Measurement of the mandibular canal and mandibular incisive canal using cone beam tomography in adults from South Brazil.

PURPOSE: To identify and measure the distance from the dental apices to the mandibular (MC) and mandibular incisive (MIC) canals, the diameter of the MC and the distances of the mental foramen (MF). METHODS: In this retrospective study, cone-beam computed tomography scans of 144 adult patients (males and females) from a dental school in South Brazil were evaluated. Cross-sections were selected on the MC and the MIC paths, perpendicular to the mandibular base, and measurements were taken from the dental apices to the mandibular cortices. The measurement and location of the mandibular and mental foramen on both sides were compared. Paired t-tests compared sides, while Student's t-tests compared sexes (P < 0.05). RESULTS: The distance from the dental apices to the upper wall of the MC was closest in the third molar and farthest in the central incisor region. In both sexes and sides, the path of the MC is in most cases lingually in the molar regions and moves to the buccal region from the second premolar. The MF emerges in the regions between the premolars or near the second premolar. CONCLUSION: The results of this study highlight the importance of evaluating specific individual characteristics of a given population.

Radiographic interpretation of changes in the tooth and adjacent bone tissue using the tools of the Moodle virtual environment / Interpretação radiográfica de alterações no órgãodentário e tecido ósseo adjacente utilizando as ferramentas do ambiente virtual Moodle

Virtual learning environments (VLEs) have numerous possibilities for the use of their tools and can assist in the processesof teaching and learning aboutthe radiographic image interpretation. This study aimed to evaluate the use of a virtual learning environment as a support material for students in the discipline of Dental Radiology.This radiographic interpretation was conducted to contribute to the knowledge and training of the changes in the tooth andadjacent bone tissue,visualized in periapical and interproximal radiographs. The scores of the virtual test (via the Moodle platform) and the interpretation test (in the classroom) were used to compare Group Number 1 (students thatperformed the virtual test before the classroom test) and Group Number 2 (students thatperformed the virtual test after the classroom test). It was observed that,in general, the mean score of the interpretation test was higher than the virtual.Also,66% of the students used the platform as the main resourceto follow the discipline, due to the possibility of reviewing the contents andactivities. The virtual learning environment can be considered an important complementary sourcefor teaching radiographic interpretation. The Moodle platform acts as a remarkable tool, with the potential capacity to support the teaching and learning process. For this, mutual collaboration among students, University,and educational institution isnecessarily required for the constant use, maintenance,and updating of the virtual environment (AU).

Os ambientes virtuais de aprendizagem (AVA) possuem inúmeras possibilidades de utilização de suas ferramentas e podem auxiliar nos processos de ensino e aprendizagem sobre a interpretação de imagens radiográficas. Este estudo teve como objetivo avaliar a utilização de um ambiente virtual de aprendizagem como material de apoio para alunos da disciplina de Radiologia Odontológica. Essa interpretação radiográfica foi realizada para contribuir com o conhecimento e treinamento das alterações no órgão dentário e tecido ósseo adjacente, visualizadas em radiografias periapicais e interproximais. As notas da prova virtual (via plataforma Moodle) e da prova de interpretação (em sala de aula) foram utilizadas para comparar o Grupo Número 1 (alunos que realizaram a prova virtual antes da prova presencial) e o Grupo Número 2 (alunos que realizaram a prova virtual, após o teste em sala de aula). Observou-se que, em geral, a média da prova de interpretação foi superior à da prova virtual. Além disso, 66% dos alunos utilizaram a plataforma como principal recurso para acompanhar a disciplina, devido à possibilidade de revisão dos conteúdos e atividades. O ambiente virtual de aprendizagem pode ser considerado uma importante fonte complementar para o ensino da interpretação radiográfica. A plataforma Moodle atua como uma ferramenta notável, com potencial capacidade de apoiar o processo de ensino e aprendizagem. Para isso, é necessária a colaboração mútua entre alunos, Universidade e instituição de ensino para a constante utilização, manutenção e atualização do ambiente virtual (AU).

