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1.
Orthod Craniofac Res ; 27(2): 332-338, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37728033

ABSTRACT

AIM: The present study was designed to compare, on cone-beam computed tomography imaging, the skeletal and dental effects of the SARPE (Surgically assisted rapid palatal expansion) and MISMARPE (Minimally Invasive Surgical and Miniscrew-Assisted Rapid Palatal Expansion) techniques. MATERIALS AND METHODS: The sample of adult patients with transverse maxillary deficiency (TMD) was divided into two groups, and scans were obtained preoperatively (T0) and immediately after completion of expansion (T1). The posterior and anterior linear transverse distances of the maxilla and the angulation of the maxillary first molars were evaluated. The data were entered into a generalized estimating equations model to verify the postoperative effects of the different techniques. RESULTS: None of the techniques caused any appreciable change in the angulation of the molars. The skeletal changes were similar, with significantly greater gains in the nasal fossa and intermaxillary distance when using the MISMARPE. CONCLUSION: The technique can be an effective and lower morbidity alternative to SARPE.


Subject(s)
Maxilla , Palatal Expansion Technique , Adult , Humans , Maxilla/diagnostic imaging , Maxilla/surgery , Cone-Beam Computed Tomography/methods , Molar , Palate
2.
J Maxillofac Oral Surg ; 21(3): 779-784, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36274902

ABSTRACT

Objective: The internal fixation has been purpose of study for many years, but there is still no consensus on the best method of fixation in relation to resistance for bilateral sagittal split ramus osteotomy (BSSO) using plates. Therefore, the aim of this study was to assess five different methods of osteosynthesis using resorbable and non-resorbable plates and screws in simulated sagittal split osteotomy (SSO) of the mandibular ramus. Materials and Methods: SSO was performed in 25 polyurethane synthetic mandibular replicas. The distal segments were moved forward 5 mm, and the specimens were grouped according to the fixation method: Inion resorbable plate, KLS resorbable plate, standard four-hole titanium miniplate (Medartis), two standard four-hole titanium miniplates (Medartis) and an adjustable titanium miniplate (Slider/Medartis). Mechanical evaluation was performed by applying compression loads to first molar using an Instron universal testing machine up to a 5 mm displacement of the segments. Resistance forces were obtained in Newtons (N), and statistical analysis was performed using the software R v. 3.5 with significance level of 0.05. Linear mixed models were used to compare the force required to move each type of plate. Results: The results showed that the resistance of SSO was better accomplished using two titanium miniplates and KLS resorbable plate showed the least resistance. However, both titanium and resorbable plates behaved similarly in small displacements, which are most commonly observed in BSSO postoperative time. Conclusion: It can be concluded that both resorbable and non-resorbable systems might offer suitable mechanical resistance in the procedures where there are no mechanical postoperative complications.

3.
J Craniofac Surg ; 33(3): e250-e253, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35727653

ABSTRACT

ABSTRACT: Temporomandibular joint (TMJ) reconstruction with customized alloplastic implants has become a safe and effective treatment option of TMJ end-stage pathology with excellent outcomes reported in the literature. The purpose of this study is to report 5 cases of severe TMJ pathology and customized alloplastic reconstruction using a combined intraoral approach and extraoral approach. Four patients with TMJ involved for benign tumor and one patient with severe TMJ resorption were enrolled. Compromised joints were replaced with customized prosthesis under general anesthesia using an association of intraoral approach/extraoral approach. An implant handpiece with adapted drills for bone drilling and the insertion of screws was used to fixate the mandibular component intraorally; the fossa component was inserted via preauricular approach. The hemimandibulectomies/codilectomy with safety margin were successfully performed and for 2 patients Orthognathic Surgery was also required. Follow-up period was from 15 to 28 months (average 22 months), with no history of surgical site infection or damage to the prostheses. Occlusal relationship and function, as well as facial symmetry were kept stable in all patients. The combination of an intraoral and extraoral approach for total TMJ replacement with customized prosthesis may be an alternative and reliable strategy for pathologic reconstruction, keeping function and reducing aesthetic damage.


