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INTRODUCTION: Even though is rarely, mandibular fracture after the extraction of third molars can occur in almost 1% of the procedures. Gender, age, position of third molar, tooth volume, bone fragility, systemic disorders, associated lesions, and degree of mandibular atrophy are factors that contribute to increase the incidence of fracture. The installation of the titanium miniplate during exodontia is an important tool to prevent the fracture. PRESENTATION OF CASE: The objective of this study is to present a clinical case of extraction of inferior impacted third molar, in atrophic mandible, with posterior installation of titanium miniplate, to prevent mandibular fracture. DISCUSSION AND CONCLUSION: preventive installation of titanium miniplate was effective and indeed prevented the mandibular fracture. No trans-operative or immediate post-operative complications were observed. Post-operative follow-up was of three years, with no complications, showing the success of the procedure.

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Sinus lifting has become a routine procedure in modern implant dentistry. Despite its predictability, this type of surgery may eventually lead to serious complications and sequelae. Most of the time, such complications are due to technical failures, such as perforation of the sinus membrane during surgery, which may eventually lead to graft loss due to infection within the sinus, which finds its drainage path into the mouth and leads to an oroantral communication (OAC). Epithelization of such a draining duct characterizes an oroantral fistula (OAF). This report presents the use of a palatal pedicle flap to successfully close an OAF in a patient who had previously undergone a sinus lifting procedure. Several surgical techniques may be used in the closure of an OAF, and the choice of a particular technique is subject to the characteristics and location of the communication as well as to the preference of the surgeon. The palatal pedicle flap was successfully chosen in the present case report. The palatal pedicle flap was considered an adequate option for closure of an OAF in a single-stage surgical procedure, with no loss of either keratinized mucosa or buccal sulcus depth in the area of the fistula.

A cirurgia de elevação da mucosa do seio maxilar para enxerto ósseo e posterior colocação de implantes osseointegráveis vem se tornando um procedimento de rotina na implantodontia moderna. Embora previsível, em alguns casos, tal procedimento, pode levar a complicações e sequelas consideráveis. Na maioria das vezes, essas complicações são ocasionadas por falhas técnicas, como a perfuração da membrana sinusal no momento transcirúrgico, o que pode acarretar perda do enxerto devido a um processo infeccioso no interior do seio maxilar, cuja via de drenagem acaba provocando a comunicação com a cavidade oral. A fístula bucossinusal é caracterizada pela persistência e epitelização desse pertuito. Neste relato é apresentado um caso de fechamento de fístula bucossinusal com o uso de um retalho palatino pediculado, em um paciente que havia desenvolvido um processo infeccioso, após ter sido submetido à realização de uma cirurgia para a elevação do seio maxilar. A cirurgia para o fechamento das comunicações bucossinusais apresenta técnicas variadas, que podem ser eleitas de acordo com as preferências do operador, além da localização e características da comunicação. Para o presente relato de caso, a técnica do retalho palatino pediculado foi eleita para o tratamento cirúrgico, proporcionando a cura do paciente. A técnica do retalho palatino pediculado mostrou-se uma opção adequada para o fechamento da fístula bucossinusal em um único ato cirúrgico, sem perda de mucosa ceratinizada ou diminuição do sulco vestibular na região da fístula.

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PURPOSE: The aim of this study was to evaluate the efficacy of three drug protocols in patients undergoing extraction of fully impacted lower third molars. METHODS: Eighty surgeries were performed on healthy patients using three randomized double-blind drug protocols: group 1 (G1), amoxicillin (1 g) 1 h before surgery + 500 mg 8/8 h for 7 days; group 2 (G2), 1-g amoxicillin 1 h before surgery plus placebo, with identical appearance to G1, 8/8 h for 7 days; and group 3 (G3), placebo 1 h before surgery and 500 mg 8/8 h for 7 days. The primary outcome criterion was mouth opening, and the secondary outcome criteria were facial edema and pain. Signals as body temperature, lymphadenopathy, and dysphagia characterize the sample. Evaluation was performed at baseline and on the 4th and 7th postoperative days by the same researcher. RESULTS: There was no difference among groups with respect to any of the parameters evaluated (p > 0.05). CONCLUSION: Under these experimental conditions, there is no advantage in the administration of antibiotics in healthy patients undergoing extraction of fully impacted lower third molars with a controlled aseptic chain.

