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1.
J Craniofac Surg ; 29(6): e595-e596, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29877979

ABSTRACT

Animal bites are relatively common occurrences reaching about 4.5 millions of people every year. The main aggressor is the domesticated dog, responsible for around 90% of the patients, with children being the most affected, with 70% of the registered patients, while with adults that number is a lot lower (15%). Bites around the head and neck require special attention. Due to the presence of noble structures and the rich local vascularization, any wounds have been immediately addressed to stop bleeding and further complications. The present study shows a woman patient, victim of a dog bite in her face, where the dog is her own, a domesticated Weimaraner. The patient was attended to in the Unidade de Pronto Atendimento, the procedure was to first apply anesthesia, then clean up the wound, debris of borders, and the plane suturation. Two months after the surgery, the patient showed satisfactory healing, with no complaints about pain or esthetics. As final considerations, it has to be remembered that facial trauma has to be assessed and taken care of immediately, in a way that closing the wound in the first hours after the trauma increase the chances of obtaining a better esthetic as physiologic result for the patient, also preventing infections from the wound and external environment. Also, in the case of animal bites, it is important that the professional possess the knowledge to deal with each individual situation, employing the correct prophylactic vaccine and perform the correct notification.


Subject(s)
Bites and Stings/complications , Facial Injuries/etiology , Lip/injuries , Rhytidoplasty/methods , Animals , Dogs , Facial Injuries/surgery , Female , Humans , Lip/surgery , Middle Aged
2.
Oral Maxillofac Surg ; 22(3): 323-327, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29725779

ABSTRACT

Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment. The pathogeneses and multidisciplinary management of ROD are discussed with a brief literature review. Eight years after the conservative treatment of exuberant jaw lesions, no noticeable bone changes were observed in the patient. A multidisciplinary therapy is essential for correct diagnosis of ROD and optimal multimodality treatment. The conservative management was an efficient alternative for the success of the case reported.


Subject(s)
Chronic Kidney Disease-Mineral and Bone Disorder/etiology , Hyperparathyroidism, Secondary/complications , Kidney Failure, Chronic/complications , Mandibular Diseases/etiology , Mandibular Diseases/surgery , Maxillary Diseases/etiology , Maxillary Diseases/surgery , Oral Surgical Procedures/methods , Osteitis Fibrosa Cystica/etiology , Osteitis Fibrosa Cystica/surgery , Palate/pathology , Palate/surgery , Diagnosis, Differential , Esthetics, Dental , Female , Humans , Imaging, Three-Dimensional , Kidney Failure, Chronic/surgery , Kidney Transplantation , Mandibular Diseases/diagnostic imaging , Maxillary Diseases/diagnostic imaging , Palate/diagnostic imaging , Surgical Flaps , Tomography, X-Ray Computed , Young Adult
3.
J Craniofac Surg ; 27(7): e683-e685, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27763946

ABSTRACT

One of the most impressive soft tissue injuries is the facial degloving, normally associated with industrial machines and traffic accidents. This injury is characterized by the separation of the skin and cartilage from the bones, compromising the soft tissues correlated in the trauma area, nerves, and blood vessels. A 28-year-old patient, male, was referred to Araçatuba's Santa Casa Hospital, after a motorcycle accident, hitting his face on the sidewalk. The patient was conscious, oriented, denying fainting and unconsciousness during the accident, and complaining of pain in the nasal region of the face. The suture of wounds was performed using 5-0 absorbable sutures for muscle planes, and reconstruction of the septum and nasal cartilages. The skin was sutured with interrupted stitches using 6-0 nylon. After reducing the edema, a slight increase in alar base was observed. Subsequently, the alar base cinch suture was performed aiming to bring the alar bases to a measure of 34.0 mm in diameter. As a conclusion, the knowledge of the anatomy of the region involved, the healing of tissues, and suture techniques for the facial region process were critical to the successful treatment. The evaluation of the alar base in degloving cases can involve aesthetic features.