Subject(s)
Arthroplasty, Replacement , Joint Prosthesis , Orthognathic Surgical Procedures , Temporomandibular Joint Disorders , Humans , Temporomandibular Joint/surgery , Temporomandibular Joint Disorders/surgery
4.
Dentomaxillofac Radiol ; 51(3): 20210340, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-34520241

ABSTRACT

OBJECTIVES: A systematic review was performed to analyze the current evidence on three-dimensional (3D) computed tomography (CT) superimposition protocols used to assess dentomaxillofacial changes after orthognathic and orthofacial surgery. Accuracy, reproducibility, and efficiency were evaluated. METHODS: The search was divided into Main Search (PubMed, EMBASE, Cochrane Library, LILACS, and SciELO), Grey Literature search (Google Scholar and Open Grey), and Manual search. Thirteen studies were included. Of these, 10 reported data on accuracy, 10 on reproducibility and five on efficiency. Seven proposed or evaluated methods of voxel-based superimposition, three focused on the surface-based technique, one compared surface- and voxel-based superimposition protocols, one used the maximum mutual information algorithm, and one described a landmark-based superimposition method. Cone-beam computed tomography (CBCT) was the most common imaging technique, being used in 10 studies. RESULTS: The accuracy of most methods was high, showing mean differences smaller than voxels' dimensions, ranging between 0.05 and 1.76 mm for translational accuracy, and 0.10-1.09° for rotational accuracy. The overall reproducibility was considered good as demonstrated by the small mean error (range: 0.01-0.26 mm) and high correlation coefficients (range: 0.53-1.00). Timing to complete virtual superimposition techniques ranged between a few seconds up to 40 min. CONCLUSIONS: Voxel-based superimposition protocols presented the highest accuracy and reproducibility. Moreover, superimposition protocols that used automated processes and involved only one software were the most efficient.


Subject(s)
Orthognathic Surgery , Clinical Protocols , Cone-Beam Computed Tomography/methods , Facial Bones , Humans , Imaging, Three-Dimensional/methods , Reproducibility of Results
5.
J Craniofac Surg ; 30(6): 1809-1814, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31033755

ABSTRACT

OBJECTIVES: The primary objective of the present study was to find the gold-standard accuracy of voxel-based superimposition of cone-beam computed tomography (CBCT) datasets with a protocol developed for the Dolphin Imaging 3D software. The secondary objectives were to analyze reproducibility and efficiency of this protocol. STUDY DESIGN: Twenty-five CBCT datasets of patients with dental implants present were selected. Each Base Volume dataset was duplicated to create a second volume. Subsequently, both volumes were superimposed with a voxel-based protocol consisting of 3 successive steps "Side-by-side Superimposition"; "Overlay Superimposition"; and "Export Orientation to 2nd Volume". The protocol's accuracy was evaluated by measuring the mean distance between the apex of each dental implant on the Base Volume and second volume datasets. Efficiency was given by the mean time needed to complete all superimposition steps. Reproducibility was analyzed by calculating the intraclass correlation coefficients. RESULTS: Mean time needed to complete the protocol was 198 seconds. The protocol had a rotational accuracy of 0.10° to 019° and a translational accuracy of 0.20 to 0.24 mm. Intra-observer and inter-observer reproducibility were 1 and 0.921 to 1, respectively. CONCLUSIONS: The protocol is accurate, precise, reproducible, and efficient. The validation of this method enables unbiased analysis of surgical outcomes based on a single, user-friendly software product that is widely available in academic and clinical settings.


Subject(s)
Cone-Beam Computed Tomography , Skull Base/diagnostic imaging , Adult , Aged , Female , Humans , Imaging, Three-Dimensional/methods , Male , Middle Aged , Reproducibility of Results
6.
RGO (Porto Alegre) ; 67: e20190043, 2019. tab, graf
Article in English | LILACS | ID: biblio-1040931

