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2.
Lasers Med Sci ; 35(2): 395-402, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31273569

RESUMO

The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.


Assuntos
Lasers Semicondutores/efeitos adversos , Lasers Semicondutores/uso terapêutico , Cirurgia Ortognática , Osteotomia , Adolescente , Adulto , Eletrocoagulação , Feminino , Gengiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Ferida Cirúrgica/etiologia , Resultado do Tratamento , Cicatrização , Adulto Jovem
3.
Lasers Med Sci ; 33(1): 51-56, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28951983

RESUMO

The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 µm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.


Assuntos
Lasers Semicondutores , Procedimentos Cirúrgicos Ortognáticos , Osteotomia de Le Fort , Adolescente , Adulto , Feminino , Seguimentos , Gengiva/cirurgia , Humanos , Lasers Semicondutores/efeitos adversos , Masculino , Mucosa Bucal/cirurgia , Procedimentos Cirúrgicos Ortognáticos/efeitos adversos , Osteotomia de Le Fort/efeitos adversos , Dor Pós-Operatória/etiologia , Estudos Prospectivos , Adulto Jovem
4.
J Craniomaxillofac Surg ; 40(2): 116-23, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21458284

RESUMO

OBJECTIVE: To analyze the mandibular fractures which presented over a 3-year period at an emergency hospital in Belo Horizonte, Brazil. METHODS: The data collected included age, sex, aetiology, date of trauma, associated maxillofacial trauma, anatomic site of fracture, and treatment. The analysis involved descriptive statistics and the Pearson's chi-square, Bonferroni, Kolmogorov-Smirnov, Kruskal-Wallis and Mann-Whiney tests, and analysis of variance. RESULTS: There were 1,454 mandibular fractures in 1,023 patients. Males of 20-29 years of age sustained the majority of fractures. Traffic accidents were the major causes of trauma, followed by violence and falls. A high incidence of fractures in women due to violence was observed. The condyle region was found to be the most common fracture site in the mandible. A surgical approach was performed in most cases. There were more accidents causing mandibular fractures on the weekends. CONCLUSION: The individuals with mandibular fractures due to "traffic accidents" were younger than those due to "violence" and "falls". There was a significant statistical association between age and aetiology as well as between sex and aetiology of mandibular fractures.


Assuntos
Fraturas Mandibulares/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Fixação de Fratura/métodos , Fixação de Fratura/estatística & dados numéricos , Humanos , Lactente , Masculino , Côndilo Mandibular/lesões , Fraturas Mandibulares/complicações , Fraturas Mandibulares/etiologia , Fraturas Mandibulares/terapia , Fraturas Maxilares/complicações , Fraturas Maxilares/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Estatísticas não Paramétricas , Violência/estatística & dados numéricos , Adulto Jovem , Fraturas Zigomáticas/complicações , Fraturas Zigomáticas/epidemiologia
5.
Dental press j. orthod. (Impr.) ; 16(4): 132-136, jul.-ago. 2011. ilus
Artigo em Português | LILACS | ID: lil-604335

RESUMO

O presente estudo consiste no relato de um caso onde a distalização do segundo molar inferior impactado do lado direito foi obtida através da ancoragem esquelética com o uso de miniplaca. A verticalização dos segundos molares inferiores impactados, durante muito tempo, colocou-se como um grande desafio para ortodontistas e cirurgiões bucais devido à escassez de recursos de ancoragem destinados para esse fim. A utilização da ancoragem esquelética foi iniciada na clínica ortodôntica em meados dos anos 80 e, desde então, diversas modalidades têm sido desenvolvidas para esse princípio, como a utilização de mini-implantes, implantes dentários e, finalmente, miniplacas, que foram testadas e apresentaram resultados animadores. O assunto é relevante para ortodontistas e cirurgiões bucais, uma vez que o uso das miniplacas pode influir de forma significativa no tratamento de molares inferiores impactados.


