MANEJO EFICIENTE DE DESAFIOS EM CIRURGIAS DE EXTRAÇÃO DE TERCEIROS MOLARES

Third molar extraction is a common surgical intervention in dentistry, but it can present challenges due to the complex anatomy that the region can present. Complications during or after the procedure can range from temporary discomfort to more serious problems. OBJECTIVE: This study aims to explore strategies for efficiently managing these challenges, highlighting the importance of prior assessment and surgical planning and technology applications. METHODOLOGY: A comprehensive literature review was carried out, using PubMed and Google Scholar, with terms such as "Third molar", "impacted teeth" and "surgical complications". The careful selection considered the contribution to research and reliability, with Lakatos and Marconi (2017) being key references. The analysis only included articles in Portuguese to ensure accurate interpretation. DISCUSSION: Risk factors, such as anatomical position, patient age and systemic conditions, were identified as crucial. Post-surgical complications, related to inflammation and infection, require prior analysis to determine the need for antibiotic therapy. The review addressed the importance of anamnesis, imaging exams and asepsis protocols New technologies, such as CBCT, 3D printing, diode lasers and ultrasound. CONCLUSION: The study concludes that third molar extraction requires a careful and preventive approach. The identification of risk factors, the application of preventive strategies and the use of innovative technologies are fundamental to the success of the surgery.A extração do terceiro molar, é uma intervenção cirúrgica comum na odontologia, porém pode apresentar desafios devido à anatomia complexa que a região pode vim apresentar. Complicações durante ou após o procedimento podem variar de desconforto temporário a problemas mais sérios. OBJETIVO: Este estudo visa explorar estratégias de manejo eficiente desses desafios, destacando a importância da avaliação prévia e do planejamento cirúrgico e aplicações de tecnologias. METODOLOGIA:  Realizou-se uma revisão abrangente de literatura, utilizando PubMed e Google Acadêmico, com termos como "Terceiro molar", "dentes impactados" e "complicações cirúrgicas". A seleção criteriosa considerou a contribuição à pesquisa e a confiabilidade, com Lakatos e Marconi (2017) sendo referências-chave. A análise incluiu apenas artigos em língua portuguesa para garantir interpretação precisa. DISCUSSÃO: Os fatores de risco, como posição anatômica, idade do paciente e condições sistêmicas, foram identificados como cruciais. Complicações pós-cirúrgicas, relacionadas à inflamação e infecção, demandam análise prévia para determinar a necessidade de antibioticoterapia. A revisão abordou a importância da anamnese, exames de imagem e protocolos de assepsia Novas tecnologias, como CBCT, impressão 3D, lasers de diodo e ultrassom. CONCLUSÃO: O estudo conclui que a extração do terceiro molar demanda uma abordagem cuidadosa e preventiva. A identificação de fatores de risco, a aplicação de estratégias preventivas e o uso de tecnologias inovadoras são fundamentais para o sucesso da cirurgia

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved