Profilaxis antibiótica del paciente con prótesis corporal sometido a cirugía bucal: Reporte de un caso clínico / Antibiotic prophylaxis of the patient with body prostheses undergoing oral surgery: A case report

Resumen Introducción: En Chile, según el último censo 2017 del Instituto Nacional de Estadísticas (INE), la población con 65 años o más, corresponde al 11,4% del total de los chilenos. Esto refleja un claro envejecimiento de sus ciudadanos, al ser comparado con versiones anteriores del censo. Estos cambios demográficos conllevan a un aumento de las patologías osteoarticulares, tendencia que puede apreciarse a nivel global. Objetivo: Junto a una revisión narrativa de la literatura, se presenta el caso de un paciente de sexo femenino. Método: Paciente de 82 años, con prótesis de cadera, que acude a la clínica de Cirugía Bucal de la Universidad Andrés Bello de Santiago de Chile. Fue derivada para realizar exodoncia de caninos inferiores por indicación protésica. Al realizar la anamnesis remota personal, la paciente relata haber sido sometido de artroplastia de reemplazo de cadera total hace 5 meses producto de un traumatismo. En el intraoperatorio, se realizó la exodoncia lo menos traumática posible y se aplicaron medidas de hemostasia locales. Conclusión: Según las últimas guías realizada por diversas sociedades del ámbito médico y odontológico, se sugiere el uso de profilaxis antibiótica únicamente en el caso de pacientes con patología sistémica descompensada, polimedicados, sistema inmunológico debilitado y/o con antecedentes de infección protésica.

Abstract Introduction: In Chile, according to the last census 2017, performed by the National Statistics Institute (INE), the population with 65 years or older, accounts for 11,4% of Chileans. This reflects an apparent aging of its citizens, in comparison to previous versions of the census. These demographical changes imply an increase in the numbers of osteoarticular pathologies, tendency that may be observed globally. Objective: Alongside with a narrative review of the literature regarding patients with hip prostheses, a case of a female patient. Method: 82 years old patient, attends the surgery clinic of the Andrés Bello University of Santiago de Chile, to perform extraction of lower canines by prosthetic indication. During the anamnesis, the patient reports a total hip replacement arthroplasty 5 months ago due to trauma. Intrasurgically, the extraction was performed as little traumatic as possible and local hemostasis measures. Conclusion: According to the latest guidelines reported by diverse medical and dental societies, it is suggested that the application of antibiotic prophylaxis only in patients with an uncontrolled systemic pathology, polymedicated, weakened immune system, and/or with a history of prosthetic infection.

Comparison of Microscopic Endodontic Techniques: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the success rates of resin-based endodontic surgery (RES) and endodontic microsurgery (EMS), and compare their results. Material and Methods: A total of 19 and 34 full-text papers were reviewed, and finally, 2 and 6 studies were selected for RES and EMS, respectively. The stages of the study selection process were illustrated in Figure 1. The demographic characteristics were also described using the IBM SPSS Software, and the meta-analysis was fulfilled via Stata V.14. Results: A total number of 811 teeth were analyzed in this systematic review and meta-analysis, with a mean follow-up of 38.63 months. Besides, the results of the meta-analysis indicated that both methods not only differed in terms of implementation but also produced varying outcomes. Accordingly, EMS demonstrated a higher success rate likelihood with a significant difference from that of RES. Conclusion: An excellent proof was made available through this meta-analysis regarding the resin-based endodontic surgery success rate likelihood (79.9%) and an update for the endodontic microsurgery success rate possibility (100%).

The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life

ABSTRACT Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals.

Patterns of Mandibular Third Molar Impaction in an Iranian Subpopulation

Abstract Objective: To assess the patterns of mandibular third molar impaction in an Iranian subpopulation. Material and Methods: This retrospective descriptive study evaluated 1000 panoramic radiographs retrieved from the archives of a private radiology clinic in Kermanshah city, Iran. Depth of impaction, position of impacted mandibular third molar relative to the mandibular ramus according to Pell and Gregory's classification and angle of impacted tooth according to Winter's classification were determined. Data were analyzed using the Chi-square and Wilcoxon tests. Results: Of 1000 radiographs, 230 (23%) showed an impaction of at least one mandibular third molar. Mandibular third molar impaction was more common in females (60%). Mesioangular (35.9%) and vertical (34.8%) impactions were the most common angles of impaction in the right and left sides, respectively. Level C (40.3%) and Class I (63.7%) were the most common types of impaction in terms of depth of impaction and position relative to ramus, respectively. No significant difference was observed between the right and left sides of the mandible in terms of patterns of mandibular third molar impaction (p>0.05). Conclusion: Mandibular third molar impaction was relatively common in the studied population. The mesioangular, level C and Class I impaction patterns were the most frequent.

Caso Clínico: Neumomediastino Anterior, Secundario a Procedimiento Dental / Case Report: Anterior Pneumomediastinum, Secondary to Dental Procedure

INTRODUCCIÓN: El neumomediastino es la presencia de aire en el mediastino, tiene incidencia variable que oscila entre 1/80 000 y 1/42 000 a nivel mundial, genera una diversidad de características clínicas, puede ser secundario a entidades torácicas o extra torácicas; dentro de las causas extratorácicas, podemos asociarlo a procedimientos dentales siendo de vital importancia considerar la posibilidad y la asociación a dichos procedimientos para su diagnóstico y tratamiento adecuado. CASO CLÍNICO: Paciente de sexo femenino de 23 años, que 24 horas previas a su ingreso, se realizó procedimiento dental tipo exodoncia del tercer molar inferior izquierdo, en el que se usó instrumental manual y neumático, que debió ser suspendido; la paciente presentó dolor intenso más dificultad respiratoria, posterior a ello dolor torácico opresivo, mandibular y en cuello de lado izquierdo, acompañado de enfisema subcutáneo en hemicara izquierda, cuello bilateralmente y subclavicular izquierdo. EVOLUCIÓN: Paciente es ingresada con diagnóstico de neumomediastino secundario a procedimiento dental para tratamiento antibiótico de amplio espectro y vigilancia, durante su hospitalización por tres días permanece estable, afebril con mejoría clínica general. CONCLUSIÓN: El neumomediastino es una complicación poco frecuente tras intervenciones odontológicas, se debe sospechar por el uso de instrumental neumático que disecan los tejidos blandos faciales, del cuello y tórax; la paciente tuvo una evolución favorable en base al diagnóstico y tratamient

BACKGROUND: Neumomediastinum is defined as the presence of air in the mediastinum, It has variable incidence that oscillates between 1/80000 and 1/420000, generates a diversity of clinical characteristics. It can be secondary to thoracic or extra thoracic entities, within extrathoracic causes; it can be associated with dental procedures, being of vital importance consider the possibility and the association to this procedure to get to an adequate diagnosis and treatment. CASE REPORT: A 23-year-old female patient who, 24 hours prior to admission, underwent a dental procedure such as a third-molar left third molar extraction, in which manual instruments and pneumatics dental lathe were used, which had to be suspended; the patient presented severe pain plus respiratory difficulty, after that she presented oppressive chest pain, mandibular and left side neck, accompanied by subcutaneous emphysema in the left side of the face, neck bilaterally and left subclavicular EVOLUTION: The patient was hospitalize with a diagnosis of neumomediastinum secondary to dental procedure to receive treatment with broad spectrum antibiotic and surveillance, during her hospitalization for three days she remains stable, afebrile with general clinical improvement. CONCLUSIONS: The neumomediastinum is a rare complication after odontological interventions. It should be suspected when pneumatic instrument lathe are used that dissect facial, neck and thorax soft tissues; the patient had a favorable evolution based on the diagnosis and early treatment proposed by the doctors according to the patients symptoms.

High-intensity laser application in Orthodontics

ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

Reconstrução estética com instalação imediata de implante / Aesthetic reconstruction with immediate implant installation ­ case report

A diminuição do tempo de tratamento com implantes osseointegrados, assim como a redução da complexidade do plano de tratamento e a otimização de protocolos minimamente invasivos, é um dos aspectos atuais em reabilitações com implantes. A instalação imediata de implantes em sítios pós-exodontia tem sido relatada na literatura como uma técnica previsível, permitindo a redução do tempo e do número de procedimentos para reabilitação protética. Este artigo relatou um caso clínico de reabilitação de um incisivo central superior perdido por reabsorção radicular, em que foi instalado um implante com confecção imediata de uma prótese temporária. No intuito de minimizar as alterações volumétricas inerentes ao processo de exodontia, além da utilização de um substituto ósseo entre a tábua óssea alveolar e o implante, foi utilizado enxerto de tecido conjuntivo removido do palato. A técnica possibilitou uma reabilitação estética e funcional adequada, e redução no tempo de tratamento com mínimo trauma ao paciente.

