As life expectancy increases, a larger number of elderly people require dental health care attention for implant-supported rehabilitation, with the aim of restoring the function and aesthetics of the oral cavity. Most of these patients have lost their teeth long time ago, causing a severe bone resorption and maxillary sinus pneumatization. Therefore, the current study aims to demonstrate, through the description of the clinical case, the treatment with zygomatic implants as an option for treating severely atrophic maxillas. In this clinical study, the patient presented, in the clinical and image evaluation, severe alveolar bone atrophy, with height and thickness loss, in addition to a high-level pneumatization of the maxillary sinus, bilaterally. The classical zygomatic fixation technique was suggested, with 2 anterior conventional implants and 2 zygomatic implants in the posterior region with the placement of implant-supported prosthesis with immediate loading. The patient was monitored for 7 years and did not present pain complaints, absence of infection, or implant loss. Based on this clinical case study, it was concluded that the zygomatic implants are satisfactory options to aid the implant-supported rehabilitation of atrophic maxillas.
The implant placed in the nasopalatine canal region is a viable option to assist in the rehabilitation with implant-supported prostheses in atrophic maxilla.
A problemática da inervação laríngea tem motivado o aparecimento de grande número de pesquisas, especialmente àquelas relacionadas ao nervo laríngeo recorrente (NLR). As numerosas variações anatômicas, a importante aplicação cirúrgica e ainda as dificuldades na comprovação funcional dos ramos nervosos para laringe tornam este assunto intrigante e desafiador. Diante disto, o presente estudo objetiva a investigação minuciosa dos ramos do nervo laríngeo recorrente (NLR), destinados aos músculos cricoaritenóideos posterior (CAP) e lateral (CAL). Forma de estudo: Experimental. Material e Método: Foram realizadas dissecções bilaterais, ao microscópio cirúrgico, de 20 laringes de adultos, de ambos os sexos, referentes às regiões posterior e posterolateral da laringe. Resultados: Encontraram-se diferenças morfológicas nos ramos do NLR que alcançam os músculos CAP e CAL, observando-se inervação unipedicular, bipedicular e tripedicular. Encontraram-se, também, fibras do músculo CAP dispostas obliquamente às do feixe principal, em forma de um "aqueduto", sob o qual passa o NLR. Conclusões: O nervo laríngeo recorrente (NLR) penetra na laringe sob a sua margem inferior, atrás da articulação cricotireoidea; a inervação característica de ambos os músculos (CAP e CAL) é predominantemente bipedicular; o mencionado "aqueduto", formado por um feixe de fibras do CAP, seria uma variação anatômica pouco estudada.
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