Orthognathic surgery in a patient with von Willebrand disease: case report

Aim: This study aims to report the perioperative management of a patient with von Willebrand disease (vWd) who underwent orthognathic surgery. The report follows the guidelines of the Case Report Guidelines (CARE) and focuses on the steps taken to prevent bleeding during the surgical procedure. Methods: A 39-year-old female patient with skeletal Class III was treated with maxillary advancement and mandibular setback. Despite normal test results for ristocetin cofactor activity, measures were taken to prevent bleeding, including atraumatic surgical techniques, use of antifibrinolytic medication, induced hypotension during anesthesia, and preparation of blood products for transfusion during trans and postoperative periods if needed. In the end, these measures were not required. Results: The patient did not experience any bleeding during the surgical procedure or postoperative period, demonstrating the effectiveness of the measures taken to manage their blood dyscrasia. Two years after the surgery, the patient had satisfactory aesthetic and functional results and no evidence of relapse. Conclusion: Thus, this case report demonstrates that vWd does not prevent largescale oral and maxillofacial surgeries such as orthognathic surgery as long as proper precautions are taken pre-, intraand postoperatively

Orthodontic treatment in traumatized permanent teeth: a systematic review / Tratamento ortodôntico em dentes permanentes traumatizados: uma revisão sistemática

Objective: to analyze, through literature review, the available literature on orthodontic treatment in traumatized permanent teeth. Methods: A literature search was performed in electronic databases (PubMed and SciELO) using the descriptors [tooth injuries] OR [injuries, teeth] OR [injury, teeth] OR [teeth injury] OR [injuries, tooth] OR [injury, tooth] OR [tooth injury] OR [teeth injuries] AND [orthodontics]. Observational studies and clinical trials were included, narrative reviews, laboratory and in vitro studies, case reports and series as well as articles that presented abstracts written in languages other than Portuguese, English and Spanish were excluded from the study. Two reviewers considered the eligibility, the risk of bias of the analyzed data and the qualitative synthesis of the studies included. A total of 1,322 references were found and 4 articles met all inclusion criteria and were included in the qualitative analysis. Some consequences like pulp necrosis and root resorption have been highlighted and trauma severity should be considered when orthodontically intervening in previously traumatized teeth. Final considerations: The traumatized teeth can be orthodontically treated as long as the time of tissue reorganization is respected, and the pull and periodontal conditions are followed up.(AU)

Objetivos: analisar, por meio de revisão de literatura, a respeito do tratamento ortodôntico em dentes permanentes traumatizados. Metodologia: Uma pesquisa bibliográfica foi realizada em bancos de dados eletrônicos (PubMed e SciELO) usando os descritores [tooth injuries] ou [injuries, teeth] ou [injury, teeth] ou [teeth injury] ou [injuries, tooth] ou [injury, tooth] ou [tooth injury] ou [teeth injuries] e [orthodontics]. Foram incluídos estudos observacionais e ensaios clínicos, revisões narrativas, estudos laboratoriais e in vitro, relatos de casos e séries, bem como artigos que apresentassem resumos redigidos em idiomas diferentes do português, inglês e espanhol foram excluídos do estudo. Dois revisores consideraram a elegibilidade, o risco de viés dos dados analisados e a síntese qualitativa dos estudos incluídos. Foram encontradas 1.322 referências e 4 artigos atenderam a todos os critérios de inclusão e foram incluídos na análise qualitativa. Algumas consequências como necrose pulpar e reabsorção radicular têm sido destacadas e a gravidade do trauma deve ser considerada na intervenção ortodôntica em dentes previamente traumatizados. Considerações finais: Os estudos incluídos nesta revisão sugerem que dentes traumatizados podem ser tratados ortodônticamente desde que respeitado o tempo de reorganização tecidual e acompanhadas as condições pulpares e periodontais.(AU)

Factors associated with root migration after lower third molar coronectomy - preliminary results / Fatores associados com a migração radicular após coronectomia de terceiros molares inferiores - resultados preliminares