ABSTRACT

ABSTRACT Objective: to analyze aesthetic and functional outcomes of the rehabilitation of single tooth morse taper implant restoration with single crown prosthesis immediately after tooth extraction. Methods: Retrospective longitudinal clinical study of 57 patients submitted to an oral rehabilitation protocol with morse taper (Ankylos® Classic) dental implants, without performing incision, grafts nor suture, followed by the placement of a provisional prosthesis immediately after tooth removal in the anterior maxillary region. The pre-and post-operative clinical data (alveolar bone contour at vestibular aspect, soft tissue contour at cervical aspect and papillae level) and postoperative radiographic findings (bone height / implant ratio) were submitted to descriptive statistics (mean and standard deviation) and Fisher's Exact Test. Results: the implant success rate was 98.25%. The alveolar bone vestibular aspect was maintained in 69.6% of the cases. There was no soft tissue retraction on the cervical aspect and the papillae height was preserved in 89.3% of the cases.The bone level remained above the implant neck in 92.8% of the cases. There was no significant association between implant diameter and soft tissue retraction (p = 0.910) or retraction of the interproximal papilla (p = 0.148) or resorption of the alveolar bone crest (p = 0.610). Conclusion: This protocol is characterized by the application of minimally traumatic techniques, reducing rehabilitation time and offering positive aesthetic and functional results.


RESUMO Objetivo: Analisar os resultados estéticos e funcionais da reabilitação bucal com implante cone morse e prótese provisória unitária imediatamente após exodontia. Métodos: Estudo clínico longitudinal retrospectivo de 57 pacientes submetidos a um protocolo de reabilitação bucal com implantes osseointegráveis cone morse (Ankylos® Classic.), sem incisão, sem enxertos e sem sutura, seguida de instalação de prótese provisória unitária imediatamente após exodontia em região estética maxilar. Os dados clínicos pré e pós-operatórios (contorno alveolar vestibular, contorno gengival cervical e papilas) e radiográficos pós-operatórios (relação nível ósseo/ implante) foram submetidos a estatística descritiva (média e desvio-padrão) e ao Teste Exato de Fisher. Resultados: A taxa de permanência dos implantes foi de 98,25%. O contorno alveolar vestibular foi mantido em 69,6% dos casos. Não houve retração do contorno cervical gengival e as papilas foram preservadas em 89,3% dos casos. O osso se manteve acima do espelho do implante em 92,8% dos casos. Não houve associação significativa entre diâmetro do implante e retração gengival (p=0,910) ou retração da papila gengival (p=0,148) ou ainda reabsorção da crista óssea alveolar (p=0,610). Conclusão: Este protocolo caracteriza-se por técnicas minimamente traumáticas, reduz o tempo da reabilitação e oferece bons resultados estéticos e funcionais. Termos de indexação: Implantes dentários. Reabilitação bucal. Osseointegração.

7.
Oral Maxillofac Surg ; 22(1): 105-111, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29356906

ABSTRACT

PURPOSE: Sialolithiasis is defined as the presence of one or more calcified structures within the duct of a major or minor salivary gland. It occurs as a result of deposition of calcium salts around an accumulation of organic debris in the duct lumen. The main signs and symptoms are edema and bacterial infection with abscess formation. METHODS: This study aimed to report two cases of submandibular sialolithiasis treated surgically with diode laser and conduct a review of the literature by means of a systematic search. In the two cases, the calculi were located in the distal part of the submandibular duct and could be palpated intraorally. Surgery was performed in an outpatient setting under local anesthesia. A linear incision was made in the floor of the mouth, in the region of the opening of Wharton's duct, to expose and remove the calculi. Laser cutting was performed using a diode laser module coupled to a 400-µm optical fiber emitting at a wavelength of 980 nm (infrared), 2.5 W output power, and in continuous pulse mode. RESULTS: The use of diode laser is a safe and minimally invasive option for this type of procedure. CONCLUSION: Offering advantages such as enhanced coagulation properties and high-quality incision, absence of bleeding, low risk of nerve damage, and few comorbidities.


