Un cuerpo extraño inusual de cianoacrilato en el oído. Presentación de un caso clínico y revisión de la literatura / An unusual cyanoacrylate foreign body in the ear. Presentation of a clinical case and literature review

El pegamento basado en cianoacrilato posee una gran capacidad de adherencia a los tejidos, representando un problema cuando se encuentra en el oído externo debido a sus características anatómicas particulares. Se presenta un caso clínico de cuerpo extraño de cianoacrilato que ocluye el conducto auditivo externo y el tímpano, alterando la audición. Se describen los hallazgos y los intentos de extracción utilizando las alternativas terapéuticas descritas en la literatura, sin obtener resultados positivos, debiendo recurrir a la extracción quirúrgica. Además, se presentan detalles del procedimiento y los resultados. El paciente recupera la audición y la normalidad anatómica.

Cyanoacrylate-based glue has a great capacity for adhering to tissue, which is a problem when it is placed in the ear canal due to the anatomy of this structure. A clinical case of a cyanoacrylate foreign body occluding the external auditory canal and the tympanic membrane is presented. The therapeutics alternatives described in the literature used in the case failed, so, it was surgically removed by drilling the glue. Details of the procedure and results are presented. The patient recovers the hearing and anatomical normality.

Risk factors of complications subsequent third molar extractions: A prospective cohort study / Fatores de risco de complicações subsequentes à extrações de terceiros molares: um estudo de coorte prospectivo

Objective: The aim of this study was to determine the complications that were associated with the surgical removal of third molars (M3s), and to assess the association of patient, anatomic, and surgical risk factors with the postoperative complications of surgically removed impacted M3s. Material and Methods: This study was a cohort prospective study conducted on patients, aged 17 and older, admitted to the oral and maxillofacial surgery clinic. All patients who needed 1 or more extractions were included and totalled 268 patients with 314 extracted teeth. Risk factors were divided into patient factors, anatomic factors and surgical factors. The postoperative complication variables mainly included: pain, alveolar osteitis, infection, bleeding, swelling, trismus. Statistical analysis used: Chi-square test was used for the bivariate analyses while Pearson correlation coefficient (1- tailed) test was used for the purpose of determining the association between the study variables. The significance of associations was considered statistically significant at p < 0.05. Results: Patients aged of 25 years and above experienced more complications, 39 (88.6%). With respect to gender, females experienced more complications, 29 (65.9%). Mandibular M3s had more complications than maxillary M3s, 34 (8.0%), followed by distoangular inclined M3s, 23 (52.3%), and last was full bony impaction, 13 (29.5%). Pain was the most frequent complication, 18 (40.9%), followed by alveolar osteitis 12 (27.3%). Conclusion: The results indicated that the most frequently complications were pain, infection, alveolar osteitis. These complications were associated with common risk factors such as age, gender, medical history, M3 angulation, impaction level, bone removal, tooth sectioning, and number of M3 removed per session. (AU)

Objetivo: O objetivo deste estudo foi determinar as complicações que estavam associadas à cirurgia de remoção dos terceiros molares (3Ms) e avaliar a associação dos fatores de risco do paciente, anatômicos e cirúrgicos com as complicações pós-operatórias dos 3Ms impactados removidos cirurgicamente. Material e Métodos: Esse estudo foi um estudo de coorte prospectivo realizado em pacientes com idade igual ou superior a 17 anos, admitidos na clínica de cirurgia oral e maxilofacial. Todos os pacientes que precisaram de uma ou mais extrações foram incluídos, totalizando 268 pacientes e 314 dentes extraídos. Os fatores de risco foram divididos em fatores do paciente, fatores anatômicos e fatores cirúrgicos. As variáveis de complicações pós-operatórias incluíram principalmente: dor, osteíte alveolar, infecção, sangramento, edema, trismo. Análise estatística utilizada: o teste de Qui-quadrado foi utilizado para as análises bivariadas enquanto o teste do coeficiente de correlação de Pearson (unicaudal) foi usado para determinar a associação entre as variáveis do estudo. A significância das associações foi considerada estatisticamente significativa para p < 0,05. Resultados: Pacientes com 25 anos ou mais apresentaram mais complicações (39; 88,6%). Com relação ao gênero, o sexo feminino apresentou mais complicações (29; 65,9%). 3Ms mandibulares tiveram mais complicações do que 3Ms maxilares (34; 8,0%), seguidos por 3Ms com inclinação distoangulada (23; 52,3%) e, por último, com impactação óssea total (13; 29,5%). Dor foi a complicação mais frequente (18; 40,9%), seguida de osteíte alveolar (12; 12,3%). Conclusão: Os resultados indicaram que as complicações mais frequentes foram dor, infecção, osteíte alveolar. Essas complicações foram associadas a fatores de risco comuns, como idade, sexo, histórico médico, angulação do 3M, nível de impactação, remoção de osso, secção dentária e número de 3Ms removidos por sessão. (AU)

Sparganosis of the Unilateral Breast: A Case Report

Sparganosis is a parasitic infection caused by the sparganum, the plercercoid of the genus Spirometra. The preoperative diagnosis of breast sparganosis is difficult in most cases because it is a rare parasitic infection less than 2% of all cases. We report a 62-year-old woman case of breast sparganosis that were confirmed by surgical removal of worms from the right breast. The radiologic images of the patient also revealed characteristic features of breast sparganosis. The patient described the migrating palpable breast mass, which strongly suggested the possibility of breast sparganosis. The treatment of choice and confirmative diagnosis for sparganosis are complete surgical extraction of the sparganum irrespective of infected site. Inspection of the mass site with detailed medical history and radiological examinations are important for preoperative diagnosis of sparganosis patients.

Posición más frecuente de inclusión de terceros molares mandibulares y su relación anatómica con el conducto dentario inferior en pacientes del Hospital Nacional de Itauguá hasta el año 2012 / Most common position of including mandibular third molar and its anatomical relationship with the inferior dentary canal in patients of National Hospital of Itauguá until 2012

RESUMEN Introducción: Los terceros molares mandibulares incluidosson de importante estudio por su variedad de presentación, por la patología y accidentes que frecuentemente desencadenan.El tercer molar mandibular es la última pieza dentaria en hacer erupción en la cavidad oral, presenta mayor frecuencia y variedad de anomalías en su proceso eruptivo, así como patologías y accidentes que puedendesencadenar. Objetivo: determinar la posición radiográfica más frecuente de inclusión de terceros molares mandibulares y su relación anatómica con el conducto dentario inferior. Materiales y métodos: estudio observacional descriptivo temporalmenteretrospectivo con componente analítico. Fueron analizadas radiografías panorámicas de pacientes que acudieron al Hospital en un periodo de tiempo, teniendo en cuenta la edad y el género. Resultados: Ingresaron al estudio 138 casos en donde, según la clasificación de Winter, tanto el lado derecho como el izquierdo mandibular presentaron mayor predominancia por la posición mesioangular (56,5%) (58%) respectivamente. Según la clasificación de Pell-Gregory, se constató que tanto para el tercer molar inferior derecho (50,7%) como para el tercer molar inferior izquierdo (58,7%) predominó la clase II. El tipo más frecuente para el lado izquierdo fue el Tipo A con un 50,7% y para el lado derecho el Tipo B con un 50,7%. En cuanto a la relación anatómica con el conducto dentario inferior, se observó que las las posiciones vertical y mesioangular ambas con 8% guardan mayor relación. Así mismo seconstató que el 39,1% de los terceros molares inferiores, cualquiera sea el lado,se encontraban en posición cercana. El lado derecho con 17,4% presentó mayor relacionamiento con el conducto. Conclusión: La franja etárea comprendida entre 18 y 25 años acumuló mayor porcentaje de inclusión,siendo también el sexo femenino el porcentaje mayor. En ambos géneros predominó la posición mesioangular, siendo en mayor proporción para el lado izquierdo. La posición vertical y mesioangular fueron observadas con mayor frecuencia en relación con el conducto dentario inferior.

