RESUMO
The objective of this study was to assess the need for secondary orthognathic surgery in patients undergoing two different condylectomy protocols for active unilateral condylar hyperplasia (UCH). A retrospective cohort study evaluated UCH patients treated by condylectomy. Two groups were established: group 1 comprised those who had undergone a high condylectomy (5 mm removed) and group 2 comprised those who had undergone a proportional condylectomy (removing the difference observed between the measurements of the hyperplastic and the healthy side). Data analysis was done with the Levene test and t-test; a P-value of <0.05 indicated a statistically significant relationship. Forty-nine patients, with an average age of 19.83 years, were analyzed; 11 were included in group 1 and 38 in group 2. There was no statistical difference between the two groups with regard to age or sex (P=0.781). An average of 5.81 mm was removed in the high condylectomy group, while an average of 9.28 mm was removed in the proportional condylectomy group; this difference was statistically significant (P=0.042). Comparing the two groups, proportional condylectomy reduced the need for secondary orthognathic surgery (P<0.001). The proportional condylectomy can be used as the sole surgical treatment in cases of UCH, thus avoiding the need for secondary orthognathic surgery.
Assuntos
Assimetria Facial/cirurgia , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/patologia , Feminino , Humanos , Hiperplasia , Masculino , Côndilo Mandibular/diagnóstico por imagem , Osteotomia Mandibular , Ortodontia Corretiva , Osteotomia Sagital do Ramo Mandibular , Modalidades de Fisioterapia , Reoperação , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
RESUMEN: Entre los concentrados plaquetarios de segunda generación, ha suscitado creciente interés, el uso de fibrina rica en plaquetas y leucocitos inyectable (i-PRF); que se obtiene a partir de la centrifugación inmediata de sangre venosa del propio individuo, y que aporta concentraciones elevadas de factor de crecimiento vascular endotelial, factor de crecimiento transformante beta, y factor de crecimiento derivado de plaquetas, entre otras proteínas que inician y coordinan el proceso reparativo. Su nula citotoxicidad y consistencia líquida abren un nuevo campo de estudio y experimentación en el ámbito de la Cirugía Oral y de la Periodoncia, como sustancia para irrigar. El objetivo de este manuscrito fue reportar el uso del i-PRF como irrigador subgingival en el tratamiento periodontal convencional de defectos infra óseos con 6 meses de seguimiento. En ambos casos, se verificó un efecto positivo de irrigación, lo que abre el debate al uso de productos farmacéuticos tradicionales como la clorhexidina versus preparados autólogos sin efectos adversos reportados a la fecha.
ABSTRACT: Second generation platelet concentrates include the use of injectable platelet-rich fibrin (i-PRF), which has generated increasing interest because it is derived from immediate centrifugation of venous blood from the patients themselves. It provides high concentrations of vascular endothelial growth factor, transforming growth factor beta, and platelet-derived growth factor, among other proteins that initiate and coordinate the healing process. Its null cytotoxicity and liquid consistency has opened new research lines in the field of oral surgery and periodontics, as an irrigation substance. The aim of this manuscript was to report the use of i-PRF, as a subgingival irrigator in conventional periodontal treatment of infra osseous defects, with six months follow-up. In both cases, a positive effect of irrigation was confirmed. These findings, open the debate as regards the use of traditional pharmaceutical products (such as chlorhexidine), versus autonomous preparations without adverse effects reported to date.
Assuntos
Humanos , Feminino , Adulto , Idoso de 80 Anos ou mais , Periodontia/métodos , Regeneração/efeitos dos fármacos , Substitutos Ósseos/uso terapêutico , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Fibrina Rica em Plaquetas , Materiais Biocompatíveis/farmacologia , Matriz Óssea , Radiografia Dentária , Oclusão Dentária , Irrigação Terapêutica/métodosRESUMO
RESUMEN: Los concentrados plaquetarios han emergido como un potencial material regenerativo, utilizado de forma aislada o como andamiaje para otros materiales de injerto. Son extractos de sangre, obtenidos después de procesar una muestra de sangre completa, mediante centrifugación. El primer reporte data de 1970, con un CP utilizado como pegamento para mejorar cicatrización de heridas de piel. En 1998, se usaron en cirugía oral y maxilofacial. Desde entonces, se han desarrollado diferentes técnicas y una variedad de preparaciones. Entre ellas, cabe destacar el plasma rico en plaquetas, fibrina rica en plaquetas y leucocitos (L-PRF) y plasma rico en factores de crecimiento (PRGF). El desarrollo de estos biomateriales, se debe en parte, a la posibilidad de alterar la concentración de mediadores químicos liberados en una lesión que provoque la formación de un coágulo, que pueda madurar conforme transcurran las fases del proceso inflamatorio y concluya con la regeneración íntegra del tejido dañado. El objetivo de este manuscrito fue describir las principales vías de señalización intracelular que se activan en presencia del L-PRF en cirugía oral, y sus efectos en la regulación del ciclo celular.
