Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: results of a multicentre study.

BACKGROUND: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach. METHODS: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up. RESULTS: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement. CONCLUSION: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.

Intraoral Schwannomas: Presentation of a series of 12 cases.

INTRODUCTION: Schwannomas are benign and not very frequent tumors of the peripheral nerves, derived from the nerve supporting Schwann cells. STUDY DESIGN: Data were collected on the clinical manifestations (sex, age), location, size and symptonts of the lesions as well as the evolution time and the initial (presumption) diagnosis. RESULTS: Twelve patients were documented, with a mean age of 29,5 ± 12,1 years (range 16-50) and a balanced gender distribution. The mean duration of the lesions was 42,17± 45,3 months. The lesion located in the floor of the mouth was the largest tumor, measuring about 4 cm in maximum diameter, while the average size of the 12 schwannomas was 2.04± 1.1 cm. CONCLUSION: We present 12 oral schwannomas diagnosed and treated over a period of 10 years. Key words:Schwannomas, oral benign tumor, neurilemmoma.

Incidence of maxillary sinusitis following Le Fort I osteotomy: clinical, radiographic, and endoscopic study.

PURPOSE: The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities. PATIENTS AND METHODS: Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery. RESULTS: Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population. CONCLUSION: Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up.

Osteotomia sagital da crista alveolar para instalação de implantes Bicon / Mandibular ridge split expansion for Bicon Implant placement: technical report

As atrofias ósseas representam um desafio para os cirurgiões que se propõem a reabilitá-las. No passado, a única opção viável era a enxertia do tipo aposicional, provenientes dos mais variados sítios doadores. Entretanto, a enxertia óssea requer um segundo sítio cirúrgico, que com certa frequência aumenta a morbidade pós-operatória, sem mencionar a necessidade de espera para a incorporação do enxerto e posterior instalação dos implantes. A osteotomia sagital da crista alveolar representa uma opção mais rápida, pois elimina a necessidade de espera para incorporação do enxerto ósseo e segura. Possibilitando a reabilitação de áreas edêntulas que apresentem as cristas alveolares afiladas, que sem a utilização de algum tipo de procedimento de enxertia adicional inviabilizariam a sua reabilitação de forma satisfatória. Os autores apresentam neste artigo um caso clínico de reabilitação unitária, em que demonstram detalhes da técnica cirúrgica para expansão de rebordos alveolares associado à instalação mediata de implantes Bicon, para casos em que a espessura óssea do rebordo alveolar mandibular se mostrar insuficiente para a colocação de implantes.

This case report presents details of a new surgical technique for mandibular ridge sagittal osteotomy and expansion associated to immediate dental implants in atrophic ridges. The bone atrophies represents a challenge for the surgeons that intends to modify this situation. In the past, the only viable option was the onlay bone graft. However, the bone graft requests a second surgical site that certainly increases the postoperative morbidity, without mentioning the longer treatment time required. The sagittal osteotomy of the alveolar crest represents a faster option, because it eliminates the time requested for bone graft integration, providing rehabilitation of edentulous areas with thin alveolar crests that otherwise would need additi onal surgical procedures for a satisfactory result. The authors report a clinical case in which this technique was used with the installation of a Bicon dental implant in the same surgical time, showing all the steps for this single-tooth rehabilitation.

Osteopetrosis of the jaws.

Osteopetrosis is a rare hereditary condition characterized by increased bone density. The jaws, bones, and teeth invariably are affected and the osteopetrosis is directly proportional with the severity of the disease. This article describes a clinical case of osteopetrosis and reviews the clinicopathologic, radiographic, and treatment features.