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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 45-49, set.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1291672

ABSTRACT

Os ferimentos por arma de fogo (FAF) são um grande problema de saúde pública. Na face, a mandíbula é o local de maior incidência, sendo a região de corpo mandibular a mais atingida e as lesões aos tecidos moles frequentemente a ela associadas. Em alguns casos, tais ferimentos apresentam-se de difícil resolução, sobretudo, em casos de fraturas cominutivas e lesões de tecidos moles com alta complexidade. Isso torna o atendimento desses pacientes um desafio para cirurgiões buco-maxilo-faciais. Desta forma, o objetivo deste artigo é relatar um caso de FAF em terço inferior da face, com comprometimento de tecidos moles e mandíbula, pela equipe de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Geral do Estado - Bahia. Paciente de 28 anos de idade, sexo feminino, vítima de FAF em terço inferior da face, por disparo acidental de espingarda. Ao exame clínico, pode-se observar ferimento perfuro-contuso em região de mandíbula e fratura cominutiva de corpo e ângulo mandibular à direita. A paciente foi submetida à cirurgia para remoção de fragmentos ósseos/corpos estranhos, fixação dos cotos com placa de reconstrução 2.4mm e sutura dos planos, em mesmo tempo cirúrgico, reestabelecendo a função da mandíbula. Portanto, devido à fisiopatologia variável dos FAF na mandíbula, não se indica um único padrão de tratamento para as fraturas cominutivas. Além disso, é indispensável o emprego de protocolos de limpeza cirúrgica imediata e antibioticoterapia nos casos com alto grau de cominuição, bem como, sugere-se realizar o tratamento definitivo o mais breve possível(AU)


Firearm injuries (FIs) are a major public health problem. On the face, the mandible is the place with the highest incidence of this trauma, with the mandibular body region being the most affected and the lesions to the soft tissues frequently associated with it. In some cases, such injuries are difficult to resolve, especially in cases of comminuted fractures and soft tissue injuries with high complexity. This makes the care of these patients a challenge for oral and maxillofacial surgeons. Thus, the objective of this article is to report a case of care for a FAF victim in the lower third of the face, with soft tissue and mandible involvement, by the Maxillofacial Surgery and Traumatology team at the Hospital Geral do Estado - Bahia. 28-year-old female patient, victim of FAF in the lower third of the face, due to acidental shotgun firing. On clinical examination, a perforated-blunt wound can be seen in the mandible region and comminuted fracture of the body and angle of the mandible on the right. The patient underwent surgery to remove bone fragments / foreign bodies, fix the stumps with a 2.4 mm reconstruction plate and suture the planes, at the same surgical time, reestablishing the function of the mandible. Therefore, due to the variable pathophysiology of FAF in the mandible, a single treatment pattern is not indicated for comminuted fractures. In addition, it is essential to use immediate surgical cleaning protocols and antibiotic therapy in cases with a high degree of comminution, as well as, it is suggested to carry out the definitive treatment as soon as possible(AU)


Subject(s)
Humans , Female , Adult , Wounds, Gunshot , Soft Tissue Injuries , Fractures, Comminuted , Oral and Maxillofacial Surgeons , Fractures, Bone , Jaw Fractures , Mandible , Anti-Bacterial Agents
2.
Braz. j. oral sci ; 20: e218796, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1254745

ABSTRACT

Forensic physical anthropometry allows the determination of animal species and estimates sex, ancestry, age and height. Aim: To analyze the effectiveness of a cranioscopic/ morphological evaluation for sex estimation with a sample of the Brazilian mixed-race population by conducting a qualitative visual assessment without prior knowledge of sex. Methods: This is a blind cross-sectional study that evaluated 30 cranial characteristics of 192 skulls with mandible, 108 male and 84 female individuals, aged 22 to 97 years, from the Osteological and Tomographic Biobank. The qualitative characteristics were classified and compared to the actual sex information of the Biobank database. The statistical analysis was used to calculate de Cohen's kappa coefficient, total percentage of agreement, sensitivity and specificity of visual sex classification. Results: Of the 30 cranial variables analyzed, 15 presented moderate degree of agreement, achieving value of Kappa test between 0.41­0.60: Glabella (Gl), Angle and lines (At), Mental eminence (Em), Mandible size (Tm), Cranial base (Bc), Mouth depth (Pb), Nasal aperture (Anl), Supraorbital region (Rs), Orbits (Orb), Mastoid processes (Pm), Alveolar arches (Aa), Zygomatic arch (Az), Orbital edge (Bo), Supraorbital protuberances (Pts), and Supramastoid crests and rugosity (Crsm). The Facial physiognomy (Ff) presented substantial reliability (0.61-0.80) with 89.8% sensitivity for male sex and 70.2% specificity. Conclusions: Cranial morphological characteristics present sexual dimorphism; however, in this study only 15 variables showed moderate degree of agreement and can be used in sex estimation. Only one variable (Ff) 81.2% total agreement with substantial reliability. Quantitative methods can be associated for safe sex estimation


Subject(s)
Skull , Sex Characteristics , Forensic Anthropology , Mandible
3.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 42-46, maio-ago. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1283885

