Morphological characterization of the nasopalatine region in human fetuses and its association to pathologies

The nasopalatine region is composed of structures such as the vomeronasal organ and nasopalatine duct. The nasopalatine duct may provide the communication of the mouth to the nasal cavity in human fetuses and can be obliterated in an adult human. Knowledge on the development of the nasopalatine region and nasopalatine duct in humans is necessary for understanding the morphology and etiopathogenesis of lesions that occur in this region. Objective: The aim of the present study was to describe the morphological aspects of the nasopalatine region in human fetuses and correlate these aspects with the development of pathologies in this region. Material and Methods: Five human fetuses with no facial or palatine abnormalities were used for the acquisition of specimens from the nasopalatine region. After demineralization, the specimens were histologically processed. Histological cuts were stained with methylene blue to orient the cutting plane and hematoxylin-eosin for the descriptive histological analysis. Results: The age of the fetuses was 8.00, 8.25, 9.00 and 9.25 weeks, and it was not possible to determine the age in the last one. The incisive canal was observed in all specimens as an opening delimited laterally by the periosteum and connecting oral and nasal cavity. The nasopalatine duct is an epithelial structure with the greatest morphological variation, with either unilateral or bilateral occurrence and total patent, partial patent and islet forms. The vomeronasal organ is a bilateral epithelized structure located alongside the nasal septum above the incisive canal in all the fetuses. Conclusions: The incisive canal, nasopalatine duct and vomeronasal organ are distinct anatomic structures. The development of nasopalatine duct cysts may occur in all forms of the nasopalatine duct

Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? : a systematic review

Background: Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. Material and Methods: An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed. Results: Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials. Conclusions: There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fracture

FASN expression, angiogenesis and lymphangiogenesis in central and peripheral giant cell lesions

Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) are non-neoplastic proliferative processes of the jaws. PGCL is a reactive process induced by irritant local factors and CGCL is an intra-osseous lesion of unknown etiology. Both lesions exhibit similar histologic features showing abundant mononuclear cells, admixed with a large number of multinucleated giant cells and a rich vascularized stroma with extravasated erythrocytes, hemosiderin deposition, and blood-filled pools. Recent studies have linked fatty acid synthase (FASN) with angiogenesis. Objective: To evaluate angiogenesis and lymphangiogenesis and their relationship with FASN expression in CGCL and PGCL. Material and Methods: Thirteen CGCL and 14 PGCL of the jaws were selected for immunoexpression of FASN; CD34 and CD105 (to assess blood microvessel density [MVD] and microvessel area [MVA]); and D2-40 (to assess lymphatic MVD and MVA). Results: Within PGCL and CGCL, MVD-CD34 was signifcantly higher than MVD-CD10S, followed by MVD-D2-40. Moreover, a signifcantly higher number of FASN-positive multinucleated giant cells than mononuclear cells were observed. Between PGCL and CGCL, only MVD-CD34 and all MVA were signifcantly higher in PGCL. Positive correlation between MVA-CD10S with FASNpositive mononuclear cells in both lesions was observed. Conclusions: Our results show both lesions exhibiting similar levels of FASN expression and neoangiogenesis, suggesting constitutive processes that regulate tissue maintenance

Immunohistochemical evaluation of FASN, CD34, CD105 and D2-40 in Peripheral and Giant Cell Lesions

