Evaluation of five standard protocols for the obtention of canine platelet rich plasma

Introduction: platelet rich plasma (PRP) usage has acquired great relevance within the last few years, which has demonstrated its usefulness in the treatment of some pathologies. Up until now, there is not enough information on efficient obtention processes that warrants a wished minimal concentration for therapeutical purposes. This study compared five known protocols for PRP obtention and stablished the best performance to determine which protocol offers the greatest number of platelets with common resources within the clinic. Methodology: five standard protocols recommended by international literature were compared by its capacity to accomplish larger amounts of platelets. Canine blood with a normal hemogram was used to evaluate each protocol by counting each PRP number. Results: a platelet count was carried out and it was found that 163% for protocol C, followed by protocol B, E, D and A with 96%, 8.62%, 6.38% and 4.47%, respectively. Conclusions: there is a great variability between platelet count within each protocol. In this case, protocol C gave the best result, being the one that demands more revolutions and time for the obtention of PRP.Introducción: el uso de plasma rico en plaquetas (PRP) ha tomado gran importancia durante los últimos años, lo que ha demostrado su utilidad en el tratamiento de algunas patologías. Por otra parte, no se encuentra adecuada información sobre los procesos más eficientes de obtención, que garanticen la concentración mínima deseada para los propósitos terapéuticos. Este estudio comparó cinco protocolos conocidos de obtención de PRP y estableció el mejor rendimiento para determinar qué protocolo de PRP ofrece el mayor número de plaquetas con los implementos de uso corriente en la clínica. Metodología: se compararon cinco protocolos estándar clásicos recomendados por la literatura internacional, por su capacidad de lograr altas concentraciones de plaquetas. Se utilizó sangre de caninos con un hemograma normal para evaluar cada protocolo, vía conteo del PRP de cada uno de ellos. Resultados: se realizó conteo plaquetario y se encontró en un 163 % para el protocolo C, seguido por protocolo B, E, D y A con un 96 %, 8,62 %, 6,38 % y 4,47 %, respectivamente. Conclusiones: existe variabilidad de concentración de plaquetas entre los diferentes protocolos, en este caso, el protocolo C dio mejores resultados, siendo el que demanda un número menor de revoluciones y tiempo para la obtención de PRP.Introdução: o uso de plasma rico em plaquetas (PRP) vem ganhando importância nos últimos anos, o que demonstra sua utilidade no tratamento de algumas patologias. Contudo, não se encontra adequada informação sobre os processos mais eficientes para obtê-lo que garantam a concentração mínima desejada para os fins terapêuticos. Este estudo comparou cinco protocolos conhecidos de obtenção de PRP e estabeleceu o melhor desempenho para determinar qual protocolo de PRP oferece o maior número de plaquetas com os implementos de uso comum na clínica. Metodologia: foram comparados cinco protocolos-padrão clássicos recomendados pela literatura internacional, por sua capacidade de atingir altas concentrações de plaquetas. Foi utilizado sangue de caninos com um hemograma normal para avaliar cada protocolo, via contagem de PRP de cada um deles. Resultados: foi realizada contagem plaquetária e foi verificado em 163 % para o protocolo C, seguido por protocolo B, E, D e A com 96 %, 8,62 %, 6,38 % e 4,47 %, respectivamente. Conclusões: existe variabilidade de concentração de plaquetas entre os diferentes protocolos, nesse caso, o protocolo C apresentou melhores resultados, sendo o que demanda menor número de revoluções e tempo para obter PRP

Treatment of maxillary hypoplasia in cleft lip and palate: segmental distraction osteogenesis with hyrax device

The objective of this work is to describe a segmental maxillary distraction osteogenesis (SDO) with segmental Lefort I with an inexpensive device.Four patients who presented severe class III and maxillary hypoplasia due to cleft lip and palate sequel were treated. A SDO was performed using a dental-anchored Hyrax device, achieving enlargement of the upper jaw without altering speech, with adequate and stable occlusion. Dental implants in a new formed bone were installed.The authors can conclude that SDO is a good treatment alternative for patients with maxillary hypoplasia. It preserves velopharyngeal function and is a stable treatment, maintaining the overjet achieved with distraction osteogenesis, without changes in posterior occlusion. The open bite generated with tooth-borne devices can be solved with temporary anchorage devices and intermaxillary elastics during consolidation phase. Modified Hyrax device allows expanding and moving forward the maxillary arch, with a low cost