ABSTRACT

Introdução: Por sua posição na face, a mandíbula é frequentemente atingida pelos traumas, surgindo em algumas estatísticas como o osso fraturado com maior incidência em face. Em fraturas de mandíbulas atróficas o tratamento conservador, com fixação intermaxilar não costuma ser uma opção viável pela falta de dentes e pequena área de contato ósseo existente. Dessa forma, a redução aberta e fixação interna estável tem sido o tratamento de escolha sempre que a condição do paciente permitir. Objetivo: relatar um caso de osteossíntese de fratura de mandíbula atrófica por acesso extraoral. Relato de caso: Paciente 64 anos, faioderma, sexo feminino, procurou o serviço de Cirurgia e Traumatologia Bucomaxilofacial da Universidade Federal da Bahia apresentando traumatismo facial por queda da própria altura, referindo severas queixas álgicas espontâneas em região mandibular. Ao exame físico notou-se edentulismo total em ambas as arcadas, edema, hematoma e degrau ósseo á palpação em região de corpo de mandíbula a direita, alémde mobilidade atípica a manipulação da mandíbula. Ao exame de imagem notou-se sinais de fratura em corpo mandibular direito e côndilo esquerdo. O tratamento instituído foiconservador para a fratura de côndilo e cirúrgico para a fratura de corpo, o acesso foi extraoral ea fixação rígida foi realizada com placa e parafusos dos dispositivos Load-Bearing. Considerações finais: A paciente não apresentou quaisquer déficits funcionais pós-procedimento cirúrgico, sendo o tratamento abertocom fixação interna estável bastante promissor por restabelecer a união de focos fraturados e deslocados, proporcionando estabilidade da fratura e conforto imediato para a paciente(AU)


Introduction: Due to its position on the face, the jaw is frequently affected by trauma, appearing in some statistics as the fractured bone with a higher incidence in the face. In fractures of atrophic jaws, conservative treatment, with intermaxillary fixation, is not usually a viable option due to the lack of teeth and small area of existing bone contact. Thus, open reduction and stable internal fixation have been the treatment of choice whenever the patient's condition permits. Objective: to report a case of osteosynthesis of atrophic mandible fracture through extraoral access. Case report: Patient 64-year-old, female, sought the service of Maxillofacial Surgery and Traumatology at the Federal University of Bahia presenting facial trauma due to falling from his own height, referring to severe spontaneous pain complaints in the mandibular region. On physical examination, total edentulism was noted in both arches, edema, hematoma and bone step on palpation in the right jaw body region, in addition to atypical mobility in the jaw manipulation. On imaging examination, signs of fracture were noted in the right mandibular body and left condyle. The treatment instituted was conservative for condyle fracture and surgical for body fracture, access was extraoral and rigid fixation was performed with plate and screws of the Load-Bearing devices. Final considerations: The patient did not presente any functional deficits after the surgical procedure, and the open treatment with stable internal fixation is very promising for restoring the union of fractured and displaced foci, providing fracture stability and immediate comfort for the patient(AU)


Subject(s)
Humans , Female , Middle Aged , Fracture Fixation, Internal , Mandibular Fractures , Atrophy , Jaw, Edentulous , Mandible/surgery
4.
Braz. dent. j ; 32(3): 116-126, May-June 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345509

ABSTRACT

Abstract This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.


Resumo Os objetivos do presente estudo foram comparar e avaliar a estabilidade do tratamento precoce da mordida aberta anterior (MAA) com diferentes dispositivos. A amostra inicial foi composta por 99 pacientes randomizados em quatro grupos experimentais: BS - esporões colados; CC - mentoneira; FPC - grade palatina fixa; RPC - grade palatina removível. Análise cefalométrica foi realizada para avaliar os dados do período inicial (T1), final do tratamento (T2) e 2 anos após tratamento (T3), sendo a variável overbite o desfecho principal. Em T3, após perdas de seguimento, haviam 63 indivíduos, sendo BS (n=15; overbite 0.19 mm; 11.54 anos; 10 Feminino (F)/5 Masculino (M)); CC (n=11; overbite -0.19 mm; 11.41 anos; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 anos; 15 F/6 M) e; RPC (n=16; overbite 0.73 mm; 11.67 anos; 6 F/10 M). Comparações das alterações nas variáveis dentoesqueléticas e abandono de hábitos bucais deletérios durante o tempo de acompanhamento foram estatisticamente analisados com p<.05. Medidas esqueléticas lineares mandibulares e componentes verticais aumentaram gradualmente com a idade, principalmente com o surto de crescimento puberal e estabelecimento da dentição permanente no pós-tratamento. O overbite foi significantemente melhorado durante o tratamento, permanecendo estável com alterações positivas. A extrusão dos incisivos impactou na correção da MAA e estabilidade nos 4 grupos, que registraram uma melhora de 1.15 mm no pós-tratamento (T3-T2). Com suas limitações, todos dispositivos experimentais foram efetivos e mostraram resultados estáveis no tratamento precoce da MAA, sendo que a FPC apresentou a maior correção da MAA e o menor índice de desistência.


Subject(s)
Humans , Male , Female , Child , Open Bite/therapy , Malocclusion, Angle Class II , Cephalometry , Follow-Up Studies , Mandible
5.
Rev. inf. cient ; 100(2): e3383, mar.-abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1251820

ABSTRACT

RESUMEN Se presentó el caso de una paciente femenina de 40 años de edad que acudió a consulta por presentar aumento de volumen en la región parotídea izquierda. Se realizó ortopantomografía, radiografías simples anteroposterior y lateral de cráneo que revelaron la presencia de una imagen radiolúcida en la región lateral de la rama mandibular izquierda. El diagnóstico clínico fue de osteoma periférico a este nivel, por lo que se realizó remoción quirúrgica total de la lesión. La biopsia confirmó el diagnóstico de osteoma ebúrneo periférico. El osteoma es una neoplasia benigna de tejido óseo, poco frecuente y, rara vez, se localiza de manera aislada en la mandíbula. No se diagnosticaron complicaciones posoperatorias y la paciente mostró satisfacción con la atención estomatológica brindada.


ABSTRACT A 40-year-old female patient came to the consultation due to an increase in volume in the left parotid region. Orthopantomography and simple anteroposterior and lateral skull radiographies were performed, revealing the presence of a radiolucent image in the lateral region of the left mandibular side. The clinical diagnosis at this point was of peripheral osteoma, for which a total surgical removal of the lesion was performed. The biopsy confirmed the diagnosis of peripheral osteoma. An osteoma is a rare benign neoplasm of bone tissue, and is rarely found isolated in the mandible. Postoperative complications were not diagnosed and the patient was satisfied with the dental care provided.


