Fractura de mandíbula en pacientes parcialmente edéntulos. Alternativa de tratamiento cerrado. Serie de casos

For the treatment of mandibular fractures, there are protocols whose primary purpose is early function. However, several reasons prevent the execution of these techniques in Venezuela, mainly due to economic problems regarding the acquisition of specialized osteosynthesis materials. As a result, there is a necessity to resort to old surgical techniques. A study with a descriptive longitudinal design is presented, reporting 5 clinical cases of jaw fractures with the following inclusion criteria: presenting a mandibular fracture in partially dentate patients with impossibility of accessing the osteosynthesis material of the load-bearing system. The treatment conducted under closed surgical procedures. The condition of partial edentulism confers instability to the mandible fracture, hindering anatomical reduction and causing a loss of vertical and transverse dimension. These issues are addressed through the utilization of modified Gunning-type splints, which help in recovery. The splints were maintained in position with circum-mandibular and circum-zygomatic bone suspension wiring as a means to establish stability over time. Satisfactory results were obtained, indicating that these techniques can still be considered as treatment options today.Para el tratamiento de fracturas mandibulares existen protocolos cuyo propósito primordial es la función temprana. Existen diversos motivos por los cuales no se puede ejecutar ciertas técnicas en Venezuela, principalmente por problemas económicos para la adquisición de materiales de osteosíntesis especializados. Por esta razón, se ha recurrido a técnicas quirúrgicas antiguas. Se presenta un estudio con diseño longitudinal de tipo descriptivo, para el reporte de serie de 5 casos clínicos de fracturas de mandíbula, con los siguientes criterios de inclusión: presentar fractura mandibular en pacientes dentados parcialmente con imposibilidad al acceso al material de osteosíntesis del sistema de cargas soportadas. Tratados bajo procedimiento quirúrgico cerrado, la condición de edentulismo parcial confiere a la fractura de mandíbula inestabilidad, dificulta la reducción anatómica, pérdida de dimensión vertical y transversal, las que se recuperan a través de la elaboración de férulas tipo Gunning modificadas. Estas férulas se mantuvieron en posición con alambrados de suspensión ósea tipo circummandibulares y circumzigomáticos, como medios para establecer estabilidad en el tiempo. Se obtuvieron resultados satisfactorios, por lo que, aún hoy en día se pueden plantear como opciones de tratamiento

Xantoma verruciforme da gengiva: relato de caso

Oral verruciform xanthoma is a benign inflammatory lesion of unknown etiology. It is a reactive, non-tumorous lesion affecting the oral mucosa, the semi-mucosa, and the skin of the extremities. Its clinical presentation consists of a single, elevated lesion with an irregular surface. Its microscopic characteristic is the accumulation of lipid-containing macrophages in the papillae of the connective tissue between the epithelial ridges. This report reviews the literature and presents a case of this pathology. The patient is an 11-year-old female who came for consultation with her guardian. Clinically, a single pale pink lesion approximately 4 mm in length, oval in shape with defined borders, rough, keratinized surface, firm consistency, and a base adhered to the tissue was observed. An excisional biopsy and histopathological study were performed. In conclusion, the diagnosis of verruciform xanthoma is complex. Despite being a benign lesion, it can be confused with other malignant differential diagnoses. Therefore, we recommend evaluating the patient's medical history, risk factors, and establishing an accurate treatment plan.El xantoma verruciforme oral es una lesión inflamatoria benigna, de etiología desconocida. Es una lesión reactiva, no tumoral, que afecta a la mucosa oral, las semimucosas y la piel de extremidades. Su presentación clínica consiste en una lesión única, elevada, de superficie irregular. Su característica microscópica es la acumulación de macrófagos con lípidos en las papilas del tejido conectivo entre las crestas epiteliales. En el presente reporte se revisa la literatura y un caso de esta patología. Se trata de una paciente de sexo femenino de 11 años de edad, que acude a consulta con su tutor. Clínicamente, se observa una lesión única de color rosa pálido, de 4 mm de longitud aproximadamente, de forma ovalada con bordes definidos, superficie rugosa, queratinizada, de consistencia firme y base adherida al tejido. Se realiza biopsia excisional y estudio histopatológico. Se concluye que diagnosticar el xantoma verruciforme es complejo; aunque es una lesión benigna, se puede confundir con otros diagnósticos diferenciales malignos, por lo cual recomendamos evaluar la anamnesis, los factores de riesgo y establecer un plan de tratamiento acertado.O xantoma verruciforme oral é uma lesão reativa não tumoral que afeta a mucosa oral, a semimucosa e a pele das extremidades. Clinicamente, apresenta-se como uma única lesão elevada de superfície irregular e cor rosa-clara. Sua característica microscópica é a presença de macrófagos ricos em lipídios nas papilas do tecido conjuntivo entre as cristas epiteliais. No caso discutido, a paciente, uma menina de 11 anos, procurou a clínica acompanhada de seu responsável. A lesão apresentava características típicas: cor rosa-clara, formato oval, cerca de 4 mm de comprimento, bordas distintas, superfície áspera e queratinizada, consistência firme e base aderente ao tecido. Uma biópsia excisional foi realizada e o estudo histopatológico confirmou o diagnóstico de xantoma verruciforme. Conclui-se que o diagnóstico de xantoma verruciforme é complexo, uma vez que, embora seja uma lesão benigna, pode ser confundido com outras patologias malignas. Portanto, é recomendado uma avaliação detalhada da anamnese, fatores de risco e a formulação de um plano de tratamento preciso para garantir um diagnóstico e tratamento adequados