Decreasing treatment time with dental implants, as well as reducing the complexity of the treatment plan and optimize minimally invasive protocols, are current issues in rehabilitation with implants. Immediate implant placement in post-extraction sites have been reported in the literature as a predictable technique allowing to reduce the time and number of procedures for prosthetic rehabilitation. This is a case report of an upper central incisor lost due to root resorption, receiving an immediate implant and construction of a temporary prosthesis. In order to minimize volumetric changes inherent in the extraction process, besides the use of a bone substitute between alveolar bone plate and the implant, it was used connective tissue graft removed from the palate. The technique allowed an aesthetic and functional rehabilitation and appropriate reduction in treatment time with minimal tissue trauma.

Análise imunoistoquímica após terapia fotodinâmica com cloro-alumínio ftalocianina em tecidos gengivais de humanos / Immunohistochemical analyzes after photodynamic therapy with chloro-aluminum phthalocyanine in human gingival tissues

Embora a terapia fotodinâmica venha sendo utilizada como uma ferramenta útil nos últimos 30 anos em oncologia, poucos estudos clínicos em odontologia têm sido conduzidos. A terapia fotodinâmica (TFD) utiliza fotossensibilizantes atóxicos e seletivos que são administrados nas células alvo seguida de aplicação local de luz visível, produzindo espécies reativas de oxigênio capazes de ocasionar morte celular por apoptose ou necrose, de afetar a vascularidade local, além de exercer importantes efeitos no sistema imune. Novas gerações de fármacos fotossensibilizantes, como as ftalocianinas nanoparticuladas tem apresentado excelentes resultados na atividade antitumoral e antibacteriana. Neste contexto, o presente trabalho realizou o primeiro protocolo clínico de aplicação local da nanoemulsão de cloroalumínio ftalocianina (AlClFc) seguida de irradiação em gengiva de humanos, e analisou descritiva e comparativamente, por meio de imunoistoquímica, a expressão de RANK, RANKL, OPG e VEGF em um modelo split-mouth. Oito voluntários saudáveis com indicação clínica de exodontia foram incluídos no estudo. Sete dias antes da exodontia, foi aplicado na gengiva dos participantes, 5µM de nanoemulsão de AlClFc seguida de irradiação com laser diodo (660nm, 7J/cm2), o lado contralateral foi utilizado como controle. Os espécimes teciduais foram removidos sete dias após a TFD e subdivididos em dois grupos (grupo teste e grupo controle) para análise histológica e imunoistoquímica. Os pacientes foram monitorados no dia aplicação, 7, 14 e 30 dias após a terapia para avaliação de efeitos adversos da terapia. Alterações vasculares foram observadas nas amostras gengivais que receberam a TFD. Áreas de edema e congestão vascular, além de intensa vascularização foram visualizadas. Adicionalmente, focos de calcificação distrófica em região subepitelial foram visualizados nos espécimes do grupo teste. Os resultados demonstraram um padrão similar dos escores de imunomarcação de RANK, RANKL e VEGF entre os grupos teste e controle, não havendo diferença estatística significante (p=0.317, p=0.777, p=0.814, respectivamente). RANK e RANKL exibiram imunomarcação fraca ou ausente na maioria dos espécimes analisados. Não houve imunomarcação para a OPG. O VEGF mostrou imunomarcação moderada a forte nos espécimes do grupo teste. Adicionalmente, o estudo clínico mostrou que a terapia foi bem tolerada por todos os pacientes. Os efeitos adversos foram de curta duração e totalmente reversíveis. Tomados em conjunto, os resultados apresentados neste estudo mostraram que o protocolo utilizado por nós, mediado por nanoemulsão contendo AlClFc, é seguro para aplicação clínica em tecido gengival e, sugerem uma forte imunomarcação para o VEGF após a terapia. (AU)

Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non-toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the immune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local application of nanoemulsion chloro-aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split -mouth model. Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5µM of nanoemulsion AlClFc followed by irradiation with diode laser (660nm, 7J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and control groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular congestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and control groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0.814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was no immunostaining for OPG. VEGF showed moderate to strong immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short-time and completely reversible. Taken together, the results presented in this study showed that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy. (AU)

Redução de defeito ósseo maxilar por meio de distração osteogênica horizontal / Reduction of maxillary bone defect by horizontal distraction osteogenesis

