Use of bone plates and screws to manage chronic mandibular dislocation

Different treatment modalities are described in literature to treat mandibular recurrent dislocation, including intra- capsular esclerosant injections, articular eminence reduction, soft tissues suture to limit condilar movement, and grafts or implants to create mechanical interference, like zygomatic arch down fracture or articular eminence in- crease by bone plates. In this paper, a patient with mandibular recurrent dislocation episodes were eliminated after bilateral fixation of bone plates to the lateral sur-face of the zygomatic arch to restrict mandibular movements. One arm of the plate was extended me-dially just below the articular eminence and fixed at lateral zygomatic arch portion by two screws. The surgical technique is described and 24 months follow-up period is demonstrate with excellent recovery and functional activities. The temporomandibular joint (TMJ) function was unimpeded and no recu-rrence of condilar dislocation was observed. We concluded that this technique is safe and efficient to hinder dislocations of mandible, preserve the TMJ initial characteristics, and prevent abnormal condi-lar movements over the eminenc

Bone response to biosilicates® with different crystal phases

The aim of this study was to investigate the histological and histomorphometrical bone response to three Biosilicates with different crystal phases comparing them to Bioglass®45S5 implants used as control. Ceramic glass Biosilicate and Bioglass®45S5 implants were bilaterally inserted in rabbit femurs and harvested after 8 and 12 weeks. Histological examination did not revealed persistent inflammation or foreign body reaction at implantation sites. Bone and a layer of soft tissue were observed in close contact with the implant surfaces in the medullary canal. The connective tissue presented few elongated cells and collagen fibers located parallel to implant surface. Cortical portion after 8 weeks was the only area that demonstrated significant difference between all tested materials, with Biosilicate 1F and Biosilicate 2F presenting higher bone formation than Bioglass®45S5 and Biosilicate® vitreo (p=0.02). All other areas and periods were statistically non-significant (p>0.05). In conclusion, all tested materials were considered biocompatible, demonstrating surface bone formation and a satisfactory behavior at biological environment.O objetivo deste estudo foi investigar histologicamente e histomorfometricamente a resposta óssea a três diferentes fases cristalinas do Biosilicato®, comparando-os aos implantes de Bioglass®45S5 utilizados como controles. Implantes de cerâmicas de Biosilicato® e implantes de Bioglass®45S5 foram inseridos bilateralmente em fêmures de coelho e avaliações histológicas realizadas após 8 e 12 semanas. As avaliações histológicas não revelaram inflamação persistente ou reação de corpo estranho nos sítios de implantação dos biovidros. A formação de tecido ósseo pôde ser observada em maior quantidade na porção cortical, com tecido conjuntivo sendo observado em íntimo contato com as superfícies dos implantes apenas na porção medular. O tecido conjuntivo apresentou células com forma alongada e fibras de colágeno localizado paralelamente à superfície do implante. A porção cortical (após 8 semanas) foi a única área que demonstrou diferença significante entre os materiais estudados, com o Biosilicato 1F e o Biosilicato 2F demonstrando maior formação de tecido ósseo em contato com a superfície quando compardos aos implantes de Bioglass®45S5 e Biosilicato®vítreo (p=0,02). As outras áreas estudadas nos diferentes períodos não foram consideradas estatisticamente significantes (p>0,05). Pode-se concluir que todos os materiais testados foram considerados biocompatíveis, com formação óssea na superfície e comportamento em ambiente biológico satisfatório.The authors thank Mr. Sebastião Carlos Bianco for technical assistance and declare no conflict of interes

Management of Bell's Palsy: A Report of 2 Cases

Bell's palsy is a neuropathy of the peripheral seventh cranial nerve, resulting from traumatic, compressive, infective, inflammatory or metabolic abnormalities or it can be idiopathic. HIV, Epstein-Barr virus and hepatitis B virus have been suspected as initiating organisms, but herpes simplex virus is the most frequently implicated. This report describes 2 cases of Bell's palsy in children that were managed with antiviral agents. Both patients experienced complete recovery within 28 days; after 1 year follow-up, no recurrence was observed and both patients have normal facial movement. Differential diagnosis is essential to guide the treatment plan in Bell's palsy. Special attention should be given to children with respect to prescription of medications that can cause important side effects

Color change of the bleached enamel treated with calcium silicate- sodium phosphate-sodium monofluorophosphate-based system

