Aplicaciones para dispositivos móviles de uso estomatológico

Introducción: El uso de tecnologías móviles para apoyar el logro de los objetivos de salud tiene el potencial de influir y transformar la provisión de servicios mundialmente. Objetivo: Reflexionar sobre la utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas. Comentarios principales: Las aplicaciones para dispositivos móviles tienen muchas ventajas: son constantemente accesibles, se pueden ajustar a las necesidades del usuario, pueden proporcionar comentarios personalizados, son más anónimas que el contacto cara a cara, pueden enviar recordatorios, y tienen un amplio alcance y características interactivas. Consideraciones globales: La utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas es innegable. Esta variante tecnológica se ha impuesto como un arma valiosa dentro de los servicios de salud móvil en áreas como la promoción y la prevención de salud, la información a pacientes, la comunicación entre profesionales y el diagnóstico de entidades patológicas. Es una necesidad la búsqueda de la calidad en las que se creen y que se incorporen a la práctica de la profesión para potencializar los beneficios que ofrecen(AU)

Introduction: Using mobile technologies to support the achievement of health goals is very much likely to influence and transform service provision globally. Objective: To reflect on the usefulness of mobile device applications in the branches of dentistry. Key remarks: Mobile device applications have many advantages: they are accessible at any time, they can be adjusted to the user's needs, they provide personalized feedback, they are more anonymous than face-to-face contact, they can send reminders; in addition, they have a wide reach and interactive features. Global considerations: The usefulness of mobile device applications in the branches of dentistry is undeniable. This technological variant has established itself as a valuable weapon within mobile health services in areas such as health promotion and prevention, patient information, communication between professionals, and diagnosis of pathological entities. It is necessary to search for quality, creating and incorporating mobile device applications into the professional practice, in order to maximize the benefits that they offer(AU)

Comportamiento y gravedad del trauma maxilofacial en urgencia en el Hospital Universitario "General Calixto García" / Characteristics and Severity of Maxillofacial Trauma in the Emergency Room at General Calixto García University Hospital

Introducción: La región maxilofacial es vulnerable al trauma. Se utilizan herramientas para evaluar la gravedad del trauma maxilofacial. Objetivo: Caracterizar el comportamiento y gravedad del trauma maxilofacial en los pacientes atendidos en el servicio de urgencias de cirugía maxilofacial del Hospital Universitario "General Calixto García". Métodos: Se realizó un estudio observacional descriptivo transversal en pacientes que acudieron al servicio de urgencias de cirugía maxilofacial del Hospital Universitario "General Calixto García", desde septiembre de 2018 hasta marzo de 2021. El universo fue de 57 pacientes. Se aplicó la escala de severidad de lesiones faciales. Variables analizadas: edad, sexo, etiología, diagnósticos, exámenes complementarios, gravedad del trauma maxilofacial, procederes terapéuticos inmediatos. Resultados: Prevaleció la fractura mandibular como diagnóstico (66,7 por ciento). La etiología más frecuente fue la violencia interpersonal (29,8 por ciento). Predominó la gravedad leve del trauma maxilofacial (71,9 por ciento). La extracción de cuerpos extraños de la vía aérea, tracción lingual, inserción de cánula orofaríngea, intubación orotraqueal (5,3 por ciento), y sutura (64,9 por ciento), fueron los procederes terapéuticos inmediatos más utilizados. Conclusiones: Prevalecen los pacientes del sexo masculino y del grupo de edad de 19 a 30 años. Predomina la fractura mandibular como diagnóstico. Los exámenes complementarios más utilizados son, la tomografía computarizada, el hemograma completo y el coagulograma. Impera la violencia interpersonal como etiología. Prevalece la gravedad leve del trauma maxilofacial. Los procederes terapéuticos inmediatos más empleados son, extracción de cuerpos extraños de la vía aérea, tracción lingual, inserción de cánula orofaríngea, intubación orotraqueal y sutura(AU)

Introduction: The maxillofacial region is vulnerable to trauma. Tools are used to assess the severity of maxillofacial trauma. Objective: To characterize maxillofacial trauma and its severity in patients cared for at the maxillofacial surgery emergency department of General Calixto García University Hospital. Methods: A cross-sectional, descriptive and observational study was carried out in patients attending the maxillofacial surgery emergency department at General Calixto García University Hospital, from September 2018 to March 2021. The study universe was 57 patients. The facial injury severity scale was applied. The analyzed variables were age, sex, etiology, diagnoses, complementary examinations, severity of maxillofacial trauma, immediate therapeutic procedures. Results: Mandibular fracture prevailed as a diagnosis (66.7 percent). The most frequent etiology was interpersonal violence (29.8 percent). Mild severity of maxillofacial trauma predominated (71.9 percent). Extraction of foreign bodies from the airway, tongue traction, insertion of oropharyngeal cannula, orotracheal intubation (5.3 percent) and suturing (64.9 percent) were the most frequently used immediate therapeutic procedures. Conclusions: There is a prevalence of male patients and the age group 19 to 30 years. Mandibular fracture predominates as a diagnosis. The most frequently used complementary tests are computed tomography, complete blood count and coagulogram. Interpersonal violence prevails as an etiology. Mild severity of maxillofacial trauma prevails. The most commonly used immediate therapeutic procedures are extraction of foreign bodies from the airway, tongue traction, insertion of oropharyngeal cannula, orotracheal intubation and suturing(AU)

