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1.
Tokai J Exp Clin Med ; 45(3): 121-125, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901899

RESUMO

Clear cell carcinoma is an extremely rare low-grade malignancies occurring in less than 1% of salivary gland tumors. We report a case of clear cell carcinoma of the hard palate in a 15-year-old adolescent patient. She first noticed a palatal tumor at age 9, but the tumor was left untreated for 6 years. We performed incisional biopsy, but no definitive diagnosis was obtained. Excisional biopsy was then performed, and the histopathological diagnosis was clear cell carcinoma of the salivary gland. However, the tumor was exposed at the margin of the surgical specimen; thus, additional excision was performed. Five years after the treatment, no local recurrence or metastasis has been observed.


Assuntos
Carcinoma/diagnóstico , Carcinoma/patologia , Palato , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia , Adolescente , Biópsia , Feminino , Humanos , Margens de Excisão , Palato/patologia , Doenças Raras , Resultado do Tratamento
2.
Artigo em Inglês | MEDLINE | ID: mdl-32926004

RESUMO

One standard approach for wound closure after ridge augmentation is coronal flap advancement. Coronal flap advancement results in displacement of the mucogingival junction and reduction of the vestibulum. In the maxilla, a buccal sliding palatal flap can be applied for primary wound closure after ridge augmentation. The dissected part of the palatal connective tissue is left exposed, thus eliminating or reducing the amount of the coronal flap advancement respectively and increasing the amount of keratinized gingiva. In combination with guided soft tissue augmentation, this flap design enables a three-dimensional peri-implant soft tissue augmentation.


Assuntos
Aumento do Rebordo Alveolar , Implantação Dentária Endo-Óssea , Gengiva , Maxila/cirurgia , Palato/cirurgia , Retalhos Cirúrgicos/cirurgia
3.
Stomatologiia (Mosk) ; 99(3): 60-70, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608952

RESUMO

The aim of this research is to increase the accuracy of determining the position of the tongue, the amount of space occupied by the tongue and space, free from tongue, increase of efficiency of diagnostics of dentofacial anomalies in patients based on CBCT analysis-the study of the skull conducted in transversal, sagittal and coronal planes. Clinical and x-ray examination and orthodontic treatment were carried out in 120 patients with anomalies of the dentition complex. Patients were divided into three groups. Group 1 - 30 patients aged 5 to 11 years. Group 2 - 50 patients aged 12 to 17 years. Group 3 - 40 patients aged 18 to 40 years. All patients underwent CT examination of the skull before treatment, and during the retention period of treatment. After a diagnostic examination of the proposed method for diagnosing the anatomical and functional state of the dentition complex and drawing up a treatment plan, all patients underwent orthodontic treatment, which consisted in the expansion of the upper jaw using various orthodontic appliances for expansion. This method allows to identify anomalies in the position of the tongue before and after orthodontic treatment, to assess the quality of orthodontic treatment, based on the analysis of not only the tongue filling the space of the dome of the palate, but also the position of the bone structures of the skull in three planes. The high quality of the study allows us to give a reliable assessment of the state of maxillofacial structures: the position of the upper and lower jaws, inclination of teeth, the stage of formation of the patient's growth, airway lumen and the influence of tongue on these structures at different stages of development of the maxillofacial skull. When comparing the results of the study, not all patients carried out recovered the anatomical and functional balance of the maxillofacial complex after orthodontic treatment, suggesting the need for more myogymnastics of the tongue before, during, and after treatment.


