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1.
Medicine (Baltimore) ; 100(17): e24399, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907087

RESUMO

ABSTRACT: Neuroblastoma (NB) metastasized into the mandible and spinal extradural region was rarely reported. We present a case with metastatic NB to the mandible and the spinal extradural regions. The patient received chemotherapy using NB 97 regimen and was tumor free after 8 months, but 9 months after the treatment, the patient presented with lower limb paralysis and persistent pain in maxillofacial region as well as swelling in the left mandibular area. Metastasis to the mandible and the spinal extradural regions was diagnosed based on the spinal and maxillofacial magnetic resonance imaging. Radiotherapy with a density of 2 Gy per day was given via a linear accelerator. The total dose of the intraspinal occupying lesion was subject to radiotherapy with a regimen of 30 Gy (10 fractions). For the management of the maxillofacial pain, tumor in the maxillofacial region was subject to a density of 50 Gy (25 fractions). The maxillofacial pain disappeared after a density of 10 Gy and soft tissue tumefaction was eliminated after a density of 50 Gy, and the maxillofacial appearance was much better than before. Finally, the patient died from tumor progression 2 years after diagnosis for NB.


Assuntos
Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias Mandibulares/secundário , Neuroblastoma/patologia , Neuroblastoma/secundário , Neoplasias da Coluna Vertebral/secundário , Pré-Escolar , Espaço Epidural/patologia , Evolução Fatal , Feminino , Humanos , Mandíbula/patologia
2.
Nutrients ; 13(2)2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33567797

RESUMO

Osteonecrosis of the jaw (ONJ) is a severe clinical condition characterized mostly but not exclusively by an area of exposed bone in the mandible and/or maxilla that typically does not heal over a period of 6-8 weeks. The diagnosis is first of all clinical, but an imaging feedback such as Magnetic Resonance is essential to confirm clinical suspicions. In the last few decades, medication-related osteonecrosis of the jaw (MRONJ) has been widely discussed. From the first case reported in 2003, many case series and reviews have appeared in the scientific literature. Almost all papers concerning this topic conclude that bisphosphonates (BPs) can induce this severe clinical condition, particularly in cancer patients. Nevertheless, the exact mechanism by which amino-BPs would be responsible for ONJ is still debatable. Recent findings suggest a possible alternative explanation for BPs role in this pattern. In the present work we discuss how a condition of osteomalacia and low vitamin D levels might be determinant factors.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Osteomalacia/complicações , Deficiência de Vitamina D/complicações , Animais , Humanos , Mandíbula/patologia , Maxila/patologia , Osteomalacia/patologia , Deficiência de Vitamina D/patologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33567592

RESUMO

This cross-sectional study aimed to investigate the influence of possible factors in the patient history on decision making in the therapy for a severely atrophied edentulous mandible. A vignette-based survey among 250 maxillofacial and oral surgeons was conducted. Determinants that could influence the therapy decision were patient age, smoking, fear of surgery, and radiotherapy in the head and neck area (the implant region is not in the direct radiation area). To achieve a suitable implant site, the options offered to the surgeons were bone split, bone block, augmentation with bone substitute material, and bone resection. There also was the option of rejecting any therapy. The response rate was 47%. Patient age, radiotherapy, and fear of surgery did not influence the approval of a therapy. Smoking was associated with a significantly lower endorsement of a treatment. Resection was preferred by a large majority to all other forms of therapy, regardless of the four determinants. Surgeons tend to refrain from bone block transplants in older patients. In summary, it can be said that, of the four determinants, only smoking influenced treatment refusal. Bone resection is the preferred therapy independent of all determinants.


Assuntos
Substitutos Ósseos , Mandíbula , Idoso , Atrofia , Estudos Transversais , Humanos , Mandíbula/patologia
4.
Int J Oral Maxillofac Implants ; 36(1): 30-37, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600520

