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1.
Int J Health Sci (Qassim) ; 15(5): 60-63, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34548864

RESUMO

Odontomas are common benign odontogenic tumors, being often detected on routine radiographs during the first two decades of life. Rarely, odontoma can interfere with jaw movements, causing mouth opening limitation. A 28-year-old male patient was referred complaining of restriction of mouth opening and mandibular movements, which started 6 months ago. Clinical examination revealed a painless increase of volume on the right maxilla, which interfered the mandibular movements, being associated with pain in these attempts. A well-defined, oval radiopaque lesion in close relationship with the impacted maxillary right third molar was detected in tomographic reconstructions. A surgical excision of the lesion was performed, and microscopy revealed complex odontoma. After 4 months of follow-up, the patient achieved adequate mouth opening and recovered mandibular movements. In the current case, the lesion was placed in a difficult access site, which directly interfered with the displacement of coronoid process. Odontoma should be included in the differential diagnosis when assessing causes of restricted mouth opening.

2.
Oral Maxillofac Surg ; 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33987751

RESUMO

PURPOSE: To evaluate the effect of vomer position and prevalence of periodontal dehiscence in patients who underwent surgically assisted rapid palatal expansion (SARPE). The null hypotheses were the following: (1) vomer position in the coronal plane does not influence the degree of skeletal and dental expansion; and (2) there is no association between expansion, periodontal dehiscence and vomer position. METHODS: Twenty-one patients were evaluated before treatment (T0) and immediately after SARPE expansion (T1). After SARPE, the vomer was in the right side in 11 patients and in the left in 10 patients. Skeletal and dental effects were evaluated using CBCT, landmarks and measurements. RESULTS: The maxilla and the nasal cavity expanded asymmetrically. The side containing the vomer had less skeletal expansion but more dental tipping. Dehiscence increased significantly from T0 to T1 and was associated with the amount of skeletal displacement, especially when greater than 3.20 mm. In the first premolars region, there was more than 2 mm of asymmetric expansion observed in 38.5% of the patients. CONCLUSION: The null hypotheses were rejected. The side containing the vomer had less skeletal expansion of the maxilla and nasal cavity but more dental tipping. Dehiscence increased after expansion, but there were no differences between sides.

3.
Am J Orthod Dentofacial Orthop ; 159(3): e281-e290, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33487498

RESUMO

INTRODUCTION: This study aimed to assess the static posture in patients with Angle Class II and III malocclusions in the first 2 months after orthognathic surgery. METHODS: This was a longitudinal observational study. Eligible participants were adult patients who had an indication of orthognathic surgery (bilateral sagittal split osteotomy of the maxilla and/or mandible, can be associated or not with genioplasty). Thirty-five patients were evaluated from the orthognathic surgery group (OSG) and control group (CG). Measurements in OSG were performed at 3 time points: preoperative orthognathic surgery (P0), first postoperative month (P1), and second postoperative month (P2). Static posture was evaluated using the PostureScreen Mobile (PostureCo Inc, Trinity, Fla) application in 4 views. RESULTS: Patients with Angle Class II malocclusion in the OSG evidenced a tendency to a left hip translation at P1 with a significant difference at P2 in the anterior view (P = 0.052). In the right lateral view, patients with Angle Class II malocclusion in the OSG at P1 presented an accentuated anterior shoulder translation when compared with CG (P <0.001). At P1, patients with Angle Class II malocclusion in the OSG showed a significant anterior knee translation compared with the CG and OSG at P0 and P2 (P <0.001 for all). Patients in the OSG with Angle Class III malocclusion presented an average posterior head translation in the right lateral view at P1 when compared with those in the CG and OSG at P0, who presented an anterior translation (P = 0.0008). CONCLUSIONS: These findings suggest a realignment of static posture in the first 2 months after orthognathic surgery.