RESUMO Foi apresentado o caso de uma paciente do sexo feminino, 40 anos de idade, que compareceu à consulta por aumento de volume na região da parótida esquerda. Foram realizadas ortopantomografia, radiografias simples ântero-posterior e lateral do crânio, que revelaram a presença de imagem radiotransparente na região lateral do ramo mandibular esquerdo. O diagnóstico clínico foi de osteoma periférico a este nível, para o qual foi realizada a remoção cirúrgica total da lesão. A biópsia confirmou o diagnóstico de osteoma periférico ebúrneo. O osteoma é uma neoplasia benigna do tecido ósseo, pouco frequente e raramente localizada de forma isolada na mandíbula. Complicações pós-operatórias não foram diagnosticadas e o paciente ficou satisfeito com o atendimento odontológico prestado.


Subject(s)
Humans , Female , Adult , Osteoma/surgery , Osteoma/diagnostic imaging , Mandible/pathology , Rhytidoplasty/methods , Mandibular Neoplasms
6.
Rev. cuba. estomatol ; 58(1): e3391, ene.-mar. 2021. graf
Article in Portuguese | LILACS, CUMED | ID: biblio-1156426

ABSTRACT

Introdução: O ameloblastoma é uma neoplasia benigna, mas localmente invasiva, geralmente diagnosticada na quarta e quinta décadas, com relação à localização em 80 porcento dos casos, o tumor está na mandíbula e 20 porcento na maxila. É classificada histopatologicamente como células foliculares, plexiformes, acantomatosas, granulares e basais. O ameloblastoma desmoplásico foi reclassificado como subtipo histológico. Radiograficamente, pode ser mostrado de maneira unicística ou multicística, onde geralmente é descrito como favos de mel ou bolhas de sabão. Objetivo: O objetivo deste trabalho é relatar um caso de ameloblastoma com características clínicas e de imagem incomuns, enfatizando a importância diagnóstico correto como estratégia para garantir tratamento adequado e melhor prognóstico da doença. Apresentação do caso: Paciente branca, 72 anos, moradora da cidade de Itabaiana-Sergipe, queixou-se do aumento de volume na região da mandíbula anterior de desenvolvimento lento. Ela foi encaminhada ao do Campus do Hospital Universitário Prof. João Cardoso Nascimento, Aracaju / Sergipe. A tomografia computadorizada mostrou uma área multilocular hipodensa, localizada na região anterior da mandíbula, e uma biópsia incisional realizada juntamente com exames de imagem, o seguinte diagnóstico de ameloblastoma folicular foi concluído com uma extensa área de degeneração cística. Decidiu-se realizar uma cirurgia para remover completamente a lesão em centro cirurgico, formou-se uma extensa aloja ossea, por isso foi decidido aplicar em sua extensão a solução de Carnoy. Conclusões: Este relato é altamente relevante por apresentar um caso que contradiz os fatos existentes e aumenta a importância de se fazer um diagnóstico correto, é importante enfatizar que, embora o comportamento das lesões que afetam a cavidade oral seja bem conhecido, é extremamente importante estuda-las(AU)


Introducción: El ameloblastoma es una neoplasia benigna pero localmente invasiva, generalmente diagnosticada en las décadas cuarta y quinta. En el 80 por ciento de los casos el tumor está localizado en la mandíbula y el 20 por ciento, en el maxilar. Se clasifica histopatológicamente en folicular, plexiforme, acantomatoso, células granulares y células basales. El ameloblastoma desmoplásico se ha reclasificado como un subtipo histológico. Radiográficamente se puede mostrar de forma unicista o multiquística, donde generalmente se describe como panales o pompas de jabón. Objetivo: Describir un caso de ameloblastoma con características clínicas y de imagen poco comunes. Presentación del caso: Paciente blanca, de 72 años, que vivía en la ciudad de Itabaiana-Sergipe, se quejó del aumento de volumen (de desarrollo lento) en la región de la mandíbula anterior. La tomografía computarizada mostró un área hipodensa, multilocular, ubicada en la región mandibular anterior. Se realizó una biopsia incisional, además de los exámenes por imágenes. Se diagnosticó ameloblastoma folicular con un área extensa de degeneración quística. Se decidió realizar una cirugía de extirpación completa de la lesión, luego de la extracción de la misma se formó un alojamiento óseo circular, por lo que se decidió aplicar la solución de Carnoy. Conclusiones: Este informe tiene una gran relevancia porque presenta un caso que contradice los hechos existentes y plantea la importancia de hacer un diagnóstico correcto. Aunque el comportamiento de las lesiones que afectan la cavidad oral es bien conocido, es extremadamente importante continuar estudiándolas(AU)


Introduction: Ameloblastoma is a benign but locally invasive neoplasm generally diagnosed in the fourth and fifth decades of life. Its location is the mandible in 80 percent of the cases and the maxilla in 20 percent. Histopathologically, it may be classified as follicular, plexiform, acanthomatous, granular cells or basal cells. Desmoplastic ameloblastoma has been further classified as a histological subtype. Radiographically, it presents as either unicystic or multicystic, in which case it resembles a honeycomb or soap bubbles. Objective: Describe a case of ameloblastoma with uncommon clinical and imaging characteristics. Case presentation: A white female 72-year-old patient from the city of Itabaiana, Sergipe, presented with increased volume (of slow development) in her anterior mandibular region. Computed tomography revealed a hypodense, multiloculated area in the anterior mandibular region. Incisional biopsy and imaging tests were performed. The diagnosis was follicular ameloblastoma with a broad area of cystic degeneration. It was decided to perform total excision of the lesion. A circular bone housing was formed, which was treated with Carney's solution. Conclusions: The present report is of great relevance, since a case is described which contradicts the existing facts and points to the importance of making a correct diagnosis. Although the behavior of oral cavity lesions is well known, it is extremely important to continue to study them(AU)