RESUMO

PURPOSE: This study aimed to assess the survival rate, marginal bone levels, and prosthetic success of short implants when placed in posterior areas of severely reabsorbed mandibles. MATERIALS AND METHODS: A systematic review was performed of all randomized controlled trials with at least 10 patients with a control group where bone augmentations were performed that were published between January 2015 and February 2020. From 77 pertinent studies, 14 full-text publications were studied, and 6 studies fulfilled the inclusion criteria. RESULTS: The implant survival rates of short dental implants ranged from 92% to 96.9% with a follow-up from 1 to 5 years, and the prosthetic success rate ranged from 90% to 100% during the same follow-up. The mean marginal bone level values of involved short implants ranged from -0.51 to -2.30 mm. CONCLUSION: The obtained data showed that short dental implants are a valid therapeutic choice to rehabilitate severe mandibular atrophy in the medium to long term.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Atrofia/patologia , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Resultado do Tratamento
5.
Artigo em Inglês | MEDLINE | ID: mdl-33528453

RESUMO

In everyday practice, surgeons have to deal with bone atrophy. These rehabilitations are even more complex in the posterior mandible, and it is still unclear in the literature which fixed rehabilitation option is best. The purpose of this article was to help oral surgeons to choose the proper and updated treatment for their atrophic patients. Posterior mandible bone atrophies were divided into four main groups depending on the bone height measured above the inferior alveolar nerve: (1) ≤ 4 mm; (2) > 4 mm ≤ 5 mm; (3) > 5 mm ≤ 6 mm; (4) > 6 mm < 7 mm. Different approaches were proposed for each group, considering patient expectations. If ≤ 4 mm of bone height was available, guided bone regeneration was used as the adequate approach. For bone heights > 4 mm and ≤ 6 mm, the "sandwich" technique and/or short implants were used, depending on esthetics. In cases with > 6 mm and < 7 mm above the mandibular canal, short implants might be the proper option. The authors' clinical experience and the literature were considered in order to suggest a possible correct treatment decision based on the residual bone height in the posterior mandible.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Atrofia/patologia , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Resultado do Tratamento
6.
J Oral Maxillofac Surg ; 79(5): 1122-1132, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33493432

RESUMO

PURPOSE: Our current understanding of unilateral condylar hyperplasia (UCH) was put forth by Obwegeser. He hypothesized that UCH is 2 separate conditions: hemimandibular hyperplasia and hemimandibular elongation. This hypothesis was based on the following 3 assumptions: 1) the direction of overgrowth, in UCH, is bimodal-vertical or horizontal, with rare cases growing obliquely; 2) UCH can expand a hemimandible with and without significant condylar enlargement; and 3) there is an association between the condylar expansion and the direction of overgrowth-minimal expansion resulting in horizontal growth and significant enlargement causing vertical displacement. The purpose of this study was to test these assumptions. PATIENTS AND METHODS: We analyzed the computed tomography scans of 40 patients with UCH. First, we used a Silverman Cluster analysis to determine how the direction of overgrowth is distributed in the UCH population. Next, we evaluated the relationship between hemimandibular overgrowth and condylar enlargement to confirm that overgrowth can occur independently of condylar expansion. Finally, we assessed the relationship between the degree of condylar enlargement and the direction of overgrowth to ascertain if condylar expansion determines the direction of growth. RESULTS: Our first investigation demonstrates that the general impression that UCH is bimodal is wrong. The growth vectors in UCH are unimodally distributed, with the vast majority of cases growing diagonally. Our second investigation confirms the observation that UCH can expand a hemimandible with and without significant condylar enlargement. Our last investigation determined that in UCH, there is no association between the degree of condylar expansion and the direction of the overgrowth. CONCLUSIONS: The results of this study disprove the idea that UCH is 2 different conditions: hemimandibular hyperplasia and hemimandibular elongation. It also provides new insights about the pathophysiology of UCH.


Assuntos
Assimetria Facial , Côndilo Mandibular , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/etiologia , Assimetria Facial/patologia , Humanos , Hiperplasia , Hipertrofia/patologia , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia
7.
Av. odontoestomatol ; 36(4): 200-207, sept.-dic. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-198590