Assuntos
Má Oclusão Classe III de Angle , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria , Seguimentos , Humanos , Má Oclusão Classe III de Angle/cirurgia , Mandíbula , Maxila , Osteotomia de Le Fort , Postura
4.
Oral Maxillofac Surg ; 25(1): 27-34, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32661574

RESUMO

PURPOSE: The aim of the present study was to evaluate the four methods for bilateral sagittal osteotomy fixation. METHODS: In this study, 56 replicas of whole mandibles made of rigid polyurethane were used. After simulation of major advancement (11 mm) with clockwise rotation of the mandible (6o) in relation to the occlusal plane, the bone segments were fixed with plates and screws of the 2.0-mm system on both the right and left sides: group I, double "H" plate; group II, two mini-plates; group III, "hybrid technique"; and group IV, three bicortical screws in the "inverted L" pattern. The mandibles were submitted to load on the central incisors and right first molar. RESULTS: The mean value of group I was higher than those of groups IV and II in the displacement of 1 mm (F = 4.705; p = 0.010) with load on the incisor. The mean value of group III was higher than those of groups I and II in the displacement of 1 mm (F = 5.166; p = 0.007) and 3 mm (F = 5.166; p = 0.007). The mean value of group IV was higher than that of group II (F = 3.142; p = 0.044) with load on the molar. CONCLUSION: Therefore, after the analyses, the hybrid technique was the one that showed the best results.


Assuntos
Placas Ósseas , Parafusos Ósseos , Fenômenos Biomecânicos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Osteotomia , Osteotomia Sagital do Ramo Mandibular , Rotação
5.
Am J Orthod Dentofacial Orthop ; 159(1): 71-80, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33234461

RESUMO

INTRODUCTION: Surgically assisted rapid maxillary expansion is a widely used surgical procedure for resolving transverse maxillary occlusal changes in patients with bone maturity. However, few studies about the postoperative morphologic alterations in the nasal cavity in its inferior portion and the nasal septum positioning exist. METHODS: The linear nasal septum measurements of 26 adult patients treated with surgically assisted rapid maxillary expansion from 2009 to 2013 were assessed through a retrospective analysis of cone-beam computed tomographies, in Digital Imaging and Communications in Medicine files, through the Dolphin Imaging program (Dolphin Imaging and Management Solutions, Chatsworth, Calif), aimed to identify significant changes during 3 time periods of the treatment: preoperative, immediately after the palatal expansion device locking (immediate postoperative), and 6-months postoperative (late postoperative). The analyses were performed in the inferior third of the nasal septum, from 4 equidistant points in anteroposterior position and height, using fixed cranial references for lateral measures of displacement. RESULTS: No significant difference was found between preoperative, immediate postoperative, and late postoperative measurements in the 4 fixed nasal septum measurements, applying the analysis of variance test with a significance level of 5%. Comparing the surgical times alone, we found no statistically significant difference between the right and left sides applying the Student t test, which also showed symmetry in the nasal septum. CONCLUSIONS: The measurements of the nasal septum did not change in the different surgical times throughout their inferior extension, and they remained symmetrical throughout patients' follow-up period.


Assuntos
Septo Nasal , Técnica de Expansão Palatina , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Cavidade Nasal , Septo Nasal/diagnóstico por imagem , Septo Nasal/cirurgia , Estudos Retrospectivos
6.
Oral Oncol ; 108: 104910, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32771332

RESUMO

Lymphoblastic lymphoma (LBL) is a clinically aggressive disease, representing approximately 2% of all non-Hodgkin lymphoma cases. In the oral and maxillofacial (OMF) region, approximately 39 cases, diagnosed as LBL, acute lymphoblastic leukemia (ALL) or ALL/LBL, have been reported to date. Noteworthy, the CD9 expression, which indicates a poor outcome in ALL, has not been reported in LBL and lymphoblastic neoplasms of the OMF region. Herein, we report an additional maxillary intraosseous B-cell LBL, affecting a 14-year-old girl, which also showed positivity for CD9, Bcl-6 and MUM1/IRF4. Aiming at diagnostic and prognostic criteria, further studies focusing CD9 expression in LBL is recommended.


