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1.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 48-54, set./dez. 2020. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1121747

RESUMO

A Disostose Cleidocraniana (DC), também conhecida como Displasia Cleidocraniana (DCC), é uma doença autossômica de caráter dominante, relatada pela primeira vez no século XVIII, sendo descrita em 1897 por Pierre Marie e Paul Sainton, relacionando-a a fatores genéticos. Suas manifestações clínicas apresentam-se através do desenvolvimento tardio de estruturas e defeitos ósseos, anormalidades estomatognáticas e craniofaciais. O diagnóstico baseia-se nas características clínicas e imaginológicas e o tratamento odontológico geralmente é cirúrgico, envolvendo a exodontia de unidades supranumerárias e decíduas, em associação com a abordagem ortodôntica. Este trabalho possui como objetivo, relatar o caso clínico sobre as principais manifestações bucais evidenciadas em uma paciente jovem diagnosticado com Displasia Cleidocraniana, bem como demonstrar a importância do diagnóstico preciso para auxílio no sucesso do tratamento e qualidade de vida do paciente(AU)


Cleidocranial Dysostosis (CD), also known as Cleidocranial Dysplasia (DCC), is an autosomal dominant disease, first reported in the 18th century, being described in 1897 by Pierre Marie and Paul Sainton, relating it to genetic factors. Its clinical manifestations appear through the late development of bone structures and defects, stomatognathic and craniofacial abnormalities. The diagnosis is based on clinical and imaging characteristics and dental treatment is usually surgical, involving the extraction of supernumerary and deciduous units, in association with the orthodontic approach. This work aims to report the clinical case about the main oral manifestations evidenced in a young patient diagnosed with Cleidocranial Dysplasia, as well as to demonstrate the importance of accurate diagnosis to aid in the success of the treatment and quality of life of the patient(AU)


Assuntos
Assistência Odontológica , Displasia Cleidocraniana , Anormalidades Craniofaciais , Procedimentos Cirúrgicos Bucais
2.
Swiss Dent J ; 130(11): 916-917, 2020 Nov 09.
Artigo em Alemão | MEDLINE | ID: mdl-33161695

RESUMO

Antibiotics can be used in oral surgery. The effective benefits are offset by the dangers of resistance and sensitization, which requires a strict indication. There are controversial views regarding indication, dosage and, above all, duration and timing of antibiotic medication in oral surgery.


Assuntos
Antibacterianos , Procedimentos Cirúrgicos Bucais , Antibacterianos/uso terapêutico , Antibioticoprofilaxia
3.
Medicine (Baltimore) ; 99(45): e23065, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157964

RESUMO

Dental general anesthesia (DGA) is a safe and high-quality restorative and preventive treatment option for children with severe early childhood caries (S-ECC), who require extensive dental treatment and exhibit anxiety and emotional or cognitive immaturity or are medically compromised. However, several postoperative complications have been reported in children under DGA. This study aimed to evaluate and analyze the prevalence of the relevant factors of postoperative complications in healthy Chinese children following DGA to provide a foundation for pre-, intra-, and postoperative overall health management for healthy and disabled children after DGA.A total of 369 systematically healthy Chinese children (36-71 months old) undergoing a DGA were studied. Data were collected on patients' histories, characteristics, anesthesia, and dental procedures. Parents or caregivers were interviewed before and 72 hours after the procedure. Data were analyzed using logistic regression.Approximately 94.86% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain (62.70%), followed by weariness, agitation, masticatory problems, drowsiness, oral bleeding, coughing, fever, sore throat, nausea, constipation, epistaxis, vomiting, excitement, and diarrhea. The long duration of the operation was a risk factor for postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever.Prolonged operation means complex treatment, such as pulp therapy or extraction. We speculate that the longer the duration is, the more difficult the dental procedures are. The accumulation of discomfort leads to pain. We suspect that children in lower nutritional levels are more likely to suffer from bacteremia or dehydration, resulting in fever.Postoperative pain was the most prevalent complication after the DGA. A decrease in dental procedure duration might reduce the odds of postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever. Children with low nutritional status could be more susceptible to postoperative fever.


