Search

A reabilita??o dent?ria segura, duradoura e est?tica p?s-exodontia ? um desafio para a Odontologia. A implantodontia foi um grande avan?o nesse campo, por?m manter ou recriar o volume ?sseo adequado e a arquitetura alveolar que suportar? implante e tecidos moles segue sendo um desafio. Os enxertos ?sseos, aut?geno, al?geno, xen?geno ou sint?tico, possuem limita??es como morbidade adicional, custo elevado, risco de transmiss?o de doen?as ou barreiras ?ticas/religiosas. A dentina aut?gena proveniente de dentes condenados ou extra?dos por outras indica??es possui atributos f?sicos, qu?micos e biol?gicos de um excelente enxerto ?sseo; por?m ?, rotineiramente, descartada ap?s a exodontia. O presente trabalho teve por objetivo avaliar o efeito do uso de matriz de dentina associada a c?lulas-tronco mesenquimais (MSC) no reparo alveolar p?s-exodontia. Sessenta ratos Wistar tiveram seus primeiros e segundos molares superiores direitos extra?dos, subsequente confec??o de um defeito ?sseo, e foram alocados em seis grupos, de acordo com o tratamento de enxerto dispensado: (1) Gelita-Spon?, (2) Bio-Oss?, (3) Dentina, (4) MSC, (5) Dentina/MSC, (6) Controle. Aos 35 dias de p?s-operat?rio, os animais foram eutanasiados, e as maxilas dissecadas para posterior an?lise histomorfom?trica em hematoxilina e eosina (H&E), imunoistoqu?mica (col?geno tipo I, osteopontina, VEGF e osteocalcina), bem como por microtomografia computadorizada (micro-CT) e microscopia eletr?nica de varredura (MEV). O soro dos animais foi submetido ? an?lise de concentra??es de c?lcio e f?sforo. O grupo Bio-Oss exibiu significativamente menos osso que os grupos Gelita-Spon and Dentina/MSC; n?o sendo verificadas outras diferen?as significativas na an?lise em H&E. O grupo Bio-Oss teve express?o de col?geno tipo I significativamente maior que os grupos Dentina e Dentina/MSC, bem como maior express?o de osteocalcina que o grupo Dentina/MSC. Embora sem signific?ncia estat?stica, foi observada tend?ncia a maior express?o de osteopontina nos grupos MSC, Dentina e Dentina/MSC e de maior VEGF no grupo MSC. ? micro-CT, os grupos Bio-Oss e Dentina/MSC exibiram maior volume ?sseo que o Controle. Os n?veis s?ricos de c?lcio e f?sforo n?o diferiram significativamente entre os grupos. A MEV evidenciou part?culas de dentina e Bio-Oss nos respectivos grupos, bem como importante celularidade no grupo MSC. Conclus?o: A dentina aut?gena n?o desmineralizada constitui alternativa de enxerto ?sseo alveolar, que pode ter seu desempenho melhorado pela combina??o com MSC. In terms of safety, durability and esthetics, dental rehabilitation after tooth extraction is a challenge in Dentistry. Implants represent a great advance in this field, nevertheless, to maintain or retrieve adequate bone volume and alveolar structure to support the implant and soft tissues is still a challenge. Bone grafts, autogenous, allogeneic, xenogeneic, or alloplastic materials have limitations such as additional morbidity, high financial cost, risk of disease transmission and ethical/religious barriers. Autogenous dentin from extracted teeth has physical, chemical, and biological properties of an excelent bone graft; however, it is routinely discarded. The present work aimed to evaluate the effect of dentin matrix alone or combined with mesenchymal stem cells (MSC) on post-extraction alveolar bone repair. Sixty Wistar rats were subjected to extraction of first and second right upper molars with subsequent osteotomy and allocated into groups according to the graft inserted: (1) Gelita-Spon?; (2) Bio-Oss?; (3) Dentin; (4) MSC; (5) Dentin/MSC; (6) Control. At 35 days of postoperative period, the animals were euthanized, and maxillae dissected to be analyzed by means of hematoxylin and eosin (H&E) staining, immunohistochemical (IHC) analysis (collagen type I, osteopontin, VEGF and osteocalcin), micro-computed tomography (micro-CT) and scanning electron microscopy (SEM). Serum levels of calcium and phosphorus were quantified. The Bio-Oss group showed significantly less bone than Gelita-Spon and Dentin/MSC; no other significant differences were seen in H&E analysis. The Bio-Oss group showed significantly higher expression of collagen type I compared to the Dentin and Dentin/MSC groups and also higher osteocalcin expression than the Dentin/MSC group. Although not statistically significant, there was a tendency of higher expression of osteopontin in the MSC, Dentin and Dentin/MSC groups and higher VEGF in the MSC group. On micro-CT analysis, the Bio-Oss and the Dentin/MSC groups exhibited greater bone volume than the Control. Serum calcium and phosphorus levels did not significantly differ between the groups. SEM analysis depicted particles of Bio-Oss and dentin in the respective groups, as well as significant cellularity in the MSC group. Conclusion: Autogenous non-demineralized dentin is an alternative for alveolar bone grafting, which can be improved by combination with MSC. Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

The study aimed to evaluate the survival and failure rate, in the short- and medium-term, in addition to its relationship with risk factors, in implants placed by postgraduate students of the Master of Medicine, Surgery, and Oral Implantology course from the University of Barcelona. The study was designed including 192 patients with 422 implants placed between 2015 and 2018. Variables of implant failure were evaluated and related. Failure was split into early failure and late failure. Qualitative data were compared using the chi-squared test, taking p ≤ 0.05 as a significant value. The comparison of quantitative variables was carried out using the Student’s t-test for independent samples. The survival rate in a period of 6 months to 3 years was 97.87%. The mean age of the patients was (54.5 ± 13), and the largest number of implants were placed in the 51–60 age range. The failure rate was 2.13% (N = 9), 6 failed early and 3 failed after definitive prosthetic loading, with a p value < 0.0001. When comparing the failures according to their location in the anterior/posterior sector of the arch, the anterior sector showed statistically significant results (p = 0.027). Failed implants had a statistically significant relationship when they were placed in the anterior sector and were performed in the early stage.

Autogenous dental transplantation is characterized by the translocation of an element to another alveolar space. It is a procedure considered as a rehabilitation treatment, with a good prognosis mainly for young patients. Presenting as a great advantage the lower cost compared to the rehabilitation with implants and fixed prostheses, in addition to great acceptance by the patient for being his own tooth, without involving “nonself” materials. The objective of this work is to expose a case report on dental transplantation related to supernumerary teeth in the anterior region of the maxilla. In which it was carried out based on concepts of ethical principles and after signing the Informed Consent Form (ICF) by the person in charge. Melanoderma patient, 14 years old, presenting a supernumerary element in the region of element 11. After imaging studies, it was possible to notice the presence of element 11 impacted by palatine. The removal of the supernumerary and element 11 was performed, which was transplanted to its ideal alveolus, being maintained in position with the aid of semi-rigid containment. On the 35th postoperative day, the patient showed excellent recovery and healing of the periodontal tissues. Splinting was removed, with good stability of the unit, without mobility, absence of phlogistic signs or pulp changes to the vitality test. Radiographic examination showed good root adaptation, with no signs of resorption. However, the literature states that this follow-up must be carried out for up to 1 year, aiming to analyze pulp revascularization and the subsequent need for endodontics. To date, after 2 months of follow-up, the patient has no signs of pulp necrosis and is scheduled to start orthodontic treatment. Thus, it can be said that this is a valid and accessible rehabilitation treatment, and when properly indicated it brings good results. El trasplante dentario autógeno se caracteriza por la translocación de un elemento a otro espacio alveolar. Es un procedimiento considerado como tratamiento rehabilitador, con buen pronóstico principalmente para pacientes jóvenes. Presentando como una gran ventaja el menor costo frente a la rehabilitación con implantes y prótesis fijas, además de una gran aceptación por parte del paciente por ser su propio diente, sin involucrar materiales “no propios”. El objetivo de este trabajo es exponer un caso clínico de trasplante dental relacionado con dientes supernumerarios en la región anterior del maxilar. En el cual se llevó a cabo en base a conceptos de principios éticos y previa firma del Formulario de Consentimiento Informado (CIF) por parte del responsable. Paciente con melanoderma, 14 años, que presenta un elemento supernumerario en la región del elemento 11. Tras los estudios de imagen, se pudo notar la presencia del elemento 11 impactado por palatino. Se realizó la remoción del elemento supernumerario y 11, el cual fue trasplantado a su alvéolo ideal, manteniéndose en posición con la ayuda de contención semirrígida. En el día 35 del postoperatorio, la paciente mostró una excelente recuperación y cicatrización de los tejidos periodontales. Se retiró ferulización, con buena estabilidad de la unidad, sin movilidad, ausencia de signos flogísticos o alteraciones pulpares a la prueba de vitalidad. El examen radiográfico mostró una buena adaptación radicular, sin signos de reabsorción. Sin embargo, la literatura indica que este seguimiento debe realizarse hasta por 1 año, con el objetivo de analizar la revascularización pulpar y la posterior necesidad de endodoncia. Hasta la fecha, después de 2 meses de seguimiento, el paciente no presenta signos de necrosis pulpar y está programado para iniciar tratamiento de ortodoncia. Así, se puede decir que se trata de un tratamiento rehabilitador válido y accesible, y cuando está debidamente indicado da buenos resultados. O transplante dentário autógeno dentário é caracterizado pela translocação de um elemento para outro espaço alveolar. É um procedimento considerado como um tratamento reabilitador, com bom prognóstico principalmente para pacientes jovens. Apresentando como grande vantagem o menor custo se comparada com a reabilitação com implantes e próteses fixas, além de grande aceitação pelo paciente por ser um dente próprio, sem envolver materiais “nonself”. O objetivo deste trabalho é expor um relato de caso sobre transplante dentário relacionado com dentes supranumerários em região anterior de maxila. Em que foi realizada a partir de conceitos dos princípios éticos e após assinatura do Termo de Consentimento Livre e Esclarecido (TCLE) pelo responsável. Paciente melanoderma, 14 anos, apresentando elemento supranumerário na região do elemento 11. Após exames imaginológicos pôde-se notar a presença do elemento 11 impactado por palatino. Foi realizada a remoção do supranumerário e do elemento 11, sendo este transplantado para o seu alveolo ideal, sendo mantido em posição com auxílio de contenção semirrígida. No 35º dia pós operatório, o paciente apresentou uma excelente recuperação e cicatrização dos tecidos periodontais. Foi retirada a esplintagem verificando-se boa estabilidade da unidade, sem mobilidade, ausência de sinais flogísticos ou alterações pulpares ao teste de vitalidade. Ao exame radiográfico percebeu-se boa adaptação da raiz, sem sinais de reabsorção. Entretanto, a literatura afirma que este acompanhamento deve ser feito por até 1 ano, objetivando analisar revascularização pulpar e necessidade posterior de endodontia. Até o presente momento, após 2 meses de follow up, o paciente não apresenta sinais de necrose pulpar e está em programação de iniciar o tratamento ortodôntico. Assim, pode-se afirmar que este é um tratamento reabilitador válido e acessível, e quando bem indicado traz bons resultados.