RESUMO

INTRODUCCIÓN: En pacientes con crecimiento esqueletal clase II, el tratamiento ideal es etiológico modificando la cantidad y dirección de crecimiento mandibular. Con estos objetivos, se usan activadores funcionales (AF) que estimulan el crecimiento mandibular, redirigiéndolo posterosuperiormente a nivel condilar por medio del avance mandibular. Después del peak de crecimiento puberal, la corrección etiológica es quirúrgica. El objetivo del presente artículo es reportar un tratamiento exitoso de un paciente después de su peak de crecimiento puberal, tratado con un AF removible. MÉTODOS: Paciente de 13 años, 3 meses, braquifacial y con perfil facial convexo, presentaba clase II esqueletal debido a mandíbula retrognática. El paciente tenía dentición permanente completa, clase II de Angle, resalte incisivo y sobremordida aumentados, proinclinación incisiva bimaxilar y mordida en tijera de dientes #2.4 y #2.5. RESULTADOS: Después de ocho meses de tratamiento, se observó posición mandibular estable en clase I esqueletal, verificada mediante exámenes funcionales y radiográficos. Se logró resolución de la mordida en tijera. Mejoraron resalte incisivo y sobremordida, así como la proinclinación incisiva bimaxilar. CONCLUSIONES: El momento ideal para utilizar AF en tratamiento de clases II esqueletales es durante o ligeramente después del peak de crecimiento puberal. Sin embargo, los resultados clínicos del presente caso, permiten recomendar el avance mandibular con AF en pacientes braquifaciales clase II, a pesar de que se haya producido el peak de crecimiento puberal. En estos casos, el uso de AF está dirigido principalmente a beneficios dentarios, pero, al mismo tiempo, puede favorecer el crecimiento mandibular


INTRODUCTION: In growing skeletal class II patients, the ideal treatment is etiological and is obtained by modifying the amount and direction of mandibular growth. With this objective in mind, functional activators (FA) are used as they stimulate growth, redirecting it at the condylar level through forward mandibular advancement. After pubertal growth peak, etiological correction is surgical. OBJECTIVE: The present article aims to report a successful treatment in a patient after pubertal growth peak treated with a removable FA. METHODS: >A 13 years 3 months male patient, skeletal class II due to retrognathic mandible, brachyfacial and with a convex facial profile. The patient had complete permanent dentition, Angle class II, increased overjet and overbite. Maxillary and mandibular incisive proclination. Scissor bite of teeth #2.4 and #2.5. RESULTS: Treatment started using a FA for one year after first evaluation. Following eight months of treatment, stable mandibular position was observed in skeletal class I, verified by functional and radiographic examinations. Resolution of scissor bite was accomplished. Overjet and overbite, and bimaxillary incisive proclination were improved. CONCLUSIONS: The ideal time to use FAs for skeletal management in skeletal class II is during, or slightly after peak pubertal growth. However, the clinical results of present case, allows recommending the forward mandibular advancement in brachyfacial skeletal class II patients, even though pubertal growth peak had occurred. In these cases, the use of FA is primarily aimed at the dental benefits, but, at the same time, favoring mandibular growth


Assuntos
Humanos , Masculino , Adolescente , Má Oclusão Classe II de Angle/terapia , Aparelhos Ortodônticos Removíveis , Aparelhos Ativadores , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Desenvolvimento Musculoesquelético/fisiologia , Cefalometria
8.
BMC Oral Health ; 20(1): 195, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641041

RESUMO

BACKGROUND: It is not well-known which pre-implantological procedures are preferred by maxillofacial (MFS) and oral surgeons (OS) for the narrow atrophic alveolar ridge under practice based conditions and, if different training paths in surgery lead to other pre-implantological techniques being preferred. This study aims to identify which procedures are preferred by the respective specialists in which indication. METHODS: A questionnaire was sent to a total of 300 MFS and OS in southern Germany. The questionnaire examined pre-implantological procedures (bone block, bone grafting material and/or particulate autogenous bone, titanium mesh, bone split, resection) in the edentulous severely atrophic mandible and in the severely atrophic single-tooth gap. Kendall's Tau-b test was used for statistical analyses. RESULTS: One hundred seventeen participants returned the questionnaire. 68 (58%) were OS and 49 (42%) were MFS. In the edentulous mandible, bone substitute material and resection were most preferred by both specialists. Bone blocks were statistically significantly more frequently associated with MFS and bone substitute materials with OS. Bone split was more frequently used in the atrophic single tooth gap than in the edentulous mandible. OS preferred bone blocks in the single tooth gap more often than in the edentulous mandible. MFS and OS preferred resection in the edentulous mandible significantly more frequently than in the single tooth gap. CONCLUSIONS: MFS in general prefer more invasive pre-implantological therapies with the same initial diagnosis than OS, which seems to be attributed to different training paths.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Cirurgiões Bucomaxilofaciais/psicologia , Padrões de Prática Médica , Processo Alveolar/patologia , Atrofia/patologia , Transplante Ósseo , Implantação Dentária Endo-Óssea , Alemanha , Humanos , Masculino , Mandíbula/patologia
9.
Oral Maxillofac Surg ; 24(4): 515-520, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32621034

RESUMO

INTRODUCTION: Elongated mandibular coronoid process is a rare condition defined as enlargement of the coronoid process. The only useful way to treat the mouth-opening limitation is resection of the elongated coronoid process. Four-dimensional CT (4DCT; three spatial dimensions plus time axis) is a novel imaging technique. Its usefulness of for evaluation of dynamic movements such as joint motion has been reported. Here, we show the potential usefulness of 4DCT evaluation in a patient with elongated mandibular coronoid process. CASE PRESENTATION: A 59-year-old female who suffered from mouth-opening difficulty and pressure during mouth opening was referred to our department. Elongation of the right coronoid process was evident in a panoramic X-ray image. The mandibular movement and temporal muscle motility before and after coronoidectomy in this patient on 4DCT could be evaluated. CONCLUSIONS: 4DCT is useful in the diagnosis and surgical outcome of elongated coronoid process.


Assuntos
Tomografia Computadorizada Quadridimensional , Osteotomia Mandibular , Feminino , Humanos , Hiperplasia/patologia , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Pessoa de Meia-Idade , Radiografia Panorâmica
10.
Int J Oral Maxillofac Surg ; 49(11): 1397-1401, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32423691

RESUMO

Unilateral condylar hyperplasia (UCH) causes progressive asymmetry of the mandible. The aetiology of this growth disorder is unknown. A two-centre prospective study was established, and 10 consecutive adult UCH patients scheduled for high condylectomy were included. The resected condylar tissue was divided into two parts, one for regular histopathology and one for DNA extraction. A panel of eight selected overgrowth genes (AKT1, AKT3, MTOR, PIK3CA, PIK3R2, PTEN, TSC1, TSC2) were sequenced using next-generation sequencing, with coverage of a minimum 500 times in order to be able to detect low-grade mosaicisms. Subsequently, untargeted whole exome sequencing (WES) was performed to detect variants in other genes present in three or more patients. No mutation was detected in any of the overgrowth genes, and untargeted exome sequencing failed to detect any definitively causative variant in any other gene. Ten genes had a rare variant in three or more patients, but these cannot be designated as causative without additional functional studies. The hypothesis that the cause in at least some patients with UCH is a somatic mutation in a gene that controls cell growth could not be confirmed in this study.


Assuntos
Assimetria Facial , Côndilo Mandibular , Adulto , Assimetria Facial/patologia , Humanos , Hiperplasia/genética , Hiperplasia/patologia , Mandíbula/patologia , Côndilo Mandibular/patologia , Estudos Prospectivos
11.
BMC Oral Health ; 20(1): 113, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32299394

RESUMO

BACKGROUND: Myxofibrosarcoma (MFS) is a soft tissue sarcoma that commonly occurs in late adult life. It is mainly located in the subcutaneous soft tissues of extremities characterized by a high recurrence rate at the original site. MFS of the head and neck is rare, while it occurs in the maxilla and mandible is extremely rare. CASE PRESENTATION: We report a case of MFS of the mandible in a 51-year-old female who presented with a painless gingival swelling and mobile, super-erupted right mandibular second and third molars. Panoramic x-ray and maxillofacial CT revealed an ill-defined radiolucent lesion surrounding the mandibular molars giving a teeth-floating-in-air appearance. Histopathological examination showed scattered spindle and stellate cells with mild atypia distributed in the myxoid stroma. Only a few mitotic figures were identified and no area of tissue necrosis was found. The characteristic thin-walled and curvilinear vasculature were prominent. Immunohistochemistry analysis revealed the tumor cells being positive for vimentin and vascular CD31. CK, S-100, P63, HHF-35 stains were negative. The labeling index of Ki-67 was about 30%. Based on the histopathological and immunohistochemical examinations, the diagnosis of a low-grade MFS was established. This patient underwent a radical segmental excision with a 2-cm margin, supraomohyoid neck dissection and immediate reconstruction of the mandibular continuity defect with a fibular osteocutaneous free flap. This patient has been followed for 20 months to date and has remained disease free. CONCLUSIONS: This report describes a rare case of MFS of the mandible. Recognizing the histopathological features of MFS and applying the appropriate immunohistochemical examinations are crucial in establishing the correct diagnosis. Our case may provide diagnosis and treatment experiences of MFS occurs in the mandible.