Assuntos
Anestesia Dentária/efeitos adversos , Anestesia Geral/métodos , Cárie Dentária/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Anestesia Geral/estatística & dados numéricos , Ansiedade/epidemiologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Estudos de Casos e Controles , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estado Nutricional , Dor Pós-Operatória/epidemiologia , Prevalência , Estudos Prospectivos , Segurança
4.
ScientificWorldJournal ; 2020: 7945309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029109

RESUMO

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Odontólogos , Procedimentos Cirúrgicos Bucais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Papel Profissional , Segurança , Infecções por Coronavirus/epidemiologia , Humanos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Medição de Risco
5.
Indian J Cancer ; 57(4): 481-484, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33078758

RESUMO

Worldwide, hospitals are facing problems in managing cancer patients during the ongoing COVID-19 pandemic. Given the immense cancer burden of oral cancer in India, scheduling surgeries are becoming increasingly difficult. Upfront surgeries are recommended for curative treatment of oral cancers and postponing them raises the fear of progression. Metronomic chemotherapy can be considered during the waiting period given its potential oncological benefits and ease of administration without much toxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Infecções por Coronavirus/complicações , Neoplasias Bucais/tratamento farmacológico , Pandemias , Pneumonia Viral/complicações , Administração Metronômica , Protocolos de Quimioterapia Combinada Antineoplásica/provisão & distribução , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Índia/epidemiologia , Neoplasias Bucais/complicações , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/virologia , Procedimentos Cirúrgicos Bucais , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia
6.
Medicine (Baltimore) ; 99(43): e22288, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120732

RESUMO

INTRODUCTION: Dexmedetomidine and midazolam have become important approaches for the sedation of dental surgery. However, the comparison of these 2 drugs for the sedation of dental surgery has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of dexmedetomidine versus midazolam for dental surgery. METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of dexmedetomidine versus midazolam on dental surgery are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. RESULTS: Five RCTs and 420 patients are included in the meta-analysis. Compared with midazolam intervention for dental surgery, dexmedetomidine intervention has similar lowest SpO2, lowest heart rate and lowest systolic blood pressure, duration of surgery, and total volume of local anesthetic, but is associated with stable and reduced lowest diastolic blood pressure. CONCLUSIONS: Similar benefits of dexmedetomidine and midazolam intervention are observed for the sedation of dental surgery in terms of SpO2, heart rate, systolic blood pressure, and the volume of local anesthetic, but dexmedetomidine may result in more stable diastolic blood pressure.


Assuntos
Dexmedetomidina/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Midazolam/uso terapêutico , Procedimentos Cirúrgicos Bucais , Anestésicos Locais/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Diástole/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Humanos , Duração da Cirurgia , Oxigênio/sangue , Sístole/efeitos dos fármacos
7.
Niger J Clin Pract ; 23(9): 1260-1265, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913166

RESUMO

Backgound: There are many methods used to alleviate edema, trismus, and pain after impacted third molar (3M) removal, one of which is Kinesio Taping (KT). Aims: This study aimed to evaluate the effectiveness of Kinesio Taping with Web Strip technique on postoperative morbidity after impacted mandibular 3M extraction. Methods: The study employed a split-mouth and controlled randomized clinical trial design. A total of 60 patients were scheduled for surgical extractions of bilateral lower 3Ms. They were randomly divided into two groups, and KT was applied to one group while the others was determined as a control group without KT application. Tape was applied directly after surgery and maintained for postoperative (post-op) 7 days. Pain intensity was recorded subjectively using a Visual Analogue Scale (VAS). Pain and analgesic usage were recorded on the post-op 1st, 2nd, 3rd, and 7th days. Trismus was evaluated before the surgery and on the post-op 2nd and 7th days. Facial edema was analyzed on the post-op 2nd and 7th days by VAS and by measuring the lengths of three lines using a flexible plastic tape measure. Results: VAS pain scores were statistically lower in the KT group on the post-op 1st, 3rd and 7th days. Total analgesic usage was also significantly lower in the KT group. On the post-op 2nd day, measurement of the lengths of three lines showed a statistically less edema in the KT group. Similar results were obtained from the measurement of edema using VAS. Maximum mouth opening was statistically higher in the KT group on the post-op 2nd and 7th day. Conclusion: KT with the web strip technique should be considered more economic and less traumatic than other approaches, as it is free from systemic side effects and is a simple method to carry out to decrease morbidity.


