Search

Objectives: This paper aims to provide a bibliometric analysis on publication trends and a list of the top 100 most cited articles on platelet concentrates over the past 20 years. Methods: A bibliographic search was performed on Microsoft Academic using the following strategy “(plateletrich)”. The number of citations related to specific use, favorable outcomes, and disciplines were analyzed using Microsoft Excel and XLSTAT. A second table with the number of citations, the altmetric attention score (AAS) and the year of publication was created. A ranking was sorted according to the number of citations with the 100 most frequently cited articles and variables being discussed. A graphical visualization of keywords was created with VOSviewer. Statistical analyzes have taken into account a 95% confidence interval. Results: A helpful list of the top 100 articles has been developed to help professionals in a wide variety of ways. Platelet concentrates trends are valuable for researchers to visualize what interests’ readers and editors more. Surgical use of platelet concentrates and some results are in the uptrend of publications (p < .05). Conclusions: Bibliometrics and altmetrics are valuable tools to be updated in any healthcare profession. Both tools save those interested in the topic a lot of effort and time. Having a suitable keyword is critical to article dissemination.

To assess the analgesia and side effects of 10 mg oxycodone as compared to 30 mg of codeine phosphate associated with 500 mg of paracetamol after bilateral lower third molar extraction.This is a prospective, randomized, double-blind study applied to a sample of 16 patients. They were evaluated for seven days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Wilcoxon distribution. The side effects of these medications were assessed by the Q Cochran test. AThe mean score of the VAS of pain was higher in the oxycodone side, where few patients reported the use of rescue analgesic. There was no report of rescue medication in codeine phosphate associated with paracetamol side. The most common side effects reported in both groups, predominantly in patients using the oxycodone, were drowsiness, dizziness, and headache.The use of codeine phosphate associated with paracetamol after the extraction of impacted mandibular third molars is a better choice than oxycodone for controlling postoperative pain.RBR-8ntwmyq 07/07/2021.

The odontogenic keratocyst (OKC) is a potentially aggressive odontogenic lesion and there is an ongoing debate regarding its biological behavior and classification. The present systematic review aims to assess the expression of the p53 protein in the odontogenic keratocyst in comparison to the dentigerous cyst and ameloblastoma. We searched MEDLINE, Web of Science and Scopus for immunohistochemical studies reporting OKC's, dentigerous cysts and solid/multicystic ameloblastomas. The Risk Difference between the lesions expressing the p53 was the effect measure and a P value

Sports etiology is one of the most common causes of maxillofacial injuries. This work aimed to provide an up-to-date review of sports-related maxillofacial injuries.An updated review was conducted on Pubmed and Google Scholar. No publication year and language restrictions were applied. Two different search strategies were performed, the first addressed which sports, generally associated with maxillofacial injuries, and the second search was conducted to determine the frequency of maxillofacial injuries associated with each sport individually.The first search returned 26 articles distributed across different sports, from different countries, and with varied age distribution. The second search displayed 85 articles on individual sports group. Papers were rated and categorized according by the sport associated to the reported injury. A useful sports risk scale for maxillofacial injuries has been developed. Peculiar themes from all participating sports were evaluated. The use of protective equipment and other preventive measures were highlighted.Some sports with ball and cycling can be considered riskier sports for maxillofacial injuries. Athlete education and the mandatory use of mouthguards, helmets, and eye protection, among other things, are crucial to prevent these injuries. Tailor-made mouthguards and protective masks, which are becoming cheaper, are in vogue. The Sports-related Maxillofacial Injuries Risk scale can be useful for athletes, athletic coaches, and maxillofacial surgeons.

Objetivo: Analisar a eficácia da expansão rápida de maxila assistida cirurgicamente (ERMAC) no ganho de distância maxilar horizontal. Métodos: Onze pacientes com deficiência transversa da maxila submetidos à ERMAC participaram do estudo. Os modelos de estudo foram obtidos antes e após a cirurgia. As medidas transversais dos modelos superiores foram realizadas entre as cúspides caninas, cúspides palatinas dos primeiros pré-molares e cúspides vestibulares dos primeiros molares superiores. Essas medidas foram realizadas antes e depois da ERMAC. Resultados: Em relação ao número total de voltas aplicado ao Hyrax e ao ganho médio na distância transversal da maxila, existe uma correlação estatisticamente significativa (p = 0,006) entre o número total de voltas do aparelho e o ganho médio na região. Em relação à região de caninos (p = 0,45) e região molar (p = 0,925), não há correlação estatisticamente significativa entre o número de voltas no aparelho e a distância obtida. Conclusão: O ganho médio na distância transversal da maxila foi estatisticamente significativo para as regiões de canino, pré-molar, molar e perímetro da arcada. Existe uma correlação estatisticamente significativa entre o número total de ativações do aparelho e a distância ganha na região pré-molar.

Objective Evaluate topical use of hydrocortisone as a trans-operative irrigant solution for controlling postoperatory edema and pain in third molar surgery. Methods Twenty-eight healthy patients with necessity of impacted bilateral third molar removal were divided in two groups: group H received 250 ml 500 mg-hydrocortisone solution irrigation during surgery and control group received saline solution at the same volume. Edema was assessed by the percentage of swelling after 48 h postoperative measured by face anatomical points distances. Postoperative pain level parameters considered: measurement in Visual Analog Scale (VAS) at the end of anesthetic perception and at 4, 6, 8, 24 and 48 h after surgery, number of analgesic intakes, time interval between the end of the surgery and the use of the first analgesic tablet. Results Group H showed significant reduction of edema but similar postoperative pain level comparatively to control group. Conclusion Trans-operative hydrocortisone solution irrigation is a useful, of low-cost alternative for control swelling in mild and high complex impacted inferior third molar surgeries.