Subject(s)
Humans , Female , Aged , Biopsy/methods , Ameloblastoma/diagnostic imaging , Mandible/surgery
7.
Rev. cient. odontol ; 9(1): e046, ene.-mar. 2021. ilus
Article in Spanish | LILACS, LIPECS | ID: biblio-1254252

ABSTRACT

El objetivo de este estudio fue realizar una revisión actualizada de la literatura sobre la importancia del uso de la tomografía computarizada de haz cónico (TCHC) en el reconocimiento de la trayectoria y las variantes del canal mandibular (VCM), ya que esta permite obtener imágenes de alta calidad, con una exactitud de 94%, aproximadamente, mientras que la radiografía intraoral periapical (RIP) tiene un 53% y la radiografía extraoral panorámica (REP) presenta un 17% de exactitud. Las incidencias de las variantes del canal mandibular en estudios realizados utilizando TCHC fueron entre un 1,3% y un 69%. Estas pueden diferir entre los pacientes de diferentes orígenes étnicos y, a su vez, dentro de la misma población étnica; además, hay grandes diferencias en los tipos y configuraciones de las VCM dentro de cada grupo étnico. Estudios realizados han demostrado histológicamente el contenido de las VCM; la presencia de haces de nervios y arterias de diferentes calibres sugieren también que los pacientes presentan síntomas clínicos solamente si el paquete neurovascular alcanza cierto tamaño y número de fascículos. En este estudio se describieron las diferentes clasificaciones realizadas y actualizadas con TCHC. (AU)


The objective of this study was to provide an updated review of the literature on the importance of the use of cone beam computed tomography (CBCT) in the recognition of the trajectory and variants of the mandibular canal (MCV ).CBCT allows obtaining high quality images and visualization with an accuracy of approximately 94%, compared to 53% with periapical intraoral radiography (RIP) and 17% with panoramic extraoral radiography (REP), making CBCT an important diagnostic tool.The incidences of MCV in CBCT studies were between 1.3% and 69%, with differences between patients of different ethnic origins and within the same ethnic population, and in the types and configurations of MCV within each ethnic group. The studies available in the literature provide a histological description of the content of MCV. The presence of nerve and artery bundles of different calibers suggests that patients present clinical symptoms only if the neurovascular bundle reaches a certain size and number of fascicles. This review provides a description of the different classifications available and updated with CBCT. (AU)


Subject(s)
Cone-Beam Computed Tomography , Mandible
8.
Rev. cient. odontol ; 9(1): e050, ene.-mar. 2021. ilus
Article in English | LILACS, LIPECS | ID: biblio-1254402

ABSTRACT

Objective: The aim of this study was to update the concepts of the diagnosis of idiopathic osteosclerosis (IO) of the jaws by digital panoramic radiographs and cone beam tomography and describe the impact of this disease on oral and general health. Methods: A search of the main databases of dental medical research was carried out using the search terms "osteosclerosis, panoramic radiography, cone beam computed tomography, jaws". Articles without language restriction until September 30, 2020 were identified. The prevalence and clinical and radiographic characteristics of IO of the jaws were examined in 2D and 3D imaging studies, as well as the interaction during treatments in the various dental specialties. Results: We analyzed the current situation regarding the diagnosis of IO, with an update of the diagnostic criteria used to accurately identify IO in the latest generation imaging studies, as well determine its possible interactions in oral an general health. Conclusions: It is important to have a clear differential diagnosis of IO and be able to distinguish different radiopacities in the maxilla. Accurate reporting and monitoring of the morphometric characteristics are necessary taking into account the impact the presence of IO of the jaws has on future dental treatments. (AU)


Objetivo: El propósito de esta investigación fue actualizar las consideraciones para el diagnóstico de la osteoesclerosis idiopática en radiografías panorámicas digitales y tomografías de haz cónico, a fin de determinar sus implicancias en la salud oral y general. Métodos: Se realizó las pesquisas en las principales bases de datos de investigación médica estomatológica, utilizando las palabras "osteoesclerosis", "radiografía panorámica", "tomografía computarizada de haz cónico" y "mandíbula". Se identificaron artículos sin restricción de idioma, desde las primeras publicaciones hasta el 30 de septiembre del 2020. Se examinaron la prevalencia, las características clínicas y radiográficas en estudios imagenológicos de dos y tres dimensiones, así como su interacción durante los tratamientos realizados en las diversas especialidades estomatológicas. Resultados: La información obtenida nos permitió analizar la situación actual con respecto al diagnóstico de la OI y actualizar los criterios diagnósticos para una identificación certera de la OI en los estudios imagenológicos de última generación, así como sus posibles interacciones en la salud oral y general. Conclusiones: Es importante tener un criterio diagnóstico diferencial claro al distinguir las diferentes radiopacidades como la OI, que se pueden presentar en los maxilares, mediante un registro preciso de sus características morfométricas y seguimiento en el tiempo, teniendo en cuenta su existencia y sus implicancias en los tratamientos dentales a futuro. (AU)


Subject(s)
Humans , Osteosclerosis , Radiography, Panoramic , Diagnosis, Differential , Cone-Beam Computed Tomography , Mandible
9.
Article in English | WPRIM | ID: wpr-879963

