Conservative treatment of the dentigerous cyst: report of two cases

The purpose of this paper is to present two cases of dentigerous cyst associated to permanent teeth in children treated by conservative techniques. Dentigerous cyst is the most common developmental cysts of the jaws. Conservative treatment is very effective to this entity and aims at eliminating the cystic tissue and preserving the permanent tooth involved in the pathology. Two techniques are described as conservative treatment for these cysts, marsupialization and the decompression. Two children presented with dentigerous cysts. A female child was affected by a large lesion at the right side of the mandible associated to tooth 45. The other lesion arose at the left maxilla associated to tooth 21 of a male child. Each dentigerous cyst promoted severe tooth displacement. The first patient was treated with decompression and the second with marsupialization.

Pattern of osteogenesis during onlay bone graft healing.

OBJECTIVE: The aim of this paper was to analyze how healing occurs between onlay bone graft and the mandible cortex. STUDY DESIGN: Autologous and allogeneic corticocancellous bones, harvested from the ilium wing, were grafted at each mandible side of 40 rabbits. One side received platelet-rich plasma (PRP). Killings occurred at 3, 7, 14, 28, and 56 days. Tissues were stained by hematoxylin-eosin and toluidine blue. New bone area was measured at different regions of sections stained with toluidine blue. Wilcoxon test was used to analyze differences among regions and Bonferroni test to analyze the influence of PRP, graft nature, and days. RESULTS: Osteogenesis was higher at the lateral region (P < .05). PRP tended to improve bone neoformation, which was higher at the allogeneic graft. Statistical significance among the different categories of variables-grafts, use of PRP, and days of observation-did not have a linear behavior. A linear behavior of statistical tests was not detected. Bone new formation increased until the 14th day (P < .05). CONCLUSIONS: Onlay grafts heal due to osteogenesis which occurs at the lateral region and between the cortex and host mandible. Allogeneic grafts and PRP tend to improve bone formation.

Retromandibular approach to condyle fractures: two case reports.

Retromandibular approach was first described in 1967 for vertical subcondylar osteotomy and later became popular for surgical treatment of temporomandibular joint dysfunction and low condyle fractures. The trajectory of the incision, parallel to the posterior border of the mandibular ramus, allows a good approach with easy separation of the buccal and marginal mandibular branches of the facial nerve, when they are present in the surgical field. When open reduction and internal rigid fixation with plates and screws are indicated for condylar fractures, retromandibular approach offers an excellent esthetic result with low morbidity. Two clinical cases are presented, in which the surgical treatment was carried out for condylar fractures, and clearly illustrate the proposed approach.

Efeitos biológicos do plasma rico em plaquetas / Biological effect of the plateled rich plasma

Muitas pesquisas têm investigado variáveis que influenciam a velocidade de cicatrização, especialmente alguns biomateriais e suas propriedades frente ao processo de reparo tecidual. O plasma, rico em plaquetas, (PRP) é um adjuvante recentemente introduzido nesse contexto. Esse biomaterial, de acordo com as suas características, é também conhecido por outras denominações na literatura. Gel de plaquetas, fonte autógena de fator de crescimento, coquetel natural de fatores de crescimento, tecido rico em plaquetas e concentrado plaquetário são as sinônimos do PRP. Independentemente da denominação recebida, desde seu lançamento tem crescido a esperança de que ele intensifique a neoformação óssea. A sua vasta utilização em diversos segmentos da cirurgia foi revisada, com um enfoque maior nas pesquisas de reconstruções ósseas, enxertos, bioengenharia e osteointegração. Foram revisados e discutidos os achados de ensaios clínicos, pesquisas com animais e com cultura de células avaliando-se a eficácia do PRP como potencializador do reparo tecidual e as possibilidades do seu uso isolado e associado a outros biomateriais. A experiência dos autores com a utilização do PRP também foi apresentada e discutida.