Robots are a technological innovation adapted to use in surgical procedures of the most varied areas, assisting health professionals in fulfilling their role. When associated with dentistry, they have applicability in several areas such as oncology and implantology. The objective of this work was to carry out an integrative review of the current literature on robotic surgical procedures in dentistry, highlighting its techniques, indications, advantages and disadvantages. A research of articles had been done on the electronic databases CAPES, PubMed and MEDLINE, using the descriptors: robotic surgical procedures, dentistry, oral surgery, indexed in the period from 2015 to 2020 that dealt with case reports, literature reviews, in vivo studies that report the use of robots in dental surgical procedures, feasibility studies and clinical trials. After the eligibility criteria, 18 articles published in English were analyzed. Studies have shown that the use of robots in dental surgery brings more precision to the procedure, decreasing tissue loss, reducing the possibility of hemorrhage, reducing possible residual scarring, and post-surgical. Robotic surgery in several areas of dentistry has already demonstrated high reliability, allowing from better precision to greater assertiveness, in addition to providing less invasive surgical access with damage tissue adjacent to the relatively smaller area of operation, optimizing the surgical procedure. Los robots son una innovación tecnológica adaptada para la utilización en procedimientos quirúrgicos de los más variados ámbitos, asistiendo al profesional de la salud en el cumplimiento de su papel. Asociándose a la odontología, se encuentran aplicabilidades en diversas áreas como la oncología e implantología dental. El objetivo de este trabajo fue realizar una revisión integrativa de la literatura actual sobre procedimientos quirúrgicos robotizados en la odontología, destacando sus técnicas, indicaciones, ventajas y desventajas. Fue hecha una investigación de los artículos en las bases de datos electrónicas CAPES, PubMed y MEDLINE, utilizando los descriptores: ''Robotic Surgical'' ''Procedures'', ''Dentistry'', ''Oral Surgery'', indexados en el periodo de 2015 a 2020, que trataban de reporte de caso, revisiones de la literatura, estudios in vivo que relatan la utilización de robots en procedimientos quirúrgicos, odontológicos, estudios de viabilidad y ensayos clínicos. Posteriormente a los criterios de elegibilidad, fueron analizados 18 artículos integralmente publicados en lengua inglesa. Los estudios mostraron que la utilización de robots en la cirugía odontológica trae más precisión al procedimiento, disminuyendo la pérdida de tejido, reduciendo la posibilidad de hemorragia, reduciendo posibles resquicios de cicatrices, y post cirugía. La cirugía robótica en diversos ámbitos de la odontología ya demostró alta confiabilidad permitiendo desde mejor precisión hasta mayor asertividad, además de proporcionar un acceso cirúrgico menos invasivo con daño tisular adyacente al área de actuación relativamente menor, optimizando el procedimiento quirúrgico. Os robôs são uma inovação tecnológica adaptada para utilização em procedimentos cirúrgicos dos mais variados âmbitos, auxiliando o profissional de saúde no cumprimento de seu papel. Quando associados à odontologia, tem-se aplicabilidade em diversas áreas como a oncologia e implantodontia. O objetivo deste trabalho foi realizar uma revisão integrativa da literatura atual sobre procedimentos cirúrgicos robotizados na odontologia, destacando suas técnicas, indicações, vantagens e desvantagens. Foi feita uma pesquisa dos artigos nas bases de dados eletrônicas CAPES, PubMed e MEDLINE, utilizando os descritores: “Robotic Surgical” “Procedures”, “Dentistry”, “Oral Surgery”, indexados no período de 2015 a 2020, que tratavam de relatos de caso, revisões de literatura, estudos in vivo que relatam a utilização de robôs em procedimentos cirúrgicos odontológicos, estudos de viabilidade e ensaios clínicos. Após os critérios de elegibilidade, foram analisados 18 artigos integralmente publicados em língua inglesa. Os estudos mostraram que a utilização de robôs na cirurgia odontológica traz mais precisão ao procedimento, diminuindo a perda de tecido, reduzindo a possibilidade de hemorragia, reduzindo possíveis cicatrizes resquiciais, e pós-cirúrgico. A cirurgia robótica em diversos âmbitos da odontologia já demonstrou alta confiabilidade permitindo desde melhor precisão até maior assertividade, além de proporcionar um acesso cirúrgico menos invasivo com dano tecidual adjacente à área de atuação relativamente menor, otimizando o procedimento cirúrgico.