ABSTRACT

To evaluate the therapeutic effect of using micro-implant anchorage (MIA) to rotate the functional occlusal plane (FOP) counterclockwise. Forty skeletal class Ⅱ high-angle patients who had completed orthodontic treatment were enrolled, including 20 patients treated with MIA orthodontic system (MIA group) and the other 20 patients treated with traditional sliding straight wire appliance (control group). Cephalometric measurements on the lateral cranial radiographs before and after treatment were performed, all acquired data were statistically analyzed with SPSS 26.0. At the end of treatment, MIA group obtained better effect of FOP and mandibular plane counter-clockwise rotation than the control group. In the MIA group, the average change of FOP-frankfort horizontal plane (FH), FOP-SN and mandibular plane angle (MP-FH) angle was -4.5(-7.3, -3.7)°, (3.3)° and -1.7(-3.0, -0.9)°, respectively. In the control group, the average change of FOP-FH, FOP-SN and MP-FH angle was -0.1(-4.1, 3.0)°, (-0.1±5.1)° and -0.4(-2.4, 0.7)°, respectively. There was significant difference between the change of the two groups (all <0.05). Compared with the traditional sliding straight wire appliance, counterclockwise rotation of FOP can be more effectively reversed by using MIA orthodontic system, and the MP-FH can be reduced as well.


Subject(s)
Cephalometry , Dental Occlusion , Humans , Malocclusion, Angle Class II/therapy , Mandible , Maxilla , Treatment Outcome
10.
Article in English | WPRIM | ID: wpr-878456

ABSTRACT

With a case of mesial impaction of maxillary first and second molar, the mechanical analysis and clinical applications of a self-made helical spring for the uprighting treatment of mesial impacted molars was introduced.


Subject(s)
Humans , Mandible , Maxilla , Molar , Molar, Third , Tooth Movement Techniques , Tooth, Impacted
11.
Article in English | WPRIM | ID: wpr-878454

ABSTRACT

Due to the complicated anatomical structures in the furcation area of multirooted mandibular first molars, dental hygiene is greatly compromised once the furcation is involved in the periodontitis, leading to the unfavorable prognosis of teeth with furcation involvement. A patient came to a dental office with the chief complaint of "mobile mandibular posterior tooth" 27 years ago. The periapical film showed alveolar bone resorption at the root furcation of the right mandibular first molar. Flap surgery and fine supportive therapy were conducted. The patient was diagnosed with "furcation involvement Class Ⅲ" during a revisit three years ago. Satisfactory and healthy periodontal statuses were observed 2, 9, 24, and 33 months after the periodontal flap surgery plus tunneling procedures. A follow-up of 27 years in the present case demonstrated that a favorable prognosis of furcation involvement can be achieved after adequate periodontal treatment.


Subject(s)
Follow-Up Studies , Furcation Defects/surgery , Humans , Mandible , Molar , Periodontitis
12.
Article in Chinese | WPRIM | ID: wpr-878437

ABSTRACT

When design an implant restoration for edentulous patients, many doctors ignore the sufficiency of the interarch distance (vertical distance) or horizontal distance of the patient to accommodate the superstructure and restoration before designing the implant plan. However, the connotation of measuring the interarch distance or horizontal distance has not been clarified in clinical practice. It is often based on visual estimation after operation, and the decision-making path of implant restoration is inverted, resulting in many mistakes regarding the restoration after implantation. The main reason is the lack of standardized paths and practical methods to use before surgery. This article recommended initially establishing a maxillo-mandibular relationship based on natural teeth, old dentures, or new ones and then using the height and horizontal distance or angle of the target restorative space, which was easier to grasp as the measured index. The minimum vertical distance (including the height of the gingival surface and the bone surface) and the horizontal distance (or the angle from the bone or gingival surface to the proposed occlusal plane) should be measured before operation. A decision tree of edentulous jaw restoration guided by the values of the repair space was established based on the measured values. This article clarified the measuring points and planes and thus provided a quantitative relationship basis for the design of implant restoration.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis, Implant-Supported , Humans , Jaw, Edentulous , Mandible , Mouth, Edentulous
13.
Article in Chinese | WPRIM | ID: wpr-878435

ABSTRACT

Secretory carcinoma, a low-grade malignant tumor, occurs mainly in parotid, submandibular gland, and small salivary glands in the mouth. It has not yet been reported in the mandible. Now we report a case occurred in the right mandibular angle of secretory carcinoma, accompanying with its diagnosis, treatment and prognosis.


Subject(s)
Carcinoma , Humans , Mandible , Parotid Gland , Salivary Gland Neoplasms , Salivary Glands
14.
Article in Chinese | WPRIM | ID: wpr-878431

ABSTRACT

OBJECTIVES@#To investigate the differences in the temporomandibular joints (TMJs) between patients with anterior disc displacement with reduction (ADDwR) and asymptomatic subjects by using 3D morphometric measurements.@*METHODS@#A total of 15 patients with ADDwR and 10 asymptomatic subjects were enrolled. Then, 3D models of the maxilla and mandible were reconstructed using MIMICS 20.0. Nine morphologic parameters of TMJs on both sides were measured on the 3D solid model. The differences in the parameters were analyzed between the patients and the asymptomatic subjects and between the left and right sides of each group.@*RESULTS@#The horizontal and coronal condylar angles on the ipsilateral side of the patients were significantly greater than those of the asymptomatic subjects (@*CONCLUSIONS@#ADDwR will increase the condylar angles to be significantly greater than the normal level and decrease SRA and articular spaces to be significantly smaller than the normal level. The condyles will be displaced upward, closer to the fossa.