The increasing demand of tooth bleaching has also increased the need of researches focusing on the durability of the resultant color. The aim of this study was to evaluate the effect of a system based on calcium silicate, sodium phosphate and sodium monofluorophosphate (Regenerate?) on color maintenance of bleached enamel considering two waiting times for the contact with a cola drink. This in vitrostudy was performed on bovine enamel specimens (n = 100), bleached with 35% H2O2 and treated with: G1 Distilled water; G2 Artificial saliva; G3 RegenerateTM Serum and Toothpaste; G4 RegenerateTM Toothpaste; G5 RegenerateTM Serum. The groups G3, G4 and G5 received one application of the respective products for 3 min, in 3 consecutive days. The color parameters (?E, L*, a*, b*) were evaluated by spectrophotometry before and after bleaching and after surface treatments and immersion (15min) in cola drink, on the waiting times of 24 hours (T1) and 7 days (T2). The effect of surface treatments and waiting times was evaluated by Two-Way ANOVA, Kruskal-Wallis, Wilcoxon and T test (p<0.05). There was no significant effect of the surface treatments (p=0.57), waiting times (p=0.97) and their interaction (p=0.47) considering ?E. The analysis of repeated measures of the color coordinates L*, a* and b* showed a decrease of chromaticity (a*, b*) for G3, G4 and G5 and an increase of lightness (L*) for G5, after immersion in cola drink, suggesting some protection against bleached enamel pigmentation. RegenerateTM has a potential protective effect on bleached enamel color maintenance. The waiting times of 24 hours and 7 days for the contact with the cola drink did not influence bleached enamel color maintenance

A retrospective study of oral manifestations in patients with paracoccidioidomycosis

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (&#945;=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health

Bone Quality of the Dento-Maxillofacial Complex and Osteoporosis. Opportunistic Radiographic Interpretation

Research suggests the use of different indexes on panoramic radiography as a way to assess BMD and to be able to detect changes in bone metabolism before fractures occur. Therefore, the objective of this chapter is to describe the use of these parameters as an auxiliary mechanism in the detection of low bone mineral density, as well as to characterize the radiographic findings of patients with osteoporosis

Bone response to Biosilicate® and Biosilicate®Vítreo implanted in rabbit femur

O objetivo do presente estudo foi avaliar histologicamente e histomorfometricamente a resposta óssea a três composições de Biosilicato com diferentes fases de cristalização (Vítreo, 1F e 2F) comparando-as com o Bioglass®45S5, que foi empregado como controle. Cilindros de Biosilicato 2F, Biosilicato 1F, Biosilicato®vítreo e Bioglass®45S5 foram implantados em fêmur de coelhos e as amostras obtidas após 8 e 12 semanas da colocação, sendo as mesmas preparadas para análise histológica e histomorfométrica utilizando microscopia de luz. Nesses períodos foi avaliada a resposta óssea e o contato direto osso/implante na porção cortical e no canal medular do fêmur de todos os materiais. A maior quantidade de contato osso implante na região cortical, após 8 semanas, foi observada no material Biosilicato 2F, seguido pelo Biosilicato 1F, Bioglass®45S5 e Biosilicato®vítreo. A análise estatística não evidenciou diferença estatisticamente significante entre os materiais Biosilicato 1F e 2F (p=0,06). Entretanto, nesse período, esses materiais mostraram diferenças estatisticamente significantes em relação aos materiais Biosilicato®vítreo e Bioglass®45S5 (p=0,02). Após 12 semanas o Biosilicato 2F também apresentou os melhores resultados, seguido pelo Bioglass®45S5, Biosilicato®vítreo e Biosilicato 1F, sem contudo serem observadas diferenças estatisticamente significantes (p>0,05). Avaliando a porção medular no período de 8 semanas, observa-se maior formação óssea ao redor do implante de Biosilicato®vítreo, seguido pelos implantes de Bioglass®45S5, Biosilicato 2F e Biosilicato 1F. Decorridas 12 semanas, observa-se melhor resposta óssea nos implantes de Biosilicato 1F, seguido pelos implantes de Biosilicato 2F, Biosilicato®vítreo e Bioglass®45S5, sem contudo serem observadas diferenças estatisticamente significantes entre os materiais ou tempos analisados. Os resultados do presente trabalho demonstram o excelente comportamente biológico das cerâmicas de Biosilicato®.The aim of this study was to investigate the histological and histomorphometric bone responses to three Biosilicate® with different crystal phases (Vítreo, 1F and 2F) compared to Bioglass®45S5 used as control. Rods of Biosilicate 2F, Biosilicate 1F, Biosilicate®vítreo, and Bioglass45S5 were implanted in rabbits femurs. Implants were harvested at 8 and 12 weeks and prepared for histological and histomorphometric analyses at light microscope level. At these periods bone response and bone-to-implant contact were evaluated at cortical and medullar portion. Considering bone-to-Implant contact at cortical portion Biosilicate 2F presented the highest bone formation, followed by Biosilicate 1F, Bioglass®45S5, and Biosilicate®vítreo (eight weeks). Biosiliacate 1F and 2F presented similar results with no statistic difference (p=0,06). However, in this period Biosilicate 2F demonstrated higher values than Bioglass®45S5 and Biosilicato®vítreo (p=0,02). After twelve weeks direct bone contact was similar between all tested materials (Biosilicate 2F > Bioglass®45S5 > Biosilicate®vítreo > Biosilicate 1F) with no statistically significant difference (p>0,05). When medullar portion was evaluated Biosilicate®vítreo presented a higher amount of new formed bone followed by Bioglass®45S5, Biosilicate 2F, and Biosilicate 1F (eight weeks). After twelve weeks Biosilicate 1F demonstrated the best result, followed by Biosilicate 2F, Biosilicate®vítreo, and Bioglass®45S5. No statistically significant difference between the materials or the periods was observed (p>0,05).All the Biosilicate® glassceramics appeared to have an excellent behavior at biological environment

