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1.
Rev. cuba. estomatol ; 58(3): e3073, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347440

ABSTRACT

Introducción: El posicionamiento de implantes dentales simultáneos a la elevación de seno maxilar en rebordes con reabsorción severa < 4mm es una técnica quirúrgica sensible que disminuye los tiempos operatorios. Sin embargo, es considerada cirujano-dependiente y en caso de no darse el manejo adecuado puede generar complicaciones. Objetivo: Evaluar, luego de 24 meses de carga funcional, la estabilidad de los tejidos periimplantares del implante dental que se posicionó simultáneo a la elevación de seno maxilar en un reborde alveolar con reabsorción ósea severa < 4mm. Presentación de caso: Paciente masculino de 62 años con reabsorción ósea severa en zona de primer molar superior derecho. Luego de analizar los medios diagnósticos y la evidencia científica; se logró posicionar un implante dental simultáneo a la elevación de seno maxilar técnica de ventana lateral; cuatro meses después se realizó la segunda fase quirúrgica y finalmente fue rehabilitado con una corona en zirconio. Tuvo un periodo de seguimiento de 24 meses. Conclusiones: Un buen diagnóstico, manejo quirúrgico adecuado, la colaboración del paciente y los controles periódicos, resultan en una técnica segura, que proporciona estabilidad de los tejidos periimplantares(AU)


Introduction: Dental implant placement simultaneous with maxillary sinus lifting on ridges with severe resorption < 4 mm is a sensitive surgical technique that shortens the duration of interventions. However, it is considered to be operator dependent, and may cause complications if not appropriately managed. Objective: After 24 months of functional load, evaluate the stability of the peri-implant tissue of a dental implant placed simultaneously with maxillary sinus lifting on an alveolar ridge with severe bone resorption. Case presentation: A case is presented of a male 62-year-old patient with severe bone resorption in the area of the first upper right molar. Analysis of the diagnostic means and scientific evidence involved led to placement of a dental implant simultaneous with maxillary sinus lifting (lateral window technique). The second surgical stage was performed four months later. A zirconium crown was finally placed, and a 24-month follow-up period was started. Conclusions: With a good diagnosis, appropriate surgical management, patient cooperation and periodic controls, it is a safe technique that ensures the stability of peri-implant tissue(AU)


Subject(s)
Humans , Male , Middle Aged , Bone Resorption/diagnosis , Dental Implants/adverse effects , Maxillary Sinus/surgery , Aftercare
2.
Rev. Soc. Odontol. La Plata ; 31(60): 23-26, jul. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284468

ABSTRACT

Las neoplasias malignas de la cavidad oral en gran medida (90%) consisten en carcinoma de células escamosas que surgen de la mucosa de revestimiento. El 10% restantes de neoplasias malignas orales de un grupo heterogéneo de tumores de diferente etiología. Presentamos dos casos de patología oncohematológica: Mieloma Múltiple (AU)


Malignant neoplasms of the oral cavity largely (90%) consist of squamous cell carcinoma arising from the lining mucosa. e remaining 10% of oral malignancies from a heterogeneous group of tumors of different etiology. We present two cases of oncohematological pathology: Multiple Myeloma (AU)


Subject(s)
Humans , Male , Middle Aged , Plasmacytoma/diagnosis , Plasmacytoma/pathology , Plasmacytoma/diagnostic imaging , Mouth Neoplasms/diagnosis , Radiotherapy , Biopsy/methods , Tomography, X-Ray Computed , Oral Surgical Procedures/methods , Diphosphonates/therapeutic use , Maxillary Sinus/surgery , Multiple Myeloma
3.
Rev. cir. traumatol. buco-maxilo-fac ; 21(1): 40-43, jan.-mar. 2021. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1252437

ABSTRACT

Introducão: O granuloma central de células gigantes é uma lesão intraóssea incomum com predileção pela região mandibular e sexo feminino. Classifica-se como agressivo ou não agressivo de acordo com seu comportamento clínico. O tratamento de eleição para este tipo de lesão varia desde modalidades não cirúrgicas até a ressecção óssea. Relato de caso: Paciente do sexo masculino, 21 anos, com lesão osteolítica agressiva em região de parede anterior de seio maxilar direito, tratada com excisão cirúrgica e reconstrução imediata com malha de titânio sem interferências estéticas ou funcionais no pósoperatório. Considerações finais: O granuloma central de células gigantes tem apresentação clínica diversa e o tratamento deve levar em consideração as características da lesão em cada paciente, em lesões agressivas, o manejo cirúrgico é sempre o indicado... (AU)


