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1.
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
2.
Rev. Ateneo Argent. Odontol ; 64(1): 28-35, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1252444

ABSTRACT

El carcinoma de conductos salivales (CCS) es una neoplasia maligna primaria clínica y patológicamente distinta de las glándulas salivales. Debido a su rareza existe una falta de documentación exhaustiva en la literatura con respecto a sus características, manejo y resultados clínicos. En la presente publicación se presenta un caso de un paciente de sexo masculino de 74 años, que acudió al servicio de odontología del Hospital Interzonal General de Agudos Presidente Perón de Avellaneda. El resultado ecográfico arrojó a nivel submaxilar derecho una imagen nodular de aspecto solido que mide 25 x 24 mm Se le realizó la intervención quirúrgica y el resultado anatomopatológico confirmó el diagnóstico de carcinoma de conductos salivales, una de las neoplasias salivales más agresivas. En la actualidad, la muerte ocurre en 60 a 80% de los pacientes, por lo general dentro de los 5 años; alrededor del 33% desarrolla recidiva local y más del 50% metástasis a distancia, en sitios que incluyen pulmones, huesos, hígado, cerebro y piel (AU)


Salivary duct carcinoma (SDC) is a clinically and pathologically distinct primary malignant neoplasm of the salivary glands. Due to its rarity, there is a lack of exhaustive documentation in the literature regarding its characteristics, management, and clinical results. This publication presents a case of a 74-year-old male patient who attended the dentistry service of the Interzonal General Acute Hospital President Perón by Avellaneda. The ultrasound result revealed a nodular image at the right submaxillary level solid aspect measuring 25 x 24 mm. Surgical intervention was performed, and the pathological result confirmed the diagnosis of salivary duct carcinoma, one of the most aggressive salivary neoplasms. Currently, death occurs in 60% to 80% of patients, usually within 5 years; about 33% develop local recurrence and more than 50% distant metastases, at sites including the lungs, bones, liver, brain, and skin (AU)


Subject(s)
Humans , Male , Aged , Salivary Gland Neoplasms/surgery , Salivary Gland Neoplasms/diagnostic imaging , Carcinoma/classification , Argentina , Postoperative Care , Recurrence , Biopsy , Salivary Gland Neoplasms/mortality , Immunohistochemistry , Oral Surgical Procedures/methods , Dental Service, Hospital , Age and Sex Distribution , Neoplasm Metastasis
3.
Rev. cuba. invest. bioméd ; 39(3): e676, jul.-set. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1138938

ABSTRACT

Introducción: La profilaxis antibiótica es controvertida, además que su uso inapropiado expone a los pacientes en riesgo de reacciones adversas y desarrollo de resistencia bacteriana. Objetivo: Realizar una revisión sistemática de ensayos clínicos aleatorizados que evaluaron le eficacia de la profilaxis antibiótica en la reducción de infecciones posoperatorias luego de la extracción de terceros molares impactados. Métodos: Fueron utilizadas las bases de datos ScienceDirect, Clinical trials.gov y Scopus para ubicar ensayos clínicos. Las variables primarias incluyeron: presencia de infecciones posoperatorias (de la herida y/o alveolitis), reacciones adversas, trismo y dolor. Se realizó un metaanálisis con los estudios homogéneos a través del análisis de efectos aleatorios. El riesgo de sesgo de los ensayos incluidos fue evaluado a través de la guía Cochrane. El riesgo relativo global fue calculado utilizando el enfoque del inverso de la varianza con el método de efectos aleatorios. Resultados: Fueron analizados cualitativamente 14 ensayos clínicos y 9 cuantitativamente. De un total de 874 pacientes, 49 (5,6 por ciento) presentaron infecciones posoperatorias (16/446 para el grupo experimental y 33/428 para el grupo placebo). El metaanálisis arrojó un riesgo relativo global de 0,5 (IC 95 por ciento: 0,27-0,94). El riesgo de sesgo para los estudios que utilizaron solo amoxicilina como medida profiláctica fue de 0,53 (IC 95 por ciento: 0,27-1,03). Las principales reacciones adversas incluyeron: diarreas, reacciones gastrointestinales, fiebre y dolor gástrico. Conclusiones: Los antibióticos sistémicos administrados antes de la cirugía fueron eficaces para reducir las frecuencias de aparición de infecciones posoperatorias luego de la extracción de terceros molares impactados(AU)


Introduction: Antibiotic prophylaxis is controversial, and its inappropriate use exposes patients to the risk of adverse reactions and the development of bacterial resistance. Objective: Carry out a systematic review of randomized clinical trials evaluating the efficacy of antibiotic prophylaxis for the reduction of postoperative infections after extraction of impacted third molars. Methods: The search for clinical trials was conducted in the databases ScienceDirect, Clinicaltrials.gov and Scopus. The primary variables considered were presence of postoperative infections (of the wound and/or alveolitis), adverse reactions, trismus and pain. A meta-analysis was made of homogeneous studies applying the random effects model. The risk of bias in the trials included was evaluated using the Cochrane guide. The inverse variance approach and the random effects method were used for estimation of the global relative risk. Results: Fourteen clinical trials were analyzed qualitatively and 9 quantitatively. Of the total 874 patients, 49 (5.6 percent:) developed postoperative infections (16 / 446 for the experimental group and 33 / 428 for the placebo group). The meta-analysis found a global relative risk of 0,5 (CI 95 percent: 0,27-0,94). Bias risk for studies using only amoxicillin as a prophylactic measure was 0,53 (CI 95 percent:: 0,27-1,03). The main adverse reactions were diarrhea, gastrointestinal reactions, fever and abdominal pain. Conclusions: The systemic antibiotics administered before the surgery were effective to reduce the frequency of appearance of postoperative infections after extraction of impacted third molars(AU)


