Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility.

This study aimed to examine individuals undergoing surgery for the treatment of the fractured mandibular angle, using bite force, mandibular mobility, and electromyographic (EMG) analysis in many different clinical conditions, after 2 months postoperatively. Bite force was recorded with a digital dynamometer, model IDDK. The EMG activity (Myosystem-Br1) included the analysis of the masseter and temporal muscles. Mandibular mobility was measured using a digital pachymeter. The subjects were divided into 3 groups: G1, mandibular angle fracture (n = 7); G2, condylar process fracture (n = 5); and G3, control (n = 12). Data were tabulated and submitted to statistical analysis using the repeated-measure test carried out over time and the Student's t-test (P < 0.05), using the Statistical Package for the Social Sciences software, version 19 (SPSS Inc, Chicago, IL). G1 and G2 had an increase in bite force. In G1, there was a regular decrease in the EMG activity in the second postoperative month. G2 presented an irregular pattern in EMG data during the period tested. Regarding the mandibular mobility, both groups obtained amplitude of all mandibular movements with a high percentage, when compared with control. A good functional recovery was achieved by the individuals who had a mandible angle fracture or condylar process fracture, after 2 postoperative months.

Retained Third Molars Removal in a Severely Resorbed Edentulous Mandible. A Case Report

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.

A presença de terceiros molares inclusos assintomáticos pode representar um grande problema quando estes dentes encontram-se inclusos em um paciente desdentado total. Uma vez que os primeiros e segundos molares foram extraídos, o corpo mandibular torna-se mais frágil com o passar do tempo, o que aumenta a complexidade, a morbidade e a incidência de complicações nas cirurgias de remoção de terceiros molares inclusos. Neste artigo é apresentado um caso de uma paciente de 54 anos de idade com severa reabsorção do osso mandibular onde os terceiros molares mandibulares encontravam-se inclusos e com necessidade de extração. O plano de tratamento objetivou a extração segura dos dentes e a reabilitação mandibular com o uso de uma prótese implanto-suportada. Se a extração dos terceiros molares inclusos é indicada em pacientes que apresentam mandíbula atrófica, o plano de tratamento deve incluir não apenas as medidas preventivas com o intuito de prevenir a fratura da mandíbula durante ou após a remoção dos dentes, mas também alternativas de tratamento que possibilitem uma adequada reabilitação.

Retained third molars removal in a severely resorbed edentulous mandible. A case report.

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.

Orbital abscess during endodontic treatment: a case report.

INTRODUCTION: Orbital infections may result in permanent morbidity because of the severity of infection. Furthermore, delayed diagnosis or treatment of orbital infections can lead to intracranial complications and even death. The majority of orbital infections develop from paranasal sinus infections, cutaneous infections, and periorbital trauma. Dacryocystitis and odontogenic infection are also accounted as potential etiologies but are scarcely reported in scientific literature. METHODS: The patient revealed a history of having endodontic treatment on left maxillary second molar performed 2 weeks previously. Moreover, she exhibited signs of facial pain accompanied by sinusitis symptoms, fever, and nasal obstruction the week after this endodontic procedure. The patient presented proptosis, impairment of ocular motility to the right side, facial tenderness, palpebral erythema, and referred decreased visual acuity. Intraoral exam revealed root fragments of left maxillary first molar and an extensive carious lesion on left maxillary second molar. Computed tomography enabled the observation of frontal sinus, left-sided maxillary, opacity of sphenoidal and ethmoidal sinuses, and apical lesion of left maxillary first and second molars, all suggesting the presence of their apex in the maxillary sinus. In addition, images revealed ocular proptosis and presence of high-density areas suggestive of pus in the medial orbital wall region. RESULTS: The patient was submitted to surgical drainage under general anesthesia approximately 8 hours after the clinical evaluation. CONCLUSIONS: Early detection of orbital infection, proper diagnostic tests, and treatment may provide successful outcomes of this rarely occurring disease.

Bite force, electromyography, and mandible mobility during the 6-month period after surgical treatment for isolated fractures of the zygomatico-orbital complex.

OBJECTIVE: The aim of this study was to identify the behavior of masticatory muscles after fractures of the zygomatico-orbital complex (ZOC) and subsequent surgical treatment, by using analyses of bite force, electromyography (EMG), and mandible mobility during a 6-month period after surgery. STUDY DESIGN: Five patients with fractured ZOCs treated surgically by using an intraoral approach and fixation exclusively in the region of the zygomaticomaxillary buttress were evaluated. The control group included 12 other patients. During postoperative follow-up, bite force, mandible mobility, and EMG analysis of the masticatory muscles were evaluated. RESULTS: There was an increase in bite force with time, but a decline in EMG activity during the same period. In the mandible mobility analysis, only maximum mouth-opening values increased significantly after the surgical treatment. CONCLUSIONS: The masticatory musculature, according to bite force and EMG, returned to its normal condition by the second month after surgery, and maximum mouth opening was observed after the first month.