Subject(s)
Lasers, Semiconductor/therapeutic use , Salivary Gland Calculi/surgery , Submandibular Gland/surgery , Adult , Aged, 80 and over , Cone-Beam Computed Tomography , Female , Humans , Male , Radiography, Dental , Salivary Ducts/diagnostic imaging , Salivary Ducts/surgery , Salivary Gland Calculi/diagnostic imaging , Submandibular Gland/diagnostic imaging
8.
J. health med. sci. (Print) ; 4(1): 23-27, Ene.-Mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-1151498

ABSTRACT

The process of facial analysis for orthognathic surgery has become of utmost importance over the last several decades, many studies show that the correction of occlusion in a dentofacial deformity does not always reach the desired facial proportions. There is no face completely symmetrical; However, the absence of some asymmetry is essential for an aesthetic outcome. Moreover, the perfect understanding of the face balance prior to treatment is critical to obtain the success of the treatment plan. Thus, the search for facial harmony requires an organized process of facial evaluation; which we intend to address in this article.


El proceso de análisis facial para la cirugía ortognática se ha vuelto de suma importancia en las últimas décadas, muchos estudios muestran que la corrección de la oclusión en una deformidad dentofacial no siempre alcanza las proporciones faciales deseadas. No hay rostro completamente simétrico; sin embargo, la ausencia de alguna asimetría es esencial para un resultado estético. Además, la comprensión perfecta del equilibrio facial antes del tratamiento es fundamental para obtener el éxito del plan de tratamiento. Por lo tanto, la búsqueda de armonía facial requiere un proceso organizado de evaluación facial; que intentamos abordar en este artículo.


Subject(s)
Humans , Orthognathic Surgical Procedures , Orthognathic Surgery , Facial Recognition , Algorithms , Facial Bones
9.
J Craniofac Surg ; 27(6): 1561-4, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27428915

ABSTRACT

The present article reports the treatment of a 7-year-old girl with maxillary hypoplasia associated with multiple tooth agenesis through maxillary protraction with skeletal anchorage and pterygomaxillary separation. Two titanium mini-plates were placed in the lateral region of the nasal cavity and used as anchorage for maxillary protraction with a reverse-pull facemask. Pterygomaxillary separation was also performed to enhance the effects of maxillary protraction. One week after surgery, 300 g of force was applied on each side to protract the maxilla. Active treatment time was 4 months, with 12 additional months of follow-up. Analysis of the cone beam computed tomography images demonstrated that skeletal anchorage enabled the correction of the maxillomandibular discrepancy, with an improvement in facial appearance and occlusion and with no dental effects. Pterygomaxillary separation was not effective, showing no superior orthopedic response on maxillary advancement or restrictions to maxillary growth in the 12-month post-treatment follow-up.


Subject(s)
Malocclusion, Angle Class III/therapy , Maxilla/abnormalities , Maxilla/surgery , Nasal Cavity/surgery , Orthodontic Anchorage Procedures/methods , Palatal Expansion Technique , Pterygopalatine Fossa/surgery , Suture Anchors , Bone Plates , Cephalometry/methods , Child , Cone-Beam Computed Tomography/methods , Extraoral Traction Appliances , Female , Follow-Up Studies , Humans , Micrognathism/therapy
10.
Head Neck ; 38(9): 1436-9, 2016 09.
Article in English | MEDLINE | ID: mdl-27087672

ABSTRACT

BACKGROUND: Locking reconstruction plates are used in the treatment of jaw trauma and diseases if there is a need for surgical resection and to prevent pathologic fracture after tumor excision. Fixation is typically performed using an extraoral approach. METHODS: This article describes a technique for the intraoral fixation of locking reconstruction plates that uses prototyping to model the plate before the procedure as well as an implant handpiece with adapted drills for bone drilling and the insertion of screws into relatively inaccessible areas. CONCLUSION: Intraoral fixation not only prevents nerve damage and facial scarring but also minimizes the plate's risk of extraoral exposure and reduces surgical morbidity. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1436-1439, 2016.


