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BACKGROUND/AIMS: Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service. MATERIALS AND METHODS: A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed. RESULTS: Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay. CONCLUSION: Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.
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Traumatismos Maxilofaciais , Fraturas Orbitárias , Acidentes de Trânsito , Humanos , Masculino , Traumatismos Maxilofaciais/etiologia , Estudos Prospectivos , Estudos Retrospectivos , ViolênciaRESUMO
ABSTRACT: This systematic review was carried out to determine if maxillomandibular fixation, used in the treatment of maxillary fractures, interferes with respiratory function, and appraised studies that evaluated pulmonary function using spirometry on patients with and without maxillomandibular fixation. Searches were conducted on the following databases: Medline/Pubmed, Embase, Cochrane, Web of Science, Scopus, and Scielo, in addition to a search of the grey literature and a manual search. Five studies were included in the qualitative analysis, but it was not possible to conduct a quantitative study due to the lack of data. Forced vital capacity, forced expiratory volume in the first second, the ratio of these values, and peak expiratory flow were the parameters studied. In all the studies included in this review, it was possible to observe the lowest respiratory parameter values during maxillomandibular fixation and, after removal, normal respiratory function was restored. Accordingly, it was possible to conclude that maxillo-mandibular fixation temporarily affects respiratory function, during use, but it is restored on removal, therefore, not precluding its use on healthy patients who have good nasal breathing prior to the procedure. However, in patients suffering from some form of respiratory limitation or pulmonary disease, and also mouth breathers, maxillomandibular fixation should not be used so as to avoid more severe respiratory complications, underlining the importance of preoperative pulmonary evaluation.
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Técnicas de Fixação da Arcada Osseodentária , Humanos , Capacidade Vital , Volume Expiratório Forçado , Espirometria , Testes de Função Respiratória/métodosRESUMO
Introduction: Despite the vast literature reporting the prevalence of oral and maxillofacial diseases in the last decades, few studies have focused on lesions biopsied in the pediatric population. Objective: To determine the prevalence of oral and maxillofacial lesions that were biopsied in children and adolescents aged 0-19 years. Methods: Observational and descriptive study. We carried out a retrospective review of 862 reports of pathological examinations performed in an oral pathology laboratory of the northeast of Brazil, during the period from March 2001 to December 2009. The categories were neoplasms, hyperplastic/reactionary lesions, salivary gland lesions, bone lesions, healthy tissues and teeth, oral mucosal lesions, cystic lesions, odontogenic tumors, periapical inflammation, dental alteration and conclusive diagnosis. Results: The epidemiological profile of patients was characterized by females (53.24 percent), Caucasian (45.12 percent), with a mean age of 13.06 years. Salivary gland lesions were the category with the largest number of cases (182), and mucocele was the most prevalent histopathological diagnosis (18.44 percent), with an average size of 1.97 cm. Most cases were asymptomatic (70.88 percent). Conclusions: This study showed a predominance of lesions diagnosed as benign, the most prevalent lesions were associated with the salivary gland. Females were the most affected(AU)
Introducción: A pesar de la gran cantidad de literatura que informa sobre la prevalencia de enfermedades bucales y maxilofaciales en las últimas décadas, pocos estudios se concentraron en las lesiones biopsiadas en la población pediátrica. Objetivo: Determinar la prevalencia de las lesiones bucales y maxilofaciales que fueron biopsiadas en los niños y adolescentes de 0 a 19 años. Métodos: Estudio observacional y descriptivo. Se realizó una revisión retrospectiva de 862 informes de los exámenes patológicos realizados en un laboratorio de Patología Oral del nordeste de Brasil, durante el período comprendido entre marzo de 2001 y diciembre de 2009. Las categorías fueron: neoplasias, hiperplásicas / lesiones reactivas, lesiones de las glándulas salivales, lesiones óseas, tejidos y dientes sanos, lesiones de la mucosa bucal, lesiones quísticas, tumores