Expansión rápida del maxilar quirúrgicamente asistida, abordaje unilateral / Surgically assisted rapid maxillary expansion, unilateral approach

Una adecuada dimensión transversal del maxilar superior es un componente crítico para obtener una oclusión funcional estable. Aunque la expansión rápida del maxilar puede ser usada en pacientes jóvenes, con el pasar del tiempo y el envejecimiento del individuo, las suturas óseas van ínter digitándose y llegan a fundirse parcial o totalmente. La expansión rápida del maxilar quirúrgicamente asistida en pacientes que presentan una madurez esquelética avanzada es el procedimiento de preferencia para corregir las deficiencias transversales del maxilar. En el siguiente artículo, presentamos un relato de caso clínico de deficiencia transversa del maxilar superior tratada con Expansión Rápida Quirúrgicamente Asistida, de forma unilateral.

Uma adequada dimensão transversal da maxila e um componente crítico para obter uma oclusão funcional estável. A pesar da expansão rápida da maxila ser usada m pacientes jovens, com o decorrer do tempo e o envelhecimento do individuo, as suturas ósseas vão ínterdigitándose chegando a se fundir parcial o totalmente. A expansão rápida da maxila cirurgicamente assistida em pacientes que apresentam uma maturidade esquelética avançada é o procedimento de preferência para corrigir as deficiências transversais da maxila. No seguinte artículo, apresentamos um relato de caso clínico de deficiência transversa da maxila tratada com Expansão Rápida Cirurgicamente Assistida, de forma unilateral.

An adequate transverse maxillary dimension is a critical component to obtain a stable functional occlusion. Although the rapid palatal expansion of the jaw can be used in young patients, the facial suture lines become significantly more interdigitated and become either partially or totally fused as individual's age. The surgically assisted rapid maxillary expansion in patients with advanced skeletal maturity is the procedure of preference to correct the transverse deficiencies. In the following article, we present a clinic case of maxillary transverse deficiency, treated with surgically assisted rapid maxillary expansion, with unilateral approach.

Tratamiento de quiste dentígero bilateral mandibular por medio de dos tipos de tratamientos: relato de caso clínico y comparación entre las técnicas / Treatment of bilateral mandibular dentigerous cyst by means of two types of approach: report of a case and comparison between the techniques

Los quistes dentígeros son el segundo tipo mas común de lesión quística de desarrollo en la mandíbula y han sido asociados con la retención de los terceros molares. Son pocos los reportes sobre quistes dentígeros bilaterales o múltiples en pacientes no sindrómicos. Su tratamiento puede ser por medio de la enucleación o descompresión y este es determinado principalmente por el tamaño de la lesión. Algunos artículos hablan del tratamiento de los quistes dentígeros pero no encontramos en la literatura ninguno comparando ambos tratamientos. En este artículo reportamos un caso de quiste dentígero bilateral en un paciente no sindrómico en el cual se realizó como tratamiento, del lado izquierdo descompresión y del lado derecho enucleación, con un acompañamiento posterior de 5 años consecutivos, sin observarse recidiva de la lesión

Dentigerous cyst are the second most common developmental cyst of the jaws and its been associated with impacted third molar teeth. Its rare reports about bilateral or multiple dentigerous cysts in nonsyndromic patients. They treatment can be enucleation or decompression and must be predicated upon the size of lesion. Some articles talk about treatment of dentigerous cyst but we don't find any one comparing both treatments. Here, we report a case of bilateral nonsyndromic dentigerous cyst comparing the treatment decompression vs. enucleation and follow up for 5 years, without recurrence.

Radiographic evaluation of alveolar distraction osteogenesis: analysis of 60 cases.

PURPOSE: The aim of this study was to evaluate radiographically the effectiveness of alveolar distraction osteogenesis (ADO) technique for vertical reconstruction of atrophy alveolar ridges in partially edentulous patients. MATERIALS AND METHODS: A total of 60 vertical distraction osteogenesis procedures were performed in 55 patients. Two panoramic radiographies were performed in all patients, one the day before the beginning of distraction, and one after consolidation period, 12 weeks postoperatively. The radiographic analysis consisted of obtaining the amount of the vertical bone gain (VBG) in each radiography. For this, we obtained initially the magnification factor (MF) of each panoramic radiography by dividing the real size (RS) of the activation rod among the image size (IS) of the activation rod. After this, to obtain the VGB, we measured initially the length of the distracton preactivation (LD1), which consisted of the distance between the superior portion of the basal plate and the superior portion of the transport plate, multiplying by the MF. Then, we measured the length of the distraction postactivation (LD2), using the same method described before, in radiographies performed 12 weeks postoperatively. The VBG was obtained using the following formula: VBG = LD2 - LD1. The results were applied to descriptive statistical analysis. Complications were also investigated during all of the treatments. RESULTS: The mean alveolar distraction achieved in 60 cases was 6.27 mm (range, 0 to 10.83 mm). According to the region treated, 51.6% were in the posterior mandible (mean VBG, 4.60 mm), 36.66% were in the anterior maxilla (mean VBG, 7.46 mm), 8.33% were in the anterior mandible (mean VBG, 6.73 mm), and 3.33% were in the posterior maxilla (mean VBG, 6.32 mm). The overall rate of complications that compromised the success of the technique was 8.44%. The increased radiopacity of the distracted region could be observed in the 12-week period after surgery. CONCLUSIONS: The ADO technique was demonstrated to be an effective tool to treat vertical defects of the alveolar ridge with a success rate of 91.66%. Our radiographic analysis seems to be an important tool in verifying the technique as well as planning implant placement after ADO.

Conceptos actuales en el tratamiento de las fracturas mandibulares: Revisión de literatura y reporte de casos

Actualmente la reducción abierta de las fracturas mandibulares y la fijación y estabilización de los segmentos óseos por medio de la fijación interna rígida es considerado el tratamiento de elección versus técnicas mas conservadores como lo son la reducción cerrada y el bloqueo maxilo-mandibular o el uso de osteosíntesis por medio de alambre de acero. La fijación interna rígida es una técnica que brinda la suficiente estabilidad para propiciar un correcto reparo óseo así como brindar al paciente un postoperatorio mas confortable y una reincorporación mas temprana a su vida normal, sin limitar notablemente sus actividades fisiológicas y sociales, en comparación con las técnicas antes mencionadas.

At the moment, the open reduction of the mandibular fractures and the fixation and stabilization of the bone segments by rigid internal fixation is considered the election treatment versus more conservative techniques as are the closed reduction and the intermaxillary fixation or the use of osteosíntesis by steel wire. The rigid internal fixation is a technique that offers enough stability to propitiate a correct bone repair as well as to offer the patient a more comfortable postoperative period and an early reincorporation to a normal life, without limiting his activities, in comparison with the techniques before mentioned.

Atualmente, a redução aberta das fraturas mandibulares e a fixação dos segmentos ósseos por meio da fixação interna rígida é considerado o tratamento de eleição frente a técnicas mais conservadoras como são a redução fechada e o bloqueio maxilo-mandibular, ou o uso de osteosíntesis por meio de fio de aço. A fixação interna rígida é uma técnica que oferece a suficiente estabilidade para propiciar um adequado reparo ósseo, além de oferecer ao paciente um pós-operatório mais confortável e uma reincorporação mais precoce a suas atividades, sem limitar notavelmente suas atividades fisiológicas e sociais, em comparação com as outras técnicas anteriormente mencionadas.