Estabilização zigomática e retalho de avanço facial lateral em canino filhote / Zygomatic stabilization and lateral facial advancement flap in a puppy dog

O trauma é frequentemente relatado na rotina clínica de pequenos animais, podendo gerar fraturas de componentes ósseos e lesões de tecidos moles adjacentes. No presente trabalho, objetivou-se relatar o caso de um canino, macho, sem raça definida, de sete meses de idade, vítima de trauma craniomaxilofacial decorrente de mordedura, diagnosticado com fratura e deslocamento de osso zigomático, além de importante laceração de pele. O tratamento estabelecido baseou-se no debridamento da ferida, estabilização cirúrgica de arco zigomático com fios de Nylon e na sutura dos ferimentos de pele causados. Em um segundo tempo cirúrgico, foi realizada enucleação e recobrimento do defeito na órbita com malha cirúrgica de polipropileno, além de remoção de tecido exuberante e confecção de retalho subdérmico de avanço facial lateral para recobrimento do defeito cutâneo. A complicação evidenciada na primeira intervenção cirúrgica foi a deiscência das suturas de pele, enquanto no segundo tempo cirúrgico, não houve sinais de complicações. No pós-operatório, o paciente apresentou evolução clínica satisfatória, recebendo alta médica 21 dias após o segundo procedimento cirúrgico realizado. Tendo em vista a adequada evolução clínica, bem como os reduzidos efeitos colaterais, sugere-se que a conduta clínica e técnicas cirúrgicas adotadas para tratamento do paciente em questão foram efetivas.

Trauma is frequently reported in the small animal clinics, and can lead to fractures of cranial bone components and injuries to the adjacent soft tissues. In the present study, the objective was to report the case of a seven-month-old male mongrel dog, that had a craniomaxillofacial trauma resulting from a bite, characterized by zygomatic bone fracture and displacement, in addition to a major skin laceration. The stablished treatment was based on wound debridement, surgical stabilization of the zygomatic arch with nylon threads and in the suturing of skin wounds. In a second surgical procedure, enucleation was performed and a surgical polypropylene mesh was applied to cover the orbital defect, exuberant tissue was removed and a subdermal advancement flap was used to cover the skin defect. The complication observed in the first surgical intervention was dehiscence of the skin sutures, while in the second surgical procedure, there were no signs of complications. Postoperatively, the patient had a satisfactory clinical recovery, being discharged 21 days after the second surgical procedure. Considering the adequate clinical evolution and the reduced complications, it issuggestedthat the clinical conduct and surgical techniques adopted for the treatment of the patient in question were effective.

Perfil epidemiológico das fraturas de face: uma revisão de literatura / Epidemiological profile of face fractures: a literature review

As fraturas de face são um problema de saúde pública que afeta a qualidade de vida dos indivíduos que sofreram esse agravo. Sabendo-se da importância dos estudos epidemiológicos para o enfrentamento desse problema, este trabalho teve como objetivo traçar o perfil epidemiológico das fraturas de face, contribuindo assim, para a elaboração de políticas públicas mais eficazes e tratamento adequado. Para isso foi ralizada uma revisão de literatura nas principais bases de dados, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrievel System Online (MEDLINE) e Bibliografia Brasileira de Odontologia (BBO) através da Biblioteca Virtual em Saúde (BVS) e diretamente pela interface da Literature Analysis (PubMed/MEDLINE), nos últimos 20 anos, contemplando populações, culturas e faixas etárias heterogêneas. Observou-se que o sexo masculino foi o mais acometido e sua incidência foi maior entre os jovens, as principais etiologias foram às agressões físicas e os acidentes de transito sobretudo com o envolvimento de motocicletas associado ao uso de álcool e drogas. Os ossos nasais e a mandíbula foram as estruturas que sofreram mais fraturas e o tratamento mais utilizado foi a redução fechada. Neste contexto, faz-se necessário medidas ao combate às desigualdades sociais e desemprego, incentivo à educação e intensificação das leis de trânsito.

Face fractures are a public health problem that affects the quality of life of individuals who have suffered this condition. Knowing the importance of epidemiological studies to face this problem, this study aimed to outline the epidemiological profile of facial fractures, thus contributing to the development of more effective public policies and adequate treatment. For this, a literature review was carried out in the main databases, Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrievel System Online (MEDLINE) and Brazilian Bibliography of Dentistry (BBO) through the Library Virtual Health (VHL) and directly through the Literature Analysis interface (PubMed / MEDLINE), in the last 20 years, covering heterogeneous populations, cultures and age groups. It was observed that the male gender was the most affected and its incidence was higher among young people, the main etiologies were physical aggressions and traffic accidents, especially with the involvement of motorcycles associated with the use of alcohol and drugs. The nasal bones and the mandible were the structures that suffered the most fractures and the most used treatment was closed reduction. In this context, measures are needed to combat social inequality and unemployment, encourage education and intensify traffic laws.

