Do third molars weaken the mandibular angle?

Objective: The purpose of this study is to estimate how is the magnitude of the impact of a mandibular third molar on the mandibular angle stiffness. Study Design: It was performed a literature search on whole MEDLINE and LILACS data base to find articles that match the following inclusion criteria: cohort studies presenting data on patients with mandibular fractures and third molars; that had a similar angle fracture definition; and that present data available to be cross-classified in a statistic analysis. Results: The sample was composed by 4 studies, involving 2533 patients from USA, Nigeria, Germany and Jordan, evaluated between 1976 and 2001. The analysis of the sample shows a relative risk for a mandibula to fracture, comparing patients with and without third molars, ranging from 1,18 to 2,25. The data of the sample was grouped because of the homogeneity of the articles methods. The estimated relative risk across the 4 studies was 1,94 (95% CI 1,6 - 2,35). Conclusions: The presence of a third molar may double the risk of an angle fracture of the mandible to occur. Even with this data, the present study cannot support conditions related to the third molar that may affect this impact. Further studies are necessary to discuss the true indication of removal of these teeth as a prophylactic measure in population groups more predisposed to fracture. © Medicina Oral

Maxillofacial and dental-related injuries from a Brazilian forensic science institute : victims and perpetrators characteristics and associated risk factors

Trauma due to external causes represents one of the greatest challenges for public health services in different regions around the world. This study aimed to determine the prevalence of facial trauma, associated risk factors, and classification of body injuries in individuals who underwent forensic examination in a Brazilian center. Data were collected at the Ceará State Forensic Medicine unit in a 12-year period. Sociodemographic data related to the etiological agent and lesions resulting from the bodily injury were recorded. Among 1,031 physical injury exams, physical aggression (p<0.001), male victims aged between 21 and 30 years (p<0.001), salaried workers (p<0.001), and soft tissue and dentoalveolar injuries were significant findings. Regarding aggression, domestic violence was prevalent (p<0.001), perpetrated by the victim?s partner (p<0.001), using a blunt instrument during the aggression (p<0.001), and directly associated with soft tissue injury (p<0.001). In traffic accidents, the most common type was motorcycle accident (p<0.001), on weekdays (p=0.036), at nighttime (p=0.134), showing a significant association with bone fractures (p=0.001). Oral and maxillofacial injuries obtained from a Brazilian forensic science center were significantly associated with sociodemographic and etiological factors

Lingual amyloidosis associated to long-term hemodialysis: report of a case

A amiloidose representa uma situação clínica resultante do depósito de proteína amilóide nos espaços extracelulares de órgãos e tecidos, a qual pode coexistir sem causar nenhuma anormalidade ou produz sérias conseqüências ao organismo. Geralmente, é classificada em uma variante limitada a órgãos e uma forma sistêmica. Embora apenas raramente possa envolver os tecidos orais, o cirurgião-dentista deve reconhecer as suas manifestações clínicas para ajudar no tratamento ou interromper a sua progressão. O propósito deste trabalho é relatar o caso de uma paciente que apresentava depósitos de amilóide na língua causados por uma hemodiálise de longa duração.Amyloidosis represents a clinical situation resulting from deposits of amyloid protein in the extra cellular spaces of the organs and tissues that can coexist without causing any abnormality or produce serious consequences the body. Generally, it is classified in a variant limited to organs or in a systemic form. Although only rarely it can involve oral tissues, dentistry must recognize their clinical manifestations to help in the treatment or interruption of its progression. The purpose of this work is report a case of a patient that shows amyloid deposits in the tongue caused by long term hemodialysis

Alterated lingual frenulum associated with gagging during breastfeeding: case reporta

Objetivo: o presente trabalho tem como objetivo relatar o caso de um paciente recém-nascido prematuro com lesão lingual frênulo associado a episódios de engasgos. Caso Relatório: todos os dados foram obtidos diretamente no discurso serviço de terapia, bem como do hospital do paciente registros. A família autorizou as imagens usadas nesta apresentação. Uma vez que o recém-nascido começou oral alimentação, ele apresentou episódios de engasgos e respiração aflição. A equipe de fonoaudiologia realizou a Avaliação do frênulo lingual proposto por Martinelli e adaptado para recém-nascidos, em outros para observar aspectos funcionais e funcionais e os aspectos sucção não nutritiva e nutritiva. A avaliação concluíram que o frênulo lingual era disfuncional. Quanto à conduta terapêutica, o recém-nascido foi submetido a uma frenulotomia lingual realizada por um cirurgião oral, com apoio do fonoaudiólogo, em um ambiente ambulatorial e sem complicações. A ação interdisciplinar proporciona eficácia dos resultados, baseado no aspecto de que a função de a língua pode ser verificada imediatamente após a cirurgia. Uma semana após a frenulotomia, foi observado a ausência de engasgos, cansaço durante a amamentação, redução do período de pausa e aumento de o poder de sucção. Conclusão: este caso esclarece a discussão sobre frênulo lingual alterado e sua importância para funções essenciais como sucção e deglutição.Objective: the present work aims to report the case of a premature newborn patient with altered lingual frenulum associated with gagging episodes. Case Report: all data was obtained directly in the speech therapy service, as well as from the patient’s hospital records. The family authorized the images used on this presentation. Once the newborn started oral feeding, he presented gagging episodes and respiratory distress. The speech therapy team performed the lingual frenulum evaluation proposed by Martinelli and adapted to newborns, in other to observe anatomical and functional aspects functional aspects and the non-nutritive and nutritive suction. The evaluation concluded that the lingual frenulum was dysfunctional. As to the therapeutic conduct, the newborn was submitted to a lingual frenulotomy performed by an oral surgeon, with speech therapist support, in an outpatient setting and with no complications. The cross-disciplinary action provides effectiveness of the results, based on the aspect that the function of the tongue can be checked immediately after the surgery. One week after the frenulotomy, it was observed the absence of gagging, tiredness during breastfeeding, reduction of the pause period and increase of the suction power. Conclusion: this case clarifies the discussion about disturbed lingual frenulum and its importance to essential functions such as suction and deglutition

Correlation between radiographic signs of third molar proximity with inferior alveolar nerve and postoperative occurrence of neurosensory disorders: A prospective, double-blind study

PURPOSE: To evaluate the interference of radiographic factors in the appearance of sensory deficit related to inferior alveolar nerve (IAN) after third molars (3Ms) removal. METHODS: A prospective, double-blind, observational, unicentric study was performed with 126 patients submitted to a surgical procedure of lower 3Ms removal in the period from March to October/2011. Collected data included gender, age, eruption stage of 3Ms, position/angle of 3Ms (Pell-Gregory and Winter classifications, respectively), presence/absence of radiographic signs of 3Ms proximity with the inferior alveolar canal and surgical technique. Occurrence evaluation of the IAN injury was performed on the seventh postoperative day through pin-prick, two-point discrimination and brush directional stroke tests. RESULTS: Predominant radiographic signs were: narrowing of the inferior alveolar canal (68.25%), darkening of root (46.82%) and diversion of the canal (31%). None of the patients presented sensory loss. Sixty-one (48.41%) of the cases had at least one or two radiographic signs of proximity with NAI. Forty-seven (37.3%) had 3 or more signs, and 18 (14.29%) did not have any radiographic signs of proximity to mandibular canal. CONCLUSION: There was not a positive correlation between presence of radiographic signs of 3Ms with IAN proximity and postoperative neurosensory disorders occurrence