Factors associated with the diagnosis, aetiology, and treatment of mandibular fractures occurring during the postoperative period following the removal of a lower third molar are discussed. The following databases were searched using specific key words: PubMed/MEDLINE, LILACS, Embase, and Scopus. The search yielded 124 cases. Sex, age, side, tooth position and angulation, bone impaction, relationship between the tooth and the inferior alveolar nerve, local pathological conditions, aetiology of the fracture, symptomatology, and time between surgery and fracture, as well as any displacement of the fracture and the treatment of the fracture, were evaluated. Data were tabulated and the χ statistical test was applied (P<0.05). Male patients aged >35 years, with teeth in positions II/III and B/C, complete bony impaction, and local bone-like alterations, were found to have a higher frequency of fracture and pericoronitis (P<0.05). Late fractures generally occurred between the second and fourth postoperative weeks (P<0.05). They were generally not displaced and the typical treatment was the non-surgical approach (P<0.05). It is concluded that the risk of mandibular fracture after extraction is associated with excessive ostectomy and/or local alterations. At-risk patients should be thoroughly briefed on the importance of a proper postoperative diet.

ResumoO objetivo desta pesquisa foi analisar o conhecimento, opinião, acompanhamento e a execução do cirurgião-dentista na Odontologia Hospitalar. Foram aplicados 500 questionários a cirurgiões-dentistas na cidade de Araçatuba do estado de São Paulo. Os resultados demonstraram que 49% dos profissionais nunca tiveram a experiência no âmbito hospitalar e 64% afirmaram que este conteúdo é carente como parte integrante do currículo de graduação. Outro resultado foi de que 46% dos entrevistados não têm interesse ou não acham necessário atuar dentro do hospital e 24% acreditam que esse atendimento seja feito somente por especialistas. Pode-se sugerir que há carência de conhecimento sobre Odontologia Hospitalar, assim o cirurgião-dentista deve ser instruído desde a sua formação acadêmica para a inserção na equipe hospitalar.Palavras-chave: conhecimento; Odontologia, hospital. AbstRAct Level of knowledge of dentists about Hospital Dental Care Introdução AOdontologia Hospitalar pode ser definida como prática de atividades que visam melhorar a saúde geral e a qualidade de vida dos pacientes hospitalizados. O tratamento integral do paciente é fundamental para que a equipe multidisciplinar atue de forma eficiente e segura, permitindo melhor desempenho no compromisso de melhora do quadro clínico do paciente internado (1).Inúmeras pesquisas comprovam a relação entre doenças bucais e sistêmi-cas, mostrando que dependendo da condição bucal pode haver foco de disseminação de micro-organismos patogênicos com efeito metastático (2, 3). Deste modo, o tratamento odontológico contribui significativamente com a prevenção e/ou melhora da condição sistêmica, principalmente em paciente hospitalizado (4, 5).As doenças infecciosas na cavidade bucal estão intimamente relacionadas com alterações na resposta imunológica, falta de higiene oral, desnutrição severa, tabagismo, alcoolismo e diabetes, os quais podem aumentar a susceptibilidade ao desenvolvimento de gengivite, periodontite e doenças respiratórias (6,7,8). Além disso, o comprometimento da resposta imune local e sistêmica facilita a colonização da cavidade oral por micro-organismos superinfectantes, como as bactérias entéricas e pseudomonas (9, 10).Os procedimentos realizados em ambiente hospitalar requerem uma equipe multiprofissional da área da saúde, considerando a complexidade do ser humano, principalmente do indivíduo hospitalizado. Sendo assim, um único profissional não é capaz de realizar de forma segura o diagnóstico e o plano de tratamento do paciente hospitalizado (11). Desta forma, percebe-se a importância da abordagem integral dos indivíduos hospitalizados, indicando que nenhuma profissão da área da saúde atua isoladamente.Partindo do exposto mostra-se a importância das faculdades de Odontologia abordarem este tema pouco abordado na grade curricular durante a graduação. Como futuro profissional da área da saúde, o aluno de graduação, durante sua formação acadêmica, deve ser incentivado e preparado para o manejo do paciente em âmbito hospitalar.Muitos dos profissionais da...