Sports-related facial trauma in the Indian population - A systematic review

Background: Sports injuries are a growing concern which requires immediate attention. Dental injuries are the most common type of orofacial injuries sustained during sports activities. Objectives: This study aims to review the prevalence of sports-related facial trauma in India, to identify the most common types of oro-facial injury incurred due to sports, and to assess the level of awareness regarding preventive measures used in sports. Methodology: The present review was performed in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. All articles published from 2005 to 2019 on sports-related facial trauma were analyzed. PubMed, Google Scholar, and Cochrane reviews databases were searched using primary keywords. Results: A total of 24 articles published in the period of 2005–2019 were included. The prevalence of sports-related facial trauma was found to be the highest in the study conducted by Selva et al., in 2018, at a rate of 75%, whereas it was found to be minimal in the study conducted by Bali et al. in 2013. While the awareness of mouthguards was reported the highest in a study conducted by Ramagoni et al., in 2007. Conclusion: This study shows that there is a definite need to improve the awareness as well as the usage of protective gear, from the level of schooling, where children are introduced to sports. Prevention of sports-related facial trauma is essential to avoid the serious and lifelong consequences which could be the aftermath of such injuries.

Facial Trauma Prevalence from Traffic Accidents in the City of Cuenca - Ecuador, 2017

ABSTRACT: Trauma is defined as physical damage by the use of external force towards the human body. (Salazar et al., 2019). The etiology of facial trauma is multifactorial. Contusions caused by traffic accidents constitute the eighth cause of death worldwide. The aim of this study is to determine the prevalence of facial trauma due to vehicular accidents in 2017, and its relationship with age, gender and frequency in the level of emergency care at Vicente Corral Moscoso (VCMH) and José Carrasco Arteaga (JCAH) hospitals. In this way, real statistical information will be registered related to the degree of trauma, main causes and initial management, providing elements for the planning and execution of new studies, thus establishing prevention measures in the city of Cuenca. This is a retrospective descriptive study, carried out with data collection and authorized analysis of cases of patients diagnosed with facial trauma due to vehicular accidents who attended VCMH and JCAH emergency units in Cuenca Ecuador, in 2017. Variables were analyzed: hospital operating units, gender, age, type of facial trauma distribution, type of vehicle and ethylic status. The total prevalence of facial trauma due to vehic ular accidents in the city of Cuenca in 2017 was 3.34 % from which, the male gender exceeded the female group, representing a 69.76 %, being the 20 to 44-year-old-group more prevalent with a 57.56 %. Panfacial trauma predominated representing a 28.48 %. The kind of vehicle which was commonly used up to a 65.69 % was an automobile. Ethyl breath was detected in 38 % of the patients. A predominance of Panfacial trauma was evidenced in the male sex and in the age group of 20-44. The kind of vehicle which was commonly used was the automobile. Ethyl status was verified in 4 of 10 patients.

RESUMEN: El trauma es definido como un daño físico por el empleo de fuerza externa, hacia el cuerpo. (Salazar et al.). La etiología del trauma facial es multifactorial. Las contusiones causadas por accidentes de tránsito, constituyen la octava causa de muerte a nivel mundial. El objetivo de este estudio es determinar la prevalencia de trauma facial por accidente vehicular en el año 2017, y su relación con; la edad, género y frecuencia en el nivel de atención de urgencias en los hospitales Vicente Corral Moscoso (HVCM) y José Carrasco Arteaga (HJCA). De esta forma se registrará información estadística real en relación al grado de trauma, sus causas principales y manejo inicial proporcionando elementos para la planificación y ejecución de nuevos estudios, estableciendo así, medidas de prevención en la ciudad de Cuenca. Este es un estudio descriptivo retrospectivo, realizado con la recopilación de datos y el análisis autorizado de los casos de pacientes diagnosticados con trauma facial por accidente vehicular que acudieron a la unidad de urgencias del HVCM y HJCA, Cuenca Ecuador, en el año 2017. Fueron analizadas las variables: unidad operativa hospitalaria, distribución de género, edad, tipo de trauma facial, tipo de vehículo y estado etílico. La prevalencia total de trauma facial por accidente vehicular en la ciudad de Cuenca en el año 2017 fue de 3.34% de los cuales, el sexo masculino supera al grupo femenino representando el 69.76 %, siendo el grupo etario de 20 a 44 años el más prevalente con 57.56 %. Predominó el trauma panfacial, representando un 28.48 %. El vehículo de uso común fue el automóvil en un 65.69 %. En el 38 % de los pacientes se detectó aliento etílico. Se evidenció predominio del sexo masculino y del grupo de edad entre 20-44; predominó el trauma panfacial. El vehículo de uso frecuente fue el automóvil. En 4 de 10 pacientes se comprobó estado etílico.