Subject(s)
Bone Plates , Fractures, Spontaneous/surgery , Imaging, Three-Dimensional , Mandibular Fractures/surgery , Mandibular Neoplasms/surgery , Plastic Surgery Procedures/instrumentation , Bone Screws , Female , Fracture Fixation/instrumentation , Fracture Fixation/methods , Fracture Healing/physiology , Fractures, Spontaneous/diagnostic imaging , Humans , Male , Mandibular Fractures/diagnostic imaging , Mandibular Neoplasms/diagnostic imaging , Oral Surgical Procedures/methods , Radiography, Panoramic/methods , Plastic Surgery Procedures/methods , Tomography, X-Ray Computed/methods , Treatment Outcome , Wound Healing/physiology
11.
Head Neck Pathol ; 10(3): 340-4, 2016 Sep.
Article in English | MEDLINE | ID: mdl-26703385

ABSTRACT

Traumatic myositis ossificans (TMO) is a rare ossifying disease that occurs in the muscle or soft tissues. A case of TMO isolated in the temporalis muscle is reported. In the case described, calcification in the temporalis muscle was confirmed after computed tomography. Surgery, physiotherapy, and histopathological analysis were performed. One year after treatment, further ossification was present but without interference in function. The most accepted treatment for TMO in the maxillofacial region is excision followed by physiotherapy. The high rate of non-recurrence may be concealed due to the short follow-up period. TMO is a lesion that may frequently recur and long-term follow-up must be provided.


Subject(s)
Myositis Ossificans/pathology , Temporal Muscle/pathology , Accidents, Traffic , Adolescent , Female , Humans , Myositis Ossificans/etiology , Myositis Ossificans/therapy , Oral Surgical Procedures , Orbital Fractures/complications , Physical Therapy Modalities , Zygomatic Fractures/complications
12.
Toxicol Lett ; 232(2): 513-8, 2015 Jan 22.
Article in English | MEDLINE | ID: mdl-25479058

ABSTRACT

The use of poly(L-lactic acid) (PLA) has been considered an important alternative for medical devices once this polyester presents biomechanical, optical and biodegradable properties. Moreover, the use of PLA results in less inflammatory reactions and more recently it has been proposed its application in drug delivery systems. Genotoxicological evaluations are considered part of the battery assays in toxicological analysis. Considering the wide applications of PLA, the present work evaluated the potential cytotoxic and genotoxic effects of PLA in CHO-K1 cells, as well as its physicochemical properties. No cytotoxic effects of PLA were detected by colorimetric tetrazolium assay (XTT) analysis, and the clonogenic survival assay showed that PLA did not disrupt the replicative cell homeostasis, neither exhibited genotoxic effects as evidenced by comet and micronucleus assays. Thermogravimetric properties of PLA were not altered after contact with cells and this film exhibited ability in absorb and release Europium(III) complex. All these data suggest genotoxicological safety of PLA for further applications in drug delivery systems.


Subject(s)
Lactic Acid/chemistry , Lactic Acid/toxicity , Membranes, Artificial , Mutagens/toxicity , Polymers/chemistry , Polymers/toxicity , Animals , CHO Cells , Cell Survival/drug effects , Colony-Forming Units Assay , Comet Assay , Cricetinae , Cricetulus , Drug Delivery Systems , Micronucleus Tests , Mutagenicity Tests , Polyesters
13.
J Craniofac Surg ; 25(2): e180-2, 2014.
Article in English | MEDLINE | ID: mdl-24621765

ABSTRACT

Facial beauty depends on shape, proportion, and harmony between the facial thirds. The chin is one of the most important components of the inferior third and has an important role on the definition of facial aesthetic and harmony in both frontal and lateral views. There are 2 principal therapeutic approaches that one can choose to treat mental deformities, alloplastic implants, and mental basilar ostectomy, also known as genioplasty. The latest is more commonly used because of great versatility in the correction of three-dimensional deformities of the chin and smaller taxes of postoperative complications. Possible transoperative and postoperative complications of genioplasty include mental nerve lesion, bleeding, damage to tooth roots, bone resorption of the mobilized segment, mandibular fracture, ptosis of the lower lip, and failure to stabilize the ostectomized segment. The study presents 2 cases of displacement of the osteotomized segment after genioplasty associated with facial trauma during postoperative orthognathic surgery followed by rare complications with no reports in the literature.


