Pharyngeal airway space changes after maxillomandibular advancement: a five-year retrospective study.

The aim of this study was to compare the alterations in three regions of the airway-nasopharynx, oropharynx, and hypopharynx-in relation to the area of the midsagittal plane, volume, and minimal axial area after maxillomandibular advancement (MMA) surgery. Thirty patients who had undergone MMA surgery were evaluated at four time points: preoperative (T0), immediately postoperative (T1), 1year postoperative (T2), and ≥5 years postoperative (T3). All measurements were performed using computed tomography, analyzed in Dolphin Imaging 11.0 Premium 3D software. The area in the midsagittal plane presented a mean increase of 22.0% between T0 and T3 (P<0.001), with the highest increase in the oropharynx (24.1%, P<0.001). The total volumetric increase at T3 was 16.7% (P<0.001), with the highest increase in the nasopharynx (15.7%; P<0.001). The lowest minimal axial area was found for the oropharynx at all time points, and the highest increase in minimal axial area was found for the nasopharynx (114.9%; P<0.001). MMA surgery showed the highest increase in upper posterior airway between T0 and T1, and this was followed by a progressive reduction until T3, but with a statistically significant increase at T3 compared with T0 in all cases.

Changes in condylar volume and joint spaces after orthognathic surgery.

The aim of this study was to evaluate the changes in condylar volume and joint spaces occurring in patients undergoing bimaxillary orthognathic surgery for the treatment of class II deformities, by means of cone beam computed tomography (CBCT). Initial and follow-up (at least 6 months) CBCT examinations of 114 condyles (57 patients) were studied retrospectively. Linear measurements of the joint space and volumetric analysis of changes in condylar volume were performed using Dolphin 3D Imaging in association with ITK-SNAP 3.0.0 segmentation software. The paired t-test and Pearson correlation coefficient were applied, and a descriptive analysis was performed. Mean condyle volumes were significantly smaller at follow-up (P=0.0125). There were significant reductions in superior and medial joint spaces in the follow-up examinations (both P<0.05). Positive correlations were found when comparing the mean changes in anterior, superior, and posterior space values between the right and left sides. No significant correlation was observed between changes in volume and joint spaces. In conclusion, there was a reduction in mean condylar volume after orthognathic surgery in class II patients. However, changes in volume for each condyle may be variable. Such changes in condylar volume may occur independently on the left and right sides, and do not correlate with changes in joint spaces.

Efficacy and Safety of 2% and 4% Articaine for Lower Third Molar Surgery.

This double-blind crossover randomized clinical trial compared the efficacy of 2 concentrations of articaine, 2% (A2) and 4% (A4), with 1:200,000 epinephrine, for lower third molar removal. During 2 separate appointments with either A2 or A4, both similarly positioned lower third molars in 46 volunteers were extracted. The following were evaluated: onset and duration of anesthetic action on soft tissues, intraoperative bleeding, hemodynamic parameters, postoperative analgesia, and mouth opening and wound healing during the 7th postoperative day, along with the incidence, type, and severity of adverse reactions. Nearly identical volumes of both anesthetic solutions were used for each appointment: 3.4 ± 0.9 mL ≈ 68 mg of articaine (A2) and 3.3 ± 0.8 mL ≈ 132 mg of articaine (A4). Statistical analysis indicated no differences in onset or duration of anesthetic action on soft tissues or duration of postoperative analgesia evoked by A2 and A4 anesthetic solutions (P > 0.05). The surgeon's rating of intraoperative bleeding was considered minimal throughout all surgery with both anesthetic solutions. While transient changes in blood pressure, heart rate, and oxygen saturation were observed, these factors were clinically insignificant and were uninfluenced by articaine concentration (P > 0.05). No systemic or local adverse reactions were observed in the preoperative and postoperative periods due to A2 or A4, but 1 case of bilateral paresthesia was observed. There were no significant differences between preoperative and postoperative (7th day) values of mouth opening and wound healing whether volunteers received A2 or A4 (P > 0.05). In conclusion, both A2 and A4, administered in equal volumes, were effective and safe during lower third molar surgery, and no significant differences were found between their efficacy and safety (ClinicalTrials.gov NCT02457325).