This study describes a case with an impacted right mandibular second molar which was distalized using miniplates for skeletal anchorage. Uprighting impacted mandibular second molars has been a great challenge for orthodontists and oral surgeons because of the scarcity of anchorage options. Skeletal anchorage was first used in clinical orthodontics in the middle of the 1980s. Since then, several devices have been developed for that purpose, such as mini-screws, tooth implants and, lately, miniplates, which have been tested and showed encouraging results. This topic is relevant for orthodontists and oral surgeons because the use of miniplates may significantly change the treatment of impacted mandibular molars.

6.
Dent Traumatol ; 27(5): 393-8, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21615862

RESUMO

BACKGROUND: Maxillary tuberosity fractures during molar teeth extraction commonly occur in dental practice; however, very few cases have been reported and discussed in the literature. A correct preoperative radiographic interpretation, coupled with the anatomical knowledge of the structures involved, is essential to prevent such complications. AIM: The purpose of this paper is to enumerate the predisposing and etiological factors of maxillary tuberosity fractures during the extraction of upper molars, discuss the procedures that need to be taken when small or large fractured fragments of the tuberosity are evident during surgery, and suggest appropriate recommendations. This study is based on a thorough literature review. CONCLUSIONS: Upon discovering that a maxillary tuberosity has fractured, the dentist must first halt the procedure before inadvertent laceration of the adjoining soft tissue occurs and then determine the extent of the fracture by palpating the mobile fragment. After performing the dissection of the soft tissues, immediate removal of the small fractures, including the tooth with small bony fragments, may be the best option, because of the difficulty incurred when attempting to retain the bone. When a large bony fragment is present, it is recommended (i) that the extraction be abandoned and surgical removal of the tooth be performed using root sectioning, (ii) that the dentist tries to detach the fractured tuberosity from the roots, or (iii) that the dentist stabilizes the mobile part(s) of the bone by means of a rigid fixation technique for 4-6 weeks and, at a future moment, attempts a surgical removal without the use of a forceps.


Assuntos
Fraturas Maxilares/etiologia , Dente Molar/cirurgia , Extração Dentária/efeitos adversos , Humanos , Fraturas Maxilares/cirurgia
7.
J Craniomaxillofac Surg ; 39(7): 538-43, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21071237

RESUMO

Neurofibromatosis type 1, or von Recklinghausen disease, is one of the most common hereditary neurocutaneous disorders in humans. Clinically, Neurofibromatosis type 1 is characterized by café-au-lait spots, freckling, skin neurofibroma, plexiform neurofibroma, bony defects, Lisch nodules and tumors of the central nervous system. Central giant cell granuloma is a benign central lesion of bone, primarily involving the jaws, of variably aggressive nature characterized by aggregates of multinucleated giant cells in a background of cellular vascular fibrous connective tissue and spindle-shaped mononuclear stromal cells. The association between neurofibromatosis and central giant cell granuloma has been reported in the literature. A case of mandibular bilateral central giant cell granuloma in a patient with Neurofibromatosis type 1 was conservatively but successfully treated by adequate surgical curettage of mandibular bone lesions.


Assuntos
Granuloma de Células Gigantes/complicações , Doenças Mandibulares/complicações , Neurofibromatose 1/complicações , Adolescente , Curetagem , Diagnóstico Diferencial , Feminino , Granuloma de Células Gigantes/patologia , Granuloma de Células Gigantes/cirurgia , Humanos , Doenças Mandibulares/patologia , Doenças Mandibulares/cirurgia , Tomografia Computadorizada por Raios X
8.
Head Neck Pathol ; 5(2): 159-64, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21161456

RESUMO

The paradental cyst is commonly misinterpreted when associated with atypical clinical and radiographic characteristics, in turn causing diagnostic problems. For this reason, the study of the differential diagnosis of this lesion has become extremely important. In addition, the correlation of clinical, histologic, and radiographic findings are also of great value in obtaining accurate diagnoses. The minor variations in the clinical appearance of paradental cysts make it feasible to consider the two main groups of cysts separately: those associated with 1st and 2nd permanent molars of the mandible and those associated with the 3rd mandibular molar. Moreover, this distinction in localization may well dictate the necessary treatment. Bearing in mind the minor clinical variations, the present article aims to discuss the differential diagnosis of this lesion and its different possible treatments by presenting a case report to illustrate the findings.