Evaluation of Masseter Muscle Dimensions Through Ultrasonography

ABSTRACT: The objective this study was to determine mean values of masseter muscle thickness in male and female, at rest and contraction, in healthy individuals. At first, 102 questionnaires were distributed between students. Thirty patients were selected, 15 male and 15 female, according to the inclusion criteria, excluding all individuals with symptoms of temporo-mandibular dysfunction or syndromes with craniofacial disorders. Masseter muscle thickness was determined bilaterally, at rest and contraction. As a reference point for the measurement of thickness (axial plane), the posterior prolon gation of the labial commissure was used. Normality values of the masseter muscle in females were 11.75 ± 1,14 mm in contraction and 10.19 ± 1.04 mm in relaxation; and in the male were 13.95 ± 1.62 mm in contraction and 11.64 mm ± 1.68 mm in relaxation. The results obtained are in agreement with those described in the literature. Demonstrating the accuracy and reproductibility of the ultrasound if a protocol is applied, mainly aimed at controlling the pressure applied by the transducer.

RESUMEN: El objetivo de este estudio fue determinar los valores medios del grosor del músculo masetero, en reposo y contracción, en hombres y mujeres sanos. Inicialmente se distribuyeron 102 cuestionarios entre los estudiantes. Se seleccionaron 30 pacientes, 15 hombres y 15 mujeres, según los criterios de inclusión, excluyendo a todos los individuos con síntomas de disfunción temporo-mandibular o síndromes con alteraciones craneofaciales. El grosor del músculo masetero se determinó de forma bilateral, en reposo y contracción. Como punto de referencia para la medición del espesor (plano axial), la prolongación posterior de la comisura labial. Los valores de normalidad del músculo masetero en las mujeres fue de 11,75 ± 1,14 mm en contracción y 10,19 ± 1,04 mm en relajación; y en los varones 13,95 ± 1,62 mm en contracción y 11,64 mm ± 1,68 mm en relajación. Los resultados obtenidos coinciden con los descritos en la literatura, señalando la precisión y reproducibilidad del ultrasonido si se aplica un protocolo, principalmente dirigido a controlar la presión aplicada por el transductor.

Masseter muscle measurement performed by ultrasound: a systematic review.

The aim of this study was to systematically review the existing scientific literature and evidence about (a) the validation of masseter muscle ultrasonography for accurate assessment of muscle thickness and (b) the reproducibility of masseter muscle thickness measures. An electronic literature search was conducted using determined keywords on specific databases. Preliminary search revealed 298 articles listed in Medline, Scopus and Web of Science. 60 duplicates were rejected, leaving 238 articles for review. After reading titles and abstracts, 31 articles remained. 23 articles were assessed for eligibility. These articles were categorized as follows: thickness, cross-section, volume and the length of the masseter muscle measured by ultrasonography. It is possible to verify the thickness of the masseter muscle in males and females in relaxation (10-15 and 9-13 mm, respectively) and contraction (14-19 and 12-15 mm, respectively). A similar tendency can also be evidenced in other measurements. Many studies evaluate masseter muscle dimensions to relate it to cephalometric analysis as such to evaluate morphological variations. It can be concluded that ultrasound is a reliable clinical tool for masseter muscle measurements, yet there is a need for standardization of methods and parameters to be recorded.