ABSTRACT: Platelet concentrates (PC) have emerged as a potential regenerative material, used in isolation or as scaffolding for other graft materials. They are blood extracts, obtained after processing a sample of whole blood, by centrifugation. The first report dates from 1970, with a PC used glue to improve the healing of skin wounds. In 1998, they were used in oral and maxillofacial surgery. Since then, different techniques and a variety of preparations have been developed. These include platelet-rich plasma, fibrin rich in platelets and leukocytes (L-PRF) and plasma rich in growth factors (PRGF). The development of these biomaterials, is due in part to the possibility of altering the concentration of chemical mediators released in a lesion that causes the formation of a clot, which can mature as the phases of the inflammatory process pass and conclude with the complete regeneration of the damaged tissue. The aim of this manuscript was to describe the main intracellular signaling pathways that are activated in the presence of LPRF in oral surgery, and its effects on the regulation of the cell cycle.
Assuntos
Humanos , Centrifugação , Peptídeos e Proteínas de Sinalização Intercelular , Fibrina Rica em Plaquetas , Periodontite Periapical , Regeneração Óssea , Transdução de Sinais , Ciclinas , Fator A de Crescimento do Endotélio VascularRESUMO
Dentofacial deformities present some shades and variations that determine the inclusion of different anatomical components as part of the disease; the aim of this study was to ascertain the nasal characteristics in patients with a Class III dentofacial deformity. A descriptive study was conducted on 20 patients diagnosed with a Class III facial deformity and a surgical indication; frontal and lateral as well as CT images were taken to analyze variables of nasal morphology and deformities associated with the nasal bridge, tip and septum. The results showed that the nasal angles are outside normal parameters and that the basal width of the nose is approximately 3 mm smaller than the intercanthal width; 45% of the subjects have lateral deviations, 50% bridge deformity and 80% septum deviation. It is concluded that there are nasal deformities in subjects with a Class III facial deformity and that this component must be carefully evaluated in the preoperative stage.
Las deformidades dentofaciales presentan algunos matices y variaciones que determinan la inclusión de diferentes componentes anatómicos dentro de la enfermedad; el objetivo de esta investigación es conocer las características de la nariz en pacientes con deformidad dentofacial de clase III. Se desarrollo un estudio descriptivo en 20 pacientes con diagnóstico de deformidad facial declase III e indicación quirúrgica; se estudiaron análisis fotográficos frontales y laterales así como tomografías computadorizadas para analizar variables de morfología nasal y deformidades asociadas al puente nasal, punta nasal y septo nasal. Los resultados demostraron que los ángulos nasales se encuentran fuera de los parámetros de normalidad y que el ancho basal de la nariz es aproximadamente 3 mm menor que el ancho intercantal; el 45% de los sujetos presentó desviación lateral, 50% deformidad del puente nasal y el 80% desvío de septo nasal. Se concluye que existen deformidades nasales en sujetos con deformidad facial de clase III y que este componente debe ser evaluado criteriosamente en la etapa preoperatoria.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Face/anormalidades , Má Oclusão Classe III de Angle , Nariz/anatomia & histologiaRESUMO
El procedimiento endodóntico en la actualidad representa un gran desafío, ya que a pesar de que día a día aparecen innovaciones tecnológicas que facilitan este acto, se pueden encontrar casos cuya resolución no siempre es factible de lograr como se esperaría. El presente artículo muestra un caso control de cirugía apical en piezas incisivos laterales maxilares de un mismo paciente en el cual se realizó cirugía apical utilizando cemento sellador MTA (©Angelus Brasil) en la pza 1.2, y tomando su homóloga como control, solo con cirugía apical sin MTA (pza 2.2). El resultado obtenido en el control radiográfico a los seis meses de realizada la cirugía, fue una mejor cicatrización a nivel periapical de la pieza 1.2 tratada con MTA, en comparación con su homóloga del lado opuesto que sólo recibió apicectomía como tratamiento.
Currently endodonctics therapy represents an important issue, and at present new technological innovations that help in these treatments are appearing. It is possible however, to find cases wherein the solution of these problems is difficult. The present case-control paper shows an apical surgery in the upper maxillary lateral incisive in the same patient using MTA (@Angelus -Brazil) sealer cement in pcs. 1.2 and takes pcs. 2.2 control only with apical surgery without sealer cement. The result at the six month Rx control after the apical surgery showed better apical healing in the pcs. 1.2 with MTA root-end filling, with the homologue pcs. 2.2 that was only treated with apical section.