Subject(s)
Face/surgery , Facial Injuries/surgery , Rhytidoplasty/methods , Suture Techniques/instrumentation , Sutures , Accidents, Traffic , Adult , Humans , Male , Nasal Cartilages/surgery
4.
Article in English | MEDLINE | ID: mdl-24451853

ABSTRACT

PURPOSE: This study evaluated and compared bone heating, drill deformation, and drill roughness after several implant osteotomies in the guided surgery technique and the classic drilling procedure. MATERIALS AND METHODS: The tibias of 20 rabbits were used. The animals were divided into a guided surgery group (GG) and a control group (CG); subgroups were then designated (G0, G1, G2, G3, and G4, corresponding to drills used 0, 10, 20, 30 and 40 times, respectively). Each animal received 10 sequential osteotomies (5 in each tibia) with each technique. Thermal changes were quantified, drill roughness was measured, and the drills were subjected to scanning electron microscopy. RESULTS: Bone temperature generated by drilling was significantly higher in the GG than in the CG. Drill deformation in the GG and CG increased with drill use, and in the CG a significant difference between G0 and groups G3 and G4 was observed. In the GG, a significant difference between G0 and all other groups was found. For GG versus CG, a significant difference was found in the 40th osteotomy. Drill roughness in both groups was progressive in accordance with increased use, but there was no statistically significant difference between subgroups or between GG and CG overall. CONCLUSION: During preparation of implant osteotomies, the guided surgery technique generated a higher bone temperature and deformed drills more than the classic drilling procedure. The increase in tissue temperature was directly proportional to the number of times drills were used, but neither technique generated critical necrosis-inducing temperatures. Drill deformation was directly proportional to the number of times the drills were used. The roughness of the drills was directly proportional to the number of reuses in both groups but tended to be higher in the GG group.


Subject(s)
Dental Implantation, Endosseous/instrumentation , Dental Instruments , Equipment Failure Analysis/methods , Hot Temperature , Osteotomy/instrumentation , Tibia/surgery , Animals , Dental Instruments/statistics & numerical data , Equipment Reuse/statistics & numerical data , Hot Temperature/adverse effects , Male , Microscopy, Electron, Scanning , Osteonecrosis/etiology , Rabbits , Tibia/pathology
5.
Med. oral patol. oral cir. bucal (Internet) ; 18(2): 226-232, mar. 2013. tab
Article in English | IBECS | ID: ibc-112390

ABSTRACT

Objective: The aim of this study was to evaluate the response of treatment of central giant cell lesion to intralesional corticosteroid injections. Study Design: Review of articles indexed in PubMed on the topic between the years 1988 and 2011, and development of a descriptive meta-analysis of the results. Results: Sample of 41 patients primarily treated with intralesional corticosteroid injections was obtained, with a male female ratio of 1:0.95, being 23 aggressive and 18 non-aggressive central giant cell lesions. Triamcinolone acetonide and triamcinolone hexacetonide were the drugs used, and 78.0% cases were considered as good result, 14.6% were considered as moderate response and 7.3% were considered as negative result to treatment. Considering the aggressiveness, 88.9% of non-aggressive lesions presented a good response to treatment, in aggressive (..) (AU)


Subject(s)
Humans , Adrenal Cortex Hormones/administration & dosage , Giant Cell Tumors/drug therapy , Maxillary Neoplasms/pathology , Triamcinolone/administration & dosage , Injections, Intralesional
6.
Med Oral Patol Oral Cir Bucal ; 18(2): e226-32, 2013 Mar 01.
Article in English | MEDLINE | ID: mdl-23385503

