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1.
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 de Angle Classe II/terapia , Aparelhos Ortodônticos Removíveis , Aparelhos Ativadores , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Desenvolvimento Musculoesquelético/fisiologia , Cefalometria
2.
Cir. plást. ibero-latinoam ; 46(4): 455-464, oct.-dic. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198730

RESUMO

INTRODUCCIÓN Y OBJETIVO: Para la reconstrucción del maxilar se han descrito múltiples clasificaciones y algoritmos de manejo. Actualmente, el más aceptado es el planteado por Cordeiro y Santamaría. Presentamos nuestra experiencia en reconstrucción microquirúrgica del maxilar con colgajos libres de peroné y ánterolateral de muslo, con el objetivo de que se consideren herramientas de primera elección en la reconstrucción de defectos clasificados como tipo II y III. MATERIAL Y MÉTODO: Estudio retrospectivo descriptivo, serie de casos, en el que presentamos 7 casos clínicos de reconstrucción de maxilar con colgajo libre de peroné y ánterolateral de muslo realizados en el Hospital Universitario de La Samaritana (HUS) en Bogotá, Colombia, entre enero de 2018 y febrero de 2019. RESULTADOS: Para la reconstrucción de los defectos IIa, IIb y IIIa utilizamos el colgajo libre de peroné. En maxilectomías clasificadas como IIIb implementamos el colgajo ánterolateral de muslo quimérico con vasto lateral. La supervivencia de los colgajos fue del 100%. CONCLUSIONES: El colgajo libre de peroné es nuestra principal opción reconstructiva en los defectos por maxilectomías IIa, IIb y IIIa, mientras que el colgajo ánterolateral de muslo quimérico con vasto lateral es nuestro colgajo de elección en defectos tipo IIIb


BACKGROUND AND OBJECTIVE: Multiple classifications and management algorithms have been described for maxillary reconstruction, at the present time, the most widely accepted is described by Cordeiro and Santamaría. We present our experience in microsurgical reconstruction of the maxillary with free flaps retrieved from fibula and anterolateral thigh with the intent to consider it as a first-choice option in the reconstruction of defects classified as type II and III. METHODS: A retrospective, descriptive, case series study of 7 maxillary reconstruction cases with free flap from fibula and anterolateral thigh is described. Database was recollected between January 2018 and February 2019 from Hospital Universitario de La Samaritana (HUS) in Bogotá, Colombia. RESULTS: For the reconstruction of IIa, IIb and IIIa defects, a fibular free flap was used. For maxillectomies classified as IIIb, an anterolateral thigh and vast lateral chimeric free flap was implemented. Survival rate of the free flaps was observed at 100%. CONCLUSIONS: The fibular free flap is our primary reconstructive option in defects by maxillectomy classified as IIa, IIb and IIIa. In defects constituted as IIIb, our choice is an anterolateral thigh and vast lateral chimeric flap


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Microcirurgia/métodos , Maxila/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos de Tecido Biológico/cirurgia , Maxila/lesões , Maxila/patologia , Estudos Retrospectivos , Neoplasias Maxilares/cirurgia , Neurofibroma/cirurgia , Carcinoma Basocelular/cirurgia
3.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(6): 642-646, 2020 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-33377340

RESUMO

OBJECTIVE: To study the comprehensive impact of scar and maxillary expansion combined with protraction on the development of maxilla with cleft lip and palate after repair operation. METHODS: In the original finite element model of the maxilla with cleft palate, a finite element model of the maxilla with cleft lip and palate was established by using Boolean operation in ANSYS. Scar force after cleft lip and palate repair and maxillary expansion force combined with protraction were added simultaneously to process the stress analysis. RESULTS: Maxillary deformation occurred in the three-dimensional direction. The comparison of displacements was as follows: X-axis>Z-axis>Y-axis. CONCLUSIONS: Maxillary growth is significantly inhibited in the three-dimensional direction under the comprehensive impact of scar and maxillary expansion combined with protraction after repair operation, especially transverse and sagittal growth.


