Bone exostosis has long been described in the literature, appearing in most cases as a torus palatinus or mandibularis. These two variations are relatively common and affect approximately 30% of the world's population. Incidence is even higher when human skulls are examined post mortem, indicating that in some cases the exostosis is small and cannot be seen under the soft tissue. Removal of an exostosis is usually associated with the construction of a prothesis, but in rare cases such as the present, the lesion enlarges enough to affect speech and feeding. Few studies have reported the removal of such a large exostosis, and all were conducted in a hospital environment. In this case, complete removal was successfully conducted in an ambulatory clinic under local anesthesia. (J. Oral Sci. 50, [229][230][231] 2008)
Objective: To investigate the effects of sitagliptin, a dipeptidyl peptidase 4 inhibitor used to treat type II diabetes, on bone tissue and on implant osseointegration in diabetic rats.Design: Thirty-two male rats were divided into four groups: 1) Diabetic animals (GD);2) Diabetic animals that received sitagliptin (GDS); 3) Normoglycemic animals (GN); and 4) Normoglycemic animals that received sitagliptin (GNS). All animals received titanium implants in the right tibia. Sitagliptin or its dilution vehicle were administered for 4 weeks. Glycemia, HOMA-IR, insulinemia, microtomographic parameters of the left tibia, implant bone area fraction occupancy (BAFO) and of the right tibia were evaluated. Results:The model used to induce diabetes led to hyperglycemia. However, HOMA-IR results showed no insulin resistance, and insulinemia was lower in diabetic animals, demonstrating the development of type I diabetes. Sitagliptin administration did not influence glycemic control. The diabetic animals showed a lower BAFO, and bone volume fraction, as well as a lower trabecular number and thickness, revealing the deleterious effect of diabetes on bone metabolism and osseointegration. Conclusion:In this model, sitagliptin administration did not reverse the negative effects of type I diabetes on bone, suggesting that sitagliptin has no direct action on bone tissue and has no protective bone action in decompensated diabetic animals.
Objective: this study evaluated hemodynamic variations of normotensive and hypertensive patients undergoing dental extraction under local anesthesia with 3% prilocaine with felypressin 0.03UI/ml. Material and Methods: 49 patients of the Department of Surgery and Maxillo-facial Traumatology ambulatory were evaluated, 30 normotensive and 19 hypertensive, presenting initial systolic blood pressure lower then 160 mmHg and diastolic blood pressure lower then 100 mmHg, besides being under medical supervision. Patients underwent molar or premolar extraction, typically deployed with maximum degree of mobility 2, according to Miller’s classification. The parameters evaluated were systolic and diastolic blood pressures and heart rate, using an automatic digital pulse device, in the following periods: T1 - initial (5 minutes before the beginning of surgery, T2 – post-anesthesia (2 minutes after anesthetic administration); T3 – trans-operatory (each 5 minutes after T2 until 20 minutes completition, totalyzing 4 trans-operatory mensurations); T4 – post-surgery (5 minutes after surgery). Results: statistical analysis showed that for the parameters systolic blood pressure (P = 0.959) and diastolic blood pressure (P = 0.754) no statistically significant difference for these parameters in different evaluation periods. The analysis of heart rate values showed no statistical difference (p <0.05) between the values obtained in T1 in hypertensive and normotensive patients in T3.3. Conclusion: it was concluded that the evaluated hemodynamic parameters varied in different periods evaluated in the group of normotensive and hypertensive patients, but did not differ significantly.
The present study describes a clinical case in which the buccal fat pad (BFP) was used to improve the contour of the peri-implant mucosa. To our knowledge, this is the first case report of such an application in the literature. A 58-year-old woman presented with teeth #2 and #3 missing and an indication for extraction of tooth #4. After clinical examination and CBCT analysis, immediate implants were placed in the region of the extracted tooth and that of tooth #2 for prosthetic rehabilitation using a three-unit fixed partial denture. There was an extensive mucosal defect in the region of tooth #3, with vertical and horizontal changes in the contour of the mucosa. As an alternative to the use of a subepithelial connective tissue graft, we opted for displacement of the BFP and its accommodation on the alveolar ridge of tooth #3 to improve the buccal tissue contour. After 5 years of follow-up, satisfactory gain and maintenance of mucosal volume were observed in the treated area, as well as improvement of buccal tissue contour. The use of BFP seems to be a feasible alternative for filling and treating peri-implant mucosal defects.
Considering the probable causal association between the use of bisphosphonates and osteonecrosis of the jaw, as well as the high number of prescriptions and use these drugs every year, this paper aims to show different treatment. The combined use of ozone therapy and laser therapy in tissue regeneration and bone repair in patients with osteonecrosis induced by bisphosphonates, held by the discipline of Oral and Maxillofacial Surgery and Traumatology, Paulista State University "Júlio de Mesquita Filho". Female patient, white, 53 years after a breast cancer had an evolution for bone metastases throughout the body, and start the chemotherapy treatment using intra-venous pamidronate 90 mg monthly from 2007 which has been used to the present day, due to disease stabilization. The patient sought the institution complaining of painful symptoms in the mandible and maxilla, and the clinical examination and CT were diagnosed initial sites suggestive of osteonecrosis induced by bisphosphonates. In seeking to reduce the symptoms and clinical signs, to prevent progress in the lesions, we recommend treatment by ozone therapy together to infrared low-power laser, which showed satisfactory reduction in bone necrosis sites. Although there are wide variations and difficulties in treatments for osteonecrosis induced by bisphosphonates, it was possible regression of the lesions through the joint processing applied, and the improvement in life expectancy of the patient.
Objective: Extraction of semi-impacted or impacted, lower, third molars is one of the most performed procedures in the maxillofacial surgery, and inherent to it, there may be post-operative inflammatory response. Among the most common factors related to this response, pain, swelling, and trismus are the main ones. In this sense, therapeutic bandage has been used in the post-operative physiotherapy for several specialties so that muscular functions can be fully resumed and swelling, muscle spasms and pain reduced. Materials and Methods: The randomized, split-mouth, clinical trial was to assess 20 post-operative patients who underwent extraction of lower third molars with therapeutic bandage. Seven days after the extraction, swelling and trismus were the variables evaluated and pain was assessed according to the visual analogue scale (VAS). The Student’s t-test was used for comparison at significance level of 5% (α = 0.05). Results: With the results found, it was not possible to state that the therapeutic bandage protocol used in this study, given the evaluated signs and symptoms, were favorable, even providing greater comfort to patients. Conclusion: Therefore, we suggest that further studies should be performed in order to develop a protocol for application of therapeutic bandage for stomatognathic system. Clinicaltrials.gov NCT03393533. 12/05/2017 retrospectively registered.
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