odontogénicos, inflamación periapical, alteración dental y diagnóstico concluyente. Resultados: El perfil epidemiológico de los pacientes se caracterizó por las mujeres (53,24 por ciento), de raza caucásica (45,12 por ciento) con una edad media de 13,06 años. Lesiones de las glándulas salivales fueron la categoría con el mayor número de casos (182), y el mucocele fue el diagnóstico histopatológico más frecuente (18,44 por ciento), con un tamaño medio de 1,97 cm. La mayoría de los casos fueron asintomáticos (70,88 por ciento). Conclusiones: Este estudio mostró un predominio de las lesiones diagnosticadas como benignas. Las lesiones más frecuentes se relacionaron con la glándula salival. Las mujeres fueron las más afectadas(AU)
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Humanos , Feminino , Glândulas Salivares/lesões , Tumores Odontogênicos/diagnóstico por imagem , Traumatismos Maxilofaciais/epidemiologia , Doenças da Boca/epidemiologia , Epidemiologia Descritiva , Estudos Retrospectivos , Estudo ObservacionalRESUMO
Odontogenic tumors (OTs) are important lesions of the gnathic bones due to their clinicopathological heterogeneity and variable biological behavior; therefore, epidemiological studies are needed to outline the incidence and behavior of these tumors. To evaluate the incidence and epidemiological profile of ameloblastoma (AMB) and keratocystic odontogenic tumor (KCOT) from an oral pathology service, and correlate morphological findings of these tumors with the immunoexpression of a cellular proliferation marker (Ki-67), a retrospective study (2002-2012) was conducted to characterize demographic, clinical, radiological, and morphological data of AMBs and KCOTs. Then, a representative sample composed of 49 cases of each tumor was selected to perform immunohistochemical (IHC) analysis of Ki-67 through the streptavidin biotin peroxidase technique. For statistical analysis, we used Fisher's exact test (p < 0.05). A total of 279 OTs were found in the service, in which 91 (32.6%) were AMB and 98 (35 %) were KCOT. Most cases occurred in white women, and the average age of patients with AMB and KCOT was 32 and 33 years, respectively. The maxilla-mandible ratio was 1:6 and 1:3.6 for AMB and KCOT, respectively. Regarding IHC analysis, AMB and KCOT had similar levels of cellular proliferation. However, KCOTs with intense inflammation showed higher Ki-67 expression (p < 0.001). Recurrent cases had similar Ki-67 immunoexpression. The demographic profile of the studied tumors corroborates with data reported in the literature, and the levels of cellular proliferation were similar in both tumors, although the inflammation seems to induce a differential proliferative behavior in KCOT.
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Neoplasias Mandibulares/patologia , Neoplasias Maxilares/patologia , Tumores Odontogênicos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ameloblastoma/epidemiologia , Ameloblastoma/metabolismo , Ameloblastoma/patologia , Brasil/epidemiologia , Proliferação de Células , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Incidência , Antígeno Ki-67/metabolismo , Masculino , Neoplasias Mandibulares/epidemiologia , Neoplasias Mandibulares/metabolismo , Neoplasias Maxilares/epidemiologia , Neoplasias Maxilares/metabolismo , Pessoa de Meia-Idade , Tumores Odontogênicos/epidemiologia , Tumores Odontogênicos/metabolismo , Estudos Retrospectivos , Adulto JovemRESUMO
PURPOSE: The purpose of this study was to evaluate the profile of pediatric oral lesions in northeastern Brazil. METHODS: Biopsy records of oral lesions were retrieved from patients aged zero to 18 years who were treated over 18 years in two university hospitals in northeastern Brazil. Routine pathological sections were re-examined and classified into six groups: (1) odontogenic and nonodontogenic cysts; (2) odontogenic tumors; (3) salivary gland pathology; (4) nonodontogenic tumors and tumor-like lesions; (5) bone pathology; and (6) miscellaneous. RESULTS: From a total of 4,690 oral biopsies, 564 (12 percent) were from children and adolescents. The largest number of cases was salivary gland pathology, followed by nonodontogenic tumors and tumor-like lesions. The most common oral biopsies were mucocele, pericoronal dental follicle, pyogenic granuloma, dentigerous cyst, and odontoma. Only three cases of malignant tumors were observed. Our results were similar to most studies. CONCLUSIONS: Although malignant tumors comprised a small portion of the pediatric oral biopsies, the possibility of their occurrence in children and adolescents should not be overlooked.