Moncorvo Filho e algumas histórias do instituto de proteção e assistência à infância / Moncorvo Filho and some stories about the institute for the preservation and assistence of children

O Movimento Higienista teve grande impacto nas políticas públicas brasileiras do final do século XIX e início do século XX, dando destaque à proteção e cuidados com a infância. Tal preocupação, influenciada diretamente por aportes teóricos oriundos da Europa, teve em Carlos Arthur Moncorvo Filho um de seus principais representantes no país. O objetivo deste artigo é analisar algumas histórias do Instituto de Proteção e Assistência à Infância (IPAI) e dos anexos criados junto a ele, idealizados pelo próprio Moncorvo Filho. Ao longo das análises, pôde-se perceber o quanto discursos e práticas de proteção à infância carregavam em si estratégias de normatização de condutas e moralização social. Retomar algumas histórias ligadas à preservação da infância no Brasil é de grande importância para a Psicologia e demais Ciências Humanas e Sociais. Tal estratégia tende a possibilitar aos especialistas de hoje refletir sobre a prática profissional e avaliar que modelos estão sendo produzidos ou reproduzidos nestas práticas

The Hygienist’s Movement had a big impact on Brazilian public policy at the end of XIX century and beginning of XX century, shedding light on child’s protection and care. That question was directly influenced by European theories. Carlos Arthur Moncorvo Filho was a major representative in the country. This paper aims at analyzing some stories that happened at the Institute for the Preservation and Assistence of Children and its extensions. The medical doctor Moncorvo Filho founded these clinics. Through analyses, it is possible to notice that discourse and practices toward children’s protection carry strategy and standardize behavior and social moral. Retelling some stories linked to childhood preservation in Brazil is vital to psychology and others human and social sciences. Such a strategy enables specialists at present to reflect upon professional practices and to evaluate models that have been produced or copied in these practices

Moncorvo Filho e algumas histórias do Instituto de Proteção e Assistência à Infância / Moncorvo Filho and some stories about the Institute for the Preservation and Assistence of Children

O Movimento Higienista teve grande impacto nas políticas públicas brasileiras do final do século XIX e início do século XX, dando destaque à proteção e cuidados com a infância. Tal preocupação, influenciada diretamente por aportes teóricos oriundos da Europa, teve em Carlos Arthur Moncorvo Filho um de seus principais representantes no país. O objetivo deste artigo é analisar algumas histórias do Instituto de Proteção e Assistência à Infância (IPAI) e dos anexos criados junto a ele, idealizados pelo próprio Moncorvo Filho. Ao longo das análises, pôde-se perceber o quanto discursos e práticas de proteção à infância carregavam em si estratégias de normatização de condutas e moralização social. Retomar algumas histórias ligadas à preservação da infância no Brasil é de grande importância para a Psicologia e demais Ciências Humanas e Sociais. Tal estratégia tende a possibilitar aos especialistas de hoje refletir sobre a prática profissional e avaliar que modelos estão sendo produzidos ou reproduzidos nestas práticas.(AU)

The Hygienist’s Movement had a big impact on Brazilian public policy at the end of XIX century and beginning of XX century, shedding light on child’s protection and care. That question was directly influenced by European theories. Carlos Arthur Moncorvo Filho was a major representative in the country. This paper aims at analyzing some stories that happened at the Institute for the Preservation and Assistence of Children and its extensions. The medical doctor Moncorvo Filho founded these clinics. Through analyses, it is possible to notice that discourse and practices toward children’s protection carry strategy and standardize behavior and social moral. Retelling some stories linked to childhood preservation in Brazil is vital to psychology and others human and social sciences. Such a strategy enables specialists at present to reflect upon professional practices and to evaluate models that have been produced or copied in these practices.(AU)

Fibroma de células gigantes: una presentación inusual en un niño de 2 años de edad / Giant cell fibroma: an unusual presentation in a child of 2 years old

El objetivo de este artículo es relatar un caso clínico de fibroma de células gigantes en un niño de 2 años de edad. Asimismo, presentar una revisión de literatura sobre esta entidad y discutir sobre posibles factores involucrados a su etiología

The aim of this paper is to report a clinical case of giant cell fibroma in a 2-years-old child. Also present a review of literature from this entity and discuss possible factors involved in its etiology