Motivo de consulta de urgencias por cirugía maxilofacial en un hospital venezolano desde 2006 hasta 2012. Estudio retrospectivo

ResumenEl departamento de Cirugía Bucal y Maxilofacial del Hospital General del Oeste Dr. José Gregorio Hernández (OMS-GTH), ubicado en la ciudad de Caracas (Venezuela) proporciona atención de urgencia las 24 h del día, los 365 días del año.ObjetivoDeterminar la edad, el sexo y el motivo de consulta más frecuente en las urgencias de OMS-GTH entre enero de 2006 y diciembre de 2012.MétodoHemos realizado un estudio transversal retrospectivo epidemiológico de los pacientes atendidos en las urgencias de OMS-GTH mediante una evaluación de 7.531 historias clínicas de los pacientes tratados entre ese período.ResultadosPredominó el sexo masculino con el 58,3% (n = 4.391); la edad promedio fue de 16 a 30 años de edad; el 46,5% (n = 3.509) de los pacientes presentaron trauma de tejidos blandos 65,71% (n = 4.949), el 15,1% (n = 1.139) fracturas faciales y el 15,9% (n = 1.203) infecciones odontogénicas.ConclusiónLa población masculina entre 16 y 30 años es más propensa a trauma de tejidos blandos.AbstractThe department of Oral and Maxillofacial Surgery of the West General Hospital Dr. José Gregorio Hernández (OMS-WGH) located in the city of Caracas, Venezuela, provides emergency care 24h a day, 365 days a year.ObjectiveTo determine the age, gender and most frequent reason for consultation in the emergency room of the OMS-WGH between January 2006 and December 2012.MethodA cross-sectional retrospective epidemiological study was conducted on patients seen in the emergency room of the OMS-WGH, by evaluating 7,531 medical records of patients treated in that period.ResultsThere was a predominance of males with 58.3% (n = 4,391), and a mean age of 16 to 30 years old, with 46.5% (n = 3,509) of the patients having soft tissue trauma 65.71% (n = 4,949), 15.1% (n = 1,139) facial fractures, and 15.9% (n = 1,203) odontogenic infections.ConclusionThe male population between 16 and 30 years are more prone to soft tissue trauma

AUDITORÍA CLÍNICA: UNA HERRAMIENTA COSTO EFICIENTE PARA CAMBIAR LA ODONTOLOGÍA EN VENEZUELA

La investigación es parte fundamental en la formación profesional de los odontólogos, su propósito es fomentar la educación continua y mejorar la calidad del tratamiento. Objetivo: Determinar la frecuencia en que estudios de tipo auditoria clínica han sido publicados en revistas científico-odontológicas venezolanas (RCOV). Introducir la auditoría clínica como una herramienta costo- efectiva para implementar mejoras de calidad en el cuidado de pacientes en la odontología a nivel nacional. Materiales y Métodos: Hemos realizado un estudio transversal retrospectivo de artículos publicados entre el período 2016 - 2020 en RCOV. Resultados: de 3 RCOV, con un total de 221 artículos publicados en 5 años, sólo 16 (N=7.2%) se consideraron de tipo auditoria clínica. Conclusión: Existe una baja frecuencia de artículos tipo auditorías en las RCOV. Es propósito de este artículo el presentar las auditorías clínicas como una herramienta de bajo costo, que, de una manera sencilla busca mejorar la calidad en la atención al paciente, es recomendación de los autores estimular la aplicación y publicación de este tipo de investigaciones desde la formación en pregrado para estimular la constante revisión y actualización de los protocolos en odontología