Subject(s)
Humans , Joint Dislocations , Magnetic Resonance Imaging , Mandible , Mandibular Condyle , Maxilla , Temporomandibular Joint , Temporomandibular Joint Disorders , Tooth
15.
CoDAS ; 33(6): e20200193, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1249634

ABSTRACT

RESUMO Objetivo Investigar a influência da fotobiomodulação associada à terapia miofuncional orofacial (TMO) em pacientes com disfunção temporomandibular muscular (DTM). Método Trata-se de uma pesquisa do tipo ensaio-clínico randomizado e cego, com uma amostra de 11 mulheres com DTM muscular, dividida em dois grupos. O Grupo Experimental (GE) composto por 05 voluntárias submetidas à TMO associada à fotobiomodulação, e o Grupo Controle Positivo (GC) composto por 06 mulheres submetidas à TMO associada à fotobimodulação inativa (placebo). A intervenção foi realizada em 12 sessões: uma avaliação, 10 sessões de fonoterapia associada à fotobiomodulação, e uma reavaliação. Para os desfechos foram consideradas a investigação da percepção de dor, com a Escala Visual Analógica (EVA), a investigação da sensibilidade à palpação com o protocolo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), e a verificação da qualidade de vida (QV) por meio do protocolo Oral Health Impact Profle - short form (OHIP-14). Resultados o GE teve aumento nas medidas dos movimentos de abertura e de protrusão mandibular, e evidenciou melhora na avaliação da QV. Conclusão A TMO quando associada à fotobiomodulação contribuiu no aumento da amplitude dos movimentos mandibulares e com ganhos importantes na percepção da qualidade de vida, e com melhora significativa nos quadros dolorosos das voluntárias com DTM.


ABSTRACT Purpose To investigate the influence of photobiomodulation associated with orofacial myofunctional therapy (OMT) in patients with temporomandibular muscle disorders (TMD). Methods Randomized, blinded trial clinical study with a sample of eleven women with muscle TMD divided into two groups. The experimental group (EG) consisted of five women submitted to orofacial myofunctional therapy associated with photobiomodulation, and the control group (CG) consisted of six women submitted to orofacial myofunctional therapy associated with inactive photobiomodulation (placebo). The intervention was performed in the following twelve sessions: one evaluation, ten speech therapy sessions associated with photobiomodulation, and one reevaluation. For outcomes, investigation on pain perception using the visual analogue scale (VAS), investigation of palpation sensitivity with the research diagnostic criteria for temporomandibular disorders (RDC/TMD), and quality of life (QOL) verification through oral health impact profile - short form (OHIP-14) were considered. Results The EG increased measurements of mandibular movements of opening and protrusion and improved in the evaluation of QOL. Conclusion Orofacial myofunctional therapy, when associated with photobiomodulation, contributed to increase the range of mandibular movements, with important improvements in the perception of quality of life and with significant improvement in the painful conditions of volunteers with TMD.


Subject(s)
Humans , Female , Quality of Life , Temporomandibular Joint Disorders/therapy , Temporomandibular Joint , Myofunctional Therapy , Mandible
16.
J. appl. oral sci ; 29: e20200932, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250188

ABSTRACT

Abstract Third molar removal surgery usually comes accompanied by postoperative discomfort, which could be influenced by the surgical approach chosen. This scoping systematic review aimed at compiling the available evidence focused on the influence of flap design, including envelope flap (EF), triangular flap (TF), and modified triangular flap (MTF), on postoperative pain, swelling, and trismus, as primary outcome measures, and any result mentioning healing promotion or delay, as secondary outcome measure, after mandibular third molar extraction surgery. An electronic search, complemented by a manual search, of articles published from 1999 to 2020 was conducted in the Medline (PubMed), EMBASE and Web of Science databases including human randomized controlled trials, prospective, and retrospective studies with at least 15 patients. The risk of bias of the included studies was assessed either with the Cochrane's Risk of Bias tool or with the Newcastle-Ottawa scale. Every step of the review was performed independently and in duplicate. The initial electronic search recovered 2102 articles. After applying the inclusion criteria, 12 articles were included. For patient's perceived postoperative pain, TF and MTF frequently reported better results than EF. For swelling, the literature is divided, despite a trend favoring EF. For trismus, data showed that its occurrence is mostly associated with the duration of the surgery rather than with the chosen flap. For healing, the limited data is inconclusive. Finally, randomized studies showed a high risk of bias, whereas nonrandomized studies were mostly of good quality and low risk of bias. Although there was no clear consensus regarding the influence of different flap designs for third mandibular molar extraction on postoperative clinical morbidities; the surgeon's experience, estimated surgical difficulty, molar position and orientation, and surg ery duration should be considered when choosing among the different flap designs.


Subject(s)
Humans , Tooth, Impacted/surgery , Trismus/etiology , Pain, Postoperative/etiology , Postoperative Complications , Tooth Extraction/adverse effects , Prospective Studies , Retrospective Studies , Edema , Mandible , Molar , Molar, Third/surgery
17.
J. appl. oral sci ; 29: e20210199, 2021. tab, graf
Article in English | LILACS | ID: biblio-1340100

ABSTRACT

Abstract Objective To assess craniofacial changes from early adulthood to the seventh decade of life in individuals with normal occlusion. Methodology The sample comprised lateral cephalograms of 21 subjects with normal occlusion (11 male, 10 female), taken at 17 (T1) and 61 years of age (T2). Anteroposterior and vertical maxillomandibular relationships, and dentoalveolar and soft tissue changes were analyzed. Interphase comparisons were performed using paired t-tests. Differences between sexes, and subgroups with and without tooth loss were evaluated using t-tests (p<0.05). Results Maxillary and mandibular anterior displacement, and facial and ramus height increased from T1 to T2. Maxillary molars showed significant mesial angulation. Maxillary and mandibular molars, and mandibular incisors developed vertically during the evaluation period. Soft tissue changes included a decrease of the nasolabial angle, upper and lower lip retrusion, decrease of upper lip thickness and increase of the lower lip and soft chin thickness. Maxillary incisor exposure by the upper lip decreased 3.6 mm in 40 years. Males presented counterclockwise rotation of the mandible, whereas females showed mandibular clockwise rotation and backward displacement of the chin. The group with tooth loss showed a greater increase of the posterior facial height and ramus height. Conclusion We observed aging changes in dentoskeletal structures and soft tissue, as well as sexual differences for craniofacial changes during the maturational process. Subjects with multiple tooth losses showed a greater increase in mandibular ramus height.