Assuntos
Maxila , Técnica de Expansão Palatina , Adolescente , Adulto , Cefalometria , Criança , Pré-Escolar , Humanos , Palato , Língua , Adulto Jovem
5.
Am J Orthod Dentofacial Orthop ; 157(6): 783-791, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487308

RESUMO

INTRODUCTION: Rapid palatal expansion is an effective intervention for correcting transverse maxillary deficiency in growing patients. However, relapse after treatment is often observed, and the mechanisms of tissue remodeling during expansion and relapse remain unclear. This study aimed to gain insight into such a mechanism. METHODS: A total of 24 5-week-old male Wistar rats were randomly divided into either the expansion or sham device (control) group. Each rat underwent 7 days of expansion and 7 days of relapse. The width of the dental arch, palatal bone, and suture, as well as the angle of the teeth, were measured. Tissue remodeling in the midpalatal suture was examined using microcomputed tomography and histologic and immunohistochemical analyses. RESULTS: The mechanical expansion force caused an increase in arch width, which relapsed after the removal of force. Bilateral tilting of the teeth and midpalatal suture expansion contributed to the widening of the maxillary arch, and only the relapse of the palatal bone width was observed. Histochemical staining showed that suture tissue remodeling was activated by mechanical force in the expansion group and reverted to the level of the control group after relapse. Immunohistochemistry staining revealed that the expression of cathepsin K, osteocalcin, and collagen type I was higher in the expansion group than that in the control group on day 7; however, the difference dissipated by day 14. CONCLUSIONS: The expansion force stimulated osteogenic activity in the midpalatal suture area. After removal of the expansion force, tissue remodeling went back to the normal level.


Assuntos
Técnica de Expansão Palatina , Palato , Animais , Humanos , Masculino , Maxila , Ratos , Ratos Wistar , Recidiva , Microtomografia por Raio-X
6.
J Oral Sci ; 62(3): 318-321, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32581179

RESUMO

This study used finite element (FE) analysis to investigate the stability of miniscrews (screws) placed at the median palate. FE models with variable suture maturity and screw-suture distances were used to examine the relationship with screw stability. Four groups were classified by extent of maturation of the midpalatal suture (0%, 60%, 75%, and 100%). The placement position was set at the center of the suture (0.0 mm), or 0.5, 1.0, and 1.5 mm to the side of the suture, and von Mises stress values in bone and screw displacement were compared among models. The stress value for the unsutured model, in which the screw was placed at the center of the suture, was greater than 30 MPa. Stress values for models in which screws were placed to the side (0.5-1.5 mm) were less than 28 MPa. Maximum screw displacement was greater in the 0.0-mm incomplete suture model than at other placement positions. Because bone conditions vary among patients, placement position and suture maturation should be examined on cone beam-computed tomography images, to ensure screw stability.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Palato , Análise de Elementos Finitos , Humanos
7.
Shanghai Kou Qiang Yi Xue ; 29(1): 1-6, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32524112

RESUMO

PURPOSE: This study was aimed to investigate the effect of quercetin on rats' palatal suture during rapid maxillary expansion(RME). METHODS: Eighteen male 6-week-old(specific pathogen free,SPF) rats were randomly divided into 3 groups. Group A was control group, group B underwent expansion alone, and group C underwent expansion plus quercetin administration. Each group had 6 rats. Neither expansion nor quercetin was given to group A. Each rat in group B and C was set an orthodontic appliance with an initial expansive force (0.98 N). The rats in group C were administered with quercetin (100 mg/kg) at the same time every day after RME, while equal normal saline was given to rats in group A and B. Then the rats were sacrificed on day 14. Sections were cut perpendicular to the midpalatal suture and stained with hematoxylin and eosin (H-E) for observation of celluar response, and immunostained for evaluation of bone formation.The changes of collagen were observed through Masson's staining. Image-pro plus adhesive was used to analyze the slice absorbance, and SPSS19.0 software package was used to analyze the data. RESULTS: The results showed that small amount of fibrous tissue was found in the palate of group A, and there were chondrocytes, mesenchymal cells and osteoblasts. There were more fibrous tissues in the palate of group C, fibroblasts and cartilage cells increased, and osteoblasts were seen near the bone region of the palate. The number of osteoblasts in group C was significantly higher than that in group B, and there were new bone calcification deposits. The expression of BMP-2 in the midpalatal suture was significantly greater in group B than in group A at day 14 (P<0.01); the expression of BMP-2 in the midpalatal suture in group C was significantly greater than in group B (P<0.05). CONCLUSIONS: Rapid maxillary expansion can enlarge the middle palatal suture of rats during growth and development, quercetin can promote the expression of BMP-2 in the middle palatal suture of rats during rapid maxillary expansion, make bone deposition and calcification, and accelerate new bone formation.