Assuntos
Fibrossarcoma/diagnóstico , Mandíbula/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico , Feminino , Fibrossarcoma/cirurgia , Humanos , Imuno-Histoquímica , Mandíbula/patologia , Pessoa de Meia-Idade , Radiografia Panorâmica , Neoplasias de Tecidos Moles/cirurgia
12.
Artigo em Inglês | MEDLINE | ID: mdl-32260243

RESUMO

This bibliometric study evaluated the scientific impact of papers dealing with osteoporosis detected by dental panoramic radiographs by performing citation analysis and cited reference analysis. Retrospective data was extracted from the Web of Science Core Collection database and imported into VOSviewer, CRExplorer, and CitNetExplorer for analyzing semantic contents, cited references, and temporal citation network. The 280 relevant papers identified were cited 4874 times, having an h-index of 38 and 17.4 citations per paper. The top five major contributing countries were Japan (n = 54, 19.3%), USA (n = 43, 15.4%), Brazil (n = 38, 13.6%), Turkey (n = 38, 13.6%), and the UK (n = 32, 11.4%). Citation per paper correlated with publication count among the authors and institutions. Mandibular cortical width was the most frequently used and most cited measurement index. References published during the 1970s and 1980s have built the foundation for the development of research that investigates the potential associations between osteoporosis and radiographic measurements on panoramic radiographs. Osteoporosis detection by dental panoramic radiographs is a perennially investigated research topic with global contributions. Panoramic radiographs are considered early detection and screening tools for osteoporosis by worldwide research.


Assuntos
Osteoporose , Radiografia Panorâmica , Brasil , Humanos , Japão , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Osteoporose/diagnóstico por imagem , Estudos Retrospectivos , Turquia
13.
J Vet Diagn Invest ; 32(2): 344-347, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32081087

RESUMO

A unilateral, malformed gnathotheca in a green-winged macaw (Ara chloropterus) was managed for 16 mo with periodic beak trims. Biopsy of the affected beak did not identify an underlying cause; however, at postmortem examination, a densely cellular neoplasm invaded the mandible from the beak, dissecting and effacing the cortex and trabecular bone and inciting periosteal proliferation. There was no evidence of metastasis. Neoplastic cells were strongly immunopositive for cytokeratin AE1/AE3, consistent with squamous cell carcinoma (SCC). A black-headed caique (Pionites melanocephalus) was presented with a similar clinical history, timeline, and gross appearance. Biopsy of the mandibular portion of the lesion resulted in a diagnosis of SCC. Medical management with toceranib at a palliative dose resulted in adverse side effects and was discontinued. Early diagnosis of mandibular SCC may allow for early intervention and development of treatment modalities. Our 2 cases suggest that the mandibular bone, not the beak, may be a preferred biopsy site in the diagnosis of mandibular SCC in psittacines.


Assuntos
Doenças das Aves/patologia , Carcinoma de Células Escamosas/veterinária , Mandíbula/patologia , Neoplasias Bucais/veterinária , Papagaios , Animais , Doenças das Aves/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Feminino , Masculino , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia
14.
Medicine (Baltimore) ; 99(2): e18069, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914012

RESUMO

This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.The incisive foramen (IF) was measured 20.55 ±â€Š2.81 mm to margo inferior of incisor, and 45.27 ±â€Š5.27 degree from the axial midline. The greater palatine foramen located 43.17 ±â€Š2.55 mm from the IF, while 21.08 ±â€Š3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ±â€Š5.74 mm from the IF and 20.05 ±â€Š3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ±â€Š1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ±â€Š2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ±â€Š1.86 mm, while it became 13.00 ±â€Š2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ±â€Š3.22 mm. It turned out to be 25.78 ±â€Š5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ±â€Š3.06 mm from the upper margin of the second premolar to the MF.The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Mandíbula/anatomia & histologia , Forame Mentual/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/cirurgia , Criança , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Forame Mentual/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
15.
Biomed Mater Eng ; 30(5-6): 541-558, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31903978