Correction of chin ptosis

Chin ptosis is described as a descent of the soft tissue from the symphyseal region to a position under the lower contour of the mandible. Given its multifactorial causes, treatment must be determined on a patient-by-patient basis. While augmentation of the submental crease is a versatile option for the correction of chin ptosis, this only corrects the soft tissue component. A technical modification to treat dynamic chin ptosis, associated with bone reduction in the mandibular symphysis, is presented here

Low condylectomy as the sole treatment for active condylar hyperplasia: facial, occlusal and skeletal changes. An observational study

Artículo de publicación ISIThe purpose of this study was to measure the changes in facial, occlusal, and skeletal relationships in patients with active unilateral condylar hyperplasia whose sole treatment was a low condylectomy. A retrospective observational descriptive study was conducted. All patients had undergone a low condylectomy as the sole or initial surgical treatment. The size of the condylar segment removed was decided by matching the affected side with the healthy side, leaving them both like the healthy one. The length of the ramus was measured using panoramic X-ray (distance from the highest part of the condyle to the mandibular angle). Facial, occlusal, and skeletal changes were evaluated using clinical, photographic, and radiological records before and after surgery. Condylectomy as the sole treatment for patients with active condylar hyperplasia allowed improvements to the alterations produced by this pathology, such as chin deviation, tilted lip commissure plane, tilted occlusal plane, angle of facial convexity, unevenness of the mandibular angles, and length of the mandibular ramus. The occlusal relationship also improved with orthodontic and elastic therapy. To conclude, low condylectomy as a sole and aetiological treatment for patients with active condylar hyperplasia allowed improvements to alterations produced by this pathology

Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm

Background: Mandibular reconstruction has been the subject of much debate and research in the fields of maxillofacial surgery and head and neck surgery. Materials and Methods: A retrospective observational study was undertaken with 14 patients diagnosed with benign tumorous pathologies and who underwent immediate mandibular resection and reconstruction at the Hospital del Salvador Maxillofacial Surgery Unit and Dr. Rodrigo Farina's private clinic between the years 2002 and 2012. We propose a treatment algorithm, which is previous teeth extractions in area that will be removed. Results: Fourteen patients underwent surgery, and a total of 40 dental implants were installed in 6 men and 8 women, the mean age of 33.5 (age range, 14-58 y). Reconstruction with iliac crest bone graft, and rehabilitation following this protocol (average of reconstruction was 8.7 cm), was successful with no complications at all in 12 patients. One patient had a minor complication, and the graft was partially reabsorbed because of communication of the graft with the oral cavity. This complication did not impede rehabilitation with dental implants. Another patient suffered the total loss of the graft due to infection because of dehiscence of oral mucosa and great communication with the mouth. Another iliac crest free graft reconstruction was undertaken 6 months later. Conclusions: The scientific evidence suggests that mandibular reconstruction using free grafts following the removal of benign tumors is a biologically sustainable alternative. The critical factor to improve the prognosis of free grafts reconstruction in benign tumors is to have good quality soft tissue and avoid communication with the oral cavity. For this, it is vital to do dental extractions before removing the tumo

Relationship between Nostril, Nasal Valve and Minimal Cross-Sectional Area in Functional Upper Airway

PURPOSE: To propose a three-dimensional cephalometric analysis of upper airway (UA) related to its functionality, defining normal reference values in healthy individuals and the relationship between nostril, nasal valve, and minimal cross-sectional area (MCS) in functional upper airway. MATERIALS AND METHODS: The UAs of 20 Class I patients were analyzed with CBCT using Nemoceph 3D-OS and HOROS software, determining linear distances, volumes and cross-sectional areas, including MCS. RESULTS: MCS was mostly located in the middle-upper oropharynx and high hypopharynx. MCS showed moderate correlation with the area of both nares (BNA) (r = 0.60, P = 0.004) and high correlation with the area of both internal nasal valves (BNV) (r = 0.66, P = 0.0016). BNA and BNV showed a moderate correlation (r = 0.445, P = 0.049). A total upper airway (TUA) and functional upper airway (FUA) volumes were established. TUA and FUA showed the strongest statistical correlation (r = 0.82, P = 0.00). A paired samples t test compared the measurement as absolute values of MCS with BNA (t = 0.781, P = 0.44), with BNV (t = -0.12, P = 0.90); and BNA with BNV (t = -0.76, P = 0.45), showed no significant differences. CONCLUSIONS: A functional cephalometric analysis of the UA with stable parameters in cervical spine and normal reference values has been proposed. BNA and BNV could be used as reference to establish the MCS compatible with respiratory health

