Repair process of surgical defects filled with autogenous bone grafts in tibiae of diabetic rats

From a biological standpoint, the best material for reconstruction of bone defects is the autogenous bone graft. However, as tissue healing is affected under diabetic conditions, major changes might take place in the revascularization, incorporation, replacement and remodeling phases of the grafted area. The purpose of this study was to assess the bone healing process in surgical wounds prepared in tibiae of diabetic rats and filled with autogenous bone. Forty male rats (Rattus norvegicus albinus, Wistar) were randomly assigned to receive an endovenous injection (penile vein) of either citrate buffer solution (Group 1 - control; n=20) or streptozotocin dissolved in citrate buffer solution (35 mg/kg) to induce diabetes (Group 2 - diabetic; n=20). After determination of glycemia, the animals were anesthetized and the anterolateral regions of the tibiae of both limbs were shaved, antisepsis was performed and longitudinal incisions were made in each limb. The tibiae were exposed and two 2mm-diameter surgical cavities were prepared: one in the right limb, filled with particulate autogenous bone and the other in the left limb, filled with blood clot. The animals were euthanized at 10 and 30 postoperative days. The anatomic pieces were obtained, submitted to laboratory processing and sections were stained by hematoxylin and eosin and Masson's Trichrome for histomorphologic and histometric analyses. In both groups, the wounds filled with autogenous bone graft showed better results than those filled with blood clot. The control group showed higher new bone formation in wounds filled with autogenous bone graft at 30 days than the diabetic group, but without statistical significance. It may be concluded that, in general, the new bone formation occurred with autogenous graft was quantitatively similar between control and diabetic groups and qualitatively better in the control group

Surgical-Orthodontic Traction for Impacted Maxillary Canines: A Critical Review and Suggested Protocol

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical-orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages

The characterisation of the craniofacial morphology of infants born with Zika virus:Innovative approach for public health surveillance and broad clinical applications

Background: This study was carried out in response to the Zika virus epidemic which constituted a public health emergency and to the 2019 WHO calling for strengthened surveillance for the early detection of related microcephaly. The main aim of the study was to phenotype the craniofacial morphology of microcephaly using novel approach and new measurements, relate the characteristics to brain abnormalities in Zika infected infants in Brazil to improve clinical surveillance. Methods: We captured 3D images of the face and the cranial vault of 44 Zika infected infants and matched healthy controls using 3D camera. The CT scans of the brain of the infected infants were analysed. The Principal Component Analysis (PCA) was applied to characterise the craniofacial morphology. In addition to the head circumference (HC), we introduced a new measurement, head height (HH) to measure the cranial vault. The level of brain abnormality present in the CT scans was assessed, the severity of parenchymal volume loss and ventriculomegaly was quantified. Findings: The PCA identified a significant difference (p <0.001) between the cranial vaults and the face of the Zika infants and that of the controls. Spearman's rank-order correlation coefficients show that the head height (HH) has a strong correlation (0.87 in Zika infants; 0.82 in Controls) with the morphology of the cranial vaults which are higher than the correlation with the routinely used head circumference (HC). Also, the head height (HH) has a moderate negative correlation (-0.48) with the brain abnormalities of parenchymal volume loss. Interpretation: We discovered that head height (HH), the most sensitive and discriminatory measure of the severity of cranial deformity which should be used for clinical surveillance of Zika syndrome, evaluation of other craniofacial syndromes and assessment of various treatment modalities

O MÚLTIPLO E O DIVERSO EM "VÍCIOS E VIRTUDES"

The Helder Macedo's narrative presents us the writer who meets a friend, also writer, and listens from him the story of his loves. The text inside the text leads us, in a spiral movement, from the author to the character, from the present to the past, from the contingent to the history. The present work aims to reflect on the games of masks formulated by Macedo from the overlapping of registers and narrative plans that is presented in his novel.A narrativa de Helder Macedo conta-nos do escritor que encontra o amigo, também escritor, e ouve desse a história de seus amores. O texto dentro do texto vai nos levando, em espiral, do autor à personagem, do presente ao passado, do contingente ao  histórico.  Este  trabalho  pretende  refletir  sobre  os  jogos  de  máscaras  e  fingimentos formulados por Macedo a partir da sobreposição de registros e de planos narrativos que este seu livro apresenta

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

Ozônioterapia no controle da infecção em cirurgia oral

The objective of the literature review showing their main biological properties involved in the tissue repair process and its therapeutic potential in the prevention , control and treatment of infection in oral surgeries . To carry out this study , a search of the PubMed database . 13 articles that met the inclusion criteria were found . Antimicrobial properties , antiálgicas , anti-inflammatory , imunu - stimulants , oxygenation and neoangiogenesis were attributed to ozone in several studies . And indications such as the treatment of alveolitis , osteomyelitis , osteonecrosis , wound healing in skin and mucosa and antisepsis been suggested. However , many of its effects have not been well understood. The doses and concentrations for their use are not standardized . Studies to establish doses and periods of administration are still needed for increasingly traumatic and biologically effective therapies are found to practice dentistry .O objetivo do estudo de revisão da literatura mostrando suas principais propriedades biológicas envolvidas no processo de reparação tecidual, e seu potencial terapêutico na prevenção, controle e tratamento de infecção em cirurgias orais. Para o desenvolvimento deste estudo, uma busca na base de dados PubMed. Foram encontrados 13 artigos que se enquadravam nos critérios de inclusão. Propriedades antimicrobianas, antiálgicas, antiinflamatórias, imunuestimulantes, de oxigenação e neoangiogênese foram atribuídas ao ozônio em diversos estudos. E indicações como o tratamento da alveolite, osteomielite, osteonecrose, cura de feridas em mucosa e em pele e antissepsia foram sugeridas. No entanto, muitos de seus efeitos ainda não foram bem esclarecidos. As doses e concentrações para seu uso não são padronizadas. Estudos para o estabelecimento de doses e períodos de administração ainda são necessários para que terapias cada vez mais atraumáticas e biologicamente eficazes sejam encontradas para a prática odontológica