Biosafety measures intensified after the beginning of the COVID-19 pandemic, which is a disease that can develop a clinical picture ranging from asymptomatic infections to severe respiratory conditions. Thus, dental surgeons, as well as other health professionals, had to adapt to stricter criteria for dressing. The objective of this study is to present the main recommendations regarding biosafety in dental surgical procedures in the face of the pandemic. This work is a systematic review of the literature, carried out through articles published in English, Spanish and Portuguese, between 2010 and 2020, published in the PUBMED, BVS, RESEARCH GATE, SCIELO databases, with the following descriptors: oral surgery, biosafety, COVID-19. It was found that the specialty of Buccomaxillofacial Surgery and Traumatology is the most exposed to the risks of infections by bioaerosols, and due to this, the use of surgical masks is necessary, PFF2 / N-95, faceshields, goggles and disposable cloak, as well as the adoption of strict protocols for hygiene, disinfection, sterilization, and organization of the surgical environment, whereas Teledentistry proved to be a viable auxiliary instrument in this period in order to reduce the risks to exposure by SARS-CoV-2. The professional who works in urgent and emergency surgical care must follow the biosafety measures issued by the health surveillance agencies in order to ensure that the worker's health is guaranteed, as well as that of the patient. Las medidas de bioseguridad se intensificaron tras el inicio de la pandemia COVID-19, que es una enfermedad que puede desarrollar un cuadro clínico que va desde infecciones asintomáticas hasta afecciones respiratorias graves. Así, los cirujanos dentistas, así como otros profesionales de la salud, tuvieron que adaptarse a criterios más estrictos de vestimenta. El objetivo de este estudio es presentar las principales recomendaciones en materia de bioseguridad en los procedimientos quirúrgicos dentales ante la pandemia. Este trabajo es una revisión sistemática de la literatura, realizada a través de artículos publicados en inglés, español y portugués, entre 2010 y 2020, publicados en la base de datos PUBMED, BVS, RESEARCH GATE, SCIELO, con los siguientes descriptores: cirugía oral, bioseguridad, COVID-19. Se encontró que la especialidad de Cirugía y Traumatología Buccomaxilofacial es la más expuesta a los riesgos de infecciones por bioaerosoles, por lo que es necesario el uso de mascarillas quirúrgicas. PFF2 / N-95, protectores faciales, goggles y manto desechable, así como la adopción de estrictos protocolos de higiene, desinfección, esterilización y organización del ambiente quirúrgico, mientras que la Teleodontología demostró ser un instrumento auxiliar viable en este período. para reducir los riesgos de exposición al SARS-CoV-2. El profesional que trabaja en la atención quirúrgica de urgencia y emergencia debe seguir las medidas de bioseguridad emitidas por los organismos de vigilancia de la salud a fin de asegurar que la salud del trabajador, así como la del paciente, esté garantizada. As medidas de biossegurança se intensificaram após o início da pandemia do COVID-19, que é uma doença que pode desenvolver um quadro clínico que varia de infecções assintomáticas a quadros respiratórios graves. Deste modo, cirurgiões-dentistas, assim como outros profissionais da saúde, tiveram que se adequar a critérios mais rigorosos de paramentação. O objetivo desse estudo é apresentar as principais recomendações no que tange a biossegurança nos procedimentos cirúrgicos odontológicos frente a pandemia. Este trabalho é uma revisão sistematizada da literatura, realizada através de artigos publicados na língua inglesa, espanhola e portuguesa, entre 2010 e 2020, publicados na base de dados PUBMED, BVS, RESEARCH GATE, SCIELO, tendo por descritores: odontologia, cirurgia oral, biossegurança, covid-19. Constatou-se que a especialidade de Cirurgia e Traumatologia Bucomaxilofacial é a mais exposta aos riscos de infeções por bioaerossóis, e devido a isto, é necessário o uso de máscaras cirúrgicas. PFF2/N-95, protetores faciais, óculos de proteção e capote descartável, assim como a adoção de protocolos rígidos de higienização, desinfecção, esterilização, e organização do ambiente cirúrgico, ao passo que a Teleodontologia se mostrou como um instrumento auxiliar viável neste período a fim de reduzir os riscos à exposição pelo SARS-CoV-2. O profissional que atua nos atendimentos cirúrgicos de urgência e emergência devem seguir as medidas de biossegurança emitidas pelos órgãos de vigilância em saúde a fim de que a saúde do trabalhador seja assegurada, igualmente a do paciente.

Statement of problem The implant abutment connection interface has been considered one of the major factors affecting the outcome of implant therapy. However, drawbacks of traditional meta-analyses are the inability to compare more than 2 treatments at a time, which complicates the decision-making process for dental clinicians, and the lack of a network meta-analysis. Purpose The purpose of this network meta-analysis was to assess whether the implant abutment connection influences the outcome of implant-supported prostheses. Material and methods An electronic search was undertaken to identify all randomized clinical trials comparing the effect of at least 2 different implant abutment connection designs published from 2009 up to May 2020. Outcome variables were implant survival rate, peri-implant marginal bone loss, and biologic and prosthetic complication rates at 12 months after prosthetic loading. Relevant information was extracted, and quality and risk of bias assessed. Pairwise meta-analyses and network meta-analyses based on a multivariate random-effects meta-regression were performed to assess the comparisons (α=.05 for all analyses). Results For peri-implant marginal bone loss and prosthetic complications, conical interfaces were determined to be the most effective, with significant differences when compared with external hexagonal connections (P=.011 and P=.038, respectively). No significant differences were found among the implant abutment connections in terms of survival and biologic complications (P>.05 in all direct, indirect, and mixed comparisons). Conclusions After 1 year of loading, conical connections showed lower marginal bone loss and fewer prosthetic complications than external hexagonal connections. However, the implant abutment connection design had no influence on the implant survival and biologic complication rates.

A novel computer-assisted surgery (CAS) technique that merges dynamic and static CAS approaches to treat completely edentulous patients with dental implants is described. Radiographic and surgical stents are designed with specific fiducial markers that are recognized by the static and dynamic CAS software program. During the surgical procedure, implants are placed following the static surgical guide and the indications from the dynamic navigation system. This technique combines the advantages of static and dynamic CAS approaches to allow accurate and predictable minimally invasive implant placement.

Submitted by Elisabeth Figueiredo (efigueiredo@viseu.ucp.pt) on 2020-09-28T17:33:30Z No. of bitstreams: 1 RAC Colnaghi Final.pdf: 4764374 bytes, checksum: ebc1c940ad1a116e03adfc8baa03820d (MD5) Approved for entry into archive by Maria Helena Ribeiro (helena.ribeiro@lisboa.ucp.pt) on 2020-10-01T07:54:41Z (GMT) No. of bitstreams: 1 RAC Colnaghi Final.pdf: 4764374 bytes, checksum: ebc1c940ad1a116e03adfc8baa03820d (MD5) Made available in DSpace on 2020-10-01T07:54:42Z (GMT). No. of bitstreams: 1 RAC Colnaghi Final.pdf: 4764374 bytes, checksum: ebc1c940ad1a116e03adfc8baa03820d (MD5) Previous issue date: 2020-08-19