Sella landmark variability and its effect on the Angles SNA and SNB: a comparative study / Variabilidade do ponto Sela e seu efeito em ângulos SNA e SNB: um estudo comparativo

ABSTRACT Objective: To determine intra- and inter-observer precision in Sella (S), Nasion (N), point A and B identification. Additionally, to determine how it can interfere with angular measurements of SNA and SNB by orthodontists and dentomaxillofacial radiologists. Methods: Twenty digital lateral cephalometric radiographs were evaluated by five orthodontists and five dentomaxillofacial radiologists. Results: Differences in linear and angular measuremts were assessed. Intra- and inter-observer agreement was evaluated. Intra- and inter-observer reproducibility of the horizontal and vertical components of the S landmark identification (ICC: 0.75/0.90). Orthodontists tended to produce larger SNA (-0.18º), while SNB angle had a tendency to be smaller (0.55º). In general, SNA angle was smaller (DMFRs: -0.308º and orthodontists: -0.092º), and SNB presented with larger values (DMFR: 0.078º and orthodontists: -0.074º). Conclusion: Identification of the Sella landmark revealed a better agreement amongst dentomaxillofacial radiologists. Orthodontists, however, showed a larger variability in S identification and, consequently, the SNA and SNB angles drifted significantly.

RESUMO Objetivo: Determinar a precisão intra e inter-observador na identificação dos pontos Sella (S), Násio (N), A e B. Também, verificar como a identificação dos pontos pode interferir nas medições angulares de SNA e SNB por ortodontistas e radiologistas odontológicos. Métodos: Vinte telerradiografias laterais digitais foram avaliadas por cinco ortodontistas e cinco radiologistas odontológicos. Diferenças de medidas lineares e angulares foram avaliadas. Resultados: Concordância intra e inter-observador foi avaliada e a reprodutibilidade intra e inter-observador dos componentes horizontais e verticais da identificação S marco (ICC: 0,75 / 0,90). Ortodontistas tenderam a produzir maior valor para SNA (-0.18º), enquanto que para o ângulo SNB houve tendência a dimininuição do valor (0.55º). Em geral, os valores obtidos para o ângulo SNA foram menores (radiologistas: -0.308º e ortodontistas: -0.092º) e SNB apresentados com valores maiores (radiologistas: -0.074º: 0.078º e ortodontistas). Concordância intra e inter-observador foi avaliada e a reprodutibilidade intra e inter-observador dos componentes horizontais e verticais da identificação S marco (ICC: 0,75 / 0,90). Ortodontistas tenderam a produzir maior valor para SNA (-0.18º), enquanto que para o ângulo SNB houve tendência a dimininuição do valor (0.55º). Em geral, os valores obtidos para o ângulo SNA foram menores (radiologistas: -0.308º e ortodontistas: -0.092º) e SNB apresentados com valores maiores (radiologistas: -0.074º: 0.078º e ortodontistas). Conclusão: A identificação do ponto Sella revelou uma melhor concordância entre os radiologistas odontológicos. Ortodontistas, no entanto, mostraram uma maior variabilidade na identificação do ponto S e, consequentemente, os ângulos SNA e SNB variaram significativamente. A identificação do ponto Sella revelou uma melhor concordância entre os radiologistas odontológicos. Ortodontistas, no entanto, mostraram uma maior variabilidade na identificação do ponto S e, consequentemente, os ângulos SNA e SNB variaram significativamente.

Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study.

PURPOSE: The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. MATERIALS AND METHODS: Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. RESULTS: Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). CONCLUSION: We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.

Agressive central giant cell granuloma of the mandible: case report / Agressivo granuloma central de células gigantes de mandíbula: relato de caso

Granulomas de células gigantes (GCCG) são lesões benignas intra-ósseas proliferativas. Estas lesões podem aparecer na região anterior da maxila ou da mandíbula, porém mais frequentemente encontradas na mandíbula. A etiopatogenia permanece desconhecida, no entanto, alguns autores consideram como uma resposta reparadora, ao invés de uma condição neoplásica. Clinicamente, o CGCG é assintomático, podendo causar expansão com desvio ou a proliferação da cortical óssea. Esta condição é geralmente unifocal. A remoção cirúrgica é, na maioria dos casos, o tratamento de escolha. Embora, os métodos de tratamento não-cirúrgicos, tais como injeções intralesionais de corticoesteróides, administração sistêmica de calcitonina e interferon foram relatados. Este artigo descreve as características radiográficas de um CGCG extenso na região anterior mandibular em um paciente de 09 anos de idade. O tratamento incluiu ressecção óssea com substituição por tíbia e aplicação de fatores de crescimento ósseo.