Subject(s)
Humans , Female , Adolescent , Adult , Face/anatomy & histology , Mandible , Aging , Cephalometry , Incisor , Maxilla
18.
Rev. bras. cancerol ; 67(2): e-02785, 2021.
Article in English | LILACS | ID: biblio-1282759

ABSTRACT

Introduction: The inhibition of osteoclastic activity, associated with different treatment modalities in patients with head and neck cancer, make bones unable to respond to repair processes related to physiological traumas or infection and may result in bone necrosis. The present study aims to report a clinical case of osteoradionecrosis in mandible, and how its sequels were controlled by ozonotherapy. Case report: A 73-year-old female patient with infiltrative ductal breast carcinoma with mandibular metastasis was submitted to chemo and radiotherapy at head and neck region associated with bisphosphonate. Three years later, she was diagnosed with hemimandibular osteoradionecrosis that exhibited communication with oral cavity and with a chronic, suppurative and persistent associated infection. It was applied adjuvant therapy with ozone through the cutaneous fistula and the exposed and necrotic bone. Additionally, non-vital bone debridement was proceeded in two surgical steps. The patient is after a 1-year follow-up non-symptomatic. Conclusion: It is supposed that ozonotherapy, due to its antibacterial and immunoregulatory mechanism of action, was an important therapeutic agent for improving the patient's quality of life.


Introdução: A inibição da atividade osteoclástica, associada a diversas modalidades de tratamento utilizadas em pacientes com câncer de cabeça e pescoço, torna o osso incapaz de responder aos processos de reparo relacionados a traumas fisiológicos ou à infecção, e pode resultar em necrose óssea. O presente estudo tem como objetivo relatar um caso clínico de osteonecrose em mandíbula como consequência do uso de bisfosfonato associado à quimioterapia e à radioterapia para tratamento de câncer de mama com metástase para mandíbula, tendo suas sequelas controladas por meio do uso da ozonioterapia. Relato do caso: Paciente do sexo feminino, 73 anos, com história de carcinoma ductal infiltrante de mama com metástase óssea em mandíbula, a qual foi submetida ao tratamento de quimioterapia e radioterapia em região de cabeça e pescoço; três anos depois, foi diagnosticada com osteonecrose da hemimandíbula direita com exposição completa para a cavidade bucal e infecção crônica, supurativa e persistente. Foi realizada terapia adjuvante com aplicação de ozônio nas fístulas cutâneas e no remanescente ósseo exposto e necrosado, além do desbridamento dos sequestros ósseos em duas etapas cirúrgicas. Paciente encontra-se em acompanhamento há 1 ano, sem sintomatologia associada. Conclusão: Observou-se que a ozonioterapia, em razão da sua ação antibacteriana e cicatrizante, foi um importante agente terapêutico para a melhora da qualidade de vida da paciente.


Introducción: La inhibición de la actividad osteoclástica, asociada con las diversas modalidades de tratamiento utilizadas por los pacientes con cáncer de cabeza y cuello, hace que el hueso no pueda responder a los procesos de reparación relacionados con traumas o infecciones fisiológicas y puede provocar necrosis ósea. El presente estudio tiene como objetivo informar un caso clínico de osteonecrosis mandibular como consecuencia del uso de bisfosfonato asociado con quimioterapia y radioterapia para tartar el cáncer de mama con mandíbula metastásica, controlando sus secuelas mediante el uso de la terapia con ozono. Relato del caso: Paciente de 73 años con antecedentes de carcinoma ductal mamario infiltrante con metástasis en la mandíbula ósea fue sometida a quimioterapia y radioterapia en la región de la cabeza y el cuello. Tres años después, le diagnostica con osteonecrosis hemimandibular derecha con exposición completa a la cavidad oral e infección crónica, supurativa y persistente. La terapia adyuvante se realizó con la aplicación de ozono en las fístulas cutáneas y en el remanente óseo expuesto y necrótico, además del desbridamiento de los secuestros óseos en dos etapas quirúrgicas. El paciente ha estado bajo seguimiento durante 1 años in síntomas asociados. Conclusión: Debido a su acción antibacteriana y curativa, la ozonioterapia fue un importante agente terapéutico para mejorar la calidad de vida del paciente.


Subject(s)
Humans , Female , Aged , Ozone/therapeutic use , Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnosis , Bisphosphonate-Associated Osteonecrosis of the Jaw/therapy , Breast Neoplasms , Mandibular Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast , Bisphosphonate-Associated Osteonecrosis of the Jaw/radiotherapy , Mandible/pathology
19.
Dental press j. orthod. (Impr.) ; 26(2): e2119378, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1249704