Assuntos
Imuno-Histoquímica/métodos , Hibridização In Situ/métodos , Maxila/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Feminino , Humanos
7.
Gen Dent ; 67(6): 34-37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31658022

RESUMO

Although the incidence of broken needles in dental practice is minimal, needle breakage can occur as a result of manufacturing defects, inadequate patient management, or poor practitioner technique. Retrieval of a broken needle is justified not only because of the potential for needle migration but also because of psychological and medicolegal considerations. This case report describes the surgical removal of a dental needle that fractured during an attempt at local anesthesia. Identifying the precise location of the broken needle fragment and its relationship with the surrounding bones, vessels, and nerves is essential to designing an adequate treatment plan. If surgical retrieval is indicated, it should be performed immediately, especially in cases in which the needle fragment has not been bent or deformed. In the present case, the use of C-arm fluoroscopy aided the surgical removal while saving time and reducing the cost of treatment.


Assuntos
Anestesia Dentária , Falha de Equipamento , Corpos Estranhos , Agulhas , Anestesia Local , Instrumentos Odontológicos , Humanos
8.
J Craniofac Surg ; 30(4): 1125-1130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30614997

RESUMO

The maxillary advancement obtained by the Le Fort I osteotomy can also generate significant changes in the soft tissue of the nose and lips. The aim of this study was to compare the alterations in the soft tissue of the nose following the Le Fort I osteotomy maxillary advancement technique in a population of young adults submitted to orthognathic surgery. Seven men and 8 women aged between 23 and 45 underwent orthognathic surgery using the Le Fort I osteotomy and bilateral mandibular sagittal osteotomy. Sixty 3-dimensional images were analyzed (Vectra M3, Canfield, NJ) after labeling landmarks on the face and determining linear and angular measurements, proportion, and volume difference indices at the following intervals: preoperatively (baseline), then 2 months, 6 months, and 1 year after surgery. Following Le Fort I, there was an increase in the alar base, and reduction of nasal tip protrusion, nasal angles, and the nasal tip protrusion index (P < 0.05). There were no differences in the facial thirds, the nasal index, and angles of nasal and mentolabial convexity (P > 0.05). There was a difference in the volume of the nose only 2 months after surgery. The Le Fort I osteotomy caused significant alterations in linear, angular, and nasal proportion measurements. The volume differences were reversible in the early postoperative period and probably associated with edema. The possibility of variations in the size and shape of the nose should be presented to prospective patients preoperatively.


Assuntos
Imageamento Tridimensional/métodos , Maxila , Nariz/diagnóstico por imagem , Osteotomia de Le Fort/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Adulto Jovem
9.
Case Rep Dent ; 2018: 9379608, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29977626

RESUMO

Tooth loss can result in loss of facial esthetics, in addition to its effect on mastication, swallowing, and speech. Adequate planning is required in order for the prosthetic treatment of the teeth and implants to be successful. Here, we present a clinical case demonstrating that improper positioning of an implant can make prosthetic rehabilitation unfeasible, necessitating new surgical and rehabilitation planning to achieve the desired esthetics. The patient had a missing right lateral incisor and cuspid, and a buccally directed implant. The preferred treatment regimen involved the removal of this implant and placement of another one more properly positioned distally and three dimensionally. The repositioning of the implant made rehabilitation treatment with a mesial cantilever possible. Due to esthetic considerations, gingival conditioning in the cantilever region was performed in the temporary prosthesis phase. The changes adopted in planning the surgery and rehabilitation resulted in good esthetics as well as functional outcomes.