Assuntos
Fenda Labial , Fissura Palatina , Cicatriz/patologia , Fenda Labial/cirurgia , Fissura Palatina/patologia , Fissura Palatina/cirurgia , Análise de Elementos Finitos , Humanos , Maxila/patologia , Maxila/cirurgia , Técnica de Expansão Palatina
4.
BMC Infect Dis ; 20(1): 614, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811466

RESUMO

BACKGROUND: The most common aetiological agents of mucormycosis are Rhizopus, Mucor, Apophysomyces and Lichtheimia. Apophysomyces is comparatively rare, as it has been reported in less than 3% of mucormycosis cases. The genus Apophysomyces includes six species, and only A. elegans, A. mexicanus, A. variabilis and A. ossiformis have been reported to cause infections in both immunocompetent and immunocompromised patients. CASE PRESENTATION: We present a case of a 46-year-old male patient with bilateral blepharoedema, corneal opacity in the left eye and poorly controlled diabetes mellitus. The patient was subjected to total maxillectomy, exenteration of the left orbit and treatment with liposomal amphotericin B. Direct mycological analysis with KOH 10% revealed hyaline, coenocytic, long and wide hyphae. Apophysomyces ossiformis was identified from maxillary biopsy using 18S-ITS1-5.8S-ITS2-28S rRNA gene amplification and sequencing. The patient requested to be transferred to another hospital to continue treatment, where he died on the ninth day after admittance. CONCLUSION: To the best of our knowledge, this is the first case of rhino-orbital mucormycosis due to A. ossiformis with a fatal outcome. This case reveals the need to identify the fungus causing mucormycosis with molecular methods to identify adequate treatment therapies for patients with this infection.


Assuntos
Complicações do Diabetes/microbiologia , Mucorales/genética , Mucormicose/complicações , Doenças Orbitárias/complicações , Rinite/complicações , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Biópsia , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/cirurgia , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Masculino , Maxila/microbiologia , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Mucormicose/cirurgia , Doenças Orbitárias/tratamento farmacológico , Doenças Orbitárias/microbiologia , Doenças Orbitárias/cirurgia , RNA Ribossômico 28S/genética , Rinite/tratamento farmacológico , Rinite/microbiologia , Rinite/cirurgia
5.
J Pathol ; 251(3): 323-335, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32418202

RESUMO

The lymphatic system plays a crucial role in the maintenance of tissue fluid homeostasis and the immunological response to inflammation. The effects of lymphatic drainage dysfunction on periodontitis have not been well studied. Here we show that lymphatic vessel endothelial receptor 1 (LYVE1)+ /podoplanin (PDPN)+ lymphatic vessels (LVs) are increased in the periodontal tissues, with accumulation close to the alveolar bone surface, in two murine periodontitis models: rheumatoid arthritis (RA)-associated periodontitis and ligature-induced periodontitis. Further, PDPN+ /alpha-smooth muscle actin (αSMA)- lymphatic capillaries are increased, whereas PDPN+ /αSMA+ collecting LVs are decreased significantly in the inflamed periodontal tissues. Both mouse models of periodontitis have delayed lymph flow in periodontal tissues, increased TRAP-positive osteoclasts, and significant alveolar bone loss. Importantly, the local administration of adeno-associated virus for vascular endothelial growth factor C, the major growth factor that promotes lymphangiogenesis, increases the area and number of PDPN+ /αSMA+ collecting LVs, promotes local lymphatic drainage, and reduces alveolar bone loss in both models of periodontitis. Lastly, LYVE1+ /αSMA- lymphatic capillaries are increased, whereas LYVE1+ /αSMA+ collecting LVs are decreased significantly in gingival tissues of patients with chronic periodontitis compared with those of clinically healthy controls. Thus, our findings reveal an important role of local lymphatic drainage in periodontal inflammation-mediated alveolar bone loss. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/metabolismo , Periodontite Crônica/terapia , Terapia Genética , Linfa/metabolismo , Vasos Linfáticos/metabolismo , Maxila/metabolismo , Fator C de Crescimento do Endotélio Vascular/biossíntese , Fator C de Crescimento do Endotélio Vascular/genética , Perda do Osso Alveolar/genética , Perda do Osso Alveolar/metabolismo , Perda do Osso Alveolar/patologia , Processo Alveolar/patologia , Animais , Estudos de Casos e Controles , Periodontite Crônica/genética , Periodontite Crônica/metabolismo , Periodontite Crônica/patologia , Modelos Animais de Doenças , Humanos , Vasos Linfáticos/patologia , Masculino , Maxila/patologia , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Osteoclastos/metabolismo , Osteoclastos/patologia , Fator de Necrose Tumoral alfa/genética
7.
Tunis Med ; 98(3): 246-253, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32395819

