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31698953

RESUMO

OBJECTIVE: This study aimed to review the existing evidence regarding reconstruction of the alveolar cleft using recombinant human bone morphogenetic protein-2 (rhBMP-2) in terms of bone volume and bone height. DESIGN: Systematic review and meta-analysis. PATIENTS­PARTICIPANTS: A systematic search was done. Randomized and nonrandomized clinical trials, where rhBMP-2 was used in the reconstruction of human alveolar cleft were included. INTERVENTIONS: Reconstruction of alveolar cleft with rhBMP-2. MAIN OUTCOME MEASURES: Average bone volume formation and average bone height formation in the alveolar cleft. Mean difference was calculated and pooled by meta-analysis. RESULTS: Of 709 identified articles, 5 studies met the inclusion criteria. The average bone volume formation was higher in the rhBMP-2 group than in the control group (61.11% vs 59.12%). The average bone height formation was higher in the control group compared to the rhBMP-2 group (75.4% vs 61.5%). The risk of bias in the selected articles was high. The meta-analysis showed that rhBMP-2 treatment may benefit bone formation compared to iliac crest graft (low certainty evidence; mean difference: -208.76; 95% confidence interval: -253.59 to -163.93; -I2 = 0%). CONCLUSIONS: The results obtained in primary articles are promising but have a high risk of bias and have low quality of evidence; therefore, it is necessary to conduct controlled clinical trials with a greater number of patients to recommend the use of rhBMP-2 in the treatment of the alveolar cleft. PROSPERO registration number: CRD42018077741.

14.
Int. j. odontostomatol. (Print) ; 14(3): 299-309, 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1114896

RESUMO

COVID-19 es una enfermedad altamente contagiosa y potencialmente mortal que nos acompañara por largo tiempo. Las profesiones de la salud y la vida en general ha sido afectada de forma significativa en todo lugar del mundo. La odontología ha pasado de una etapa de gran desarrollo clínico a una etapa donde el manejo de barrera de protección, el control de tratamientos y el tiempo asignado a los pacientes cambiará la forma de realizar la profesión. El presente trabajo pretende resumir las indicaciones y recomendaciones basadas en la evidencia disponible y realizar un análisis de la condiciones de salud oral para Latinoamérica en esta época de pandemia.


COVID-19 is a profound, highly contagious and life-threatening viral disease that will be with us for a long time. Health Care-related professions and life in its entirety are significantly, and perhaps irreversibly affected, all around the World. COVID-19 is and will continue to transform Dentistry and its practise. Based on the available evidence accrued to date, this work attempts to address such changes, current and anticipated, as well as present recommendations for clinical practise implementation, tailored for Latin/South America, in light of such lifealtering momentous pandemic.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Assistência Odontológica/normas , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/transmissão , Assistência Odontológica/métodos , Infecções por Coronavirus/transmissão , Odontologia , Emergências , Equipamento de Proteção Individual , Betacoronavirus , América Latina , Máscaras
15.
Int. j. morphol ; 37(4): 1564-1571, Dec. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1040170

RESUMO

Las glándulas salivales humanas pueden ser gravemente lesionadas por la radioterapia utilizada contra neoplasias de cabeza y cuello, produciendo hiposialia y xerostomía, las cuales afectan la salud oral y sistémica, mermando la calidad de vida de la persona. Los tratamientos convencionales actuales están diseñados para disminuir los síntomas, sin actuar sobre los cambios fisiopatológicos que se dan a nivel glandular. Esta revisión intenta analizar aquellas terapias preventivas y/o curativas que están desarrollándose en el campo biomolecular y que tienen un futuro prometedor por sus características innovadoras: terapia génica, terapia con células madre y terapia con factores de crecimiento. Se evidencia un aporte adicional de la nanotecnología, la cual está mejorando las vías de aplicación de los tratamientos.


Human salivary glands can be seriously injured by the radiotherapy used against head and neck neoplasms, producing hyposialia and xerostomy, which affect oral and systemic health, diminishing the person's quality of life. Current conventional treatments are designed to reduce symptoms, without acting on the pathophysiological changes that occur at the glandular level. This review attempts to analyze those preventive and /or curative therapies that are developing in the biomolecular field and that have a promising future due to their innovative features: Gene therapy, stem cell therapy and growth factor therapy. An additional contribution of nanotechnology is evident, which is improving the routes of treatment application.