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the response of treatment of central giant cell lesion to intralesional corticosteroid injections. STUDY DESIGN: Review of articles indexed in PubMed on the topic between the years 1988 and 2011, and development of a descriptive meta-analysis of the results. RESULTS: Sample of 41 patients primarily treated with intralesional corticosteroid injections was obtained, with a male female ratio of 1:0.95, being 23 aggressive and 18 non-aggressive central giant cell lesions. Triamcinolone acetonide and triamcinolone hexacetonide were the drugs used, and 78.0% cases were considered as good result, 14.6% were considered as moderate response and 7.3% were considered as negative result to treatment. Considering the aggressiveness, 88.9% of non-aggressive lesions presented a good response to treatment, in aggressive central giant cell lesions, 69.6% presented a good response to intralesional corticosteroid injections. CONCLUSION: In view of the results analyzed, intralesional corticosteroid injections could be considered as first treatment option for central giant cell lesion.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , Giant Cell Tumors/drug therapy , Jaw Neoplasms/drug therapy , Female , Humans , Injections, Intralesional , Male
7.
J Oral Maxillofac Surg ; 71(3): 505-12, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23298799

ABSTRACT

PURPOSE: To evaluate the effect of implant osteotomy on immediate bone cell viability, comparing guided surgery for implant placement with the classic drilling procedure. MATERIALS AND METHODS: For this study, 20 rabbits were used. The animals were divided into a guided surgery group (GG) and a control group (CG) and were then divided into 4 subgroups--subgroups 1, 2, 3, and 4--corresponding to drills used 10, 20, 30, and 40 times, respectively. All animals received 5 osteotomies in each tibia, by use of the classic drilling procedure in one tibia and guided surgery in the other tibia. The osteotomized areas were removed and processed immunohistochemically for detection of osteocalcin, receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and caspase 3. RESULTS: Immunohistochemical analysis showed that osteocalcin expression was initially higher in the CG and remained constant after drill reutilization. Although the expressions of RANKL and OPG were not statistically different for the GG and CG, the RANKL/OPG ratio tended to be higher for the GG. Moreover, caspase 3 expression was elevated in the GG, proportionally to the number of osteotomies, indicating an increase in the apoptosis index in the GG. CONCLUSIONS: The classic drilling procedure is more favorable to cell viability than guided surgery.


Subject(s)
Bone and Bones/cytology , Dental Implantation, Endosseous/methods , Surgery, Computer-Assisted , Animals , Bone and Bones/metabolism , Caspase 3/biosynthesis , Caspase 3/genetics , Cell Survival , Dental Implantation, Endosseous/instrumentation , Hot Temperature/adverse effects , Male , Models, Anatomic , Osteocalcin/biosynthesis , Osteocalcin/genetics , Osteoprotegerin/biosynthesis , Osteoprotegerin/genetics , RANK Ligand/biosynthesis , RANK Ligand/genetics , Rabbits , Surgery, Computer-Assisted/adverse effects , Tibia/surgery , Tomography, X-Ray Computed
8.
J Craniofac Surg ; 23(2): 537-8, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22421848

ABSTRACT

The intraoral approach to zygomatic fracture treatment was introduced by Keen in 1909. This technique allows both an adequate visualization of the zygomaticomaxillary buttress and intraoral reduction of zygomatic arch fractures. Similar techniques have been published over the last 30 years. The aim of this study was to describe a modification of the Keen technique that promotes adequate visualization of the infraorbital rim and permits reduction and fixation of this region in cases of zygomatic fractures. The present technique has several advantages such as that (a) only 1 incision is necessary to approach the zygomaticomaxillary buttress and infraorbital rim, (b) it optimizes surgical time, and (c) it avoids periorbital scars.


Subject(s)
Fracture Fixation, Internal/methods , Orbital Fractures/surgery , Orthognathic Surgical Procedures/methods , Zygomatic Fractures/surgery , Humans , Mouth , Surgical Flaps
9.
J Oral Maxillofac Surg ; 70(2): 314-9, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21782305