Subject(s)
Humans , Surgical Wound Infection/prevention & control , Antibiotic Prophylaxis/methods , Molar, Third/surgery , Oral Surgical Procedures/methods
4.
Rev. medica electron ; 42(2): 1713-1723, mar.-abr. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1127028

ABSTRACT

RESUMEN La implantología es una rama en constante evolución que cada vez presenta técnicas más rápidas, predecibles y mínimamente invasivas; hoy en día es una solución bastante completa para aquellas personas que por distintos motivos han perdido una o más piezas dentales y ha traído grandes avances en el área odontológica. Los avances científicos y tecnológicos, así como la mejora de la praxis quirúrgica, han logrado que la tasa de éxito de los implantes dentales sea superior al 95% después de un año de la colocación de los implantes dentales. Se conoce que el porcentaje de fracaso de estos procedimientos es relativamente bajo. Se realizó una revisión bibliográfica con el objetivo de actualizar información sobre la importancia de la implantología, sus causas y complicaciones (AU).


SUMMARY Implantology is a branch in constant evolution, presenting every time faster, more predictable and minimally invasive techniques; nowadays it is a very complete solution for those persons that, for any reason, have lost one or more teeth, and has meant great advances in odontology. Scientific and technological advances, and also the improvement of surgical praxis, have made the success rate of dental grafts higher than 95 % after a year of being made. It is known that failure percentage is relatively low. A bibliographic review was carried out with the aim of updating the importance of implantology, its causes and complications (AU).


Subject(s)
Humans , Dental Implants/adverse effects , Causality , Dentition, Permanent , Oral Surgical Procedures/methods , Methods , Dentistry/methods , Dentistry/standards
5.
Int. j interdiscip. dent. (Print) ; 13(1): 40-43, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1114892

ABSTRACT

OBJETIVO: El propósito de esta revisión fue evaluar sistemáticamente la literatura científica sobre los resultados clínicos que se obtienen al remover los frenillos aberrantes al utilizar los procedimientos quirúrgicos convencionales y el láser. MATERIALES Y MÉTODOS: Búsqueda detallada en las bases de datos PubMed, ScienceDirect, Cochrane y SciELO para obtener la información más actualizada los resultados clínicos (dolor posoperatorio, dolor al hablar, dolor al masticar y complicaciones posquirúrgicas) entre las técnicas convencionales (uso del escalpelo) y las técnicas de remoción con el láser (búsqueda de ensayos clínicos). RESULTADOS: De los 501 archivos identificados inicialmente, se excluyeron reportes clínicos, revisiones, estudios observacionales, comentarios, estudios con pacientes pediátricos, etc. Se incluyeron cuatro ensayos clínicos que contrastaron las variables entre la técnica convencional y las técnicas con el láser Nd: YAG y láser CO2 CONCLUSIÓN: La percepción del dolor posoperatorio, el dolor al hablar y el disconfort al masticar luego de la frenectomía es menor en las técnicas que utilizan el láser de Nd: YAG y CO2 frente a las técnicas que utilizan el escalpelo. El tiempo quirúrgico con el uso del láser es significativamente menor que al utilizar el escalpelo. La heterogeneidad de los estudios limita la realización de un metanálisis con respecto a los resultados.


OBJECTIVE: The purpose of this review was to evaluate systematically the scientific literature on the clinical results obtained by removing aberrant frenulums using conventional surgical procedures and laser. MATERIALS AND METHODS: A detailed search was performed in the PubMed, ScienceDirect, Cochrane and SciELO databases to obtain the most up-to-date clinical results (postoperative pain, pain when speaking, pain when chewing and postoperative complications) among conventional (scalpel use) and laser removal techniques (search for clinical trials). RESULTS: Of the 501 records initially identified, clinical reports, reviews, observational studies, comments, studies with pediatric patients, etc. were excluded. We included four clinical trials that contrasted the variables between the conventional technique and the techniques with the Nd: YAG laser and CO2 laser. CONCLUSION: The perception of postoperative pain, pain when speaking and chewing discomfort after frenectomy is lower in the techniques using the Nd: YAG and CO2 laser versus the techniques using the scalpel. The surgical time when using of laser is significantly lower than when using the scalpel. The heterogeneity of the studies limits the performance of a meta-analysis with respect to the results.


Subject(s)
Humans , Oral Surgical Procedures/methods , Labial Frenum/surgery , Postoperative Complications , Surgery, Oral , Carbon Dioxide , Treatment Outcome , Laser Therapy , Lasers, Solid-State , Operative Time
6.
Rev. Soc. Odontol. La Plata ; 30(59): 23-28, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1224121

ABSTRACT

Objetivo: mostrar el tratamiento que realizamos en comunicaciones a nivel del reborde alveolar en los FLAP, tanto para pacientes con fisura unilateral como bilateral, realizados con cresta ilíaca tomada del paciente y basados en nuestra experiencia de más de 40 años. Casos clínicos: nuestro protocolo está dentro de lo que es el tratamiento que proponemos para FLAP, ortopédico y quirúrgico, teniendo en cuenta el crecimiento y desarrollo del maxilar superior, realizando dentro de éste lo que son las periostioplastías y los injertos óseos, con el correspondiente seguimiento de pacientes en el tiempo. Conclusión: se realiza un protocolo adecuado para cada paciente, para realizar el cierre de la comunicación bucosinusal, teniendo siempre en cuenta el crecimiento y desarrollo de cada paciente y no un tiempo fijo en general para todos ellos. Nos diferenciamos de otras personas que lo hacen en forma sistemática en tiempos quirúrgicos preestablecidos, igual para todos los pacientes (AU)