Charged-particle production as a function of the relative transverse activity classifier in pp, p−-Pb, and Pb−-Pb collisions at the LHC

International audienceMeasurements of charged-particle production in pp, p$-$Pb, and Pb$-$Pb collisions in the toward, away, and transverse regions with the ALICE detector are discussed. These regions are defined event-by-event relative to the azimuthal direction of the charged trigger particle, which is the reconstructed particle with the largest transverse momentum ($p_{\mathrm{T}}^{\rm trig}$) in the range $8<p_{\mathrm{T}}^{\rm trig}<15$ GeV$/c$. The toward and away regions contain the primary and recoil jets, respectively; both regions are accompanied by the underlying event (UE). In contrast, the transverse region perpendicular to the direction of the trigger particle is dominated by the so-called UE dynamics, and includes also contributions from initial- and final-state radiation. The relative transverse activity classifier, $R_{\mathrm{T}}=N_{\mathrm{ch}}^{\mathrm{T}}/\langle N_{\mathrm{ch}}^{\mathrm{T}}\rangle$, is used to group events according to their UE activity, where $N_{\mathrm{ch}}^{\mathrm{T}}$ is the charged-particle multiplicity per event in the transverse region and $\langle N_{\mathrm{ch}}^{\mathrm{T}}\rangle$ is the mean value over the whole analysed sample. The energy dependence of the $R_{\mathrm{T}}$ distributions in pp collisions at $\sqrt{s}=2.76$, 5.02, 7, and 13 TeV is reported, exploring the Koba-Nielsen-Olesen (KNO) scaling properties of the multiplicity distributions. The first measurements of charged-particle $p_{\rm T}$ spectra as a function of $R_{\mathrm{T}}$ in the three azimuthal regions in pp, p$-$Pb, and Pb$-$Pb collisions at $\sqrt{s_{\rm NN}}=5.02$ TeV are also reported. Data are compared with predictions obtained from the event generators PYTHIA 8 and EPOS LHC. This set of measurements is expected to contribute to the understanding of the origin of collective-like effects in small collision systems (pp and p$-$Pb)

Charm production and fragmentation fractions at midrapidity in pp collisions at s=13\sqrt{s} = 13 TeV

International audienceMeasurements of the production cross sections of prompt ${\rm D^0}$, ${\rm D^+}$, ${\rm D^{\ast +}}$, ${\rm D_s^+}$, ${\rm \Lambda_{c}^{+}}$, and ${\rm \Xi_{c}^{+}}$ charm hadrons at midrapidity in proton$-$proton collisions at $\sqrt{s}=13$ TeV with the ALICE detector are presented. The D-meson cross sections as a function of transverse momentum ($p_{\rm T}$) are provided with improved precision and granularity. The ratios of $p_{\rm T}$-differential meson production cross sections based on this publication and on measurements at different rapidity and collision energy provide a constraint on gluon parton distribution functions at low values of Bjorken-$x$ ($10^{-5}-10^{-4}$). The measurements of ${\rm \Lambda_{c}^{+}}$ (${\rm \Xi_{c}^{+}}$) baryon production extend the measured $p_{\rm T}$ intervals down to $p_{\rm T}=0(3)$~GeV$/c$. These measurements are used to determine the charm-quark fragmentation fractions and the ${\rm c\overline{c}}$ production cross section at midrapidity ($|y|<0.5$) based on the sum of the cross sections of the weakly-decaying ground-state charm hadrons ${\rm D^0}$, ${\rm D^+}$, ${\rm D_s^+}$, ${\rm \Lambda_{c}^{+}}$, ${\rm \Xi_{c}^{0}}$ and, for the first time, ${\rm \Xi_{c}^{+}}$, and of the strongly-decaying J/$psi$ mesons. The first measurements of ${\rm \Xi_{c}^{+}}$ and ${\rm \Sigma_{c}^{0,++}}$ fragmentation fractions at midrapidity are also reported. A significantly larger fraction of charm quarks hadronising to baryons is found compared to e$^+$e$^-$ and ep collisions. The ${\rm c\overline{c}}$ production cross section at midrapidity is found to be at the upper bound of state-of-the-art perturbative QCD calculations