Objective: The aim of this prospective study, with preliminary results, was to evaluate factors related with root migration after lower third molar coronectomy, especially radiographic bone density. Material and Methods:Twenty-two patients were submitted to 31 lower third molar coronectomies. Clinical and radiographic evaluation of all patients were performed preoperatively and at 7, 90 and 365 days postoperatively. Sociodemographic, clinical and radiographic data were collected. The root migration was analyzed by the distance from the tooth apex to the mandibular canal, and radiographic bone density above the remaining roots was obtained, both using the software Image J©.Results: After 1-year follow-up no patients showed paresthesia, symptoms or required reintervention, however all roots showed migration. The mean root migration was 2.66 mm at 90 days, and 3.37 mm at 365 days (p = 0.0007). The rate of migration was higher at the early postoperative period. The simple linear regression test between root migration and radiographic bone density was not significant (R=-0.173 and p=0.453; R=-0.045 and p=0.902; at 90 days and 365 days, respectively) as well as the analysis between root migration and other clinical and radiographic variables. Conclusion: It was possible to conclude, based on these preliminary results, that all roots showed migration during the follow-up period. The radiographic bone density increases and, consequently, the root migration rate diminishes within time, however none of the evaluated factors showed significant association with root migration. (AU)

Objetivo: O objetivo deste estudo prospectivo, com resultados preliminaraes, foi avaliar os fatores relacionados com a migração das raízes após corocetomia de terceiros molares inferiores, especialmente a densidade óssea radiográfica. Material e Métodos: Vinte e dois pacientes foram submetidos à 31 coronectomias de terceiros molares inferiores. Avaliação clínica e radiográfica de todos os pacientes foi executada no momento pré-operatório e aos 7, 90 e 365 dias pós-operatórios. Dados sociodemográficos, clínicos and radiográficos foram coletados. A migração das raízes foi analisada pela distância do ápice radicular ao canal mandibular, e a densidade óssea radiográfica foi mensurada acima dos remanescentes radiculares, usando o software Image J©.Resultados: Após 1 ano de acompanhamento, nenhum paciente apresentou parestesia, sintomatologia ou necessitou reintervenção, porém todas as raízes migraram. A média da migração radicular foi de 2,66mm aos 90 dias e de 3,37mm aos 365 dias (p=0,0007). A taxa de migração foi maior no pós-operatório inicial. O teste de regressão linear simples entre migração das raízes e densidade óssea radiográfica não foi significante (R=-0,173 e p=0,453; R=-0,045 e p=0,902; aos 90 e 365 dias, respectivamanete), assim como a análise entre migration radicular e outras variáveis clínicas e radiográficas. Conclusão: Foi possível concluir, com base nesses resultados prelimiares, que todas as raízes apresetaram migração durante o período de acomapanhamento. A densidade óssea radiográfica aumentou e, consequentemente, a taxa de migration radicular dimininiui com o tempo, porém nenhum dos fatores avaliados mostrou associação significante com a migração das raízes(AU)

What is the relapse after Le Fort I maxillary advancement in cleft lip and palate patients? A systematic review.

Le Fort I osteotomy is the most common procedure for maxillary advancement in cleft patients, and a significant relapse is expected in the postoperative period. This study purpose is to evaluate the maxillary relapse and associated factors in cleft lip and palate (CLP) patients submitted to standard Le Fort I advancement. This systematic review sought studies in PubMed, SCOPUS, and Cochrane and included papers that evaluated the maxillary relapse with at least 1-year postoperative period. The quality assessment was adapted following PRISMA statement. The initial electronic search found 345 papers, and the final selection included 10 studies. In total, 275 CLP patients were evaluated 198 had unilateral CLP and 41 had bilateral CLP. Isolated maxillary advancement was performed in 166 patients, while 109 had bimaxillary surgery. The mean relapse in horizontal and vertical plane was 1.2 mm (19.7%) and 1.0 mm (29.4%), respectively. In conclusion, a relapse after maxillary advancement in patients with CLP is expected, being higher in vertical plane. Patients with UCLP and those who underwent bimaxillary surgery had a higher relapse rate. Due to the miscellaneous data and methodologies, future prospective clinical trials should apply rigorous selection of CLP patients sample and methods for variable analysis to obtain more accurate results.

Complications and sequelae of concussion and subluxation in permanent teeth: A systematic review and meta-analysis.