Recomendaciones para la Categorización y Manejo de Pacientes con Traumatismos Faciales Durante Pandemia por COVID-19 (SARS-CoV-2). Revisión de la Literatura

RESUMEN: El Trauma facial como tal constituye un problema de relevancia en los centros hospitalarios de alta complejidad debido a las consecuencias funcionales y estéticas que pueden conllevar. Es por eso la necesidad de un diagnóstico, respuesta asertiva y manejo adecuado de éstos y más en los tiempos de una pandemia como el COVID-19. Se revisaron diferentes protocolos respecto a la categorización y manejo de esta patología tomando en cuenta la situación pandémica que nos afecta. El objetivo de este artículo es presentar y acercar estos protocolos, y así, lograr ser un aporte a los distintos profesionales dedicados a tratamientos del trauma facial a nivel hospitalario respecto a las medidas de seguridad tanto con todo el personal como con los pacientes.

ABSTRACT: Facial trauma constitutes itself a problem of relevance in highly complex hospital centers, due to the functional and aesthetic consequences that it may entail. That is why diagnosis is needed, as an assertive response and proper management of it, mostly in times of a pandemic disease like COVID-19. Different protocols were reviewed, regarding the categorization and management of this pathology, taking into account the pandemic situation that affects us. The objective of this article is to present and bring these protocols closer together, and then, be a contribution to the different professionals dedicated to facial trauma treatments at hospital centers, regarding the safety measures with the staff and also its patients.

Absorbable versus Non-Absorbable Sutures in Paediatric Facial Trauma - A Cosmetic Assessment

Paediatric age group is most vulnerable to trauma. Children often suffer facial injuries. Though many topical skin adhesives and strips are available in the market which have given excellent cosmetic results, deeper injuries especially along the lines of high tension need suturing both with buried and skin sutures. Different variety of sutures are available in the market which are used as per the choice of the surgeon. Children are more apprehensive when it comes to suture removal. So use of absorbable sutures in place of non-absorbable sutures in skin can save the children from this fear factor. MethodsA prospective study was done in the department of plastic surgery from May 2012 to Dec. 2013 with an objective of studying the outcome of plain catgut suture as skin sutures versus non-absorbable skin suture Nylon in facial trauma in the paediatric age group. Chromic catgut was used as buried suture in both groups. All the patients presenting in emergency department with facial trauma with age 10 years or less were included in the study. Skin sutures, where needed removal, were removed on 5th post-operative day followed by follow up on 7th post-operative day, 3rd month and 8th month during which cosmetic assessment of scar was done. 25 patients who presented first in emergency and fulfilled the study criteria were sutured with 5 - 0 chromic catgut buried sutures and skin suture used was 6 - 0 Nylon and this group was labelled group A. Next 25 patients who presented in emergency for suturing were sutured with 5 - 0 chromic catgut as buried and plain catgut as skin suture. This group was labelled as Group B. Cosmetic outcome was assessed on 7th post-operative day, 3rd month and 8th month by using Beusang E cosmetic scar assessment scale based on two parameters which included colour and texture of scar.1 Statistical analysis was done with continuous variables expressed as Mean ± S.D. and categorical variables were expressed as count (percentage). Chi-square was used to compare the categorical variables between groups or Fisher exact test was used. ResultsOn 7th post-operative day follow up, out of 50 patients, 25 patients (50 %) in whom nylon was used as skin suture, 4 patients (16 %) had mismatch of colour. All scars were smooth in texture. In rest 25 patients (50 %) in whom plain catgut was used as a skin suture, 1 (4 %) patient had mismatch of the colour. None of the patients had frank pus in both groups & hypertrophic scar was seen in one patient. On 3rd month follow up, Group A patients with nylon as skin suture, 1 (4 %) patient showed hypertrophic scar whereas in Group B (8 %) patients had hypertrophic scar. On 8th month follow up, both group A & B had colour mismatch of 12% with firm texture of scar in 8% patients. ConclusionsThere is no long-term differences in cosmetic outcomes and complication rates between absorbable catgut suture and commonly used nylon sutures in the repair of facial trauma in paediatric age groups. So, absorbable sutures are acceptable alternative to non-absorbable suture especially in paediatric age group, keeping in mind their apprehensive nature and fear of suture removal.

Tratamento de fraturas múltiplas da face associadas a ferimento extenso: relato de caso / Reconstruction of multiple face fractures associated with extensive injury: case report

As fraturas panfaciais acometem concomitantemente os terços superior, médio e inferior da face, decorrentes de acidentes automobilísticos, arma de fogo, atropelamento, agressão física, entre outros. Essas fraturas geralmente envolvem osso frontal, zigomático, maxila, mandíbula e ossos nasais, necessitando assim, fixação interna rígida através do uso de miniplacas e parafusos com o propósito de estabilizar as estruturas fraturadas, dar suporte aos tecidos moles e evitar deformidades estéticas da face. O objetivo deste trabalho é relatar o manejo cirúrgico de um caso clinico atendido em um hospital público de Salvador/BA, no qual a vítima apresenta ampla laceração na face e fratura exposta do terço médio da face. O tratamento executado sob anestesia geral foi redução dos cotos ósseos fraturados, fixação com miniplacas e parafusos, reconstrução imediata dos tecidos moles acometidos(AU)

