Dynamic three-dimensional finite element analysis of orbital trauma.

This study comprises a dynamic finite element (FE) analysis of the mechanisms of orbital trauma, specifically buckling and hydraulic theories. A digital model of the orbital cavity - including the eyeball, fatty tissue, extraocular muscles, and the bone orbit - was created from magnetic resonance imaging and computed tomographic data from a real patient. An impactor hit the FE model following two scenarios: one was a hydraulic mechanism for direct impact to the eyeball and the other a buckling mechanism for direct impact over the infraorbital rim. The first principal stress was calculated to determine the stress distribution over the orbital walls. The FE model presented more than 900,000 elements and time of simulation was 4.8 milliseconds (ms) and 0.6 ms, for the hydraulic and buckling mechanisms, respectively. The stress distribution in the hydraulic mechanism affected mainly the medial wall with a high stress area of 99.08 mm2, while the buckling mechanism showed a high stress area of 378.70 mm2 in the orbital floor. The presence of soft tissue absorbed the energy, especially in the hydraulic mechanism. In conclusion, the applied method of segmentation allowed the construction of a complete orbital model. Both mechanisms presented results that were similar to classic experiments. However, the soft tissue in the hydraulic mechanism absorbed the impact, demonstrating its role in orbital pathophysiology.

Folliculogenesis-related genes are differently expressed in secondary and tertiary ovarian follicles.

The relative mRNA abundance of 10 genes associated with folliculogenesis was compared between late preantral (secondary) and early antral (tertiary) ovarian follicles in goats. In total, 100 follicles in each category were mechanically isolated. The relative transcript abundance of the mRNAs were determined by qPCR. Data were analyzed using unpaired Student's t-test. Of the 10 tested genes, ABLIM mRNA was not detected in either follicle category, six genes (SLIT3, TYMS, GTPBP1, AKR1C4, PIK3R6, and MAOB) were upregulated in secondary follicles compared with tertiary follicles, and three genes (ARHGEF12, CLEC6A, and CYTL1) showed similar mRNA abundances in both secondary and tertiary follicles. In conclusion, SLIT3, GTPBP1, AKR1C4, and PIK3R6 mRNA abundance was upregulated in secondary follicles (preantral phase) compared with in tertiary follicles (antral phase) in goats.

Surgically assisted rapid maxillary expansion: a systematic review of complications.

A systematic review of the literature on the complications of surgically assisted maxillary expansion (SARME) was performed. The search strategy was based on the PRISMA guidelines. The PubMed, SCOPUS, and Cochrane Library databases were searched. Data were extracted from the full texts after screening of the abstracts and titles. Human clinical studies encompassing 'maxillary expansion', 'palatal expansion', 'SARME', or 'SARPE' and that reported sufficient data for 'complication' were included. In vitro studies, case reports, meta-analyses, reviews, book chapters, animal studies, and studies with missing or insufficient data were excluded. The final selection included 12 articles for data extraction. A total of 851 patients underwent SARME, with 187 reported complications (21.97%). Epistaxis (2.47%) and postoperative pain (2.00%) were the most often reported minor complications, and asymmetric or inadequate expansion presented an occurrence rate of 4.47%. Minor complications were equally distributed between surgical (49.30%) and orthodontic complications (50.70%). The technique without pterygomaxillary disjunction increased the occurrence of minor complications (29.95% vs. 16.87%), and the expansion pattern with less than 0.5 mm/day increased the occurrence of orthodontic complications (30.93% vs. 1.83%), i.e. asymmetric expansion. In conclusion, SARME procedures mostly present minor complications. Although several types of complication are described in the literature, occurrence rates are low, and technical issues such as pterygomaxillary disjunction and the pattern of distraction can be predictors of the complication risk.