Assuntos
Fita Atlética/estatística & dados numéricos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Dor Pós-Operatória/reabilitação , Trismo/reabilitação , Adolescente , Adulto , Edema/epidemiologia , Edema/etiologia , Edema/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Procedimentos Cirúrgicos Bucais/métodos , Medição da Dor , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/reabilitação , Período Pós-Operatório , Resultado do Tratamento , Trismo/epidemiologia , Trismo/etiologia , Escala Visual Analógica , Adulto Jovem
10.
Medicine (Baltimore) ; 99(31): e21537, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756204

RESUMO

In head and neck surgery where the oropharyngeal area is the operative field, postoperative respiratory depression and upper airway obstruction are common. Therefore, supplemental oxygen is administered to prevent severe postoperative early hypoxemia. However, a high concentration of oxygen increases the likelihood of secondary complications, such as carbon dioxide (CO2) narcosis. Nasal high-flow (NHF) therapy generates high flows (≤60 L/min) of heated and humidified gas delivered via nasal cannula and provides respiratory support by generating positive airway pressure, clearance of dead space and reduction of work of breathing. This study aims to determine whether the postoperative hypoxemia and hypercapnia can be prevented by NHF without the requirement of supplemental oxygen. The study will recruit adult patients undergoing planned oral surgery under general anesthesia at Nagasaki University Hospital. It is a randomized parallel group comparative study with 3 groups: NHF with room air only and no supplemental oxygen, no respiratory support, and face mask oxygen administration. The study protocol will begin at the time that the patient is returned to the general ward and will finish 3 hours later. The primary endpoint is the time-weighted average of transcutaneous O2 over the 180 minutes and secondary endpoints are the time-weighted average of transcutaneous CO2 (tcpCO2), SpO2, and respiratory rate, incidence rate of marked hypercapnia (tcpCO2 ≥60 mm Hg for 5 minutes or longer), incidence rate of moderate hypercapnia (tcpCO2 ≥50 mm Hg for 5 minutes or longer) and the percentage of time that SpO2 is <90%. Included also is a group in which the postoperative management is performed only by spontaneous breathing without performing respiratory support such as oxygen administration, to investigate the efficacy and necessity of conventional oxygen administration. This exploratory study will investigate the use of NHF without supplemental oxygen as an effective respiratory support during the acute postoperative period. TRIAL REGISTRATION:: The study was registered the jRCTs072200018. URL https://jrct.niph.go.jp/latest-detail/jRCTs072200018.


Assuntos
Anestesia Geral/métodos , Hipercapnia/prevenção & controle , Hipóxia/prevenção & controle , Procedimentos Cirúrgicos Bucais/métodos , Oxigenoterapia/métodos , Cânula , Humanos , Oxigênio/sangue , Oxigenoterapia/efeitos adversos , Período Pós-Operatório , Projetos de Pesquisa
11.
PLoS One ; 15(8): e0236981, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810135

RESUMO

This study aimed to assess the dosage and types of antibiotics prescribed in oral implant surgery, compare them among the different subpopulations (country and prescription regimens) and against the evidence-based recommended dosage: a 2-gram single preoperative dose of amoxicillin. A meta-analysis of cross-sectional surveys was conducted, which reports the overall dosage (and type) of antibiotics prescribed in combination with implant placement. PubMed, Cochrane, Science, Direct, and EMBASE via OVID were searched until April 2019. Three reviewers independently undertook data extraction and risk of bias assessment. The outcome variable was set on the average of prophylactic antibiotics prescribed per oral implant surgery. Overall, 726 participants from five cross-sectional surveys, representing five different countries were finally included. Amoxicillin was the most prescribed antibiotic. On average, 10,724 mg of antibiotics were prescribed per implant surgery. This average was significantly (p<0.001) higher than 2,000 mg. Overall, amoxicillin doses were significantly higher than 2,000 mg (9,700 mg, p<0.001). All prescribed amoxicillin regimens independently contained more than 2,000 mg, including those comprising only preoperative amoxicillin (2,175 mg, p = 0.006). Exclusive preoperative antibiotic regimens were the only subgroup with prescription dosages below this threshold (p = 0.091). Significant variations in antibiotic prescriptions were found among different countries and antibiotic regimens (p<0.001). In conclusion, the average dose of antibiotics prescribed per oral implant surgery was larger than the evidence-based recommended dose in healthy patients and straightforward conditions. In addition, variations in the average antibiotic dosages were found among different countries and prescription regimens.


