Accidental Intraoperative Mandibular Fracture in a Third Molar Surgery: When Surgical Skills Are Mandatory in the Face of Empiricism.

Iatrogenic mandible fractures are rare complications from third molar removal surgeries. While most documented cases stress risk factors inherent to the patient and tooth presentation in fractures' etiology, appreciation of the risk factors underlying the practitioner's skills is scarce. Here, we describe an intraoperative fracture in a healthy 26-year-old female resulting from an incompatible surgical technique during the right mandibular third molar removal. The patient showed facial swelling, pain, malocclusion, and significant mobility of the fractured segment. The surgical management involved an intraoral open reduction with the installation of titanium plates for the fixation of the bone segments. Thus, we highlight that acknowledging the extent of the operator's surgical skills should be part of comprehensive treatment planning, serving as a valuable measure to prevent iatrogenic mandible fractures besides avoiding a traumatic experience for the patient.

Diagnostic Accuracy of Caries and Periapical Lesions on a Monitor with and without DICOM-GSDF Calibration Under Different Ambient Light Conditions.

To evaluate the diagnostic accuracy of caries and periapical lesions on a monitor with and without DICOM part 14: grayscale standard display function (DICOM-GSDF) calibration under different ambient light conditions. Forty digital bitewing radiographs were selected, with or without radiographic images of carious lesions and forty digital periapical radiographs with or without periapical lesions were selected from archives of the Radiology Department at the University Hospital of the Federal University of Sergipe. The gold standard radiographic images were determined through consensus between two radiologists with more than 15 and 30 years of experience. The selected radiographs were evaluated on a LG LED monitor with and without DICOM-GSDF calibration under different ambient light conditions: Lx1 (low ambient lighting), Lx2 (moderate ambient lighting) and Lx3 (high ambient lighting). Kappa (Kw) values determined that evaluator 1 showed almost perfect agreement for all devices, while evaluator 2 presented a substantial agreement for all devices. Monitors with and without DICOM-GSDF calibration have similar accuracy values. The three ambient light conditions analyzed have similar accuracy and can be used for caries lesions diagnosis (p > 0.05); however, the best diagnostic accuracy of periapical lesions was found in Lx 2. The displays with and without DICOM-GSDF calibration studied in this research have similar accuracy and can be used to evaluate digital radiographs without changing the diagnostic capacity. The different ambient lighting conditions did not influence the evaluation of caries lesions. The best diagnostic accuracy of periapical lesions was found in moderate ambient lighting.

Autogenous Bone Graft Versus Bovine Bone Graft in Association With Platelet-Rich Plasma for the Reconstruction of Alveolar Clefts: A Pilot Study.

OBJECTIVE: To compare the outcomes of 2 different bone graft materials: autogenous bone grafts from mandibular symphysis and bovine bone grafts associated with platelet-rich plasma (PRP). METHODS: Twenty individuals met the inclusion criteria and accepted to participate in the study. Group A patients underwent alveolar bone grafting using autologous bone and group B patients using a bovine bone graft associated with PRP. Cone beam computed tomography scans were taken and reconstructed 3-dimensionally for all patients preoperatively and 1 year postoperatively. RESULTS: A significant reduction was detected for area and volume within group A and group B. Between groups, no significant difference was found for area or volume. CONCLUSIONS: Bovine grafts associated with PRP are a good option for the reconstruction of alveolar clefts and provide good results such as autologous bone grafts.

Tooth Abnormalities In Individuals With Unilateral Alveolar Clefts: A Comparison Between Sides Using Cone-Beam Computed Tomography.

BACKGROUND: Tooth abnormalities are most often present in individuals with oral clefts than general population, and lead to a long-term impact on facial anatomy and self-esteem. The purpose of this study was to compare the proportion of dental anomalies between the cleft side and non-cleft side in individuals with non-syndromic unilateral alveolar clefts (AC). MATERIAL AND METHODS: Twenty cone beam computed tomography (CBCT) scans were converted into three-dimensional (3D) virtual models. The dental anomalies considered were: tooth agenesis; supernumerary teeth; giroversion; and microdontia. Statistical analysis was performed using the McNemar's test and Fisher's exact test (p<0.05). RESULTS: Statistically significant differences were not found either between the prevalence of individuals with dental abnormalities on the non-cleft side and the sides of the AC (p = 1.00), or sex (p = 0.36). Tooth agenesis was the most prevalent dental anomaly (55.6%). On the cleft side the lateral incisor was tooth most involved by dental anomalies; and the second premolar was the most affected on the non-cleft side. CONCLUSIONS: This study showed a high frequency of dental anomalies in the cleft individuals and indicated that the side of AC and sex do not interfere in the proportion of dental anomalies on non-cleft side. Key words:Cone beam computed tomography, Hypodontia, Tooth abnormalities.