Background: Autogenous bone grafts are the most favorable and predictable types of bone graft due to their osteogenic, osteoinductive, and osteoconductive properties. The advantages of harvesting from mandibular bone are that it requires only local anesthesia, is less invasive, has less morbidity, and avoids harvesting from distant sites, thus making it the best choice for maxillary bone reconstruction.Purpose: The aim of this study was to evaluate inferior alveolar nerve (IAN) neurosensory disturbances after autogenous bone graft harvesting from the mandibular symphysis and retromolar region to reconstruct maxillary sinus height for posterior dental implant placement and the effect of these disturbances on patient satisfaction.Materials and Methods: Fifty-four patients were invited to participate in this study.Autogenous bone graft was harvested from the mandibular symphysis and retromolar regions. After the procedure, the patients were evaluated by means of an adapted questionnaire to determine if they had complaints of neurosensory disturbances at the following time intervals: immediately, 1, 2-5, 6, 7-11, and 12 months postsurgery.Results: Immediately after surgery, 28 patients described sensory changes and 25 reported paresthesia of inferior lip. Only three patients reported pain, and one patient experienced dental hypersensitivity after the surgical procedure. During the evaluation period, the patients reported a decrease in paresthesia and a return of sensation to areas innervated by the IAN. After 12 months, five patients still reported paresthesia of areas innervated by the IAN. Beside this, patients reported significant clinical improvement from the beginning of the evaluation, as 49 patients were satisfied with their treatment outcomes.Conclusion: Harvesting bone grafts from the mandibular symphysis results in greater postoperative morbidity upon immediate evaluation compared with bone graft harvesting from the retromolar region. Nevertheless, during clinical follow-up, the results of both treatments showed that sensation was eventually recovered, depending on the healing period.
Paraendodontic surgeries have been increasingly used to solve problems related to failures in conventional endodontic treatment. Better anatomical knowledge of the structures as well as the development of techniques and materials involved has resulted in substantial paraendodontic surgery increase and success. In some cases, teeth endodontic treatment highly benefits treatment accomplishment. This report describes a case of an endodontic treatment complemented by paraendodontic surgery in periapical region of 21, 22 and 23 of a female patient who had been treated at the clinic of the Brazilian Dental Association Dentistry - in the city of Cascavel, State of Parana, Brazil. The case presents a 12-month follow-up for the resolution of painful symptoms, lesion reduction, and bone formation. Literature review was performed regarding paraendodontic surgery in order to assess the determining factors, failure causes and procedure indications/contraindications, as well.
O interesse pelo uso da laserterapia de baixa intensidade tem surgido fortemente dentre os clínicos e estudiosos, a fim de compreender o potencial das interações da luz laser, e em particular, para bioestimular os processos de regeneração dos tecidos, controlar o processo inflamatório e a dor. O objetivo do presente trabalho é realizar uma revisão integrativa a fim de discutir a eficácia da laserterapia de baixa intensidade na prática odontológica. Para tal, utilizamos artigos científicos oriundos das bases de dados Scielo e Pubmed. Foram selecionados 19 artigos, os quais se enquadram nos seguintes critérios de inclusão: publicações dos últimos 10 anos, artigos que avaliem a efetividade na melhora da dor, edema, trismo, parestesia e estudos “in vitro” relacionados a aplicabilidade da laserterapia. Não foram considerados artigos com mais de 10 anos e estudos que não envolvam aplicação laserterapia de baixa intensidade. Os resultados dessa revisão integrativa sugerem novos ensaios clínicos randomizados para comprovar sua efetividade na prática clínica. Portanto, de acordo com a literatura consultada, a laserterapia de baixa intensidade se mostrou eficaz em diferentes aplicações e em outros quesitos, como na regeneração tecidual e no controle de processos inflamatórios. Porém, é necessário realizar novos estudos, pois pesquisas específicas a fim de avaliar efetividade da laserterapia no dor, edema, trismo e parestesia, são escassas e carecem de protocolos específicos para seu uso.
