Osteomielite crônica associada a trauma pós-exodontia: relato de caso / Osteomyelitis associated with post-extraction trauma: case report

Introdução: Relatar um caso de osteomielite crônica associada a trauma pós-exodontia, localizado em região posterior de mandíbula. Relato de caso: Paciente do sexo masculino, 44 anos, compareceu à clínica odontológica e foi submetido à extração dos dentes 36 e 38. No alvéolo do 36, foi deixado um fragmento da raiz distal, e, quase dois meses após a data da extração, o paciente retornou à clínica com um abscesso extraoral, com um período de evolução de 2 semanas. Foi observado um aumento de volume do lado esquerdo na região mandibular, o qual não exibia sintomatologia, não era móvel à palpação e continha secreção. Ao exame intraoral, apresentava uma fístula. Dessa forma, foi prescrito penicilina para combater a infecção, e, após uma semana, foi realizada a reabertura, curetagem e drenagem da região. Considerações Finais: A osteomielite dos maxilares está sendo melhor entendida e tratada devido ao acesso do paciente a procedimentos diagnósticos. Por outro lado, o desenvolvimento de microrganismos resistentes a antibióticos comumente usados, a presença de um maior número de indivíduos clinicamente comprometidos e a falta de experiência e recursos diagnósticos por alguns clínicos ainda têm tornado difícil o controle e a prevenção dessa patologia... (AU)

Introduction: To report a case of osteomyelitis associated with post-extraction trauma, located in the posterior region of mandible. Case report: A 44-year-old male patient attended at dental clinic was submitted to extraction of teeth 36 and 38, a fragment of distal root was left in the alveolus of 36, almost two months after extraction date, this patient returned to clinic with an extra oral abscess with an evolution period of 2 weeks. An increase in left side volume was observed in mandibular region, which showed no pain symptoms, but it was palpable and contained secretion. On intraoral examination, he had a fistula. Thus, penicillin was prescribed to combat infection and after one week, reopening, curettage and region drainage were performed. Final considerations: Osteomyelitis of jaws is being better understood and treated, due to patient's access to diagnostic procedures. On the other hand, the development of commonly used antibiotic resistant microorganisms, presence of a greater number of clinically compromised individuals, lack of experience and diagnostic resources by some clinicians have made it difficult to control and prevent this pathology... (AU)

Relationship between articular eminence inclination and alterations of the mandibular condyle: a CBCT study

Abstract This study aimed at verifying the correlation among angulation of the articular eminence (AE), shape of the condyle and its degenerative bone diseases (DBDs), according to age and sex, through Cone Beam Computed Tomography (CBCT). Five hundred and twenty-eight temporomandibular joints (TMJ) were evaluated. The condyles were classified as: flat, convex, angled and rounded, and the AE angulation was measured. The DBDs evaluated were osteophytes, flattening, erosion, subcortical cysts and spinal sclerosis. There was no difference in the mean angulations in relation to age group (p>0.05). In age groups of 60-69 years (p=0.003) and 70 years or over (p=0.021), the angulation was higher in males. There was an association between DBD and sex (p=0.047), in that the prevalence was higher in females. Differences in AE angles were not observed in condyles with one or no DBDs (p>0.05). However, the presence of two or more DBDs led to a decrease in the angle (p<0.05). Angled condyles showed higher AE angulations than the flat and convex types (p<0.01). In conclusion, the AE inclination is influenced by DBD and condyle shape; an association of two or more bone diseases in the condyle, or its flat or convex anatomy, results in a decrease in the angulation.