ABSTRACT
Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics. After 6 years from fibular graft and 24 months of dental implants, an excellent outcome was observed, with oral health and normal functions properly restored, and the immediate reconstruction of the mandible in resective cases, associated with oral rehabilitation with dental implants, may be considered a suitable treatment option.
ABSTRACT
Objetivo: tentar entender como as deficiências nutricionais no paciente pós-operatório à cirurgia bariátrica impactam a saúde oral e periodontal. Material e métodos: uma pesquisa na base de dados PubMed com os termos "by-pass gástrico e doenças periodontais", "cirurgia bariátrica e deficiências nutricionais", e "saúde bucal e obesidade" tentando esclarecer a relação com doença periodontal e as deficiências nutricionais. Resultados: foi realizada uma revisão de artigos sobre o fato da cirurgia bariátrica ser um procedimento cirúrgico indicado para o tratamento da obesidade mórbida e promover alteração da anatomia gastrintestinal, levando à perda de peso, diminuindo a absorção de açúcares, gorduras e outros nutrientes importantes, como vitaminas A, C, D, B12, cálcio e ferro, responsáveis pela regulação de muitas funções críticas no organismo e participantes efetivos na produção de colágeno e matriz óssea. Conclusão: a cavidade oral sofre complicações em vista dessa nova situação, e os dentistas precisam entender como essas deficiências podem afetar na doença periodontal, a fim de desenvolver estratégias de prevenção e tratamento para este novo grupo de população.
Objective: the aim of this article is try to understand how the nutritional deficiencies in the post-operative patient submitted to bariatric surgery impact on oral and periodontal health. Material and methods: a survey in PubMed database with these terms "gastric by-pass and periodontal diseases", "bariatric surgery and nutritional deficiencies" and "oral health and obesity" was done trying to clarify the relationship with periodontal disease. Results: bariatric surgery is a surgical procedure indicated for the treatment of morbid obesity and promotes an alteration of gastrointestinal anatomy leading to a marked weight loss by decreasing the absorption of sugars and fats, but other important nutrients such as decreased absorption of vitamins A, C, D, B12, calcium and iron, which are also responsible for the regulation of many critical functions in organism, and effectively participate in the production of collagen and bone matrix and an overview of papers about this topic was conducted. Conclusion: the oral cavity suffers complications from this new situation and dentists need to understand how these deficiencies may impact on periodontal disease in order to develop treatment and prevention strategies for this new population group.
Subject(s)
Humans , Bariatric Surgery/adverse effects , Deficiency Diseases/drug therapy , Obesity, Morbid/complications , Obesity, Morbid/surgery , Oral Health , Periodontal DiseasesABSTRACT
A relação implante/estética está se tornando cada vez mais desafiadora, pois para uma prótese adequada, devemos conhecer e imitar forma e contorno do dente adjacente, papila interdental, zênite gengival, dentre outros. Pensando nesta combinação, os autores propuseram, neste trabalho, uma técnica modificada visando oferecer um prognóstico estético favorável. As técnicas utilizadas foram a de preenchimento alveolar com osso liofilizado bovino pós-exodontia e deslizamento de retalho palatino modificado no fechamento da ferida alveolar. O objetivo desta associação de técnicas é a manutenção do rebordo para diminuição da perda de crista óssea e/ou parede vestibular, manutenção do arcabouço alveolar quando existem defeitos estabelecidos, fechamento por primeira intenção da ferida cirúrgica e ganho de tecido gengival para a reorganização de papila interdental e zênite gengival evitando, assim, a necessidade de um segundo momento cirúrgico na manipulação de tecido mole para ganho estético. Os resultados são provenientes da prática clínica, porém, de extrema satisfação.
The relationship between aesthetics and implants is becoming more and more important. It is imperative that we know about the restored tooths planned shape and contour to have an appropriate prosthesis with adequate interdental papillae and gingival margins. In this paper, the authors propose a modified extraction closure procedure attempting to offer a favorable aesthetic prognosis for the final implant. We used two different alveolar preservation techniques with freeze-dried bone after tooth extraction and a modified palatal rotation flap for soft tissue coverage. The aim was to keep buccal and alveolar crest bone loss to a minimum and to have closure and healing by primary intention. The procedure was designed to enhance soft tissue reorganization of the interdental papillae and marginal gingival tissue. Using these combined techniques, there is no need to gain soft tissue in a second surgical procedure. The results are variable, but extreme satisfactory.