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INTRODUCTION: Efficacy of anesthetic supplementation with bupivacaine to control both pain and the number of analgesics ingested after surgery has been proposed; however, no report was found in the literature regarding supplemental use of bupivacaine. Thus, the aim of this study was to evaluate the clinical efficacy of bupivacaine in appeasing postoperative pain, when used as supplemental anesthesia at the end of surgeries to extract mandibular third molars. METHODS: Eighty surgeries were performed in 40 healthy ASA I patients of mandibular bilateral, semi-enclosed, and symmetrical third molars, in a randomized, double-blind, placebo-controlled, and split-mouth clinical trial. Two procedures were performed. In one case, a preoperative anesthetic block was performed with bupivacaine (0.5 %) and epinephrine (1:200,000). Supplementation with the same anesthetic composition was used at the end of the surgery (test group). In the second case (control group), the procedure was identical to that used in the test group, but was supplemented in a randomized double-blind trial with saline (placebo), using the split-mouth method. Postoperative pain (measured with a visual analog scale) was the primary variable studied, and analgesic consumption was the secondary variable. Nonparametric analysis of variance (Wilcoxon test) and a two-tailed test to determine the ratio was used. P value was set at 0.05. RESULTS: No statistically significant difference (P > 0.05) was found in the variables studied. An adverse effect related to the anesthetic under study was not observed. CONCLUSION: There is no appreciable value to the second injection regarding pain and analgesia use, but there was a difference regarding patient acceptance in surgeries of mandibular semi-enclosed and impacted third molars.

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The objective of the study was to compare the analgesic effectiveness of dexamethasone and diclofenac sodium administered preemptively after surgical removal of third molars. Forty-four ASA (American Society of Anesthesiologists) I patients (19 men, 35 women; 16–28 years old) randomly and double-blindly received diclofenac sodium (50 mg) or dexamethasone (8 mg) or placebo 1 h before surgery. Intensity of pain, measured with a visual analog scale (VAS), was the variable studied at different postoperative times (1 h, 2 h, 3 h, 6 h, 8 h, 12 h, 48 h, 4 d and 7 d). The total amount of rescue medication (TARM) ingested (paracetamol) was another variable of the study. The Kruskal-Wallis statistical test was used. A p value of < .05 was adopted to reject the null hypothesis. The dexamethasone group showed lower pain intensity (p < .05) than the diclofenac sodium and placebo groups (p < .05). No difference in TARM was observed among the groups (p < .05). Preemptively administered, dexamethasone was effective in controlling postoperative pain.

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The objective of the study was to compare the analgesic effectiveness of dexamethasone and diclofenac sodium administered preemptively after surgical removal of third molars. Forty-four ASA (American Society of Anesthesiologists) I patients (19 men, 35 women; 16-28 years old) randomly and double-blindly received diclofenac sodium (50 mg) or dexamethasone (8 mg) or placebo 1 h before surgery. Intensity of pain, measured with a visual analog scale (VAS), was the variable studied at different postoperative times (1 h, 2 h, 3 h, 6 h, 8 h, 12 h, 48 h, 4 d and 7 d). The total amount of rescue medication (TARM) ingested (paracetamol) was another variable of the study. The Kruskal-Wallis statistical test was used. A p value of < .05 was adopted to reject the null hypothesis. The dexamethasone group showed lower pain intensity (p < .05) than the diclofenac sodium and placebo groups (p < .05). No difference in TARM was observed among the groups (p < .05). Preemptively administered, dexamethasone was effective in controlling postoperative pain.

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O cisto nasolabial é um cisto de desenvolvimento não odontogênico raro, que acomete os tecidos moles entre a asa e base do nariz e o lábio superior podendo levar a assimetria facial. Sua patogênese é ainda muito discutida, no entanto, seu diagnóstico é clínico confirmado pelo exame anatomo-patológico. O tratamento clássico é a enucleação da lesão. O objetivo deste artigo é descrever as características, o diagnóstico e o tratamento do cisto nasolabial e relatar um caso clínico.

Nasolabial cyst is arare non-odontogenic development cyst, which affects soft-tissues between the ala and the base of the nose and the upper lip and may lead to facial asymmetry. Its pathogenesis is still controverse, although clinical diagnosis is confirmed by the anatomo-pathological examination. The treatment is enucleation of the lesion. The aim of this article is to describe the characteristics, diagnosis and the treatment of nasolabial cysts and report a clinical case.

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A sialolitíase é uma alteração, que acomete as glândulas salivares, representada pela obstrução da glândula ou de seu ducto excretor devido à formação de um sialólito, resultando na diminuição do fluxo salivar. a glândula submandibular é a mais acometida, seguida da glândula parótida e sublingual. a sialolitíase pode ocorrer em qualquer idade, sendo mais comum em adultos acima dos 40 anos, tendo uma predileção pelo gênero masculino. O tratamento vai depender do tamanho e da localização do sialólito, podendo variar de estimulação da saliva até a remoção cirúrgica do sialólito com sua glândula envolvida. Neste trabalho, iremos relatar um caso clínico de um paciente com uma sialolitíase em glândula submandibular, em que o tratamento proposto foi a exérese do cálculo salivar, seguida de submandibulectomia da glândula correspondente.

Sialolithiasis is a change that affects the salivary glands, represented by the obstruction of the gland or its excretory duct due to the formation of a sialolith, resulting in a decreased salivary flow. The submandibular is the gland most affected, followed by the parotid and sublingual glands. Sialolithiasis can occur at any age, but is more common in adults over 40 years of age and has a predilection for males. The treatment will depend on the size and location of the sialolith and may range from stimulation of the saliva to the surgical removal of the gland with its involved sialolith. In this paper we report a case of a patient with sialolithiasis of the submandibular gland in which the proposed treatment was the removal of calculus, followed by submandibulectomy of the gland in question.

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INTRODUCTION: There is no conclusive evidence from clinical trial studies regarding preemptive analgesic interventions. Clinical trials are necessary to evaluate the efficacy of preemptive analgesic interventions already demonstrated in animal studies. Thus, it is necessary to evaluate the analgesic effect of preoperative administration of ibuprofen alone or coadministered with dexamethasone after third molar surgery. MATERIAL AND METHODS: A randomized, double-blind, and controlled clinical trial was conducted with 94 bilateral symmetrical third molar surgeries. Preemptive analgesic medication was randomly defined: ibuprofen or placebo and ibuprofen + dexamethasone or placebo was administered to patients who served as their own control (split mouth). The variables analyzed were postoperative pain through visual analog scale (VAS), total number of rescue analgesic (TNRA), and patient satisfaction. Data were analyzed with the Mann-Whitney test. RESULTS: There was no significant difference (p > 0.05) between ibuprofen and placebo for postoperative pain (VAS) and TNRA. Patients consumed less analgesics (TNRA) for dexamethasone + ibuprofen (p < 0.05) and felt more comfortable in the postoperative period after surgery (p < 0.05). DISCUSSION: The preemptive analgesia with ibuprofen was insufficient to inhibit central sensitization, whereas its association with dexamethasone was more effective in preventing pain in third molar surgery.

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BACKGROUND: The benign cementoblastoma is an odontogenic tumor originated from neoplastic cementoblasts, a rare lesion mainly associated to impacted and deciduous teeth. It affects mostly young people with an average age of 20 years old, and its preferred location is in the posterior region of the mandible; the lesion will present itself fused both radiologically and microscopically to a root of an erupted permanent tooth, and the anatomopathological diagnosis is obtained through the analysis of the piece sent together with the involved dental element. CASE REPORT: The present study presents a case of cementoblastoma in the mandible involving the second deciduous molar tooth and preventing the eruption of the premolar tooth in a girl aged 11 years old. DISCUSSION: This report discusses relevant aspects concerning clinical, radiographic, and histopathological characteristics and treatments.

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