BACKGROUND/AIM: The overall prognosis for teeth that have suffered concussion and/or subluxation is not yet known. The aim of this study was to systematically review the literature to identify the incidence of sequelae or complications associated with concussion and subluxation of permanent teeth. METHODS: Four databases were used as follows: PubMed, Web of Science, Scopus, and Lilacs. The search for studies was carried out up to March 31, 2019, to identify studies evaluating patients diagnosed with dental trauma classified as concussion or subluxation and reporting their respective sequelae and/or complications. No restrictions were made for gender, follow-up period, and the year of publication or language. The selection of studies and data extraction were carried out independently by two researchers. The studies were grouped according to the type of trauma. A random-effect model was applied to calculate the pooled odds ratios (OR) and their respective 95% confidence intervals for each type of trauma. RESULTS: Thirteen articles were included in the systematic review, and six were included in the meta-analysis. The pooled incidence of unfavorable outcomes (any sequel or complication) in teeth with concussion was 12% by the end of 1 year of follow up (0.12; CI95% 0.00-0.26). The pooled incidence of unfavorable outcomes in teeth with subluxation was 18% (0.18; CI95 % 0.07-0.29) by the end of 1 year of follow up. CONCLUSION: Concussion and subluxation showed sequelae and/or complications by the end of 1 year, including pulp necrosis. Patients who have suffered mild supportive tissue injuries should be monitored.

Outcomes after mandibular third molar coronectomy / Desfechos após coronectomia de terceiros molares inferiores

ABSTRACT Coronectomy is an alternative technique to mandibular third molar removal to avoid inferior alveolar nerve impairment. It is indicated in cases where the dental roots are in close relationship with the nerve which results in a higher risk of damage and paresthesia. The coronectomy technique is considered a safe method to prevent inferior alveolar nerve injury, however it shows particular postoperative outcomes as migration and exposure of the retained roots, and possibility of additional intervention. The aim of this case series is to describe four different outcomes from coronectomy, in patients treated by the same protocol. The outcomes ranged from asymptomatic to migration, infection and root removal. Although the variety of outcomes, none of the patients showed inferior alveolar nerve impairment. Therefore, the main objective of coronectomy was reached.

RESUMO A coronectomia é uma técnica alternativa à extração de terceiros molares inferiores para a prevenção de lesão ao nervo alveolar inferior. É indicada em casos em que as raízes dentárias estão em íntimo contato com o nervo alveolar, resultando em um maior risco de lesão, e consequentemente parestesia. A técnica de coronectomia é considerada um método seguro para prevenção de lesões ao nervo alveolar inferior, entretanto pode apresentar desfechos pós-operatórios singulares, incluindo a migração e exposição dos remanescentes radiculares, além da possibilidade de intervenções adicionais. O objetivo desta série de casos é descrever quatro desfechos diferentes da técnica de coronectomia, em pacientes tratados por meio de um único protocolo. Os desfechos pós-operatórios apresentados variaram entre casos assintomáticos até migração das raízes, infecção e necessidade de remoção do remanescente radicular. Entretanto, apesar da variedade de desfechos, nenhum dos pacientes apresentou lesão ao nervo alveolar inferior. Desta forma, conclui-se que o objetivo principal da técnica foi alcançado apesar dos diferentes desfechos.

What Are the Parameters for Reoperation in Mandibular Third Molars Submitted to Coronectomy? A Systematic Review.

PURPOSE: Coronectomy is an alternative technique to conventional lower third molar removal that aims to decrease inferior alveolar nerve impairment. The purpose of this study was to identify factors associated with reoperation after mandibular third molar coronectomy. MATERIALS AND METHODS: This systematic review sought scientific articles in the MEDLINE (PubMed), Scopus (Elsevier), and Cochrane Library databases. Studies that evaluated reoperation after coronectomy and reported a minimum follow-up of 6 months were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality assessment of the included articles was performed, and the following data were analyzed: demographic characteristics, reason for reoperation, and time from coronectomy to reoperation. The data were subjected to descriptive analysis. RESULTS: The initial search yielded 362 studies and 15 were included in the final review. In total, 1,664 patients and 2,062 teeth underwent coronectomy. Most patients were women (60.58%). The follow-up period for reoperation ranged from 6 months to 10 years and the mean time until the second procedure was 10.4 months (quartile 1, 3; quartile 3, 8.5). Only 105 teeth (5.1%) were reoperated on. The main reasons for reoperation were root exposure (53.33%), infection (10.47%), pain (9.52%), and enamel residual (9.52%). In the PRISMA quality evaluation, only 1 article presented a low risk of bias. CONCLUSIONS: Reoperation after mandibular third molar coronectomy was low (cases, ∼5%); the main reasons for reoperation were residual root exposure and symptomatology. Owing to the possibility of late exposure or symptomatology, a follow-up longer than 6 months is recommended until root exposure or the end of the migration process.