RESUMO

INTRODUCTION: By means of orthopedics, orthognathic surgery or orthodontics, the management of the maxillary transverse defisciency is a key element of the orthodontic treatment plan, and the guarantee of its stability. the following work aims to support, through a clinical case, the management and the progression of the treatment of the maxillary transverse deficiency associated to a class III skeletal anomaly. OBSERVATION: The authors report the case of a 15-year-old patient with a severe class III    malocclusion, with severe maxillary transverse deficiency. The objectives of the treatment were, first, to solve the transverse disharmony by surgically assisted rapid maxillary expansion (SARME), then, secondly, to remove the dentoalveolar compensations and a bimaxillary orthognathic surgery, was carried out to correct the sagittal and vertical disharmony. CONCLUSION: Surgically assisted rapid maxillary expansion (SARME) appears to be advantageous, both functionally and aesthetically to overcome transverse maxillary deficiency. The agreement between the orthodontist, the maxillofacial surgeon and / or the plastic surgeon, both in the schedule and in the choice of surgical interventions, remains decisive concerning ortho-surgical treatments.


Assuntos
Má Oclusão de Angle Classe III/cirurgia , Maxila/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Técnica de Expansão Palatina , Adolescente , Humanos , Má Oclusão de Angle Classe III/patologia , Maxila/patologia , Índice de Gravidade de Doença
8.
Artigo em Chinês | MEDLINE | ID: mdl-32268686

RESUMO

Objective: To investigate the application and clinical outcomes of using 3D computer-assisted printing technique combined with plastic titanium mesh in the reconstruction of maxillary defect. Methods: Clinical data of 14 patients in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital from January 2016 to June 2018, who were treated for partial or total removal of the maxilla due to benign or malignant tumors and those acquired maxillary defects caused by severe compound trauma were analyzed retrospectively. Twelve males and 2 females were included, with the age ranging from 16 to 51 years old. The sinonasal malignant tumors included squamous carcinoma (n=2) while benign tumors included hemangioma (n=1), maxillary fibrous dysplasia (n=3), maxillary cyst (n=2) and giant cell tumor of the maxilla (n=1). Five cases of post-traumatic maxillary defect were also included. According to preoperative thin-layer CT scanning data, computer modeling data was transmitted to a 3D printer to print out the original model and the reconstructed model. Preoperative simulation of tumor removal and maxillary reconstruction was done on the patient's original model, and the titanium mesh was shaped on the reconstructed model in order to properly reconstruct the area needed to be repaired. The pre-made titanium mesh was implanted into the defect area, the soft tissue flaps were reset, layered stitching and the local pressured bandage were used after surgery. Through postoperative clinical and CT examination, the patient's maxillofacial shape, nasal function and complications were evaluated. The results were analyzed by descriptive statistical method. Results: Lesions could be completely removed within the predicted range on the preoperative 3D-printed models of all cases. After debridement, titanium mesh could be implanted easily without re-shaping and trimming during surgery as in trauma cases. Titanium mesh could completely cover the missing bone surface closely, with titanium nails fixed smoothly, and the implanted titanium mesh was solid and stable. After the follow-up of 6 to 20 months, all patients were satisfied with the facial symmetry and the function was recovered well. Conclusion: Using 3D computer-assisted printing technique combined with plastic titanium mesh in the reconstruction of maxillary defect can accurately restore the maxillary structure for soft tissue support, and restore the facial shape and function.