Introdução: Cisto cirúrgico ciliado ou cisto maxilar pós-operatório é uma lesão que ocorre próximo ao ápice dos dentes, porém é originária do epitélio do seio maxilar. É definido como um sequestro da membrana do seio que fica aprisionado e se prolifera, gerando uma cavidade cística verdadeira. Tem aspecto radiográfico semelhante ao cisto radicular, sendo unilocular de centro radiolúcido e bordas radiopacas bem delimitadas. O tratamento é a remoção do epitélio, sendo recomendada a enucleação cirúrgica do cisto. Raramente é relatado recorrências da lesão. Objetivo: relatar um caso clínico e a conduta adotada para resolução do caso de cisto maxilar pós-operatório. Relato de Caso: A paciente de gênero feminino, 59 anos, leucoderma, edentada total, procurou a clínica de odontologia da Universidade Estadual do Oeste do Paraná para confecção de novas próteses totais superiores e inferiores. No exame radiográfico panorâmico, constatou-se uma lesão unilocular em maxila direita. Clinicamente não apresentava nenhuma alteração e nenhuma sintomatologia. Foi realizada a punção da lesão, sob anestesia local, que revelou conteúdo seroso. Em seguida, a lesão foi enucleada. Não houve comunicação com o seio maxilar. A paciente permaneceu em acompanhamento clínico e radiográfico por 3 anos apresentando reparação total da loja sem sinais de recidiva. Conclusão: O acompanhamento à longo prazo é essencial em casos de lesões intraósseas. Mesmo pacientes edêntulos necessitam de exames de imagens para avaliação inicial, descartando alterações intraósseas.Descritores: Cirurgia Bucal; Cistos Ósseos; Seio Maxilar.ReferênciasLi CC, Feinerman DM, MacCarthy KD, Woo SB. Rare mandibular surgical ciliated cysts: report of two new cases. J Oral Maxillofac Surg. 2014;72(9):1736-43.Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia oral e maxilofacial. 3. ed. Rio de Janeiro: Elsevier; 2009.Shafer WG, Hine MK, Levy BM, Tomich CE. Tratado de Patologia Bucal. 4. ed. 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J Oral Surg. 1981;39(3):191-98.Cano J, Campo J, Alobera MA, Baca R. Surgical ciliated cyst of the maxilla. Clinical case. Med Oral Patol Oral Cir Bucal. 2009;14(7):e361-64.Moe JS, Magliocca KR, Steed MB. Early maxillary surgical ciliated cyst after Le Fort I untreated for 20 years. Oral Surg. 2013;6(4):224-28.Basu MK, Rout PGJ, Rippin JW, Smith AJ. The post-operative maxillary cyst: Experience with 23 cases. Int J Oral Maxillofac Surg. 1988; 17(5):282-84.Yamamoto H, Takagi M. Clinicopathologic study of the postoperative maxillary cyst. Oral Surg Oral Med Oral Pathol. 1986;62(5):544-48.Heo MS, Song MY, Lee SS, Choi SC, Park TW. A comparative study of the radiological diagnosis of postoperative maxillary cyst. Dentomaxillofacial Radiol. 2000;29(6):347-51.Marano R, Santos SE, Sawazaki R, de Moraes M. Um raro caso de cisto cirúrgico ciliado após 5 anos de extração dentária. Rev Port Estomatol Med Dent Cir Maxilofac. 2012;53:246-51.Amin M, Witherow H, Lee R, Blenkinsopp P. Surgical ciliated cyst after maxillary orthognathic surgery: report of a case. J Oral Maxillofac Surg. 2003;61(1):138-41.Shik CK. The post-operative maxillary cyst: report of 14 cases. Taehan Chikkwa Uisa Hyophoe Chi. 1989;27(11):1049-57.Sugar AW, Walker DM, Bounds GA. Surgical ciliated (postoperative maxillary) cysts following mid-face osteotomies. Br J Oral Maxillofac Surg. 1990;28(4):264-67.Hayhurst DL, Moenning JE, Summerlin DJ, Bussard DA. Surgical ciliated cyst: a delayed complication in a case of maxillary orthognathic surgery. J Oral Maxillofac Surg. 1993;51(6):705-8.Lockhart R, Ceccaldi J, Bertrand JC. Postoperative maxillary cyst following sinus bone graft: report of a case. Int J Oral Maxillofac Implants. 2000;15(4):583-86.Shakib K, McCarthy E, Walker DM, Newman L. Post operative maxillary cyst: report of an unusual presentation. Br J Oral Maxillofac Surg. 2009;47(5):419-21.Bourgeois SL Jr, Nelson BL. Surgical ciliated cyst of the mandible secondary to simultaneous Le Fort I osteotomy and genioplasty: report of case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(1):36-9.An J, Zhang Y. Surgical ciliated cyst of the medial canthal region after the management of a midfacial fracture: a case report. J Craniofac Surg. 2014;25(2):701-2.Samuels HS. Marsupialization: Effective management of large maxillary cysts: report of a case. Oral Surg Oral Med Oral Pathol. 1965;20(5):676-83.Pe MB, Sano K, Kitamura A, Inokuchi T. Computed tomography in the evaluation of postoperative maxillary cysts. J Oral Maxillofac Surg. 1990;48(7):679-84.Lee KC, Lee NH. Comparison of clinical characteristics between primary and secondary paranasal mucoceles. Yonsei Med J. 2010;51(5):735-39.
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