Background. A solitary bone cyst or simple bone cyst is a nonneoplastic osseous lesion, with no epithelial lining, also considered as a pseudocyst. These lesions, with an intact bony wall and fluid-filled, are frequently discovered by chance in radiological studies. The etiopathogenesis has not been studied in depth, and the management remains controversial. Case Presentation. We present a clinical case of a 15-year-old boy who underwent an orthopantomography to assess the development and position of the third molars during a routine postorthodontic check-up. By chance, the X-ray identified an asymptomatic radiolucent image in the left jaw, measuring 12.0 mm×17.8 mm and compatible with a solitary bone cyst involving teeth 35 and 36. We describe our technique for performing minimally invasive decompression of the lesion using a microperforated catheter. We describe the entire course of the follow-up, both clinical and radiological, until complete cure. Conclusions. This straightforward continuous decompression technique poses no problems for the patient, has a low risk of sequelae, and is clearly cost-effective. In view of the highly satisfactory evolution, whenever possible, we favor this minimally invasive technique for the treatment of solitary bone cysts in the jaw.

Gingival recession occurs due to the migration of the gingiva in the apical direction, leading to compromising local aesthetics and root hypersensitivity. Connective tissue graft is the gold standard treatment in these cases improving both functional and aesthetics aspects.The purpose of this case is to report root coverage using the free connective tissue graftingtechnique (CTG) associated with topical application of active oxygen oral gel and mouthwash (blue®m). A 27-year-old female sought care with the main complaint of root hypersensitivity and the presence of gingival recession in the anterior region of the mandible. Clinical examination revealed the presence of type 1 gingival recession in the left mandibular central incisor. The treatment of choice was a modified graft (free connective graft). The graft and recipient bed received applications of blue®m oral gel. The patient was instructed to use blue®m mouthwash and blue®m oral gel after the surgery for 10 days. At 60 days, the patient showed satisfactory healing in the area of the free CTG, with gain of keratinized tissue and partial covering of the gingival recession. Free CTG with the support of the gel and the mouthwash with active oxygen release makes the technique viable, preventing graft necrosis and achieving root coverage and keratinized tissue. La recesión gingival se produce por la migración de la encía en dirección apical, lo que compromete la estética local y la hipersensibilidad radicular. El injerto de tejido conectivo es el tratamiento estándar de oro en estos casos mejorando tanto los aspectos funcionales como estéticos. El propósito de este caso es reportar la cobertura radicular utilizando la técnica de injerto de tejido conectivo libre (CTG) asociada a la aplicación tópica de gel oral de oxígeno activo y enjuague bucal (blue®m). Una mujer de 27 años solicitó atención con el síntoma principal de hipersensibilidad radicular y presencia de recesión gingival en la región anterior de la mandíbula. El examen clínico reveló la presencia de recesión gingival tipo 1 en el incisivo central mandibular izquierdo. El tratamiento de elección fue un injerto modificado (injerto conectivo libre). El injerto y el lecho receptor recibieron aplicaciones de gel oral blue®m. Se le indicó al paciente que usara enjuague bucal blue®m y gel oral blue®m después de la cirugía durante 10 días. A los 60 días, la paciente presentó cicatrización satisfactoria en la zona de la CTG libre, con ganancia de tejido queratinizado y recubrimiento parcial de la recesión gingival. El CTG libre con el apoyo del gel y el enjuague bucal con liberación activa de oxígeno hace viable la técnica, previniendo la necrosis del injerto y consiguiendo cobertura radicular y tejido queratinizado. A recessão gengival ocorre devido à migração da gengiva no sentido apical, levando ao comprometimento da estética local e à hipersensibilidade radicular. Enxerto de tecido conjuntivo é o tratamento padrão ouro nesses casos, melhorando os aspectos funcionais e estéticos. O objetivo deste caso é relatar a cobertura da raiz usando a técnica de enxerto de tecido conjuntivo (CTG) livre associada à aplicação tópica de gel de oxigênio ativo e enxaguatório bucal (blue®m). Uma mulher de 27 anos procurou atendimento com queixa principal de hipersensibilidade radicular e presença de recessão gengival na região anterior da mandíbula. O exame clínico revelou a presença de recessão gengival tipo 1 no incisivo central inferior esquerdo. O tratamento de escolha foi um enxerto modificado (enxerto conjuntivo livre). O enxerto e o leito receptor receberam aplicações de gel oral blue®m. O paciente foi orientado a usar enxaguatório bucal blue®m e gel oral blue®m após a cirurgia por 10 dias. Aos 60 dias, a paciente apresentava cicatrização satisfatória na área do CTG livre, com ganho de tecido queratinizado e cobertura parcial da recessão gengival. A CTG livre com o suporte do gel e o enxaguatório com liberação ativa de oxigênio tornam a técnica viável, evitando a necrose do enxerto, possibilitando o recobrimento radicular com tecido queratinizado.

Objectives: The understanding and adherence to postoperative care instructions are factors that influence the recuperation process after any surgical procedure. The aim of this study was to determine the percentage of patients who strictly follow the postoperative instructions after the extraction of an impacted lower third molar in relation to sociocultural level, preoperative anxiety scores and how postoperative information is provided to the patient. Study Design: Patients were randomly assigned to one of three different test groups according to how the postoperative instructions were presented: verbal, written and a group that received additional information. Before surgery, patients were required to complete the Corah Dental Anxiety Scale and personal information (age, gender and educational level) was also collected. P 0.05). Quitting smoking or drinking of alcoholic/carbonated beverages were the main influential factors for the lack of adherence to postoperative care instructions during the week after surgery. Conclusions: Presentation of postoperative instructions, preoperative anxiety scores and sociocultural level do not appear to be key factors that promote the adherence to postoperative instructions.

