Split crest: immediate expansion rim technique for rehabilitation of atrophic maxilla: a case report

While the deploy planning, we come across morphological changes in the intervention area and the bone volume, which is extremely important for the treatment outcome. The objective of this study is to describe the technique "Split-Crest" through a clinical case in which success was obtained. Demonstrate indications and advantages of the technique in order to gain a significant increase in bone density to achieve an excellent aesthetic and functional result. Female patient, leucoderma, 46 years old, attended the Dental Clinic of Specialization in Implantodontics of ESAMAZ, with report of early teeth loss and poorly adapted prosthesis in the upper anterior region of the pre jaw. During the clinical evaluation was observed Edentulism in the anterior arch of the jaw. Total tomographic filming was done on the jaws, the initial diagnosis was a severe resorption present in the premaxilla requiring regenerative process to achieve bone gain. During surgery the patient had immediate installation of previous implants in the region of the elements 12 and 22 through the technique of "Slplit-Crest", which consisted of two vertical cuts on the vestibular cortical portion and longitudinal osteotomy followed by the the shift vestibular cortical-spongy plate. Eight weeks later, the patient had clinically significant bone gain, proving the viability and success of the technique. A minimally invasive surgical procedure with well executed manipulation of tissue grafts and accelerates the clinical outcome, the working hours by the end of the treatment is smaller, has lower morbidity and lower operating costs.

Durante o planejamento do caso, foram encontradas alterações morfológicas na área de intervenção e do volume ósseo, que se torna extremamente importante para o resultado do tratamento. O objetivo deste estudo é descrever a técnica "Split-Crest" através de um caso clínico em que o sucesso foi alcançado. Assim, demonstrar indicações e vantagens da técnica, a fim de obter um aumento significativo na densidade óssea para obter um excelente resultado estético e funcional. Paciente do sexo feminino, leucoderma, 46 anos, procurou a Clínica de Especialização em Implantodontia da ESAMAZ, com relato de perda precoce de dentes e prótese mal adaptada na região anterior superior da pré-maxila. Durante a avaliação clínica foi observado o edentulismo no arco anterior da mandíbula. Solicitou-se uma Tomografia Computadorizada dos maxilares, e o diagnóstico inicial foi uma reabsorção grave presente na pré-maxila que requer processo regenerativo para obter ganhos ósseos. Durante a cirurgia, o paciente apresentou instalação imediata de implantes anteriores na região dos elementos 12 e 22 por meio da técnica de "Slplit-Crest", que consistiu em dois cortes verticais na porção cortical vestibular e osteotomia longitudinal seguido pela cortical vestibular - placa de repouso. Oito semanas depois, o paciente apresentou ganho ósseo clinicamente significativo, provando a viabilidade e o sucesso da técnica. Um procedimento cirúrgico minimamente invasivo com manipulação bem executada de enxertos de tecido e acelera o resultado clínico, tempo clínico menor, menor morbidade e menores custos operacionais.

Estimate of age through the analysis of x-ray of third molar and hand and wrist: case reports

The Forensic Anthropology and Forensic Dentistry, in one of its branches, aim to base skills making possible to estimate the age period for an individual, through factors such as tooth mineralization and bone development. This paper aims to report on two cases from Scientific Expertise Center - Renato Chaves, Belém- PA, where two individuals after committing crime, were referred to under 18s without supporting documents. Through data collected in the archives of the Scientific Expertise Center, an analysis of the mineralization of the teeth were made, highlighting the third molars by panoramic radiography; as well as the study of bone development of the hands and wrists of individuals through radiographs. After, the analysis was compared to surveys conducted by Nicodemos, Moraes and Médici-Filho, befitting the chronology of mineralization of permanent teeth among Brazilian citizens together with the work of Greulich-Pyle, Radiographic correlation concerning the chronology of the development of the hand and wrist. As a result of the analysis, it was obtained, for case 01, an estimated age of 17; and for case 02 the estimated age was between 18-19 years.