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Objective: This study aims to identify fracture patterns on the lingual aspect of the mandible following Bilateral Sagittal Osteotomy of the Mandibular Ramus and correlate these patterns with mandibular anatomical characteristics in patients with cleft lip and palate., Methods: Two hundred cone beam CT scans were analyzed, with 100 scans in the preoperative period to assess mandibular anatomy and 100 in the postoperative period to evaluate the course of fractures on the lingual surface after surgery., Results: Statistical analysis revealed no correlation between the depth of the mandibular fossa and the type of fracture after bilateral sagittal osteotomy. Similarly, there was no association between the height and angle of the mandibular body and the type of fracture. The most common fracture type observed was the type 3 pattern, characterized by a line running through the mandibular canal. Furthermore, no relationship was identified between the studied anatomical aspects and the occurrence of undesired fractures., Conclusions: The anatomical data presented in this study can assist surgeons in selecting the safest surgical techniques and optimal osteotomy sites, particularly in patients with cleft lip and palate., Competing Interests: Conflicts of interest/Competing interests: The authors declare no conflict of interest

Background: Mandibular Sagittal Split Osteotomy (MSSO) is a popular technique in orthognathic surgery used both to advance and to retreat the mandible. However, MSSO may incur in important complications, such as bad splits and sensorineural injuries. Knowing the location of the fusion between the buccal and lingual cortical (FBLC) in the mandibular ramus and the bone thickness in the region where osteotomies will be performed is determinant in MSSO planning to avoid complications. The aim of this study was to document and evaluate possible differences between sexes regarding the location of the FBLC in relation to the superior cortical of mandibular foramen (MF) and bone thickness in the region of interest for MSSO in a Brazilian population., Material and Methods: Eighty five cone-beam Computed Tomography (CBCT) scans were used to perform linear measurements to determine the location of the FBLC. Bone thickness from the mandibular canal (MC) to the cortical external surfaces and the diameter of the MC were measured at three different points: mandibular ramus (A), mandibular angle (B) and mesial of the second molar (C)., Results: The FBLC was located at a mean distance of 8.3 mm from the superior cortical of the MF in males and 8.1 mm in females. There was no difference between males and females regarding the mean bone thickness from the MC to the buccal external surface at all the points investigated (p>0.05). Bone thickness from the lingual external surface to the MC was bigger among females than males in regions B and C (p < 0.05). The diameter of the MC was bigger among males in regions B and C., Conclusion: Sexual dimorphism regarding mandibular bone thickness but not regarding the location of FBLC was present. This fundamental knowledge may assist to the panning of MSSO.

Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient., (© 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Objective: To evaluate the evolution of facial edema in the postoperative period after alveolar graft surgeries performed with collagen membrane soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) in individuals with cleft lip and palate., Design: Longitudinal prospective., Setting: Tertiary craniofacial center., Participants: One hundred fifty individuals submitted to alveolar graft., Interventions: In the preoperative consultation and 4 days after surgery, the individuals were assessed as to age, professional performing the surgery, duration of the procedure, type of cleft, measurement of facial edema, mouth opening, and global evaluation of the postoperative period., Main Outcome Measures: Statistical analysis was performed to compare the facial edema and different variables, at a significance level of .05., Results: The maximum facial edema occurred between 3 and 4 days postoperatively, was inversely proportional to age and mouth opening, greater for female patients compared with male patients, for incomplete unilateral cleft lip and palate compared with other types of clefts, and for surgeon 1 compared with the other surgeons at some moment postoperatively. The surgeries were longer for complete unilateral and bilateral clefts. The difference was statistically significant for these variables., Conclusions: The facial edema was influenced by the rhBMP-2 used in alveolar graft, and trismus was proportional to the intensity of facial edema.