Assuntos
Humanos , Radioterapia/efeitos adversos , Doenças das Glândulas Salivares/prevenção & controle , Células-Tronco/fisiologia , Terapia Genética/métodos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Lesões por Radiação/prevenção & controle , Protetores contra Radiação/uso terapêutico , Doenças das Glândulas Salivares/terapia , Glândulas Salivares/efeitos da radiação , Xerostomia/prevenção & controle , Nanotecnologia
16.
Int. j. odontostomatol. (Print) ; 13(3): 258-265, set. 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1012419

RESUMO

ABSTRACT: The aim of this research was to perform a systematic review to identify the most frequent uses of PLA/ PGA in alveolar bone regeneration and their results. A study was designed to answer the question: What are the most frequent uses of PLA/PLGA and their copolymers in alveolar bone regeneration?. A systematic search was done on MEDLINE, EMBASE and LILACS from April 1993 to December 2017. The search string used on MEDLINE was: (((polylactic acid) OR PLA) OR PLA-based copolymers) OR PLA blends) OR PLA scaffolds)) AND ((("Bone Regeneration"[Mesh]) OR bone regeneration) OR guided bone regeneration). The search was complemented by a manual review of the references from the articles included. Most of the studies selected were weak and, regarding the most frequent uses of PLA/PGA, 13 studies used it as a resorbable membrane, two as an absorbable mesh, one as an absorbable screw and three as filling material. Based on our results, the authors consider that PLA/PGA requires a delicate relation between the mechanical resistance and the degradation process. PLA/PGA does not interrupt bone regeneration; however, the influence in cellular events related to bone regeneration and later osseointegration have not been identified.


RESUMEN: El objetivo de esta revisión fue realizar una revisión sistemática de la literatura para identificar los usos más frecuentes de PLA/PGA en regeneración ósea en área maxilofacial y sus resultados. Se diseñó un estudio para responder a la pregunta: ¿Cuáles son los usos más frecuentes de PLA/PLGA y sus copolímeros en regeneración ósea en el sector maxilofacial?. Los estudios seleccionados fueron en su mayoría débiles y sobre los usos más frecuentes de PLA/PGA, 13 estudios lo utilizaron como membrana reabsorbible, 2 estudios como malla absorbible, un estudio como tornillo absorbible y 3 estudios como material de relleno. En base a nuestros resultados, los autores estiman que PLA/PGA requiere una delicada relación entre la resistencia mecánica que ofrece y la degradación que se produce; PLA/ PGA no interrumpe la regeneración ósea, sin embargo, no se ha identificado la potencialidad o influencia que presenta en los eventos celulares de la regeneración y posterior oseointegración.

17.
Biomed Res Int ; 2019: 8043510, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428646

RESUMO

The aim was to analyze histologically the bone repair in a mandibular osteotomy model with different gaps between the segments. Nine male rabbits who underwent osteotomies on the mandibular body were fixed with a 1.5 system plate and no bone graft; group 1 (2 mm gap between segments), group 2 (5 mm gap between segments), and group 3 (8 mm gap between segments) were included. After 8 weeks they were euthanized and the sample was processed for histological analysis. Group 1 showed advanced bone repair with cartilaginous tissue and cancellous bone, showing osteoblasts and type III collagenous fibers. In group 2, a more delayed ossification was observed, with an extensive area of peripheral ossifying cartilage and chondrocytes in greater number at the center of the defect; group 3 showed no evidence of ossification with fibrous tissue, a very low level of chondrocytes, and some bone sequestrate. We can conclude that, in this animal model, 2 or 5 mm gap in the osteotomy could be repaired as bone when fixation is used. The size of the gap is an important factor for the use of bone grafts considering endochondral ossification. This model can be used for graft analysis and related technologies.


