Bone regeneration in surgically created defects filled with autogenous bone: an epifluorescence microscopy analysis in rats

Although the search for the ideal bone substitute has been the focus of a large number of studies, autogenous bone is still the gold standard for the filling of defects caused by pathologies and traumas, and mainly, for alveolar ridge reconstruction, allowing the titanium implants installation. OBJECTIVES: The aim of this study was to evaluate the dynamics of autogenous bone graft incorporation process to surgically created defects in rat calvaria, using epifluorescence microscopy. MATERIAL AND METHODS: Five adult male rats weighing 200-300 g were used. The animals received two 5-mm-diameter bone defects bilaterally in each parietal bone with a trephine bur under general anesthesia. Two groups of defects were formed: a control group (n=5), in which the defects were filled with blood clot, and a graft group (n=5), in which the defects were filled with autogenous bone block, removed from the contralateral defect. The fluorochromes calcein and alizarin were applied at the 7th and 30th postoperative days, respectively. The animals were killed at 35 days. RESULTS: The mineralization process was more intense in the graft group (32.09%) and occurred mainly between 7 and 30 days, the period labeled by calcein (24.66%). CONCLUSIONS: The fluorochromes showed to be appropriate to label mineralization areas. The interfacial areas between fluorochrome labels are important sources of information about the bone regeneration dynamics

Epidermal Cyst Causing Facial Asymmetry

Epidermoid cysts are rare benign tumors that are derived from the development of abnormally situated ectodermal tissue and are often an incidental finding. They are usually diagnosed between 15 and 50 years of age, with both sexes equally affected. In epidermoid cyst management, complete excision is the therapy of choice. The authors reported a case of a 24-year-old man with an epidermoid cyst located on the left side of the face, on the region of mandibular body, which was treated by complete surgical excision. The patient has been followed up for 2 years without signs of recurrence.242E112E11

Decompression for Management of Keratocystic Odontogenic Tumor in the Mandible

Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of odontogenic origin with high recurrence rate. To date, various conservative or aggressive management strategies have been suggested as a method of treatment. Decompression is a conservative method that has been used in the treatment of large odontogenic cysts. The present paper reports a case of KCOT located in the mandible and discusses the importance of its management using conservative methods. The authors present a case of a 38-year-old patient with a KCOT located in the right mandibular angle and ascending ramus, which was treated by decompression followed by enucleation and curettage. The lesion did not recur during a follow-up period of 3 years after surgery. Preserving important structures of the bone and soft tissue decompression is a method with low morbidity. In addition, according to the literature, decompression has a success rate at least as high as the one of most aggressive treatments.236E639E64

Use of BioGran and Calcitite in bone defects: Histologic study in monkeys (Cebus apella)

The present study compares the biologic behavior of BioGran and Calcitite as fillers for surgical cavities in the mandibles of 4 adult monkeys (Cebus apella). The surgical cavities were prepared through both mandibular cortices, with a diameter of 5 mm, in the angle region. Two cavities were prepared on the right side and 1 on the left and divided into 3 groups: R-1 sites were filled with bioglass (BioGran), R, sites were not filled, and L sites were filled with hydroxyapatite (Calcitite). After 180 days the animals were sacrificed and the specimens were removed for histologic processing. Results showed no bone formation in group R, (empty cavities). BioGran-treated sites showed bone formation and total repair of the bone defect, and the bioglass particles were almost totally resorbed and substituted by bone. The few remaining crystals were in intimate contact with newly formed bone. Calcitite did not allow bone formation, and granules inside the cavities were involved by connective tissue. Based upon those results, the authors concluded that bioglass resulted in total obliteration of the surgical cavity with bone and hydroxyapatite was present in a large amount and involved by connective tissue, without bone formation

Deep Venous Thrombosis Prophylaxis In Oral And Maxillofacial Surgery: A Brazilian Survey

