Single Nucleotide Polymorphisms in Runt-related Transcription Factor 2 and Bone Morphogenetic Protein 2 Impact on Their Maxillary and Mandibular Gene Expression in Different Craniofacial Patterns - A Comparative Study.

Introduction: This study aimed to evaluate if single nucleotide polymorphisms (SNPs) in runt-related transcription factor 2 (RUNX2) and bone morphogenetic protein 2 (BMP2) are associated with different craniofacial patterns. Furthermore, we also investigated if RUNX2 and BMP2 expression in the maxilla and mandible are differently expressed according to facial phenotypes and influenced by the SNPs in their encoding genes. Orthognathic patients were included. Materials and Methods: Lateral cephalometric radiographs were used to classify facial phenotypes based on Steiner's ANB and Ricketts' NBa-PtGn angles. Bone samples from 21 patients collected during orthognathic surgery were used for the gene expression assays. DNA from 129 patients was used for genotyping the SNPs rs59983488 and rs1200425 in RUNX2 and rs235768 and rs1005464 in BMP2. The established alpha was 5%. Results: A statistically significant difference was observed in the relative BMP2 expression in the mandible between Class I and III participants (P = 0.042). Homozygous GG (rs59983488) had higher RUNX2 expression (P = 0.036) in the mandible. In maxilla, GG (rs1200425) had a higher BMP2 expression (P = 0.038). Discussion: In conclusion, BMP2 is expressed differently in the mandible of Class I and Class III participants. Genetic polymorphisms in RUNX2 and BMP2 are associated with their relative gene expression.

Delayed removal of maxillary third molar displaced into the infratemporal fossa / Extracción diferida del tercer molar maxilar desplazado a la fosa infratemporal

Third molar extraction is a common procedure and it is rarely associated with complications. One complication that may be associated with this procedure is displacement of the tooth into the infratemporal fossa, an anatomical structure that contains the temporalis muscle, medial and lateral pterygoid muscles, the pterygoid plexus, the maxillary artery and its branches, the mandibular nerve and its branches, and the chorda tympani. The present case report illustrates delayed surgical removal of a maxillary third molar that was displaced into the infratemporal fossa, via the intraoral access and under local anesthesia. Despite the rarity of this complication, oral and maxillofacial surgeons should be aware of its management and able to choose the optimal technique, taking into account the patient’s signs and symptoms as well as the knowledge and experience of the surgeon (AU)

La extracción del tercer molar es un procedimiento habitual que pocas veces se asocia a complicaciones. Una posible complicación asociada es el desplazamiento de la pieza dental a la fosa infratemporal, una estructura anatómica que contiene el músculo temporal, el músculo pterigoideo interno y externo, el plexo pterigoideo, la arteria maxilar y sus ramas, el nervio mandibular y sus ramas y la cuerda del tímpano (una rama del nervio facial). El caso descrito en este manuscrito ilustra la extracción quirúrgica diferida de un tercer molar maxilar que se había desplazado a la fosa infratemporal, a través de un acceso intraoral y con anestesia local. A pesar de que es una complicación excepcional, el cirujano experto en cirugía oral y maxilofacial debe conocer su tratamiento y seleccionar la técnica óptima, teniendo en cuenta los signos y síntomas manifestados por el paciente, y en función de sus conocimientos y experiencia (AU)

Factors associated with complications of removal of third molars: A transversal study

Objectives: The purpose of this study is to estimate the overall frequency of complications associated with thirdmolars (M3) removal and to identify the risk factors associated with these complications. Study design: To thetransversal analysis, a researcher confidentially reviewed the records of all M3 surgery patients. The predictorvariables were demographic (i.e. age and gender), localization and position of third molar, bone removal and toothsectioning. Results: 210 patients had one or more third molars teeth removed, a total of 605 teeth. The sample’smean age was 21,6 ±9,2 years, with 1,4 woman to 1 man. Postoperative complications were recorded in 54 extractionsof third molars. The most common complications were infection (42,6%), followed by radicular fractures(11,1%) and gingival alterations (11,1%). Complications were significantly affected by 3 factors: age over 25 yearsold (p=0,002 – OR 2,21), location (p=0,006 – OR 2,36), bone removal (p=0,002 - OR 3,03) and tooth sectioning(p=0,00002 – OR 3,59). Conclusions: The results of these analyses suggest that age, location of the tooth, boneremoval and tooth sectioning appear to be associated with a higher complication rate for M3 extractions (AU)

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Factors associated with complications of removal of third molars: a transversal study.

