ABSTRACT
The treatment of mandibular fractures by gunshot ranges from late conservative repair to more aggressive early repair in a single stage. Treatments that preserve bony architecture as much as possible should be used, minimising patient morbidity and the complexity of future surgeries. The purpose of this study was to use a systematic review to determine which method of treatment was most effective for mandibular fractures by gunshot. Searches were conducted on Medline via PubMed, Scopus, Central Cochrane, and Sigle via Open Grey up to August 2019. Four studies were eligible to this systematic review, considering the previously establish inclusion and exclusion criteria. A total of 211 patients were evaluated. The mandibular body was the region more fractured followed by the symphyseal/parasymphyseal region. The closed treatment with intermaxillary fixation (IMF) was the most used followed by open surgery with internal rigid fixation (IRF) and external fixator. Considering the total adverse effects, the meta-analysis showed no statistically significant difference between the IMF and IRF groups (p=0.840), but IMF showed five times less infection and IRF six times less malunion. The algorithm was delineated from the types of injuries by gunshot, proposing forms of treatment from initial stabilisation to functional rehabilitation with implant-supported prostheses. The treatment of mandibular fractures by gunshot remains a challenge for surgeons. There was a statistically significant prevalence of success in the IRF group, however this group was also associated with a higher index of infection than the IMF group. New studies with high methodological quality and larger numbers of participants are needed to offer more safety for surgeons who treat patients with mandibular fractures by gunshot.
Subject(s)
Mandibular Fractures , Algorithms , Fracture Fixation, Internal , Humans , Jaw Fixation Techniques , Mandibular Fractures/diagnostic imaging , Mandibular Fractures/surgery , Treatment OutcomeABSTRACT
Trauma is one of the leading causes of death worldwide. Due to its anatomy and position in the facial skeleton, the orbit becomes a region susceptible to trauma which may also involve the penetration of foreign bodies (FBs). These events can have serious repercussions depending on their extent due to the proximity of the orbit with other noble structures of the face and skull. Because of this, a system of prehospital management of traumas must be established, in order to promote a better prognosis for patients. The present study aims to report the case of a patient suffering from a motorcycle accident with multiple fragments of FBs in the region of orbit-zygomatic-maxillary complex. The emergency surgical removal of the fragments was performed by a multidisciplinary team, involving Ophthalmology and Oral and Maxillofacial Surgery and Traumatology (OMST). Wound cleansing and debridement were performed with subsequent removal of the foreign bodies by the OMST team, in addition to the reduction and fixation of related fractures. As for Ophthalmology, the evisceration of the affected eye was performed due to its anatomical and functional impairment. The patient is 12 months postoperatively, with no aesthetic or functional complaints regarding OMST. The anatomical knowledge of the traumatized region, besides the establishment of the conduct regarding the removal of possible associated foreign bodies are required so that the success of the treatment can be obtained, aiming to minimize the damages to the patient.
Subject(s)
Accidents, Traffic , Foreign Bodies/surgery , Maxilla/surgery , Orbit/surgery , Zygoma/surgery , Debridement , Female , Humans , Maxilla/injuries , Middle Aged , Orbit/injuries , Plastic Surgery Procedures , Zygoma/injuriesABSTRACT
Objective: This study investigated the sexual and occupational exposure of dentists to hepatitis B virus. Methods: The study used a self-administered, structured, and anonymous questionnaire to collect data from 318 dentists who attended the International Congress of Dentistry held in 2009. The findings were tabulated and associations between variables were determined by the chi-square and Fisher-Freeman-Halton tests. Results: Most (84.9%) dentists used all the personal protective equipment. Roughly 68.0% had experienced percutaneous injuries but only 36.4% sought specialized care. An unimpressive 75.8% of the sample received the three doses of the hepatitis B vaccine, and a meager 27.0% was tested for hepatitis B surface antibodies (anti-HBs). Only 20.1% of the study dentists used condoms and those with more years of practice were less likely to use them (p=0.006). Conclusion: The results show that the study sample is at sexual and occupational risk of hepatitis B infection.
Objetivo: Comparar os riscos de transmissão sexual do Vírus da Hepatite B e o perfil de proteção profissional de cirurgiões-dentistas. Métodos: Questionário auto-aplicável, estruturado e anônimo foi respondido por 318 profissionais participantes de Congresso Internacional de Odontologia, em 2009. Os achados foram agrupados em tabelas, e a associação de variáveis foi feita por meio do teste qui-quadrado e teste de Fisher-Freeman-Halton. Resultados: Foi observado que 84,9% dos profissionais relataram utilizar todos os Equipamentos de Proteção Individual.Aproximadamente 68,0% já se feriram com instrumento pérfuro-cortante, mas apenas 36,4% procuraram serviço especializado. A prevalência de vacinação completa contra hepatite B foi 75,8%, todavia somente 27,0% realizaram o teste de conversão sorológica(anti-HBs). Quanto ao uso de preservativo, apenas 20,1% afirmaram ter utilizado esse insumo e o tempo de formado foi estatisticamente significante quando associado à menor frequência na utilização (p = 0,006).Conclusão: Os resultados revelaram possível vulnerabilidade dos dentistas para hepatite B nos âmbitos sexual e profissional.
Subject(s)
Humans , Hepatitis B , Dentistry , SexualityABSTRACT
Os cistos dermóides são lesões congênitas de desenvolvimento, raras, principalmente na cavidade oral, podendo localizar-se na linha média do soalho bucal ou lateralmente a ela. Apresentam um crescimento lento e indolor. Essas características podem retardar a procura dos pacientes por tratamento e fazer com que aslesões se apresentem bastante volumosas no momento do diagnóstico.O objetivo deste artigo é relatar um caso clínico de cisto dermóide localizado no soalho lingual, que, por apresentar-se com um grande volume (evolução de 17 anos), produzia prejuízos funcionais ao paciente