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Doenças Estomatognáticas/epidemiologia , Adolescente , Biópsia , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Doenças Estomatognáticas/patologiaRESUMO
CONTEXT: Focal fibrous hyperplasia, also known as irritation or traumatic fibroma, is a reactive, inflammatory hyperplastic lesion of the connective tissue. AIM: The aim of this study is to perform a retrospective study of a focal fibrous hyperplasia of 18 years. MATERIALS AND METHODS: We retrospectively reviewed 193 cases of focal fibrous hyperplasia of the oral cavity from the medical and histological reports of the Department of Oral Pathology, Pernambuco University, Brazil, during the period between January 1992 and December 2009. SETTINGS AND DESIGN: Data with regard to age, gender, location, size of the lesion (equal to or less than 1 cm, between 1 and 2 cm and greater than 2 cm), pain, history of trauma, treatment, length of follow-up (from diagnosis to release or last review) and recurrence, were collected. RESULTS: The most commonly affected site was the buccal mucosa (n = 119, 61.7%). Almost two-thirds of the cases were concentrated from the second to the fifth decade of life. Females were more affected than men and a history of trauma was related by 90.7% of the patients. Two recurrences were notified (1.0%). CONCLUSION: Further studies are needed on the distribution of the lesion in different ethnic and geographical populations. The influence of sex hormones on the development of focal fibrous hyperplasia must be clarified.
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PURPOSE: The purpose of this study was to determine the prevalence and predicitve factors of dental anxiety among Brazilian adolescents. METHODS: This was a cross-sectional study of a random sample of 340 Brazilian adolescents, done between 2005 and 2010. Corah's Dental Anxiety Scale and an objective questionnaire were used to determine the degree of dental anxiety. RESULTS: The prevalence of moderate to severe dental anxiety was approximately 18%. Dental anxiety was correlated with the following factors: gender (P<.05), age group (P<.001), degree of schooling (P<.001), access to newspapers and/or the Internet (P<02), oral hygiene frequency (P=.005), visits to the dentist (P<.02), reason for last visit to the dentist (P<.001), and experience with dental pain (P=.002). CONCLUSIONS: Dental fear and anxiety in Brazilian adolescents are associated with lack of economic resources, negligence of oral health, low educational level, female gender, and younger age.
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Ansiedade ao Tratamento Odontológico/epidemiologia , Ansiedade ao Tratamento Odontológico/etiologia , Adolescente , Comportamento do Adolescente , Fatores Etários , Análise de Variância , Brasil , Criança , Estudos Transversais , Assistência Odontológica/efeitos adversos , Escolaridade , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
The calcifying cystic odontogenic tumor or Gorlin cyst is an uncommon lesion with a variable clinical behavior and considerable histopathologic diversity. The authors report a case of calcifying cystic odontogenic tumor that was being treated as a maxillary sinus mucocele. The possibility of mimicking numerous odontogenic and nonodontogenic lesions makes the calcifying cystic odontogenic tumor difficult for a clinical diagnosis. The present case demonstrates that a specific knowledge in oral pathology is required to differentiate odontogenic lesions.
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Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/cirurgia , Cisto Odontogênico Calcificante/diagnóstico , Cisto Odontogênico Calcificante/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Maxilares/patologia , Mucocele/diagnóstico , Cisto Odontogênico Calcificante/patologia , Radiografia Panorâmica , Tomografia Computadorizada por Raios XRESUMO
The aim of the present study was to assess the clinical and radiographic repercussions of surgically assisted maxillary expansion on the septum, nasal cavity and nasal conchae. The sample was made up of 15 patients with skeletal maturity (9 females and 6 males between 16 and 45 years of age) and maxillary transverse deficiency. Assessments were performed through anterior rhinoscopy and frontal cephalometric radiographs on three occasions: (T0) preoperative period, (T1) locking of the expander and (T2) six months following the locking procedure. An increase was observed in the basal portion of the pyriform aperture and distances between the lateral wall of the basal portion of the pyriform aperture and the septum. The radiographic exam revealed that the nasal septum did not undergo any statistically significant change in its position. Moreover, no significant changes in the position of the nasal septum or nasal conchae were detected throughout the three evaluation times. The results suggest that surgically assisted maxillary expansion is capable of widening the basal portion of the pyriform aperture, with little repercussion on the anterior position of the nasal septum and inferior nasal conchae.