ABSTRACT
RESUMEN: Objetivo: Determinar las dimensiones de la cresta ósea vestibular de los incisivos maxilares con indicación de implantación inmediata. Pacientes y método: Un estudio transversal fue realizado en pacientes con necesidad de colocación de implantes inmediatos unitarios en la zona incisiva superior, durante el periodo de Enero-2015 a Diciembre-2017. Cortes tomográficos sagítales fueron utilizados para determinar la altura y el grosor de la cresta ósea alveolar vestibular. El punto de medición del grosor fue localizado a 4 mm apical a la linea amelocementaria. Un análisis T-student, fue utilizado para comparar las variables según la edad, el género y el grupo dentario, con un intervalo de confianza de 95%. Resultados: 298 imágenes fueron incluidas en la evaluación. El promedio de altura fue 10,68 mm, no hubo diferencias al comparar los grupos. El grosor promedio fue de 0,73 mm, diferencias de grosor, estadísticamente significativas, fueron observadas al comparar la edad y el género, no así en el grupo dentarlo. Conclusiones: La altura del hueso alveolar vestibular de incisivos superiores es suficiente para colocar implantes inmediatos dentro de un marco óseo. No obstante, el grosor observado, se traduciría en la necesidad de complementar la implantación con técnicas de regeneraciónn tisular guiada.
ABSTRACT: Objective : Determine the dimensions of the facial bone ridge of the maxillary incisors with indication of immediate implantation. Patients and method: A cross-sectional study was carried out in patients in need of single immediate implant placement in the upper incisor area, during the period from January-2015 to December-2017. Sagittal tomographic sections were used to determine the height and thickness of the vestibular alveolar bone ridge. The thickness measurement point was located 4 mm apical to the amelocementary junction. A T-student analysis was used to compare the variables according to age, gender, and dental group, with a 95% confidence interval. Results: 298 images were included in the evaluation. The mean height was 10.68 mm, there were no differences when comparing the groups. The mean thickness was 0.73 mm, statistically significant differences in thickness were observed when comparing age and gender, but not in the dental group. Conclusions: The height of the vestibular alveolar bone of the upper incisors could be sufficient to place immediate implants within a bone framework. However, the thickness observed would result in the need to complement the implantation with guided tissue regeneration techniques.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Therapeutics , Facial Bones , Incisor , Jaw , Cross-Sectional StudiesABSTRACT
RESUMEN: El foramen y canal palatino mayor (FPM y CPM) comunican boca con fosa pterigopalatina. El conocimiento adecuado de su morfología, permite el abordaje anestésico del nervio maxilar. En el vivo, el FPM está recubierto por una mucosa gruesa, debido a esto los puntos de referencia óseos y dentarios son importantes para ubicar el sitio de punción. Se ha descrito gran variabilidad en cuanto a la etnia, posición, forma, diámetros, longitudes y permeabilidad. Este estudio tuvo como objetivo describir éstas características en cráneos de adultos chilenos. Se utilizaron 31 cráneos de ambos sexos. En los paladares se determinó; forma, largo, profundidad y ancho. En los FPM se consideró su forma, diámetros y localización. En los CPM se registró su permeabilidad y su coincidencia con la forma del FPM. Los registros se realizaron con cámara digital, compás de precisión, caliper digital, compas tridimensional de Korkhaus y sonda metálica. Los resultados muestran un predominio de la forma cuadrada del paladar por sobre las formas triangular y redondeada. Las mediciones de su largo, ancho y profundidad indican diferencias por sexo y por etnia. La forma del FPM no muestra diferencia por sexo, primando la forma ovalada por sobre la fusiforme y la redondeada. La posición de este mismo foramen tampoco muestra diferencias sexuales, primando la posición frente al tercer molar superior, seguida por la posición frente al espacio entre segundo y tercer molar superior y por último frente al 2do molar superior. Las dimensiones del FPM son mayores en individuos masculinos. Los CPM se observaron en su totalidad permeables y los FPM no siempre coincidieron en forma con la sección transversal del CPM. Estos resultados y su comparación con la literatura indican variaciones importantes, lo que impide establecer directrices objetivas a la técnica anestésica que utiliza esta vía anatómica.