Central giant cell granulomas (CGCG) are benign intraosseous proliferative lesions. Usually located are at the anterior region of the maxilla ormandible, although are more frequently found in the mandible. Etiopathogenesis of these lesions has remained unknown, however, some consider them as reparative response rather than neoplastic condition. Clinically CGCG present as asymptomatic, with expansive swelling causing deviation or proliferation of cortical bone. This condition is usually unifocal. Surgical removal is often the preferred treatment. Although nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. This article describes the radiographic features of a large CGCG in the anterior mandibular region seen in a9 year-old patient. Treatment of this lesion included resection of the anterior region of the mandible and replacement by tibia with bone growth factors.

Projection of the oblique line in periapical radiographs of mandibular molars / Projeção da linha oblíqua na região de molares inferiores em radiografias periapicais

Purpose: To identify and quantify the frequency of the projection of the oblique line over the alveolar crests of the mandibular molars in periapical radiographs. Methods: Five hundred periapical radiographs of the mandibular molar region were selected and evaluated for the presence or absence of the oblique line. When present, its interference on the image of the alveolar crest of the mandibular molars was analyzed. The data obtained was expressed as a percentage of the overlap of the oblique line to the alveolar crests of the mandibular molars. Results: The oblique line was observed in 363 out of the 500 periapical radiographs (72.6%). Out of the 363, 308 (84.8%) showed an overlap of the oblique line over the alveolar crests. However, 55 radiographs (15.1%) did not show such interference. Of the radiographs showing an overlap (308), the incidence of an overlap was 64.6% at a single site (199 radiographs), 33.4% at two sites (103 radiographs), and 1.9% (6 radiographs) at three sites. Conclusion: The overlap of the oblique line over the image of the alveolar crests in the mandibular molar region was observed in a significant portion of the total sample.

Objetivo: Identificar e quantificar a frequência da projeção da linha oblíqua sobre as cristas alveolares dos molares inferiores em radiografias periapicais. Metodologia: Foram selecionadas 500 radiografias periapicais da região de molares inferiores e avaliada a presença ou a ausência da linha oblíqua. Quando presente, foi analisada a interferência desta estrutura sobre a imagem das cristas alveolares dos molares inferiores. Os dados obtidos, considerando a frequência da sobreposição da linha oblíqua sobre as cristas alveolares dos molares inferiores foram expressos em percentagens. Resultados: Nas 500 radiografias periapicais avaliadas, a linha oblíqua foi observada em 363 radiografias (72,6%). Nestas, em 308 (84,8%), houve sobreposição da linha oblíqua sobre as cristas alveolares. Entretanto, em 55 radiografias (15,1%) não foi encontrada interferência. Nas radiografias em que houve a sobreposição da linha oblíqua sobre as cristas alveolares (308), a incidência de sobreposição em apenas um local foi de 64,6% (199 radiografias); em dois locais foi de 33,4% (103 radiografias) e em três locais foi de 1,9% (6 radiografias). Conclusão: A sobreposição da linha oblíqua sobre a imagem das cristas alveolares na região de molares inferiores representou uma fração significativa do total da amostra.

Healing process after surgical treatment with scalpel, electrocautery and laser radiation: histomorphologic and histomorphometric analysis.