Assuntos
Antibacterianos/administração & dosagem , Antibioticoprofilaxia/métodos , Implantes Dentários , Procedimentos Cirúrgicos Bucais/métodos , Amoxicilina/administração & dosagem , Estudos Transversais , Odontologia Baseada em Evidências , Humanos , Inquéritos e Questionários
12.
Rev. Asoc. Odontol. Argent ; 108(2): 68-74, mayo-ago. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1121446

RESUMO

Objetivo: Presentar la respuesta clínica a largo plazo del tratamiento de un granuloma periférico de células gigantes en un implante oseointegrado en el maxilar inferior. Caso clínico: Un paciente de 60 años, de sexo masculino, sin antecedentes sistémicos, concurrió por una lesión con márgenes definidos, de color rojizo morado y consistencia blanda sobre los tejidos blandos en la cara vestibular de un implante colocado en zona de 46. Se realizó la escisión quirúrgica de la lesión, se procesó el tejido extirpado y se envió al laboratorio. El estudio anatomopatológico confirmó el diagnóstico de granuloma periférico de células gigantes. La lesión recidivó dos veces. En la tercera extirpación se realizó la implantoplastía de la superficie del implante. La cicatrización no presentó inconvenientes. Hasta el último control, a los 5 años, no volvió a haber recidiva. Conclusión: En este caso clínico, se logró mantener la salud periimplantaria durante 5 años luego de la eliminación de un granuloma periférico de células gigantes. No obstante, este tuvo que ser removido en tres oportunidades debido a la alta recidiva (AU)


Aim: To evaluate the long-term clinical response to the treatment of a peripheral giant cell granuloma in an osseointegrated implant in the lower jaw. Clinical case: A 60-year-old male patient, with no systemic medical problems, presented a soft tissue lesion located at the buccal aspect of an implant placed in the 46 area. The lesion had defined reddish-purple margins and soft consistency. Surgical excision of the lesion was performed, processed and sent to the laboratory. The histopathology confirmed the diagnosis of peripheral giant cell granuloma. The lesion recurred twice. During the third surgical removal an mplantoplasty of the implant surface was performed. The healing was uneventful and there was no recurrence until the last control at 5 years. Conclusion: In this clinical case, perimplantar gingival health was maintained for 5 years after the surgical removal of a giant cell peripheral granuloma. However, it had to be removed three times, demonstrating a high recurrence (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Granuloma de Células Gigantes/cirurgia , Granuloma de Células Gigantes/etiologia , Implantes Dentários/efeitos adversos , Argentina , Recidiva , Faculdades de Odontologia , Cicatrização/fisiologia , Biópsia , Seguimentos , Procedimentos Cirúrgicos Bucais
13.
J Oral Sci ; 62(4): 452-454, 2020 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-32830165

RESUMO

The Coronavirus disease 2019 (COVID-19) pandemic suddenly took the world by storm and Italy was one of the hardest hit countries. Maxillo-facial surgery and dentistry procedures had to be significantly reorganized, since they are considered high-risk procedures. Protocols had to be changed and interdepartmental cooperation was put in place to plan surgical interventions and maintain high standards. Various improvements have been made to prevent and reduce the risks of spreading the infection. Even if the situation seems to have improved, being unprepared is not an option. In this paper the experience gained during these months has been shared and possible future challenges has been highlighted, suggesting practical adjustments based also on new guidelines and recommendations.