Made available in DSpace on 2022-04-28T19:48:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-11-01 AIMS: Identify variations of skull base measurements in individuals with dentofacial deformities associated or not with cleft lip and palate and compare the results with individuals without dentofacial deformities. METHODS AND RESULTS: The individuals were categorized into three different groups: dentofacial deformity without cleft malformation, dentofacial deformity associated with cleft lip and palate, and without facial deformity. The inclusion criteria were individuals over 18 years of age, without any intervention involving facial bones or structures of interest for the study and field of view encompassing from the glabella to the hyoid bone. Poor quality CT scans or lack of adequate medical records were considered exclusion criteria. In the analysis by computerized tomography using the Dolphin Imaging Software, the length determined by the Ba-S and S-N lines was evaluated, as well as the Ba-S-N angle formed by landmarks. RESULTS: The length of S-N was not statistically different between the groups, the Ba-S length and the Ba-S-N angle demonstrated statistical difference. CONCLUSION: There was statistically significant difference in the morphometry of the (Ba-S) between groups (FS) and (C). This suggests that the standard values for cephalometric analyzes involving these structures, especially to determine the treatment planning, should be used with caution. Department of Diagnosis and Surgery Aracatuba School of Dentistry Sao Paulo State University School of Medicine Federal University of Amazonas Department of Dentistry Cuiabá University Department of Oral and Maxillofacial Surgery Sao Paulo University Department of Oral and Maxillofacial Surgery General Hospital of Cuiaba Integrated Dental Sciences Faculty of Dentistry of the University of Cuiaba Department of Diagnosis and Surgery Aracatuba School of Dentistry Sao Paulo State University

BACKGROUND Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an osteoinductor frequently used for bone regeneration in oral and maxillofacial surgery. There is no consensus about the ideal carrier for this growth factor. The aim of this study was to compare the bone augmentation, bone microarchitecture, and biodegradation rate of additional carriers to rhBMP-2/absorbable collagen sponge (ACS) in a vertical guided bone regeneration model. METHODS Four titanium cylinders were fixed onto the calvaria of rabbits (n = 20) that received (n = 10) or not (n = 10) rhBMP-2/ACS in conjunction with one of the carriers: beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), bovine bone mineral (BBM) or blood clot. The samples were analyzed by means of microcomputed tomography and histomorphology after 14 weeks. RESULTS All the materials with rhBMP-2/ACS exhibited improvement on bone augmentation, mainly BCP (P = 0.033) and β-TCP (P = 0.038), in the upper portion of the cylinder. Although trabecular anisotropy was improved in all the materials groups, trabecular connectivity was diminished when the biomaterials received rhBMP-2/ACS. Resorption rate of the remaining biomaterial was improved by rhBMP-2/ACS, mainly in BBM (P

Introdução: os fabricantes de brocas cirúrgicas não informam a durabilidade dos materiais após usos sucessivos, dificultando a escolha do instrumental mais eficaz pelo cirurgião-dentista. Objetivo: comparar a precisão e a perda de corte de duas brocas de carbeto de tungstênio em odontoseções de terceiros molares inferiores. Métodos: a odontosecção foi realizada em vinte pares de dentes homólogos, sendo feita com a broca Zecrya em um dente, e com a broca Talon 12 Surg no dente contralateral. A precisão e a perda de corte foram analisadas, respectivamente, por meio da espessura da odontosecção e dos desgastes na ponta ativa. Os resultados foram comparados por ANOVA de uma via e teste de Tukey, com nível de significância de 0,05. Resultados: as duas brocas apresentaram redução da ponta ativa. No entanto, a broca Talon 12 Surg apresentou, durante o exame de estereomicroscopia, uma grande deformação após o vigésimo corte e um desgaste significativo em sua ponta ativa (p

Inadequate craniofacial orientation of computed tomography (CT) scans can have significant implications in all three planes of space. The purpose of this study was to present the reproducibility of a 3-dimensional skeletal-based method of craniofacial orientation for virtual surgical planning. The protocol was defined by landmarks commonly used for cephalometry, and required identification of basion, nasion, right porion, and right orbitale, and navigation in all CT views (coronal, sagittal, and axial) for correction of yaw, roll, and pitch. Reproducibility of the method was assessed using eight CT scans that were randomly selected and anonymised. The observer group consisted of six oral and maxillofacial surgeons with varying levels of experience (resident or faculty) who performed craniofacial orientation according to the proposed method. Results were expected to be below 2° of variation, when overall accuracy as well as the influence of the academic level of the observers and symmetry of the evaluated anatomy, were considered as independent variables. Overall accuracy for all cases and for yaw, roll, and pitch were always below 2° of variation, without influence of level of experience and symmetry. Interobserver assessment was categorised as excellent in all instances, and intraobserver evaluation demonstrated consistency in the orientation of all axes. The proposed craniofacial orientation protocol presented in this study is easy to learn, applicable to computer-aided surgical planning, and can be performed by the non-technical clinician, resulting in excellent reproducibility and consistency.