Estratégias alimentares na larvicultura do peixe ornamental amazônico acará-severo (Heros severus) (Heckel, 1840) / Feeding strategies on larval rearing of severum (Heros severus) (Heckel, 1840), Amazonian ornamental fish

Com o presente estudo, objetivou-se avaliar o tempo de fornecimento de náuplios de artêmia e o período de transição alimentar para pós-larvas de acará-severo (Heros severus). Foram utilizadas 450 pós-larvas de acará-severo, distribuídas em 45 aquários, em delineamento inteiramente ao acaso, em esquema fatorial 3x5, com três repetições. Foram avaliados três períodos de fornecimento de náuplios de artêmia: zero, cinco e 10 dias. Além disso, foram testados cinco períodos de transição alimentar: um, dois, três, quatro e cinco dias, quando os animais receberam alimentação conjunta de náuplios de artêmia e dieta farelada. Ao final do experimento, os peixes foram contados, pesados e fotografados, para avaliação do desempenho produtivo e das variáveis morfométricas. Para todos os parâmetros avaliados, não foi constatada interação entre o tempo de fornecimento de artêmia e o período de transição alimentar. Os animais alimentados por 10 dias com náuplios de artêmia apresentaram os melhores resultados de desempenho e as maiores variáveis morfométricas. Os peixes que receberam alimentação conjunta por três dias apresentaram desenvolvimento satisfatório. Dessa forma, recomendam-se 10 dias de fornecimento de náuplios de artêmia e três dias de transição alimentar, antes de se iniciar o fornecimento exclusivo de dieta inerte para pós-larvas de acará-severo.(AU)

The aim of this study was to evaluate the supply time of artemia and the period of food transition to post-larvae of severum (Heros severus). A total of 450 post-larvae of severum were distributed in 45 aquaria, in a completely randomized design, in a 3x5 factorial scheme, with three replicates. Three feeding periods with artemia nauplii were evaluated: zero, five, and ten days. In addition, five feeding transitions were tested: one, two, three, four and five days, when the animals received joint feeding of artemia nauplii and dry diet. At the end of the experiment the fish were counted, weighed and photographed, to evaluate the productive performance and the morphometric variables. For all parameters evaluated, no interaction between the time of artemia supply and the feeding transition period was observed. Animals fed for 10 days with artemia nauplii showed the best performance results and the highest morphometric variables. The fish that received joint feeding for three days presented satisfactory development. Thus, 10 days of artemia nauplii supply and three days of feeding transition is recommended before starting the exclusive supply of diet inert to post-larvae of severum.(AU)

Buccal fat pad removal to improve facial aesthetics: an established technique?

BACKGROUND: Buccal fat pad (BFP) is a singular structure between the facial muscles. Its removal may enhance the zygomatic prominences resulting in an inverted triangle of beauty. OBJECTIVE: The aim of this study was to perform a systematic review of literature about BFP removal for facial aesthetic improvement. In order to answer the following research question: What are the indications, complication types and rates, surgical techniques and outcomes of the technique? MATERIAL AND METHODS: The initial search in Pubmed, Scopus, and Cochrane databases recognized 220 articles. The final review included eight of them. None of the included studies were clinical trials. RESULTS: BPF removal was performed by intraoral incision or associated with the face lift procedure. In 71 patients submitted to the procedure and evaluated about complications, only 8.45% presented minor complications. Parotid duct and facial nerve injuries were not found. No study evaluated facial aging and long-term effects, therefore the harmless effect of the procedure to those features is not clear. CONCLUSIONS: Although it is not a novel procedure, there is a lack of information about long-term outcomes. Thus, controlled clinical studies should be performed to achieve adequate clinical evidence of those aspects.

Three-dimensional strut plate for the treatment of mandibular fractures: a systematic review.