ABSTRACT Introduction: Mandibular third molars are important study for its variety of presentation, pathology and accidents often trigger.The mandibular third molar is the last tooth to erupt into the oral cavity, has greater variety and frequency anomalies in the eruptive process, as well as diseases and accidents that can trigger. Objective: To determine the most frequent radiographic position including mandibular third molar and its anatomical relation to the mandibular canal. Materials and Methods: Retrospective descriptive study with an analytical component. Panoramic radiographs were analyzed from patients attending the Hospital over a period of time, taking into account age and gender. Results: 138 cases were admitted to the study where, as rated by Winter, both right and left mandibular showed more predominance by mesioangular position (56.5%) (58 %) respectively. According to the classification of Pell-Gregory, it was found that for both the third lower right molar (50.7 %) to the lower left third molar (58.7 %) predominated class II. The most common type for the left side was the Type A with 50.7% for the right side and the Type Bwith 50.7 %. Regarding the anatomical relationship with the mandibular canal, it was observed that the vertical positions and mesioangular both with 8% relate more. So, it was verified that 39.1 % of the third molars inferior, whichever side was found in close position. The right side with 17.4% had a higher relationship with the canal. Conclusion: The age group between 18 and 25 years old accumulated higher percentage of inclusion, being also the highest percentage female. Sex both genders predominated the mesioangular position, being in greater proportion to the left. The vertical position and mesioangular were observed more frequently in relation with the inferior mandibular canal.

Needs of Preoperative Blood Sample Test in Surgical Extraction: Suggestion of New Policy

EFFECT OF IMMEDIATE DRAINAGE ON THE SURGICAL EXTRACTION OF IMPACTED MESIODENS IN CHILDREN: REPORT OF CASES

Clinical study of maxillary anterior supernumerary teeth

The prevalence of supernumerary teeth is between 1~3%. Of these, 90~98% occur in the maxilla with particular predilection for the premaxilla, preceded by mandibular third premolars, mandibular forth molars and maxillary paramolars. The most common ones occur in the maxillary anterior region, they may occur singly between the central incisors(mesiodens), or they may be double(mesiodentes). Maxillary anterior supernumeraries may erupt into the oral cavity or remain unerupted. It is found that approximately 25% are erupted, while the rest are unerupted. They are usually a small tooth with a cone-shaped crown and a short root. They may cause delayed eruption, median diastema, bodily displacement or rotation of the adjacent permanent teeth. Occasionally they may lead to the developement of dentigerous cyst or primordial cyst, or eruption into nasal cavity. In this study, 109 supernumeraries surgically extracted from premaxilla in 84 patients are analysed. The results are as follows : 1. Sex distribution of male and female is 2.2 : 1 2. Almost cases are in pediatric age from 5 to 12 years old (87%). 3. Problems with supernumeraries are tooth malpositon, diastema, delayed eruption, eruption to nasal cavity and cyst formation. 4. Of 109 supernumeraries, 16(15%) are erupted into oral cavity, 92(84%) are impacted, and 1(1%) is erupted into nasal cavity. 5. Of 84 patients, 59(70%) have one supernumeray while 25(30%) have two supernumeraries. 6. Of 109 supernumeraries, 96(88%) are found within the region of the central incisors. 7. Of 109 supernumeraries, 94(86%) are vertically impacted , 11(10%) are horizontally impacted , 3(3%) are labiopalatally impacted and 1(1%) is impacted in nasal cavity. 8. Of 84 patients, we used palatal flap in 67(80%), labial flap in 6(7%), both flaps in 4(5%) and no flap in 7(8%). And incisive nerve was cut in 33(49%) of 67 palatal flaps. 9. Extration with ostectomy was done in 72 supernumeraries(66%), without ostectomy in 37 teeth(34%). 10. Extraction with tooth sectioning was done in 21 supernumeraries(19%), without tooth sectioning was done in 88 teeth(81%). 11. We used local anesthesia in 70 patients(83%) and general anesthesia in 14 ones(17%).

A CLINICAL STUDY OF ODONTECTOMY IN IMPACTED MANDIBULAR THIRD MOLARS

Surgical removal of impacted mandibular third molars frequently require tooth sectioning or bone removal. In this study, 361 mesioangular or horizontal impacted mandibular third molars are removed surgically by tooth section, the methods of tooth section are classified as 4 stages and 12 grades in the number of times and technics of crown or roots section and difficulties. Grades and their cases are followings: 1. occlusal crown first section(100, 28%) 2. distal crown first section(69, 19%) 3. occlusal crown second section(29, 8%) 4. distal crown second section(52, 14%) 5. occlusal crown first section and root section(10, 3%) 6. distal crown first section and root section(27, 7%) 7. occlusal crown third section(3, 1%) 8. distal crown third section(22, 6%) 9. occlusal crown second section and root section(13, 3%) 10. distal crown second section and root section(17, 5%) 11. occlusal crown third section and root section(2, 1%) 12. distal crown third section and root section(17, 5%)