Introduction: Central giant cell granuloma is an uncommon intraosseous lesion with a predilection for the mandibular anterior region and females. It is classified as aggressive or non-aggressive according to its clinical behavior. The treatment of choice for this type of pathology ranges from non-surgical modalities to bone resection. Case report: Male patient, 21 years old with an aggressive osteolytic lesion in the anterior wall of the right maxillary sinus, treated with surgical excision and immediate reconstruction with titanium mesh without aesthetic or functional disturbances in the postoperative period. Final considerations: The Central giant cell granuloma may have differents clinical presentations and treatment must take into account the characteristics of the lesion in each patient, in aggressive lesions, surgical management is always indicated... (AU)


Subject(s)
Humans , Female , Adult , Periapical Granuloma , Giant Cells , Maxillary Sinus/surgery
4.
Article in English | WPRIM | ID: wpr-887748

ABSTRACT

The tilted implantation technique is characterized by placing the implant at an angle of more than 15° and less than 45° from the horizontal plane. This technique can avoid damaging the maxillary sinus, inferior alveolar nerve, nasal base, and other anatomical structures when the height of the upper and lower jaw available bone is insufficient, to maximize the use of available bone and avoid a large range of bone increment. The tilted implantation technique can reduce the trauma of the surgery, increase the possibility of immediate restoration and shorten the treatment cycle, which has been widely used clinically. In this review, the scope of application, design elements, design scheme and complications of the tilted implantation technique for edentulous patients will be described.


Subject(s)
Alveolar Bone Loss , Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Follow-Up Studies , Humans , Jaw, Edentulous/surgery , Mandible , Maxilla/surgery , Maxillary Sinus/surgery , Mouth, Edentulous/surgery
5.
J. appl. oral sci ; 29: e20200568, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143153

ABSTRACT

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Subject(s)
Humans , Osteogenesis , Dental Implants , Bone Transplantation , Bone Substitutes , Sinus Floor Augmentation , Dental Implantation, Endosseous , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
6.
Int. j. odontostomatol. (Print) ; 14(4): 586-589, dic. 2020. graf
Article in English | LILACS | ID: biblio-1134543

ABSTRACT

ABSTRACT: Our objective was report an extremely rare case of isolated meningitis and suppurative dacrioadenitis as consequences of odontogenic sinusitis. We describe the diagnostic tools including imaging and culture, as well as surgical treatment and follow-up. Our final diagnosis was odontogenic sinusitis caused by Streptococcus Anginosus complicated by isolated meningitis and lacrimal gland abscess. Urgent surgical treatment to restore the paranasal sinuses and drainage of the lacrimal gland was performed. Culture from purulent material collected from maxillary sinus indicated the targeted therapy. Clinical assessment and imaging obtained 20 days after surgery demonstrated successful results. This case emphasizes the importance of evaluating intracranial complications of rinosinusitis, the need to search for a dental infection when a maxillary sinusitis is encountered, the key role of a thorough diagnostic workup in order to plan a comprehensive and effective surgical treatment, as well as targeted medical therapy.


RESUMEN: En este estudio se informa un caso extremadamente raro de meningitis aislada y dacrioadenitis supurativa, como consecuencia de sinusitis odontogénica. Describimos las herramientas de diagnóstico que incluyen imágenes y cultivo, como también el tratamiento quirúrgico y el seguimiento. El diagnóstico final fue de sinusitis odontogénica causada por estreptococo anginoso complicado por una meningitis aislada y el absceso de la glándula lagrimal. Se realizó un tratamiento quirúrgico de urgencia para restaurar los senos paranasales y drenar la glándula lagrimal. Se determinó el tratamiento de acuerdo a los resultados de cultivo del seno maxilar. La evaluación clínica y las imágenes obtenidas 20 días después de la cirugía demostraron resultados exitosos. Es importante la evaluación de las complicaciones intracraneales de la rinosinusitis además de la necesidad de considerar una infección dental frente a una sinusitis maxilar. Por otra parte, es clave una evaluación exhaustiva de diagnóstico para planificar un tratamiento quirúrgico completo y efectivo, así como el tratamiento médico.


