Introduction: With the current need for large bone reconstructions due to very robust losses in skeletal architecture, not only of the maxillary and mandibular regions but also in other regions of the body, this guided bone regeneration has been increasingly used. Case Report: A leukoderma patient at 52 years of age sought the implantology clinic of the Brazilian Dental Association (ABO) to solve his case of tooth loss. The patient presented overly aggressive bone loss in the total maxilla, and, because of this, it was planned to reconstruct the lost area with a synthetic particulate nano-biomaterial (Blue Bone, Curitiba, Brazil), with the help of the platelet aggregate (PRF). For the surgery, 6 grams of this biomaterial were used, in the anterior region of the maxilla, tent screws were placed to stabilize the grafted bilateral and maxillary sinus lifting surgeries were performed in the posterior regions. The entire regenerated area was covered with L-PRF membrane for better stability and healing. An incredibly significant gain in bone volume was observed six months after surgery throughout the regenerated region, enabling the placement of dental implants (Systhex, Curitiba, Brazil) and later the placement of the supported prosthesis. Conclusion: The nano graft presented a very favorable result in the gain of bone volume, proving to be an excellent indication for more severe cases of bone loss.
The internal derangement of the temporomandibular joint (TMJ) represents 8% of all cases of temporomandibular disorders (TMD) posing difficulties to establish an accurate diagnosis and treatment because of its low prevalence. This article presents the case of an 18-year-old Caucasian female patient who came to our Orofacial Pain and TMD Outpatient Service with complaints of intense pain on the right TMJ and limitation of mouth opening (maximum interincisal opening of 29 mm) with deviation to right, which she had been experiencing for the past 3 years. After a detailed clinical interview, a diagnosis hypothesis of nonreducing disc displacement with mouth opening limitation was established. The proposed treatment consisted of intra-joint infiltration with anesthetic in the right TMJ followed by jaw manipulation to recapture the articular disc, which was impeding the complete translation movement of the affected TMJ. After jaw manipulation, a new evaluation was done and showed the re-establishment of jaw dynamics with mouth opening and closing without deviation to the right side, clicking, opening limitation or pain. The patient was followed up at 6 months intervals. Two years after treatment, the patient was reevaluated and her mandibular range of motion without aid increased to 54 mm with no clicking, deviation to right, trismus or pain on the TMJ, indicating success of the treatment approach without recurrence of the pathology.
The purpose of this work was evaluating the fracture strength of bovine roots weakened experimentally, restored with two different techniques: internal reinforcement of root canal walls with composite resin and a cast metal post and core or anatomic post (glass fiber post associated with composite resin). Thirty bovine lower central incisive were selected and transversally sectioned, remaining 14 mm of root in order to approximate to the human maxillary central incisive. A sequence of standardized wear was used to weak the root until the walls remaining achieved from 0.5 to 0.7 mm of thickness at the cervical edge. Two groups were separated randomly (n=15) in order to test the roots reinforced with composite resin associated with cast metal post and core (CMP), or roots restored with composite resin associated to the glass fiber post (GFP). The test were applied in a Universal Test Machine (EMIC) with tangential compressive loading focused on the lingual face of core in an angle of 135° with the long axis of the tooth at a crosshead speed of 0.5 mm/min until failure occurred. The results showed that the fracture strength of remaining roots with weakened walls was influenced by the restorative technique, and the higher values of strength fractures were observed in the group of roots reinforced by composite resin associated with CMP (p<0.001) when compared to the group of roots restored with anatomic post.
Displacement of the non-reduction disk with limitation of opening (DDwLO) can be treatment of the non-surgical form. However, it required scientific and clinic knowledge of diagnostic area of the disorders temporomandibulares. This study was performed with the patient CN, 18 years, white, female, who went to the orofacial pain ambulatory with complaints of extreme pain on the right temporomandibular joint (TMJ) and limitation of maximum opening of 29 mm with shift to right, which she has been suffering for at least three years. After a criterion anamnese the diagnosis hypothesis found was a displacement of the non-reduction disk with limitation of opening. The treatment was based on infiltration in the right TMJ with anesthesic followed by mandibular manipulation. After the therapeutic conduct the patient presented clinical signals of normality with absence of trismus and mandibular movement without shift to right. The patient was followed up during five years not presenting return of the pathology.
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