10.
Oral Maxillofac Surg ; 22(1): 91-96, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29344821

RESUMO

OBJECTIVE: This study aimed to evaluate the resistance of four fixation techniques used to treat subcondylar fractures. The following techniques were evaluated: fixation with one 4-hole single straight plate; fixation with one 2-mm 4-hole system plate and one 1.5-mm 3-hole system plate; fixation with two 2-mm plates with a 3-hole anterior plate; and fixation with two 2-mm plates with four holes each. STUDY DESIGN: Each fixation technique was subjected to a resistance test. The load values were measured when displacement of 1, 2, and 5 mm was reached. Load values were compared for statistically significant differences using analysis of variance (ANOVA; p < 0.5) and Tukey's test. RESULTS: Statistically significant differences were observed, when the load was applied to the first molar on the side of the fracture. The group treated with a 4-hole, 2-mm, one plate system showed resistance to lower load values than the groups treated with two plates in any combination. CONCLUSIONS: When the fracture was fixed using two plates, regardless of the kind of plates used, no statistically significant difference between the groups was observed. However, two plate systems showed better resistance than one plate systems.


Assuntos
Placas Ósseas , Desenho de Equipamento , Fixação Interna de Fraturas/instrumentação , Fraturas Mandibulares/cirurgia , Modelos Dentários , Resistência à Flexão , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Humanos
11.
Head Neck Pathol ; 12(4): 610-618, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29274041

RESUMO

Salivary adenocarcinoma, not otherwise specified (AdCaNOS) is a rare malignant tumor with potential diagnostic challenge, which mainly affects the parotid glands; however, the minor salivary glands can also be involved by AdCaNOS. This paper reports a case of a 45-year-old Afro-descendant woman complaining of a slow-growing mass with 6 months of evolution in the left superior vestibular fornix. Microscopic examination revealed an infiltrative epithelial neoplasm composed of predominantly solid growth pattern, arranged in a lobular configuration, admixed with glandular or ductal structures. Perineural invasion was evident. The tumor cells were polygonal or oval showing focally mild nuclear pleomorphism, and eosinophilic or clear cytoplasm. Notably, some areas exhibited intracytoplasmic pigment granules mainly in non-luminal cells, as well as sebaceous-like cells, discrete hyaline material deposition and foci of infiltration of residual salivary gland parenchyma. Tumor cells were negative for PAS, mucicarmine and Alcian blue stains. By immunohistochemistry, the tumor cells were diffuse and strongly positive for pan-cytokeratin (CK) AE1/AE3, 34betaE12 CK, vimentin, p63 and S100. CK7 and EMA strongly highlighted the ductal structures. Solid areas also showed diffuse and moderate expression of CD56. Podoplanin (D2-40), GFAP and Calponin, followed by DOG-1, were focally positive; whereas CK20, α-SMA, h-Caldesmon, CD57, ERBB2/HER2 and p53 were negative. Ki-67 was < 2%. Consecutive serial tissue sections using CD57 confirmed the perineural invasion. Positivity for HMB-45 and MART-1/Melan-A, as well as Fontana-Masson stain (and potassium permanganate bleaching-sensitive), identified the pigment granules as melanin. To the best of our knowledge, this is the first case of intraoral low-grade AdCaNOS with intracytoplasmic melanin granules.


Assuntos
Adenocarcinoma/patologia , Neoplasias das Glândulas Salivares/patologia , Biomarcadores Tumorais/análise , Feminino , Humanos , Imuno-Histoquímica , Melaninas , Pessoa de Meia-Idade , Pigmentação
12.
Implant Dent ; 26(4): 645-648, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28542040

RESUMO

PURPOSE: To describe an unusual case of mandibular fracture after osseointegrated dental implant removal placed after inferior alveolar nerve transposition. REPORT OF CASE: The patient underwent inferior nerve transposition for implant placement due to lack of interarch space. Two months after metal-ceramic crowns installation, the patient began to complain of pain in the region of the implant. In an attempt to remove the implant, there was a fracture of the implant, and only two third of it was removed, leaving only the apical portion of the implant in the mandible. The patient opted for the total removal of implant. At 15 days of follow-up, the patient returned with mandibular fracture, which was treated through an internal fixation with a titanium reconstruction plate of 2.0-mm thickness with locking screws. CONCLUSION: The inferior alveolar nerve transposition may represent the only rehabilitation option, especially in cases where there is insufficient bone remaining for installation of short implants with reduced interarch space.