A reabilitação de maxilas edêntulas em muitas situações pode se tornar um desafio para os implantodontistas. Em um grande numero de casos a instalação de implantes só pode ser realizada após o procedimento de enxertia óssea. No entanto existem casos em que o defeito ósseo atinge níveis tão severos que não permite a instalação de implantes mesmo após procedimentos de enxertia. No presente trabalho, relatamos um caso clinico onde o paciente apresentava um grande defeito ósseo na região posterior da maxila causado por projétil de arma de fogo. Devido a inviabilidade de se realizar um procedimento de enxertia convencional, foi optado por realizar a distração osteogênica horizontal. Após o período de ativação e de consolidação o aparato foi removido e foi instalada uma placa para garantir a estabilidade do local. O procedimento se mostrou de fácil realização e o resultado obtido foi a quase que completa eliminação do defeito ósseo

The rehabilitation of edentulous jaws in many situations can become a challenge for implantodontists. In a large number of cases the installation of implants can only be performed after the bone grafting procedure. However there are cases where the bone defect so severe that reaches levels not allow the installation of implants even after grafting procedures. In this paper, we report a clinical case where the patient had a large bony defect in the posterior region of the maxilla caused by a projectile from a firearm. Because of the impracticality of conducting a conventional grafting procedure was chosen to perform the horizontal distraction osteogenesis. After the activation period of consolidation and the apparatus was removed and a plate was installed to ensure the stability of the site. The procedure proved easy to perform and the result was the almost complete elimination of the bone defect

Cisto radicular residual – relato de um caso clínico / Residual cyst – clinical case report

Cisto residual forma-se a partir da ressecção incompleta do cisto radicular, lateral ou dentigero, também podem surgir a partir da extirpação ou esfoliação de um dente, e como conseqüência de uma degeneração cística de material granulomatoso de um dente que sofreu procedimento de extração e exibia um granuloma associado; ou também podem surgir a partir do desenvolvimento ou proliferação de restos epiteliais odontogê-nicos residuais de um dente extraído. Aproximadamente 10% dos cistos são do tipo residual. O cisto radicular é um cisto odontogênico inflamatório que se origina dos restos epiteliais odontogênicos, associado à necrose da polpa do dente envolvido, em um granuloma preexistente, sendo geralmente descoberto através de radiografia de rotina. Caracteristicamente os cistos periapicais não apresentam sintomas, a menos que exista uma exacerbada inflamação aguda. Além disso, se o cisto atingir um tamanho grande, podem ser observadas tumefação e sensibilidade leve. Quanto ao tratamento, o mais indicado é o cirúrgico, através de dois tipos principais: enucleação e marsupialização, sendo este último através da criação de uma janela na parede do cisto, com o posterior esvaziamento do seu conteúdo. O objetivo deste trabalho é expor um caso de remoção cirúrgica de três cistos radiculares residuais. Um através de marsupialização, seguido de enucleação, e os outros dois com enucleação, desenvolvidos em um paciente gênero masculino, 44 anos de idade que procurou atendimento na FO-UFPel para execução de próteses. Ao exame radiográfico evidenciou-se as lesões radiolúcidas uniloculares em mandíbula, lado esquerdo e 2 lesões igualmente radiolúcidas do lado direito e após um adequado planejamento, optou-se pelos tratamentos de marsupializa-ção e enucleação onde pode se observar um bom resultado no caso relatado

Residual cyst forms from the incomplete resection of radicular cyst, lateral or dentigero, can also arise from extirpation or exfoliation of a tooth, and as a consequence of a cystic degeneration of material granulomatoso of a tooth that underwent extraction procedure and displayed a granuloma associated; or can also arise from the development or proliferation of epithelial remnants of a residual keratocysts, tooth extracted. Approximately 10% of cysts are residual type. Radicular cyst is an inflammatory odontogenic cyst originated from rest of odontogenic epithelial, and it is associated to pulp necrosis of the tooth evolved, in preexisting granuloma, and it is generally found thought routine radiography. Periapical cysts characteristically do not present symptoms, unless there is an aggravated acute inflammatory. Further more, if the cyst reaches a bigger size, edema and some sensitivity can occur. The more indicated treatment is surgery, and there are two mayor types: enucleation and marsupialization, this last one consisting of making an opening on the cyst wall, and followed by removal of its content. The objective of this work is to show a surgical removal of three residual radicular cysts. One of them was removed thought marsupialization, followed by enucleation, and the other two were removed thought enucleation. Patient gender male, 44 years old searched for attendance at the FO-UFPEL (Faculty of Odontology of the Federal University of Pelotas) for execution of prostheses. The radiographic examination showed himself radiolucid injury, unilocular in jaw, left side and 2 injuries also radiolucid the right side. After an adequate planning, we opted for treatments of marsupialização and enucleação where you can observe a good result in the case reported