Estudo radiográfico de terceiros molares inferiores retidos e parcialmente irrompidos e revisão de literatuda

Introduction: Pathology associated with retained or partially erupted teeth are common in the general population. Objective: the aim was to evaluate the measurement of pericoronal space of retained third molars and partially erupted teeth in panoramic radiographs. Method: a retrospective study was carried on on the frequency of tooth retention and the problems it can cause in 107 radiographs of patients where the width was measured to verify the presence or absence of diseases associated with the involved teeth. Results: in the 107 panoramic radiographs analyzed the most frequent measurement was of 1.0 mm with 32.71% of cases followed by 2.0 mm with 29.91% of cases. Conclusion: The measurement of the pericoronal sapce of retained third molars and partially retained through its greatest width is in a practical and effective technique for application in routine clinical practice, which suggests the presence or absence of eraly odontogenic pathologyIntrodução: Patologias associadas a dentes retidos ou parcialmente erupcionados são comuns na população em geral. Objetivo: pretendeu-se avaliar a mensuração do espaço pericoronário de terceiros molares inferiores retidos e parcialmente erupcionados em radiografias panorâmicas. Método: tratou-se de um estudo retrospectivo sobre a frequência da retenção dental e dos problemas que a mesma pode causa em107 radiografias de pacientes onde foi medida a largura em sua maior dimensão a fim de verificar a presença ou não de patologias associadas aos dentes em questão. Resultado: Num total de 107 ortopantomografias analisadas a mensuração mais encontrada foi a de 1,0 mm com 32,71% dos casos seguido da de 2,0 mm com 29,91% dos casos. Conclusão: a mensuração do espaço pericoronário de terceiros molares inferiores retidos e parcialmente retidos, através da sua maior largura, constitui-se em uma técnica prática e efetiva para aplicabilidade na rotina clínica, permitindo sugerir a presença ou não de patologias odontogênicas com precocidade

Using the bottom-up and outside-in sequence for panfacial fracture management: Does it provide a clinical significance?

Panfacial fractures usually refer to simultaneous facial fractures, which affect the upper, middle, and lower thirds of the face. The management of panfacial fracture is complex because of the lack of reliable landmarks. Literature has shown many approaches for management of panfacial fractures. Every segment of bone has a precise function in the repair. Therefore, the bottom-up and outside-in sequence is the most widely used approach in the management of panfacial fractures. These facial fractures present remarkable challenges for both experienced and inexperienced surgeons. This article aimed to report a case of a panfacial fracture (mandibular condylar and symphysis fractures associated with an atypical Le Fort III fracture) in a 48-year-old man. The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and esthetic outcomes. Copyright © 2013 by Mutaz B. Habal, MD

Assistência cirúrgico-odontológica a pacientes imunodeprimidos por uso crônico de corticoides

Objective: The objective of this work, and review concepts on the physiology of hormones Adrenals to enhance pre, trans and post-operative care to dentists facing surgical, dental care of immunosuppressed patients. Literature review: The corticosteroids are among the most used drugs in medicine in recent times due to its anti-inflammatory and immunosuppressive activities, especially in transplant patients and patients with chronic autoimmune diseases. However, the continuing use of these drugs leads to a decrease in endogenous production of cortisol by the adrenal. Besides depressing the patient’s immune system, it may generate many parallel undesirable effects like blocking the production of the natural hormone of adrenal cortex, or steroid called cortisol, which may be the cause of a malfunctioning of the adrenal gland, causing hypofunction or hyperfunction of the gland. Final considerations: This fact will lead to changes in the planning of dental surgery, where it will be necessary special actions towards the patients who have this condition.Objetivo: Este trabalho, além de revisar conceitos sobre a fisiologia dos hormônios suprarrenais, tem a finalidade de ressaltar os cuidados pré, trans e pós-operatórios para os cirurgiões-dentistas diante da assistência cirúrgico-odontológica de pacientes imunodeprimidos. Revisão de literatura: Os corticoides ou corticosteroides estão entre os medicamentos mais aplicados na área médica nos últimos tempos em razão de suas atividades anti-inflamatórias e imunossupressoras, especialmente em pacientes transplantados e portadores de doenças autoimunes crônicas. Todavia, o uso contínuo desses medicamentos leva à diminuição da produção endó- gena de cortisol pela suprarrenal. Além de deprimir o sistema imunológico do paciente, pode gerar inúmeros efeitos paralelos indesejáveis, entre os quais o bloqueio na produção do hormônio natural do córtex suprarrenal, denominado cortisol ou corticoide, podendo ser a causa de um funcionamento inadequado da glândula suprarrenal, gerando hipofunção ou hiperfunção da glândula. Considerações finais: Tal fato terá como consequência mudanças no planejamento do tratamento cirúrgico-odontológico, sendo necessária a realização de condutas especiais para os pacientes portadores dessa condição