Panfacial fractures affect concomitantly the upper, middle, lower third of the face, resulting from automobile accidents, firearms, hit-and-run, physical aggression, among others. These fractures usually involve frontal bone, zygomatic, maxilla, jaw and nasal bones, thus requiring rigid internal fixation through the use of miniplates and screws in order to stabilize fractured structures, support soft tissues avoiding aesthetic face deformities. The objective of this work is to report the surgical management of a clinical case attended in a public hospital in Salvador/BA, in which the victim has wide laceration of the face and exposed fracture of the middle third of the face. Treatment performed under general anesthesia was reduction of fractured bone stumps, fixation with miniplates and screws, immediate reconstruction of the affected soft tissues(AU)

Tratamento tardio de fratura do complexo zigomático-orbitário com uso de fixação interna rígida / Late treatment of the zygomatic-orbital complex fracture with rigid internal fixation

RESUMO: As fraturas do complexo zigomático-orbitário são bastante frequentes devido a sua localização e projeção na face, podendo gerar grandes transtornos funcionais e estéticos ao paciente. O osso zigomático é essencial na configuração da face, sendo a principal estrutura formadora do terço médio dela. Os traumas que mais frequentemente provocam fraturas do complexo zigomático-orbitário são agressões físicas, acidentes de trânsito e esportivos. O tipo de fratura, tempo decorrido, a severidade e o envolvimento de outras estruturas faciais influenciam a modalidade de tratamento a ser empregado. O presente trabalho apresenta um caso clínico de fratura do complexo zigomático-orbitário esquerdo, diagnosticada tardiamente, e tratada por meio de osteotomia, redução e fixação em três pontos com placas e parafusos do sistema 1.5, e reconstrução do assoalho orbitário com tela de titânio. (AU)

ABSTRACT: Fractures of the zygomatic-orbital complex are quite frequent due to their location and projection on the face, which can cause major functional and aesthetic disorders to the patient. The zygomatic bone is essential in the configuration of the face, being the main forming structure of the middle third of it. The traumas that most often cause fractures of the zygomatic-orbital complex are physical aggression, traffic accidents, and sports. The type of fracture, elapsed time, severity, and the involvement of other facial structures influence the type of treatment to be employed. The present work presents a clinical case of fracture of the left zygomatic-orbital complex, diagnosed late, and treated by osteotomy, reduction, and fixation in three points with 1.5 system plates and screws, and reconstruction of the orbital floor with titanium mesh. (AU)

Profile of Plastic Surgery Trauma Patients at H. Adam Malik General Hospital Medan

Introduction: According to data from Perhimpunan Dokter Bedah Plastik Rekonstruksi dan Estetik Indonesia(PERAPI), there are only 193 plastic surgeons throughout Indonesia. There is no sufcient data that described pattern of incidence, workload, and role of Plastic Surgery in trauma cases at Indonesian Referral Center Hospital, especially in the Province of North Sumatra.Methods: This research is a descriptive study with a retrospective approach. Sample of this study was medical records of trauma patients who required Plastic Surgery who came to the H. Adam Malik General Hospital Medan Emergency Room (1 January 2016-31 December 2018). This study used total sampling method.Results: This study involved 536 patients and 40.85% included in the adult age range. Men vs women ratio is 3:1 (405 vs 131). Based on type of injury, the most common injury is facial trauma, followed by burns and soft tissue injuries (291, 178 and 66). The most common etiology is trafc accidents (90 cases). Most of facial bone fractures located at mandibular bone (segmental fracture). Inhalation trauma due to burns only occurred in 6 cases (3.24%). Most of soft tissue injuries occurred at lower extremities (upper limbs).Conclusion: Trafc accidents are the most common etiology for trauma in Plastic Surgery. Most of the patients are men and included in the adult age range. Facial trauma is the most common injury in Plastic Surgery. Most facial bone fractures located at mandible (symphysis and parasymphysis). Most of burns injury are re burns. Most soft tissue injuries are located at lower extremities (upper limbs).

Caracterização de lesões bucomaxilofaciais decorrentes de agressão física: diferenças entre gênero / Characterization of oral maxillofacial lesions resulting from physical aggression: differences between genders