Subject(s)
Humans , Male , Adolescent , Streptococcal Infections , Maxillary Sinusitis/diagnostic imaging , Streptococcus anginosus , Abscess/microbiology , Tomography, X-Ray Computed/methods , Maxillary Sinusitis/surgery , Dacryocystitis/microbiology , Focal Infection, Dental/complications , Focal Infection, Dental/therapy , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging , Meningitis
8.
Rev. bras. anestesiol ; 70(3): 302-305, May-June 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1137181

ABSTRACT

Abstract Background and objectives: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic cardiomyopathy characterized by potentially lethal ventricular tachycardia. Here we describe a patient with ARVC and an Implantable Cardioverter Defibrillator (ICD) in whom maxillary sinus surgery was performed under general anesthesia. Case report: The patient was a 59 year-old man who was scheduled to undergo maxillary sinus surgery under general anesthesia. He had been diagnosed as having ARVC 15 years earlier and had undergone implantation of an ICD in the same year. Electrocardiography showed an epsilon wave in leads II, aVR, and V1-V3. Cardiac function was within normal range on transthoracic echocardiography. The ICD was temporarily deactivated after the patient arrived in the operating room and an intravenous line was secured. An external defibrillator was kept on hand for immediate defibrillation if any electrocardiographic abnormality was detected. Remifentanil 0.3 µg/kg/min, fentanyl 0.1 mg, propofol 154 mg, and rocuronium 46 mg were administered for induction of anesthesia. Tracheal intubation was performed orally. Anesthesia was maintained oxygen 1.0 L.min−1, air 2.0 L.min−1, propofol 5.0-7.0 mg.kg−1.h−1, and remifentanil 0.1-0.25 µg.kg−1.min−1. The surgery was completed as scheduled and the ICD was reactivated. The patient was then extubated after administration of sugammadex 200 mg. Conclusion: We report the successful management of anesthesia without lethal arrhythmia in a patient with ARVC and an ICD. An adequate amount of analgesia should be administered during general anesthesia to maintain adequate anesthetic depth and to avoid stress and pain.


Resumo Introdução e objetivo: A Cardiomiopatia Arritmogênica do Ventrículo Direito (CAVD) é uma cardiomiopatia genética caracterizada por taquicardia ventricular potencialmente letal. Descrevemos um paciente com CAVD com Cardioversor Desfibrilador Implantável (CDI) submetido a anestesia geral para cirurgia de seio maxilar. Relato do caso: Paciente masculino, 59 anos, a ser submetido a anestesia geral para cirurgia de seio maxilar. O paciente foi diagnosticado com CAVD há 15 anos, momento em que foi submetido a implante de CDI. A eletrocardiografia mostrou onda épsilon nas derivações II, aVR e V1-V3. O ecocardiograma transtorácico revelou função cardíaca normal. Após a entrada do paciente na sala de cirurgia, o CDI foi temporariamente desativado e uma via intravenosa foi instalada. Um desfibrilador externo foi mantido próximo ao paciente caso fosse detectada alguma anormalidade eletrocardiográfica que indicasse desfibrilação do paciente. Foram administrados 0,3 mg/kg/min de remifentanil, 0,1 mg de fentanil, 154 mg de propofol e 46 mg de rocurônio para indução da anestesia. A intubação traqueal foi realizada por via oral. A anestesia foi mantida com 1 L/min de oxigênio, 2 L/min de ar, 5-7 mg/kg/h de propofol e 0,1-0,25 µg/kg/min de remifentanil. O procedimento cirúrgico proposto foi concluído e o CDI foi reativado. O tubo traqueal foi retirado após administração de 200 mg de sugamadex. Conclusão: Descrevemos técnica de anestesia bem sucedida sem arritmia letal em paciente com CAVD e CDI. Analgesia adequada deve ser administrada durante a anestesia geral para manter profundidade anestésica correta e evitar estresse e dor.