Oral and maxillofacial rehabilitation of a patient suffering from intraosseous adenoid cystic carcinoma / Reabilitação bucomaxilofacial de paciente portador de carcinoma adenóide cístico intraósseo

ABSTRACT Treatment of cancers of the head and neck may provoke sequelae that affect the quality of life of patients during and after treatment. Mouth-sinus communication resulting from partial or total surgical resection of the palate leads to the patient experiencing dysphagia, dysphonia and trismus, which can lead to social isolation of the individual. As a result, the work of the dental surgeon, together with the multidisciplinary team caring for cancer patients, is fundamental and can help with the diagnosis, assist in the management of chemotherapy and radiotherapy complications and enable postsurgical rehabilitation. The present study reports the case of a patient with adenoid cystic carcinoma in the right maxilla, who underwent a partial maxillectomy, the resulting sequela being mouth-sinus communication. The dental treatment was performed at the Hospital of the Federal University of Pelotas preoperatively, during and after treatment. At this time the patient is rehabilitated with an obturator prosthesis and is being monitored by the dental team and the head and neck surgeon.

RESUMO O tratamento das neoplasias em região de cabeça e pescoço pode deixar sequelas que afetam a qualidade de vida do paciente durante e após o tratamento. A comunicação buconasosinusal decorrente da ressecção cirúrgica parcial ou total do palato traz ao paciente alterações na função mastigatória, estética, fonética e de deglutição o que pode levar a um isolamento social do indivíduo. Em vista disso, a atuação do cirurgião dentista junto à equipe multiprofissional de atendimento ao paciente oncológico se faz fundamental, podendo contribuir no diagnóstico, auxiliar no manejo de complicações do tratamento quimioterápico/radioterápico, e na reabilitação bucomaxilofacial, sendo esta uma alternativa para melhorar a qualidade de vida do paciente, pois visa restabelecer as funções alteradas em decorrência do procedimento cirúrgico. O presente estudo relata o caso de uma paciente portadora de carcinoma adenóide cístico na maxila submetida à maxilectomia parcial, deixando como seqüela a comunicação buconasosinusal. O acompanhamento odontológico foi realizado no Hospital Escola da Universidade Federal de Pelotas no pré-operatório, durante e após o tratamento. No momento a paciente está reabilitada com uma prótese obturadora em acompanhamento pela equipe de odontologia e pelo cirurgião de cabeça e pescoço.

Therapeutic Approach to Pulp Canal Calcification as Sequelae of Dental Avulsion.

Tooth avulsion represents the most complicated dental injury, and the classic treatment is tooth replantation. The most common sequelae are pulp canal calcification (PCC) and pulp necrosis. The presence of pulp necrosis after PCC is reported in up to 30% of the cases and is a challenge due to the difficulty of endodontic treatment. This case report describes the surgical treatment of a replanted tooth presenting PCC and periapical pathology eight years after the trauma. An endodontic surgery was performed to remove the apical granuloma, to prepare the apical root, and to seal the apical region with an endodontic cement. In a three-year follow-up, there was an absence of inflammatory signs and symptoms or apical lesion. This report shows the importance of close follow-up after dentoalveolar injuries. After the initial dental trauma and its consequences to pulpal tissues, the executed procedures allowed a favourable outcome.

Frequência de reabsorção radicular inflamatória decorrente de trauma em dentes anteriores / Inflammatory root resorption frequency due to trauma in anterior teeth