Resumo Em países desenvolvidos, a violência é a principal causa de lesões bucomaxilofaciais (LBMF). No Brasil, há poucas evidências sobre tais lesões. Objetivou-se caracterizar as LBMF resultantes de agressão física em uma capital do nordeste brasileiro e analisar diferenças entre gêneros. Foram investigados 15.847 laudos do Instituto Médico Legal de São Luís/MA, ocorridos em 2012. Coletaram-se dados socioeconômicos, demográficos e características das LBMF. Utilizaram-se os testes Qui-quadrado e Exato de Fisher para avaliar diferenças entre gêneros. Dos casos periciados, 1977 eram LBMF. Vítimas do sexo feminino, com 20-59 anos de idade, cor parda, sem companheiro e empregadas foram mais afetadas. Lesões do tipo equimose, nas regiões bucinadora e labial, decorrentes do uso de instrumentos contundentes, ocasionando debilidade funcional permanente foram mais incidentes em mulheres (P < 0,05), ao passo que fratura dental, ferida contusa e perfurocontusa, decorrentes de instrumentos cortantes e perfurocontundentes, ocasionando deformidade permanente, incapacidade ocupacional e perigo de vida, em homens (P < 0,05). Conclui-se que a incidência de LBMF decorrente de agressão física é alta em São Luís, MA, e, embora as mulheres sejam mais acometidas, as LBMF em homens são mais severas.

Abstract In developed countries, violence is the main cause of oral maxillofacial (OMF) injuries. In Brazil, there are scant records of such lesions. The scope of this study was to detail the OMF injuries resulting from physical aggression in a capital of the Brazilian northeast and analyze gender differences. The Forensic Medicine Institute of São Luís, state of Maranhão, featured 15,847 reports, which occurred in 2012, and they were investigated. Socioeconomic, demographic data and OMF characteristics were analyzed. The Chi-square and Fisher's Exact tests were applied to assess gender differences. Of the cases examined, 1977 were OMF. Female victims, aged 20-59, dark-skinned, without a partner and maids were the most affected. Ecchymosis-type lesions, in the mouth and lip regions arising from the use of blunt instruments, causing permanent functional impairment, were the most prevalent in women (P < 0.05), whereas dental fracture and contusion arising from sharp instruments causing permanent deformity, occupational disability, and threat to life were detected in men (P < 0.05). The conclusion drawn is that the incidence of OMF due to physical aggression is high in São Luís, state of Maranhão, and although women are the most affected, the OMF in men are more severe.

Treatment of oral and maxillofacial dog bites in children / 口腔疾病防治

Objective @#To summarize experience treating dog bites in the oral and maxillofacial regions of children and provide a reference for clinical practice.@*Methods @#Nineteen children with dog bite wounds in the maxillofacial region were treated from July 2011 to June 2018 with primary debridement and suturing. A rabies vaccine, tetanus vaccine and human immunoglobulin as a passive immune agent were given via intramuscular injection. Anti-inflammatory therapy with amoxicillin and clavulanate potassium or other antibiotics. Follow-up observation and a retrospective analysis of the treatment effect were carried out.@*Results@#After treatment, among the 19 pediatric patients, 18 cases showed primary healing and 1 case showed secondary healing. The follow-up period ranged from six months to seven and a half years. No cases of rabies occurred.@*Conclusion @#For the treatment of patients with maxillofacial dog bite wounds, the first stage debridement and suture can reduce the scar after operation and is beneficial to the recovery of face.

Avaliação da utilização do capacete e do risco de dependência para utilização de bebidas alcoólicas nos motociclistas internados no Hospital da Restauração / Evaluation of the helmet use and the risk of dependence for the use of alcoholic beverages in the motorcyclists in the Hospital da Restauração

O objetivo deste trabalho foi avaliar o uso do capacete e o risco de dependência para utilização de bebida alcoólica nos motociclistas internados no HR. A metodologia aplicada nessa pesquisa é de natureza epidemiológica, quantitativa, descritiva e prospectiva. As seguintes variáveis foram estudadas: sexo, idade, tipo de capacete, potência da moto, finalidade de uso, ossos e fraturas, complexidade das fraturas e risco de dependência do uso álcool. Foram analisados dados de 100 pacientes, dos quais o sexo mais acometido foi o masculino na faixa etária entre 18-29 anos; a potência da moto disparadamente mais procurada pelos pacientes encontra-se acima de 50 cc, tendo sido o tipo de capacete mais utilizado o integral com viseira, porém com uma deficiência muito grande na utilização de capacete pelos motociclistas; a maior finalidade para o uso da moto pelos pacientes foi para o trabalho. O osso mais fraturado foi o zigomático. A maioria dos pacientes foi classificada com uso de baixo risco do álcool na classificação do AUDIT... (AU)

The purpose of this work was to evaluate the use of helmet and the risk of addiction to the use of alcoholic beverage in motorcyclists admitted at the HR hospital. The methodology applied in this research is epidemiological, quantitative, descriptive and prospective. The following variables were studied: gender, age, type of helmet, motor power, purpose of use, bones and fractures, fracture complexity and risk of dependence on alcohol use. Data from 100 patients were analyzed, in which male was the most affected gender in the age group 18-29 years old; The motorcycle's power most frequently sought by the patients is above 50 cc and the type of helmet most used was the integral with visor, but with a great deficiency in the use of helmets by the motorcyclists; The major purpose for motorcycle use by patients was to work. The most fractured bone was the zygomatic. The majority of patients were classified as having been included in the use of alcohol risk in the AUDIT classification... (AU)

Airway management through submental derivation: a safe and easily reproduced alternative for patients with complex facial trauma

OBJECTIVES: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. MATERIALS AND METHODS: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients. RESULTS: The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction. CONCLUSION: Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option.