Assuntos
Placas Ósseas , Transplante Ósseo , Mandíbula , Osteotomia Mandibular , Osteoblastos , Osteogênese , Aloenxertos , Animais , Osso Esponjoso/metabolismo , Osso Esponjoso/patologia , Osso Esponjoso/cirurgia , Humanos , Masculino , Mandíbula/metabolismo , Mandíbula/patologia , Mandíbula/cirurgia , Osteoblastos/metabolismo , Osteoblastos/patologia , Coelhos
18.
Int. j. morphol ; 37(2): 724-729, June 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1002284

RESUMO

La influencia de la función respiratoria en el desarrollo de estructuras orofaciales y postura craneocervical ha sido ampliamente discutida. El objetivo del estudio fue comparar valores cefalométricos de la región craneocervical e hioidea en sujetos con respiración nasal y oral. Se incluyeron sujetos de entre 18 y 27 años, de ambos sexos, donde 20 presentaban diagnóstico de respiración oral y 20 no presentaban esta alteración; mediante telerradiografía lateral de cabeza y cuello se realizó análisis cefalométrico craneocervical de Rocabado y aplicación de la técnica de Penning, obteniendo medidas craneocervicales e hioideas, dimensión anterior nasofaríngea y curvatura cervical. Para el análisis estadístico se utilizó la prueba de normalidad Shapiro-Wilk y la prueba T para muestras independientes, considerando un valor de p <0,05 para obtener diferencias significativas; en aquellos parámetros en donde no se presentó distribución normal se aplicó la prueba U de Mann-Whitney. No se encontraron diferencias significativas entre los grupos de estudio y los valores cefalométricos analizados, a excepción de la distancia entre la base del hueso occipital y el arco posterior del atlas (p=0,03). Existen limitadas diferencias cefalométricas entre sujetos con respiración oral y respiración nasal, no asociándose el espacio aéreo nasofaríngeo con las modalidades de respiración estudiadas. Deben ser consideradas condiciones de morfología facial o mandibular, para determinar más adecuadamente la influencia de los parámetros cefalométricos en el diagnóstico del modo respiratorio en estudios futuros.


The influence of respiratory function on the development of orofacial structures and craniocervical posture has been widely discussed. The objective of the study was to compare cephalometric values of the craniocervical and hyoid region in subjects with nasal and oral respiration. Subjects between 18 and 27 years of age, of both sexes, were included, where 20 presented oral breathing diagnosis and 20 did not present this alteration; using lateral telerradiography of the head and neck, craniocervical cephalometric analysis was performed of Rocabado and Penning technique was applied, obtaining craniocervical and hyoid measurements, anterior nasopharyngeal dimension and cervical curvature. For the statistical analysis we used the Shapiro-Wilk normality test and the T test for independent samples, considering a value of p <0.05 to obtain significant differences; in those parameters where no normal distribution was presented, the MannWhitney U test was applied. No significant differences were found between the study groups and the cephalometric values ??analyzed, except for the distance between the base of the occipital bone and the posterior arch of the atlas (p=0.03). There are limited cephalometric differences between subjects with oral breathing and nasal breathing, with no association of the nasopharyngeal air space with the breathing modalities studied. Conditions of facial or mandibular morphology should be considered in order to determine more adequately the influence of cephalometric parameters in the diagnosis of the respiratory mode in future studies.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Crânio/anatomia & histologia , Vértebras Cervicais/anatomia & histologia , Osso Hioide/anatomia & histologia , Respiração Bucal , Postura , Crânio/diagnóstico por imagem , Estudos de Casos e Controles , Obstrução Nasal , Vértebras Cervicais/diagnóstico por imagem , Nasofaringe/anatomia & histologia , Cefalometria , Telerradiologia , Estudo Observacional , Osso Hioide/diagnóstico por imagem
19.
Biomed Res Int ; 2019: 8217602, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31008113

RESUMO

Cyanoacrylate adhesives have been used in medicine and dentistry with some controversial opinions. The aim of this review was to summarize the relevant literature regarding the use of cyanoacrylate adhesives for oral wounds during dental and surgical procedures, with focus on the applications, indications, advantages, and disadvantages. In conclusion, in vivo and clinical studies have demonstrated in the last few years convincing results regarding the safety, efficacy, ease of application, and feasibility of all types of cyanoacrylate adhesives used in intra- and extraoral procedures.


Assuntos
Adesivos/uso terapêutico , Cianoacrilatos/uso terapêutico , Odontologia/tendências , Cicatrização , Humanos , Adesivos Teciduais
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