O objetivo deste artigo é relatar um caso clínico de fibroma de células gigantes em uma criança de 2 anos de idade. Além disso, apresentar uma revisão de literatura sobre esta entidade e discutir sobre possíveis fatores associados a sua etiologia

Abscesso tardio após exodontia de terceiros molares inferiores: relato de dois casos

Complicações associadas à exodontia de terceiros molares, embora incomuns, podem ocorrer em alguns casos. As infecções são tratadas local e sistemicamente e nem sempre se disseminam para os espaços fasciais primários e secundários. O presente artigo relata dois casos com evoluções atípicas após exodontia de terceiro molar de dois pacientes jovens, leucodermas e saudáveis que apresentaram quadro de abscesso três semanas após a cirurgia. No caso 1, foi diagnosticada a presença de um fragmento ósseo expelido, correspondente à tábua óssea lingual e teve sua drenagem intra-oral. Porém, no caso 2, o abscesso se disseminou envolvendo os espaços fasciais e foi necessária drenagem por via extra-oral. Além disso, não foi definida a causa específica, e algumas hipóteses foram levantadas e discutidas neste artigo.(AU)

"É melhor pra você!": normatização social da infância e da família no Brasil / \"It will be in your favor!\": social regulation of childhood and family in Brazil

O trabalho analisa os discursos/práticas especialistas, em funcionamento desde fins do século XIX, como mecanismos de normatização de valores e comportamentos da infância/família brasileira. Utilizou-se a abordagem genealógica para pesquisar conteúdos veiculados nos Arquivos Brasileiros de Higiene Mental. Objetivou-se promover visibilidade de especialistas do conhecimento, fomentando uma desnaturalização de práticas/saberes considerados verdades universais. Identificaram-se fundamentos políticos, ideológicos e morais que sustentam discursos/práticas contemporâneos supostamente neutros e, frequentemente, acrescidos de assistencialismo e/ou militância. Aponta-se para necessidade de reavaliações das implicações políticas, éticas e sociais presentes tanto na formação como nas práticas psi.

This report analyzes specialist speeches/practices which have acted as mechanisms for Brazilian children/families since the end of the 19 century. A genealogic approach was used to carry out a study on the contents published in the Brazilian Mental Hygiene Archives. It also aims at enhancing the experts of the knowledge which make unnatural practices/opinions considered as universal truths. This analysis has identified political, ideological and moral bases supporting contemporaneous speeches/practices disguised as neutrality, which are often increased by "assistentialism" and/or militancy. It shows the need for revaluation of political and social consequences in the graduation and in the psychology practice.

"É melhor pra você!": normatização social da infância e da família no Brasil / "It will be in your favor!": social regulation of childhood and family in Brazil

O trabalho analisa os discursos/práticas especialistas, em funcionamento desde fins do século XIX, como mecanismos de normatização de valores e comportamentos da infância/família brasileira. Utilizou-se a abordagem genealógica para pesquisar conteúdos veiculados nos Arquivos Brasileiros de Higiene Mental. Objetivou-se promover visibilidade de especialistas do conhecimento, fomentando uma desnaturalização de práticas/saberes considerados verdades universais. Identificaram-se fundamentos políticos, ideológicos e morais que sustentam discursos/práticas contemporâneos supostamente neutros e, frequentemente, acrescidos de assistencialismo e/ou militância. Aponta-se para necessidade de reavaliações das implicações políticas, éticas e sociais presentes tanto na formação como nas práticas psi.(AU)

This report analyzes specialist speeches/practices which have acted as mechanisms for Brazilian children/families since the end of the 19 century. A genealogic approach was used to carry out a study on the contents published in the Brazilian Mental Hygiene Archives. It also aims at enhancing the experts of the knowledge which make unnatural practices/opinions considered as universal truths. This analysis has identified political, ideological and moral bases supporting contemporaneous speeches/practices disguised as neutrality, which are often increased by 'assistentialism' and/or militancy. It shows the need for revaluation of political and social consequences in the graduation and in the psychology practice.(AU)

Apnoea-hypopnoea and mandibular retrusion as uncommon findings associated with Proteus syndrome.