ABSTRACT: The greater palatine foramen and canal (GPF and GPC) communicate with the pterygopalatine fossa. The adequate knowledge of its morphology allows the anesthetic approach of the maxillary nerve. In vivo, the GPF is covered by a thick mucosa, therefore, the bone and dental reference points are important to locate the puncture site. Great variability has been described in terms of ethnicity, position, shape, diameters, lengths and permeability. The objective of this study was to describe these characteristics in skulls of Chilean adults. 31 skulls of both sexes were used. In the palates shape, length, depth and width were determined. In the GPF its shape, diameters and location were considered. In the GPC, their permeability and their coincidence with the shape of the GPF were recorded. The records were made with digital camera, precision compass, digital caliper, Korkhaus three-dimensional compass and metallic probe. The results show a predominance of the square shape of the palate over the triangular and rounded forms. The measurements of its length, width and depth indicate differences by sex and ethnicity. The shape of the GPF shows no difference by sex, with the oval shape prevailing over the fusiform and the rounded. The position of this same foramen also shows no sexual differences, with the position prevailing against the upper third molar, followed by the position in front of the space between the upper second and third molars and finally against the upper 2-molar. The dimensions of GPF are greater in male individuals. The GPC were found to be entirely permeable and the GPF did not always coincide in form with the cross section of the GPC. These results and their comparison with the literature indicate important variations, which prevents establishing objective guidelines for the anesthetic technique used in these cases.
Subject(s)
Humans , Male , Female , Adult , Palate, Hard/anatomy & histology , Maxilla/anatomy & histology , Skull , Pterygopalatine Fossa/anatomy & histologyABSTRACT
Objective@#To investigate the clinical outcome of distraction osteogenesis in the treatment of pediatric maxillofacial fractures.@*Methods@#From November 2017 to November 2018, 6 cases of maxillofacial fractures were treated, including 3 cases of maxillary fracture and 3 cases of mandibular fracture. All of them were associated with facial asymmetry of different severity, disordered occlusion and displacement of fracture segments. The distraction osteogenesis device was used to fix the fracture during the operation. The distraction was initiated after 1 day latency period, and proceeded at approximately 0.5 mm each time, twice a day, until the normal occlusal relationship was achieved. Distractor was maintained for 1 month after distraction, and then removed. The degree of fracture healing, the mouth opening and the occlusal status at the fracture site were evaluated during follow-up, and the corresponding curative effect was observed and evaluated.@*Results@#All fractures were healed well, without infection, dislocation, or pseudo-joint formation after 1 month. The distraction duration is 15-20 days and the distraction distance is 15-20 mm. At the end, the occlusal relationship was normal, and the mouth opening was not limited. The follow-up period was from 1 month to 1 year. The maxillofacial appearance of the children was normal, and the maxillofacial development was not significantly affected.@*Conclusions@#Distraction osteogenesis is an effective and controllable method for child maxillofacial fracture. It can be used as a supplement to the conventional treatment of maxillary and mandibular fracture in children.
ABSTRACT
La rinosinusitis es una patología muy frecuente en la infancia. Entre sus complicaciones, se encuentra la osteomielitis, rara complicación que, cuando se presenta, ocurre, principalmente, en lactantes y niños pequeños. El agente etiológico más frecuente es el Staphylococcus aureus. Clínicamente, se manifiesta con fiebre alta, edema de párpado inferior, rinorrea unilateral y edema palatino ipsilateral; luego se agrega un absceso sobre el área maxilar yuxtanasal y/o sobre los alvéolos dentarios. Secundariamente, pueden desarrollarse secuestros, expulsiones espontáneas de piezas dentarias y trayectos fistulosos, así como complicaciones orbitarias y endocraneales. El diagnóstico es, sobre todo, clínico; se confirma con tomografia computada. El tratamiento es médico quirúrgico. Se presenta un niño de 5 años de edad con rinosinusitis complicada con osteomielitis del hueso maxilar, cuyo germen responsable fue el Staphylococcus aureus meticilino resistente.
Rhinosinusitis is a very common childhood condition. Osteomyelitis is an unusual complication, which mainly occurs in toddlers and young children. The most frequent etiologic agent is Staphylococcus aureus. Iniatially, it is characterized by fever, low eyelid edema, unilateral rhinorrhea and ipsilateral palatine edema. Subsequently, abscesses develop in the maxillar yuxtanasal and/or the dental alveolar area. Secondary, it can be complicated by sequestrations, spontaneous expulsion of dental pieces and/or fistula, as well as orbital and intracranial complications. The diagnosis is based on clinical findings and is confirmed by computed tomography findings. The treatment is clinical and surgical. Here we report a five year old child, with rhinosinusitis complicated by osteomyelitis of maxillary bone, mediated by a methicillin-resistant Staphylococcus aureus infection.
Subject(s)
Humans , Male , Child, Preschool , Osteomyelitis/complications , Osteomyelitis/diagnosis , Sinusitis/complications , Staphylococcal Infections/complications , Methicillin-Resistant Staphylococcus aureusABSTRACT
Immunoglobulin G4 (IgG4)-related disease is an inflammatory condition characterized by IgG4 positive plasma cell infiltration. It can affect any organ in the body and mainly involves the pancreas, liver, biliary tracts, orbits, salivary glands and lymph nodes. It can manifest as an inflammatory pseudotumor. Pseudolymphoma as an inflammatory pseudotumor is a group of benign tumors that exhibit histological and clinical features suggestive of malignant lymphoma. Studies on IgG4-related disease are rarely reported, and no case of the disease that involved the maxillary bone and adjacent soft tissue, except for the skin, has been reported. Therefore, we report herein a case of pseudolymphomatous IgG4-related disease that involved the maxilla, with a literature review.
