Background/Aims
Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT ...victims on the health system. The aim of this study was to conduct an 8‐year prospective analysis of OMFT cases from an emergency service.
Materials and Methods
A hospital‐based 8‐year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio‐economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors alcohol consumption and personal protective equipment (PPE) use, OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed.
Results
Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital‐zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41–60 years with better socio‐economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non‐use of PPE also contributed to increasing the length of hospital stay.
Conclusion
Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non‐use of PPE contributed to increase the length of hospital stay and OMFT severity.
Neoplasms of the salivary glands comprise more than thirty subtypes of lesions with various clinical behaviors. The present study aimed to describe the incidence and main features of salivary gland ...tumors in Brazil.
A retrospective descriptive cross-sectional study was performed (1997–2017). A total of 88,430 biopsy records of oral and maxillofacial lesions from 5 pathology referral centers were analyzed. All cases of salivary gland tumors were reviewed and data such as gender, age, skin color, anatomical location, symptomatology, tumor size and histopathological diagnosis were collected.
Among all lesions, there were 2,292 (2.6%) cases of salivary gland tumors. The most frequent benign and malignant neoplasm was pleomorphic adenoma (n = 1,086; 47.4%) and mucoepidermoid carcinoma (n = 322; 14.0%), respectively. The majority of the patients were white (n = 757; 33%) and female (n = 1,391; 60.7%), and most cases involved the parotid gland (n = 933; 40.7%; p < 0.001). Age ranged from 1 to 101 years, occurring more in the fourth decade of life. Tumor size varied from 0.3 to 15 cm and the presence of symptomatology (pain/swelling) occurred more in patients with malignant tumors (p < 0.001).
The incidence profile and clinical findings of salivary gland tumors were similar to those described worldwide; nevertheless, multicenter studies are valuable to better characterize these neoplasms.
Background
Lower third molar (M3) eruption is unpredictable. The purpose of this study was to correlate radiographic position of M3 on a preexistent film with the current clinical, histopathological, ...and radiographic findings.
Methods
A retrospective cohort study was performed. The sample was collected from a database of patients covered by Medical Fund of Brazilian Army. Radiographs were obtained a minimum of 5 years prior to the presurgical visit and after their clinical exam. The primary outcome variables were the teeth positions using Pell and Gregory/Winter classifications on panoramic X-rays. Those variables were analyzed at both the beginning (T0) and end of the study (T1). Clinical assessments and histopathological study of the thirds that were extracted were performed only at T1. Correlation between the teeth positions were related to the clinical, histopathological, and radiographic parameters using statistical analysis tests with significance set at
p
< 0.05.
Results
Twenty-six patients with 49 M3 were assessed over 10 months. Mean age was 14.92 years at T0 and 21.87 years at T1. The average time between T0 and T1 was 6.77 years. A significant relationship (
p
= 0.024) was found between the presences of root resorption on the second molar if M3 presented in an IB horizontal position at T1. There was also a significant correlation (
p
= 0.039) between dental crowding of the anterior lower teeth with IIIB position at T0 and if the patient finished orthodontic treatment without lingual retainers.
Conclusions
Lower M3 in position IIIB seen in a teenager and IB seen in an adult is more likely to have negative consequences and should be followed closely.
INTRODUCTIONPeripheral nerves transmit nerve signals between periphery and the spinal cord or brain stem. Its function can be compromised by trauma to the nerve, such as those that occur in surgical ...procedures such as orthognathic surgery. Depending on the type of injury, treatment may be proposed, but this is still a controversial point in literature. Alternative methods that assist in the treatment of paresthesia should be studied, and in this context, selegiline hydrochloride seems to be a promising drug.
AIMBased on the above, the aim of this study was to evaluate the effectiveness of selegiline hydrochloride in the treatment of facial sensory changes resulting from nerve injuries in patients undergoing maxillary orthognathic surgery.
