Surgical Treatment of Synovial Chondromatosis in the Inferior Compartment of the Temporomandibular Joint With Articular Disc Involvement.

The authors report an unusual case of painful synovial chondromatosis originated in the inferior compartment of the temporomandibular joint (TMJ) with articular disc involvement in a 56-year-old woman with complaint of severe pain in the right preauricular region. Magnetic resonance images showed advanced destruction of the right articular disc anteriorly displaced, condylar erosion, and distinct nodules within an extremely expanded inferior joint compartment with large amount of fluid, as well as a large TMJ effusion. A scintigraphy showed elevated bone uptake in the right TMJ, demonstrating intense bone remodeling activity in the region. After a right internal maxillary artery embolization, the patient underwent open surgery. The intraoperative procedures, including articular disc removal, condylar remodeling, and replacement of the articular disc, are described in detail. Synovial chondromatosis of the TMJ is a rare disease, especially when it affects the inferior compartment and the articular disc. Initial diagnosis is challenging and imaging techniques (magnetic resonance imaging and scintigraphy) play an important role in identifying signs, making accurate diagnosis, and offering additional information not available with conventional imaging, such as TMJ inflammation or remodeling. In these patients, open surgery may be considered a definitive treatment, since the postoperative recurrence rate is very low.

Three-dimensional analysis of the pharyngeal airway space and hyoid bone position after orthognathic surgery.

PURPOSE: The aim of this study was to evaluate changes in the pharyngeal airway space (PAS) and hyoid bone position after orthognathic surgery with cone-beam computed tomography (CBCT). MATERIAL AND METHODS: This study was conducted with the tomographic records of 30 patients with skeletal class II or III deformities submitted to two different types of orthognathic surgery: Group 1 (n = 15), maxillary advancement, and mandibular setback; and Group 2 (n = 15), maxillomandibular advancement. CBCT scans were acquired preoperatively (T0); and at around 1.5 months (T1) and 6.7 months (T2) postoperatively. PAS volume, minimum cross-sectional area (min CSA), and hyoid bone position changes were assessed with Dolphin Imaging 3D software, and results analyzed with ANOVA and a Tukey-Kramer test (p < 0.05). RESULTS: The hyoid bone was significantly displaced in the horizontal dimension, moving posteriorly in Group 1, and anteriorly in Group 2. Although PAS volume and min CSA increased after both surgeries, these measurements were significantly larger only in Group 2. The significant differences that existed between groups preoperatively no longer existed after the surgeries. CONCLUSIONS: Both orthognathic surgeries assessed resulted in changes in hyoid bone position and increased PAS volume and min CSA, particularly after maxillomandibular advancement surgery.

Use of biomaterials with or without platelet-rich plasma in postextraction sites: a microscopic study in dogs.

PURPOSE: Sites that will receive dental implants need to be quantitatively and qualitatively suitable for this therapy. The treatment of postextraction areas with biomaterials associated with platelet-rich plasma (PRP) might make the repair process more efficient, resulting in desirable bone characteristics. The present study sought to evaluate the effectiveness of PRP in the process of new bone formation when associated with biomaterials. MATERIALS AND METHODS: Four female dogs were used for this study. Mandibular postextraction sites received implants, along with bone substitutes (Bio-Oss [BO] or Biogran [BG]), on the right side of the mandible and these biomaterials plus PRP on the left side of the mandible. Thirty days later, the tissues were prepared and histologic analyses were carried out to compare the repair processes. RESULTS: PRP accelerated the repair process for both BO and BG; however, the action of PRP associated with BO did not surpass that of BG alone. CONCLUSIONS: The addition of PRP appears to accelerate the repair process.

Periimplantite: revisão de literatura / Peri-implantitis: literature review

A periimplantite é um processo inflamatório dos tecidos periimplantares associado à reabsorção óssea que pode levar à perda do implante. Este estudo tem como objetivo fazer uma revisão de literatura a respeito da anatomia dos tecidos periimplantares, dos critérios de sucesso da osseointegração, da avaliação da saúde periimplantar, da etiologia e do tratamento da periimplantite para facilitar a conduta clínica.

Estudo epidemiológico das deformidades dentofaciais de Maringá/PR - 1997 - 2003 / Dentofacial deformities an epidemiologic study in Maringá/PR - 1997 - 2003

Atualmente observa-se que grande parte da população apresenta algum tipo de desvio morfológico e/ou funcional do sistema estomatognático (BOECK; GIMENEZ; COLETA, 2003). O desenvolvimento dos centros de correção de deformidades dentofaciais em nossos pais e o notável aumento na demanda destes serviços cria a necessidade de realizar estudos de prevalência destas deformidades para planejar e efetuar tratamentos de maneira mais adequada (BELLO; RODRIGUEZ, 1985).O tratamento das deformidades dentofaciais está focado na correção da má-oclusão severa, deformidade facial, e consequentemente a relção maxilo-mandibular por uma combinação de ortodontia e cirurgia ortognática (BARBER et al., 1992). O presente trabalho visa um estudo epidemiológico das deformidades dentofaciais tratadas na região de Maringá