Estudo comparativo entre dois programas de computador (Dolphin Imaging® e Nemotec®) e método manual para análises cefalométricas de pacientes com deformidade dentofacial Padrão II / Comparative study of two computer software programs (Dolphin Imaging® and Nemotec®) and a manual method of cephalometric analysis for patients with dentofacial deformity Class II

Este estudo analisou traçados digitais obtidos por dois programas de computador (Dolphin Imaging® e Nemotec®) em comparação aos obtidos pelo método manual nas análises cefalométricas SNA, SNB, Co-A, Co-Gn, altura facial anterior, A-Nperp, Pg-Nperp e plano mandibular. 30 pacientes leucodermas, portadores de retrognatismo mandibular, foram avaliados e submetidos à cirurgia ortognática para correção da deformidade por meio da osteotomia sagital do ramo mandibular. Os traçados cefalométricos foram realizados em telerradiografias laterais obtidas uma semana antes da cirurgia. O método Manual e o Nemotec® apresentaram excelente confiabilidade em todas as medidas. Por outro lado, o método Dolphin Imaging® apontou baixa confiabilidade nas medidas altura facial anterior, Co-A e Co-Gn. Nas medidas A-Nperp, Pg-Nperp, Plano md, SNA e SNB, não houve diferença entre três métodos estudados. Na medida altura facial anterior, houve diferença entre os métodos Dolphin Imaging® e Nemotec®, mas não foram observadas diferenças em relação ao método manual. Nas medidas Co-A e Co-Gn, foi observado que o método Dolphin Imaging® apresentou média significativamente inferior aos demais métodos estudados. No método manual, somente as medidas Co-Gn, Pg-Nperp e SNB confirmaram o diagnóstico de retrognatismo mandibular, tendo o programa Nemotec® apresentado resultados melhores que o programa Dolphin Imaging®... (AU)

This study analyzed digital tracings obtained by two different computer software programs (Dolphin Imaging® and Nemotec®) and compare them to the manual method using cephalometric measurements SNA, SNB, Co-A, Co-Gn, anterior facial height, A-Nperp, Pg-Nperp and mandibular plane. Thirty Caucasian patients exhibiting mandibular retrognathia were analyzed and were submitted to orthognathic surgery to correct the deformity by bilateral sagittal split osteotomy. The cephalometric tracings were performed with lateral radiographs that were obtained a week prior to the surgery. The manual method and the Nemotec® software exhibited an excellent reliability in all measurements. However, the Dolphin Imaging® method exhibited low reliability in the anterior facial height, Co-A and Co-Gn measurements. For the measurements of A-Nperp, Pg-Nperp, Mandibular plan, SNA and SNB, there were no significant differences between the three methods studied. For the anterior facial height measurement, a statistically significant difference was found between the Dolphin Imaging® and Nemotec® methods, although not in relation to the manual method. For the Co-A and Co-Gn measurements, the Dolphin Imaging® method exhibited a significantly lower mean than the other methods studied. In manual method, only the Co-Gn, Pg-Nperp and SNB measurements confirmed the diagnosis of mandibular retrognathia and Nemotec® software provided better results than Dolphin Imaging®... (AU)

Clinical, radiographic, and histological analyses of calcium phosphate cement as filling material in maxillary sinus lift surgery.

BACKGROUND: The installation of dental implants in the posterior maxilla is often faced with resorbed alveolar processes, resulting from a combination of pneumatization of the maxillary sinus, the effects of periodontal disease, and physiological bone resorption. The sinus lift surgery has been practiced since 1980 with the aim to increase bone height in this region for an implant supported prosthetic rehabilitation, and various filling materials have been used for such. OBJECTIVES: This study aimed to clinically, radiographically, and histologically evaluate a preparation of calcium phosphate cement (Bone Source(®), BS) used as filling material in maxillary sinus elevation surgery. METHODS: Ten patients were operated requiring maxillary sinus graft for future placement of osseointegrated implants. After a period ranging from 9 to 16 months, a clinical evaluation and biopsy of the grafted area in the region adjacent to the axis of the implant to be inserted were performed. RESULTS: Clinically and radiographically, no evidence of resorption/substitution of BS was noticed. Although no patients have had postoperative complications and the material presented fully biocompatible characteristics with woven bone in intimate contact with BS, it was not possible to place any implants due to minimal bone formation and friability of the material. CONCLUSION: It was concluded that despite the osteoconductive capacity of BS, this conventional calcium phosphate preparation does not support sufficient amount of new bone formation that could allow its use as filling material for maxillary sinus floor lift and subsequent dental implant placement.

Ancoragem com mini-implante para distalização de molares inferiores / Mini-implant anchorage for distal movement of mandibular molars

Intodução: A distalização de molares inferiores é um dos procedimentos mais difíceis de alcançar com ortodontia convencional. Objetivo: Apresentar um caso clínico de distalização de dentes posteriores na mandíbula, com ancoragem em mini-implante ortodôntico, visando recuperar espaço e posicionar o canino que estava fora do arco dentário em posição vestibularizada. Conclusão: O mini-implante ortodôntico demonstrou efetividade na ancoragem absoluta para distalização de molares, alcançando um resultado estável e com menos efeitos colaterais que o uso de ortodontia convencional.

Introduction: Mandibular molar distalization is a very difficult procedure on conventional orthodontics. Objective: Report a case of lower molars distalization to correct a canine buccal position with orthodontic mini-implant. Conclusion: The orthodontic mini-implant was effectiveness in absolute anchorage for mandibular molars distal movement, and an esthetic result was possible with less collateral effects than conventional orthodontics.

Preoperative incisor inclination in patients with Class III dentofacial deformities treated with orthognathic surgery.

Our aim was to evaluate cephalometrically the preoperative inclination of the incisors in a group of 50 patients with Class III dentofacial deformities whose immediate preoperative lateral cephalometric radiographs were analysed after they had been treated by maxillary advancement. The radiographs were hand-traced by the same operator who made the cephalometric analysis. Mean values for each measurement were compared with the normal values using Student's t-test (p<0.05). Results showed significantly increased inclination of the upper incisors, with a mean U1-NA angle of 27.58° and a mean U1-PP angle of 116°. The lower incisors were also inclined lingually, with a mean L1-NB angle of 22.53° and a mean IMPA of 83.13°. Thirty-five of the patients had labial inclination of the upper, and 28 lingual inclination of the lower, incisors. Mean inclinations of upper and lower incisors differed from the normal values, and the inclination of the lower incisors was more likely to be decompensated than that of the upper incisors.

Pattern and treatment of facial trauma in pediatric and adolescent patients.

Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.

Endosseous implant placement in conjunction with inferior alveolar nerve transposition: a report of an unusual complication and surgical management.

Inferior alveolar nerve transposition and placement of endosseous implants is one of the treatment options for patients with an edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal. The possible complications associated with this technique include prolonged neurosensory disturbances, infection, and pathologic fracture. This report presents the surgical management of a patient who sustained a mandibular fracture after inferior alveolar nerve transposition for the placement of 3 endosseous implants.