Assuntos
Osteogênese , Técnica de Expansão Palatina , Animais , Suturas Cranianas , Masculino , Palato , Quercetina , Ratos , Suturas
8.
Artigo em Inglês | MEDLINE | ID: mdl-32559041

RESUMO

Several approaches for peri-implant soft tissue augmentation have been proposed, including autogenous soft tissue grafts and substitutes. Palatal pedicle flaps have been introduced for increasing facial soft tissue thickness, improving esthetics, and achieving primary closure following alveolar ridge preservation or guided bone regeneration. The main advantage of these approaches is to maintain the vascularization of the flap, which may result in better healing and less shrinkage than graft-based procedures. Nevertheless, different clinical scenarios require different palatal pedicle flaps. The aim of this article was to present several palatal pedicle flap techniques for peri-implant soft tissue augmentation and alveolar ridge preservation, showing flap designs and the main advantages through case presentations.


Assuntos
Aumento do Rebordo Alveolar , Processo Alveolar , Regeneração Óssea , Transplante Ósseo , Implantação Dentária Endo-Óssea , Palato/cirurgia , Retalhos Cirúrgicos/cirurgia
10.
J Esthet Restor Dent ; 32(5): 457-462, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32583939

RESUMO

OBJECTIVE: Current approaches for soft tissue thickness evaluation and visualization still represent a challenge for full extent evaluation and visualization. The aim of this clinical technique article is to introduce a novel approach for comprehensive visualization and precise evaluation of oral soft tissue thickness utilizing a fusion of optical 3D and cone-beam computed tomography (CBCT) images. CLINICAL CONSIDERATIONS: 3D models of the maxilla were obtained by CBCT imaging and intraoral scanning. The CBCT images were reconstructed to standard tessellation language (STL) file format models by segmentation of teeth and bone using implants planning software. 3D soft tissues and teeth models were obtained by intraoral scanning and were exported in STL file format as well. 3D multimodal models were then superimposed using best-fit matching on teeth. Soft tissue thickness was then visualized and evaluated with a 3D color-coded thickness map of gingival and palatal areas created by surface comparison of both 3D models. Additionally, threshold color-coding was used to increase comprehensibility. Palatal areas were further visualized and evaluated for the optimal donor site. CONCLUSIONS: A novel approach for 3D evaluation and visualization of masticatory mucosa thickness presents all available 3D data in a comprehensible, "clinician-friendly" manner, using threshold regions and clinically relevant views. CLINICAL SIGNIFICANCE: Proposed approach could provide comprehensive presurgical treatment planning in periodontal plastic surgery and implantology without additional invasive procedures for the patient, resulting in more predictable treatment, improved outcomes, and reduced risk for complications.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional , Modelos Dentários , Humanos , Maxila , Palato
11.
Am J Orthod Dentofacial Orthop ; 158(1): 28-34, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32381436

RESUMO

INTRODUCTION: Lingual displacement of the maxillary anterior teeth is 1 of the most common forms of malocclusion. The labial alveolar bone is thinner for the maxillary lateral incisor than for the central incisor and canine; however, the alveolar bone width at the actual position of the maxillary lateral incisor has not been examined. We investigated the morphologic characteristics of the alveolar bone around palatally displaced maxillary lateral incisors using cone-beam computed tomography and a split-mouth model. METHODS: Twenty-seven patients with a unilateral palatally displaced maxillary lateral incisor were included. Axial, sagittal, and horizontal measurements were recorded at 3 levels (ie, 25%, 50%, and 75% of the root length) using cone-beam computed tomography. All obtained data were statistically analyzed using paired t tests. RESULTS: The labial alveolar bone width at 25% of root length was significantly lesser on the affected side. At all 3 levels, the distance between a line tangential to the labial alveolar bone of the central incisor and canine and the position of the labial alveolar bone of the lateral incisor was significantly greater on the affected side. At 50% and 75% of root length, the horizontal distance between the posterior nasal spine and the labial alveolar bone of the lateral incisor was significantly lesser on the affected side. CONCLUSIONS: Palatal displacement of maxillary lateral incisors is significantly associated with decreased alveolar bone width at the apical level and asymmetry. However, a further elaborate investigation is necessary to determine the clinical relevance of the study.