METHODSThis was a double-blind randomized clinical trial with the voluntary participation of individuals who underwent orthognathic surgery. The facial sensitivity of these patients was evaluated by 2-point discrimination tests and directional perception in the region related to the lower alveolar nerve. Tests were comparatively applied at times T0 (before surgery), T8 (8 days after surgery), T15 (15 days after surgery), T30 (30 days after surgery), T60 (60 days after surgery), and T90 (90 days after surgery).
RESULTSThe mean age of patients was 31.14 years. With the comparative analysis of the 2-point static test on the chin, difference was observed between groups at times T15 (P = 0.007), T30 (P = 0.010), and T90 (P = 0.027) in the intergroup evaluation. Regarding results of the comparative analysis of the 2-point static test on the lip, difference was observed between groups at times T30 (P = 0.023), T60 (P < 0.001), and T90 (P = 0.005) in the intergroup evaluation. In the direction test on the chin, difference was observed between groups at times T30 (P = 0.015), T60 (P = 0.001), and T90 (P < 0.001) in the intergroup evaluation.
CONCLUSIONSSelegiline hydrochloride has shown promising results in the treatment of neurosensory disorders resulting from maxillary orthognathic surgery.
Vascular malformations are structural anomalies in the blood vessels. They are present at birth and persist throughout life. These malformations can be classified according to the type of vessel ...involved. A port-wine stain is a vascular malformation characterized by an increased number of ectatic vessels in the dermal vascular plexus, which can be found in any part of the body, including the head and neck region. Over time, most of these stains result in soft tissue hypertrophy and this growth can cause severe facial deformity.
This study describes a rare case of a giant proliferative vascular anomaly arising from a port-wine stain on the face.
The report highlights the continuous and proliferative growth of the malformation observed after follow-up of 18 years, as well as the difficulty in establishing the diagnosis due to the complexity and dimension of the lesion and the conditions related to the patient's low socioeconomic status.
We have described a rare and unusual case report of a giant proliferative vascular malformation arising from a Port-wine stain on the face.
Abstract Purpose: To compare bone regeneration in critical-sized defects in rat calvarium using demineralized bone matrix and calcium phosphate cement. Methods: Thirty Wistar rats were divided into 3 ...groups of 10 animals each. Two defects of 5-mm were made in the parietal bones of each animal. Group I had calcium phosphate cement placed in the experimental defect, Group II had filled with demineralized bone matrix and Group III had with the combination of the matrix and cement in equal parts. All animals had one defect left unfilled to serve as controls. Five animals in each group were sacrificed at 4 and 8 weeks. Histomorphometric analysis was used to quantify the amount of new bone within the defects. Results: The results showed that demineralized bone matrix-treated defects had significantly more new bone at 4 weeks compared to calcium phosphate cement-treated defects (p=0.03) and also had significantly more new bone at 8 weeks compared to unfilled defects (p=0.04). Conclusions: The demineralized bone matrix was superior to calcium phosphate cement in bone regeneration. It seems that calcium phosphate cement acted by inhibiting the osteogenesis when associated with a demineralized bone matrix and this combination should not be recommended.
Odontogenic tumors (OTs) are considered important among oral lesions because of their clinicopathological heterogeneity, and variable biological behavior. This paper aims to determine the frequency ...and distribution of OTs, over a period of 10 years, at a public university in Northeastern Brazil and compare this data with previous reports.
We reviewed all cases of OTs from oral pathology laboratory of University of Pernambuco (UPE), from 2004 to 2014. Diagnoses were re-evaluated and the tumors were classified according to the latest (2005) World Health Organization Classification of Tumors. In addition, we searched in the English-language literature retrospective studies on OTs that used the same classification.
Within the total of 6028 oral biopsies, 289 (4.79%) were OTs. Of these, 287 (99.3%) were benign and 2 (0.7%) were malignant. The overall incidence was 31.1/million. Mandible-maxilla ratio was 2.5:1 and mean age 35 years. Keratocystic odontogenic tumor (KCOT) (34.6%) was the most frequent lesion, followed by ameloblastoma (AMB) (32.9%) and odontoma (ODO) (11.4%).