Subject(s)
Biliary Tract , Granuloma, Plasma Cell , Immunoglobulin G , Immunoglobulins , Liver , Lymph Nodes , Lymphoma , Maxilla , Orbit , Pancreas , Plasma Cells , Pseudolymphoma , Salivary Glands , SkinABSTRACT
Fibrous dysplasia is a rare disorder of the bone. It is seen in two main forms ofpresentation: monostotic and the polyostotic. A case of monostotic fibrous dysplasia of the maxillary and palatine bones in a 22-year old man who received prosthetic reconstruction is presented with a review of the literature.
La displasia fibrosa es un trastorno raro del hueso. Se le ve en dos formas principales: la monostótica y la poliostótica. Junto con la correspondiente revisión de la literatura, se presenta un caso de displasia fibrosa monostótica de los huesos maxilar y palatino en un hombre de 22 anos que recibió una reconstrucción prostética.
Subject(s)
Adult , Humans , Male , Young Adult , Fibrous Dysplasia, Monostotic/surgery , Maxilla/surgery , Palate, Hard/surgery , Prostheses and Implants , Plastic Surgery Procedures , Plastic Surgery Procedures/methodsABSTRACT
A leontíase óssea urêmica é caracterizada por hipertrofia dos ossos da face e do crânio associada ao hiperparatireoidismo secundário à insuficiência renal crônica. Esse processo acarreta elevada morbidade, com grave deformidade facial, disartria e disfagia. Pode ser fatal quando houver obstrução das vias aéreas superiores e neuropatia craniana compressiva. O objetivo deste artigo é relatar um caso dessa rara entidade, diagnosticada por tomografia computadorizada. O relato de caso enfatiza a importância do diagnóstico precoce para evitar progressão paradeformidades graves.
Uremic leontiasis ossea is characterized by facial and cranial hypertrophy, associated with secondary hyperparatyroidism due to chronic renal failure. This process results in elevated morbidity, with severe facial deformity, dysartria and dysfagia, and may result in life-threatening upper airway obstruction and compressive cranial neuropathy. The objective ofthis article is to describe a case of this rare entity, diagnosed by computed tomography. The case report emphasizes the importance of early diagnosis to prevent the progression to severe disfigurement.
ABSTRACT
En estudios centellográficos con 131I (CCT) para seguimiento, postablación o tratamiento de pacientes portadores de carcinoma diferenciado de tiroides (CDT) se observan frecuentemente en tiempos precoces áreas de captación del radiotrazador en macizo facial. Estas áreas corresponden, generalmente, a glándulas salivares y extremo anterior de mucosa nasal y se mantienen durante las primeras 48 horas y no son observadas generalmente a las 72 horas. Pero con menor frecuencia se presentan otras que persisten durante varias semanas; estas áreas fueron consideradas como posibles retención en glándulas salivares, en tejido tiroideo ectópico en piso de boca, o proteínas yodas entre otras causas. En 1996 Valdivieso y col. (Cong. Arg. Biol. Med. Nuclear, Mar del Plata) y Gutiérrez y col. (SLAT, Chile) consideraron además de las mencionadas posibilidades, que la fijación se podría realizar en hueso maxilar en relación con procesos dentales y esta idea se vio favorecida por dos presentaciones sobre pocos casos que coincidían con la idea sobre el lugar de fijación del radioelemento con producción de imágenes falsas-positivas de enfermedad metastática. Con el propósito de determinar la frecuencia de observación de estas imágenes se procedió a la revisión de 636 CCT efectuados entre el 1 de enero de 2002 y el 31 de diciembre de 2007 en 502 pacientes. En el 31,5 % de los pacientes se observaron áreas activas en maxilares que persistían por varias semanas; la intensidad de concentración fue del 0,3 al 1,2 % de la actividad administrada. En 10 pacientes se efectuaron áreas de interés sobre las zonas activas que se controlaron durante 3 semanas, determinándose el T ½ efectivo registrándose valores promedio de 6,87 ± 0,94 días muy próximos al T ½ físico del 131I, indicando fuerte unión del compuesto radiactivo formado. La intensidad de concentración del radioyodo es variable dependiendo de la intensidad de la lesión dental, (caries, prótesis, pulpitis, granulomas periapicales) y en especial se incrementa en pacientes provenientes del interior que habitaban en zonas con aguas con contenido de flúor o arsénico. Seis pacientes tratados con actividades altas de radioyodo de entre 5,55 y 11,1 MBQ (150 a 300 mCi) mostraron lesiones actínicas en mucosa bucal y lingual. En 5 pacientes se efectuaron inmediatamente después del CCT con radioyodo, estudios panorámicos de Rx maxilar y de centellograma óseo coincidiendo las imágenes maxilares positivas de ambos estudios con las áreas positivas con radioyodo, confirmándose la localización de las mismas. En 13 pacientes que se sometieron a intensos tratamientos odontológicos, en estudios de CCT posteriores se apreció la disminución de intensidad de las imágenes o su desaparición. Ninguno de los pacientes presentó metástasis de CDA en las áreas activas maxilares. Estos hallazgos confirman la concentración del radioyodo en hueso maxilar en relación con alteraciones, dentales debiendo efectuarse investigaciones más profundas sobre la naturaleza de la molécula formada y los mecanismo de fijación de la misma. Deberá tenerse en cuenta el estado de salud dentario del pacientes antes de someterlo a tratamiento de metástasis o ablaciones, en especial cuando las actividades de radioyodo a utilizar sean mayores de 3,7 GBq (100 mCi) y aún indicar tratamiento de las lesiones dentales en forma previa.