OBJECTIVES: The purpose of this study is to estimate the overall frequency of complications associated with third molars (M3) removal and to identify the risk factors associated with these complications. STUDY DESIGN: To the transversal analysis, a researcher confidentially reviewed the records of all M3 surgery patients. The predictor variables were demographic (i.e. age and gender), localization and position of third molar, bone removal and tooth sectioning. RESULTS: 210 patients had one or more third molars teeth removed, a total of 605 teeth. The sample's mean age was 21.6±9.2 years, with 1,4 woman to 1 man. Postoperative complications were recorded in 54 extractions of third molars. The most common complications were infection (42.6%), followed by radicular fractures (11.1%) and gingival alterations (11.1%). Complications were significantly affected by 3 factors: age over 25 years old (p=0.002--OR 2.21), location (p=0.006--OR 2.36), bone removal (p=0.002--OR 3.03) and tooth sectioning (p=0.00002--OR 3.59). CONCLUSIONS: The results of these analyses suggest that age, location of the tooth, bone removal and tooth sectioning appear to be associated with a higher complication rate for M3 extractions.

Epidemiological analysis of orthognathic surgery in a hospital in Curitiba, Brazil: Review of 195 cases

Objetivo: Este estudio retrospectivo explora el espectro y las características de los pacientes tratados con cirugía ortognática en la Universidade Federal do Paraná. Material y método: A lo largo de 6 años, a partir de julio de 2002 hasta julio de 2008, se efectuó el seguimiento de 195 pacientes con deformidades dentofaciales que se sometieron a procedimientos de cirugía ortognática. Resultados: La edad media de los pacientes fue de 25,87 años (de 14 a 65) y la proporción de mujeres y hombres fue de 1,5:1. El grupo racial predominante fue el "blanco". La mayoría de los pacientes eran parte de la población económicamente productiva. Sesenta y dos pacientes tenían la dentadura completa. Sólo el 3,59% de los pacientes fueron sometidos a anestesia local (expansión rápida de paladar). La deficiencia transversal maxilar fue la deformidad más común, seguida por la deficiencia anteroposterior del maxilar asociado con el exceso anteroposterior del maxilar inferior. La cirugía más realizada fue el retroceso mandibular. El procedimiento de cirugía duró una media de 3 h y 51 min, y el tratamiento de ortodoncia se prolongó 44,48 meses. Hubo complicaciones en el 22,57% de los pacientes, y las más habituales fueron parestesias (7,17%) y reducción inadecuada de la fractura (5,12%). Conclusiones: Los resultados de esta investigación muestran algunos conceptos que pueden caracterizar el perfil ortognático de los pacientes en el sur de Brasil. También tiene como objetivo colaborar en la correcta instauración de protocolos de cuidado de los pacientes a fin de mejorar los resultados de los procedimientos(AU)

Objective: The present retrospective study explored the spectrum and characteristics of patients treated with orthognathic surgery at the Universidade Federal do Paraná, Brazil. Materials and method: Over a six-year period from July 2002 to July 2008, the records of 195 patients with dentofacial deformities who underwent orthognathic surgical procedures were followed up. Results: Mean patient age was 25.87 years (range 14 to 65 years) and the female to male ratio was 1.5:1. The predominant racial group was "white". Most patients belonged to the economically productive population. Sixty-two patients had complete dentition. Only 3.59% patients had local anesthesia (rapid palatal expansion). Transverse maxillary deficiency was the most common deformity, followed by maxillary anteroposterior deficiency associated with mandibular anteroposterior excess. Mandibular set-back was the intervention most frequently performed. The surgical procedures took an average of 3 hours 51 minutes and orthodontic treatments took an average of 44.48 months. Complications occurred in 22.57% of patients, the most common of which were permanent paresthesia of the lower lip (7.17%) and inadequate fracture reduction (5.12%). Conclusions: The findings included concepts that were useful for characterizing the profile of patients who undergo orthognathic surgery in southern Brazil. The results also may help to correctly develop protocols for patient care designed to improve the overall results of the procedures(AU)