Sagittal osteotomy for the removal of deeply impacted mandibular molars: a presentation of series of cases.

Sagittal osteotomy was primarily described as a treatment for prognathism and retrognathia. It has been rarely reported as an option for the removal of deeply impacted tooth. The principal indication of this approach is when the tooth is deeply impacted on the mandibular ramus or body and it presents intimate relationship between its root and inferior alveolar neurovascular bundles. In this article the author related three rare cases of lower third molar included. Because of the unusual deeply position of these, the SRRO surgery technique was realized to remove them. Sagittal split ramus osteotomy (SSRO) is technically safe and allows the removal of teeth in situations of deeply impacted mandibular ramus, angle or body with minimal trauma in a short time.

Changes in pharyngeal airway space and soft tissue after maxillary advancement and bimaxillary surgery

AIM: To evaluate changes in pharyngeal airway space (nasopharynx and oropharynx), soft palate and lingual vallecula after maxillary advancement surgery and maxillary advancement and mandibular setback surgery (bimaxillary surgery). METHODS: Twenty Class III adult patients were included in the study. Ten patients were treated with maxillary advancement and ten with bimaxillary surgery (maxillary advancement and mandibular setback). Cephalometric landmark measurements were recorded at 3 different time intervals: pre-surgical, post-surgical and six months after surgery. Data collected were subjected to one-way ANOVA (p<0.05). RESULTS: Nasopharyngeal airway space increased after maxillary advancement and decreased after bimaxillary surgery. There was increase in oropharyngeal dimensions in the region around the uvula and loss of space for lingual vallecula, while in Group 2 there was diminished space for both uvula and vallecula. The uvula and vallecula were moved forward in Group 1, whereas these structures were moved in the posterior direction in Group 2. CONCLUSIONS: After maxillary advancement surgery there was an increased in space in the nasopharyngeal region. The oropharyngeal region related to the uvula presented an increase in space, whereas there was a reduction in relation to the lingual vallecula. The uvula and lingual vallecula were moved forward. Bimaxillary surgery promoted a reduction in the nasopharyngeal and oropharyngeal regions as regards both the uvula and lingual vallecula. The uvula and lingual vallecula were moved in the posterior direction...

Reabilitação de maxilas atróficas com implantes zigomáticos em carga imediata: estudo retrospectivo de 22 casos / Rehabilitation of atrophic maxilla with immediate loading through zigomatic implants: review of 22 cases

Realizou-se uma análise retrospectiva de 22 casos de maxilas atróficas, reabilitadas proteticamente com carga imediata, por meio de implantes cônicos na região anterior de maxila em conjunto com dois implantes zigomáticos bilateralmente. Objetivamos discutir a efetividade deste método a partir de informações relativas à técnica empregada (tipo de implante, quantidade, comprimento e torque de inserção) e da taxa de sucesso durante o tempo de acompanhamento da pesquisa. Os pacientes apresentaram-se com média de idade de 57,3 anos, variando de 39 a 76, sendo 6 do gênero masculino e 16 feminino. A média do torque de inserção foi de 47,75N.cm para os implantes cônicos anteriores (n = 68) e de 68,5N. cm para os zigomáticos (n = 44), ambos apresentaram taxa de sucesso de 100% durante o período de acompanhamento médio de 34,7 meses

The present study evaluated retrospectively 22 atrophic maxilla cases treated by prosthodontic rehabilitation with immediate loading using conic implants in the pre-maxilla with two zigomatic implants bilaterally disposed. We aimed at discussing the effectiveness of this treatment through information on the applied method (type of implant, quantity, length and placement torch) and on the success rate during follow-up period. The average age of the patients was 57.3 years old, varying from 39 to 76 and six of them were males and sixteen females. The insertion torch average was of 47.75N.cm for anterior conic implants (n = 68) and 68.5Ncm on the right and left zigomatic implants (n = 44), both with success rate of 100% during a 34.7 months follow-up period

Implant migration into maxillary sinus: description of two asymptomatic cases.

BACKGROUND: Rehabilitation of edentulous jaws with dental implants has become a usual practice around the world. A very low incidence of complications is associated with this therapy. One of them is migration of dental implants into maxillary sinus. Foreign bodies inside maxillary sinus should be removed because they can cause sinusitis, but if any symptoms are present, preservation alone can be indicated. Implant removal and bone reconstruction on the same procedure reduce treatment time and allow rehabilitation with implant-supported prosthesis. METHODS: In the present study, we report two cases of dental implants displaced into maxillary sinus that receive different treatment. RESULTS: In one of them, implant removal and sinus lift were carried out on same procedure while on the other preservation alone was advocated. CONCLUSION: Both treatment modalities treatments allowed installation of implant-supported prosthesis.

Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery.