Subject(s)
Humans , Male , Female , Child , Adult , Cleft Lip/surgery , Cleft Palate/surgery , Bone Transplantation/instrumentation , Ilium/transplantation , Periosteum/surgery , Surgical Flaps , Oroantral Fistula/surgery , Oral Surgical Procedures/methods , Orthopedic Procedures , Growth and Development
7.
Cienc. tecnol. salud ; 6(2): 149-157, jul dic 2019.
Article in Spanish | LILACS | ID: biblio-1095877

ABSTRACT

La recesión gingival (RG) es un problema de salud bucodental frecuente que aumenta con la edad, predispone a hipersensibilidad dentaria, caries radicular, inflamación gingival y efectos antiestéticos. El objetivo de este ensayo clínico aleatorizado fue evaluar comparativamente el efecto clínico del recubrimiento radicular utilizando la técnica estenopéica Pinhole con colágeno y la técnica estenopéica Pinhole modificada al incorporarle plasma rico en fibrina (PRF). Veintiséis participantes sistémicamente sanos, con diagnóstico de RG grado I de Miller, fueron reclutados y seguidos por 6 meses después de la cirugía. Los parámetros clínicos registrados fueron nivel de inserción clínica (NIC), RG y banda de encía queratinizada. Los participantes fueron asignados aleatoriamente a un grupo en quienes se utilizó PRF con 14 participantes, tratando 36 piezas dentales, y otro grupo en quienes se utilizó membrana de colágeno con 12 participantes, tratando 35 piezas dentales. Los resultados muestran un logro de ganancia en el NIC en ambos grupos, (M = 45.24 %, DE = 17.37 %) en el grupo PRF y (M = 47.37 %, DE = 15.67 %) en el grupo colágeno, diferencia que no fue significativa (p = .59). En ambos grupos existió un aumento significativo en la banda de encía queratinizada (p < .01). El uso de PRF como material de relleno al realizar la técnica estenopéica genera resultados similares al ser comparado con la técnica convencional que utiliza colágeno. Al presentar un menor costo el PRF aumenta las posibilidades que más personas tengan acceso al tratamiento.


Gingival recession (GR) is a frequent oral health disease that increases with age and may increase risk of dental hypersensitivity, root decay, gingival inflammation and aesthetic problems. The aim of this randomized clinical trial was to compare clinical parameters of dental root coverage using Pinhole technique with collagen and modi¬fied Pinhole technique using platelet-rich fibrin (PRF). Twenty-six participants, systemically healthy, with Miller class I GR diagnosis, were recruited and measured at baseline and after 6 months follow-up. Clinical parameters measured included clinical attachment level (ICL), GR and keratinized gingival width (KGW). All participants were randomly assigned to a group using PRF, with 14 participants and 36 teeth treated, and other group using collagen, with 12 participants and 35 teeth treated. Both PRF group and collagen group gained ICL, (M = 45.24 %, SD = 17.37 %) in PRF group and (M = 47.37 %, SD = 15.67 %) in collagen group, with no statistically significant difference (p = .59). Both groups gained KGW (p < .01). Use of PRF as filled material by using Pinhole technique resulted in similar clinical improvements compare to collagen as filled material. Considering that PRF is cheaper than collagen, it increases chances that people can have access to treatment.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Fibrin/administration & dosage , Oral Surgical Procedures/methods , Root Canal Therapy/methods , Collagen , Root Caries , Gingival Recession/surgery
8.
Autops. Case Rep ; 9(3): e2018086, July-Sept. 2019. ilus
Article in English | LILACS | ID: biblio-1021057

ABSTRACT

Fibrous dysplasia (FD) is part of a rare group of bone dysplasia. It exhibits benign behavior and can lead to osteolytic lesions, deformities, and fractures. The treatment is challenging, and accurate removal of the lesion is necessary to restore function and esthetics. Here we present two cases of FD where virtual planning with presurgical computed tomography (CT) was used for the production of a surgical guide for bone contouring. First, CT image reconstruction was performed to mirror the patient's original anatomy. Then, three surgical guides that determined the area and depth of bone wear were prepared and used in the relevant sequence during the actual surgeries, which were successfully performed in both patients. This technique is termed the template guide holes (TGH) technique. The findings from this report suggest that presurgical virtual planning and guide preparation allows direct and objective measurement of the level of bone wear and improves the functional and esthetic outcomes of surgery for FD. In particular, the TGH technique is safe and allows adequate preoperative surgical simulation, reduces the surgical duration, and increases the predictability of the final result.