Subject(s)
Humans , Male , Defibrillators, Implantable , Arrhythmogenic Right Ventricular Dysplasia/complications , Anesthesia , Maxillary Sinus/surgery , Middle Aged
9.
Odovtos (En línea) ; 22(1): 61-70, ene.-abr. 2020. graf
Article in Spanish | LILACS, BBO | ID: biblio-1091506

ABSTRACT

RESUMEN La elevación de piso de seno maxilar ha sido sumamente documentada en implantología como una técnica segura y predecible en el procedimiento de ganancia vertical ósea, en el maxilar posterior atrófico. Sin embargo, conjuntamente se han reportado complicaciones en este procedimiento, las cuales podrían poner en peligro los resultados de la regeneración, y por consiguiente la colocación del implante. El propósito de esta revisión de literatura es exponer y analizar diferentes complicaciones que pueden presentarse en la elevación de piso de seno maxilar.


ABSTRACT Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.


Subject(s)
Dental Implants/adverse effects , Sinus Floor Augmentation/adverse effects , Maxillary Sinus/surgery , Maxillary Nerve/injuries , Nasal Mucosa/injuries
10.
Int. j. odontostomatol. (Print) ; 14(3): 380-386, 2020. tab
Article in Spanish | LILACS | ID: biblio-1114911

ABSTRACT

El objetivo de nuestro estudio de tipo longitudinal prospectivo simple de medidas repetidas fue determinar la variación del flujo aéreo nasal medido con un flujómetro nasal portátil, en niños entre 6 y 14 años de edad con compresión maxilar, después de la expansión rápida del maxilar (ERM). El trabajo constó de 16 niños diagnosticados con compresión maxilar y a quienes se les indicó una disyunción maxilar rápida. Los valores de la cantidad de expansión fueron registrados y la medición del flujo inspiratorio nasal máximo (FINM) se realizó antes de la ERM (T1), inmediatamente después (T2) y al cabo de 3 meses del período de retención (T3), manteniendo las mismas condiciones iniciales. El valor máximo y el promedio de las mediciones del FINM en T2 fueron significativamente mayores que en T1 (p-valor, 0,0056) y (p-valor 0,0062) respectivamente, mientras que entre T2 y T3 no existieron tales diferencias (p-valor: 0,3021) y (p-valor: 0,3315) respectivamente. Existe un aumento significativo en los valores del FINM inmediatamente después de la expansión rápida del maxilar que se mantienen en un período de tiempo de 3 meses.


The objective of our simple prospective longitudinal type study of repeated measures, was to determine the variation of nasal airflow measured with a portable nasal flow meter, in children between 6 and 14 years of age with maxillary compression, after rapid maxillary expansion (RME). The study consisted of 16 children diagnosed with maxillary compression and those who were identified with a rapid maxillary disjunction. The values of the amount of expansion were recorded and the measurement of the peak nasal inspiratory flow (PNIF) was performed before the ERM (T1), immediately after (T2) and after 3 months of retention period (T3), maintaining the same initial conditions. Results: the value maximum and average measurements of FINM in T2 were greater than in T1 (p-value, 0.0056) and (p-value 0.0062) respectively, while between T2 and T3 there were no differences (p value: 0.3021) and (p value: 0.3315) respectively. There is a significant increase in PNIF values immediately after rapid maxillary expansion that is in a period of 3 months.


Subject(s)
Humans , Male , Female , Child , Adolescent , Inhalation/physiology , Nose/physiology , Malocclusion/therapy , Maxillary Sinus/surgery , Nasal Obstruction/physiopathology , Prospective Studies , Longitudinal Studies , Palatal Expansion Technique , Flowmeters
11.
Article in Chinese | WPRIM | ID: wpr-878392