RESUMO

This study investigated the effect of three different parameters of a dental implant on stress and strain values in the peri-implant bone by finite element analysis. In this work, the effect of diameter, length and elastic modulus on the biomechanical behavior of a new dental implant was simulated using the finite element method. A three-dimensional model of a mandible segment corresponding to the premolar region and twelve dental implant models were obtained. Loads in three directions were distributed on the surface of the coronal area of the dental implants. The dental implant models were obtained in the FreeCAD 0.16 software and the simulations were made using the Abaqus/CAE software. In all cases, higher stress concentrations were obtained in the peri-implant cortical bone between 40.6 and 62.8 MPa, while the highest levels of strain were observed in the peri-implant trabecular bone between 0.002544 and 0.003873. In general, the highest von Mises equivalent stress values were observed in the peri-implant cortical bone. However, in this bone, both the maximum von Mises equivalent stress values and the von Mises strain are similar or inferior to those reported in different studies by finite element for other models of dental implants under immediate loading. Maximum von Mises strain values were observed in peri-implant trabecular bone. However, in this bone strains levels were obtained that maintain bone density or increase it. The effect of the three simulated variables (implant diameter, length, and elastic modulus) have a statistically significant influence on the von Mises equivalent stress and in von Mises strain values.


Assuntos
Interface Osso-Implante , Implantes Dentários , Planejamento de Prótese Dentária , Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Fenômenos Biomecânicos/fisiologia , Interface Osso-Implante/patologia , Interface Osso-Implante/fisiopatologia , Implantes Dentários/normas , Modelos Dentários , Módulo de Elasticidade , Humanos , Imageamento Tridimensional , Mandíbula/patologia , Mandíbula/fisiologia , Estresse Mecânico , Suporte de Carga/fisiologia
16.
Acta Histochem ; 122(2): 151501, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31892437

RESUMO

This study investigated the effects of aging on the articular cartilage of the mandible. Wistar rats were divided in two groups (n = 10/per group): 3-months-old group (young group); and 13-months-old group (aged group). After euthanasia, the head of the mandible was collected and stained with hematoxylin and eosin (HE) to evaluate the thickness of the articular layer and cartilage. Sections stained with Picrosirius red and Safranin O were used to evaluate the collagen and proteoglycans deposition, respectively. First, aging has decreased the articular layer thickness. Second, the results suggest a decrease of chondrocytes followed by an increase of the matrix to maintain the mandible homeostasis. Finally, both collagen and proteoglycans increased with aging. Aging displayed important effects to the mandible of aged rats.


Assuntos
Fatores Etários , Cartilagem Articular/metabolismo , Condrócitos/metabolismo , Colágeno/metabolismo , Animais , Cartilagem Articular/patologia , Condrócitos/patologia , Masculino , Mandíbula/patologia , Proteoglicanas/metabolismo , Ratos Wistar
17.
Homo ; 71(1): 51-61, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-31939991

RESUMO

Syphilis, together with its variant congenital syphilis, is a disease caused by Treponema pallidum subsp. pallidum. This paper documents possible new skeletal evidence for congenital syphilis from the Medieval Era (twelfth and thirteenth centuries CE) burial site of Medinaceli in the Province of Soria in North-Central Spain. What is involved is dental alteration due to congenital syphilis, mercury treatment, or a combination of both. This study focuses on the hypoplastic dental changes observed in a child approximately eight years of age. Only a fragmented skull with left maxilla and the left side of the mandible were preserved. Macroscopic analysis, X-rays, computerized tomography (CT) and mercury detection analysis by inductively coupled plasma mass spectrometry (ICP-MS) techniques were used to observe dental abnormalities. In addition to extensive caries in the upper second deciduous molar, pulpo-alveolar lesions and facial alterations were observed. The absence of the rest of the skeleton tends to make a diagnosis of congenital syphilis difficult. However, the dental stigmata observed do permit a reasonable diagnosis.