Subject(s)
Humans , Male , Female , Child , Adult , Oral Surgical Procedures/methods , Reconstructive Surgical Procedures/methods , /surgery , Four-Dimensional Computed Tomography
9.
Int. j. odontostomatol. (Print) ; 13(3): 266-270, set. 2019. graf
Article in Spanish | LILACS | ID: biblio-1012420

ABSTRACT

RESUMEN: Se presenta el caso de un paciente sexo femenino 31 años, insuficienciente renal crónica en hemodiálisis, hipertensa secundaria, consulta por aumento de volumen oral en relación a encía marginal vestibular izquierda, 6 meses de evolución. Al examen se observa aumento de volumen de 15 mm en relación a piezas. 3.6 y 3.7. Radiografía muestra compromiso periodontal pieza 3.7. Se realiza biopsia excisional y exodoncia pieza 3.7. Histopatología informa granuloma periférico de células gigantes. Se solicitan exámenes de laboratorio para estudio de hiperparatiroidismo (PTH elevada, calcemia fosfatemia normales). Evoluciona favorablemente. Sin signos de recidiva a los 3 meses. El diagnóstico histopatológico de lesión de células gigantes debe ser complementado con la clínica, exámenes de laboratorio e imagenología, el objetivo final es definir si tal diagnóstico corresponde a un tumor pardo, a un granuloma central de células gigantes o a un granuloma periférico de células gigantes. En la literatura los reportes de asociación entre granuloma periférico de células gigantes e hiperparatiroidismo son escasos. Este caso corresponde a granuloma periférico células gigantes, asociado a hipersecreción de paratohormona.


ABSTRACT: A 31-year-old female patient with chronic renal insufficiency in hemodialysis and secondary hypertension consulted due to an enlarging intraoral lesion in relation to the left marginal vestibular gingival, with 6 months of evolution. A 15mm mass in relation to mandibular left molars was noted. Radiograph showed periodontal involvement of mandibular left second molar. Excisional biopsy and tooth 3.7 extraction were performed. Histopathology reported a peripheral giant cell granuloma. Laboratory tests were requested for suspected hyperparathyroidism (aiding in the diagnosis) (high PTH, normal phosphatemia and calcemia). Evolution was favorable, without signs of reappearance after 3 months. The histopathological diagnosis of giant cell lesions should be complemented with clinical, laboratory and imaging tests. The final objective is to make the differential diagnosis between brown tumor, central giant cell granuloma and peripheral giant cell granuloma because the treatment varies considerably. There are few reports in the literature about the association between peripheral giant cell granuloma and hyperparathyroidism. This case corresponds to peripheral giant cell granuloma, possibly associated with parathormone hypersecretion.


Subject(s)
Humans , Female , Adult , Parathyroid Neoplasms/surgery , Granuloma, Giant Cell/diagnosis , Granuloma, Giant Cell/pathology , Hyperparathyroidism, Primary/surgery , Gingival Diseases/etiology , Gingival Diseases/pathology , Radiography, Panoramic , Oral Surgical Procedures/methods , Gingival Diseases/surgery
10.
Rev. Círc. Argent. Odontol ; 78(228): 18-20, ago. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1123348

ABSTRACT

El adenocarcinoma de células basales, también conocido como carcinoma salival basaloide, adenoma maligno de células basales, es una neoplasia epitelial de bajo grado, infiltrante, localmente destructivo y con tendencia a ser recidivante. Su aparición es entre la 5ª y 6ª década de vida, sin predilección por sexo. Clínicamente se manifiesta con un edema o un aumento repentino de tamaño en la zona, de consistencia firme, crecimiento lento e indoloro. El diagnóstico de certeza es a través de la histopatología; su tratamiento quirúrgico, y tiene buen pronóstico en sus estadios iniciales (AU)


Basal cells adenocarcinoma also known as salivary basaloide carcinoma basal cells malignant adenoma is a low degree, infiltrating, locally destructive and prone to be relapsing, epithelial neoplasia. It occurs between the 5th and 6th decade of life, with no predilection for sex. Clinically it manifests with an edema or sudden increased size in the area, of firm consistency, slow growth and pain-less. Its treatment is surgical and the diagnosis of certainty is histopathological with a good prognosis. The purpose of this presentation is to show the case of a 57- years-old male patient with clinical and anatomopathological diagnosis of adenocarcinoma of basal cells located in the yugal mucosa (AU)


Subject(s)
Humans , Male , Middle Aged , Mouth Neoplasms/classification , Adenocarcinoma/surgery , Adenocarcinoma/diagnosis , Neoplasms, Basal Cell , Prognosis , Biopsy/methods , Oral Surgical Procedures/methods , Diagnosis, Differential , Age and Sex Distribution , Mouth Mucosa/injuries , Neoplasm Recurrence, Local/prevention & control
11.
Rev. Asoc. Odontol. Argent ; 107(2): 63-71, abr.-jun. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1016010

ABSTRACT

Objetivo: Presentar cuatro situaciones clínicas de comunicaciones bucosinusales crónicas que fueron resueltas mediante tres técnicas quirúrgicas diferentes con un mismo protocolo, que consta de tres principios fundamentales. Primero, el seno maxilar se debe encontrar libre de infección, permeable y funcional. Segundo, el cierre debe realizarse en dos planos, debido a las diferentes características histológicas de las cavidades. Tercero, el colgajo de cierre debe ser bien vascularizado y estar libre de tensión. Casos clínicos: Se trataron cuatro casos de comunicaciones bucosinusales crónicas siguiendo los tres principios fundamentales, para lo cual se utilizaron tres técnicas quirúrgicas diferentes: colgajo de avance vestibular, bola adiposa de Bichat y raqueta palatina. Todos los casos evolucionaron de manera favorable y sin recurrencia. Conclusión: A pesar de que en la literatura ha sido descripta una gran cantidad de técnicas quirúrgicas para el tratamiento de las comunicaciones bucosinusales crónicas, concluimos que el éxito del cierre dependería de los principios fundamentales previamente enumerados y de la correcta selección del colgajo para cada caso clínico (AU)