Assuntos
Infecções por Coronavirus , Coronavirus , Procedimentos Cirúrgicos Bucais , Pandemias , Pneumonia Viral , Betacoronavirus , Humanos
14.
J Hist Dent ; 68(2): 93-100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32852271

RESUMO

Many stalwarts in the dental profession stood out during the conflagrations of the Focal Infection Era 100 years ago, in an attempt to prevent the wholesale extraction of teeth. One of these individuals, Dr. Meyer L. Rhein, both a physician and dentists often scolded the dental profession for their proclivity in disregarding the biological basis for root canal treatment. His understanding and management of the apical root anatomy challenges did not go unnoticed as he fought to retain teeth regardless of the status of the dental pulp and surrounding supportive structures.


Assuntos
Infecção Focal , Procedimentos Cirúrgicos Bucais/história , Antraquinonas , Infecção Focal/história , História do Século XX , Humanos , Masculino , Tratamento do Canal Radicular , Estados Unidos
15.
PLoS One ; 15(7): e0234866, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645108

RESUMO

BACKGROUND: Traditional neonatal uvulectomy is unsupervised, unscientific and potentially dangerous cultural malpractice. It is often accompanied with life threatening neonatal morbidities such as infection, septicemia, anemia, aspiration and oropharyngeal injury. However, there is no current regional and even national data of its public health importance in the health care system. Therefore, this study was aimed at assessing the burden, associated factors and reasons of traditional uvulectomy among neonatal admissions at Debre Tabor General Hospital, North Central Ethiopia, from September 2018 to August 2019. METHODS: A quantitative cross sectional study supplemented with phenomenological study was employed on 422 mother-neonate pairs. Eight mothers who were not included in the quantitative part were involved as key informants of the qualitative study. Systematic and purposive sampling techniques were used to select study participants for the quantitative and qualitative parts of the study respectively. Multivariable logistic regressions were fitted to investigate significant predictors of traditional neonatal uvulectomy at p-value ≤ 0.05 and 95% CI. Moreover, the qualitative data were carefully transcribed, coded, screened, thematized, synthesized and then triangulated with the quantitative results. RESULTS: The burden of postuvulectomy admission was 67 (15.88%). Most of these admissions had post uvulectomy sepsis [59 (88.1%)] followed by anemia (55.23%). From multivariable analysis, factors that had significant odds of association with traditional neonatal uvulectomy include: having male neonate [AOR = 4.87; 95% CI: 1.10, 21.59], antenatal couple counseling about traditional neonatal uvulectomy [AOR = 0.053; 95% CI: 0.01, 0.35], home delivery [AOR = 6.02; 95% CI: 1.15, 31.61], postnatal couple counseling about traditional neonatal uvulectomy [AOR = 0.101; 95% CI: 0.02, 0.65], prior history of traditional neonatal uvulectomy [AOR = 7.15; 95% CI: 1.18, 43.21] and knowing at least one adverse effect of traditional neonatal uvulectomy [AOR = 0.068; 95% CI: 0.01, 0.44]. Furthermore, maternal perception of "there is no modern medicine to treat elongated and swollen neonatal uvula' was the most explained reason to practice traditional neonatal uvulectomy. CONCLUSION AND RECOMMENDATION: The burden of traditional neonatal uvulectomy was high. Fortunately, its predictors are modifiable. Therefore, several advocacy teams of neonatal health consisting of mainly women health development armies, elders, religious fathers, health professionals and criminal prosecutors should be actively mobilized against traditional neonatal uvulectomy. Besides, parental couple counseling about the adverse effects of traditional neonatal uvulectomy should be properly implemented in the routine antenatal and postnatal continuum of care in South Gondar Zone, North Central Ethiopia.


Assuntos
Mães/psicologia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Úvula/cirurgia , Adulto , Comportamento Ritualístico , Estudos Transversais , Etiópia/epidemiologia , Feminino , Parto Domiciliar , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/tendências , Masculino , Razão de Chances , Morte Perinatal/etiologia , Cuidado Pós-Natal , Gravidez
16.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 448-454, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634882

RESUMO

Orthodontic moving teeth are closely related to the health of periodontal support tissues, and the combined periodontal orthodontic treatment is becoming more and more normalized. Inflammation control is the prerequisite for orthodontic treatment in patients with periodontitis. For many adult patients, the long course of treatment and the risk of periodontal tissue damage during orthodontic treatment have gradually attracted the clinicians' attention. Periodontally accelerated osteogenic orthodontics (PAOO) is one of the surgical strategies by combining selective decortication with alveolar augmentation to promote orthodontic treatment. It is aiming to accelerate the movement of teeth for shortening the treatment course, to increase the bone volume for reshaping the alveolar bone and expanding the range of tooth movement and to reduce the risk of tooth movement beyond the "alveolar bone boundary" during orthodontic treatment. Based on the retrieve and review of current literature, this article will focus on how to design and implement PAOO surgery so as to maximize the effectiveness in clinical practice.