Objetivo: revisar a literatura atualmente disponível sobre as evidências que justificam ou não a extração profilática de terceiros molares assintomáticos não irrompidos. Material e Métodos: as bases eletrônicas PubMed, Capes Periódicos, Web of Science e Scopus foram pesquisadas de novembro a dezembro de 2016 por dois autores, simultaneamente, utilizando como termos de pesquisa: Terceiro Molar / Molar, Terceiro e Extração Profilática / Remoção Profilática OU Extração Profilática . Incluímos artigos de pesquisas originais e ensaios clínicos publicados em inglês e português. Não foram aplicados limites à data de publicação. Artigos de revisão e relatos de casos clínicos foram removidos. Resultados: foram identificados 13 estudos que abordaram, em algum aspecto, a remoção profilática de terceiros molares assintomáticos não irrompidos. Os resultados desta revisão de literatura que aludiram ao potencial para a formação de alterações patológicas em terceiros molares assintomáticos são conflitantes; Enquanto alguns justificam o procedimento profilático baseado na possível formação de lesões associadas, outras evidências científicas não corroboram tal prática. Conclusão: em vista dos pontos de vista conflitantes encontrados na literatura, a remoção profilática de terceiros molares assintomáticos requer avaliação caso a caso de cada paciente, e o processo de tomada de decisão, quanto à retenção versus a remoção profilática desses dentes, deve ser com base em evidências científicas combinadas com a experiência clínica do profissional. Objective: to review the literature currently available on the evidence that does or does not justify the prophylactic extraction of unerupted asymptomatic third molars. Material and Methods: the electronic databases PubMed, Capes Periodicals, Web of Science and Scopus were searched from November to December 2016 by two authors, simultaneously, using as search terms: Terceiro Molar/Molar, Third AND Extração Profilática/Prophylatic Removal OR Prophylatic Extraction. We included articles from original research and clinical trials published in English and Portuguese. No limits were applied to the date of publication. Review articles and clinical case reports were removed. Results: we identified 13 studies that addressed, at some aspect, the prophylactic removal of unerupted asymptomatic third molars. The results of this literature review which alluded to the potential for the formation of pathological alterations in asymptomatic third molars are conflicting; While some justifies the prophylactic procedure based on the possible formation of associated lesions, other scientific evidence does not support such practice. Conclusion: in view of the conflicting viewpoints found in the literature, the prophylactic removal of asymptomatic third molars requires case-by-case evaluation of each patient, and the decision-making process, regarding the retention versus the prophylactic removal of these teeth should be based on scientific evidence combined with the clinical experience of the professional.

Background The objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar. Material and methods A retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master's Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies. Results The sample included 203 patients, 94 males (46.3%) and 109 females (53.7%), with a mean age of 26,8 years and 327 lower third molars. The prevalence of second molar distal caries was 25.4% (95% CI= 20.6% to 30.2%). This pathology was significantly more frequent when the third molar was in a horizontal position (27.7%), when the contact point was at (45,8%) or below (47.0%) the cementoenamel junction (CEJ), and when the distal CEJ of the mandibular second molar and the mesial CEJ of the third molar was 7 to 12 mm apart. Conclusions Horizontal lower third molars with contact points at or below the CEJ are more likely to produce distal caries in the mandibular second molars. Due to the high prevalence of this pathology (20.6% to 30.2%), a prophylactic removal of lower third molars with the above-mentioned features might be advisable. Key words:Second molar, caries, third molar, prophylactic removal.

Objectives: To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona (Spain). Study design: A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables, using the SPSS version 15.0. Results: The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42 years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm, with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%). Conclusions: The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to be slightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment.

Background The aim of this study was to evaluate the clinical and microbiological impact of an antibacterial suture (Monocryl® Plus) in the surgical removal of I3M. Material and Methods A “split-mouth”, prospective pilot clinical study was designed involving 20 patients programmed for the surgical removal of I3M. Each side was randomly sutured with Monocryl® Plus or silk suture and removed for microbiological study 72 hours and 7 days after surgery. Presence of SSI, wound bleeding and the degree of discomfort associated with each type of suture material (scored by means of a visual analog scale) were evaluated. The level of contamination of each material was observed under the scanning electron microscope. Results Wound bleeding upon suture removing was slightly greater after 72 hours and 7 days with black silk suture, though the differences were not statistically significant (p=0.752 and p=0.113, respectively). Patient discomfort was very similar with both types of suture material (p=0.861). Only one case of SSI was recorded with black silk suture after 72 hours. Microbiologically, the antibacterial suture showed a lesser presence of microorganisms (p

Background Coronectomy is the surgical removal of the crown of the tooth deliberately leaving part of its roots. This is done with the hope of eliminating the pathology caused, and since the roots are still intact, the integrity of the inferior alveolar nerve is preserved. Objectives The aim is to carry out a systematic review in order to be able to provide results and conclusions with the greatest scientific evidence possible. Material and Methods A literature review is carried out through the following search engines: Pubmed MEDLINE, Scielo, Cochrane library and EMI. The level of evidence criteria from the Agency for Healthcare Research and Quality was applied, and the clinical trials’ level of quality was analyzed by means of the JADAD criteria. Results The following articles were obtained which represents a total of 17: 1 systematic review, 2 randomized clinical trials and 2 non-randomized clinical trials, 3 cohort studies, 2 retrospective studies, 3 case studies and 4 literature reviews. Conclusions Coronectomy is an adequate preventative technique in protecting the inferior alveolar nerve, which is an alternative to the conventional extraction of third molars, which unlike the former technique, presents a high risk of injury to the inferior alveolar nerve. However, there is a need for new clinical studies, with a greater number of samples and with a longer follow-up period in order to detect potential adverse effects of the retained roots. Key words: Coronectomy, inferior alveolar nerve, nerve injury, wisdom tooth removal, paresthesia, and systematic review.

Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2014-11-07T11:28:11Z No. of bitstreams: 1 RAC Gonçalo Fortuna.pdf: 1593822 bytes, checksum: 19ebbd17c1234114e29bad0728a1bec7 (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2014-11-07T11:29:32Z (GMT) No. of bitstreams: 1 RAC Gonçalo Fortuna.pdf: 1593822 bytes, checksum: 19ebbd17c1234114e29bad0728a1bec7 (MD5) Made available in DSpace on 2014-11-07T11:29:32Z (GMT). No. of bitstreams: 1 RAC Gonçalo Fortuna.pdf: 1593822 bytes, checksum: 19ebbd17c1234114e29bad0728a1bec7 (MD5) Previous issue date: 2014-06

Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-01-16T15:36:29Z No. of bitstreams: 1 Rac.pdf: 915102 bytes, checksum: b1f07f9317a754b5c19d5eb33ba047f3 (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-01-16T15:36:38Z (GMT) No. of bitstreams: 1 Rac.pdf: 915102 bytes, checksum: b1f07f9317a754b5c19d5eb33ba047f3 (MD5) Made available in DSpace on 2015-01-16T15:36:38Z (GMT). No. of bitstreams: 1 Rac.pdf: 915102 bytes, checksum: b1f07f9317a754b5c19d5eb33ba047f3 (MD5) Previous issue date: 2014-09-09

La actividad asistencial de los profesionales de la Odontología tiene como consecuencia una baja disponibilidad de tiempo para dedicarse a la lectura de artículos científicos. Ante la dificultad de mantener un buen nivel de información en el campo de la Implantología Bucofacial, nuestro interés es exponer de forma sintética una revisión de la literatura científica publicada en las revistas más relevantes de la especialidad durante el año 2008. El lector interesado encontrará en este artículo algunos de los diferentes temas que integran esta disciplina, expuestos por apartados (plan de tratamiento, pacientes especiales, diseño y superficies, regeneración ósea, regeneración tisular guiada, carga inmediata, pacientes irradiados, implantes extraorales).

La Cirugía Bucal Mayor Ambulatoria ( CBMA) se define como un modelo organizativo óptimo de asis­tencia quirúrgica multidisci­plinaria que permite tratar a determinados pacientes de una forma segura y efectiva sin necesidad de contar con la cama de hospitalización tradicional. De esta manera se llevan a cabo distintos procedimientos diagnósticos y terapéuticos de mediana complejidad en los que el enfermo regresa a su domici­lio después de un periodo de observación y control. Entre las ventajas de la CBMA debe destacarse el trato personalizado, la des­dramatización de la cirugía, la reincorporación precoz del paciente al trabajo, la disminución de la burocra­cia hospitalaria, la disminu­ción del costo asistencial y la disminución de la lista de espera. El objetivo de este trabajo es demostrar y justificar la viabilidad de un programa de Cirugía Bucal Mayor Ambulatoria realizada por odontólogos o estomatólo­gos con formación reglada en Cirugía Bucal, así como valorar y exponer la activi­dad quirúrgica de las Unida­des de Cirugía Bucal e Implantología del Máster de Cirugía e Implantología Bucal de la Facultad de Odontología de la Universi­dad de Barcelona durante un periodo de tiempo compren­dido entre noviembre de 2001 y julio de 2003. Se pretende estudiar el espectro de las patologías bucales tratadas quirúrgicamente, el número de intervenciones quirúrgicas llevadas a cabo, las técnicas anestésicas realizadas, la duración de los procedimien­tos quirúrgicos efectuados y los datos epidemiológicos referidos a la edad y el sexo de los pacientes.

En los pacientes mayores de 65 años es común la presencia de enfermedades sistémicas graves como la hipertensión arterial, accidentes cerebrovasculares, enfermedades cardíacas, diabetes mellitus y las enfermedades mentales, lo que conlleva que consuman diversos tipos de medicamentos para su tratamiento. Este hecho puede repercutir sobre la salud bucodental de estos pacientes y hay que tenerlas en cuenta a la hora de efectuar cualquier tratamiento odontológico. Se ha realizado un estudio retrospectivo en 196 pacientes mayores de 65 años para constatar qué tipo de tratamiento quirúrgico se practicó en ámbito ambulatorio bajo anestesia locorregional valorando la presencia de patología sistémica, la polimedicación, el estado bucodental, el motivo de consulta y el tipo de anestesia utilizada, con el fin de relacionarlos con la aparición de complicaciones intra o postoperatorias sistémicas y/o locales. El 88,4% de los pacientes presentaba algún tipo de patología sistémica; la hipertensión arterial fue la más frecuente con un 44,9% de los pacientes afectados. El 78,6% acudía para realizar un tratamiento sobre tejidos duros (extracciones dentarias, remodelaciones óseas, etc.) y el 64,8% del total de los tratamientos que se realizaron incluía extracciones de restos radiculares (54,3% de intervenciones del total de las realizadas en tejidos duros), de terceros molares sintomáticos (15,3%) o de otras inclusiones dentarias. Del total de las intervenciones quirúrgicas realizadas únicamente apareció algún tipo de complicación de tipo leve o moderado en un 13,3%, ya fueran de carácter local ( 25 casos) o sistémico (1 caso). No se constató ninguna relación significativa entre la aparición de complicaciones intra o postoperatorias y el tipo de tratamiento realizado o la medicación que tomaban estos pacientes. Sólo en el caso de padecer diabetes mellitus se apreció un aumento significativo de la incidencia de complicaciones locales intra y postoperatorias (p

La Universidad de Barce­lona ante la ausencia del título oficial homologado equivalente, y de acuerdo con las recomendaciones de la Unión Europea (Directivas Ill/D/114/4/82 y lll/D/1374/5/84), desde el curso académico 1989-1990 estableció un pro­grama de especialización en Cirugía Bucal de tres años de duración, tras el cual se obtiene el título de Máster en Cirugía e Implantología Bucal. De acuerdo con la normativa comunitaria ( CEE/lll/13 74/5/84), la Cirugía Bucal es la parte de la Odontología que se ocupa del diagnóstico y tratamiento quirúrgico de las enfermedades, anoma­lías y lesiones de los dien­tes, de la boca, de los maxilares y de los tejidos adyacentes...