Assuntos
Desenho Assistido por Computador , Maxila/cirurgia , Impressão Tridimensional , Procedimentos Cirúrgicos Reconstrutivos , Telas Cirúrgicas , Adolescente , Adulto , China , Feminino , Humanos , Masculino , Maxila/patologia , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Plásticos , Estudos Retrospectivos , Titânio , Adulto Jovem
9.
Artigo em Chinês | MEDLINE | ID: mdl-32268687

RESUMO

Objective: To evaluate the application of computer-assisted design and three-dimensional printing technique in reconstruction of maxillary defects with individual free fibular flap. Methods: A total of 13 patients, 7 males and 6 females with age from 12 to 55 years old, underwent the reconstruction of maxillary defects after subtotal or total maxillectomy for benign or malignant tumors between January 2016 and December 2018 were reviewed. Ther were 4 cases of subtotal maxillectomy and 9 cases of total maxillectomy. Before operation, osteotomy line was planned on three-dimensional images. A three-dimensional individual resin fibula model based on mirror images of the healthy side maxilla was obtained to fabricate an anatomically adapted osteomyocutaneous fibula free flap using computer-assisted design and forming. Oral, nasal, and eye functions and facial appearance were evaluated. Results: The 13 cases were followed up for 5-40 months, all flaps were alive except one due to flap failure and all cases were tumor free confirmed by CT or MRI. Ten patients could eat normal food without nasal food return, and 3 cases had palatal fistula. Eleven cases showed good speaking functional results. All cases had normal eye positions, no cases with diplopia and loss of vision. With evaluation by VAS, an average score of 8 was obtained, and most of patients were satisfied with their postoperative facial appearances. Conclusion: Reconstruction of maxillary defects by free fibular flap designed by three-dimensional printing and computer-assisted technique not only restored oral, nasal and eye functions, but also showed satisfactory facial appearance.


Assuntos
Desenho Assistido por Computador , Retalhos de Tecido Biológico , Maxila/cirurgia , Impressão Tridimensional , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Assistida por Computador , Adolescente , Adulto , Criança , Feminino , Fíbula , Humanos , Masculino , Maxila/patologia , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
10.
Cient. dent. (Ed. impr.) ; 17(1): 19-26, ene.-abr. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-189745

RESUMO

La pérdida ósea vertical en los sectores posteriores maxilares es un hecho frecuente tras la extracción dental. En muchas ocasiones para rehabilitar estas zonas podemos emplear técnicas de regeneración u optar por un abordaje más conservador con implantes cortos. En el presente caso clínico mostramos un caso rehabilitado bilateralmente con dos técnicas diferentes: elevación de seno y la inserción de implantes cortos, con un seguimiento de ocho años donde ambas técnicas han logrado resultados igualmente predecibles


Vertical bone loss in the posterior maxillary sectors is a frequent occurrence after tooth extraction. These areas can often be rehabilitated using regeneration techniques or by opting for a more conservative approach with short implants. The present clinical case shows bilateral rehabilitation with two different techniques: sinus lift and the insertion of short implants, with a follow-up of 8 years where both techniques have achieved equally predictable results


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Atrofia , Maxila/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Implantes Dentários , Maxila/patologia , Dente Molar/patologia , Radiografia Panorâmica
11.
PLoS One ; 15(2): e0229360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092128