Influence of degree of edentulism in mandible fractures / Influência do grau de edentulismo em fraturas mandíbulas

Objective ­ To characterize epidemiologically the aspects of incidence, treatment and complications of mandibular fractures in dentate, partially dentate and edentulous patients. Methods ­ Data were collected from medical records of patients seen by the department of Oral and Maxillofacial Surgery, Piracicaba School of Dentistry/UNICAMP, from January 1999 to October 2009. Results ­ Were selected 738 adult patients, grouped into three age groups (18 to 30 years, 31-64 years and over 64 years), whose degree of edentulism was informed, being 330 dentition (45%), 367 partially serrated (50%) and 41 edentulous (5%). The ratio between male and female was 4:1, mean age of 31 years, with higher incidence in caucasians, and 81% were economically active. The most common causes were traffic accidents (54%), followed by assault (20%), falls (15%), sports accidents (4%) and work (4%). Condylar fractures accounted for 29% of all fractures, followed by fractures of the body (25%), symphysis (24%) and angle (19%). The only significant difference between the sites of fracture was found in the edentulous, which presented a low incidence of angle fractures. Conclusions ­ It was observed that this population, homogeneous as to the cultural and socio-environmental factors, the dentate, partially dentate and edentulous behaved similarly as to the mandibular fractures resulting from trauma energies of similar intensities.

Objetivo ­ Caracterizar epidemiologicamente os aspectos de incidência, tratamento e complicações de fraturas mandibulares em pacientes dentados, parcialmente dentados e edêntulos. Métodos ­ Os dados foram coletados de prontuários de pacientes atendidos pelo departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia de Piracicaba/UNICAMP, de janeiro de 1999 a outubro de 2009. Resultados ­ Foram selecionados 738 pacientes adultos, agrupados em três faixas etárias (18 a 30 anos, 31-64 anos e mais de 64 anos), cujo grau de edentulismo foi informado, sendo 330 dentições (45%), 367 parcialmente serrilhadas (50%) e 41 edêntulas (5%). A proporção entre homens e mulheres foi de 4:1, idade média de 31 anos, com maior incidência em caucasianos e 81% economicamente ativas. As causas mais comuns foram os acidentes de trânsito (54%), seguidos pelo assalto (20%), quedas (15%), acidentes esportivos (4%) e trabalho (4%). As fraturas condilares representaram 29% de todas as fraturas, seguidas de fraturas do corpo (25%), sínfise (24%) e ângulo (19%). A única diferença significativa entre os locais de fratura foi encontrada no edêntulo, que apresentou baixa incidência de fraturas angulares. Conclusões ­ Observou-se que esta população, homogênea quanto aos fatores culturais e socioambientais, dentada, parcialmente dentada e edêntula, comporta-se de forma semelhante às fraturas mandibulares resultantes de energias de trauma de intensidades semelhantes.

Herida facial por proyectil de arma de fuego: revisión de literatura y estudio clínico de tres casos / Gunshot caused facial wound. Literature review and clinical study of three cases

El tratamiento de las heridas por arma de fuego en la región maxilofacial es un tema complejo, controversial especialmente en relación al tiempo de tratamiento. La literatura actual respalda el tratamiento inmediato sobre el tardío, presentando mejores resultados. Las heridas son heterogéneas con particularidades que deben analizarse y definir su tratamiento con base en los principios de Kazanjian y Converse, pero adaptándose a las necesidades específicas. Su manejo va en relación al tipo de arma, características deformantes de la bala, energía cinética, lugar de impacto y estado sistémico del paciente. El objetivo del trabajo es realizar una revisión bibliográfica y exponer nuestra experiencia en el manejo de heridas por arma de fuego a nivel maxilofacial. Se presenta el tratamiento de tres casos de heridas faciales por arma de fuego atendidas en el Hospital Regional « General Ignacio Zaragoza ¼ .

Treatment of gunshot wounds in the maxillofacial region is a complex subject, especially controversial with respect to treatment time. Current literature supports immediate treatment rather than late care, claiming to achieve better results. Wounds are heterogeneous, with characteristics that must be analyzed so as to define treatment according to Kanzanjian and Converse' s principles, but always adapting to specific needs. Handling is dependent upon type of weapon, bullet's disfiguring characteristics, kinetic energy, place of impact as well as patient' s general health circumstances. The aim of the present research was to conduct a bibliographic review and expose our experience in maxillofacial gunshot wound treatment. We hereby document treatment of three facial gunshot wound patients who sought treatment at the Regional Hospital «General Ignacio Zaragoza¼, Mexico City, Mexico.