Objetivo: a reabsorção radicular inflamatória é uma das consequências do traumatismo dentário, sendo a detecção e o tratamento precoces determinantes na limitação de seus danos. Assim, o objetivo deste estudo foi investigar, em dentes anteriores permanentes traumatizados, a prevalência de reabsorção radicular inflamatória, relacionando-a com os diferentes tipos de traumatismos nos tecidos de sustentação e dentários. Sujeitos e método: os dados relativos à reabsorção inflamatória foram coletados a partir de 111 dentes, nos prontuários de 74 pacientes de um serviço de tratamento de trauma dental da FO/UFPel, no período de 2005 a 2011. Foram registrados, ainda, o sexo e a idade dos pacientes, os dentes envolvidos no trauma, a presença de rizogênese completa ou não e o tempo inicial para o aparecimento da reabsorção. A avaliação dos dados foi realizada por estatística descritiva e teste qui-quadrado, com correção de Yates, ao nível de significância de 5%. Resultados: a reabsorção radicular inflamatória foi mais frequente em pacientes do sexo masculino, em incisivos superiores, em dentes com rizogênese completa e nas lesões de menor gravidade nos tecidos dentários e de sustentação. Ainda, as lesões nos tecidos de sustentação, quando não combinadas às fraturas dentárias, apresentaram maior frequência de reabsorção. O tempo inicial para o aparecimento da patologia foi dentro dos primeiros trinta dias após o trauma. Conclusão: é importante diagnosticar detalhadamente os traumas nos tecidos dentários, a fim de verificar o comprometimento dos tecidos de sustentação, devendo a proservação desses casos ser sistemática e contínua para interceptar a reabsorção radicular.

Objective: inflammatory root resorption is one of the consequences of dental trauma so its early detection and treatment are crucial in limiting their damage. Thus, this study aimed to investigate the prevalence of inflammatory root resorption in traumatized permanent anterior teeth, relating it to the different types of trauma in support and dental tissues. Subjects and method: data concerning inflammatory resorption were collected from 111 teeth, in medical records of 74 patients of a dental trauma care in UFPel’s Dentistry School, from 2005 to 2011. Gender and age of patients, teeth involved in the trauma, presence or absence of full rooting, and the initial time of root resorption emergence were also registered. Data assessment was performed by descriptive statistics and chi-square test with Yate’s correction, at significance level of 5%. Results: inflammatory root resorption was most frequent in male patients, in upper incisors, in teeth with complete root formation, and in minor injuries of dental and support tissues. Also, the supporting tissues injury presented higher resorption frequency when not combined with dental fractures. The starting time for pathology emergence was within the first thirty days after the trauma. Conclusion: it is important to thoroughly diagnose the trauma in dental tissues to verify the impairment of support tissues, since the proservation of these cases should be systematic and continuous to intercept root resorption.

Estudo dos traumatismos alvéolo-dentários em pacientes atendidos em um Setor de Cirurgia e Traumatologia Buco-Maxilo-Facial / Study of dentoalveolar trauma in patients treated at an Oral and Maxillofacial Surgery

Objetivo: Avaliar o perfil epidemiológico dos pacientes que sofreram traumatismos alvéolo-dentários em dentes permanentes, identificando também o tipo de trauma, os dentes mais atingidos e as causas mais frequentes. Métodos: A amostra foi constituída por todos os prontuários de pacientes atendidos em cinco anos, no Departamento de Cirurgia da Faculdade de Odontologia de Pelotas, totalizando 308 casos e 793 dentes traumatizados. Os dados obtidos foram tabulados em uma planilha e analisados estatisticamente. Resultados: A faixa etária prevalente foi dos 13 aos 19 anos (32,7%); 74,6% dos traumatismos ocorreram entre pessoas do sexo masculino; a causa mais comum foram os acidentes ciclísticos (23,3%); os tipos de trauma mais frequentes foram a avulsão (17,2%) e a fratura coronária nãocomplicada(17,2%) e os dentes mais acometidos foram os incisivos centrais superiores (66,7%).Conclusão: Foi possível concluir que, nesta pesquisa, a distribuição dos traumatismos foi muito similar a maioria dos estudos publicados, no entanto,em relação à variável causa constatou-se algumas características loco-regionais, reforçando a importância de estudos epidemiológicos para o desenvolvimento de condutas preventivas e terapêuticas específicas para os serviços de saúde.

Objetive: The present study aimed to evaluate the epidemiological profile of patients with traumatic dental injuries in permanent teeth, as well as to identify the type of trauma, the teeth most affected and the most frequent causes of dentoalveolar trauma. Methods: The sample comprised all of the dental records of patients treated at the Oral and Maxillofacial Surgery Department at the Faculty of Dentistryat the Federal University of Pelotas, in the Brazilian state of Rio Grande do Sul, over a five-year period, totaling 308 cases and 793 teeth with traumatic injury. The data were evaluated statistically. Results: The results obtained demonstrated that the most prevalent age group was 13-19 (32.7%); males were affected in 74.6% of injuries; the most common etiology was cycling accidents (23.3%); the most frequent types of trauma were avulsion (17.2%) and non-complicated crown fracture (17.2%); and the most affected teeth were the maxillary central incisors (66.7%). It was concluded that the distribution of trauma injuries, in this paper, is very similar to that presented in most of the published studies. However, with regard to the etiology variable,some local/regional characteristics were found, reinforcing the importance of epidemiological studies for the development of preventive and therapeutic methods specific to the health service.