ABSTRACT

OBJECTIVE@#To explore the changes in bone height of the maxillary sinus floor at different sinus ridge heights after transcrestal sinus floor elevation (tSFE) with the simultaneous implantation of short implants.@*METHODS@#A total of 74 Bicon short implants were implanted into 37 patients during the same period of maxillary sinus elevation. The residual bone height (RBH)<4 mm group has 43 sites, and the RBH≥4 mm group has 31 sites. After 5 years of follow-up observation, the implant survival rate and the change in bone height achieved in the maxillary sinus over time were measured and analyzed via clinical examination and X-ray imaging.@*RESULTS@#In the 74 implantation sites, the elevation height of the sinus floor was (6.64±1.32) mm and the bone height of the sinus floor was (3.35±1.29) mm 5 years after loading. No statistical difference was observed in the bone resorption of the implant neck between the RBH<4 mm and RBH≥4 mm groups. Meanwhile, a statistical difference was noted in the bone height obtained in the maxillary sinus between the two groups.@*CONCLUSIONS@#When RBH in the maxillary posterior tooth area was <4 mm, the simultaneous implantation of Bicon short implants with tSFE can achieve a high implant survival rate and bone gain in the maxillary sinus, but does not increase the absorption of the alveolar ridge bone.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Humans , Maxilla , Maxillary Sinus/surgery , Retrospective Studies , Sinus Floor Augmentation , Treatment Outcome
12.
Article in Chinese | WPRIM | ID: wpr-878389

ABSTRACT

OBJECTIVE@#To investigate the effect of three anatomical parameters (maxillary sinus width, maxillary sinus angle, and residual bone height) on the outcomes of transcrestal sinus lift with simultaneous implant placement.@*METHODS@#A total of 60 maxillary sinuses in 42 patients were included in this study. All patients were treated with transcrestal sinus lift procedure associated with simultaneous implant placement using a composite graft material of autogenous bone and Bio-Oss. For each patient, beam computed tomography (CBCT) scans were performed preoperatively, immediately after surgery, and 6 months after surgery. The parameters were measured on the preoperative and postoperative CBCT images. The correlation of three anatomical parameters with graft resorption was analyzed using Pearson's correlation test.@*RESULTS@#The average residual bone height was (4.46±1.55) mm. The average width of maxillary sinus was (13.86±2.71) mm. The average sinus angle was 78.09°±10.27°. A significant positive correlation was observed between maxillary sinus width and graft resorption (P<0.01). A positive association was also found between sinus angle and graft resorption (P<0.01).@*CONCLUSIONS@#The findings show that graft bone resorption in elevated sinus has a positive correlation with the sinus width and sinus angle.


Subject(s)
Bone Resorption , Dental Implantation, Endosseous , Dental Implants , Humans , Maxillary Sinus/surgery , Sinus Floor Augmentation , Tomography, X-Ray Computed
13.
J. appl. oral sci ; 28: e20200568, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143146

ABSTRACT

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Subject(s)
Humans , Osteogenesis , Dental Implants , Bone Transplantation , Bone Substitutes , Sinus Floor Augmentation , Dental Implantation, Endosseous , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
14.
Braz. j. otorhinolaryngol. (Impr.) ; 85(6): 698-704, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1055503

ABSTRACT

Abstract Introduction: Sinonasal organising haematoma is a recently described, rare, benign inflammatory condition, which closely resembles malignancy in its clinical presentation. Objective: To describe the clinical features of organising haematoma and to review the evolution of surgical options successfully used. Methods: A retrospective review of charts of all patients with a histopathological diagnosis of sinonasal organising haematoma was performed. Results: Six (60%) of the 10 patients were male with a mean age of 47.4 years. All patients had unilateral disease with recurrent epistaxis as the presenting symptom. Maxillary sinus was the most commonly involved sinus. There was no history of trauma in any of the patients. Hypertension (80%) was the most commonly associated comorbidity. Contrast-enhanced CT scan of the paranasal sinuses showed heterogeneous sinus opacification with/without bone erosion. Histopathological examination was diagnostic. Complete endoscopic excision was done in all patients resulting in resolution of the disease. Conclusion: Awareness of this relatively new clinical entity and its evaluation and treatment is important for otolaryngologists, maxillofacial surgeons and pathologists alike. Despite the clinical picture of malignancy, histopathological features of benign disease can safely dispel such a diagnosis.