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Guided bone regeneration was studied to establish protocols and develop new biomaterials that revealed satisfactory results. The present study aimed to comparatively evaluate the efficiency of the bacterial cellulose membrane (Nanoskin®) and collagen membrane Bio-Gide® in the bone repair of 8-mm critical size defects in rat calvaria. Seventy-two adult male rats were divided into three experimental groups (n = 24): the CG—membrane-free control group (only blood clot, negative control), BG—porcine collagen membrane group (Bio-Guide®, positive control), and BC—bacterial cellulose membrane group (experimental group). The comparison periods were 7, 15, 30, and 60 days postoperatively. Histological, histometric, and immunohistochemical analyses were performed. The quantitative data were subjected to 2-way ANOVA and Tukey’s post-test, and p < 0.05 was considered significant. At 30 and 60 days postoperatively, the BG group showed more healing of the surgical wound than the other groups, with a high amount of newly formed bone (p < 0.001), while the BC group showed mature connective tissue filling the defect. The inflammatory cell count at postoperative days 7 and 15 was higher in the BC group than in the BG group (Tukey’s test, p = 0.006). At postoperative days 30 and 60, the area of new bone formed was greater in the BG group than in the other groups (p < 0.001). Immunohistochemical analysis showed moderate and intense immunolabeling of osteocalcin and osteopontin at postoperative day 60 in the BG and BC groups. Thus, despite the promising application of the BC membrane in soft-tissue repair, it did not induce bone repair in rat calvaria.

Biomaterials for use in guided bone regeneration (GBR) are constantly being investigated and developed to improve clinical outcomes. The present study aimed to comparatively evaluate the biological performance of different membranes during the bone healing process of 8 mm critical defects in rat calvaria in order to assess their influence on the quality of the newly formed bone. Seventy-two adult male rats were divided into three experimental groups (n = 24) based on the membranes used: the CG—membrane-free control group (only blood clot, negative control), BG—porcine collagen membrane group (Bio-Guide®, positive control), and the PCL—polycaprolactone (enriched with 5% hydroxyapatite) membrane group (experimental group). Histological and histometric analyses were performed at 7, 15, 30, and 60 days postoperatively. The quantitative data were analyzed by two-way ANOVA and Tukey’s test (p < 0.05). At 7 and 15 days, the inflammatory responses in the BG and PCL groups were significantly different (p < 0.05). The PCL group, at 15 days, showed a large area of newly formed bone. At 30 and 60 days postoperatively, the PCL and BG groups exhibited similar bone healing, including some specimens showing complete closure of the critical defect (p = 0.799). Thus, the PCL membrane was biocompatible, and has the potential to help with GBR procedures.

No abstract

After extraction of impacted lower third molars, we found that swelling, trismus, and pain were more effectively controlled with ETO than with IBU.

Membranes that aid the guided bone regeneration (GBR) process have been the subject of studies of compatible biomaterials that contribute to this repair process. The present study compared different membranes used in critical-size defects of rat calvaria by assessing GBR as well as histological, histomorphometric, and immunohistochemical reactions. Forty-eight male albino Wistar rats were randomly allocated into four groups (n = 12 each), namely, C: membrane-free control group (only blood clot, negative control group); BG: porcine collagen membrane group (Bio-Gide®, positive control group); GD: bovine cortical membrane group (first experimental group); and GDF: thicker bovine cortical membrane group (second experimental group). Rats were euthanized at 30 and 60 days postoperatively. Quantitative data from the histometric analysis were submitted to two-way ANOVA and Tukey’s posttest when p<0.05. Histomorphometric results of the thicker bovine cortical membrane at 30 and 60 days were promising, showing improved new bone formation values (p<0.05), and the CD group presented similar results in both analysis periods, being surpassed only by the GDF group (p<0.05). The immunohistochemical results were associated with the histomorphometric data. A less-thick membrane also assisted in GBR. All membranes promoted GBR, especially the positive control and experimental groups.