ABSTRACT

PURPOSE: The aim of this study was to evaluate the satisfaction of patients rehabilitated with zygomatic fixtures and prosthesis with immediate loading. MATERIALS AND METHODS: The study selected patients who were rehabilitated with zygomatic implants at the clinic of the Latin American Institute for Dental Research and Education (ILAPEO. Curitiba-PR. Brasil) between 2005 and 2009. The patients were asked to answer a control-questionnaire during their follow-up visits. Data were collected regarding the level of patient satisfaction, reason for dissatisfaction, number of post-operative clinical sessions, and the type of complication. Sixteen patients were selected: 10 females and 6 males. RESULTS: Half of the patients were completely satisfied while the other half were satisfied with some complaints. The complaints were related to hygiene, esthetics, phonetics, and discomfort during chewing. Regarding the post-operative evaluation, 50% of the patients were attended due to the prosthesis (62.5%) and the implant (37.5%). CONCLUSIONS: The treatment with zygomatic fixtures is predictable and reliable. The patients were satisfied both with implants and prosthesis.


Subject(s)
Dental Implants/psychology , Immediate Dental Implant Loading/psychology , Patient Satisfaction , Zygoma/surgery , Adult , Aged , Atrophy , Attitude to Health , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Dental Restoration Failure , Esthetics, Dental , Female , Follow-Up Studies , Humans , Male , Mastication/physiology , Maxilla/pathology , Maxilla/surgery , Middle Aged , Oral Hygiene , Phonetics , Postoperative Complications , Speech/physiology , Surveys and Questionnaires , Treatment Outcome
10.
J Craniofac Surg ; 22(2): 737-40, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21415651

ABSTRACT

The median palatine cyst is a rare benign nonodontogenic lesion that attacks the median palatine suture. There is controversy about its pathogenesis; however, its origin is generally attributed to the enclavement of epithelial remnants within the palatine suture between the 2 lateral maxillary processes during their fusion in the origin of the hard palate. The purpose of this report was to relate a case of a median palatine cyst, discussing the rarity of the lesion, its pathogenesis, and the different modalities that could be used for the correct treatment of this pathologic entity.


Subject(s)
Nonodontogenic Cysts/diagnostic imaging , Nonodontogenic Cysts/surgery , Palate, Hard/pathology , Adult , Diagnosis, Differential , Humans , Male , Nonodontogenic Cysts/physiopathology , Radiography
11.
Br J Oral Maxillofac Surg ; 47(2): 153-4, 2009 Mar.
Article in English | MEDLINE | ID: mdl-18771827

ABSTRACT

Eagle syndrome is symptomatic elongation of the styloid process, or calcification of the stylomandibular ligament. Difficulty with deglutition, phonation, cervical movement, and the sensation of a foreign body in the oropharynx are all symptoms of this syndrome. Its treatment consists of partial removal of the styloid process, leaving it within the range of normality. We describe the technique, report a case, and point out some of the advantages, such as the simplicity of the procedure, reduced operating time, and lack risks of operative complications.


Subject(s)
Ligaments/surgery , Oral Surgical Procedures/methods , Temporal Bone/pathology , Calcinosis/diagnostic imaging , Calcinosis/pathology , Female , Humans , Ligaments/pathology , Middle Aged , Syndrome , Temporal Bone/diagnostic imaging , Temporal Bone/surgery , Tomography, X-Ray Computed
12.
Auris Nasus Larynx ; 34(2): 259-62, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17045438

ABSTRACT

Papillary cystadenocarcinoma is an extremely rare malignant tumor of the salivary gland which is cytologically considered to be of low-grade malignancy, showing an indolent biological behavior. Histologically, the tumor is characterized by cysts and papillary endocystic projections. This tumor most commonly arises in the major salivary glands, mainly the parotid gland. We report here a case of papillary cystadenocarcinoma originating from the minor salivary gland, which showed marked growth over a short period of time. Histologically, the tumor was characterized by intense cellular and nuclear pleomorphism and numerous mitotic figures. These findings indicate a tumor of high-grade malignancy.


Subject(s)
Cystadenocarcinoma, Papillary/pathology , Salivary Gland Neoplasms/pathology , Salivary Glands, Minor/pathology , Aged , Biomarkers, Tumor/analysis , Biopsy , Humans , Immunoenzyme Techniques , Male , Mitosis , Thyroglobulin/analysis , Tomography, X-Ray Computed
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