Resumo Introdução: Hematoma nasossinusal em organização é uma condição inflamatória benigna rara, recentemente descrita, que se assemelha a lesões malignas em sua apresentação clínica. Objetivo: Descrever as características clínicas do hematoma em organização e analisar a evolução das opções cirúrgicas usadas com sucesso. Método: Foi feita a revisão retrospectiva dos prontuários de todos os pacientes com diagnóstico histopatológico de hematoma nasossinusal em organização. Resultados: Seis (60%) dos 10 pacientes eram do sexo masculino, com média de 47,4 anos. Todos os pacientes apresentavam doença unilateral com epistaxe recorrente como sintoma de apresentação. O seio maxilar era o mais comumente afetado. Não havia histórico de trauma em qualquer dos pacientes. Hipertensão (80%) foi a comorbidade mais comumente associada. A tomografia computadorizada dos seios paranasais com contraste mostrou opacificação heterogênea do seio com/sem erosão óssea. O exame histopatológico foi diagnóstico. A excisão endoscópica completa foi feita em todos os pacientes, resultou na resolução da doença. Conclusão: A conscientização a respeito dessa entidade clínica relativamente nova e sua avaliação e tratamento são importantes para os otorrinolaringologistas, cirurgiões buco-maxilo-faciais e patologistas. Apesar do quadro clínico de malignidade, as características histopatológicas da doença benigna podem descartar com segurança esse diagnóstico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Paranasal Sinus Neoplasms/pathology , Nose Neoplasms/pathology , Hematoma/pathology , Paranasal Sinus Neoplasms/surgery , Paranasal Sinus Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Nasal Obstruction/diagnostic imaging , Epistaxis/diagnostic imaging , Nose Neoplasms/surgery , Nose Neoplasms/diagnostic imaging , Retrospective Studies , Hematoma/surgery , Hematoma/diagnostic imaging , Maxillary Sinus/surgery
15.
Rev. bras. oftalmol ; 78(3): 188-191, May-June 2019. graf
Article in English | LILACS | ID: biblio-1013676

ABSTRACT

ABSTRACT Posterior fractures of the orbital floor are challenging, since an incomplete visualization of the defect through conventional surgical accesses may compromise the surgical outcome. The use of the endoscope as an auxiliary method during orbital reconstructions may be considered as a tool of considerable importance, mainly due to the visualization of the whole extension of fracture and adaptation of meshes or bone grafts. This study aims to report a clinical case of a patient diagnosed with extensive blowout fracture showing diplopy, enophthalmos, and ophthalmoplegia in supraversion, who underwent a subciliary approach combined with transantral video assisted surgery. There were no intercurrences on the procedure. Currently, patient has 1 year of follow up, with reestablished orbital function and architecture.


RESUMO As fraturas posteriores do assoalho orbital são desafiadoras, visto que a incompleta visualização do defeito por meio dos acessos cirúrgicos convencionais poderá comprometer o resultado cirúrgico. O uso do endoscópio como método auxiliar durante as reconstruções orbitais pode ser considerado uma ferramenta de grande importância principalmente para visualização de toda a extensão da fratura e adaptação das malhas ou enxertos ósseos. Este trabalho tem como objetivo relatar um caso clínico de um paciente diagnosticado com uma extensa fratura blowout apresentando clinicamente diplopia, enoftalmo e oftalmoplegia em supraversão, o qual foi submetido a tratamento através da abordagem subciliar combinada com a cirurgia vídeo-assistida transantral. O procedimento foi realizado sem intercorrências, estando o paciente com 1 ano de acompanhamento, com função e arquitetura orbital restabelecidos.


Subject(s)
Humans , Male , Adult , Orbital Fractures/surgery , Reconstructive Surgical Procedures/methods , Video-Assisted Surgery/methods , Endoscopy/methods , Orbital Fractures/diagnostic imaging , Prostheses and Implants , Surgical Mesh , Titanium , Tomography, X-Ray Computed , Diplopia , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
17.
ImplantNewsPerio ; 3(3): 463-472, mai.-jun. 2018. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-905505

ABSTRACT

Objetivos: avaliar o aumento ósseo com um biomaterial aloplástico no seio maxilar. Materiais e métodos: foram selecionados seis pacientes, totalizando nove seios maxilares, que realizaram cirurgia de reconstrução óssea em região posterior de maxila. Todas as cirurgias de elevação do seio maxilar traumáticas utilizaram o biomaterial sintético Straumann Bone Ceramic. Os pacientes realizaram uma tomografia pré-operatória, e uma após seis meses do ato cirúrgico, em que foram obtidas medidas lineares horizontais e verticais na imagem panorâmica da tomografia e medidas lineares horizontais e verticais no corte sagital da tomografia, ambas no centro das imagens. Resultados: identificou-se 100% de sucesso nas cirurgias de elevação de seio maxilar, em que verticalmente obteve-se diferença estatística significante (p < 0,05) e horizontalmente sem significância estatística (p > 0,05). Em média, obteve-se ganho vertical ósseo de 14,73 mm na imagem panorâmica e 16,05 mm no corte sagital, e espessura 20,82 mm na imagem panorâmica e 11,37 mm no corte sagital. Conclusão: o biomaterial sintético Straumann Bone Ceramic demonstrou-se excelente para a reconstrução de seios maxilares.


Objectives: to evaluate bone augmentation using an alloplastic material. Material and methods: six patients (9 maxillary sinuses) underwent surgical bone reconstruction at the posterior maxillary region. All surgeries were performed after atraumatic sinus membrane lifting and packing of Straumann BoneCeramic. Also, CBCTs were made at baseline and 6 months later to generate horizontal and vertical measurements at the panoramic and sagittal view modes both at the center of the images. Results: operative procedures were considered 100% successful. At the vertical dimension, statistical differences were obtained (p<0.05) but no significant differences were seen in the horizontal dimension (p>0.05). Overall, the vertical mean gain was 14.73mm at the panoramic and 16.05mm at the sagittal sections, being the observed thicknesses of 20.82mm and 11.37mm, respectively. Conclusion: the Straumann BoneCeramic biomaterial provided excellent results for maxillary sinus reconstructions.


Subject(s)
Humans , Biocompatible Materials/therapeutic use , Bone Regeneration , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Cone-Beam Computed Tomography , Maxillary Sinus/surgery , Sinus Floor Augmentation
18.
Braz. j. otorhinolaryngol. (Impr.) ; 84(2): 212-219, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-889376

ABSTRACT

Abstract Introduction Traditional Caldwell-Luc approach needs modifications for odontogenic cysts intruding into the maxillary sinus, to preserve sinus mucosa and bony contour. Recently, digital technology has been widely applied to the field of maxillofacial surgery, guiding the surgical plan and improving its accuracy. Objective This study attempted to present and evaluate the functional surgery of odontogenic cysts intruding into the maxillary sinus using a computer-assisted pre-surgical design. Methods Consecutive patients with odontogenic cysts intruding into the posterior part of the maxillary sinus were enrolled. Method I "Bony wall reimplantation method" was performed for large lesions exceeding the zygomatic alveolar crest but without apparent bone destruction of the anterior wall of the sinus, while Method II "bone removal method" was more convenient for small lesions near to the zygomatic alveolar crest. The gap was filled with a pedicled buccal fat pad after lesion removal and all cases were without inferior meatal antrostomy. Results A total of 45 cases were included in the study. 22 were operated using method I while 23 were operated with method II. Operations were completed in 20 min. Pain disappeared in 3.62 days on average, and swelling 6.47 days. Nasal bleeding occurred in 8 patients lasting 1-3 days. Suppurative inflammation was observed in 1 patient, and infection occurred after bone reposition. Other repositioned free bony wall was without resorption in CT images. Conclusions Sinus mucosa and bony wall should be conserved. Preoperative digital design can guide osteotomy effectively during the surgery. Bone reposition is not suitable for suppurative inflammation. The pedicled buccal fat pad is enough for drainage and inferior meatal antrostomy is not necessary.