This paper aims to provide a bibliometric analysis of the literature on oral and maxillofacial surgery, comparing different databases and discussing the advantages, disadvantages, and specific features of each one. A bibliographical search for oral and maxillofacial surgery literature was conducted on Pubmed, Scopus, Web of Science, Dimensions, SciELO, LILACS, and Google Scholar. Seven different search strategies were used on each database. VOSViewer and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95% confidence interval, which was considered significant. A table comparing the number of articles obtained during seven different literature searches was created. A correlogram created in RStudio showed the correlation between the number of articles in the different databases evaluated. The functionalities of each database were compared. It is recommended to use more than one database when searching for literature related to surgery. Among the analyzed databases, PubMed stands out for its functionalities, precision, and quantity of available articles. El objetivo de este trabajo es realizar un análisis bibliométrico de la literatura sobre cirugía oral y maxilofacial, comparando diferentes bases de datos y discutiendo las ventajas, desventajas y características específicas de cada una. Se realizó una búsqueda bibliográfica de la literatura de cirugía oral y maxilofacial en Pubmed, Scopus, Web of Science, Dimensions, SciELO, LILACS y Google Scholar. Se utilizaron siete estrategias de búsqueda diferentes en cada base de datos. Se utilizaron VOSViewer y Microsoft Excel para la tabulación y visualización de los datos. Se realizaron algunas pruebas estadísticas con un intervalo de confianza del 95%, que se consideró significativo. Se creó una tabla que compara el número de artículos obtenidos durante siete búsquedas bibliográficas diferentes. Un correlograma creado en RStudio mostró la correlación entre el número de artículos en las diferentes bases de datos evaluadas. Se compararon las funcionalidades de cada base de datos. Se recomienda utilizar más de una base de datos cuando se busque literatura relacionada con la cirugía. Entre las bases de datos analizadas, PubMed destaca por sus funcionalidades, precisión y cantidad de artículos disponibles. Este trabalho tem como objetivo fornecer uma análise bibliométrica da literatura sobre cirurgia oral e maxilofacial, comparando diferentes bancos de dados e discutindo as vantagens, desvantagens e características específicas de cada um deles. Uma pesquisa bibliográfica da literatura sobre cirurgia bucomaxilofacial foi realizada em Pubmed, Scopus, Web of Science, Dimensions, SciELO, LILACS, e Google Scholar. Sete diferentes estratégias de busca foram usadas em cada banco de dados. VOSViewer e Microsoft Excel foram usados para tabulação e visualização de dados. Alguns testes estatísticos foram realizados com um intervalo de confiança de 95%, o que foi considerado significativo. Foi criada uma tabela comparando o número de artigos obtidos durante sete diferentes pesquisas bibliográficas. Um correlograma criado no RStudio mostrou a correlação entre o número de artigos nas diferentes bases de dados avaliadas. As funcionalidades de cada base de dados foram comparadas. Recomenda-se a utilização de mais de uma base de dados na busca de literatura relacionada à cirurgia. Entre as bases de dados analisadas, o PubMed se destaca por suas funcionalidades, precisão e quantidade de artigos disponíveis.

To assess the analgesia and side effects of codeine phosphate associated with paracetamol (test medication) as compared to paracetamol (control medication) after the extraction of impacted mandibular third molars. Forty-seven patients removed the right and left impacted mandibular third molars. After one surgery, patients took the test medication and after the other surgery, they took the control medication. Patients with exacerbated pain were prescribed to use the rescue medication instead of the medication initially administered and were included in the rescue group. They were evaluated for 7 days postoperatively, and the mean score of the visual analogue scale (VAS) of pain between test and control medications was assessed by the Poisson distribution. The side effects of these medications were assessed by the patient’s complaints. A P value of

This study was conducted in order to determine whether marsupialization before definitive enucleation of nonsyndromic odontogenic keratocysts (OKCs) is capable of decreasing the recurrence rate more effectively than just enucleation. We searched MEDLINE, Web of Science, Scopus, and Cochrane Library, until August 5th of 2017 for original studies reporting on the treatment of OKCs with and without previous marsupialization and the related recurrence rate. All records and data were independently assessed, meta-analysis was performed, and the odds ratio of recurrence was the effect measure; P value for the summary effect of

Purpose To verify predicted versus obtained surgical movements in 2-dimensional (2D) and 3-dimensional (3D) measurements and compare the equivalence between these methods. Materials and Methods A retrospective observational study of bimaxillary orthognathic surgeries was performed. Postoperative cone-beam computed tomographic (CBCT) scans were superimposed on preoperative scans and a lateral cephalometric radiograph was generated from each CBCT scan. After identification of the sella, nasion, and upper central incisor tip landmarks on 2D and 3D images, actual and planned movements were compared by cephalometric measurements. One-sample t test was used to statistically evaluate results, with expected mean discrepancy values ranging from 0 to 2 mm. Equivalence of 2D and 3D values was compared using paired t test. Results The final sample of 46 cases showed by 2D cephalometry that differences between actual and planned movements in the horizontal axis were statistically relevant for expected means of 0, 0.5, and 2 mm without relevance for expected means of 1 and 1.5 mm; vertical movements were statistically relevant for expected means of 0 and 0.5 mm without relevance for expected means of 1, 1.5, and 2 mm. For 3D cephalometry in the horizontal axis, there were statistically relevant differences for expected means of 0, 1.5, and 2 mm without relevance for expected means of 0.5 and 1 mm; vertical movements showed statistically relevant differences for expected means of 0, 0.5, 1.5 and 2 mm without relevance for the expected mean of 1 mm. Comparison of 2D and 3D values displayed statistical differences for the horizontal and vertical axes. Conclusions Comparison of 2D and 3D surgical outcome assessments should be performed with caution because there seems to be a difference in acceptable levels of accuracy between these 2 methods of evaluation. Moreover, 3D accuracy studies should no longer rely on a 2-mm level of discrepancy but on a 1-mm level.