OTs are uncommon neoplasms with geographic variation. Our clinicopathological features are according to literature. In the present study, KCOT was the most frequent one, showing that the new classification of OTs altered the distribution of these lesions and possibly made KCOT the most common OT observed in diagnostic services worldwide.
ABSTRACT Objective: To compare the agreement of clinical and radiographic diagnosis with the histopathological diagnosis in fibro-osseous lesions of the jaws. Material and Methods: An analytical and ...exploratory study was made based on systematic collected data, carried out in the laboratory of surgical pathology of a public Dental School. There were evaluated cases of fibrous dysplasia (FD), cemento-osseous dysplasia (COD) and ossifyng fibroma (OF), diagnosed by clinical, radiographic (panoramic and periapical radiography), and histopathological analysis, in a period of 12 years (from March 2001 to June 2013). Descriptive and inferential statistics (Fisher's exact test) were obtained. Results: Ninety-six cases of FOLs were evaluated. The radiographic aspects of the FOLs studied did not differ significantly (p=0.09). Radiolucent lesions were the least frequent, corresponding to approximately 13.5% of radiographic findings. Mixed lesions and radiopaques were more present, how they were COD and FD, respectively. The more aggressive variation of OF (Juvenile Ossifying Fibroma - JOF) was less frequent among the pathologies evaluated. In approximately 61.46% of the cases clinical and radiographic diagnosis were confirmed by histopathological diagnosis of FOLs. The highest agreement and the highest disagreement were observed in COD cases (40.7% and 62.2%, respectively). Conclusion: FOLs of the maxillaries represent a group of lesions in which the establishment of the clinical and radiographic diagnosis supported by the histopathological confirmation is critical and challenging.
MCs (MCs) have been ascribed to mediating several diseases, including malignant neoplasms. These cells can play a role in angiogenesis, tissue remodeling and immune modulation and favor neoplasm ...progression. Despite the studies analyzing the contribution of MCs in odontogenic lesions, its biological behavior in ameloblastomas (AMBs) and odontogenic keratocysts (OKCs) remains unclear. This study aims to detect MCs in OKCs and AMBs and clarify the role of MCs in these lesions.
A total of 40 odontogenic lesions were analyzed. This included 20 OKCs and 20 AMBs, 10 being the solid type and the other 10 being the unicystic type of AMB. All cases were histologically reviewed in hematoxylin-eosin. Clinical data, such as age, gender, location, size, radiographic presentation and, histologic patterns were collected from the clinical charts. The Mann-Whitney U test (MWU) was used verify the hypothesis, through inferential statistics. The level of significance used in the statistical test was 0.5%.
MCs were observed in 60% of OKCs, and 35% of AMBs. The ratio of MCs observed in OKCs was 0.37, 0.48 in solid AMBs and 0.01 in unicystic AMBs. There was no significant difference between number of MCs in AMBs and OKCs, however, a significant difference was observed between solid and unicystic AMBs (
≤ 0.01).
MCs may play an important role in the biological behavior of AMBs and OKCs. However, in this study it was not possible to confirm the contribution of MCs in the biological behavior of these lesions and more studies are needed to clarify this relation.
AMB, OKC, MCs, histochemistry, toluidine blue.
Purpose The aim of the present study was to assess histologic changes in the temporomandibular joint (TMJ) of adult rats subjected to unilateral fracture of the mandibular condyle and soft tissue ...injury. Materials and Methods The animals were divided into 2 groups: one had surgical treatment for soft tissue repair and the other had no soft tissue treatment. All histologic evaluations were performed according to the presence or absence of synovitis, vascularity, presence or absence of joint inflammation, and presence or absence of the articular disc. The contralateral TMJs also were evaluated. Results The results showed few histologic changes in the synovial membrane and joint disc for the 2 groups and in the synovial membrane and disc of the contralateral side, where indirect trauma occurred in the unoperated joint. Conclusion This study showed that treating or not treating soft tissues does not change the treatment results of condyle fracture or interfere with TMJ pathosis.
PDF