The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in terms of stability, functional recovery, and postoperative complications. This systematic review sought scientific evidence regarding the best indication for the use of three-dimensional (3D) plates in the treatment of mandibular fractures. A systematic search of the PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases was conducted to include articles published up until November 2016. Following the application of the inclusion criteria, 25 scientific articles were selected for detailed analysis. These studies included a total of 1036 patients (mean age 29 years), with a higher prevalence of males. The anatomical location most involved was the mandibular angle. The success rate of 3D plates was high at this location compared to other methods of fixation. In conclusion, the use of 3D plates for the treatment of mandibular fractures is recommended, since they result in little or no displacement between bone fragments.

Protocols for management of oral complications of chemotherapy and/or radiotherapy for oral cancer: Systematic review and meta-analysis current.

BACKGROUND AND OBJECTIVE: Considering the high possibility of dentist consult a patient with oral complications of chemotherapy and/or radiotherapy for oral cancer because of the advances in this area, this study aims to systematically review the literature to identify and suggest effective and safe protocols for the managements of oral complications in oncology patients. MATERIAL AND METHODS: The systematic review was designed by PICO and PRISMA including eligibility and exclusion criteria; the source of information and search strategy in PubMed according MeSH: "Mouth Neoplasms and Radiotherapy" and "Mouth Neoplasms and Drug Therapy" the period from 2010 to 2015; selection and data collection of study was carried form blind and independently by two researchers; risk of bias and methodological quality: ensured by the PEDro scale; synthesis of data: of oral complications were evaluated by adapted version of associative direction classification proposed by Costigan and collaborators; and data analysis was performed by the meta-analysis of BioEstat program (5.0) in the included studies. RESULTS: 2,700 articles found, 2,371 were selected after removal of duplicate and elected 40 full-text articles. Of these, only 06 articles were included in the systematic review with exclusion of others, per obtain punctuation ≥ 7 with high methodological quality for synthesis of the managements of oral complications. Since 05 articles were associated with low risk of bias composing the protocols suggestive for managements and the meta-analysis in odds ratio (0.916) to cure and relative risk (1.049) for the development of oral mucositis and pain. CONCLUSIONS: The protocols suggestive for managements of oral mucositis and pain with MuGard - mucoadhesive hydrogel; PerioAid Tratamiento® antiseptic mouthrinse with chlorhexidine and cetylpyridinium chloride; Episil® plus benzydamine - bioadhesive oromucosal gel; 0,03% of Triclosan mouthwash Colgate Plax; and Diode Laser Therapy of low-level are safe for oncology patients applied according to adopted clinical parameters.

Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review.

The restoration of mandibular bone defects with non-vascularized bone grafts depends on the diagnosis, anatomical site, extent of the defect, and the patient's age, as well as the surgeon's experience. The aim of this study was to perform a systematic literature review on mandibular reconstruction for segmental mandibular bone defects using non-vascularized bone grafts to answer the following question: Is there scientific evidence to support the use of this technique? The initial literature search in PubMed, Scopus, and Cochrane databases identified 862 articles. Of these, 25 were included in the final review. These articles encompassed 926 procedures with non-vascularized bone grafts; 76.1% were from the iliac crest. Benign tumours were the major cause of these defects (56.8%), and 44.7% of defects were located in the lateral mandibular area. Although this technique showed a high occurrence of complications (290 in 873 patients, some with more than one complication), these did not account for treatment failure. The restoration of bone defects due to malignant tumours treated with radiation therapy had lower success rates, and these appear to be a contraindication for the technique. Although standardized randomized controlled clinical studies are needed to obtain better clinical evidence for treatment choices in general, the use of non-vascularized bone grafts for mandibular reconstruction showed an 87.6% success rate in this review.

Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review.