Assuntos
Hipoplasia do Esmalte Dentário , Mercúrio , Sífilis Congênita , Criança , Hipoplasia do Esmalte Dentário/induzido quimicamente , Hipoplasia do Esmalte Dentário/complicações , História Medieval , Humanos , Mandíbula/patologia , Maxila/patologia , Mercúrio/efeitos adversos , Mercúrio/uso terapêutico , Paleopatologia , Espanha , Sífilis Congênita/complicações , Sífilis Congênita/tratamento farmacológico , Sífilis Congênita/história , Dente/patologia
18.
J Stomatol Oral Maxillofac Surg ; 121(4): 390-396, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31904530

RESUMO

INTRODUCTION: Surgical inferior alveolar nerve (IAN) reposition techniques offer an alternative approach to implant-based rehabilitation in patients with severe mandibular atrophy The aim of this systematic review, was to determine the complications associated with the technique and to determine which of two variants (lateralization or transposition) is less invasive. MATERIALS AND METHODS: An electronic search was conducted in databases complimented by a manual search to identify clinical studies investigating complications derived from these surgical techniques. Only studies of adult humans, published in English during the last seven years were included. The initial search located 78 articles, of which seven were included in analysis on the basis of the following characteristics: four investigated inferior alveolar nerve lateralization (IANL), one inferior alveolar nerve transposition (IANT), and two investigated both reposition techniques. RESULTS: This review included data from 289 patients who were recruited for lateralization (N=319) or transposition surgery (N=33) making a total of 352 reposition procedures. Five patients (1.73%) suffered persistent damage to the IAN at the end of the follow-up periods. The overall implant survival rate was 99.26% of a total of 817 implants. The most common complications were neurosensory problems, mandibular fracture, infection, implant loss, and insufficient anatomical reconstruction of the atrophic mandible; neurosensory complications (hypoesthesia, paraesthesia, and hyperesthesia caused by traumatic damage to the nerve) were the most prevalent. CONCLUSIONS: Lateralization of the inferior alveolar nerve would appear to be less invasive as it produces lower percentages of persistent neurosensory disorders (1.56%) than transposition (12.12%). Nevertheless, both techniques offer a viable approach to implant placement in edentulous atrophic mandibles, obtaining predictable clinical and radiological results after 5 years implant loading.


Assuntos
Implantação Dentária Endo-Óssea , Implantes Dentários , Adulto , Atrofia/patologia , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Nervo Mandibular/cirurgia
19.
J Stomatol Oral Maxillofac Surg ; 121(4): 397-403, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31904534

RESUMO

Coronoid hyperplasia is one of the rare causes of progressive limitation of mouth opening due to impingement of the enlarged coronoid process of the mandible on the zygomatic bone. A review was performed on all cases reports and case series on coronoid hyperplasia. Gender, age at treatment, age of onset, types of hyperplasia (unilateral/bilateral), associated history, treatment, surgical approach, preoperative mouth opening, intraoperative mouth opening, mouth opening at follow up and follow up period were recorded and analyzed. A total of 82 articles which reported 115 cases were included. Coronoid hyperplasia was commonly reported at mean age of 22.64 years old with male preponderance. Most of the cases were diagnosed and treated between the age of 11-20 years old. This condition commonly involved bilateral coronoid process of mandible. The mean width of preoperative mouth opening was 16.5mm and was improved to a mean mouth opening of 36.3mm intraoperatively. Mean mouth opening was 34.8mm at an average follow up of 19 months. While the etiopathogenesis of coronoid hyperplasia is still not conclusive, treatment with either coronoidectomy or coronoidotomy produced good improvement in mouth opening.


Assuntos
Mandíbula , Osteotomia Mandibular , Adolescente , Adulto , Criança , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patologia , Hiperplasia/cirurgia , Masculino , Mandíbula/patologia , Mandíbula/cirurgia , Adulto Jovem , Zigoma
20.
Oral Dis ; 26(3): 711-715, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31917876

RESUMO

We present the frequency of cases of isolated odontogenic keratocysts submitted to microscopic examination at 10 Brazilian referral centres in Oral and Maxillofacial Pathology. In a retrospective (1953-2017) analysis, data on clinicoradiographic features and treatment of these lesions were collected and analysed descriptively. Among the 258,867 cases retrieved, 2,497 (0.96%) were isolated odontogenic keratocysts. In summary, an overview of individuals affected with isolated odontogenic keratocysts is reported herein. This lesion showed predilection for the posterior mandible of young adult men.


Assuntos
Cistos Odontogênicos/patologia , Tumores Odontogênicos/patologia , Brasil , Humanos , Masculino , Mandíbula/patologia , Estudos Retrospectivos , Adulto Jovem
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