Aim: To analyze four clinical cases of chronical oroantral communications that were treated with three different surgical techniques, using a unique protocol following three principles: the maxillary sinus must be free of infection, permeable and functional; the closure must be double layered (due to the different histological characteristics of the cavities); the closing flap must be well vascularized and free of tension. Cases report: Four oroantral fistulas were treated following the three basic principles, three different surgical techniques were used: a buccal flap, a palatal flap and a buccal fat pad. All surgical wounds healed uneventfully and without recurrence. Conclusion: Despite the wide range of techniques proposed in the literature, we conclude that the success of the closure of the oroantral fistulas showed to depend on the principles previously stated and the correct selection of the flap for each clinical situation (AU)


Subject(s)
Humans , Male , Middle Aged , Aged , Oroantral Fistula/surgery , Oral Surgical Procedures/methods , Maxillary Sinus , Argentina , Schools, Dental , Surgical Flaps , Wound Healing
12.
Rev. bras. anestesiol ; 69(3): 315-318, May-June 2019.
Article in English | LILACS | ID: biblio-1013411

ABSTRACT

Abstract Background: Trigeminocardiac reflex is a physiological phenomenon that may occur in head and neck surgery, and is usually benign. However, it may present with exaggerated responses with severe morbidity. Case report: Male patient, 26 years old, candidate for surgical treatment of zygomatic-orbital complex fracture. The surgery with bilateral nasal packing placed at the end of the procedure was uneventful. After being admitted to the post-anesthesia care unity, the patient complained of shortness of breath and nausea. Pulse oximetry fell below 90% in ambient air, and 100% O2 was then offered through a Hudson mask. He showed no improvement in oximetry and presented with worsening dyspnea, diffuse wheezing, reduced heart rate, and blood pressure. Atropine was given, which raised the heart rate, but without resolution of hypotension and bronchospasm. Our suspicion was of a trigeminal-cardiac reflex, and then the removal of the nasal packing was done with complete remission of the signs and symptoms. Discussion: Florian Kratschmer (1870) was the first to describe the influences of nasal mucosal reflexes on respiration and circulation, which became known as Kratschmer's reflex. It is a reflex arc whose afferent originates in the nerve endings of the trigeminal nerve. The clinical presentation of trigeminocardiac reflex is the occurrence of sudden bradycardia, hypotension, apnea, and gastric hypermotility. Conclusion: Trigeminocardiac reflex may be a protective neurogenic, oxygen-conserving response with low morbidity, however, exacerbated in certain situations. The interaction between surgeon and anesthesiologist, together with a careful monitoring of blood pressure and heart rate are fundamental for diagnosis and treatment.


Resumo Justificativa: O reflexo trigêmino-cardíaco é um fenômeno fisiológico passível de ocorrer em cirurgias da cabeça e pescoço, e normalmente é benigno. Contudo, pode apresentar respostas exageradas, com grave morbidade. Relato de caso: Paciente masculino, 26 anos, candidato a tratamento cirúrgico de fratura do complexo zigomático-orbitário. Ato cirúrgico sem intercorrências com tamponamento nasal bilateral ao final. Após admitido na sala de recuperação pós-anestésica, queixou-se de "falta de ar" e náusea. A oximetria de pulso caiu abaixo 90% em ar ambiente e foi ofertado então O2 a 100% sob máscara de Hudson. Não houve melhora da oximetria e apresentou piora da dispneia, com sibilos difusos, redução da frequência cardíaca e da pressão arterial. Administrada atropina, que elevou a frequência cardíaca, mas sem resolução da hipotensão arterial e broncoespasmo. Aventamos a hipótese de reflexo trigêmino-cardíaco e então foi feita a remoção do tamponamento nasal com remissão completa dos sinais e sintomas. Discussão: Florian Kratschmer (1870) foi o primeiro a descrever as influências de reflexos da mucosa nasal na respiração e na circulação, o que ficou conhecido como reflexo de Kratschmer. Trata-se de um arco reflexo cuja aferência é originária nas terminações nervosas do nervo trigêmeo. A apresentação clínica do reflexo trigêmino-cardíaco é a ocorrência de súbita bradicardia, hipotensão, apneia e hipermotilidade gástrica. Conclusão: O reflexo trigêmino-cardíaco pode ser uma resposta neurogênica protetora, oxigênio-conservadora, de baixa morbidade, contudo exacerbada em determinadas situações. A interação entre cirurgião e anestesiologista, aliada à monitoração criteriosa da pressão arterial e do ritmo cardíaco, é fundamental para o diagnóstico e o tratamento.


Subject(s)
Humans , Male , Adult , Postoperative Complications/diagnosis , Oral Surgical Procedures/methods , Reflex, Trigeminocardiac/physiology , Oxygen/metabolism , Blood Pressure/physiology , Heart Rate/physiology
13.
Rev. Círc. Argent. Odontol ; 77(227): 25-28, dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1122807

ABSTRACT

Los desplazamientos del tercer molar inferior a espacios extraorales constituyen un accidente poco común, sin embargo, pueden acarrear graves consecuencias a la salud del paciente. Se presentan dos casos clínicos, donde se describe la exéresis de terceros molares inferiores alojados en el espacio submaxilar, a través de un abordaje cervical (AU)


The displacement of lower third molars to extra-spaces are a rare accident, however, they can have serious consequences to the health of the patientTwo cases where excision of third molars staying in the submandibular space is described through a cervical approach are presented (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Postoperative Complications , Oral Surgical Procedures/methods , Molar, Third/surgery , Argentina , Tooth Extraction , Radiography, Dental, Digital , Dental Service, Hospital
14.
Rev. bras. cir. plást ; 33(4): 446-452, out.-dez. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-979940