Sealing ability of MTA and amalgam in different root-end preparations and resection bevel angles: an in vitro evaluation using marginal dye leakage.

This in vitro study evaluated the effect of different apicoectomy angles, instruments used in root-end preparation, and dental materials used in retrofilling on apical sealing. Root ends were resected at 45 or 90 degrees in 80 single-rooted teeth. For each type of apicoectomy, root-end cavities were prepared with either a round carbide #2 bur or an S12/90D ultrasonic tip. The root-end cavities in each subgroup (apicoectomy + root-end preparation) were filled with silver amalgam without zinc (Am) or with gray mineral trioxide aggregate -Angelus (MTA), and the specimens were immediately immersed in 0.2% rhodamine B for 24 h. Sealing was evaluated based on the dyed cross-sectional dentin area. Data were analyzed statistically by the Kruskal-Wallis test at 5% significance level. No group showed complete sealing of root-end areas. The only significant factor affecting microleakage was dental material, with MTA exhibiting less leakage.

Effects of low-level laser therapy on bone formed after distraction osteogenesis.

This study evaluated the effect of low-level laser therapy (LLLT) on the chemical composition, crystallinity and crystalline structure of bone at the site of distraction osteogenesis. Five rabbits were subjected to distraction osteogenesis (latency = 3 days; rate and frequency = 0.7 mm/day for 7 days; consolidation = 10 days), and three were given LLLT with arsenide-gallium-aluminum (AsGaAl; 830 nm, 40 mW): 10 J/cm(2) dose per spot, applied directly to the distraction osteogenesis site during the consolidation stage at 48 h intervals. Samples were harvested at the end of the consolidation stage. X-ray fluorescence and X-ray diffraction were used to analyze chemical composition, crystallinity and crystalline structure of bone at the distraction osteogenesis site. The analysis of chemical composition and calcium (Ca) and phosphorus (P) ratios revealed greater mineralization in the LLLT group. Diffractograms showed that the crystalline structure of the samples was similar to that of hydroxyapatites. Crystallinity percentages were greater in rabbits that were given LLLT. Crystallinity (41.14% to 54.57%) and the chemical composition of the bone at the distraction osteogenesis site were similar to the that of the control group (42.37% to 49.29%). The results showed that LLLT had a positive effect on the biomodulation of newly formed bone.

Sealing ability of MTA and amalgam in different root-end preparations and resection bevel angles: an in vitro evaluation using marginal dye leakage

This in vitro study evaluated the effect of different apicoectomy angles, instruments used in root-end preparation, and dental materials used in retrofilling on apical sealing. Root ends were resected at 45 or 90 degrees in 80 single-rooted teeth. For each type of apicoectomy, root-end cavities were prepared with either a round carbide #2 bur or an S12/90D ultrasonic tip. The root-end cavities in each subgroup (apicoectomy + root-end preparation) were filled with silver amalgam without zinc (Am) or with gray mineral trioxide aggregate -Angelus (MTA), and the specimens were immediately immersed in 0.2 percent rhodamine B for 24 h. Sealing was evaluated based on the dyed cross-sectional dentin area. Data were analyzed statistically by the Kruskal-Wallis test at 5 percent significance level. No group showed complete sealing of root-end areas. The only significant factor affecting microleakage was dental material, with MTA exhibiting less leakage.

Este estudo in vitro avaliou o efeito de diferentes ângulos de apicectomia, instrumentos utilizados na retrocavitação e materiais odontológicos usados na retrobturação sobre selamento apical. Oitenta dentes unirradiculares, tratados endodonticamente, foram apicectomizados. Quarenta raízes tiveram seu ápice radicular seccionado com angulação de 45º e a outra metade com angulação de 90º. Para cada tipo de apicectomia realizou-se retrocavidades com broca esférica carbide nº 2 ou com retroponta ultra-sônica S12/90D. Cada subgrupo (apicectomia/retrocavidade) foi retrobturado com MTA ou amálgama, sendo os espécimes imediatamente imersos no corante Rodamina B a 0,2 por cento por 24 h. O selamento apical foi avaliado com base na área transversal de dentina corada ao redor da retrobturação. Os dados foram submetidos á análise estatística utilizando os testes de Kruskal-Wallis e Mann-Whitney. Nenhum grupo foi capaz de selar totalmente a região apical. O tipo de material utilizado na retrobturação foi o único fator que mostrou significativa diferença no selamento apical em relação à infiltração de corante.