Subject(s)
Accidental Falls , Facial Injuries/surgery , Genioplasty/methods , Postoperative Complications/surgery , Adult , Facial Injuries/diagnosis , Facial Injuries/diagnostic imaging , Female , Humans , Osteotomy, Le Fort/methods , Postoperative Complications/diagnostic imaging , Radiography , Reoperation , Young Adult
14.
J Biomed Mater Res A ; 102(1): 30-6, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23568748

ABSTRACT

The aim of this study was to evaluate in vivo the influence of the native oxide layer on osseointegration and new bone formation on the surface of atmospheric plasma-sprayed porous titanium coatings. Porous titanium coatings were deposited on all implant surfaces, and half of the samples were subsequently submitted to oxide layer removal treatment. Samples were implanted onto the cortical bone of sheep (tibia) and evaluated at 30 and 60 days. Implants were removed en bloc and the attachment of bone to implants was examined by tensile pull-out test (osseointegration assessment), light microscopy, scanning electron microscopy (histological analysis), and instrumented hardness tests (mechanical properties of mature and newly formed bone tissue). Coatings submitted to oxide layer treatment presented higher osseointegration values at both healing periods and showed more mature and mineralized bone tissue when compared with nontreated coatings. Our findings showed that the use of acid-etching in association with atmospheric plasma spraying techniques improves osseointegration of titanium implants.


Subject(s)
Coated Materials, Biocompatible/chemistry , Implants, Experimental , Osseointegration , Plasma Gases/chemistry , Titanium/chemistry , Animals , Female , Sheep , Surface Properties
15.
Oral Maxillofac Surg ; 18(1): 81-6, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23404191

ABSTRACT

PURPOSE: Myofibroma is a rare benign spindle cell neoplasm, and the aim of the present study was to carry out a literature review and present a clinical case of a patient with a myofibroma in the submandibular region and its management. CONCLUSIONS: Diagnosis of myofibroma can be reached by a histopathologic and immunohistochemical analysis and surgical excision is the treatment of choice.


Subject(s)
Mandibular Neoplasms/diagnosis , Myofibroma/diagnosis , Adolescent , Biomarkers, Tumor/analysis , Diagnosis, Differential , Humans , Male , Mandibular Neoplasms/pathology , Mandibular Neoplasms/surgery , Myofibroma/pathology , Myofibroma/surgery , Tomography, X-Ray Computed
16.
Am J Orthod Dentofacial Orthop ; 144(1): 147-55, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23810056

ABSTRACT

INTRODUCTION: Gray level is the range of shades of gray in the pixels, representing the x-ray attenuation coefficient that allows for tissue density assessments in computed tomography (CT). An in-vitro study was performed to investigate the relationship between computed gray levels in 3 cone-beam CT (CBCT) scanners and 1 multislice spiral CT device using 5 software programs. METHODS: Six materials (air, water, wax, acrylic, plaster, and gutta-percha) were scanned with the CBCT and CT scanners, and the computed gray levels for each material at predetermined points were measured with OsiriX Medical Imaging software (Geneva, Switzerland), OnDemand3D (CyberMed International, Seoul, Korea), E-Film (Merge Healthcare, Milwaukee, Wis), Dolphin Imaging (Dolphin Imaging & Management Solutions, Chatsworth, Calif), and InVivo Dental Software (Anatomage, San Jose, Calif). The repeatability of these measurements was calculated with intraclass correlation coefficients, and the gray levels were averaged to represent each material. Repeated analysis of variance tests were used to assess the differences in gray levels among scanners and materials. RESULTS: There were no differences in mean gray levels with the different software programs. There were significant differences in gray levels between scanners for each material evaluated (P <0.001). CONCLUSIONS: The software programs were reliable and had no influence on the CT and CBCT gray level measurements. However, the gray levels might have discrepancies when different CT and CBCT scanners are used. Therefore, caution is essential when interpreting or evaluating CBCT images because of the significant differences in gray levels between different CBCT scanners, and between CBCT and CT values.