Estudio de fracturas de malar, maxilar y mandíbula de los egresos hospitalarios del 2010 a 2015 en la Caja Costarricense de Seguro Social

El objetivo del presente estudio descriptivo es determinar la prevalencia de fracturas malares, maxilares y mandibulares en los pacientes internados en hospitales de la Caja Costarricense de Seguro Social durante los años 2010 al 2015, analizando su relación con edad, sexo y variables epidemiológicas de tiempo, lugar y persona. Se registró un total de 2.729 casos, seleccionados bajo los diagnósticos de fracturas según la Clasificación Estadística Internacional de Enfermedades CIE-10. Dentro de los resultados obtenidos un 40,7 % de las fracturas se relacionó con malares y maxilares vs 59,3%en mandíbula. La causa o etiología más común fue agresión (39%), traumatismo accidental (36%) y accidentes de transporte (24%), se observó mayor prevalencia en el grupo etario de 20 a 59 años con una tasa de 85,02 por 100.000 hab. La distribución de fracturas de acuerdo al sexo fue de 9.1% en mujeres y 90.9% en hombres, con una razón de 10 hombres por cada mujer. Esta problemática produjo al sistema de salud un total 36 años de estancia hospitalaria y 39 años de incapacidad. Es de interés para los tomadores de decisiones en salud conocer el impacto que tiene este tipo de lesiones en la morbilidad de la población al ser un problema de salud pública.

The objective of this research is to determine the prevalence of malar, maxillary and mandibular fractures in patients of the Social Security Hospitals during the years 2010 to 2015 analyzing the relationship between age, sex and epidemiological variables of time, place and person. A total of 2729 cases diagnoses selected under fractures diagnose according to the International Classification of Diseases ICD-10. Among the results a 40.7% of the fractures was recorded in the malar and maxillary area versus a 59.3% in the jaw area. The most common cause or etiology was assault (39%), accidental injury (36%) transport accidents (24%), higher prevalence was observed in the age group of 20-59 years with a rate of 85,02 per 100,000 inhabitants. The distribution of fractures according to sex was 9.1% in women and 90.9% in men, with a ratio of 10 men for each woman. This problem caused the social health system an average 36 years of hospital stay and 39 years of disability. It is of interest to health policy authorities to know the impact of these injuries on the morbidity of the population because it´s a public health problem.

Perfil epidemiológico das vítimas de traumas faciais causados por acidentes motociclísticos / Epidemiologic features of facial trauma victims caused by motorcycle accidents

Objetivos: Estabelecer perfil epidemiológico das vítimas de traumas faciais causa dos por acidentes motociclísticos atendidos no Hospital Regional do Agreste (HRA), Caruaru - PE e relacionar os principais tipos de traumas com o uso e tipos de capacetes, ingestão de drogas e cilindrada da moto. Métodos: Pesquisa realizada por meio de questionário semiestruturado e acesso aos prontuários. Resultados: Dos 53 pacientes incluídos na pesquisa, houve predomínio do sexo masculino (92,5%), na terceira década de vida e baixa renda. 77,4% possuíam escolaridade até o ensino fundamental; 73,6% não possuíam habilitação para motocicletas, e 47,2% haviam ingerido bebidas alcoólicas antes do acidente. Sobre os traumas faciais, 94,3% apresentavam envolvimento de tecidos duros (algum tipo de fratura), e, em 49% desses casos houve mais de um segmento ósseo da face envolvido; 37,7% não usavam capacete e dos 62,3% que usavam, apenas 43,3% apresentavam sistema de retenção, e 26,4% não eram do tipo integral com viseira. Motocicletas entre 125 a 150cc corresponderam a 86,8% dos casos. Conclusão: Os traumas faciais, causados por acidentes motociclísticos, têm alta incidência e são predominantes em homens de renda e escolaridade baixa na terceira década de vida, tendendo fortemente a estar associados ao não uso ou uso incorreto de equipamento de proteção individual (EPI) e/ou à ingestão de álcool... (AU)

Purposes: Establish the epidemiological profile of the victims of facial traumas caused by motorcycle accidents treated at Hospital Regional do Agreste (HRA), Caruaru - PE and list the main types of trauma such as the use and type of helmets, ingestion of drugs and piston displacement of the motorcycle. Methods: Search through semi-structured questionnaire and access to medical records. Results: Of the 53 patients included in the research there was a male predominance (92.5%), in their third decade of life and low income. 77.4% had education up to primary education. 73.6% had no motorcycles driver's license and 47.2% had consumed alcohol before the accident. Regarding facial trauma, 94.3% had involvement of hard tissues (some type of fracture) and in 49% of these cases there was more than one bone segment of the face involved. 37.7% did not wear helmet and 62.3% of those who wore only 43.3% had retention system and 26.4% they were not the integral type with visor. Motorcycles between 125 to 150cc accounted for 86.8% of the cases. Conclusion: Facial trauma caused by motorcycle accidents have a high incidence and are prevalent in men of low education and income in the third decade of life and tend to be strongly associated with non-use or misuse personal protective equipment (PPE) and/or alcohol intake... (AU)

Video laryngoscope: A boon for airway management in severe facial trauma.

We report the use of video laryngoscope for the exchange of orotracheal tube to nasotracheal tube needed for mandibular repair in a case of oromaxillofacial injury.