Muito ainda se discute com rela??o ? fisiopatologia das les?es perif?ricas de c?lulas gigantes (LPCG) e les?es centrais de c?lulas gigantes (LCCG). Ambas as les?es apresentam caracter?sticas cl?nicas distintas, apesar de possu?rem caracter?sticas histol?gicas semelhantes. Assim, estudos imunoistoqu?micos em LPCG e LCCG est?o sendo realizados, para permitir um melhor entendimento dessas les?es. Tem sido relatado que a express?o aumentada de FASN e a angiog?nese est?o diretamente ligadas com desenvolvimento dos tumores. No entanto, ainda n?o se sabe se estes eventos est?o envolvidos na patog?nese das LPCG e LCCG. O objetivo deste trabalho foi avaliar a express?o de FASN e o grau de angiog?nese entre LPCG e LCCG, al?m de verificar a correla??o entre essas vari?veis. Assim, 13 casos de LCCG e 14 casos de LPCG foram selecionados para an?lise da express?o imunoistoqu?mica de FASN, CD34, CD105 e D2-40. A express?o de FASN foi avaliada nos componentes celulares da les?o, seguida da mensura??o da densidade microvascular (DMV) e ?rea microvascular (AMV) para cada uma das amostras selecionadas. Os dados coletados foram submetidos ? an?lise descritiva e sequencialmente aos testes de Mann Whitney, teste t para amostras independentes e testes de correla??o de Pearson e Spearman. Os resultados do nosso estudo indicam que: (1) n?o h? diferen?as na imunoexpress?o de FASN entre os grupos de les?es (CM ? 8% FASN+ / CGM ? 38% FASN+); (2) LPCG possuem maior DMV em CD34; n?o houve diferen?as na DMV em CD105 e D2-40 entre as les?es. A AMV em LPCG foi maior que em LCCG para CD34, CD105 e D2-40; (3) em LPCG houve correla??o positiva entre (CM ? FASN+ com DMV/CD105); (4) nas LCCG houve correla??o positiva entre (CM ? FASN+ com DMV/CD105), (CM ? FASN+ com AMV/CD105 e CD34), (CGM ? FASN+ com AMV/CD105). A partir dos resultados obtidos concluiu-se que os n?veis similares da express?o imunoistoqu?mica de FASN indicam processos constitutivos da manuten??o tissular de ambas as les?es. No entanto, as diferen?as na vasculariza??o, entre os grupos de les?es, parecem ser influenciadas por CM positivas para FASN.Disserta??o (Mestrado) ? Programa de P?s-Gradua??o em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2012.ABSTRACT There is still a lot of discussion about the pathophysiology of Peripheral Giant Cell Lesion (PGCL) and Central Giant Cell Lesion (CGCL). These lesions show distinct clinical features, although they have similar histological characteristics. Thus, immunohistochemical studies in PGCL and CGCL are being done to improve understanding these diseases. It has been reported that high level of FASN and angiogenesis are linked with tumors development. However, remains unknown whether these events are involved in the pathogenesis of LPCG and LCCG. The aim of this research was to study FASN expression and angiogenesis degree between PGCL and CGCL, in addition, verify the correlation between this variables. Thus, 13 cases of CGCL and 14 cases of PGCL were selected and examined by immunoexpression of FASN, CD34, CD105 and D2-40. The immunoexpression of FASN was assessed in components cells of lesions, followed by measurement of Microvassel Density (MVD) and Microvassel Area (MVA) for each selected sample. Data collected was submitted to descriptive analysis and followed by Mann Whitney test, ?t? test to independent samples and Person?s and Spearman?s correlation. The results of this study indicate that: (1) there are no differences in FASN immunoexpression between group lesions (MC ? 8% FASN+ / MGC ? 38% FASN+); (2) PGCL have greater MVD in CD34 than CGCL; there are no MDV differences in CD105 and D2-40 between lesions. PGCL have greater MVA in CD34, CD105 and D2-40 than CGCL; (3) in PCGL there was a positive correlation between (MC ? FASN+ and MVD/CD105); (4) in CGCL there was a positive correlation between (MC ? FASN+ and MVD/CD105), (MC ? FASN+ and MVA/CD105 and CD34), (MGC ? FASN+ and MVA/CD105). With base on these results it is concluded that similar expression of FANS levels indicate constituent process of tissue maintenance in both lesions. On the other hand, differences on angiogenesis between lesions seem be influenced by FASN+ mononuclear cells

Biomechanical and photoelastic evaluation of mandibular symphysis fracture fixation with cannulated conical screws