Subject(s)
Cone-Beam Computed Tomography/instrumentation , Image Processing, Computer-Assisted/methods , Multidetector Computed Tomography/instrumentation , Air , Algorithms , Calcium Sulfate , Color , Cone-Beam Computed Tomography/standards , Gutta-Percha , Humans , Multidetector Computed Tomography/standards , Polymethyl Methacrylate , Reference Standards , Reproducibility of Results , Software , Tomography, Spiral Computed , Water , Waxes
17.
Rev. Salusvita (Online) ; 32(2)2013. tab, graf, ilus
Article in Portuguese | LILACS | ID: lil-698380

ABSTRACT

Introdução e objetivo: este trabalho teve como objetivo comparar dois materiais de fixação interna rígida utilizados em cirurgia maxilofacial, sob o ponto de vista ultra-estrutural, dimensional e mecânico. Materiais e Métodos: foram comparadas amostras de miniplacas de 2.0mm Neoortho® e Synthes®. As amostras foram avaliadas por Microscopia Eletrônica de Varredura (MEV) e Espectroscopia por Dispersão de Energia (EDS) para avaliação superficial e identificação de contaminantes. Avaliação macroscópica foi feita com paquímetros digitais e com micrômetro. Miniplacas foram submetidas a ensaio de acordo com as normas da American Society for Testing and Materials, Norma F382-99. Resultado: Como resultado do exame pelo MEV e EDS, observa-se a presença de contaminantes, manchamentos e rebarbas em ambas as amostras. Na análise dimensional, observou-se variabilidade nas medidas entre as marcas e maior variabilidade de dimensão nas miniplacas Neoortho®. Ao ensaio de flexão, observou-se discrepância entre as amostras, sendo a Synthes® com maior homogeneidade, mas ambas dentro do intervalo preconizado pela ASTM. Conclusão: a MEV demonstrou superfícies de titânio homogêneas e com debris de superfície oriundos da fabricação e manipulação dos materiais. Dimensionalmente as miniplacas apresentam variações quando comparadas, e estas podem influenciar diretamente os resultados do dos ensaios mecânicos, sendo que mesmo com as variações ambas estão de acordo com a norma da ASTM.


Introduction and objective: this study aimed to compare two rigid internal fixation materials used in maxillofacial surgery, from the ultra-structural, dimensional and mechanical points of view. Materials and Methods: we have compared samples of 2.0 mm miniplates produced by Neoortho® and Synthes®. The samples were analyzed by Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS) for evaluation and identification of surface contaminants. Macroscopic evaluation was made with digital calipers and micrometer. The miniplates were subjected totesting in accordance with the F382-99 standards of the American Society for Testing and Materials Standard. Result: examination by SEM and EDS revealed the presence of contaminants, staining and burrs in both samples. In dimensional analysis, there was variability in measurements between brands and greater variability in size of Neoortho® miniplates. In the bending test, it was observed discrepancy between the samples, showing the Synthes® greater uniformity, but both within the range recommended by ASTM. Conclusion: the SEM showed homogeneous titanium surfaces and surface debris deriving from the manufacture and handling of materials. From the dimensional point of view, the miniplates showed variations when compared to each other, and this may directly influence the results of the mechanical tests. However, even with variations both are in agreement with the standard ASTM..


Subject(s)
/adverse effects , Facial Bones/surgery , Bone Plates , Titanium
18.
J Craniofac Surg ; 23(6): 1898-900, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23172437

ABSTRACT

Hemimandibular hyperplasia is a facial deformity in which there is an increase in the condyle, neck of the condyle or ramus, and an occlusal cant. Different surgical treatments are proposed in the literature, from simple low or high condylectomy to more complex procedures combining osteotomies in different sites of the mandible. Surgical procedure is defined by the scintigraphic diagnosis of activity or inactivity in the center of condylar growth. The case report describes a 35-year-old female patient with hemimandibular hyperplasia on the left side with inactivity of condylar growth, successfully treated with bilateral sagittal split ramus osteotomy associated with a basilar osteotomy in form of "L" on the affected side. The surgical technique was easily executed, with an improvement in function, aesthetics, and patient satisfaction. Correction of facial asymmetry caused by excessive growth of the mandible using this basilar osteotomy in the form of "L" combined with bilateral sagittal split ramus osteotomy proved to be a relatively simple technique of easy execution with a low risk of nerve damage.


