Osteomas are benign osteogenic tumors, which clinically manifest as well-defined and asymptomatic lesions. This article aims to report a case of extensive osteoma in the mandibular branch, addressing the main tools used for diagnosis and treatment modalities. Patient L.M.S, 55 years old, male, sought the service of Maxillofacial Surgery, reporting the appearance of a nodule on the face with evolution of 2 years. On physical examination, a significant volumetric increase was observed in the pre-auricular region on the left side, asymptomatic on palpation and non-bleeding. Computed tomography was requested, which showed a hyperdense bone lesion in the mandibular ramus region. The planned surgical proposal was for extra-oral access in the pre-auricular region on the left side, excision of the lesion by osteotomy followed by osteoplasty for the regularization of the remaining bone tissue and suture by planes. Subsequently, the piece was sent for histopathological analysis that identified the lesion as a compact osteoma. The patient was followed up for 1 and a half years, through clinical and radiographic evaluation, through which an excellent bone repair was observed, with no signs of recurrence. Carrying out the clink exam is essential for the diagnosis of osteoma, as it is an asymptomatic pathology. Due to the fact that it has a low probability of recurrence and does not present malignancy, a conservative approach can be performed with the appropriate postoperative follow-up. Therefore, it is concluded that the performance of a thorough clinical examination associated with the imaging and microscopic information are essential for a good clinical management of this pathology.

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O terço médio da face é funcional e esteticamente importante. De acordo com a classificação Le Fort, existem três níveis mais fracos desta região da face quando traumatizados a partir de uma direção frontal, sendo que os acidentes motociclísticos, atualmente, correspondem a causa de aproximadamente 29% destes traumas. O presente trabalho tem como objetivo relatar um caso clínico de tratamento cirúrgico de fraturas do tipo Le Fort I e Le Fort II em um paciente de 29 anos de idade, sexo masculino, vítima de acidente motociclístico, atendido no Hospital de Emergência e Trauma Senador Humberto Lucena (João Pessoa – PB). Ao exame físico observou-se mobilidade de maxila, degrau palpável em pilar zigomático e pilar canino, alteração oclusal com leve mordida aberta e degrau em rebordo infraorbitário direito, entretanto o paciente não apresentava nenhuma alteração ocular. Foi solicitada tomografia computadorizada como exame complementar para confirmação do diagnóstico e planejamento cirúrgico, o qual se deu como fratura Le Fort I e Le Fort II no lado direito. O paciente foi submetido à cirurgia sob anestesia geral para fixação dos pilares zigomático e canino através do acesso vestibular maxilar e rebordo infraorbitário através do acesso subciliar. Inicialmente foi feito o bloqueio maxilo – mandibular para a utilização da oclusão como ponto de referência, seguido da redução das fraturas e fixação com placas e parafusos do sistema 2.0. Sob acompanhamento pós – operatório o paciente apresentou retorno da oclusão dentro dos padrões de normalidade, recuperou a projeção da região zigomática fraturada e então recebeu alta. Descritores: Fraturas Ósseas; Fixação de Fratura; Traumatismos Faciais. Referências Organização das Nações Unidas no Brasil. Traumas matam mais que malária, tuberculose e AIDS, alerta OMS. Disponível em: <http://www.onu.org.br/traumas-matam-mais-que-malaria-tuberculose-e-aids-alerta-oms/>. Acesso em: 22 julho 2019 Ansari MH. Maxillofacial fractures in Hamedan province, Iran: a retrospective study (1987-2001). J Craniomaxillofac Surg. 2004;32(1):28-34.  Kostakis G, Stathopoulos P, Dais P, Gkinis G, Igoumenakis D, Mezitis M, Rallis G. An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5 Suppl):S69-73.  Li Z, Li ZB. Characteristic changes of pediatric maxillofacial fractures in China during the past 20 years. J Oral Maxillofac Surg 2008;66:2239-42. Fonseca RJ. Trauma Bucomaxilofacial 4. ed. Rio de Janeiro : Elsevier; 2015. Wulkan M, Parreira Junior JG, Botter DA. Epidemiologia do trauma facial. Rev Assoc Med Bras. 2005;51(5):290-95. Scherer M, Sullivan WG, Smith DJ Jr, Phillips LG, Robson MC. An analysis of 1,423 facial fractures in 788 patients at an urban trauma center. J Trauma. 1989;29(3):388-90.  Cohen RS, Pacios AR. Facial and cranio-facial trauma: epidemiology, experience and treatment. F Med. 1995;111(suppl):111-16. de Birolini D, Utiyama E, Steinman E. Cirurgia de Emergência. São Paulo: Atheneu; 1997. Tessier P. The classic reprint: experimental study of fractures of the upper jaw. 3. René Le Fort, M.D., Lille, France. Plast Reconstr Surg. 1972;50(6):600-7.  Buehler JA, Tannyhill RJ 3rd. Complications in the treatment of midfacial fractures. Oral Maxillofac Surg Clin North Am. 2003;15(2):195-212. Manson PN, Clark N, Robertson B, Slezak S, Wheatly M, Vander Kolk C, Iliff N. Subunit principles in midface fractures: the importance of sagittal buttresses, soft-tissue reductions, and sequencing treatment of segmental fractures. Plast Reconstr Surg. 1999;103(4):1287-306; Carr RM, Mathog RH. Early and delayed repair of orbitozygomatic complex fractures. J Oral Maxillofac Surg. 1997;55(3):253-8; 258-9. 