The aetiology of Proteus syndrome (PS) is yet unclear. This disease includes partial gigantism of the hands and/or feet, nevi, hemihypertrophy due to overgrowth of long bones, subcutaneous tumours, macrocephaly, cranial hyperostosis, and pulmonary and renal abnormalities. This case report is about a 17-year-old boy with two uncommon findings associated with PS: apnoea-hypopnoea and mandibular retrusion. A multidisciplinary team was important to provide professional care for this patient. Dentists and physicians proposed an adjusted treatment plan. Maxillary disjunction was achieved with a combination of orthodontic treatment and surgical procedure. This represented the initial care for malocclusion treatment and also the preparation for orthognathic surgery. The oral maxillofacial surgeon and the otorhinolaryngologist proposed this approach in an attempt to improve pharynx airflow. The patient has been followed for almost 3 years.

Chronic sinusitis unresponsive to medical therapy: a case of maxillary sinus actinomycosis focusing on computed tomography findings.

Actinomycosis of the paranasal sinuses is a rare occurrence and its clinical presentation does not suggest a specific diagnosis. Therefore, actinomycosis should be included in the differential diagnosis of neoplasms and granulomatous lesions of the head and neck region. However, the differentiation from a malignant neoplasm is not easy because the radiological findings are frequently similar and positive cultures are difficult to obtain. This report highlights the clinical progress of paranasal actinomycosis associated with some computed tomography findings that can be extremely helpful in the correct diagnosis. The characteristics of the disease are described and the relevant literature is discussed.

Clinical evaluation of the effects of radiographic distortion on the position and classification of mandibular third molars.

OBJECTIVE: Panoramic radiographs are routinely employed for surgical planning of unerupted third molars. The objective of this study was to evaluate distortions in the position of mandibular third molars on panoramic radiographs. MATERIALS AND METHODS: Panoramic radiographs of 14 patients with indication for extraction of the mandibular third molars were used. Transurgical impressions of the crowns of the teeth to be extracted and adjacent second molars (n=19) were achieved with addition silicone and poured with type IV plaster for comparison of the inclinations of the third molars on the radiographs and study casts. RESULTS: There was a mean difference of -5.37 degrees between the position of the third molar on the panoramic radiograph and on the study cast (standard deviation 1.46, P<0.05, Student's t-test). CONCLUSION: There is distortion in the position of teeth on the panoramic radiograph, which may influence the surgical planning; however, this does not invalidate it as the main tool for diagnosis and surgical planning of mandibular third molars.

Osteoblastoma of the mandible: systematic review of the literature and report of a case.

Benign osteoblastoma is a bone tumour that seldom occurs in the facial bones. The objective of this article is to add one more case of this rare lesion to the academic literature and to provide a systematic review of previously published cases. A new case of benign osteoblastoma is presented and clinical, radiographic and microscopic aspects, as well as differential diagnosis, treatment and follow-up are discussed. The importance of the correct diagnosis of this type of lesion is stressed, since it presents a clinical, radiographic and microscopic similarity to other bone lesions, including malignant tumours, which may lead the professional into conducting the case in an improper manner.

On the association between HLA-A1 and B5 and clinical forms of schistosomiasis mansoni

The association between both HLA-A1 and B5 antigens and chronic forms of human schistosomiasis was studied in 64 patients and 26 normal controls from a southern Brazilian hospital. No apparent correlation between the chronic forms of the disease and the expression of those antigens was detected. However, the analysis of these date together with those observed on an Egyptian sample suggests that the presence of either of the antigens and the hepatomegalic forms of schistosomiasis is significant, without heterogeneity. Converseley, the association of histocompatibility antigens with splenogegaly is consistent and significant only for HLA-B5, but not HLA-A1

On the association between HLA-A1 and B5 and clinical forms of schistosomiasis mansoni.

The association between both HLA-A1 and B5 antigens and chronic forms of human schistosomiasis was studied in 64 patients and 26 normal controls from a southern Brazilian hospital. No apparent correlation between the chronic forms of the disease and the expression of those antigens was detected. However, the analysis of these data together with those observed on an Egyptian sample suggests that the presence of either of the antigens and the hepatomegalic forms of schistosomiasis is significant, without heterogeneity. Conversely, the association of histocompatibility antigens with splenomegaly is consistent and significant only for HLA-B5, but not HLA-A1.