Feasibility of three-dimensional CT reconstruction in assessing mandibular fractures: a survey among oral surgeons and dental maxillofacial radiologists

Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections

Reconstrução mandibular com enxerto livre de crista ilíaca: relato de caso / Mandibular reconstruction with iliac crest free graft: case report

Os defeitos ósseos nos maxilares podem ser causados por patologias como ameloblastoma, carcinoma de células escamosas e sarcomas, bem como, por traumatismos faciais que vão desde acidentes de trânsito a agressões por arma de fogo. As reconstruções de tais defeitos ósseos não deverão apenas devolver a anatomia e contorno da região, mas também, restabelecer a estética e função. A escolha do melhor tipo de enxerto para reconstrução mandibular deverá ser feita de acordo com a característica do defeito e, principalmente, a observação do seu tamanho. O presente trabalho relata o caso clínico de um paciente que procurou o serviço de CTBMF do Hospital da Restauração, queixando-se de deformidade em terço inferior de face após agressão por projétil de arma de fogo (PAF) há, aproximadamente, 2 anos. Ao exame físico apresentava perda de continuidade óssea em região de parassínfise mandibular direita, oclusão pouco funcional e com prometimento funcional. Para o caso foi proposta cirurgia para reconstrução do defeito mandibular com enxerto livre de crista ilíaca. Diante disso, um diagnóstico preciso, planejamento minucioso e boa execução da técnica de reconstrução mandibular com enxerto livre de crista ilíaca proporcionam resultados estéticos satisfatórios, contorno e volume ósseos adequados possibilitando um restabelecimento funcional da área receptora... (AU)

Bone defects in the jaws can be caused by pathologies such as ameloblastoma, squamous cell carcinoma, and sarcomas, as well as facial trauma ranging from traffic accidents to gunshot wounds. Reconstructions of such bone defects should not only restore the anatomy and contour of the region, but also restore aesthetics and function. The choice of the best graft type for mandibular reconstruction should be made according to the characteristic of the defect and, especially, the observation of its size. The present study reports the clinical case of a patient who sought the CTBMF service of the Hospital da Restauração, complaining of deformity in the lower third of the face after aggression by FAP for approximately 2 years. Physical examination showed loss of bone segment in a region of right mandibular paresis, malocclusion and functional impairment. For the case, surgery was proposed to reconstruct the mandibular defect with free iliac crest graft. Therefore, a precise diagnosis, careful planning and good execution of the mandibular reconstruction technique with free iliac crest graft provide satisfactory aesthetic results, adequate bone contour and volume allowing a functional reestablishment of the receiver area... (AU)

Lipoma intraoral: relato de caso / Intraoral lipoma: case report

Os lipomas são as neoplasias mesenquimais mais frequentes do corpo humano, sendo raros na cavidade oral. No aspecto histopatógico, são constituídos basicamente de adipócitos maduros. Clinicamente, apresentam-se como massas nodulares, sésseis ou pedunculadas, de consistência amolecida, aspecto gelatinoso e de superfície lisa; frequentemente são assintomáticos e sem ulcerações. O presente artigo tem por objetivo relatar um caso de um lipoma na região do ventre da língua, que impedia a correta adaptação da prótese total inferior, além de trazer transtornos fonéticos à paciente, tendo sido proposto um tratamento cirúrgico através de uma biópsia excisional da lesão... (AU)

Lipomas are the most common mesenchymal neoplasms of the human body, being rare in the oral cavity. In histopatoógico aspect, consist primarily of mature adipocytes. Clinically, it presents as nodular masses, sessile or pedunculated, of soft consistency, gelatinous appearance and smooth surface; are often asymptomatic and without ulceration. This paper aims to report a case of a lipoma in the belly region of the tongue, which prevented accurate adaptation of the lower denture, and bring the patient phonetic disorders, surgical treatment was proposed through an excisional biopsy of the lesion... (AU)