ABSTRACT

ABSTRACT Objective: To determine whether separating the alignment and leveling phases can reduce proclination of the mandibular incisors. Methods: Eligibility criteria included Class I subjects with an irregularity index of 3-5 mm, 3-4 mm curve-of-Spee (COS), and non-extraction treatment. Thirty adults were randomly allocated into two groups: (1) Control group was leveled and aligned simultaneously with flat archwires progressively to 0.016x0.022-in stainless-steel; (2) Experimental group was aligned first with 0.014-in-superelastic NiTi with mild accentuated COS, then leveled using 0.016x0.022-in beta-titanium accentuated COS archwires and gradually reduced the curve until flat. Mandibular incisor position and inclination were evaluated by cephalometric analysis. COS and irregularity index were evaluated in study models. Assessment was conducted twice after 0.016-in NiTi and after 0.016x0.022-in stainless-steel archwire placements. Dental changes from cephalograms and models were compared within group using paired t-test and between groups using independent t-test. Results: Control group: Round-wire-phase, mandibular incisors tipped labially (4.38° and 1 mm) with intrusion (-1.13 mm); Rectangular-wire-phase, mandibular incisors further intruded and proclined (-0.63 mm and 1.38°). Experimental group: During aligning with round accentuated COS archwires, mandibular incisors tipped very slightly labially (0.75° and 0.50 mm) with no significant intrusion; during leveling with rectangular archwires, incisors majorly intruded (1.75 mm) with slight proclination (1.81°). The experimental group had significant less incisor proclination (control: 5.76°, experimental: 2.56°) with more incisor intrusion (control: -1.75 mm, experimental: -2.13 mm). The COS in experimental group showed significant greater reduction (-2.88 mm) than that of the control group (-1.69 mm). Conclusion: In control group, mandibular incisor proclination was markedly observed in round archwires, with further proclination caused by rectangular archwires. In experimental group, minimal proclination was exhibited when accentuated COS round archwires were used for aligning. Leveling with rectangular archwires caused less proclination with more COS reduction.


RESUMO Objetivo: Avaliar se separar os estágios de alinhamento e nivelamento reduz a projeção dos incisivos inferiores. Métodos: Os critérios de inclusão foram indivíduos Classe I com índice de irregularidade de 3-5mm, Curva de Spee (CS) de 3-4mm e tratamento sem extrações. Trinta adultos foram alocados aleatoriamente em dois grupos: o Grupo Controle (1) foi simultaneamente alinhado e nivelado com arcos planos progressivamente até atingir o 0,016" x 0,022" de aço inoxidável; o Grupo Experimental (2) foi inicialmente alinhado com arcos superelásticos NiTi 0,014" com CS levemente aumentada, em seguida nivelado com arcos de beta-titânio 0,016" x 0,022" com CS acentuada, que foi gradualmente reduzida até ficar plana. A posição e inclinação dos incisivos inferiores foram avaliadas por meio de análise cefalométrica. A CS e o índice de irregularidade foram avaliados por meio de modelos de estudo. A avaliação foi realizada duas vezes, sendo após a inserção dos arcos NiTi 0,016" e dos arcos 0,016" x 0,022" de aço. As mudanças dentárias visualizadas nos cefalogramas e nos modelos foram comparadas dentro dos grupos utilizando teste t pareado e entre os grupos utilizando o teste t independente. Resultados: Grupo Controle: estágio de arco redondo: os incisivos inferiores se inclinaram vestibularmente (4.38° e 1 mm) e intruíram (-1,13mm); estágio de arco retangular: os incisivos inferiores intruíram e se projetaram adicionalmente (-0.63mm e 1,38°). Grupo Experimental: Durante o alinhamento com arcos redondos e CS acentuada, os incisivos inferiores se inclinaram levemente para vestibular (0,75° e 0,50mm), sem intrusão significativa; durante o nivelamento com arcos retangulares, os incisivos, em sua maioria, intruíram (1,75mm), com uma leve projeção (1,81°). O grupo experimental apresentou projeção dos incisivos significativamente menor (controle: 5,76°; experimental: 2,56°), com maior intrusão dos incisivos (controle: -1,75mm; experimental: -2,13mm). A CS no Grupo Experimental apresentou redução significativamente maior (-2,88 mm) do que no grupo controle (-1,69 mm). Conclusão: No Grupo Controle, foi observada de forma notória a projeção dos incisivos inferiores nos arcos redondos, com projeção adicional causada pelos arcos retangulares. No Grupo Experimental, foi observada uma projeção mínima quando foram utilizados arcos redondos com CS acentuada para alinhamento. O nivelamento com arcos retangulares causou menos projeção com maior redução da CS.


Subject(s)
Orthodontic Wires , Stainless Steel , Tooth Movement Techniques , Cephalometry , Incisor , Mandible
20.
Dental press j. orthod. (Impr.) ; 26(1): e21ins1, 2021. graf
Article in English | LILACS, BBO | ID: biblio-1154067

ABSTRACT

ABSTRACT Introduction: The third molars are forgotten because they are the last in the dental arch, they do not directly influence the smile and they appear only in adolescence, when they do. Objectives: 1) to provide the clinician with a "checklist" to assess and diagnose changes to be screened in the third molar region in new patients; 2) to reveal the importance of not discharging the patient submitted to any dental treatment without first analyzing the third molars region clinically and on imaging examinations, since many diseases are associated to them. Result: A list of 10 situations that cover all diagnostic possibilities involving the third molars is presented. Conclusion: Adopting this protocol is a matter of habit, since the need is fundamental. The next professional assisting your patient may ask: "Did he not request examinations for the third molars?".


RESUMO Introdução: Os terceiros molares são esquecidos por serem os últimos dentes na arcada dentária, por não influenciarem diretamente no sorriso e por aparecerem apenas na adolescência - quando aparecem. Objetivos: 1) Fornecer ao clínico um checklist de conferência e diagnóstico de alterações a serem checadas na região dos terceiros molares em novos pacientes; e 2) Destacar a importância de não dar alta ao paciente submetido a qualquer tratamento odontológico sem antes analisar, clínica e imagiologicamente, a região dos terceiros molares, pois muitas doenças estão a eles associadas. Resultado: Criou-se uma lista de 10 situações que englobam todas as possibilidades diagnósticas envolvendo os terceiros molares. Conclusão: Adotar esse protocolo é uma questão de hábito, pois a necessidade é imperiosa. O próximo profissional a atender o seu paciente vai perguntar: "Ele não solicitou exames para os terceiros molares?".


Subject(s)
Humans , Male , Adolescent , Mandible , Molar, Third , Pericoronitis , Tooth Resorption , Tooth, Unerupted , Dentigerous Cyst , Molar, Third/diagnostic imaging
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