PURPOSE: Infections are one of the most commonly found conditions in oral and maxillofacial surgery practice. They always represent a risk to patients regardless of whether they are of odontogenic origin or not, and if not treated at an early stage they may rapidly evolve and spread to adjacent anatomical structures, leading to serious complications and, occasionally, to death. For this reason, the objective of this study was to retrospectively analyze data from patients with infections attended by the Department of Oral and Maxillofacial Surgery of the Piracicaba Dental School at the State University of Campinas-Unicamp. PATIENTS AND METHODS: In accordance with date and inclusion criteria, sampling comprised 210 patient reports from January 1999 to March 2007. Patients' demographic data reviewed were gender, age, signs and symptoms, facial spaces affected, and therapy adopted. RESULTS: The mean age of patients was 30 years old (SD = 16.6), and the main origin of infections was odontogenic (79.31%); principal signs and symptoms were trismus (43.33%), fever (28.10%), and dysphagia (25.24%). The main facial spaces affected were the buccal mandibular space (50.00%), submandibular space (31.90%), and buccal maxillary space (19.05%). Surgical drainage was carried out in 46.67% of cases, and 10.95% of these interventions were performed under general anesthetic. Only 3 of all patients developed complications. CONCLUSIONS: Infection patients were basically young adults; no predisposition concerning gender or race was detected. The therapeutic protocol adopted presented very positive results, with a small number of complications.

Oral complaints in progressive systemic sclerosis: two cases report.

Progressive systemic sclerosis is a chronic sclerotic disease which causes diffuse, increased deposition of extracellular matrix in connective tissue with vascular abnormalities, resulting in tissue hypoxia. Aesthetic and facial dysfunction are followed by important oral and facial manifestation of disturbances such as xerostomia, the lack of saliva in the mouth, and its associated complications. Most clinical manifestations begin with tongue rigidity. The facial skin changes and bone resorption of mandible angle are often reported. Other systemic changes include the involvement of internal organs which leads to serious complications as well as disorders in the cardiac muscle and Raynaud's phenomenon. The objective of the this paper is to report two cases of systemic sclerosis in patients with oral and facial manifestations of the disease. A brief review of the literature, focusing on deontological alterations is also presented.

Restabelecimento do espaço interarcos - uma abordagem multidisciplinar / Reestablishment of the intermaxillary space: a multidisciplinary approach

O restabelecimento do espaço interarcos pode ser obtido através da osteotomia segmentar posterior da maxila. Esta consiste na mobilização e movimentação de um segmento posterior da maxila com o objetivo de restabelecer o espaço protético adequado entre a maxila e a mandíbula, além de corrigir mordidas cruzadas, mordidas abertas posteriores, proporcionando o reposicionamento superior, inferior, distal e mesial do segmento em um único tempo operatório. As indicações, técnicas e complicações da osteotomia segmentar posterior da maxila serão discutidas por meio de uma revisão de literatura e relato de um caso, na qual é enfatizada a necessidade do envolvimento de duas especialidades odontológicas.

Remoção de miniplacas e parafusos na região bucomaxilofacial: revisão de literatura / Removal of miniplates and screws in the oral and maxillofacial region: a review of the literature

O emprego de miniplacas e parafusos de titânio nas cirurgias do complexo maxilo-mandibular tornou-se crescente, ao se constatar, cientificamente, sua alta resolutividade. Portanto é comum que surjam dúvidas quanto à remoção ou não dessa aparatologia após a reparação óssea. Essa revisão objetiva discutir as divergências de condutas e suas justificativas, tendo em vista a pouca abordagem deste tema nos periódicos nacionais, vindo a fornecer subsídios cientificamente embasados para uma correta opção.

Cisto paradentário bilateral / Bilateral paradental cyst

O cisto paradentário é uma lesão odontogênica de origem inflamatória, que ocorre mais comumente nas faces vestibular, distal ou mesial de terceiros molares inferiores vitais, parcialmente erupcionados e com história de pericoronarite. Apresentamos um caso de cisto paradentário bilateral envolvendo os terceiros molares inferiores de um paciente de 20 anos de idade, do sexo masculino e da raça negra, discutindo os aspectos clínicos, radiográficos e histopatológicos relevantes para o seu diagnóstico e tratamento

Angina de Ludwig: relato de caso / Ludwig's angina: a case report

A condição denominada de Angina de Ludwig é definida como uma infecção potencialmente letal de progressão rápida, envolvendo os espaços faciais sublinguais, submandibulares e submentoniano, manifestando-se por um aspecto firme e doloroso à palpação, com discreta elevação do assoalho da boca e deslocamento posterior da língua. É relatado um caso de Angina de Ludwig, ressaltando e discutindo sua etiologia, aspectos clínicos, uso de antibiótico, cultura e antibiograma, uso de corticóide, manutenção de vias aéreas, drenagem e as possíveis complicações

Cisto paradentário: revisäo de literatura / Paradental cyst: literature review

Realizou-se uma revisäo da literatura acerca da entidade patológica denominada cisto paradentário, compreendendo desde seu relato inicial na literatura, até os mais recentes. As opiniöes dos autores sobre dados como nomenclatura, classificaçäo, etiologia, características clínicas, radiográficas e histopatológicas, diagnóstico diferencial e tratamento foram avaliadas. Portanto, os autores acreditam contribuir para um maior conhecimento e discussäo sobre o cisto paradentário, que, apesar de ter sido descrito há algum tempo, ainda permanece sem seu devido reconhecimento