Arthrocentesis of the temporomandibular joint (TMJ) is a minimally invasive surgical procedure that provides good clinical results such as the improvement of jaw movements. It also helps to balance the synovial liquid viscosity and relieve TMJ pain by the washout of inflammatory components from the upper compartment. The purpose of this study is to report a case series of patients submitted to a clinical-based protocol of diagnosis of TMJ joint open lock and treatment with arthrocentesis. Patients suffering from a recurrent unilateral open lock of the TMJ were submitted to one arthrocentesis of the affected TMJ and all of them reported that the open lock was caused by daily stomatognathic activities. To decide the arthrocentesis as the initial treatment of these patients, the authors followed a rational protocol of diagnosis. Ten patients were included in the present study. No complications occurred during arthrocentesis. Immediately, 1 week, 1 month, and 6 months after arthrocentesis, patients did not suffer from open lock or disc click anymore. They also reported no more pain because it was strictly related to the disc click. All patients of the present study improved from the open lock and disc click of the affected TMJ for 6 months after arthrocentesis. The clinical-based protocol of diagnosis of TMJ open lock reported in the present study, followed by the treatment with arthrocentesis is a reasonable, low-cost, and safe method to treat patients with the acute open lock.

Introduction: LLLT is used in various clinical situations for the relief of postoperative inflammatory symptoms in TMD cases. Many treatment protocols use laser radiation, but there is still no evidence as to whether one of them is superior to all the other. The objective was to establish whether there is evidence that LLLT can reduce the main symptoms of TMDs and to determine the most effective application protocol. Methods: a systematic review of the literature was performed in the main databases: PubMed, Scopus and Web of Science, by independent researchers who evaluated studies using different LLLT protocols to treat TMD symptoms, considering specific outcomes such as pain, mouth opening and jaw movements. Results: thirteen studies fully met the eligibility criteria. The most used laser type was GaAlAg, with a wavelength of 830 nm, number of applications ranging from 8 to 10, and 4 weeks of follow-up. Conclusions: LLLT may be considered as an alternative for the relief of TMD symptoms; however, scientific evidence of one of the protocols being superior to the others could not be found. RESUMEN Introducción: la terapia láser de bajo nivel (LLLT por sus iniciales en inglés) se utiliza en diversas situaciones clínicas para el alivio de los síntomas inflamatorios posoperatorios en casos de trastornos temporomandibulares (TTM). Hay muchos protocolos de tratamiento que utilizan radiación láser, pero todavía no hay evidencia de que alguno sea superior a los demás. El objetivo de la presente revisión sistemática consistió en determiner si hay evidencia de que la LLLT pueda reducir los principales síntomas de los TTM y determinar el protocol de aplicación más eficaz. Métodos: se realizó una revisión sistemática de la literatura en las principales bases de datos, PubMed, Scopus y Web of Science, por parte de investigadores independientes que evaluaron los estudios utilizando diferentes protocolos de LLLT para tratar los síntomas de los TTM, considerando resultados específicos como dolor, apertura de la boca y movimientos de la mandíbula. Resultados: trece estudios cumplieron plenamente los criterios de elegibilidad. El tipo de láser más utilizado fue GaAlAg, con una longitud de onda de 830 nm, número de aplicaciones que oscilan entre 8 y 10, y 4 semanas de seguimiento. Conclusiones: la LLLT puede considerarse una alternativa para el alivio de los síntomas de los TTM; sin embargo, no se pudo encontrar evidencia científica de que un protocolo sea superior a los demás.

Myeloid sarcoma (MS) is a rare malignant tumor that arises outside the bone marrow and usually occurs concomitantly or after the acute myeloid leukemia (AML). The aim of the present study is to report an extremely rare case of a patient with an MS arising in the maxillofacial region before the onset of AML to serve as a guide on how to conduct the initial assessment and diagnosis of similar cases. A 29-year-old healthy man complained of a “swelling on the head,” which was rapidly increasing. He was asymptomatic and never had a previous AML. The patient presented a large mass on the left temporal region. The computed tomography showed a well-delimited lesion extending from the lateral pterygoid muscle and involving the zygomatic arch and lateral orbital rim. The mass was diagnosed as an MS arising before the onset of the AML. Masses of a rapid increase in the maxillofacial region should always raise suspicion of being an MS even in asymptomatic patients. Following a protocol of initial assessment and diagnosis will decrease the period between the initial appearance of the MS and effective treatment aimed to prevent or delay the manifestation of leukemia, improving the prognosis and survival of these patients.

The purpose of this study is to find out if the biological behavior and the capacity of the odontogenic keratocyst (OKC) in maintaining pathologic cells alive are more similar to the dentigerous cyst or to the ameloblastoma by assessing bcl-2. We searched MEDLINE, Web of Science, and Scopus for immunohistochemical studies reporting OKCs, dentigerous cysts, and ameloblastomas. Risk difference between the lesions expressing bcl-2 was the effect measure and a P value < 0.05 was considered to provide evidence to the effect estimates. OKCs have an estimated difference of 91% in the probability to express the bcl-2 over dentigerous cysts, but there is no difference in the expression of bcl-2 between OKCs and ameloblastomas. The present study demonstrated a great risk difference in the expression of bcl-2 between OKCs and dentigerous cysts and no risk difference between OKCs and ameloblastomas. OKC's growth may indirectly be attributed to the anti-apoptotic effect of bcl-2 in the cystic epithelium and not only to the increase of its intraluminal pressure. Therefore, the classification of this lesion into keratocystic odontogenic tumor should be carefully reconsidered.