Inferior alveolar nerve (IAN) repositioning has been used widely in recent years as an alternative approach for dental implant placement in the atrophic posterior mandible. The aim of this study was to answer the question: What are the complications associated with IAN repositioning? A systematic literature review performed in accordance with the PRISMA statement, using the PubMed (MEDLINE), Cochrane Library, and Scopus databases, identified a total of 116 articles related to this technique. Of those articles, 24 were included in the final review. Lateralization was the chosen technique in seven studies, transposition in 15 studies, and two studies reported both techniques. The longest follow-up period was 49.1 months and the shortest 6 months. Of the patients who underwent lateralization, 95.9% initially showed a neurosensory disturbance, and the condition remained at the end of the study for 3.4% of those patients. With regard to the patients who underwent transposition, neurosensory alterations were observed in 58.9% of patients initially, and the condition remained for 22.1% of those affected at the end of the study. Only one study found no neurosensory disturbance at any time. More data consolidation is necessary to determine scientifically if, which, and when the IAN repositioning technique can be recommended.

p16INK4 expression in precursor lesions of squamous cell cervical cancer related to the presence of HPV-DNA.

The purpose of the present study was to identify the expression of p16INK4 in cervical cancer precursor lesions by immunohistochemistry and to correlate it with lesion grade and presence of human papillomavirus (HPV) infection. Cervical specimens from 144 women seen consecutively at the gynecology outpatient clinic of our institution from December 2003 to May 2005 were analyzed by cytopathology, histopathology, polymerase chain reaction for HPV-DNA, and p16INK4 immunostaining. Histologically normal biopsies, HPV-DNA negative by polymerase chain reaction, were used as control. HPV-DNA prevalence, including the control group, was 68.1% and the prevalence of p16INK4 expression was 55.0%. The percentage of cells stained by p16INK4 ranged from 10 to 100%, both in the group consisting of cervical intraepithelial neoplasia (CIN)1/HPV specimens and in the group of CIN2/CIN3 specimens with P value of 0.0001. p16INK4 expression was 48.3% in the CIN1/HPV group, as opposed to 94.3% in the CIN2/CIN3 group (P = 0.001), showing a statistically significant difference between the two groups. The quantitative method used here is simple and less subjective than the different semiquantitative methods described in the literature. In view of the different definitions of a p16INK4-positive case, it is almost impossible to compare the findings reported by different investigators. This study confirms the association between p16INK4 and CIN2 and CIN3 lesions. Moreover, it shows that some low grade lesions expressed high levels of this protein. This may indicate that such low grade lesions may be predisposed to progress to high grade lesions. This means that p16INK4 may be a strong marker for "neoplastic lesions" induced by HPV and not just an infection marker.

p16INK4 expression in precursor lesions of squamous cell cervical cancer related to the presence of HPV-DNA

The purpose of the present study was to identify the expression of p16INK4 in cervical cancer precursor lesions by immunohistochemistry and to correlate it with lesion grade and presence of human papillomavirus (HPV) infection. Cervical specimens from 144 women seen consecutively at the gynecology outpatient clinic of our institution from December 2003 to May 2005 were analyzed by cytopathology, histopathology, polymerase chain reaction for HPV-DNA, and p16INK4 immunostaining. Histologically normal biopsies, HPV-DNA negative by polymerase chain reaction, were used as control. HPV-DNA prevalence, including the control group, was 68.1 percent and the prevalence of p16INK4 expression was 55.0 percent. The percentage of cells stained by p16INK4 ranged from 10 to 100 percent, both in the group consisting of cervical intraepithelial neoplasia (CIN)1/HPV specimens and in the group of CIN2/CIN3 specimens with P value of 0.0001. p16INK4 expression was 48.3 percent in the CIN1/HPV group, as opposed to 94.3 percent in the CIN2/CIN3 group (P = 0.001), showing a statistically significant difference between the two groups. The quantitative method used here is simple and less subjective than the different semiquantitative methods described in the literature. In view of the different definitions of a p16INK4-positive case, it is almost impossible to compare the findings reported by different investigators. This study confirms the association between p16INK4 and CIN2 and CIN3 lesions. Moreover, it shows that some low grade lesions expressed high levels of this protein. This may indicate that such low grade lesions may be predisposed to progress to high grade lesions. This means that p16INK4 may be a strong marker for "neoplastic lesions" induced by HPV and not just an infection marker.