Resumo Introdução A abordagem tradicional de Caldwell-Luc precisa de modificações para os cistos odontogênicos que se introduzem no seio maxilar, para preservar a mucosa sinusal e o contorno ósseo. Recentemente, a tecnologia digital tem sido amplamente aplicada ao campo da cirurgia maxilofacial, orienta o plano cirúrgico e melhora sua precisão. Objetivo Esse estudo teve como objetivo apresentar e avaliar a cirurgia funcional de cistos odontogênicos intrusivos no seio maxilar utilizando um desenho pré-cirúrgico assistido por computador. Método Foram recrutados pacientes consecutivos com cistos odontogênicos intrusivos na parte posterior do seio maxilar. O método I, "método de reimplante de parede óssea", foi feito em lesões grandes que excediam a crista zigomático-alveolar, mas sem destruição óssea aparente da parede anterior do seio, enquanto o método II, "método de remoção óssea", foi mais conveniente para pequenas lesões próximas à crista zigomático-alveolar. O espaço foi preenchido com um retalho pediculado do corpo adiposo bucal após a remoção da lesão e todos os casos foram feitos sem antrostomia meatal inferior. Resultados Um total de 45 casos foram incluídos no estudo. Vinte e dois foram submetidos à cirurgia utilizando-se o método I, enquanto que 23 foram submetidos ao método II. As operações foram concluídas em 20 minutos. A dor desapareceu em média após 3,62 dias, e o edema, depois de 6,47 dias. Hemorragia nasal ocorreu em 8 pacientes com duração de 1 a 3 dias. Processo supurativa foi observado em 1 paciente ocorrendo após a reposição óssea. Outros retalhos reposicionados livres da parede óssea não mostraram reabsorção em imagens de TC. Conclusões A mucosa sinusal e a parede óssea devem ser preservadas; o desenho digital pré-operatório pode orientar a osteotomia de forma eficaz durante a cirurgia; a reposição óssea não é adequada em processos supurativos. O retalho pediculado de corpo adiposo bucal é suficiente para a drenagem e antrostomia meatal inferior não é necessária.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Otorhinolaryngologic Surgical Procedures/methods , Surgical Flaps , Bone Plates , Maxillary Diseases/surgery , Odontogenic Cysts/surgery , Maxillary Sinus/surgery , Maxillary Diseases/diagnostic imaging , Odontogenic Cysts/diagnostic imaging , Computer-Aided Design , Maxillary Sinus/diagnostic imaging
19.
J. appl. oral sci ; 26: e20170296, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-954528

ABSTRACT

Abstract Objective The aim of this study was to compare the bone resorption rate, histomorphometry and immunohistochemical findings of bioactive glass (Biogran; Biomet, Warsaw, IN, USA) mixed with autogenous bone grafts (1:1) and autogenous bone graft isolate in maxillary sinus elevation surgery. Material and Methods A total of 9 maxillary sinuses were grafted with Biogran with autogenous bone graft (group 1) and 12 were mixed with autogenous bone graft (group 2). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later, another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 37.9%±18.9% in group 1 and 45.7%±18.5% in group 2 (P=0.82). After 6 months, biopsies were obtained concurrent with the placement of dental implants; these implants were subjected to histomorphometric analysis and immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). Results The average bone formation in group 1 was 36.6%±12.9 in the pristine bone region, 33.2%±13.3 in the intermediate region, and 45.8%±13.8 in the apical region; in group 2, the values were 34.4%±14.4, 35.0%±13.9, and 42.0%±16.6 of new bone formation in the pristine bone, intermediate, and apical regions, respectively. Immunostaining for TRAP showed poor clastic activity in both groups, which can indicate that those were in the remodeling phase. Conclusions The similarity between the groups in the formation and maintenance of the graft volume after 6 months suggests that the bioactive glass mixed with autogenous bone (1:1) can be used safely as a bone substitute for the maxillary sinus lift.


Subject(s)
Humans , Alveolar Bone Loss/pathology , Bone Transplantation , Bone Substitutes/therapeutic use , Bone Substitutes/chemistry , Sinus Floor Augmentation/methods , Glass/chemistry , Maxillary Sinus/surgery , Osteogenesis/physiology , Time Factors , Transplantation, Autologous/methods , Bone Regeneration/physiology , Immunohistochemistry , Prospective Studies , Reproducibility of Results , Treatment Outcome , Statistics, Nonparametric , Cone-Beam Computed Tomography , Maxillary Sinus/pathology
20.
Braz. oral res. (Online) ; 32: e86, 2018. tab, graf
Article in English | LILACS | ID: biblio-952169

ABSTRACT

Abstract This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: −0.05; 95%CI: −0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.


Subject(s)
Humans , Dental Implants/adverse effects , Dental Implantation/methods , Sinus Floor Augmentation/methods , Maxillary Sinus/surgery , Postoperative Complications , Bias , Risk Factors , Alveolar Bone Loss/etiology , Treatment Outcome , Dental Prosthesis Design , Dental Restoration Failure , Dental Implantation/adverse effects , Sinus Floor Augmentation/adverse effects
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