Dielectron production in central Pb−-Pb collisions at sNN\sqrt{s_\mathrm{NN}} = 5.02 TeV

International audienceThe first measurement of the e$^+$e$^-$ pair production at midrapidity and low invariant mass in central Pb$-$Pb collisions at $\sqrt{s_{\mathrm{NN}}}=5.02$ TeV at the LHC is presented. The yield of e$^+$e$^-$ pairs is compared with a cocktail of expected hadronic decay contributions in the invariant mass ($m_{\rm ee}$) and pair transverse momentum ($p_{\rm T,ee}$) ranges $m_{\rm ee} < 3.5$ GeV$/c^2$ and $p_{\rm T,ee} < 8$ GeV$/c$. For $0.18 < m_{\rm ee} < 0.5$ GeV$/c^2$ the ratio of data to the cocktail of hadronic contributions without $\rho$ mesons amounts to $1.42 \pm 0.12 \ ({\rm stat.}) \pm 0.17 \ ({\rm syst.}) \pm 0.12 \ ({\rm cocktail})$ and $1.44 \pm 0.12 \ ({\rm stat.}) \pm 0.17 \ ({\rm syst.}) ^{+0.17}_{-0.21} \ ({\rm cocktail})$, including or not including medium effects in the estimation of the heavy-flavor background, respectively. It is consistent with predictions from two different models for an additional contribution of thermal e$^+$e$^-$ pairs from the hadronic and partonic phases. In the intermediate-mass range ($1.2 < m_{\rm ee} < 2.6$ GeV$/c^2$), the pair transverse impact parameter of the e$^+$e$^-$ pairs (DCA$_{\rm ee}$) is used for the first time in Pb$-$Pb collisions to separate displaced dielectrons from heavy-flavor hadron decays from a possible (thermal) contribution produced at the interaction point. The data are consistent with a suppression of e$^+$e$^-$ pairs from ${\rm c\overline{c}}$ and an additional prompt component. Finally, the first direct-photon measurement in the 10% most central Pb$-$Pb collisions at $\sqrt{s_{\mathrm{NN}}}=5.02$ TeV is reported via the study of virtual direct photons in the transverse momentum range $1 < p_{\rm T} < 5$ GeV$/c$. A model including prompt photons, as well as photons from the pre-equilibrium and fluid-dynamic phases, can reproduce the result, while being at the upper edge of the data uncertainties

Dielectron production in central Pb−-Pb collisions at sNN\sqrt{s_\mathrm{NN}} = 5.02 TeV

International audienceThe first measurement of the e$^+$e$^-$ pair production at midrapidity and low invariant mass in central Pb$-$Pb collisions at $\sqrt{s_{\mathrm{NN}}}=5.02$ TeV at the LHC is presented. The yield of e$^+$e$^-$ pairs is compared with a cocktail of expected hadronic decay contributions in the invariant mass ($m_{\rm ee}$) and pair transverse momentum ($p_{\rm T,ee}$) ranges $m_{\rm ee} < 3.5$ GeV$/c^2$ and $p_{\rm T,ee} < 8$ GeV$/c$. For $0.18 < m_{\rm ee} < 0.5$ GeV$/c^2$ the ratio of data to the cocktail of hadronic contributions without $\rho$ mesons amounts to $1.42 \pm 0.12 \ ({\rm stat.}) \pm 0.17 \ ({\rm syst.}) \pm 0.12 \ ({\rm cocktail})$ and $1.44 \pm 0.12 \ ({\rm stat.}) \pm 0.17 \ ({\rm syst.}) ^{+0.17}_{-0.21} \ ({\rm cocktail})$, including or not including medium effects in the estimation of the heavy-flavor background, respectively. It is consistent with predictions from two different models for an additional contribution of thermal e$^+$e$^-$ pairs from the hadronic and partonic phases. In the intermediate-mass range ($1.2 < m_{\rm ee} < 2.6$ GeV$/c^2$), the pair transverse impact parameter of the e$^+$e$^-$ pairs (DCA$_{\rm ee}$) is used for the first time in Pb$-$Pb collisions to separate displaced dielectrons from heavy-flavor hadron decays from a possible (thermal) contribution produced at the interaction point. The data are consistent with a suppression of e$^+$e$^-$ pairs from ${\rm c\overline{c}}$ and an additional prompt component. Finally, the first direct-photon measurement in the 10% most central Pb$-$Pb collisions at $\sqrt{s_{\mathrm{NN}}}=5.02$ TeV is reported via the study of virtual direct photons in the transverse momentum range $1 < p_{\rm T} < 5$ GeV$/c$. A model including prompt photons, as well as photons from the pre-equilibrium and fluid-dynamic phases, can reproduce the result, while being at the upper edge of the data uncertainties