Tumor Benigno das Glândulas Salivares

Pleomorphic adenoma is a benign tumor with  higher prevalence in females in their 40s and 50s. It is characterized as an asymptomatic lesion mostly found in parotid glands followed by the minor salivary glands, mandibular glands, superior lip and jugal mucosa. It has a slow evolution, and intraoral tumors are mostly diagnosed when they start to interfere in mouth functions, such as masticatory activities, speaking, word pronunciations and deglutition. This paper shows three cases of pleomorphic adenomas found in the minor salivary glands of the hard palate and in the parotid gland with  different  therapeutic  procedures having been instituted and discussed. The clinical treatment was preferable in one of the cases  due  to  the  patient’s  systemic  condition. The other two cases were operated without any complication.O adenoma pleomórfico é um tumor benigno com maior prevalência em indivíduos do gê­nero feminino entre a quarta e quinta décadas de vida. É caracterizado como uma lesão assin­tomática, que acomete com mais frequência a glândula parótida, seguida pelas glândulas sa­livares menores, as glândulas mandibulares, o lábio superior e a mucosa jugal. É uma lesão de evolução lenta, sendo os tumores intraorais diagnosticados, na maioria dos casos, quando começam a interferir nas funções orais do pa­ciente, como mastigação, fala, deglutição e fo­nação. Este trabalho apresenta três casos de ade­nomas pleomórficos encontrados nas glândulas salivares menores do palato duro e na glândula parótida, com diferentes procedimentos tera­pêuticos sendo instituídos e discutidos. Em um deles, o tratamento clínico foi o de escolha, pois o paciente apresentava alterações sistêmicas gra­ves. Nos outros dois, a cirurgia para exérese da lesão foi realizada sem intercorrências

Multiple brain abscess from dental origin: Case report and literature review

Background: Brain abscess of dental origin is a rare situation and deserves attention due to its high mortality rate even when adequate treatment is done. Few reports are available when dental origin is the main cause of this infection. Case report: We present the case of a 70-year-old man diagnosed with cerebral abscess caused by apical lesions located at superior and inferior teeth. The three lesions containing pus were drained from anterior and posterior brain region and the laboratory evaluation revealed the presence of Streptococcus viridians and Bacteroides. Postoperative period was uneventful with excellent recovery after 1 year of surgery. Final diagnosis was able to be done due to excellent image exams availability like computer tomography and magnetic resonance using diffusion and perfusion techniques. Discussion: The early detection of this pathology with the correct diagnosis essential to give the patient the best treatment including antimicrobial drugs and drainage is of extreme importance. © 2011 Springer-Verlag