Facial nerve injury following surgery for the treatment of ankylosis of the temporomandibular joint

Objective: The purpose of the present paper was to carry out a longitudinal study of a series of cases in which injury of the facial nerve was observed following surgery for the treatment of temporomandibular ankylosis. Study design: The sample was composed of 13 patients, both male and female, in whom 18 surgical approaches were made. A postoperative assessment of the motor function of the facial nerve was made in accordance with the HouseBrackmann grading system. All the patients were photographed and assessed at the following postoperative times: 24 hours, one week, one month and three months. Results: The results showed that injury of the facial nerve occurred in 31% of the cases. An increase in the frequency of nerve injury was observed in the cases in which the interpositional arthroplasty technique was employed, as well as the fact that 75% of the patients had undergone at least one surgical intervention prior to the study. After three months all the patients displayed normal function of the facial nerve. Conclusion: The frequency of facial nerve injury is related to the degree of difficulty involved in the surgery determined by the type of ankylosis. The nerve lesions were shown to be of a temporary nature

Surgical treatment of temporomandibular joint ankylosis : follow-up of 15 cases and literature review

Introduction: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. Purpose: To report 15 cases treated by either gap arthroplasty, or the articular reconstruction technique using costochondral grafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literature review. Methods: The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patients submitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre- and postoperative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate and presence of facial nerve paralysis. Results: The mean maximal incisal opening in the preoperative period was 8.71 + 6.97 mm and in the postoperative period it was 28.50 + 8.10 mm, the recurrence rate was 20% (n=3), and always occurred in ankylosis type IV. Conclusion: The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function

Treatment of temporomandibular joint ankylosis by gap arthroplasty

Purpose: The purpose of this paper is to show that gap arthroplasty improve mouth opening when treating TMJ ankylosis. Patients and methods: Eight patients with TMJ ankylosis were treated by gap arthroplasty. The patients were evaluated by at least twenty-four months (minimum 24 and maximum 48 months). Results: Of the eight patients (eleven joints), five (62.5%) had unilateral involvement and three patients (37.5%) had bilateral involvement. The mean age was 20 years ± 9 (range 3 to 30 years). The mean maximal incisal opening (MIO) in the preoperative period was 9.25 ± 6.41 mm and in the postoperative period it was 29.88± 4.16 mm. The complication of temporary facial nerve paresis was encountered in two patients (25%). No recurrence was observed in our series. Conclusions: Trauma was the major cause of tempomandibular joint ankylosis in our sample. Gap arthroplasty showed good results when treating TMJ ankylosis

Facial nerve paralysis after impacted lower third molar surgery: A literature review and case report

Facial nerve paralisys (FNP) is the most commom cranial nerve disorders and it results in a characteristic facial distortion that is determined in part by the nerves branches involved. With multiples etiologies, these included trauma, tumor formation, idiopathic conditions, cerebral infarct, pseudobulbar palsy and viruses. FNP during dental treatment is very rare and can be associated with the injection of local anesthetic, prolonged attempt to remove a mandibular third molar and subsequent infection. We report a case of a 21 years-old black woman who developed a Bell?s palsy after an impacted third molar surgery under local anaesthesia, present a FNP classificated like a grade IV by the House-Brackmann?s grading system. The treatment was based of prescription of a citidine and uridine complex (NÚCLEO CMP tm) one tablet twice per day and a close follow up. Three months later that had begining the treatment, the patient recovery her normal facial muscle activity

Analysis of Dental Enamel Surface Submitted to Fruit Juice Plus Soymilk by Micro X-Ray Fluorescence: In Vitro

Objective. This paper aimed to analyze the in vitro industrialized fruit juices effect plus soy to establish the erosive potential of these solutions. Materials and Methods. Seventy bovine incisors were selected after being evaluated under stereomicroscope. Their crowns were prepared and randomly divided into 7 groups, using microhardness with allocation criteria. The crowns were submitted to the fruit juice plus soy during 15 days, twice a day. The pH values, acid titration, and Knoop microhardness were recorded and the specimens were evaluated using X-ray microfluorescence (µXRF). Results. The pH average for all juices and after 3 days was significantly below the critical value for dental erosion. In average, the pH value decreases 14% comparing initial time and pH after 3 days. Comparing before and after, there was a 49% microhardness decrease measured in groups (p<0.05). Groups G1, G2, G5, and G6 are above this average. The analysis by μXRF showed a decrease of approximately 7% Ca and 4% P on bovine crowns surface. Florida (FL) statistical analysis showed a statistically significant 1 difference between groups. Thus, a tooth chance to suffer demineralization due to industrialized fruit juices plus soy is real