K∗^{*}(892)±^{\pm} resonance production in Pb−-Pb collisions at sNN\sqrt{s_{\rm NN}} = 5.02 TeV

The production of K$^{*}$(892)$^{\pm}$ meson resonance is measured at midrapidity ($|y|$ 8 GeV/$c$, consistent with measurements for other light-flavored hadrons. The smallest values are observed in most central collisions, indicating larger energy loss of partons traversing the dense medium.The production of K$^*$(892)$^\pm$ meson resonance is measured at midrapidity ($|y|8$ GeV/$c$, consistent with measurements for other light-flavored hadrons. The smallest values are observed in most central collisions, indicating larger energy loss of partons traversing the dense medium

Multiplicity and event-scale dependent flow and jet fragmentation in pp collisions at s\sqrt{s} = 13 TeV and in p-Pb collisions at sNN\sqrt{s_\mathrm{NN}} = 5.02 TeV

Long- and short-range correlations for pairs of charged particles are studied via two-particle angular correlations in pp collisions at ${\sqrt{{\textit s}}}=13$ TeV and p-Pb collisions at ${\sqrt{s_\mathrm{NN}}} = 5.02$ TeV. The correlation functions are measured as a function of relative azimuthal angle $\Delta\varphi$ and pseudorapidity separation $\Delta\eta$ for pairs of primary charged particles within the pseudorapidity interval $|\eta| < 0.9$ and the transverse-momentum interval $1 < p_{\rm T} <4$ GeV/$c$. Flow coefficients are extracted for the long-range correlations ($1.6 < |\Delta\eta| <1.8$) in various high-multiplicity event classes using the low-multiplicity template fit method. The method is used to subtract the enhanced yield of away-side jet fragments in high-multiplicity events. These results show decreasing flow signals toward lower multiplicity events. Furthermore, the flow coefficients for events with hard probes, such as jets or leading particles, do not exhibit any significant changes compared to those obtained from high-multiplicity events without any specific event selection criteria. The results are compared with hydrodynamic-model calculations, and it is found that a better understanding of the initial conditions is necessary to describe the results, particularly for low-multiplicity events.Long- and short-range correlations for pairs of charged particles are studied via two-particle angular correlations in pp collisions at $\sqrt{s}=13$ TeV and p$-$Pb collisions at $\sqrt{s_\mathrm{NN}} = 5.02$ TeV. The correlation functions are measured as a function of relative azimuthal angle $\Delta\varphi$ and pseudorapidity separation $\Delta\eta$ for pairs of primary charged particles within the pseudorapidity interval $|\eta| < 0.9$ and the transverse-momentum interval $1 < p_{\rm T} < 4$ GeV/$c$. Flow coefficients are extracted for the long-range correlations ($1.6 < |\Delta\eta| <1.8$) in various high-multiplicity event classes using the low-multiplicity template fit method. The method is used to subtract the enhanced yield of away-side jet fragments in high-multiplicity events. These results show decreasing flow signals toward lower multiplicity events. Furthermore, the flow coefficients for events with hard probes, such as jets or leading particles, do not exhibit any significant changes compared to those obtained from high-multiplicity events without any specific event selection criteria. The results are compared with hydrodynamic-model calculations, and it is found that a better understanding of the initial conditions is necessary to describe the results, particularly for low-multiplicity events