Assuntos
Processo Alveolar , Incisivo , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Palato
12.
Indian J Dent Res ; 31(2): 241-246, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32436904

RESUMO

Background: The palatal rugae contribute to oral swallowing, taste perception, and speech. From a forensic point of view, the distinctive morphology of these structures can be used to support human identification. However, the morphology of the rugae may be altered by trauma or therapeutic interventions in the palate. Objective: This study aimed to analyze the morphology of the palatal rugae before and after orthodontic treatment performed with and without maxillary expansion and dental extractions. Materials and Methods: The sample consisted of 60 dental casts taken before (n = 30) and after (n = 30) orthodontic treatment from patients aged >18 years. The patients were treated with rapid maxillary expansion by using Haas appliance (n = 10), by extracting the maxillary first premolars (n = 10) and by using only conventional fixed orthodontic appliances (n = 10). All the dental casts were analyzed twice by two independent examiners that were blind for the type of treatment. Results: All the differences between groups were statistically significant (P < 0.05). More alterations in the morphology of the palatal rugae were observed in patients treated with rapid maxillary expansion, whereas few alterations were performed in patients treated with no maxillary expansion or dental extractions. Conclusion: The use of palatal rugae for forensic purposes must be avoided in patients that underwent invasive orthodontic treatments, such as those founded on maxillary expansion and dental extractions.


Assuntos
Técnica de Expansão Palatina , Palato , Adolescente , Dente Pré-Molar , Humanos , Mucosa Bucal , Extração Dentária
13.
J Endod ; 46(8): 1155-1162, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32417291

RESUMO

This article reports on the management of a large median symmetrical lesion of the anterior palate, which was clinically and radiographically diagnosed as an infected nasopalatine duct cyst. However, histopathology demonstrated it to be a radicular cyst of endodontic origin.


Assuntos
Doenças Maxilares , Cisto Radicular , Diagnóstico Diferencial , Humanos , Palato
14.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(2): 281-284, 2020 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-32306011

RESUMO

OBJECTIVE: To explore the predictive values of the combination of preoperative data, including medical history and physical examination, and results of sleep oximetry performed early after the surgery (one week) in predicting the treatment outcomes of uvulopalatopharyngoplasty (UPPP) in adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: All the patients who were diagnosed with OSAHS, underwent UPPP treatment and had complete follow-up data in our institution between Jan 2013 and May 2016 were enrolled in our study. The pre-operative data of these patients, including age, physical examination, and polysomnography (PSG) data, were all exactly collected for analysis. All these patients had received the evaluation of subjective efficacy scale and the sleep oximetry test in early post-operative days (within one week). The long-term efficacy evaluations including PSG and subjective efficacy scale were all finished at least three months after the surgery. RESULTS: In the research 61 patients were finally studied, including 25 responders (41.0%) and 36 non-responders (59.0%). Regression analysis revealed that the pre-operative Friedman stage and early post-operative oxygen desaturation index of ≥4% (ODI4) were found to be independently predictive parameters for the UPPP treatment outcomes (P<0.05). The ROC curve analysis was used to estimate the predictive values of ODI4 to the treatment outcomes, and it was calculated with an area under the curve of 0.822. Using the ODI4 of 15 as the cutoff value, the sensitivity and specificity of that calculated were up to 0.778 and 0.760 respectively. The response rate among the patients with an early post-operative ODI4 of <15 was 70.4%, which was significantly higher than that of the patients with an early post-operative ODI4 of ≥15, whose response rate was 17.6% (P<0.05). The similar results could also be obtained in the patients with pre-operative Friedman stage II (87.5% vs.25.0%) and Friedman stage III (33.3% vs. 6.7%). CONCLUSION: The combination of early post UPPP operation oximetry parameters, especially ODI4, and pre-operative Friedman stage could be used in better evaluating the potential surgical outcomes of UPPP.


Assuntos
Oximetria , Faringe , Adulto , Humanos , Palato , Polissonografia , Resultado do Tratamento
15.
Toxicology ; 438: 152444, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-32283119

RESUMO

As a common birth defect, Cleft palate can be caused by the disturbance during the developmental process of the palatal shelves. The 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD) is a well-known environmental teratogenic agent for cleft palate and Aryl hydrocarbon receptor (AhR) pathway can be activated by dioxins. Oct4 as a pluripotent stem cell transcription factor is also involved in the process of embryonic development. The AHR and retinoid receptors have cross-talk at CYP1A1 (cytochrome P450, family 1, subfamily A, polypeptide 1) promoter. There are also bidirectional talk between AhR and Oct4. In this study, we used C57/BL6 N mice and TCDD (64 µg/Kg body weight) to establish a model of fetal cleft palate to observe the effects of dioxin on fetal mesenchymal proliferation and apoptosis, and explore the role of Oct4 in inducing cleft palate. The results showed that dioxin inhibited mesenchymal proliferation and promoted apoptosis. In addition, dioxin inhibited Oct4 expression, and preliminary data suggest that hypermethylation of the Oct4 promoter may be a putative mechanism, suggesting that TCDD might induce cleft palate by inhibiting the proliferation of palatal mesenchymal cells mediated by Oct4.


Assuntos
Proliferação de Células , Fissura Palatina/metabolismo , Mesoderma/metabolismo , Fator 3 de Transcrição de Octâmero/metabolismo , Palato/metabolismo , Dibenzodioxinas Policloradas , Animais , Apoptose , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Fissura Palatina/induzido quimicamente , Fissura Palatina/patologia , Metilação de DNA , Modelos Animais de Doenças , Feminino , Masculino , Mesoderma/anormalidades , Camundongos Endogâmicos C57BL , Fator 3 de Transcrição de Octâmero/genética , Palato/anormalidades , Gravidez , Regiões Promotoras Genéticas , Receptores de Hidrocarboneto Arílico/genética , Receptores de Hidrocarboneto Arílico/metabolismo , Transdução de Sinais
16.
Indian J Dent Res ; 31(1): 85-90, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246688

RESUMO

Aim: : The aim of this study is to validate the Fernanda Angelieri classification method for the individual assessment of mid-palatal suture among Indian children using multi-slice computed tomography (CT) with respect to clinical application in rapid maxillary expansion. Material and Methods: Present study was conducted utilizing 760 existing head and neck CT image records. CT images were stratified into three categories based on growth spurts: Group I - 6-10 years (n = 210), Group II - 11-14 years (n = 270), and Group III - 15-18 years (n = 280). The CT images were analyzed for stages of mid-palatal suture maturation, according to age and sex. The recorded data were subjected for statistical analysis. Results: Indian children, up to age of 10 years, were distributed in stage A and B. After 11 years, up to 14 years girls showed varied distribution and spread equally among stage B, C, and D. After 15 years, more number of girls were distributed in stage D and E, whereas boys remained distributed variedly in stage B, C, and D. Mid- palatal suture maturational stages correlated to chronological age among both the genders using Fisher exact test and expected contingency table showed statistically significant variation among both the gender independently and collectively (P < 0.001). Conclusion: Cone beam computed tomography (CBCT)-based prediction of stages of mid- palatal suture maturation by Fernanda Angelieri is valid among the Indian population. During treatment plan of maxillary expansion among children above 10 years, it is better to have a diagnostic CBCT image analysis of mid-palate suture for predicable prognosis.