Bone remodeling results in loss of alveolar bone height and thickness. Photobiomodulation (PBM) based on photochemical stimulation by low-intensity lasers emerges as an adjunctive therapy for alveolar socket preservation. Our study aimed to evaluate the effects of PBM therapy on alveolar bone repair. Twenty healthy patients in need of bilateral extraction of lower molars were enrolled in this split-mouth randomized and blind clinical trial. The extraction sites were randomly selected to receive either the PBM therapy with a CW GaAIAs diode laser (808 nm; 0.028 mm2; 0.1 W; 3.6 W/cm2; 89 J/cm2; 2.5 J/point) or no treatment (Control). Bone biopsies were harvested 45 days after the dental extraction and evaluated using micro-computerized tomography (μCT), morphometric, and histological analysis. Data were compared using the paired t test, and the level of significance was set at 5%. Bone surface (p = 0.029), bone surface/total volume (p = 0.028), trabecular number (p = 0.025), and connectivity density (p = 0.029) were higher at the PBM group compared with Control. The histological observations confirmed the μCT findings. PBM samples exhibited higher number of organized and connected bone trabeculae along with higher density of blood vessels than Control. Control samples displayed a dense and highly cellular connective tissue at the central area accompanied by the presence of immature bone trabeculae at the periphery. Our results indicated that the PBM therapy improved the newly bone trabeculae formation and their connectivity which increased bone surface, indicating the positive effect of the laser on alveolar human socket repair.

O objetivo deste estudo e avaliar o efeito da terapia de fotobiomodulacao (TFBM) na viabilidade de osteoblastos e cultura de fibroblastos em diferentes concentracoes de alendronato ou acido zoledronico. Duas linhagens celulares – celulas de camundongos semelhantes a osteoblastos (OSTEO 1) e fibroblastos de mucosa bucal humana (FMM1) – foram utilizadas. As celulas foram submetidas a diferentes concentracoes de bisfosfonatos (1 μM, 10 μM e 100 μM de alendronato de sodio e 3 μM, 5 μM e 10 μM de acido zoledronico) por 24 horas. Em seguida, as culturas receberam TFBM. As irradiacoes foram aplicadas com laser de diodo (InGaAIP, 660 nm, 30 mW, spot 0,028 cm2) em modo continuo, pontual e de contato, em duas densidades de energia: 5 J/cm2 (4,5 s) ou 10 J/cm2 (9s) com intervalos de 6 horas. A viabilidade celular foi determinada pelo ensaio de atividade mitocondrial (MTT) 24 h apos a ultima irradiacao. Os dados foram comparados pelo ANOVA One-Way, complementado pelo teste de Tukey (p < 0,05). O alendronato de sodio nas concentracoes de 100 μM e 10 μM e o acido zoledronico na concentracao de 10 μM apresentaram maior toxicidade a longo prazo. A viabilidade celular do grupo tratado com TFBM foi significativamente maior que a do grupo de controle negativo. O mesmo ocorreu com os osteoblastos tratados com as maiores concentracoes do farmaco (5 e 10 μM), apesar de nao atingir a viabilidade celular do grupo de controle positivo, apresentou maior viabilidade do que o controle negativo no qual as celulas nao foram irradiadas. Nos grupos submetidos ao acido zoledronico, controles positivos apresentaram maior viabilidade celular. Concluimos que sob os parâmetros aplicados neste estudo, a TFBM, com uma densidade de energia de 5 J/cm2, foi capaz de reverter a toxicidade do alendronato sodico aplicado nas concentracoes mais altas em ambos os tipos celulares, enquanto a toxicidade do acido zoledronico, independentemente de suas concentracoes, foi nao influenciada pela TFBM.

Recent research data have suggested that the beneficial action of statins in bone tissue could improve osseointegration around titanium implants by increasing the bone implant contact (BIC), the expression of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF). The aim of this systematic review was to evaluate the influence of statins on osseointegration of titanium implants in animal studies. Two reviewers searched independently four databases (MEDLINE, SCOPUS, WEB OF SCIENCE and the Cochrane Library), until March 15, 2016. The Cochrane Collaboration's Tool for Assessing Risk of Bias was used to assess the quality of the included studies. Papers that reported outcome data considering bone implant contact (BIC), mechanical tests or other histological evaluation were eligible for inclusion. 312 references were eletronically retrieved, 21 full-text papers were screened and 17 studies were included. Thirteen trials presented histomorphometry data on bone implant contact measures. All of them showed a significant improved BIC when using statins. Despite data from included studies point to beneficial effects, standardized studies and with less risk of bias, are needed to clarify the role of statins on osseointegration.

Correction of severe vertical bone deficiency in the posterior region of mandibular alveolar ridge requires surgical management if implants are scheduled and cannot have primary stability. The aim of the present study is to report two cases; one treated with alveolar osteogenesis distraction and the other with segmental osteotomy with autologous graft interposition, by describing the surgical steps as well as show the results and experiences acquired with these techniques. We opted for these methods to reconstruct the posterior mandibular region after remarkable vertical bone loss based mainly by the height and thickness of the remaining bone. Alveolar osteogenic distraction is highly advisable when vertical deficiency is severe, and if these cases are treated with the segmental osteotomy and autologous graft interposition, complications as graft failure, necrosis and resorption are more prone to occur due to insufficient vascularization. After bone maturation and bone neoformation secondary to alveolar osteogenic osteogenic distraction and segmental osteotomy with autologous graft interposition, respectively, the two presented case reports were able to securely receive dental implants. In cases of vertical bone loss of the posterior mandibular region, both surgeries currently represent the best choice for bone gain prior dental implants placement for oral rehabilitation, without technical challenges, although biological evidence to assure the superiority of one technique over the other must be further investigated. RESUMO A correção de deficiência óssea severa em altura na região posterior do rebordo alveolar da mandíbula requer tratamento cirúrgico caso a inserção de implantes dentários seja necessária e não se pode ter uma estabilidade primária. O objetivo do presente estudo é relatar dois casos; um tratado com distração osteogênica alveolar e o outro com osteotomia segmentar associada à interposição de um enxerto autógeno, descrevendo a sequência cirúrgica, bem como mostrar os resultados e as experiências adquiridas com essas técnicas. Optamos por esses métodos para reconstruir a região mandibular posterior baseados principalmente na altura e espessura óssea remanescentes. A distração osteogênica alveolar é altamente recomendável quando essa deficiência é avançada e, se esses casos são tratados com a osteotomia segmentar e interposição de enxerto autógeno, complicações como falha do enxerto, necrose e reabsorção são mais prováveis de ocorrer devido à vascularização sua insuficiente. Após os períodos de reparação e neoformação óssea secundária à distração osteogênica alveolar e à osteotomia segmentar com interposição de enxerto autógeno, respectivamente, os dois casos relatados estavam aptos a receberem seguramente os implantes dentários. Nos casos de perda óssea em altura na região mandibular posterior, ambas as cirurgias representam, atualmente, a melhor escolha para o ganho de estrutura óssea antes da colocação dos implantes dentários e reabilitação oral, sem muita complexidade quanto à técnica cirúrgica, embora ainda sejam necessário estudos posteriores para assegurar a superioridade de uma técnica em relação a outra.

ResumoObjetivoAvaliar se um novo cimento bifásico composto por sulfato de cálcio e beta fosfato tricálcico com controle de potencial zeta poderia induzir ou conduzir a neoformação óssea em defeitos críticos.MétodosFoi feito um defeito crítico de 8mm de diâmetro na calvária de 40 ratos Wistar machos. No grupo teste (n=20) os defeitos foram preenchidos pelo cimento. No grupo controle (n=20) os defeitos não foram preenchidos, permaneceu apenas o coágulo. Os animais sofreram eutanásia em 7, 14, 21 e 42 dias do pós‐operatório. Espécimes da calvária foram microtomografados e posteriormente preparados para análise histológica. As análises incluíram a avaliação morfológica da histopatologia do reparo e a avaliação morfométrica da área de formação das trabéculas ósseas comparativamente entre os grupos e coloração histoquímica por meio da fosfatase tartrato‐resistente (TRAP) para identificação de osteoclastos.ResultadosAs imagens microtomográficas dos defeitos preenchidos pelo cimento não apresentaram diminuição da área de acordo com a progressão dos períodos pós‐operatórios. No grupo teste houve permanência do material e resposta corpo estranho até os últimos períodos de observação. A histomorfologia mostrou agrupamentos mais expressivos de células gigantes no grupo teste e osso neoformado mais maduro no grupo controle e comprovou a presença de material exógeno. Na histomorfometria, a área total de neoformação óssea foi significativamente maior (p=0,009) e crescente no grupo controle. As células gigantes apresentaram expressão histoquímica positiva para TRAP e não foram observados osteoclatos.ConclusãoO cimento cerâmico não induziu ou conduziu a neoformação óssea sob o ponto de vista microtomográfico e histológico.AbstractObjectiveTo evaluate whether a new biphasic cement composed of calcium sulfate and beta tricalcium phosphate with zeta potential control could induce or lead to bone neoformation in critical defects.MethodsA critical defect of diameter 8mm was made in the calvaria of forty male Wistar rats. In the test group (n=20), the defects were filled with cement. In the control group (n=20), the defect was not filled and only coagulum was present. The animals were sacrificed 7, 14, 21 and 42 days after the operation. Calvaria specimens were subjected to microtomography and were then prepared for histological analysis. The analyses included morphological assessment on the histopathology of the repair; comparative morphometric evaluation of the area of formation of bone trabeculae between the groups; and histochemical staining by means of tartrate‐resistant phosphatase (TRAP) in order to identify osteoclasts.ResultsMicrotomographic images of the defects filled by the cement did not show any decrease in area over the course of postoperative evolution. In the test group, the material continued to present a foreign‐body response until the last observational periods. Histomorphological analysis showed that there were more significant groupings of giant cells in the test group and greater maturity of neoformed bone in the control group. Exogenous material was also present. Histomorphometric analysis showed that in the control group, the total area of bone neoformation was significantly greater (p=0.009) and grew progressively. The giant cells presented a positive reaction to TRAP but no osteoclasts were observed.ConclusionThe ceramic cement did not induce or lead to bone neoformation from the microtomographic or histological point of view.

The sequencing of bimaxillary orthognathic surgery remains controversial, although the traditional maxilla-first approach is performed routinely. The goal of this study was to present a systematic review of the mandible-first sequence in bimaxillary orthognathic surgery, to provide data that may assist in the decision as to which jaw should undergo osteotomy first in bimaxillary orthognathic surgery cases. A literature search was conducted for articles published in the English language, reporting the use of the altered sequence for bimaxillary orthognathic surgery (mandible-first), using the following descriptors: 'orthognathic' and 'double-jaw', 'orthognathic' and 'two-jaw', 'orthognathic' and 'mandible-first', 'orthognathic' and 'bimaxillary'. Eight hundred eighty-seven abstracts were initially identified and were evaluated for inclusion according to the proposed inclusion criteria. After evaluation of these abstracts and relevant references, six publications met the criteria for consideration. Performing mandible-first surgery in bimaxillary orthognathic cases dates back to the 1970s; however the decision regarding the jaw to be operated on first seems to rely on accurate preoperative planning based upon the surgeon's experience and preference. While there appear to be significant theoretical advantages to support the use of the altered orthognathic sequence (mandible-first), future prospective studies on its reliability, accuracy, and short- and long-term outcomes are required.

This study was conducted in order to gain insight in the actual ratio of odontogenic keratocysts occurring in the tooth-bearing area as compared to the posterior region of the jaws in order to come up with reliable data to base upon a rational treatment policy. We searched MEDLINE, Web of Science, Scopus, and Cochrane databases for studies reporting on the location of mandibular and maxillary odontogenic keratocysts. All records were independently assessed and a meta-analysis was performed. Risk difference with a confidence interval of 95% of having the lesion in the posterior region versus the tooth-bearing area was the effect measure. P value for the summary effect of

Determine if conservative surgery of primary solid/multicystic ameloblastoma (SMA) is capable of decreasing the recurrence rate as effectively as radical surgery. We searched in MEDLINE, Web of Science, Scopus and Cochrane Library for original studies reporting on the conservative or radical treatment of primary SMA and the related recurrence rate. All selected data were independently assessed. Meta-analysis was performed and the Relative Risk (RR) of recurrence with a confidence interval of 95% was the effect measure. P value for the summary effect of

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferation of unknown pathogenesis that may be related to trauma. Although it affects mainly the head and neck, the zygomatic area is rarely involved. We report a case that affected the zygomatic region of a 46-year-old black man. The lesion had been present for about a year and the patient reported that it appeared after a facial injury during a soccer match. Clinical and tomographic investigations suggested a benign tumour, and the lesion was excised through an intraoral approach. Histopathological examination showed the unexpected diagnosis of ALHE. This tumour was interesting because of its rarity, and also because of its unusual site within the head and neck region. The diagnosis of ALHE is hardly ever considered in the differential diagnosis of zygomatic nodules.

The odontogenic keratocyst (OKC) is a recurrent cyst that has been recently reclassified from an odontogenic tumor to an odontogenic cyst. The aim of the present study was to investigate its treatment and address issues related to its association with nevoid basal cell carcinoma syndrome (NBCCS). Lesions from the cohort of patients included in the present study consisted of 40 OKCs, of which 27 lesions were treated by enucleation (GE) and 13 underwent decompression (GD). Complementary treatment occurred in 38 (95%) lesions, of which 10 underwent isolated peripheral ostectomy (GO) and 28 underwent peripheral ostectomy combined with Carnoy's solution (GC). Thirteen lesions were associated with NBCCS (GS), while the others (n=27) were non-syndromic lesions (GnS). The recurrence-free periods (RFP) in the sample groups were compared using the Kaplan-Meier function and log-rank test at a significance level of 5% (p < 0.05) and were used to calculate the cumulative risk of recurrence (CRR) in each postoperative year. During the follow-up period, which had a mean of 43.5 months (range: 12–102 months), six (15%) recurrences were diagnosed. There was no significant difference among the RFP for the compared groups (p > 0.05) or increased CRR for the decompression (15.4%) over five years. Application of Carnoy's solution did not increase the efficacy of the peripheral ostectomy, but was related to a CRR of 0% for the syndromic lesions over five years. Therefore, 1) decompression did not increase the recurrence risk; 2) peripheral ostectomy demonstrated a similar efficacy as the combination with Carnoy's solution; 3) the association of NBCCS did not seem to significantly influence OKC recurrence; and 4) syndromic lesions seem to behave in the same manner as non-syndromic lesions when submitted to complementary treatments.

Background Medication-Related Osteonecrosis of the Jaws (MRONJ) incidence are increasing among elderly. Treatment can be challenging. Prevent or treatment protocols that control evolution of the lesion are warranted. Objective To observe long-term outcomes of two protocols based on photonics [antimicrobial photodynamic therapy (aPDT) and photobiomodulation (PBM)] for prevention and treatment of MRONJ lesions. Methods In a prospective study, patients who needed oral surgery and had been exposed to antiresorptive drugs were long-term followed-up. For MRONJ prevention, immediately after tooth extraction aPDT was applied. For aPDT a 0.01 % methylene blue solution was applied inside socket for 5 min followed by irradiation with a diode laser [660 nm, 0.028cm2, 0.1 W, 3.57 W/cm2, 90 s and 9 J per point, 321 J/cm2, at least at in 3 points (laser probe was placed at central, and two equidistant points) and total energy of 27J]. Irradiation was repeated weekly until total tissue repair. MRONJ treatment included preoperative aPDT sessions until signs and symptoms of infection had reduced. Then, after necrotic bone removal, aPDT was applied inside surgical wounds and re-applied weekly until healing. Antibiotics were administered pre or postoperatively for no longer than 7 days. PBM therapy was applied with 808 nm diode laser, 0.028cm2, 0.1 W, 3.57 W/cm2, 30 s, 107 J/cm², 3 J and total energy of 12 J until evidence of remission. Results Eighteen patients underwent preventive protocol, and none presented signs of MRONJ after a follow-up of at least 6 months. Seventeen patients presented with MRONJ underwent aPDT protocol and sixteen of them showed total regression of lesions. Practical Implications aPDT and PBM therapy protocols appear to be effective as adjuvant approach not only for preventing MRONJ development due to tooth extraction but for treating MRONJ lesions at early stages with no adverse effects.

Mandibular position is an important parameter used for the diagnosis of dentofacial deformities, as well as for orthognathic surgery planning and execution. Centric relation (anterior and superior relationship of the mandibular condyles interposed by the thinnest portion of their disks against the articular eminencies), centric occlusion (when lower teeth contact upper teeth at centric relation), and maximal intercuspation (complete interdigitation of lower and upper teeth) are not often addressed as factors that influence the results of orthognathic surgery, although these relationships are critical to ensure accuracy during the surgery. The present study assessed occlusal measurements taken before and after the induction of general anaesthesia from consecutive orthognathic surgery subjects. The variables assessed included the differences between these occlusal measurements, patient age, gender, type of deformity, and type of proposed orthognathic surgical procedure. The results demonstrated statistically significant differences for mandibular retrusion from maximal intercuspation to centric occlusion position, whereas the mandible appeared not to change significantly from centric occlusion after the induction of general anaesthesia. Patient age and the type of deformity appeared to influence the results. While in most instances centric occlusion can be adequately reproduced under general anaesthesia, for some specific orthognathic cases more accurate results might be obtained if the mandible-first sequence is used.