The aim of this study was to evaluate and compare the healing process after surgical treatment of chemically induced lesions in the lateral edge of tongue of hamsters performed with scalpel, electrocautery, carbon dioxide (CO(2)) laser radiation or neodymium:yttrium-aluminum-garnet (Nd:YAG) laser radiation. Eighty hamsters of both sexes were used and examined at postoperative days 7, 14, 21 and 28 by histological and histomorphometric analysis of the skeletal muscle fibers. In the histological analysis it was observed that the dynamics of the healing process was faster in the group treated by scalpel than in the other groups. The histomorphometric observation of the skeletal muscle fibers was submitted to one-way analysis of variance (ANOVA) and Tukey's multiple comparison test, with a level of significance set at P < 0.05, which showed that the amount of skeletal muscle fiber formed had significantly increased in the group treated by scalpel in comparison with that in the groups treated by electrocautery (P < 0.01), CO(2) laser irradiation (P < 0.001) and Nd:YAG laser irradiation (P < 0.01) on the 14th postoperative day. A gradual increase in skeletal muscle fibers formed during the healing process was observed in all groups. When the laser irradiated groups were compared, it was possible to conclude that tissue organization and vascularization were faster and more intense in the Nd:YAG laser irradiated group than in the CO(2) laser irradiated group.

Current strategies for the management of oral mucositis induced by radiotherapy or chemotherapy / Estratégias atuais para o controle da mucosite bucal induzida por radioterapia ou quimioterapia

Oral mucositis is a clinically relevant complication during the treatment of cancer patients. It is frequently seen in subjects receiving high doses of radiation therapy in the head-neck region, chemotherapy or a combination of these treatment modalities. Due to its complex pathophysiology, this type of inflammation can also affect the gastrointestinal tract, which has attracted the attention of medical professionals. The oncologic treatment does not distinguish the malignant cells from the normal epithelial cells of the mucosa because of their high-proliferative capacity. Thus, the mucosa becomes atrophic and more susceptible to trauma, allowing the development of inflammation and installation of secondary infections, which aggravates the patient clinical conditions and reduces the quality of life. The clinical management of mucositis includes preventive and palliative strategies. The preventive measures are the education and monitoring of patients in relation to their oral hygiene. The palliative measures should be adopted as early as the mucosa lesions occur and involve the use of oral solutions, topical anesthetics, analgesics and anti-inflammatory agents, lasertherapy, cryotherapy, and other clinical alternatives to control mucositis and provide comfort to the patient.

A mucosite bucal é uma importante complicação do tratamento de pacientes oncológicos e, frequentemente, acomete uma parcela dos pacientes submetidos a altas doses de radiação na região de cabeça e pescoço e/ou quimioterapia ou à combinação de ambas. Em função de sua complexa fisiopatologia, esse tipo de inflamação também pode afetar a mucosa gastrintestinal e vem recebendo grande atenção por parte de cirurgiões-dentistas e médicos. Sabe-se que o tratamento oncológico, além de agir sobre as células malignas, também tem ação sobre as células epiteliais da mucosa, em razão de sua alta capacidade proliferativa. Dessa forma, a mucosa torna-se atrófica e suscetível a traumas, possibilitando o desenvolvimento da inflamação e a instalação de infecções secundárias, agravando o quadro clínico do paciente e reduzindo sua qualidade de vida. Há uma preocupação no controle da mucosite por meio de medidas preventivas para impedir seu desenvolvimento e de medidas paliativas, quando esta estiver instalada. Dentre as medidas preventivas estão a educação e o monitoramento do paciente visando o cuidado com a higiene bucal, enquanto as medidas paliativas envolvem o uso de soluções enxaguatórias, anestésicos tópicos, antiinflamatórios e analgésicos, laserterapia, crioterapia e outras alternativas. Essas medidas constituem estratégias que visam controlar a mucosite e propiciar melhor qualidade de vida ao paciente.

Optical density of bone repair after implantation of homogenous demineralized dentin matrix in diabetic rabbits.

This research evaluated the bone repair process after implantation of homogenous demineralized dentin matrix (HDDM) in surgical defects in the parietal bone of rabbits with alloxan-induced diabetes, using a polytetrafluorethylene (PTFe) barrier for guided bone regeneration. Thirty-six rabbits were used and divided into four groups: control (C, n = 12), diabetic (D, n = 12, left parietal bone), diabetic with PTFe (D-PTFe, same 12 rabbits, right parietal bone), and diabetic with PTFe associated to HDDM (D-PTFe+HDDM, n = 12). Bone defects were created in the parietal bone of the rabbits and the experimental treatments were performed, where applicable. The rabbits were sacrificed after 15, 30, 60 and 90 days. The bone defects were examined radiographically and by optical density (ANOVA and Tukey test, p < .05). The radiographic findings showed that the D-PTFe+HDDM group presented greater radiopacity and better trabecular bone arrangement when compared to that of the C, D and D-PTFe groups. The statistical analysis showed significant differences in the optical density of the newly formed bone among the studied groups. It was possible to conclude that HDDM was biocompatible in diabetic rabbits.

Surgical treatment of earlobe keloid with CO2 laser radiation: case report and clinical standpoints.

Keloids are considered to be benign hyperproliferative growths of dense fibrous tissue and overabundant deposition of disorganized, thick, hyalinized collagen that result from an abnormal tissue response to cutaneous injury. Keloids do not have a specific cause, although genetic predisposition is heavily implicated. We present a case report of a patient with an earlobe keloid that was treated with carbon dioxide laser radiation (CO(2)) with an 0.8-mm focus, 7 W, a power density of 2.5 W/cm(2), in a continuous mode. The patient was seen for follow-up 6 months later. An intact hole for placement of an earring was observed with a very good esthetic and functional result.

Optical density of bone repair after implantation of homogenous demineralized dentin matrix in diabetic rabbits

This research evaluated the bone repair process after implantation of homogenous demineralized dentin matrix (HDDM) in surgical defects in the parietal bone of rabbits with alloxan-induced diabetes, using a polytetrafluorethylene (PTFe) barrier for guided bone regeneration. Thirty-six rabbits were used and divided into four groups: control (C, n = 12), diabetic (D, n = 12, left parietal bone), diabetic with PTFe (D-PTFe, same 12 rabbits, right parietal bone), and diabetic with PTFe associated to HDDM (D-PTFe+HDDM, n = 12). Bone defects were created in the parietal bone of the rabbits and the experimental treatments were performed, where applicable. The rabbits were sacrificed after 15, 30, 60 and 90 days. The bone defects were examined radiographically and by optical density (ANOVA and Tukey test, p < .05). The radiographic findings showed that the D-PTFe+HDDM group presented greater radiopacity and better trabecular bone arrangement when compared to that of the C, D and D-PTFe groups. The statistical analysis showed significant differences in the optical density of the newly formed bone among the studied groups. It was possible to conclude that HDDM was biocompatible in diabetic rabbits.

Assimetria mandibular associada à hipoplasia da cabeça da mandíbula: tratamento cirúrgico e ortodôntico / Mandibular asymetry associated with condylar hypoplasia: orthodontic and surgical treatment

Este trabalho teve como objetivo um relato de caso clínico de paciente adulto apresentando hipoplasia condilar unilateral e severa assimetria facial. O tratamento realizado com cirurgia ortognática (expansão cirúrgica da maxila, osteotomia sagital de mandíbula e mentoplastia) associado a ortodontia fixa demonstrou resultados satisfatórios. Salientamos neste trabalho a importância do correto exame clínico, planejamento e execução dos procedimentos respeitando-se as características do paciente.

Densitometric analysis of the autogenous demineralized dentin matrix on the dental socket wound healing process in humans