Assuntos
Procedimentos Cirúrgicos Bucais , Ortodontia , Adulto , Humanos , Osteogênese , Técnicas de Movimentação Dentária
17.
Cir. pediátr ; 33(3): 137-142, jul. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-193556

RESUMO

INTRODUCCIÓN: La fístula palatina es la complicación más frecuente tras una palatoplastia. Los objetivos de este estudio fueron: describir las técnicas de reparación más frecuentemente empleadas, estudiar los resultados y la tasa de recidiva, analizar posibles variables predictivas de recidiva y valorar la posible superioridad de una determinada técnica según el tamaño y la localización de la fístula. MATERIAL Y MÉTODO: Estudio retrospectivo de pacientes operados de fístulas palatinas desde 2008 hasta 2018 en 7 centros. Todos operaban al menos 20 casos nuevos de fisuras labiopalatinas al año (rango 20-80) con una incidencia de fístulas de 14% (rango: 1,5-20%). El seguimiento mínimo fue de 1 año. Se recogieron 8 variables para el análisis estadístico. RESULTADOS: Se operaron 234 pacientes con fístulas. La mayoría ocurrieron en fisuras labiopalatinas bilaterales completas (tipo IV de Veau). La localización más frecuente fue el paladar duro (tipos IV y V de Pittsburgh) (63,2%) y la mayoría fueron grandes (42,1%) y medianas (39,5%). La técnica de reparación más frecuente fue la repalatoplastia (34,2%). La tasa de recidiva fue del 22%. El análisis multivariante mostró más recidivas en fístulas tipo III reparadas con repalatoplastia en mayores de 3 años. CONCLUSIÓN: Se observó una tendencia a utilizar más reparación con colgajo en fístulas grandes del paladar duro, repalatoplastia en fístulas medianas de paladar duro y de la unión y colgajos locales o repalatoplastia en fístulas pequeñas en cualquier localización, pero no se pudo demostrar estadísticamente la superioridad de una técnica reparadora concreta en diferentes situaciones clínicas


INTRODUCTION: Palate fistula is the most frequent complication following palatoplasty. The objectives of this study were: to describe the most widely used repair techniques; to study results and recurrence rate; to analyze potentially predictive recurrence variables; and to assess whether a specific technique is superior according to fistula size and location. MATERIALS AND METHODS: Retrospective study of patients undergoing palate fistula repair in 7 healthcare facilities from 2008 to 2018. All facilities had at least 20 new cases of cleft lift and palate annually (range: 20-80), with a fistula incidence of 14% (range: 1.5-20%). Minimum follow-up was 1 year. 8 variables were collected for statistical analysis purposes. RESULTS: 234 fistula patients underwent surgery. Most fistulas occurred in complete bilateral cleft lift and palate (Veau type IV). The most frequent location was the hard palate (Pittsburgh types IV and V (63.2%)), and fistulas were mostly large (42.1%) and medium (39.5%). The most frequent repair technique was re-palatoplasty (34.2%). Recurrence rate was 22%. The multivariate analysis demonstrated more recurrences in re-palatoplasty repaired type III fistulas in patients over 3 years old. CONCLUSION: A tendency towards using flap repair in large hard palate fistulas, repalatoplasty in medium hard palate and soft and hard palate junction fistulas, and local flaps or re-palatoplasty in small fistulas at any location was observed. However, it could not be statistically demonstrated whether a specific repair technique was superior in different clinical situations


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Fístula Bucal/cirurgia , Fístula Bucal/complicações , Palato Mole/cirurgia , Resultado do Tratamento , Recidiva , Estudos Retrospectivos , Análise Estatística , Retalhos Cirúrgicos/cirurgia , Procedimentos Cirúrgicos Bucais/métodos
18.
Oral Maxillofac Surg Clin North Am ; 32(3): 377-388, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32507354

RESUMO

Since the introduction of oral and maxillofacial surgery in Southeast Asia, the field has expanded considerably in the region, with existing oral and maxillofacial surgeons performing a multitude of complex surgical procedures, ranging from orthognathic surgical procedures to oncological resection and reconstruction cases. Oral and maxillofacial surgery continues, however, to have considerable potential for growth in Southeast Asia. To accomplish this growth, assistance from the global oral surgery community has proved and continues to prove invaluable and essential.