Assuntos
Palato , Respeito , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Maxila , Técnica de Expansão Palatina , Suturas
17.
Proc Natl Acad Sci U S A ; 117(11): 6255-6263, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32123070

RESUMO

Auditory speech perception enables listeners to access phonological categories from speech sounds. During speech production and speech motor learning, speakers' experience matched auditory and somatosensory input. Accordingly, access to phonetic units might also be provided by somatosensory information. The present study assessed whether humans can identify vowels using somatosensory feedback, without auditory feedback. A tongue-positioning task was used in which participants were required to achieve different tongue postures within the /e, ε, a/ articulatory range, in a procedure that was totally nonspeech like, involving distorted visual feedback of tongue shape. Tongue postures were measured using electromagnetic articulography. At the end of each tongue-positioning trial, subjects were required to whisper the corresponding vocal tract configuration with masked auditory feedback and to identify the vowel associated with the reached tongue posture. Masked auditory feedback ensured that vowel categorization was based on somatosensory feedback rather than auditory feedback. A separate group of subjects was required to auditorily classify the whispered sounds. In addition, we modeled the link between vowel categories and tongue postures in normal speech production with a Bayesian classifier based on the tongue postures recorded from the same speakers for several repetitions of the /e, ε, a/ vowels during a separate speech production task. Overall, our results indicate that vowel categorization is possible with somatosensory feedback alone, with an accuracy that is similar to the accuracy of the auditory perception of whispered sounds, and in congruence with normal speech articulation, as accounted for by the Bayesian classifier.


Assuntos
Retroalimentação Fisiológica , Fonética , Sensação/fisiologia , Percepção da Fala/fisiologia , Língua/fisiologia , Adulto , Feminino , Humanos , Masculino , Palato/fisiologia , Medida da Produção da Fala , Adulto Jovem
18.
Clin Oral Investig ; 24(4): 1517-1525, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32144515

RESUMO

OBJECTIVES: This randomized controlled trial compares for the first time effects of Alvogyl versus absorbable gelatin sponge as palatal wound dressings on postoperative pain, amount of analgesic consumption, post-surgical bleeding, and wound re-epithelization. MATERIALS AND METHODS: Following sample size calculation, 36 systemically healthy patients requiring palatal mucosal graft harvesting were randomized to receive Alvogyl (intervention group, 18 patients) or absorbable gelatin sponge (control group, 18 patients) palatal dressings. Patient-reported VAS pain scores over 2 weeks were defined as primary outcome. Post-surgical bleeding, number of analgesics consumed, and complete re-epithelialization of the palatal wound for up to 5 weeks were defined as secondary outcomes. RESULTS: Although significantly higher VAS pain scores were reported in the control as compared with the intervention group up to 12 days post-surgically (from (median [range]) 8.5 [2-10] to 1 [0-2] and from 6 [0-10] to 0 [0-2] respectively), with higher analgesics consumption (from 2 [1-3] to 1 [0-3] and from 1 [0-3] to 0 [0-2] tablets respectively), a multivariate regression analysis considering age, gender, graft width/length, tissue thickness, analgesics intake, and dressing type demonstrated no statistically significant effect of any factor, including dressing type on VAS pain scores. At 4 weeks, 22.2% of patients in the intervention group versus 11.1% in the control group demonstrated complete re-epithelization of their palatal engraftment site, before complete re-epithelization in both groups at 5 weeks. No post-surgical bleeding was reported with both dressings. CONCLUSIONS: Within the study's limitations, results suggest Alvogyl as a practical palatal surgical dressing, comparable with absorbable gelatin sponge in cost, pain reduction, hemostasis, and re-epithelization properties. TRIAL REGISTRATION: www.ClinicalTrials.gov Identifier: NCT03402321 CLINICAL RELEVANCE: Alvogyl could present a novel palatal wound dressing material, comparable with gelatin sponge.