The aim of this study was to evaluate the effects of the autogenous demineralized dentin matrix (ADDM) on the third molar socket wound healing process in humans, using the guided bone regeneration technique and a polytetrafluoroethylene barrier (PTFE). Twenty-seven dental sockets were divided into three groups: dental socket (Control), dental socket with PTFE barrier (PTFE), and dental socket with ADDM slices associated to PTFE barrier (ADDM + PTFE). The dental sockets were submitted to radiographic bone densitometry analysis and statistical analysis on the 15th, 30th, 60th and 90th days using analysis of variance (ANOVA) and Tukey's test (p £ 0.05). The radiographic analysis of the ADDM + PTFE group showed greater homogeneity of bone radiopacity than the Control group and the PTFE group, during all the observation times. The dentin matrix gradually disappeared from the dental socket during the course of the repair process, suggesting its resorption during the bone remodeling process. It was concluded that the radiographic bone density of the dental sockets treated with ADDM was similar to that of the surrounding normal bone on the 90th day. The ADDM was biocompatible with the bone tissue of the surgical wounds of human dental sockets. The radiographic analysis revealed that the repair process was discreetly faster in the ADDM + PTFE group than in the Control and PTFE groups, although the difference was not statistically significant. In addition, the radiographic image of the ADDM + PTFE group suggested that its bone architecture was better than that of the Control and PFTE groups.

O objetivo desta pesquisa foi avaliar a reparação óssea em alvéolos dentários após exodontia dos terceiros molares inferiores em humanos, com implantação de matriz dentinária desmineralizada autógena (MDDA) na cavidade e cobertura desta com barreira de politetrafluoretileno (PTFE). Foram selecionados 27 dentes, os quais foram divididos em três grupos: alvéolo dentário (Controle), alvéolo dentário com barreira de PTFE (PTFE) e alvéolo dentário com fatias de MDDA associada à barreira de PTFE (MDDA + PTFE). O alvéolo dentário foi submetido à análise de densitometria radiográfica e à análise estatística no 15°, 30°, 60° e 90° dias, utilizando-se a análise de variância (ANOVA) e teste de Tukey (p < 0,05). A análise radiográfica do grupo MDDA + PTFE mostrou maior homogeneidade na radiopacidade do trabeculado ósseo do que no grupo controle e grupo PTFE, durante todos os períodos de observação. A matriz dentinária foi desaparecendo do alvéolo dentário durante a evolução do processo de reparo, sugerindo sua reabsorção durante o processo de remodelação óssea. Concluiu-se que a densidade óssea radiográfica do alvéolo dentário tratado com MDDA foi similar à do osso normal circunjacente no 90° dia. A MDDA foi biocompatível com o tecido ósseo, quando implantada nos alvéolos dentários cruentos de humanos. Na análise radiográfica, pode-se verificar que o processo de reparo foi discretamente mais rápido no grupo MDDA + PTFE do que no grupo Controle e no grupo PTFE, porém não houve diferença estatística significante. Além disso, a imagem radiográfica sugeriu que a arquitetura óssea do grupo MDDA + PTFE foi melhor do que a arquitetura óssea do grupo controle e grupo PTFE.

Surgical treatment of erythroleukoplakia in lower lip with carbon dioxide laser radiation.

Erythroplakia is considered to represent a premalignant condition and is felt to be at high risk to progress to oral cancer development. When the lesion presents with red and white mucosal alterations concomitantly, the term erythroleukoplakia is used. However, in erythroleukoplakia lesions, the red or erythroplakia areas have been shown to be most likely to demonstrate dysplastic changes compared to the white hyperkeratotic areas. We present a case of patient with erythroleukoplakia involving the lower lip that was treating with carbon dioxide laser radiation (CO2) with 0.8 mm focus, 5 W, power density of 2.5 W/cm2 in continuous. After the surgery, the vaporized surface was protected with a fibrinolisine + chloramphenicol cream. To date, after 6 months, there has been no clinically evident recurrence on the vermilion area. The functional and esthetic results observed were judged to be excellent.