CO(2), Er: YAG and Nd:YAG lasers in endodontic surgery.

OBJECTIVES: CO(2), Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1% Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO(2) laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO(2) laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO(2) laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO(2) laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20%), B (17.24%) and F (17.84%). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.

CO2, Er: YAG and Nd: YAG lasers in endodontic surgery

OBJECTIVES: CO2, Er:YAG and Nd:YAG lasers have been used in endodontic surgery. This in vitro study evaluated 1 percent Rhodamine B dye penetration using computer-assisted morphometry (ImageTool Software®) of 108 endodontically treated human permanent canines. MATERIAL AND METHODS: Teeth were divided into 9 groups according to the technique used: A: 90-degree apicoectomy with bur, root-end cavity preparation with ultrasound and filled with MTA; B: 90-degree apicoectomy with bur, root-end cavity prepared with ultrasound and filled with MTA, and treatment of apical surface with CO2 laser (1 W, CW/CW); C: 90-degree apicoectomy with bur, and treatment of apical surface with Nd:YAG laser (150 mJ, 10 Hz); D: 90-degree apicoectomy with bur, and treatment of apical surface with CO2 laser,(1 W, CW/CW); E: apicoectomy with Er:YAG laser (400 mJ, 10 Hz), root-end cavity prepared with ultrasound and filled with MTA; F: apicoectomy with Er:YAG laser (400 mJ, 10 Hz) and treatment of apical surface with Nd:YAG laser (150 mJ, 10Hz); G: apicoectomy with CO2 laser (5W, CW/SP), root-end cavity prepared with ultrasound and filled with MTA; H: irradiation of apical end with CO2 laser (1 W, CW/CW); I: irradiation of apical end with Nd:YAG laser (150 mJ, 10 Hz). RESULTS: Dye penetration was found in all specimens at different rates, the lowest penetration occurring in groups C (16.20 percent), B (17.24 percent) and F (17.84 percent). CONCLUSIONS: Groups B, C and F represent the best technical sequences to perform endodontic surgery.

Ultrasonic tips in periradicular surgery

Technological advances have increased the rate of success of dental procedures. In periradicular surgery, the use of ultrasonic tips ensures high-quality root-end cavity preparations, enables the performance of a 90-degree apicoectomy, and removes larger amounts of contaminated material. The authors reviewed in vitro and in vivo studies in the literature and evaluated root-end cavities prepared with burs or ultrasonic tips using scanning electron microscopy.

Understanding distraction osteogenesis on the maxillofacial complex: a literature review.

Management of skeletal deformities in the maxillofacial region has been an important challenge for medicine and dentistry throughout their evolution as health care sciences. Distraction osteogenesis (DO), also referred to as osteodistraction, is a surgical technique that uses the body's own repairing mechanisms as allies for optimal tissue reconstruction. This method has gained acceptance and joined the conventional techniques for comprehensive treatment of patients with skeletal insufficiencies, and its successful application in the maxillofacial complex has been extensively reported. The primary aim of this article is to summarize the information on DO, thus contributing to its study, development, and application in challenging situations of our clinical practice as oral and maxillofacial surgeons.

Comparative chemical study of MTA and Portland cements.

Portland cement has been analyzed and compared to mineral trioxide aggregate (MTA) because of their chemical similarity. The possibility of using this material as a less expensive alternative to MTA in dental practice should be considered. In view of this, the present study compared the components of a Portland cement (Votoran) to two commercial brands of MTA (Pro-Root and MTA-Angelus). Twelve specimens of each material were fabricated and examined by scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS) to obtain their percentage of chemical elements. The means of the chemical elements found in each material was compared by descriptive statistics. Bismuth was present only in MTA cements to provide radiopacity. In conclusion, the tested cements have similar components, which supports, as far as composition is concerned, the possible clinical use of Portland as an option to MTA.