La rehabilitación bucal de los pacientes con edentulismo parcial o total con implantes denta­les tiene amplias indicaciones que en ocasiones se ven limitadas por factores anatómicos y biológicos. Una de las localizaciones en la que frecuentemente puede existir una altura insu­ficiente de hueso alveolar, ya sea debido a la reabsorción ósea, a la excesiva neumatización del seno maxilar o a ambas causas, es la zona posterior del maxilar superior, lo que además suele ir acompañado de una baja calidad ósea. Todo esto hace que tanto la técnica quirúrgi­ca convencional u otros procedimientos alternativos, como la elevación del seno maxilar, injertos en onlay, el uso de osteotomos y la osteotomia de Le Fort I, sean procedimientos qui­rúrgicos necesarios en muchas ocasiones para poder solucionar un caso de rehabilitación bucal con implantes. Por otra parte estas técnicas pueden alterar la anatomía y la fisiología del seno maxilar favoreciendo la aparición de complicaciones intra y postquirúrgicas. Una de las posibles complicaciones, aunque rara, es el desplazamiento del implante dentario hacia el seno maxilar durante la segunda fase quirúrgica, como es el caso que describimos en este artículo.

Uno de los procedimientos quirúrgicos más habituales de los cirujanos bucales y maxilofaciales es la extracción de los terceros molares incluidos. Este artículo revisa la literatura referente a las indicaciones, contraindicaciones y riesgos asociados a la cirugía de los cordales. Dentro del apartado de las indicaciones, la que genera mayor controversia es la extracción profiláctica.

Made available in DSpace on 2018-11-12T17:27:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-04-01. Added 1 bitstream(s) on 2018-11-12T17:35:02Z : No. of bitstreams: 1 S1807-25772016000200078.pdf: 1794621 bytes, checksum: b2c637c0c9e406aef95ebd49448728a5 (MD5) ResumoObjetivo O objetivo desse estudo foi de comparar os achados clínicos obtidos no tratamento de recessões gengivais utilizando o enxerto de tecido conjuntivo subepitelial (SECT), a matriz dérmica acelular (ADM) e as proteínas derivadas da matriz do esmalte (EMP).Material e método Doze pacientes que apresentavam recessões gengival classe I e II de Miller nos caninos e pré-molares superiores foram randomicamente alocados para receber o SECT, ADM ou EMP. Análises clínicas foram executadas antes e 3 meses após os procedimentos cirúrgicos. Foram avaliados os seguintes parâmetros: porcentagem de recobrimento radicular, altura e comprimento da recessão gengival, profundidade de bolsa a sondagem, nível clínico de inserção, altura e espessura da gengiva queratinizada. O teste de Kruskal-Wallis complementado pelo teste de Dunn foram usados para avaliar as diferenças entre os grupos em cada período enquanto que o teste de Wilcoxon foi utilizado para avaliar as diferenças dentro de cada grupo variando-se o período de avaliação. Os teste foram aplicados com nível de confiança de 95%.Resultado Os grupos SECT e ADM apresentaram maior porcentagem de recobrimento radicular e maior redução da altura e comprimento das recessões do que o grupo EMP (p

La sedación consciente durante el tratamiento odontológico y, en especial, durante el quirúrgico proporciona una mayor comodidad al paciente y al profesional contribuyendo a una mejor calidad de trabajo. Los fármacos más usados son las benzodiacepinas y entre ellos el midazolam está ganando gran aceptación por su rápido inicio de acción y rápida recuperación del paciente. Se dispone además del Dumazenil, un antagonista que puede revertir rápidamente una sobresedación. Otra alternativa es el uso del propofol al que se le atribuye la ventaja sobre el midazolam de tener una recuperación más rápida. Será necesario una adecuada monitorización durante todo el tratamiento y en el postoperatorio.

Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-12-09T11:42:30Z No. of bitstreams: 1 rac_joao_pedro_cunha.pdf: 969828 bytes, checksum: aa91a74b3f17ac4ee5cb2fcd5ca5cac6 (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-12-09T11:42:44Z (GMT) No. of bitstreams: 1 rac_joao_pedro_cunha.pdf: 969828 bytes, checksum: aa91a74b3f17ac4ee5cb2fcd5ca5cac6 (MD5) Made available in DSpace on 2015-12-09T11:42:44Z (GMT). No. of bitstreams: 1 rac_joao_pedro_cunha.pdf: 969828 bytes, checksum: aa91a74b3f17ac4ee5cb2fcd5ca5cac6 (MD5) Previous issue date: 2015-01-19

Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-12-02T16:49:30Z No. of bitstreams: 1 Relatório de atividade clínica_Stefanie Rei.pdf: 5081597 bytes, checksum: bc8860bfa985a668501bebb752f96235 (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2015-12-02T16:49:44Z (GMT) No. of bitstreams: 1 Relatório de atividade clínica_Stefanie Rei.pdf: 5081597 bytes, checksum: bc8860bfa985a668501bebb752f96235 (MD5) Made available in DSpace on 2015-12-02T16:49:45Z (GMT). No. of bitstreams: 1 Relatório de atividade clínica_Stefanie Rei.pdf: 5081597 bytes, checksum: bc8860bfa985a668501bebb752f96235 (MD5) Previous issue date: 2015-06-11