Malignant oral neoplasms have great relevance because they represent one of the main causes of death in the world. Squamous cell carcinoma is its most frequent form, but reports in the retromolar region are rare when compared to other oral sites. The objective of this work is to demonstrate the diagnosis and conduct in the case of a patient participating in the Oral Injury extension project (LeBu) at the State University of Maringá - PR/BR. Male patient, 67 years old, a heavy smoker for about 50 years, alcoholic, attended the university with an ulcer in the right lower retromolar region of brownish-white color, with approximately 3 to 4 mm, irregular shape, and rough surface. A biopsy was performed in the lesion region, collecting a fragment of approximately 2 mm, which was referred for histopathological examination, resulting in a diagnosis of moderately differentiated, invasive squamous cell carcinoma. The patient was referred for medical oncological, surgical, and chemotherapy treatment, remaining under dental monitoring throughout the treatment and later with scheduled returns. After 4 years of follow-up, the patient is in good general physical condition, with no signs of recurrence, orally rehabilitated, even quitting the smoking habit. Thus, it is concluded that the diagnosis and treatment of head and neck neoplasms lacks a multidisciplinary view, being the dental surgeon of great importance both for the diagnosis of these injuries, as well as in the prevention and treatment of injuries that may arise from or after the treatment.

Concrescence is a rare type of union of two teeth, with no predisposition for a particular ethnicity, gender or age, specifically united by a portion of cementum, without the fusion of dentin, commonly reported in the posterior maxilla region, in most cases, this anomaly affects the second and third molars. Its diagnosis is suggested by radiographic images when there is proximity between two teeth, without signs of the periodontal ligament, or interdental bone between them, often showing a radiographic overlap. The lack of attention to these signs can lead to complications during endodontic and surgical procedures, such as unplanned extraction of the involved teeth, even leading to legal problems. The aim of this paper is to report a histologically proven case of concrescence between an erupted second molar largely compromised by caries and an impacted third molar, in addition to presenting a literature review, along with the histological aspect, about the subject.

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The installation of immediate implants after tooth extractions is becoming a common practice in the dental clinic. During this surgical procedure, complications such as the displacement of dental implants into the maxillary sinus may occur due to the close relationship between the floor of the maxillary sinus and the upper teeth. In these cases, treatment consists of removing the implant that has been displaced in order to prevent future complications such as maxillary sinusitis and oroantral fistula. The present study aims to present a clinical case in which the removal of the maxillary sinus implant was performed using the modified Caldwell-Luc Technique. The patient sought a private clinic for extraction of the left upper second molar and oral rehabilitation with implants. Even with little bone height between the floor of the maxillary sinus and the crest of the alveolar ridge, the professional opted for immediate implant installation after extraction, but when returning after 90 days, the implant had moved into the sinus. The implant was removed using the modified Caldwell-Luc technique, which consists of making a bone window in the lateral wall of the maxillary sinus, removing the fragment, replacing the bone window, and suturing the previously folded flap. Therefore, it can be concluded that the Caldwell-Luc technique benefits the closure of the bone defect, avoids fistulas and the area of ​​fibrosis in the membrane, being an effective and viable alternative for removing implants in the maxillary sinus region.