Assuntos
Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Fixação Interna de Fraturas/métodos , Fraturas Mandibulares/etiologia , Fraturas Mandibulares/cirurgia , Perda do Osso Alveolar/complicações , Placas Ósseas , Parafusos Ósseos , Remoção de Dispositivo , Humanos , Masculino , Nervo Mandibular/cirurgia , Pessoa de Meia-Idade
13.
J Craniofac Surg ; 28(4): e405-e408, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28437271

RESUMO

Osteomas are benign osteogenic lesions that result from the proliferation of mature bone. Three variants are known: central, peripheral, and extraskeletal. The peripheral variant is the most common and it most frequently affects the paranasal sinuses, rarely occurring in the jaws. This article describes the case of a 33-year-old white male patient who was referred complaining of facial asymmetry. Clinical examination revealed an increase in volume at the base of the right side of the mandible, hard bony consistency and well delimited, painless to the touch, without signs of infection or intraoral alterations. Radiographic examination revealed an oval lobulated, radiopaque sessile lesion adhered to the mandibular base near the insertion of the masseter muscle. The patient reported practicing martial arts many years ago. Owing to the limited access, it was decided to perform the complete lesion removal through an extraoral surgical approach, by using a skin crease in the upper neck region below the lesion. The patient recovered well and the histopathological analysis confirmed the diagnosis of osteoma. The etiopathogenesis of osteoma is not completely elucidated, and 3 theories are more accepted: developmental defect, neoplastic nature, and reactive lesion owing to trauma or local infection. The clinicopathological correlation in the present case supports a traumatic origin. Traumatic peripheral osteoma should be considered in the differential diagnosis of nodular bone-forming lesions affecting the mandible.


Assuntos
Mandíbula , Traumatismos Mandibulares/complicações , Neoplasias Mandibulares , Osteoma , Osteotomia/métodos , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Neoplasias Mandibulares/etiologia , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Osteoma/etiologia , Osteoma/patologia , Osteoma/cirurgia , Exame Físico/métodos , Radiografia/métodos , Resultado do Tratamento
14.
Int J Oral Maxillofac Implants ; 32(2): 377­384, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27632155

RESUMO

PURPOSE: To report on the clinical outcome of 129 zygomatic implants placed in 37 patients with severely resorbed partially or completely edentulous maxillae. MATERIALS AND METHODS: Patients who received zygomatic implants between 2007 and 2014 were included in this retrospective analysis. All patients were treated using the same surgical protocol, the sinus slot technique. The following data were recorded: sex, age, race, medical history, etiology, addictions, degree of bone atrophy, type and size of zygomatic implants, number of implants placed, type of prosthesis, survival rate, and success of implants and complications. Follow-up included standardized clinical and tomography examinations. RESULTS: Thirty-seven consecutive patients (25 women, 12 men; mean age 55.64 years [range 40 to 77 years]) were treated. All were in need of oral reconstruction and had maxillary atrophy that warranted zygomatic implant placement. One hundred twenty nine zygomatic implants were placed in these 37 patients. Two of the implants failed, resulting in a cumulative survival rate of 98.44%. Maxillary sinusitis was the most common complication found (21.62%); however, neither of the implant failures was related to sinusitis or smoking. CONCLUSION: The zygomatic implant is a reliable option for treatment of the severely resorbed maxilla.