ABSTRACT

Introdução: O tecido gorduroso bucal foi descrito pela primeira vez em 1732, por Heister. Em 1802, Bichat diagnosticou sua natureza adiposa. Há uma estreita relação entre a gordura bucal e músculos da mastigação, auxiliando os lactentes na sucção do leite por atuar com um tecido de deslizamento. Sua projeção diminui com o aumento da idade, tanto pela redução discreta de seu volume quanto pelo crescimento facial. A bichectomia ou bichatectomia é o procedimento cirúrgico que visa remover a "bola gordurosa de Bichat", com fins estéticos e/ ou funcionais. O objetivo é demonstrar que a bichectomia é um procedimento de baixo risco cirúrgico e com bons resultados, desde que seja bem indicada e siga os padrões técnicos, respeitando a anatomia das estruturas faciais. Métodos: Estudo prospectivo de coorte, realizado entre janeiro de 2016 e abril de 2018, totalizando 59 pacientes, com média de idade de 31 anos. O tempo de seguimento foi de 12 a 26 meses. Resultados: Foram avaliados 59 pacientes, com média de idade de 31 anos, sendo 46 do sexo feminino e 13 do sexo masculino. Todos os pacientes receberam alta no mesmo dia. Em média, foram retirados 3,2ml de volume da gordura de Bichat. Conclusão: A retirada de porções das gorduras de Bichat é segura, desde que sejam observados os detalhes anatômicos. Pode oferecer maior harmonia entre os três terços da face. O sucesso dos resultados depende de uma indicação precisa para o procedimento.


Introduction: Buccal fat removal was described for the first time by Heister in 1732. In 1802, Bichat identified the adipose nature of this tissue. There is a close association between buccal fat and masticatory muscles, which helps infants suck owing to the sliding motion of the tissues. Its prominence diminishes with age, both through modest reduction in volume and facial growth. Bichectomy or bichatectomy is a surgical procedure that involves extraction of Bichat's fat pad for aesthetic and/or functional purposes. This study aimed to show that bichectomy is a low-risk surgical procedure with good results, provided it is appropriately indicated and is performed following technical standards according to the anatomy of the facial structures. Methods: This prospective cohort study was conducted between January 2016 and April 2018 and included 59 patients with a mean age of 31 years. The follow-up time was 12-26 months. Results: Of 59 patients, 46 were female, and 13 were male. All patients underwent same-day surgery. On average, 3.2 mL of fat was removed. Conclusion: Removal of Bichat's fat according to anatomical principles is safe. This technique can improve facial harmony. Success depends on application of appropriate techniques.


Subject(s)
Humans , Male , Female , Adult , Adipose Tissue/anatomy & histology , Adipose Tissue/surgery , Oral Surgical Procedures/methods , Reconstructive Surgical Procedures/methods , Facial Asymmetry/surgery , Mouth/anatomy & histology , Mouth/surgery , Fats
15.
Int. j. odontostomatol. (Print) ; 12(4): 362-367, dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-975758

ABSTRACT

RESUMEN: Uno de los objetivos de la cirugía maxilofacial es devolver anatomía, función y estética a través de distintas técnicas quirúrgicas. Dentro de los tejidos utilizados para esto se encuentra el cuerpo adiposo de la mejilla (CAM). La gran evidencia clínica existente y el conocimiento que se tiene acerca de este tejido ha permitido poder utilizarlo como injerto o colgajo para el tratamiento de una serie de condiciones que afectan al territorio maxilofacial con buenos resultados tanto estéticos como funcionales. Describir las diferentes indicaciones que tiene el CAM como colgajo e injerto autólogo para el tratamiento de las distintas anomalías que afectan al territorio maxilofacial. Se realizó una búsqueda entre abril y junio de 2018 utilizando 3 bases de datos electrónicas: PubMed, EBSCO y Cochrane. Las palabras clave utilizadas fueron buccal fat pad, bichat's fat pad y oral surgery con la selección del término booleano AND y OR. Se seleccionaron aquellos estudios publicados entre los 2014 y 2018, de texto completo. Se seleccionaron 17 artículos de que cumplieron con los criterios de inclusión; 2 revisiones sistemáticas, 8 ensayos clínicos, 6 estudios observacionales y una serie de casos. El uso del CAM como injerto y colgajo para la corrección de anomalías en el territorio maxilofacial es una técnica versátil y predecible. La totalidad de los estudios analizados avalan su uso en dicho campo. Se necesitan más estudios clínicos aleatorizados, con un mayor número de casos, seguimiento a largo plazo y parámetros a evaluar para establecer una conclusión final sobre el uso del CAM en las diversas aplicaciones de la cirugía maxilofacial.


ABSTRACT: One of the main objectives of maxillofacial surgery is to restore patient normal anatomy, function and esthetic. Among the various tissues used to achieve the above, is the buccal fat pad. Currently, there is sufficient clinical evidence and knowledge regarding this tissue type, to approve its use as graft or flap, in order to treat a number of conditions that affect the maxillofacial area. Furthermore, it has shown various esthetical as well as functional results. The purpose of this narrative review is to describe different indications of the buccal fat pad, as a flap and autologous graft in treating various maxillofacial abnormalities. A search was conducted between april and june 2018 using 3 electronic data bases: PubMed, EBSCO and Cochrane library. Key words used were buccal fat pad, Bichat's fat pad y oral surgery using Boolean terms AND/ OR. Studies published between 2014 and 2018 were selected. For the study, 17 complete text studies that met the inclusion criteria were selected; two systematic reviews, eight randomized clinical trials, six observational studies and one case series. The use of the buccal fat pad as flap and graft for correcting maxillofacial abnormalities, is a predictable and versatile technique. The total number of studies analyzed, support its use in this surgical field. In conclusion and despite these results however, there is a need for further randomized clinical trials with a greater number of cases, long term follow up, and greater parameter assessment to support the use of the buccal fat pad in maxillofacial surgery.