QUISTE FOLICULAR INFLAMATORIO. REVISIÓN BIBLIOGRÁFICA Y REPORTE DE TRES CASOS CLÍNICOS

El quiste folicular se ubica según la clasificación de la OMS como un quiste inflamatorio, siendo una patología poco frecuente. Se presenta en los niños entre los 5 a 12 años, es más frecuente en hombres y la zona anatómica más afectada es la región mandibular correspondiente a los premolares. La etiología, es inflamatoria ya que existe una progresión del proceso inflamatorio de los molares temporales tratados endodónticamente hacia el folículo del premolar.  El tratamiento de ésta patología varía desde la extracción del diente temporal hasta un tratamiento más invasivo como la enucleación del quiste. La selección del tratamiento depende de diferentes factores como la edad del paciente, tamaño de la lesión, compromiso de estructuras adyacentes, ubicación del diente retenido etc. Generalmente el pronóstico es bueno. Se presenta una revisión de la literatura sobre el quiste folicular inflamatorio, y tres casos pediátricos. Se revisarán las características clínicas, imagenológicas, posibles diagnósticos diferenciales y el tratamiento. Palabras Clave: Quiste Folicular InflamatorioSummaryThe follicular cyst was classified by the OMS in 1992 as an inflammatory cyst. The prevalence is poor and may be encountered in patients between 5 and 12 years old. There is a male predilection and a higher prevalence in the mandibular premolars. The pathogenesis is a result of the progression from a periapical inflammation from an overlying primary tooth that has been pulpotomized to the premolar follicle. The treatment for the follicular cyst varies from the extraction of the primary tooth to enucleation of the cyst. The selection of the treatment depends on the age of the patient, extension of the cyst, the compromise of the adjacent structures, location of the impacted tooth etc. Generally the prognosis is excellent. A review of the literature about the follicular cyst and three pediatric cases will be presented. The clinical and radiographic features, differential diagnosis and treatment will be discussed.Key Words: Follicular Cyst, Inflammatory Cyst

Measuring the condylar unit in condylar hyperplasia: from the sigmoid notch or from the mandibular lingula?

The objective of this study was to determine, in patients with active unilateral condylar hyperplasia, which is the most reliable point to measure the length of the condylar unit: from the sigmoid notch or from the mandibular lingula to the condylar head. On cone beam computed tomography, an observational crosssectional study was designed for 20 patients with active unilateral condylar hyperplasia. We measured and compared ramus length (affected and healthy sides) and condylar length (measured from the mandibular lingula and from the mandibular sigmoid notch) on both sides. The average of all the differences in ramus height (D.1) was 7.97 mm; the average of all the differences in condylar heights measured from mandibular lingula (D.2) was 7.16 Aim, and measured from the sigmoid notch (D.3) was 4.89 mm. No significant difference between D.1 and D.2 (P = 0.818). There was a significant difference between D.1 and D.3 (P = 0.005) and between D.2 and D.3 (P = 0.0005). It can be concluded that the mandibular lingula is the lowest point of the condylar skeletal unit and is therefore a stable parameter to be used in patients with condylar hyperplasia. On the other hand, the sigmoidal notch is not a stable parameter in patients with asymmetry due to condylar hyperplasia

Minimally invasive intraoral proportional condylectomy with a three-dimensionally printed cutting guide

The aim of this study was to describe the steps of a minimally invasive surgical technique used to perform a proportional intraoral condylectomy with a three-dimensionally (3D) printed cutting guide. The technique consists of two steps: virtual surgical planning and intraoral condylectomy. During virtual surgical planning, the mandibular ramus was measured bilaterally, the height of the proportional condylectomy was planned virtually, and a cutting guide was 3D printed. In the intraoral condylectomy, the mandibular condyle was approached intraorally, the 3D printed cutting guide was positioned in the sigmoid notch, and the proportional condylectomy was performed. The protocol reported in this technical note is the sum of knowledge acquired from a series of studies published previously by the authors, who have jointly developed a surgical technique that is both minimally invasive and accurate for the treatment of condylar hyperplasia