ABSTRACT
A randomized, blind and prospective clinical trial was conducted to compare two clinical rehabilitation protocols in patients submitted to orthognathic surgery, during the first 60 days after surgery. Pain, edema, mandibular movement, masticatory efficiency and quality of life were evaluated. Nineteen (19) patients were separated into control and experimental groups. The control group consisted of 10 patients followed by oral and maxillofacial surgeons and submitted to a rehabilitation protocol that involved active and passive mouth opening exercises. The experimental group had 9 patients and followed the surgeons' protocol, in addition to an Early Recovery After Surgery (ERAS) protocol performed by speech therapists, and involving specific motricity exercises and lymphatic drainage. The Student's t-test was applied to compare the results, and the Fisher's exact test of independence, to analyze the quality of life and the masticatory efficiency variables. The statistical significance was set at 5% (p < 0.05) for all the tests. The results showed that the ERAS protocol made a positive difference in pain perception in the first 14 days. However, it did not improve the other variables. Although many variables showed no significant difference, it was concluded that the surgeons can delegate patient rehabilitation to qualified professionals, so that they can optimize their postoperative clinical time.
Subject(s)
Orthognathic Surgery , Orthognathic Surgical Procedures , Humans , Postoperative Period , Prospective Studies , Quality of LifeABSTRACT
Abstract A randomized, blind and prospective clinical trial was conducted to compare two clinical rehabilitation protocols in patients submitted to orthognathic surgery, during the first 60 days after surgery. Pain, edema, mandibular movement, masticatory efficiency and quality of life were evaluated. Nineteen (19) patients were separated into control and experimental groups. The control group consisted of 10 patients followed by oral and maxillofacial surgeons and submitted to a rehabilitation protocol that involved active and passive mouth opening exercises. The experimental group had 9 patients and followed the surgeons' protocol, in addition to an Early Recovery After Surgery (ERAS) protocol performed by speech therapists, and involving specific motricity exercises and lymphatic drainage. The Student's t-test was applied to compare the results, and the Fisher's exact test of independence, to analyze the quality of life and the masticatory efficiency variables. The statistical significance was set at 5% (p < 0.05) for all the tests. The results showed that the ERAS protocol made a positive difference in pain perception in the first 14 days. However, it did not improve the other variables. Although many variables showed no significant difference, it was concluded that the surgeons can delegate patient rehabilitation to qualified professionals, so that they can optimize their postoperative clinical time.
Subject(s)
Humans , Orthognathic Surgical Procedures , Orthognathic Surgery , Postoperative Period , Quality of Life , Prospective StudiesABSTRACT
The calcifying odontogenic cyst (COC) is a benign odontogenic cyst that occurs in the gnathic bones. This cyst is part of a spectrum of lesions characterized by odontogenic epithelium containing "ghost cells," which may undergo calcification. Areas of an eosinophilic matrix material compatible dentinoid also may present adjacent to the epithelial component. However, these areas of dentinoid commonly do not appear so abundant in COCs. In this study, we report a case of intraosseous COC with extensive areas of dentinoid and perform an update regarding the clinical, radiographical, histopathological, and differential diagnosis, treatment, and prognosis of this cystic lesion.
ABSTRACT
PURPOSE: This descriptive analytical study evaluated the cause, type, incidence, demographic, and treatment data of zygomatico-orbital complex and zygomatic arch fractures managed at our program during a 5-year period. PATIENTS AND METHODS: A total of 1,857 charts of patients presenting maxillofacial trauma and treated by the Division of Oral and Maxillofacial Surgery, from the Piracicaba Dental School (UNICAMP), were reviewed. A total of 371 patients presented with zygomatico-orbital complex and/or zygomatic arch fractures. Patients with isolated orbital fractures were excluded. The patients ranged in age from 2 to 88 years. Epidemiological data including age, gender, etiology, site of injury, and details of treatment were collected and tabulated in Excel software (Microsoft). All maxillofacial injuries were assessed and treated by residents and staff surgeons. Other concomitant bodily injuries were treated by pertinent consulting specialists. RESULTS: The majority of fractures were sustained by males between 21 and 40 years old, usually resulting from falls, altercations, and bicycle accidents. Unilateral fractures of zygomatico-orbital complex were present in 266 patients (71.69%). Bilateral fractures were found in 22 cases (5.93%). Unilateral zygomatic arch fractures occurred in 39 cases (10.51%). A total of 210 patients (56.60%) did not receive surgical treatment. Surgical intervention was done in 161 patients (43.40%). The surgical treatment was conducted using the approach as reported by Ellis and Kittidumkerng in 1996. A complication incidence of 6.47% was observed, which is compatible with related articles in the literature. CONCLUSIONS: The study revealed interesting features about etiology, demonstrated by the high occurrence of bicycle accidents. The treatment protocol proposed to the patients showed adequate results as evidenced by low complication frequency. The findings of this study bring information about an area in Sao Paulo State, Brazil, that is valuable in reaffirming previously established trends and identifying new patterns of disease frequency.