Estudo clínico comparativo entre cirurgia convencional e / Clinical Comparative Study Between Conventional Surgery And Co2 Laser Radiation In Treatment Of Mucoceles

O objetivo deste estudo foi avaliar o aspecto clínico entre o tratamento cirúrgico convencional e a laser de dióxido de car-bono (CO2) em fenômeno de retenção de muco (FRM). Foram constituídos dois grupos de pacientes, num total de vinte e quatro. Grupo I (biópsia convencional) com nove pacientes adultos, tratados através de cirurgia do tipo biópsia excisional. Grupo II (radiação laser) com quinze pacientes adultos tratados através de vaporização a laser, em modo contínuo, foco de 0,6mm de diâmetro, 2 Watts de potência, Densidade de potência (=Intensidade) de 256 W/cm2, fluência de 0,077 J/cm2. Os dados obtidos foram analisados estatisticamente pelos métodos de Teste de Permutação Exata, Teste Exato de Fisher e análise percentual. As cirurgias em lesões do tipo FRM tratados com laser de CO2 apresentaram melhores resultados do que àquelas realizadas através de cirurgia convencional. Os pacientes submetidos à vaporização com laser de CO2 apre-sentaram ausência de hemorragia e/ou diminuição da dor e edema, assim como a desnecessidade de sutura. Comparada ao método convencional, a cirurgia com laser de CO2 requer menor tempo de trabalho constituindo uma excelente vantagem. Entretanto, o aspecto clínico final das biópsias nos dois grupos não apresentou diferenças significativas.

Densitometric analysis of the autogenous demineralized dentin matrix on the dental socket wound healing process in humans.

The aim of this study was to evaluate the effects of the autogenous demineralized dentin matrix (ADDM) on the third molar socket wound healing process in humans, using the guided bone regeneration technique and a polytetrafluoroethylene barrier (PTFE). Twenty-seven dental sockets were divided into three groups: dental socket (Control), dental socket with PTFE barrier (PTFE), and dental socket with ADDM slices associated to PTFE barrier (ADDM + PTFE). The dental sockets were submitted to radiographic bone densitometry analysis and statistical analysis on the 15th, 30th, 60th and 90th days using analysis of variance (ANOVA) and Tukey's test (p < or = 0.05). The radiographic analysis of the ADDM + PTFE group showed greater homogeneity of bone radiopacity than the Control group and the PTFE group, during all the observation times. The dentin matrix gradually disappeared from the dental socket during the course of the repair process, suggesting its resorption during the bone remodeling process. It was concluded that the radiographic bone density of the dental sockets treated with ADDM was similar to that of the surrounding normal bone on the 90th day. The ADDM was biocompatible with the bone tissue of the surgical wounds of human dental sockets. The radiographic analysis revealed that the repair process was discreetly faster in the ADDM + PTFE group than in the Control and PTFE groups, although the difference was not statistically significant. In addition, the radiographic image of the ADDM + PTFE group suggested that its bone architecture was better than that of the Control and PFTE groups.

Comparação dos métodos de Martins & Sakima e de Fishman para avaliação do surto de crescimento puberal / Comparison between Martins & Sakima and Fishman methods for evaluation of puberal growth spurt

O objetivo desta pesquisa é verificar a semelhança, confiabilidade e praticidade dos métodos de avaliação do surto de crescimento puberal (SCP) descritos por Martins, Sakima (1996) e por Fishman (1982). Para isso, dois examinadores experientes avaliaram por ambos os métodos, 211 radiografias de mão e punho, sendo 102 indivíduos do sexo masculino e 109 do feminino. As comparações foram feitas sobre uma terceira curva de avaliação elaborada nesta pesquisa, que conjugava os dois métodos, a qual denominamos curva de adaptação, para verificar o grau de concordância entre eles. Após análise estatística dos resultados, foi comprovada, positivamente, a correlação entre os métodos, constatando a correspondência de 82,35% no total geral da amostra do sexo masculino e 71,55% do feminino. Com relação à confiabilidade, concluímos que o SCP pode ser avaliado por qualquer um dos métodos, sem diferenças estatisticamente significantes. Quanto à praticidade na interpretação, os avaliadores consideraram que ambos necessitam de conhecimentos da anatomia da mão e punho e treinamento prévio. O resultado final mostra que tanto um quanto outro permite uma rápida avaliação do SCP.