Assuntos
Eugenol/uso terapêutico , Esponja de Gelatina Absorvível/uso terapêutico , Gengiva/transplante , Hidrocarbonetos Iodados/uso terapêutico , Óleos Voláteis/uso terapêutico , Palato , Cicatrização , para-Aminobenzoatos/uso terapêutico , Adulto , Bandagens , Combinação de Medicamentos , Feminino , Humanos , Masculino , Adulto Jovem
19.
J Craniomaxillofac Surg ; 48(5): 467-471, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32205021

RESUMO

PURPOSE: Surgically assisted rapid palatal expansion (SARPE) is a well-known surgical intervention for treating maxillary transverse deficiencies (MTDs). This investigation aimed to evaluate the complication rate after SARPE, and its relationship to patient age. MATERIALS AND METHODS: Based on multivariate analyses, the complication rate after SARPE and its association with increasing age in 111 patients with MTD was evaluated. In every case the following variables were evaluated: age, gender, concomitant surgery, expander appliance, perioperative and dental complications, pain score, neurosensory disturbances (NSDs), postoperative excessive haemorrhage, length of hospital stay, infection, oronasal communication, palatal ulceration, asymmetrical maxillary expansion, mal- or non-union of the bone, lacrimation, and mechanical failure. RESULTS: Overall, 58 (52.25%) patients had minor-to-severe complications. The most common complications were NSDs (27.03%) and postoperative pain (13.51%). Multivariate analysis showed that the frequency of dental complications (mean age 35.9; SD = 10.5140; p = 0.0021∗), NSDs in general (mean age 30; SD = 9.9827; p = 0.0157∗), NSDs lasting more than 4 weeks (mean age 30,9583; SD = 10.6260; p = 0.0105∗), and NSDs lasting more than 1 year (mean age 36.2; SD = 8.7579; p = 0.0201∗) increased significantly with patient age. CONCLUSION: Detailed data analysis revealed a limited number of severe, long-term complications after SARPE. However, careful patient selection is recommended in elderly cases.


Assuntos
Técnica de Expansão Palatina , Palato , Adulto , Idoso , Humanos , Lactente , Maxila , Hemorragia Pós-Operatória , Estudos Retrospectivos
20.
Orthod Craniofac Res ; 23(3): 237-249, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32187843

RESUMO

OBJECTIVE: To systematically review the existing literature comparing mini-implant assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) regarding the effect on the buccal alveolar bone thickness (BT) and marginal bone level (BL). METHODS: PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library, Virtual Health Library, Embase, Ovid, LIVIVO, CINAHL, the Portal de Periódicos da CAPES, Google Scholar and SIGLE were searched up to January 2020. Risk of bias (RoB) assessments were performed using the Cochrane Collaboration and ROBINS-I tools. Fixed-effects meta-analysis of standardized mean differences (SMD) was implemented to assess the pooled estimates for the BT outcome. The analyses were performed adopting a significance level of 5%. A narrative synthesis was performed to summarize the results on the BL. The GRADE tool was used to assess the quality of the evidence. RESULTS: Three randomized clinical trials and one retrospective study were included. Only one study was rated as with low RoB, while the others were scored as with moderate to serious RoB. Limited evidence indicated that patients using conventional RPE had a greater loss of the BT compared to patients using MARPE (SMD = 0.55; 95% CI: 0.29-0.80; P < .0001). Subgroup analyses showed that differences were significant in both premolars' regions, right (SMD = 0.75; 95% CI: 0.24-1.25; P = .004) and left (SMD = 1.05; 95% CI: 0.52-1.57; P < .0001), and these were not significant for the molars' regions (P > .05) (Low quality of evidence). LIMITATIONS: Limited amount of selected papers, methodological issues that could lead to bias and high clinical heterogeneity among the studies. Due to the statistical model applied for the quantitative synthesis of the results, no generalization to any other population is recommended. CONCLUSIONS: Limited evidence suggests that MARPE could decrease the loss of the buccal alveolar bone when compared to conventional RPE.


Assuntos
Técnica de Expansão Palatina , Zigoma , Humanos , Palato , Estudos Retrospectivos
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