Subject(s)
Orbital Fractures/epidemiology , Zygomatic Fractures/epidemiology , Accidental Falls/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Bicycling/injuries , Brazil/epidemiology , Child , Child, Preschool , Clinical Protocols , Epidemiologic Studies , Female , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Sex Factors , Treatment Outcome , Violence/statistics & numerical dataABSTRACT
This reports a case of peripheral osteoma occurring at the mandibular border in a 16-year-old girl. Clinically, a swelling with a hard surface was observed at the inferior border of the right mandibular body, causing facial asymmetry. Radiographic examination revealedradiopacity and a well-circumscribed mass approximately 2 cm in size. The lesion was treated surgically. The histopathological evaluation revealed features compatible with osteoma, such as vital compact and mature medullary bone tissue, showing osteocytes and medullary spaces containing a loose connective tissue with capillaries.There was no evidence of any recurrence
Subject(s)
Humans , Female , Adolescent , Mandible , Osteoma , Pathology, OralABSTRACT
This reports a case of peripheral osteoma occurring at the mandibular border in a 16-year-old girl. Clinically, a swelling with a hard surface was observed at the inferior border of the right mandibular body, causing facial asymmetry. Radiographic examination revealedradiopacity and a well-circumscribed mass approximately 2 cm in size. The lesion was treated surgically. The histopathological evaluation revealed features compatible with osteoma, such as vital compact and mature medullary bone tissue, showing osteocytes and medullary spaces containing a loose connective tissue with capillaries.There was no evidence of any recurrence
Subject(s)
Humans , Female , Adolescent , Mandible , Osteoma , Pathology, OralABSTRACT
A técnica de realização de enxerto ósseo de mento tem sido muito utilizada em pacientes que não possuem altura ou espessura de rebordo alveolar. Esses pacientes têm as funções fisiológicas e a estética devolvidas através de enxerto, implante e adaptação de uma prótese. A pesquisa objetivou determi nar as sensações dos pacientes nos períodos pré, trans e pós-cirúrgico, e avaliar se os benefícios do enxerto superaram o desconforto durante a cirurgia, e se esses pacientes realizariam, novamente, o mesmo procedimento cirúrgico, caso fosse necessário. Segundo o relato dos pacientes, apesar da ocorrência de parestesia, dor pós-operatória e limitações nas atividades diárias, foi constatado que os pacientes compreenderam a importância dos procedimentos realizados, tiveram credibilidade na técnica e, conseqüentemente, aceitariam realizar novo procedimento cirúrgico, senecessário.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Dental Implants , Surveys and Questionnaires , Bone Transplantation/methodsABSTRACT
The aim of this study was to evaluate, in vitro, the bending strength of internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy in sheep hemimandibles. The screws were inserted as lag screws, with an inverted "L" configuration, and the set was submitted to bending strength tests. The load and displacement of the peak and final load averages were, respectively, 18.45 kgf, 8.19 mm and 14.38 kgf for Group I, and 16.67 kgf, 6.73 mm and 13.98 kgf for Group II. The results were submitted to statistical analysis by StudentÆs t test and by the Pearson correlation analysis. The groups showed no statistically significant differences, indicating the feasibility of both for osteosynthesis in mandibular ramus sagittal split osteotomies
Subject(s)
Animals , Fracture Fixation, Internal , In Vitro Techniques , Lactic Acid , Mandibular Advancement , OsteotomyABSTRACT
The aim of this study was to evaluate, in vitro, the bending strength of internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy in sheep hemimandibles. The screws were inserted as lag screws, with an inverted "L" configuration, and the set was submitted to bending strength tests. The load and displacement of the peak and final load averages were, respectively, 18.45 kgf, 8.19 mm and 14.38 kgf for Group I, and 16.67 kgf, 6.73 mm and 13.98 kgf for Group II. The results were submitted to statistical analysis by Student s t test and by the Pearson correlation analysis. The groups showed no statistically significant differences, indicating the feasibility of both for osteosynthesis in mandibular ramus sagittal split osteotomies.
Subject(s)
Bone Screws , Fracture Fixation, Internal/methods , Mandibular Advancement , Mandibular Fractures/surgery , Osteotomy/methods , Animals , Internal Fixators , Pliability , Sheep , Tensile StrengthABSTRACT
Desde 1992 a Organizaçäo Mundial da Saúde (OMS) propôs a denominaçäo "cisto ósseo solitário" para uma lesäo descrita primeiramente por Blum em 1932. Normalmente é descoberta em uma radiografia de rotina, como a radiografia periapical. É uma lesäo incomum representando cerca de 1,1 por cento de todas as lesöes císticas dos maxilares. A radiografia mostra uma única área radiolúcida na maioria dos casos. A etiologia é incerta, muitas teorias foram propostas, mas sem sucesso. Existem basicamente duas condutas: 1)periódica avaliaçäo clínica e radiográfica; 2) exploraçäo cirúrgica. Para o diagnóstico preciso pode ser necessária a exploraçäo cirúrgica. Este artigo é uma revisäo sobre esta lesäo e discutimos um caso de cisto ósseo solitário em mandíbula
Subject(s)
Humans , Male , Child , Jaw CystsABSTRACT
Frente a evoluçäo de novos materiais restauradores estéticos adesivos, a Odontologia Restauradora tem sido cada vez mais atuante, sendo que a realizaçäo de procedimentos restauradores estéticos é crescente tanto nos dentes anteriores como nos posteriores, permitindo a realizaçäo de procedimentos mais conservadores, econômicos e com menor tempo clínico. Neste contexto, o presente trabalho relata a aplicaçäo de procedimentos clínicos estéticos em um paciente jovem, que após a perda do incisivo central superior direito optou-se pela realizaçäo de transplante do primeiro pré-molar inferior esquerdo e sua caracterizaçäo em incisivo central superior. O procedimento restaurador resumiu-se na utilizaçäo da técnica de condicionamento ácido do esmalte, aplicaçäo de sistema adesivo e inserçäo incremental de resina composta