In the whole body scans (WBS) with 131I in the follow-up or treatment of patients bearing DTC it is observed frequently fixation areas of the tracer apparently in relation with salivary glands. These areas generally belong to the salivary glands and are present during the first 48/72 hours, but others are kept during more than 3 weeks. These latter ones were considered as possible uptake in ectopic thyroid cells in the mouth floor, iodized proteins, retention of salivary glands and other assertions. Valdivieso et al (Cong. Arg. Biol. Med. Nuclear, 1996) and Gutiérrez et al (SLAT,Chile, 1997) considered that the fixation took place also in maxillary bones probably in areas in relation with dental illness (inflammation, pulpitis, dental caries, perionditis, periapical granuloma, periapical cyst and resorption of surrounding bone seen radiologically as periapical radiolucency). This presumption was sustained for two publications (Clin. Nucl. Med. 1998;23. 747-749, and Clin. Nucl. Med. 2000; 23; 314-315). This end the review of 638 131I WBS carried out between January 1st, 2002 and December 31st of 2007 in 502 patients that were studied for ablation, treatment of metastasis or relapses or follow up. In 31,5% of the patients were observed areas of activity in maxilla. The intensity of concentration of the tracer was 0.3 to 1.2 % of the activity administered. In 10 patients was determinate the effective T ½ and in 5 a panoramic Rx of the maxilla and a bone scintigraphy with 99mTc-MDP; there were correlation between both images, the 131I one an the 99mTc-MDP with radiology. The effective T½ mean value was 6,87 days ± 0,94 (S.D.) very close to the physical T ½ of the radioiodine tracer indicating a strongly labeled molecule. In 6 patients treated with high activities of radioiodine (5,55 to 11,1 MBq - 150 to 300 mCi) actinic lesions were observed in mouth and lingual mucous membrane, including ulcers. The intensity of the images and of the lesions correlate with the intensity of the administered activity of radioiodine, the previous condition of dental integrity and in patients living in the interior of our country in zones of "bad" water containing tracers of arsenic and fluorine. In 13 patients submitted to intense treatment of dental problems posterior WBS showed a decrease of the positive maxilla areas or they were not found. The presence of metastasis in the active maxilla area was in all cases negative. Our observations confirm that radioiodine is deposited in maxillary bone in relation of dental lesions and that this 131I move in a very slow place. This mechanism of fixation has to be determined. We fully recommended taking into account the existence of dental illness or incomplete dental treatments when the administration of higher activities than 3.7 GBq (150 mCi).
Subject(s)
Humans , Male , Female , Thyroid Neoplasms/diagnostic imaging , Carcinoma/diagnostic imaging , Radionuclide Imaging/adverse effects , Neoplasm Metastasis/diagnosis , False Positive Reactions , Diagnostic Uses of Chemicals , Iodine Radioisotopes/adverse effects , Jaw/diagnostic imagingABSTRACT
Subject(s)
Humans , Accidents, Traffic , Emergencies , Emergency Service, Hospital , Facial Bones , Incidence , Mandible , Mandibular Fractures , Maxilla , Nasal Bone , Research Personnel , Retrospective StudiesABSTRACT
Objective:To study the effects of LeFort I osteotomy in the treatment of old maxillary fracture.Methods:30 patients with old maxillary fracture were treated with LeFort I osteotomy,the rehabilitation of occluding relation and masticatory function were observed after operation.Results:28 patients had well-pleasing occluding relation and masticatory function; 2 patients dissatisfied with their masticatory function, because of unbalance of nerve-muscle after their occlusal plane were rebuilt.Conclusion:LeFort I osteotomy can be a method in the treatment of old maxillary fracture.