Subject(s)
Facial Asymmetry/etiology , Facial Asymmetry/surgery , Jaw Abnormalities/complications , Jaw Abnormalities/surgery , Mandible/abnormalities , Mandible/surgery , Adult , Facial Asymmetry/diagnostic imaging , Female , Humans , Hyperplasia , Jaw Abnormalities/diagnostic imaging , Mandible/diagnostic imaging , Osteotomy, Sagittal Split Ramus , Radiography, Panoramic , Tomography, X-Ray Computed
19.
J Craniofac Surg ; 23(6): e529-30, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23172465

ABSTRACT

The attachment of bilateral sagittal-split osteotomy of the mandibular ramus with bicortical screws or the combination of miniplates and a bicortical screw is complicated through the intraoral approach because of the angle required for insertion of screws, so it is necessary to use a trocater. This article aimed to report a technique developed and used in 60 patients, wherein an implant handpiece with adapted drills was used in the intraoral attachment. The setting was performed intraorally to prevent scarring and extraoral facial nerve damage, which may be caused by extraoral and transbuccal approaches routinely performed when using the trocater. The versatility of the handpiece implant allows for the insertion of monocortical and bicortical screws and rigid internal fixation of mandibular sagittal-split osteotomy, as well as surgical time reduction, decreasing postoperative morbidity.


Subject(s)
Cicatrix/prevention & control , Facial Nerve Injuries/prevention & control , Malocclusion/surgery , Orthognathic Surgery/instrumentation , Bone Plates , Bone Screws , Equipment Design , Humans , Torque
20.
J Oral Maxillofac Surg ; 70(11): e639-47, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23078826

ABSTRACT

PURPOSE: The pharyngeal airway may change after skeletal movement in patients who have undergone orthognathic surgery. The aim of this study was to evaluate the skeletal and pharyngeal airway changes in subjects with a Class III facial pattern who underwent double-jaw surgery (maxillary advancement and mandibular setback). MATERIALS AND METHODS: The present retrospective study assessed preoperative (T0), 2- to 4-month postoperative (T1), and 6- to 12-month postoperative (T2) radiographs of subjects with a Class III facial pattern treated at São Lucas Hospital (Porto Alegre, Brazil) using imaging software (Dolphin Imaging 3D 11.5). Five measurements of the pharyngeal airway space (nasopharynx; upper, middle, and lower oropharynges; hypopharynx) were evaluated and correlated with the skeletal movement of the jaws (lines perpendicular to the Frankfurt horizontal plane passing through the nasion point to points A and B). The Student t test for paired samples was used to assess the presence of significant differences between the intervals, and the Spearman correlation coefficient was used to assess the significant correlation existing between the skeletal movement and the pharyngeal airway changes. The results were considered at a maximum level of significance of 5% (P < .05). RESULTS: In the sample of 58 subjects (38 female and 20 male, 18 to 48 years old), measurements of the nasopharynx, upper oropharynx, and middle oropharynx increased, whereas measurements of the lower oropharynx and hypopharynx decreased during these periods (T0 to T1, T0 to T2). Decreases from T1 to T2 in the measurements of the nasopharynx and upper oropharynx were also identified. A correlation between the jaw movements and the change in airway measurement was found between the line perpendicular to the Frankfurt horizontal plane passing through the nasion point to point A and the nasopharynx and between the line perpendicular to the Frankfurt horizontal plane passing through the nasion point to point B and the lower oropharynx for T0 to T1 and T0 to T2. CONCLUSIONS: A correlation between skeletal movements and changes in the measurements of pharyngeal airway was found between maxillary advancement and the nasopharynx, with proportions of 102.8% and 85.5% in the short and medium terms, respectively, and between mandibular setback and the low oropharynx, with proportions of 44.8% and 43.5% in the short and medium terms. A correlation for pharyngeal airway measurements was found between those located anatomically near each other, showing the importance of the pharyngeal muscles in this relation.


Subject(s)
Malocclusion, Angle Class III/surgery , Mandibular Osteotomy , Maxillary Osteotomy , Pharynx/anatomy & histology , Adolescent , Adult , Cephalometry , Female , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Retrospective Studies , Statistics, Nonparametric , Young Adult
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