15.
Oral Maxillofac Surg ; 20(3): 255-8, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27154514

RESUMO

PURPOSE: Surgically assisted rapid maxillary expansion is performed to correct transverse deficiencies of the maxilla, and it is indicated in specific clinical situations. The literature presents different opinions in several aspects, mainly regarding the effect of disjunction of the pterygoid plates. The aim of this study was to evaluate the pattern of maxillary expansion obtained with two surgical techniques, with and without disjunction of the pterygoid plates. METHODS: Twenty patients treated with surgically assisted rapid maxillary expansion for correction of transversal discrepancies were included in this retrospective study and divided into two groups: (G1) patients operated without disjunction of pterygoid plates and (G2) patients treated with release of the pterygoid plates. RESULTS: There were seven male and 13 female patients, and the mean age was 29.9 years. Cone beam computed tomography images obtained after final activation of the expansion device were evaluated and complete disjunction of the midpalatal suture (type I) was present in 75 % of the patients whereas incomplete disjunction of the midpalatal suture (type II) was observed in 25 %. Chi-square test showed no statistically significant difference between groups (p = 0.606). CONCLUSION: No difference was found in relation to the maxillary disjunction pattern irrespective of the treatment given to pterygoid plates.


Assuntos
Técnica de Expansão Palatina , Fossa Pterigopalatina/cirurgia , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Seguimentos , Humanos , Masculino , Ortodontia Corretiva/métodos , Osteotomia de Le Fort/métodos , Fossa Pterigopalatina/diagnóstico por imagem , Estudos Retrospectivos
16.
Med Princ Pract ; 25(4): 391-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26673169

RESUMO

OBJECTIVE: To report an unusual case of oral hyaline ring granuloma (HRG) that caused an extensive osteolytic lesion. CLINICAL PRESENTATION AND INTERVENTION: A 22-year-old female was referred to our hospital with a large expansile cystic lesion in the left mandibular ramus associated with a clinically visible, partially erupted third molar. A diagnosis of paradental cyst was made. After marsupialization of the lesion, histopathological analysis of the surgical specimen showed an unusual exuberant HRG reaction supported by scarce fibrous stroma. CONCLUSION: This was a case of exuberant HRG reaction that caused extensive bone destruction.


Assuntos
Granuloma/mortalidade , Mandíbula/patologia , Dente Molar/patologia , Feminino , Granuloma/patologia , Humanos , Adulto Jovem
18.
J Craniofac Surg ; 26(4): 1214-9, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26080160

RESUMO

The aim of the study was to evaluate histologically and histometrically the bone repair at the mandibular body osteotomy and at the bone-screw interface after using a biodegradable 2.0-mm internal fixation system. Six dogs were subjected to an osteotomy in the mandibular body, which was stabilized by applying a fixation device manufactured with poly-L-DL-lactic acid (70:30). The dogs were euthanized at 2 and 18 weeks. Each screw was sectioned along its long axis, and the osteotomy sites were divided into 3 parts: the upper part was labeled the tension third (TT); the lower part, compression third (CT); and the part between the TT and CT, intermediary third (IT). Histologic analysis showed areas of direct contact between the screw surface and the parent lamellar bone at 2 weeks. At 18 weeks, 3 microscopically distinct layers at the bone-screw interface were noted. At the osteotomy sites, union between the bone fragments was observed at 18 weeks. Statistically significant differences in the newly formed bone among TT, IT, and CT (P = 0.019) were observed. In conclusion, the biomechanical environment created by the biodegradable IF system used in this study facilitated bone repair at the osteotomy site.


Assuntos
Implantes Absorvíveis , Placas Ósseas , Parafusos Ósseos , Fixação Interna de Fraturas/instrumentação , Mandíbula/cirurgia , Fraturas Mandibulares/cirurgia , Osteotomia/instrumentação , Animais , Modelos Animais de Doenças , Cães , Ácido Láctico , Masculino , Poliésteres , Polímeros , Desenho de Prótese
19.
Braz Dent J ; 26(2): 193-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25831113

RESUMO

Patients wearing complete dentures for a long time usually exhibit lack of bone and keratinized mucosa in the bearing area due to bone resorption. The patients suffering from this phenomenon usually have unstable and non-retentive complete denture, which result in constant trauma to the mucosa, pain, functional limitations and worsening of facial esthetics. An innovative technique has been described in which a novel surgical approach using osseointegrated dental implants as "tent poles" was applied concomitant with particulate autogenous bone graft. The authors claim that the control and maintenance of the surgically expanded soft tissue volume should prevent graft resorption in the long term. Nevertheless, resorption of the bone graft is usually more significant where the bone mass is poorer, in the mandibular body. This paper describes a case of severely resorbed edentulous mandible in which the "tent pole" technique was applied with some modifications. Use of the titanium mesh "shelters" and two additional implants was effective in "protecting" the bone graft in the posterior portion of the mandibular body increasing bone mass volume in this area. Furthermore, we believe that this kind of graft "protection" on the whole residual alveolar ridge can increase the width of bone mass gain optimizing the "tent pole" technique.