RESUMO

This study evaluated the von Mises stress (MPa) and equivalent strain occurring around monolithic yttria-zirconia (Zir) implant using three clinically simulated finite element analysis (FEA) models for a missing maxillary central incisor. Two unidentified patients' cone-beam computed tomography (CBCT) datasets with and without right maxillary central incisor were used to create the FEA models. Three different FEA models were made with bone structures that represent a healed socket (HS), reduced bone width edentulous site (RB), and immediate extraction socket with graft (EG). A one-piece abutment-implant fixture mimicking Straumann Standard Plus tissue level RN 4.1 X 11.8mm, for titanium alloy (Ti) and Zir were modeled. 178 N oblique load and 200 N vertical load were used to simulate occlusal loading. Von Mises stress and equivalent strain values for around each implant model were measured. Within the HS and RB models the labial-cervical region in the cortical bone exhibited highest stress, with Zir having statistically significant lower stress-strain means than Ti in both labial and palatal aspects. For the EG model the labial-cervical area had no statistically significant difference between Ti and Zir; however, Zir performed better than Ti against the graft. FEA models suggest that Ti, a more elastic material than Zir, contributes to the transduction of more overall forces to the socket compared to Zir. Thus, compared to Ti implants, Zir implants may be less prone to peri-implant bone overloading and subsequent bone loss in high stress areas especially in the labial-cervical region of the cortical bone. Zir implants respond to occlusal loading differently than Ti implants. Zir implants may be more favorable in non-grafted edentulous or immediate extraction with grafting.


Assuntos
Implantes Dentários para Um Único Dente , Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Zircônio/química , Fenômenos Biomecânicos , Simulação por Computador , Humanos , Incisivo/química , Teste de Materiais , Maxila/patologia , Estresse Mecânico , Ítrio/química
12.
BMC Oral Health ; 20(1): 55, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066451

RESUMO

BACKGROUND: The aim of this study was to assess the difference of palatal morphology in different vertical patterns between skeletal Class I subjects and skeletal Class II subjects with retrusive mandible. METHODS: Seventy-six skeletal Class II subjects with retrusive mandible (38 females, 38 males) and 85 skeletal Class I subjects (45 females, 40 males) were collected retrospectively and divided into hyperdivergent, normodivergent and hypodivergent groups. CBCT images of these subjects were reoriented by Dolphin 3D Imaging software. Three-dimensional (3D) maxilla was segmented by ProPlan software before using Geomagic Studio software to reconstruct 3D palatal morphology. Deviation patterns on 3D colored map analysis was performed to compare the difference of 3D palatal morphology between different groups. RESULTS: 3D colored map analysis showed that male's palate was higher and wider than that of female in the posterior part, regardless of different sagittal and vertical patterns. In skeletal Class II subjects with retrusive mandible, males with hyperdivergent and normodivergent showed higher and narrower in the posterior part of palate, while females with hyperdivergent and normodivergent had a higher but no obviously narrow palate compared with the hypodivergent subjects. Skeletal Class II subjects with retrusive mandible showed flatter and narrower in the posterior part of palate than that of skeletal Class I subjects. CONCLUSIONS: Sagittal and vertical patterns have great influence on the palatal morphology and as the vertical dimension increased, the palate tended to be higher and narrower.


Assuntos
Cefalometria/métodos , Imageamento Tridimensional/métodos , Má Oclusão de Angle Classe II/patologia , Mandíbula/anatomia & histologia , Maxila/anatomia & histologia , Palato/patologia , Dimensão Vertical , Adolescente , Adulto , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Maxila/diagnóstico por imagem , Maxila/patologia , Radiografia Dentária Digital/métodos , Estudos Retrospectivos , Adulto Jovem
13.
J Biol Regul Homeost Agents ; 34(1 Suppl. 1): 115-117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32064844