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

<p>Abstract</p> <p>Background</p> <p>Temporomandibular joint disorders (TMJD) are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1) identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2) evaluate their methodological quality, and (3) evaluate the evidence grade within the systematic reviews.</p> <p>Methods</p> <p>A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis) comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July). Exclusion criteria were: <it>in vitro </it>or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP) were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews.</p> <p>Results</p> <p>The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd). In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies.</p> <p>Conclusion</p> <p>The results indicate that in spite of the widespread impact of TMJD, and the multitude of potential interventions, clinicians have expended sparse attention to systematically implementing clinical trial methodology that would improve validity and reliability of outcome measures. With some 20 years of knowledge of evidence-based healthcare, the meager attention to these issues begins to raise ethical issues about TMJD trial conduct and clinical care.</p

Caracterização da saúde bucal de indivíduos renais crônicos aptos a transplante

ResumoIntroduçãoA doença renal crônica leva a alterações salivares que interferem na saúde bucal. A imunossupressão no pós-transplante pode facilitar que situações restritas à boca se tornem sistêmicas.ObjetivoCaracterizar a saúde bucal de pacientes renais crônicos aptos a transplante, avaliando fluxo e pH salivar, capacidade tamponante salivar (CTS), lesões estomatológicas, sangramento gengival, cálculo e índice de dentes cariados, perdidos e obturados (CPOD).Material e métodoEstudo transversal, observacional e analítico. Foi coletada saliva não estimulada de 83 voluntários, com hipofluxo salivar caracterizado como 7. A CTS foi avaliada pela Técnica de Ericsson. Um único examinador calibrado procedeu às avaliações clínicas. Foram utilizados Teste Exato de Fisher, ANOVA e Regressão Linear, com nível de significância de 0,05 e Intervalo de Confiança de 95%.ResultadoHipofluxo salivar esteve presente em 61% da amostra e foi influenciado pelo ganho hídrico interdialítico (p=0,01). A presença de pH salivar alcalino foi influenciada pela ureia sérica (p<0,01) e pela hiperfosfatemia (p=0,01). A CTS foi ótima em 92% e sofreu influência do pH salivar (p=0,02). Três indivíduos apresentaram lesões estomatológicas infecciosas. Sangramento gengival esteve presente em 55%, cálculo em 94% e cárie em 88%. O índice CPOD da amostra foi 17,9 ± 7,48.ConclusãoA saúde bucal dos voluntários foi considerada precária e esse agravo pode se tornar mais maléfico se esses indivíduos forem transplantados. Salienta-se a importância da inserção do Dentista na equipe que assiste o renal crônico

Ankle-brachial index by automated method and renal function

BackgroundThe ankle-brachial index (ABI) is a non-invasive method used for the diagnosis of peripheral arterial occlusive disease (PAOD).AimsTo determine the clinical features of patients submitted to ABI measurement by automatic method. To investigate association between ABI and renal function. Methods The present is a cross-sectional study. The study was performed in a private clinic in the city of Fortaleza (Ce)-Brazil. For ABI analysis, we utilized automatic methodology using a Microlife device. Data collection took place from March 2012 to January 2016. During this period, ABI was measured in 375 patients aged >50 years, who had a diagnosis of hypertension, diabetes or vascular disease. Results Of the 375 patients, 18 were categorized as having abnormal ABI (4.8 per cent) and 357 were normal ABI (95.2 per cent). Patients with abnormal ABI showed older mean age when compared to patients with normal ABI. Among patients with normal renal function, only 0.95 per cent showed abnormal ABI; among patients with abnormal renal function, 6 per cent showed abnormal ABI.ConclusionNo differences were observed when comparing the groups regarding gender or the prevalence of hypertension, diabetes, dyslipidaemia or CAD. Group with abnormal ABI had renal function greater impairment