Orientador: Roger William Fernandes MoreiraTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo desse estudo foi comparar por meio de testes mecânicos e fotoelásticos o desempenho dos parafusos canulados cônicos utilizados na fixação de fraturas de sínfise mandibular com outros métodos de fixação. Dez mandíbulas de poliuretano foram utilizadas em cada grupo e fixadas da seguinte maneira: Grupo (PRP), duas miniplacas do sistema 2,0 mm, perpendiculares; Grupo (PLL), uma placa do sistema 2,4 mm e uma miniplaca do sistema 2,0 mm, paralelas; Grupo (PC), dois parafusos canulados cônicos do sistema 2,8 mm. Foram realizados testes de carregamento linear vertical em uma máquina de ensaio universal. O teste de ANOVA One-way e o teste de Tukey foram utilizados para verificar a diferença entre as médias. O teste fotoelástico foi realizado, com o auxílio de um polariscópio plano. Foi usada uma mandíbula de resina fotoelástica para cada grupo de fixação (PRP, PLL e PC). A avaliação dos dados do teste fotoelástico foi qualitativa e descritiva. Os resultados mostraram diferença entre os grupos (PC) e (PRP) nos deslocamentos de 1 mm (p=0,025), 3 mm (p=0,013), 5 mm (p=0,036) e 10 mm (p=0,022). No teste fotoelástico foi observada maior concentração de tensões na região próxima à base mandibular em todos os grupos. No grupo (PRP) e (PLL) foi observada maior concentração de tensões na região da placa mais próxima à base enquanto no grupo (PC) as franjas isocromáticas foram mais dispersas em toda região avaliada. De acordo com os resultados do estudo foi possível concluir que os parafusos canulados cônicos apresentaram um bom desempenho nos testes mecânicos e fotoelásticos, sendo uma opção viável para a fixação das fraturas de sínfise mandibularAbstract: The aim of this study was to compare by mechanical and photoelastic tests, the performance of the cannulated screws in mandibular symphysis fractures and compare them with other fixations methods. Ten polyurethane mandibles were used in each group and fixed as follows: Group (PRP) 2 2.0-mm perpendicular miniplates; Group (PLL) 1 2.0-mm miniplate and 1 2.4-mm bone plate, parallels; Group (CS) 2 2.8-mm cannulated screws. Vertical linear loading tests were performed in a universal testing machine. Differences among means were analyzed by the One-Way ANOVA and Tukey test. The photoelastic test was carried out using a plane polariscope. One photoelastic mandible resin was used for each fixation group (PRP, PLL and CS). Data evaluation of the photoelastic test was qualitative and descriptive. The results showed differences between (CS) and (PRP) groups in 1 mm (p=0.025), 3 mm (p=0.013), 5 mm (p=0.036) and 10 mm (p=0.022), of displacement. The photoelastic test showed higher stress concentration, in all groups, close to mandibular base. In (PRP) and (PLL) groups, the stress concentration was observed closest to the plate fixed in mandibular basis, while the (CS) group showed more dispersed isochromatic fringes throughout the evaluated region. According to the results of this study, it was concluded that conical cannulated screws performed well in mechanical and photoelastic test, being a viable method for fixation of mandibular symphysis fracturesDoutoradoCirurgia e Traumatologia Buco-Maxilo-FaciaisDoutor em Clínica Odontológic

Arco barra de Erich ou parafuso autorrosqueante? Qual é o melhor método de fixação maxilo-mandibular? Uma revisão de literatura

O objetivo dessa revisão da literatura foi determinar, entre Arco Barra de Erich e Parafuso autorrosqueante, qual é o melhor método de fixação maxilo-mandibular. A busca bibliográfica foi realizada por meio da Biblioteca Virtual em Saúde (BVS), nas seguintes bases de dados: LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde), SciELO (ScientificElectronic Library Online), MEDLINE (Literatura Internacional em Ciências da Saúde) e COCHRANE (Cochrane Library), IBECS e BIREME, até maio de 2012. Foram utilizadas as seguintes palavras-chave e as combinações dessas palavras no idioma Inglês: Intermaxillary Fixation, Intermaxillary Screws Fixation, Maxillomandibular Fixation, Maxillomandibular Screws Fixation, Erich Arch Bar, Erich Arch Bars, Mandibular fracture repair e Maxillofacial fracture fixation. Foram incluídos artigos relacionados com a fixação intermaxilar com a utilização de arcos barras de Erich e parafusos corticais. Foram analisados os artigos em seres humanos em que esses métodos foram avaliados juntos ou separadamente e do total de artigos 98 foram lidos na íntegra. Após a leitura, foram incluídos 20 artigos e excluídos 78 por não preencherem os critérios de inclusão. Observou-se que arco barras de Erich é o método mais utilizado pela maioria dos cirurgiões bucomaxilofaciais, no entanto, apesar de efetivo apresenta desvantagens. Como alternativa, os parafusos autorrosqueantes tem demonstrado eficiência e consideráveis vantagens. Entretanto, para que esse método de fixação maxilo-mandibular seja implementado com segurança, é necessário que haja mais estudos comparando as duas técnicas, pois durante a revisão da literatura, foi encontrado apenas um ensaio clínico comparando-as

Passive ultrasonic irrigation in root canal: systematic review and meta-analysis

To investigate whether there are differences between the root canal disinfection, comparing the passive ultrasonic irrigation technique with the conventional technique. Materials and methods: The following electronic databases were searched: Pubmed; VHL; Web of Sciences and OVID with no publication date restriction. The study's quality evaluation was carried out using the Handbook by Cochrane. The online research identified 5464 studies. From the nine studies selected for a full reading of the text, five were included in the present systematic review. Meta-analysis was performed in three articles, which evaluated the root canal's cleanness through microbiological analysis. Results: Only one article concluded that the ultrasonic passive irrigation showed a better performance compared with the conventional irrigation. None of the articles analyzed presented a low risk of bias in all domains. According to the results of the meta-analysis, there was no statistical difference between the groups (OR = 0.34, IC 95%: 0.10-1.19). Conclusions: The level of evidence comparing the two techniques is fragile since in all studies some type of bias was observed which may interfere in the results and conclusions7715560FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE MINAS GERAIS - FAPEMI