Objective The aim of this study was to assess analgesic and adjuvant anesthetic effects of submucosal tramadol after third molar extraction. Study Design In this double-blind, split-mouth, placebo-controlled, single-dose, crossover investigation, 52 patients underwent mandibular third molar extraction under local anesthesia. Surgical side was randomly assigned to submucosal 2 mL 100 mg tramadol injection (group T) or normal saline solution (group P) immediately after surgery. Anesthetic blockade duration, time of intake and amount of analgesic rescue drug, and postoperative pain intensity were recorded immediately after anesthesia cessation and 4, 8, 24, 48, and 72 hours after surgery. Data were submitted to analysis of variance and Wilcoxon tests. Results Anesthetic blockade duration between groups was similar. Group T took significantly less rescue drug after 72 hours ( P = .008). Time elapsed before first intake of rescue drug was longer ( P = .006), and pain intensity was significantly lower ( P = .001) in group T. Conclusions Submucosal tramadol injection after oral surgery improved postoperative analgesia, but did not extend anesthetic action duration.

We have analysed the predictors of postoperative complications and the need for reoperation after grafting of the alveolar cleft from one specialised cleft centre. The data were obtained from hospital casenotes of patients operated on from December 2004 to April 2010, with a minimum one-year follow-up from the final operation. Independent variables included postoperative complications and the need for reoperation. Conditional variables were sex, age, type of cleft, sides affected, donor area, type of graft material, and the presence of an erupted tooth in contact with the cleft. A total of 71 patients had bone grafted on to the alveolar cleft. The following associations were found to be significant: postoperative complications and need for reoperation (p=0.003); age and complications (p=0.002); affected side and complications (p=0.006); age and reoperation (p=0.000); sex and reoperation (p=0.001); and type of cleft and reoperation (p=0.001). Proper attention should be given to all the variables and risk factors to overcome the many obstacles that might have an adverse influence on a successful outcome of alveolar bone grafting for patients with clefts.

Purpose Bacterial penetration and colonization of the microgap at the implant-abutment interface have been reported in several studies. The aim of this study was to evaluate the effectiveness of placing a silicone membrane between the abutment and the implant platform in an attempt to seal the interface. Materials and methods A total of 15 external-hex implants were placed in 10 patients with clinically healthy peri-implant tissues, and all of the patients had ceramic prosthetic crowns. Samples were collected from the microgaps before, 30 days after, and 90 days after insertion of a silicone membrane. Bacterial DNA was extracted and submitted in triplicate to polymerase chain reaction using primers specific for four peri-implant pathogens: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. Results In the initial samples, a positivity of 52% was found, which was different from that found in samples collected after 30 days (32%) and 90 days (27%) after insertion of the membrane. Conclusion It was evident that the silicone membrane reduced, but did not prevent, penetration of these species into external-hex implants.

Aim The present review aims to discuss the last 10 years published data on the topic of the use of osseointegrated implants in diabetic subjects, particularly regarding the influence of antibiotics administration in the perioperative period. Background In the last decades, oral rehabilitation significantly has evolved particularly with the use of osseointegrated implants. Increased life expectation of population is reflecting in a greater number of diabetic patients who might require dental osseointegrated implants rehabilitation. Diabetes was considered for a long time as a contraindication for oral implant placement. In this context, the use of antibiotics is still a controversial factor when we correlate it to implant success rate. Review results Although 228 articles were initially selected for evaluation of proposed criteria, only 16 articles were considered valid. Among the 16 selected articles, only six articles represented clinical research that discussed the influence of the antibiotic in the success of osseointegration of dental implants in diabetic subjects. Five were retrospective studies and one a prospective research. Conclusion Data favors the use of antibiotics without significant side effects but clinical investigations of the need of prophylaxis antibiotic or therapeutic antibiotics are still scarce. The lack of adequate methodology is one of the main problems of the current articles. It is important to emphasize that studies should present detailed methodology in order to allow reproducibility. Clinical significance Permanent tooth loss is a pathological condition that affects millions of people worldwide. The possibility of successful treatment of edentulous areas through osseointegrated implants in those systemic compromised patients is a matter of scientific discussion. Although antimicrobial agents must be used rationally and carefully to avoid development of bacterial resistance, more studies are needed in order to support evidence regarding the influence of antibiotics in the success of dental implant surgery in diabetic patients. How to cite this article Borba AM, Souza DFM, Brozoski MA, Burim RA, da Graça Naclério-Homem M, Deboni MCZ. Can the Use of Antibiotics interfere with the Success of Dental Osseointegrated Implants in Diabetic Patients? J Contemp Dent Pract 2013;14(6):1197-1201.

Aim: Anatomical gingival fibromatosis is an uncommon process involving the palatal gingival and maxillary tuberosity generally in a bilateral and symmetrical manner. Treatment varies from basic periodontal care to surgical removal when the condition causes difficulties with oral hygiene, is associated with secondary periodontal diseases or interferes with prosthesis stability. The authors present a plastic reduction technique modified for tooth-bearing areas and discuss its application. Material and methods: The proposed technique was accomplished in three patients presenting with anatomical gingival fibromatosis. Surgery consisted of a three-step technique that aimed at the reduction of the fibromatosis and the reconstruction of the palatal gingiva. Results: None of the patients present post-operative complications during a follow-up period that varied from 6 to 12 months. After surgery all patients improved their ability to provide proper hygiene for the affected area as well as their periodontal condition. Conclusions: The present surgical technique is a treatment option with a good result while maintaining periodontal health.