Assuntos
Procedimentos Cirúrgicos Bucais , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Bucal , Bangladesh , Países em Desenvolvimento , Humanos
19.
Artigo em Inglês | MEDLINE | ID: mdl-32559045

RESUMO

The free gingival graft (FGG) has been used predictably for gingival procedures aimed to increase the width of keratinized tissue (KT). Several soft tissue alternatives, such as xenografts and allografts, have been studied and proven to be successful with varying degrees. This pilot clinical case series evaluated the efficacy, safety, and initial clinical outcomes (measuring KT width) of a piscine xenograft material (Omega3 Wound, Kerecis) compared to the FGG (harvested from the patient palate) in correcting mucogingival deformities around teeth. A convenience sample of six subjects with unilateral or bilateral lack of KT were enrolled in the study. The primary objective of this pilot study was to determine the gain in width of KT. Secondary objectives included investigating the probing depth, recession depth, bleeding on probing, and inflammation score. There were three FGG sites and six xenograft sites. In bilateral-site treatments, FGG or piscine xenograft were randomly assigned. For unilateral sites, the piscine xenograft was used. Postoperatively, the patients returned for follow-up at 1, 2, 4, 12, 24, 48, and 52 weeks. All six subjects completed the 12-month study and reported uneventful healing. On average, the xenograft sites had a 3.25-mm gain in KT width, and the FGG had an average gain of 3.67 mm. This pilot clinical series showed the piscine xenograft to be safe and efficacious during healing and to increase the width of KT. Future studies may include a more robust study design with a greater number of subjects.


Assuntos
Retração Gengival/cirurgia , Procedimentos Cirúrgicos Bucais , Tecido Conjuntivo , Gengiva , Gengivoplastia , Humanos , Projetos Piloto , Resultado do Tratamento
20.
Ann R Coll Surg Engl ; 102(7): 532-535, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32538126

RESUMO

INTRODUCTION: Available data suggest that the two-week wait referral pathway is ineffective at expediting diagnosis of cancer due to large numbers of inappropriate referrals. This study aimed to compare the referral pathway of 125 patients who had undergone primary surgery for oral and oropharyngeal cancer with 100 who had been two-week wait referrals. MATERIALS AND METHODS: This was a case note review. RESULTS: Of the 125 patients who underwent surgery; 47 (38%) were referred via the 2WW pathway. GPs had referred 25 (53%) of the 47 patients and general dental practitioners 22 (47%). The tumour stage was similar regardless of referral pathway (two-week wait or routine). GPs recognised that the two-week wait pathway was needed in 49% of the patients they had referred, whereas the equivalent figure for GDPs was 40%. Of the 100 2WW patients, 52 were biopsied. Of these, nine (9%) were diagnosed with a malignancy. GPs referred 61% of the 100 two-week wait patients and accurately diagnosed five of the cancers (although two were basal cell carcinomas), general dental practitioners the remainder (including one basal cell carcinoma). Overall, 41% of the patients referred on the two-week wait pathway by GPs needed a biopsy, compared with 69% of those referred by general dental practitioners. CONCLUSIONS: While the criteria for referral on the two-week wait pathway lack discrimination and the majority of referrals proved benign, nearly 40% of surgically treated patients were referred via this pathway, suggesting that it does serve a useful purpose. More patients with cancer were referred by GPs, but more two-week wait referrals by general dental practitioners warranted biopsy.


Assuntos
Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Neoplasias Orofaríngeas/cirurgia , Encaminhamento e Consulta , Listas de Espera , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Fatores de Tempo , Resultado do Tratamento
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