Background : Deep venous thrombosis (DVP) is a frequent disease. Prophylaxis is the best means to reduce its incidence, for lowering morbidity and mortality rates and treatment costs caused by its complications. Objective : To evaluate the knowledge and use of any kind of DVT prophylaxis by Brazilian Oral and Maxillofacial surgeons. Materials and Methods : A questionnaire was sent to all Oral and Maxillofacial surgeons associated to the Brazilian College of Oral and Maxillofacial Surgeons that have a valid e-mail address. The data retrieved was evaluated and tabulated. Results : Of the 1100 questionnaires sent, only 4% were retrieved. The 42 retrieved were included in the study. Twenty six of the surgeons do not use any kind of deep venous thrombosis (DVT) prophylaxis, 11 use mechanical means as elastic compressive stockings or pneumatic compressive devices for prophylaxis, and 5 uses low-molecular weight heparins (LMWH) as the choice for prophylaxis. Conclusion : The data collected, despite the low rate of participation (4%) by the surgeons, shows that this subject still does not receive proper attention. Whereas other medical specialties make routine use of prophylactic means maybe the maxillofacial surgeons lack concern on that matter.234519523Esmon, C.T., Basic mechanisms and pathogenesis of venous thrombosis (2009) Blood Rev, 23, pp. 225-229Maffei, F.H., (1995) Doenças Vasculares Periféricas. Trombose Venosa Profunda Dos Membros Inferiores: Incidência, Patologia, Fisiopatologia e Diagnóstico, , 2 nd ed. Botucatu: MédiciGarcia, A.C., Souza, B.V., Volpato, D.E., Deboni, L.M., Souza, M.V., Martinelli, R., Realidade do uso da profilaxia para trombose venosa profunda: da teoria à prática (2005) J Vasc Br, 4, pp. 35-41Anderson, F.A., Wheeler, H.B., Goldberg, R.J., Hosmer, D.W., Patwardhan, N.A., Jovanovic, B., A population based perspective of the hospital incidence and case fatality rates of deep vein thrombosis and pulmonary embolism (1991) Arch Intern Med, 151, pp. 933-938Stein, P.D., Henry, J.W., Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy (1995) Chest, 108, pp. 978-981Alpert, J.S., Dalen, J.E., Epidemiology and natural history of venous thromboembolism (1994) Progr Cardiovas Dis, 36, pp. 417-422Dalen, J.E., Alpert, J.S., Natural history of pulmonary embolism (1975) Prog Cardiovasc Dis, 17, pp. 257-270Morrell, M.T., Dunnill, M.S., The post-mortem incidence of pulmonary embolism in a hospital population (1968) Br J Surg, 55, pp. 347-352Geerts, W.H., Pineo, G.F., Heit, J.A., Samama, C.M., Lassen, M.R., Colwell, C.W., Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (2008) Chest, 133, pp. 381s-453sJamal, B.T., Diecidue, R.J., Taub, D., Champion, A., Bilyk, J.R., Orbital hemorrhage and compressive optic neuropathy in patients with midfacial fractures receiving low-molecular weight heparin therapy (2009) J Oral Maxillofac Surg, 67, pp. 1416-1419Toro, C., Millese, W., Zerman, N., Robiony, M., Politi, M., Femoral nerve palsy after mandibular reconstruction with microvascular iliac flap: A complication under anticoagulation therapy (2007) Int J Otal and Maxillofac Surg, 36, pp. 270-273Lowry, J.C., Thromboembolic disease and thromboprophylaxis in oral and maxillofacial surgery: Experience and practice (1995) Br J Oral Maxillofac Surg, 33, pp. 101-106Van De Perre, J.P., Stoelinga, P.J., Blijdorp, P.A., Brouns, J.J., Hoppenreijs, T.J., Perioperative morbidity in maxillofacial orthopaedic surgery: A retrospective study (1996) J Cran Maxillofac Surg, 24, pp. 263-270Moreano, E.H., Hutchison, J.L., McCulloch, T.M., Graham, S.G., Funk, G.F., Hoffman, H.T., Incidence of deep venous thrombosis and pulmonary embolism in otolaryngology-head and neck surgery (1998) Otolaryngol Head Neck Surg, 118, pp. 777-784(1992) Br Med J, 305, pp. 567-574. , Thromboembolic Risk Factors (THRIFT) Consensus GroupSolomon, J.M., Schow, S., The potential risks, complications, and prevention of deep vein thrombosis in oral and maxillofacial surgery patients (1995) J Oral Maxillofac Surg, 53, pp. 1441-1447Sorathia, D., Naik-Tolani, S., Gulrajani, R.S., Prevention of venous thromboembolism (2006) Oral Maxillofac Surg Clin N Am, 18, pp. 95-105Blackburn, T.K., Pritchard, K., Richardson, D., Symptomatic venous thromboembolism after orthognathic operations: An audit (2006) Br J Oral Maxillofac Surg, 44, pp. 389-392Bord, S.P., Linden, J., Trauma to the globe and orbit (2008) Emerg Med Clin North Am, 26, pp. 97-123Hass, A.N., Penne, R.B., Stefanyszyn, M.A., Flanagan, J.C., Incidence of post blepharoplasty orbital hemorrhage and associated visual loss (2004) Ophth Plast Reconstruct Surg, 20, pp. 426-432Clagett, G.P., Reisch, J.S., Prevention of venous thromboembolism in general surgical patients: Results of a meta-analysis (1988) Ann Surg, 208, pp. 227-240Comerota, A.J., Stewart, G.J., White, J.V., Combined dihydroergotamine and heparin prophylaxis of postoperative deep vein thrombosis: Proposed mechanism of action (1985) Am J Surg, 50, pp. 39-44Comerota, A.J., Stewart, G.J., Alburger, P.D., Smalley, K., White, J.V., Operative venodilation: A previously unsuspected factor in the cause of postoperative deep vein thrombosis (1989) Surgery, 106, pp. 301-309Turpie, A.G., Levine, M.N., Hirsh, J., Carter, C.J., Jay, R.M., Powers, P.J., A randomized controlled trial of a low molecular weight heparin (enoxaparin) to prevent deep vein thrombosis in patients undergoing elective hip surgery (1986) N Engl J Med, 315, pp. 925-929Risk of and prophylaxis for venous thromboembolism in hospital patients (1998) Phlebology, 13, pp. 87-97. , Second Thromboembolic Risk Factors (THRiFT II) Consensus GroupPrandoni, P., Prevention and treatment of venous thromboembolism with low-molecular-weight heparins: Clinical implications of the recent European guidelines (2008) Thromb J, 9, pp. 6-1

Tracheostomy-dependent child with temporomandibular ankylosis and severe micrognathia treated by piezosurgery and distraction osteogenesis: Case report

Ankylosis of the temporomandibular joint in children is one the most difficult and complex conditions managed by oral and maxillofacial surgeons, and often leads to some facial deformity. Distraction osteogenesis of the mandible provides an excellent treatment for mandibular airway obstruction in children who do not respond to conservative measures, and allows for early removal of the tracheostomy. We report the case of a 1-year-old boy with severe micrognathia and temporomandibular ankylosis who was dependent on a tracheostomy; he was treated with piezosurgery and mandibular advancement by distraction osteogenesis. © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved