Oral motor and electromyographic characterization of adults with facial fractures: a comparison between different fracture severities

OBJECTIVES: To characterize the oral motor system of adults with facial injuries and to compare the oral motor performance/function between two different groups. METHODS: An observational, descriptive, cross-sectional study was conducted in 38 patients presenting with facial trauma who were assigned to the Division of Orofacial Myology of a Brazilian School Hospital. Patients were divided into two groups: Group 1 (G1) consisted of 19 patients who were submitted to open reduction of at least one facial fracture, and Group 2 (G2) consisted of 19 individuals who were submitted to closed fracture reduction with maxillomandibular fixation. For comparison purposes, a group of 19 healthy volunteers was recruited. All participants underwent a clinical assessment that included an oral motor evaluation, assessment of the mandibular range of motions, and electromyographic assessment of the masticatory muscles. RESULTS: Clinical assessment of the oral motor organs indicated that G1 and G2 presented deficits related to the posture, position, and mobility of the oral motor organs. Patients also presented limited mandibular ranges of movement. Deficits were greater for individuals in G1, especially for maximal incisor opening. Additionally, patients in G1 and G2 presented a similar electromyographic profile of the masticatory muscles (i.e., patients with facial fractures presented lower overall muscle activity and significant asymmetrical activity of the masseter muscle during maximum voluntary teeth clenching). CONCLUSION: Patients in G1 and G2 presented similar functional deficits after fracture treatment. The severity of facial fractures did not influence muscle function/performance 4 months after the correction of fractures.

Histologia e fisiologia do enxerto ósseo autógeno: revisão de literatua / Histology and physiology of of the autogenous bone graft: review of the literature

Inúmeras técnicas de reconstrução óssea são propostas, seja pela necessidade de quantidade e qualidade óssea, ou por melhor estética para a colocação de implantes. O enxerto autógeno de áreas doadoras intra-bucais, entre elas, é comprovadamente uma das técnicas mais realizadas hoje em Implantodontia (Triplett & Schow, 1996, Widmark et. 1996, Dinato & Polido, 2001). Assim, é de suma importância conhecer as estruturas básicas do desenvolvimento biológico e função do tecido ósseo. Concluindo, o objetivo será estudar a literatura científica a respeito da histologia e fisiologia do osso, bem como a incorporação dos enxertos ósseos autógenos.

A lot of techniques of reconstruction bone are propose, device the necessity or because the quality and quantitative bone, or to improve the esthetic in the place of implantations. The autogenous bone of the intra-oral gift area, between then, one of the main techniques today in Implantology (Triplett & Schow23, 1996, Widmark et al. 199624, Dinato & Polido, 20016). So, is very important to know the basic estructures of biology desenvelopment and the function of bone tissue. Concluding, the purpose will be study the cientific literature of histology and bone physiology, as well the incorporation mechanisms of the autogenous grafts.

Atención de Urgencia en Traumatismos de Cara / Urgency Attention in Face Traumatisms

La cara es la región del organismo más expuesta a las heridas. En el paciente traumatizado con heridas en la cara, se deben atender en primera instancia los aspectos que puedan conducirlo a la muerte. Se debe hacer una rápida inspección del paciente, controlar su respiración, la hemorragia y el posible choque y evaluar las lesiones acompañantes para diagnosticar y tratar las lesiones maxilofaciales posteriormente. Los signos y síntomas que con más frecuencia se presentan en estos pacientes son rinorrea, inconsciencia, heridas oculares y lesiones del tórax. El paciente con trauma en cara puede presentar desde abrasiones y avulsiones cutáneas, heridas de cuero cabelludo, nervio facial, parótida y del conducto de Stenon, lengua, labios, párpados, orejas y nariz, hasta heridas por arma de fuego y tatuajes. Por esto, es importante prevenir al cirujano general contra el riesgo de efectuar ciertos procedimientos quirúrgicos, que por su complicación, requieren de la intervención de un especialista