Assuntos
Mandíbula/patologia , Doenças Mandibulares/diagnóstico , Cisto Periodontal/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Mandíbula/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Dente Molar/diagnóstico por imagem , Dente Molar/patologia , Cisto Periodontal/cirurgia , Periostite/diagnóstico , Cisto Radicular/diagnóstico , Radiografia , Resultado do Tratamento
9.
J Trauma ; 69(6): E73-8, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20693928

RESUMO

BACKGROUND: An increasing incidence of maxillofacial trauma in the elderly has been noted, as a consequence of increased longevity, resulting in a higher percentage of elderly people in the population. METHODS: A retrospective study was undertaken to assess facial fractures in elderly presenting during the period 2000 to 2002 in Belo Horizonte, Brazil. The data collected included age, gender, etiology, date of trauma, maxillofacial trauma, anatomic site of fracture, and treatment. The statistical analysis involved evaluation of measures of central tendency and variability and calculation of proportions. RESULTS: It encountered 165 facial fractures in 122 elderly aged 60 years or older. The majority of fractures were sustained by elderly in the age group 60 years to 69 years. Falls was the major cause of trauma followed by car accidents. The mandible was found to be the most common fractured bone in the facial skeleton, followed by the zygomatic complex. A conservative approach was accomplished in the most of cases. CONCLUSION: Gender was associated with the presence or absence of fractures and with the etiology. There was no association between age and fractures. No association was found between etiology and age for women and men. The proportion of fractures of the zygomatic arch, mandible body, and parasymphysis treated surgically were statistically higher than the same proportion among the cases of other fractures. The fractures of the nose were more often treated conservatively than other fractures.


Assuntos
Ossos Faciais/lesões , Fraturas Cranianas/epidemiologia , Idoso , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fraturas Cranianas/etiologia , Fraturas Cranianas/terapia , Estatísticas não Paramétricas
10.
Braz J Otorhinolaryngol ; 76(3): 355-62, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20658016

RESUMO

UNLABELLED: The area above the nasal cavity plays a role in respiratory physiology. AIM: To analyze, during a period of growth, a possible change in the minimum cross sectional area (MCA) and nasal volume of the anterior nasal cavity. MATERIALS AND METHODS: We evaluated 29 children (14 boys and 15 girls) with a mean age of 7.81 years at first examination (M1) and 11.27 years in the second examination (M2), without symptoms of nasal obstruction. The interval between examinations was 36-48 months. Children were subjected to the examination of acoustic rhinometry in which we recorded the minimum cross-sectional areas, volumes and their correlations with gender. STUDY DESIGN: Cohort. RESULTS: The mean cross-sectional area of the nasal cavity of MCA for girls was 0.30 +/- 0.09 cm2 (M1) and 0.30 +/- 0.14 cm2 (M2), while for boys was 0.24 +/- 0.12 cm2 (M1) and 0.32 +/- 0.10 cm2 (M2). The mean values of the total volumes found for the whole sample were 2.17 +/- 0.23 cm3 (MCA1-M1), 2.56 +/- 0.27 cm3 (MCA1-M2), 4.24 +/- 1.17 cm3 (MCA2- M2) and 4.63 +/- 1.10 cm3 (MCA2-M2). CONCLUSION: There was no significant change in the minimum cross sectional area of the anterior nasal cavity. There was no significant difference between genders for both MCA and for the volume. There was a significant increase in MCA1.


Assuntos
Cavidade Nasal/anatomia & histologia , Rinometria Acústica , Análise de Variância , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Valores de Referência
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