Assuntos
Perda do Osso Alveolar/cirurgia , Transplante Ósseo/métodos , Prótese Dentária Fixada por Implante , Arcada Edêntula/cirurgia , Mandíbula/cirurgia , Telas Cirúrgicas , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Prótese Total , Feminino , Humanos , Arcada Edêntula/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Osseointegração , Radiografia Panorâmica , Titânio
20.
Braz. dent. j ; 26(2): 193-197, Mar-Apr/2015. graf
Artigo em Inglês | LILACS | ID: lil-741224

RESUMO

Patients wearing complete dentures for a long time usually exhibit lack of bone and keratinized mucosa in the bearing area due to bone resorption. The patients suffering from this phenomenon usually have unstable and non-retentive complete denture, which result in constant trauma to the mucosa, pain, functional limitations and worsening of facial esthetics. An innovative technique has been described in which a novel surgical approach using osseointegrated dental implants as "tent poles" was applied concomitant with particulate autogenous bone graft. The authors claim that the control and maintenance of the surgically expanded soft tissue volume should prevent graft resorption in the long term. Nevertheless, resorption of the bone graft is usually more significant where the bone mass is poorer, in the mandibular body. This paper describes a case of severely resorbed edentulous mandible in which the "tent pole" technique was applied with some modifications. Use of the titanium mesh "shelters" and two additional implants was effective in "protecting" the bone graft in the posterior portion of the mandibular body increasing bone mass volume in this area. Furthermore, we believe that this kind of graft "protection" on the whole residual alveolar ridge can increase the width of bone mass gain optimizing the "tent pole" technique.


Pacientes portadores de próteses totais por um longo período geralmente apresentam perda significativa de osso do processo alveolar e de mucosa ceratinizada na área chapeável devido ao processo de reabsorção óssea associada com a perda de função. Estes pacientes geralmente possuem próteses totais sem retenção e estabilidade, o que resulta em trauma crônico à mucosa, limitações funcionais e piora da estética facial. Uma técnica cirúrgica inovadora foi descrita na qual implantes osseointegráveis são posicionados em forma de "pilares" conjuntamente com enxerto ósseo autógeno particulado. Os autores afirmam que o controle e manutenção do volume tecidual obtido cirurgicamente diminui a perda em volume do enxerto ósseo utilizado. Entretanto esta reabsorção geralmente ocorre com maior intensidade onde a massa óssea é mais pobre, ou seja, em corpo mandibular. Este artigo descreve um caso onde uma mandíbula severamente reabsorvida foi reconstruída utilizando-se a técnica de "tent pole" com algumas modificações propostas pelos autores. O uso da malha de titânio em forma de "cabana" e dois implantes dentários osseointegráveis adicionais contribuíram para "proteger" o enxerto ósseo autógeno na região posterior do corpo mandibular aumentando o volume ósseo na região. Adicionalmente, nós acreditamos que o uso deste tipo de proteção em todo rebordo alveolar residual pode melhorar o ganho de massa óssea otimizando, portanto, a técnica original de "tent pole".


Assuntos
Humanos , Feminino , Idoso , Perda do Osso Alveolar/cirurgia , Transplante Ósseo/métodos , Prótese Dentária Fixada por Implante , Arcada Edêntula/cirurgia , Mandíbula/cirurgia , Telas Cirúrgicas , Perda do Osso Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Prótese Total , Arcada Edêntula/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Osseointegração , Radiografia Panorâmica , Titânio
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