Subject(s)
Humans , Surgery, Oral/methods , Oral Surgical Procedures/methods , Maxillary Osteotomy/methods , Adipose Tissue/anatomy & histology , Adipose Tissue/surgery
16.
Int. j. odontostomatol. (Print) ; 12(3): 309-319, Sept. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-975750

ABSTRACT

RESUMEN: La reconstrucción de la cabeza y el cuello contempla avances importantes a lo largo de los años. Los colgajos microvasculares se han convertido en la primera opción de tratamiento en grandes defectos del territorio maxilofacial, mientras tanto, la tecnología con el uso de microscopía y luego las imágenes como CT, angiografía por tomografía computarizada, dispositivo ultrasónico, RNM o Doppler contribuyen a lograr una predictibilidad excepcional de estos colgajos microvasculares. Por lo general, la técnica de anastomosis consiste en una sutura de 9-0 en 360°, pero existen autores que han descrito diversos métodos que no son de sutura con un rendimiento aceptable. Existe un buen número de diferentes colgajos microvasculares, cuatro de ellos son los más comunes en la reconstrucción maxilofacial: fíbula, ilíaco, antebrazo radial, escápula. Además el colgajo anterolateral, muy útil en defectos de piel y tejidos blandos. La evolución de los colgajos microvasculares implica los colgajos quiméricos, muy útiles en defectos grandes. El objetivo de este artículo es describir y exponer el desarrollo de la microcirugía y las diversas opciones de colgajos microvasculares en la reconstrucción maxilofacial.


ABSTRACT: Head and neck reconstruction have shown important advances over the years. Microvasculars flaps transfer has become the first treatment option in large defects of the maxillofacial area. Meanwhile technology through the use of microscopy and the subsequent use of images such as CT, CT angiography, RNM or Doppler ultrasonic device, and additional new techniques have contributed to an exceptional predictability of these microvascular flaps. Typically, the anastomosis technique consists in 9-0 suture in 360°, but since the vascular flaps exist, authors have described diverse non-suture methods with acceptable performance. There are a number of different microvasculars flaps, four of them are the most common in maxillofacial reconstruction: fibula, iliac, radial forearm, scapula. In addition the anterolateral tight flap, very useful in skin and soft tissues defects. The microvascular flaps evolution involves the chimeric flaps that are useful in large defects. The aim of this article is to describe and expose microsurgery development and the diverse microvascular flap options in maxillofacial reconstruction.


Subject(s)
Humans , Oral Surgical Procedures/methods , Reconstructive Surgical Procedures/methods , Free Tissue Flaps , Thigh , Leg , Microsurgery/methods
18.
Rev. Círc. Argent. Odontol ; 76(226): 17-20, jul. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1122081

ABSTRACT

La hiperplasia de la úvula es una entidad poco frecuente. Puede tener diversas causas, tales como: surgir a partir de un proceso infeccioso; por reacciones alérgicas; angioedema hereditario (HANE) (14,16); inhalación de sustancias psicoactivas (7); traumatismos ocasionados por procedimientos como intubación o extubación endotraqueal, así como durante la aspiración de los líquidos de la cavidad oral en procedimientos quirúrgicos. (7,14,16) El alargamiento de la úvula, en algunos casos, se manifiesta asintomático. Este trabajo tiene como objetivo la descripción de esta entidad, la presentación de un caso clínico, y su manejo clínico-quirúrgico (AU)


The hyperplasia of the uvula is a rare entity, it can have diverse causes, such as: of an infectious process, allergic reactions, hereditary angioedema (HANE), (14 16) inhalation of psychoactive substances (7) traumatisms caused by procedures such as, intubation or endotracheal extubation, as well as during the aspiration of liquids from the oral cavity in surgical procedures (7,14,16). The lengthening of the uvula, in some cases, is asymptomatic. The aim of this work is the description of this entity, the presentation of a clinical case, and the clinical and surgical management (AU)


Subject(s)
Humans , Male , Middle Aged , Uvula/surgery , Uvula/pathology , Oral Surgical Procedures/methods , Hyperplasia , Argentina , Surgery, Plastic , Dental Service, Hospital , Angioedemas, Hereditary , Intubation, Intratracheal/adverse effects
19.
Rev. bras. cir. plást ; 33(2): 196-203, abr.-jun. 2018. ilus
Article in English, Portuguese | LILACS | ID: biblio-909405

ABSTRACT

Introdução: O retalho miomucoso de músculo bucinador, descrito em 1989, pode ser utilizado para corrigir fístulas palatinas, fissuras com alongamento do palato mole ou cobrir áreas cruentas após ressecções de tumores. Métodos: Trata-se da análise do resultado após 27 anos de 6 casos de pacientes operados no Hospital de Base e na Santa Casa de São José do Rio Preto, no período de 1984 a 1989, e reavaliados em 2016, nos quais foram realizados retalhos miomucosos de bucinador para correção de fissura palatina. Resultados: Dos 36 casos operados, 6 foram reavaliados após 27 anos, dos quais 5 trataram-se de correção primária e 1 de correção secundária (fístula após fechamento de fissura palatina). Todos os casos obtiveram resultados satisfatórios no crescimento maxilar, na correção da fistula palatina e na função da fala. Conclusão: Apesar de estatisticamente não significativo, o presente estudo demonstrou que o retalho miomucoso de músculo bucinador para correção e alongamento do palato é um procedimento adequado, com resultados de crescimento maxilar normal ou próximo disso e fala praticamente normal, mesmo sem adequado tratamento fonoaudiológico.