RESUMO

Oral rehabilitation of edentulous maxilla is particularly difficult because of the lack of bone in correspondence of maxillary sinuses, therefore, the surgeon is forced to place implants in sites where bone is more prevalent. In addition, patients require more frequent oral immediate rehabilitation in order to reduce the discomfort related to wearing a total denture. A viable solution to provide stability and retention of the prosthesis in a short time is represented by the technique of intraoral welding supporting total denture or fixed prosthesis. This goal may be achieved thanks to the technique of welding titanium bars onto implant abutments. In fact, the procedure can be performed directly in the mouth, eliminating the possibility of errors or distortions due to prosthetic procedures. This paper describes a case report and the most recent data regarding long-term success and high predictability of intraorally-welded titanium bar in immediate loading implants.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Soldagem em Odontologia , Arcada Edêntula , Maxila/patologia , Humanos
14.
Oral Dis ; 26(3): 609-620, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31903673

RESUMO

OBJECTIVES: This study aimed to investigate the therapeutic effect of different doses of teriparatide (TPTD) on bisphosphonate-related osteonecrosis of the jaw (BRONJ). MATERIALS AND METHODS: To establish the BRONJ model, 20 mice were randomly divided into two groups: a group that received tail vein administration of zoledronic acid with dexamethasone (ZA-125 µg/kg, DEX 5 mg/kg) and a group that received saline weekly. The mice subsequently underwent bilateral maxillary first molar extraction. After 8 weeks of modelling administration, the maxilla samples were examined by micro-computed tomography and histological staining (haematoxylin and eosin, Masson's trichrome and tartrate-resistant acid phosphatase) and the cytokine level was measured (enzyme-linked immunosorbent assay and Western blot). To determine the role of TPTD in BRONJ, the same protocol as previously described was applied in 100 mice (80 received ZA + DEX, and 20 received saline). After 8 weeks of modelling administration, 80 ZA + DEX mice were randomly divided into four groups: three groups with subcutaneous administration of TPTD (i.e. T1-3, T2-10 and T3-30 µg kg-1  day-1 ) and one group with saline daily for the next 8 weeks. The other 20 saline mice continued to receive saline daily. RESULTS: In Part 1, the level of receptor activator of nuclear factor-kappa Β ligand and the numbers of osteoclasts differed between the model and control groups. In Part 2, we found that TPTD had a positive effect on BRONJ in a mouse model based on clinical and histomorphological observations. Among the three treatment groups, the T1 and T2 groups significantly differed from the model group, whereas the T3 group showed no statistical differences. CONCLUSION: Subcutaneous administration of TPTD has a beneficial effect on BRONJ in mice. Nevertheless, further studies are needed to determine whether the therapeutic effect on BRONJ is dose-dependent.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Maxila/patologia , Teriparatida/administração & dosagem , Animais , Maxila/efeitos dos fármacos , Camundongos , Distribuição Aleatória , Microtomografia por Raio-X
15.
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
17.
J Synchrotron Radiat ; 27(Pt 1): 199-206, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31868752

RESUMO

This study explores the application of synchrotron radiation and conventional microcomputed tomography (SR-µCT and C-µCT, respectively) in evaluating bone-biopsy specimens. Bone-biopsy specimens were obtained using a trephine bur during bone-graft removal for implant placement six months after performing a maxillary sinus bone-graft procedure. Image data of specimens were obtained using SR-µCT and C-µCT. SR-µCT was performed using the 6C biomedical imaging beamline at the Pohang Accelerator Laboratory with a monochromatic X-ray beam of 23 keV, and C-µCT was performed using a table-top CT scanner (Skyscan 1272). Reconstruction images obtained using the two methods were qualitatively compared with 2D images evaluated under 3D visualization. The SR-µCT images, especially of the new-bone-graft-woven-bone formation, were less noisy and sharper than the C-µCT images. To evaluate the new-bone-graft-woven-bone formation, only the SR-µCT images showed areas of new bone (NB) formation with bone substitute (BS; Bio-Oss) and woven bone (WB) contact, and correctly visualized true 3D structures of bone formation. Hence, µCT techniques are non-destructive and can provide detailed images of bone biopsy. In particular, SR-µCT can be used to obtain improved image quality with contrast of NB, BS and WB, demonstrating a level of detail comparable with bone formation. SR-µCT could be an unbiased 3D alternative for imaging WB formation and for high-throughput analysis.