Implante dentário unitário imediato / Immediate unitary dental implant

O presente estudo trata-se de uma revisão de literatura a respeito de Implante Dentário Unitário Imediato e também uma revisão atualizada com critérios de inclusão pré-estabelecidos relatando taxas de longevidade do ano de 1999 a 2009, bem como procedimentos clínicos associados a sua instalação. Foi realizada uma revisão de literatura com busca de artigos científicos na base de dados MEDLINE e os critérios de inclusão dos mesmos foram: artigos publicados de 1999 a 2009; ensaios clínicos randomizados e não-randomizados; estudos de coorte; estudos de caso-controle; relatos de casos clínicos com um número mínimo de 10 casos; taxas de sucesso e de longevidade devem ter um período de proservação de pelo menos 6 meses; relatos de casos clínicos somente com instalação de implantes imediatos. Foram identificados um total de dez estudos que preenchiam os critérios de seleção desta revisão. Eles relatam as taxas de longevidade de implantes imediatos e alguns ainda comparam com implantes tardios. O período de observação dos mesmos foi de seis meses a seis anos. Na presente revisão, a maior parte dos estudos apresentaram taxas de longevidade de implantes imediatos acima de 90%, ou seja, similar aos implantes colocados em alvéolos cicatrizados. Os autores não encontraram diferenças estatísticas significantes nas taxas de longevidade para técnicas de colocação imediata e tardia. A taxa de longevidade de implantes imediatos foi de 100% em quatro estudos. Dois estudos apresentaram maior taxa de sucesso com colocação imediata (96,8%) quando comparada com a tardia (93,9%). As menores taxas encontradas foram a de 89,3% e 85%. Com isso, os autores concluem que a técnica de instalação de Implante Unitário Imediato é uma técnica confiável e segura apresentado taxas de sucesso semelhante a implantes tardios

The present study is about a literature review regarding it Implants Dental Unitary Implants Immediate and an updated revision with inclusion criteria prestablished showing rates of longevity of the year from 1999 to 2009 as well as associated clinical procedures at its installation. A literature review was accomplished with a research of scientific MEDLINE database and the inclusion criteria of it were: Published from 1999 to 2009 ; randomized and non-randomized clinical rehearsals; cohort studies; case-control studies; reports of clinical cases with a minimum number of 10 cases; success and longevity rates should have a post accompaniment period of at least 6 months; reports of clinical cases only with placement of immediate implants. Ten studies that fitted out the criteria of selection of this revision were identified. They report the longevity rates of immediate dental implants and some still compare to late dental implants. The observation time was from six months to six years. In the present revision, most of the studies presented longevity rates of its immediate implants above 90%, in other words, similar to the implant placed in scarred alveoli. The authors didn’t find significant statistical differences in the longevity rates for techniques of immediate and late placement. The longevity rate of its immediate implant was 100% in six studies. Two studies presented larger success rate with immediate placement (96,8%) when compared with the late (93,9%). 89,3% and 85% were the lowest rates among reported ones, were found in two studies. Thus, we can conclude that the placement technique of it Immediate Unitary Dental Implants is a reliable technique and it holds presented rates of similar success to late implants

Fratura de tuberosidade de maxila intercorrente à extração de terceiro molar superior: relato de caso clínico / Maxillary tuberosity fracture intercurrent to extraction of upper third molar: case report

A exodontia de terceiros molares superiores consiste num procedimento cirúrgico que requer, além de destreza manual do cirurgião, um conhecimento básico acerca dos acidentes e/ou complicações decorrente da remoção desses elementos dentais. Neste trabalho os autores realizaram uma breve revisão de literatura acerca das fraturas da tuberosidade maxilar, relatando um caso clínico de fratura tuberositária decorrente da extração de um terceiro molar superior em um paciente atendido na clínica odontológica do CESUPA, Belém/PA, tratado através de redução cruenta e Fixação Interna Rígida (FIR) dos fragmentos. Os autores realizaram ainda uma discussão sobre as abordagens terapêuticas mais apropriadas para tal complicação, que preconizam a manutenção do fragmento e sua estabilização. O tratamento cirúrgico empregado no caso clínico supracitado foi a redução e fixação interna rígida com placas e parafusos de titânio sistema 1.5mm, que permitiu a conservação do bloco ósseo fraturado levando em consideração a necessidade de uma futura reabilitação protética estável