Introduction: The buccal musculo-mucosal patch, described in 1989, can be used to correct palatine fistulas and fissures with stretching of the soft palate, or to cover bloody areas after tumor resection. Methods: This is an analysis of the 27-year postoperative results for 6 patients who underwent operation at Base Hospital and Santa Casa de São José do Rio Preto between 1984 and 1989, and reassessed in 2016, when a myo-buccinator mucosa was used for cleft palate correction. Results: Of the 36 operated cases, 6 were reevaluated after 27 years, of which 5 had primary correction and 1 had a secondary correction (fistula after cleft palate closure). All the cases had satisfactory results in terms of maxillary growth, correction of the palatine fistula, and speech function. Conclusion: Although not statistically significant, the present study demonstrated that the buccal musculo-mucosal flap is an adequate procedure for correction and stretching of the palate, with normal or near-normal maxillary growth and practically normal speech even without adequate phono-audiological treatment.


Subject(s)
Humans , History, 21st Century , Palate, Soft , Surgical Flaps , Velopharyngeal Insufficiency , Cleft Lip , Cleft Palate , Oral Surgical Procedures , Fistula , Palate, Soft/anatomy & histology , Palate, Soft/abnormalities , Palate, Soft/surgery , Surgical Procedures, Operative/adverse effects , Surgical Flaps/surgery , Velopharyngeal Insufficiency/surgery , Velopharyngeal Insufficiency/complications , Velopharyngeal Insufficiency/rehabilitation , Cleft Lip/surgery , Cleft Lip/complications , Cleft Palate/surgery , Oral Surgical Procedures/methods , Fistula/surgery , Fistula/complications , Fistula/rehabilitation
20.
Rev. cuba. estomatol ; 55(1): 73-81, ene.-mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-960402

ABSTRACT

Introducción: el carcinoma de células escamosas primario intraóseo es una neoplasia maligna poco frecuente. Objetivo: presentar un caso clínico de un carcinoma primario intraóseo derivado de un quiste odontogénico en las regiones del cuerpo a la rama mandibular izquierdas. Caso clínico: acude a consulta paciente masculino de 68 años quien refiere una molestia en la mandíbula. Al examen bucal se detecta expansión cortical a nivel del 37. Se realiza estudio de ortopantomografía donde se observó un área radiolúcida con borde definidos, y bajo la impresión diagnóstica de quiste residual se efectúa curetaje y estudio histopatológico, que confirma lo sospechado. Al cabo de unos 4 meses el paciente acude nuevamente refiriendo dolor muy intenso en la región del ángulo mandibular con ligera parestesia del labio inferior izquierdo que se asociaba al examen físico facial, con edema geniano bajo y submandibular, y al examen bucal con movilidad anormal ósea mandibular izquierda. Se realiza ortopantomografía donde se observa imagen radiolúcida de bordes irregulares, poco precisos, y fractura patológica mandibular. Se decide inmovilización y toma de muestra para biopsia, que informa un carcinoma epidermoide moderadamente diferenciado, por lo que se realiza tratamiento quirúrgico radical con manejo del cuello, más radioterapia y quimioterapia posoperatorias. Conclusión: la transformación en un carcinoma primario intraóseo a partir de un quiste residual es una entidad infrecuente en la región maxilofacial. El diagnóstico en el caso presentado se realizó por exclusión. La sintomatología de dolor intenso y parestesia fueron elementos clave en la sospecha diagnóstica. El enfoque oncológico mediante cirugía radical con manejo del cuello, radio y quimioterapia permitieron el control loco-regional(AU)


Introduction: primary intraosseous squamous cell carcinoma is an infrequent malignant neoplasm. Objective: present a clinical case of primary intraosseous carcinoma arising from an odontogenic cyst in body regions to the left mandibular branch. Clinical case: a 68-year-old male patient presented with discomfort in his mandible. Oral examination revealed cortical expansion at the level of 37. Orthopantomography showed a radiolucent area with definite borders. Curettage and histological testing confirmed the preliminary diagnosis of residual cyst. Some four months later the patient presented again with very intense pain in the mandibular angle region with slight paresthesia of the left lower lip area associated on physical facial examination with lower and submandibular genian edema, and on oral examination with abnormal left mandibular bone mobility. Orthopantomography revealed a radiolucent image of irregular, imprecise borders and pathological mandibular fracture. It was decided to immobilize and take a sample for biopsy, which reported moderately differentiated epidermoid carcinoma. Therefore, radical surgical treatment was performed with neck management plus postoperative radiotherapy and chemotherapy. Conclusion: evolution of a residual cyst into a primary intraosseous carcinoma is an infrequent condition in the maxillofacial region. In the case herein presented diagnosis was made by exclusion. The symptoms of intense pain and paresthesia were crucial to the preliminary diagnosis. Application of an oncological approach based on radical surgery with neck management and radio- and chemotherapy resulted in local-regional control(AU)


Subject(s)
Humans , Male , Aged , Carcinoma, Squamous Cell/diagnosis , Radiography, Panoramic/methods , Jaw Neoplasms/drug therapy , Oral Surgical Procedures/methods
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