Assuntos
Regeneração Óssea , Osso e Ossos/ultraestrutura , Síncrotrons , Microtomografia por Raio-X/métodos , Absorção de Radiação , Biópsia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Maxila/patologia , Maxila/cirurgia , Refratometria
18.
J Craniofac Surg ; 31(1): e75-e78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31634309

RESUMO

OBJECTIVE: This article describes the case report of a prostate adenocarcinoma in the mandible. BACKGROUND: Prostate adenocarcinoma is a malignant tumor common in men from the fourth decade of life. The occurrence of oral metastatic lesions is rare. CASE REPORT: A 78-year-old male patient was referred to the oral and maxillofacial surgery service of the Pontifical Catholic University of Rio Grande do Sul for complaints of painless volume increase in the mandible. The diagnosis through the association of clinical, radiographic, and histopathological examination with the patient's health history determined that the lesion was prostatic adenocarcinoma metastasis. CONCLUSION: Despite the rare occurrence of metastases in the oral region, the dental surgeon should be aware of the possibility for correct diagnostic conduction and, subsequently, the institution of treatment in the early stages of disease.


Assuntos
Adenocarcinoma/secundário , Maxila/patologia , Neoplasias da Próstata/patologia , Idoso , Humanos , Masculino , Mandíbula/patologia
19.
Head Neck Pathol ; 14(1): 208-211, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30888637

RESUMO

Congenital granular cell epulis (CGCE) is an uncommon lesion of unclear pathogenesis. It occurs predominantly in female newborns with a predilection site of the maxillary alveolar ridge. The mass enlarges prenatally but the growth arrests after birth. Histologically, CGCE is characterized by a proliferation of polygonal cells with eosinophilic, granular cytoplasm and eccentric, bland-appearing nuclei. It closely resembles adult granular cell tumor (GCT) microscopically and S-100 immunostain is often helpful in distinguishing the two (S-100-positive in GCT and S-100-negative in CGCE). Clinically, the lesion should also be distinguished from entities such as infantile myofibroma, rhabdomyoma, melanotic neuroectodermal tumor of infancy, peripheral odontogenic fibroma, and neurofibroma. CGCE demonstrates an excellent prognosis and has not been associated with any syndromes/genetic defects or malignant transformation. Clinicians and pathologists should be familiar with this rare entity and its differential diagnosis for accurate diagnosis and management.


Assuntos
Neoplasias Gengivais/congênito , Neoplasias Gengivais/diagnóstico , Neoplasias Gengivais/patologia , Diagnóstico Diferencial , Humanos , Recém-Nascido , Maxila/patologia
20.
J Forensic Sci ; 65(1): 304-313, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31145812

RESUMO

In 1949, the American Graves Registration Service Pacific Zone proposed the identification of 27 sets of remains (skulls/crania/mandibles) based on comparisons with written dental records. All were denied, and the remains were buried as unknowns. In 2003 and 2015, the remains were exhumed by the DPAA. Currently, 26 individuals previously recommended for identification have been positively identified. The DPAA Science Director's opinion corresponded with 24 of their recommendations, while DNA excluded three. Caution should be taken by the forensic scientist when building assemblages through skeletal and dental articulation. The forensic odontologist must always consider variations in restorative care/extraction patterns and the possibility of documentation errors when reviewing/interpreting historical and current day dental records used for AM/PM comparisons. The odontologist should base their opinion on the strength of the antemortem/postmortem comparison, number and type of concordances, and distinct dental care and extraction patterns.


Assuntos
Restos Mortais , Registros Odontológicos , Odontologia Legal/métodos , Amálgama Dentário , Prótese Dentária , Exumação , História do Século XX , Humanos , Mandíbula/patologia , Maxila/patologia , Militares/história , Fotografação , Radiografia Dentária , Dente/patologia , Estados Unidos , II Guerra Mundial
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