The objective was to report a case of fracture of the maxillary tuberosity after attempted extraction of the third right upper molar. The patient for the case studieds was a male, X years who attended the emergency sector of the Dental Clinic CESUPA, Belém / PA referred to by another professional who, in an attempt to remove the 3rd molar (18), resulted in a fractured of the maxillary tuberosity. The conduct was based on the bloody reduction and rigid internal fixation of the fragment. As a conclusion it can be said that the conservative treatment with titanium plate and screws 1.5mm system is the most accepted therapeutic measure due regard to the possibility of future rehabilitation prosthesis stable

Nuevo instrumento para cirugía buco-maxilo-facial: separador anatómico adaptable / Buco-maxilo-facial surgery a new instrument: anatomic adaptable retractor

Cirugía Preprotética. Diagnóstico: Severa reabsorción del maxilar superior con ausencia de rebordes y concavidad de la bóvedapalatina.Procedimiento Quirúrgico: La bóveda palatina ósea fue elevada, el tabique nasal osteotomizado, los ligamentos pterigomaxilaresdesinsertados. Técnica de "Wassmund". Se implantó hueso sintético sobre los rebordes alveolares reabsorbidos y el paciente fuerehabilitado con una prótesis completa superior convencional.

Preprosthetic case. Diagnosis: Severe resorption of the upper jaw with absence of the alveolar ridge and palatal vault concavity.Surgical procedure: The palatal vault was elevated, nasal septum osteotomized, pterygoid ligament resected "Wassmund Technique"and HA granules implanted on the resorbed alveolar ridge. A conventional, full denture was made.

Técnica de fijación de prótesis en cirugía maxilofacial / Prosthetic fixation technique in maxillofacial surgery

A high incidence of bucal pathology such as intense atrophy, hypertrophy, fissured epulis, and cancer has been noted in the adult population of the city of Antofagasta during consultations at the clinic of the Department of Odontology at the University of Antofagasta. This pathology may be related to past exposure to drinking water containing high levels of heavy metals and arsenic. This study presents results of modifications in surgical techniques for optimizing rehabilitation procedures using prostheses in these patients.

En la población adulta de la ciudad de Antofagasta que consulta en la clínica del Departamento de odontología de la Universidad de Antofagasta, se registra una alta incidencia de patologías bucales tales como atrofias intensas, hipertrofías, épulis fisurados y cáncer, las cuales podrían estar relacionadas con la exposición en el pasado al consumo de agua potable con elevados índices de metales pesados y arsénico. En este trabajo se presentan resultados de modificaciones a técnicas quirúrgicas para optimizar los procedimientos de rehabilitación mediante prótesis de estos pacientes.

Distracción osteogénica mandibular. Experiencia en el Hospital Infantil de México Federico Gómez / Mandible distraction osteogenesis in 36 children

Introducción. En el presente trabajo los autores presentan la experiencia de su grupo multidisciplinario de la Clínica de Cirugía Craneofacial en el Hospital Infantil de México Federico Gómez, en el procedimiento de osteogénesis inducida mediante "distracción ósea". Material y métodos. Experiencia en 36 pacientes empleando el aparato distractor diseñado por el autor principal, con seguimiento máximo de 5 años y 4 meses. Los pacientes fueron valorados preoperatoriamente por mediciones antropométricas, cefalometría anteroposterior y lateral, modelos dentarios y fotografía clínica.Resultados. Se trataron 23 mujeres y 13 varones; la edad de los pacientes fluctuó de 3 meses a 16 años, con un promedio de 6 años. El procedimiento se realizó bilateralmente en 11 pacientes y unilateralmente en 25, obteniendo elongación ósea promedio de 16 mm. Conclusión. Este procedimiento es sin duda un gran recurso en la reconstrucción de defectos óseos craneofaciales, eliminando la necesidad de injertos óseos, fijación máxilo-mandibular y otros procedimientos más complejos y agresivos.

Técnica para cirugía de modelos mediante un nuevo accesorio: first part / A technique of surgical models by means of a new accessory device: first part

Presentamos en este trabajo un accesorio que hemos desarrollado y que de acuerdo a nuestra experiencia facilita la realización de la cirugía sobre modelos cuando se lo compara con métodos tradicionales