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PURPUSE: This study aimed to carry out a survey of data contained in the medical records of patients with maxillofacial trauma at the Hospital Docente Universitário Dr. Dario Contreras between 2014 and 2019. METHODS: This is a Descriptive retrospective epidemiological study. In this way, we look for: Identify the type of fracture prevalent in this city, the main etiology and most affected gender and age group. The sample was composed of 6,525 medical records of patients affected by facial trauma were found. The data collected included: age, gender, etiology, anatomical site, and form of treatment. After collecting the data, they were organized and tabulated in an Excel spreadsheet for Windows. The incidence of etiologies was analyzed and correlated with the gender of affected patients. The incidence of fractures was also evaluated according to their anatomical location, and then correlated with the type of treatment. Descriptive Statistics was then performed, with the objective of showing a global view of the prevalence of the collected data, showing its distribution through graphs and tables. RESULTS: The study consisted of 6229 individuals with maxillofacial trauma. Males had the highest incidence (73.69%) in the third decade of life. The main etiologies were traffic accidents (61.59%), followed by aggression (22.62%). Of the total fractures, 70.20% were in the middle third of the face, with the zygomatic bone and nasal bones being the most affected regions. In the mandible, the regions mainly affected were the body and the angle. As for treatment, open reduction and rigid internal fixation represented the form of treatment for most patients. CONCLUSION: It can be concluded that zygomatic bone fractures were the most prevalent facial fractures in the group of individuals studied, having mainly affected men in the third decade of life, victims of traffic accidents, treated mainly with open reduction and stable internal fixation.

To report the infected silicone chin implant due to the non-ideal placement of dental implants, in female patient, 67 years old. A patient unsatisfied with her facial profile had installed a silicone chin implant 25 years ago. Recently underwent surgery for the placement of dental implants in a region close to the silicone implant. The non-ideal positioning of the dental implants and close contact with the silicone implant led to the absence of osseointegration, with consequent mobility and infection of both. The silicone implant was removed with dental implant that shows mobility. In the imaging exams could be noted others complications of silicone implant like bone resorption and the formation of a narrow bone layer around the inferior border of implant. Alloplastic implants are an option for the esthetic correction of chin deformities. Solid silicone is biocompatible and highly resistant to degradation, with a minimal allergic reaction and risk of toxicity. However, a number of postoperative complications may arise, such as migration or displacement, extrusion, foreign body reaction, bone resorption, heterotopic bone formation and infection. The precise imaging exams are critical to arrive at a diagnosis and the best treatment plan.

During dental appointments, patients often present anxiety and exacerbated fear, especially in surgical procedures. These reactions can promote systemic alterations, such as elevated blood pressure, fainting, and convulsions. The aim of this study was to evaluate the level of anxiety of patients during the lower third molar extraction procedure, seeking indicative parameters of possible complications and, at the same time, contributing to a safe and less uncomfortable procedure for the patient. Forty patients needing extraction of the lower third molar were selected. The study had an evaluator to monitor the systemic variables: blood pressure, oxygen saturation, respiratory and heart rate - while the same surgeon performed the surgical procedures, always using the same surgical technique for all patients. At the anamnesis and at the end of the surgery, the patients answered a visual analogue scale (VAS) questionnaire on anxiety. The results showed that for the four variables observed during the surgery, only the oxygen saturation did not present a statistically significant variation during the procedure. All the others showed changes, mainly during the use of the high-speed engine. We concluded that anxiety, fear and stress showed influences on systemic factors during the extraction procedure. It shows the importance of careful anamnesis and the knowledge of patient systemic diseases before starting any surgery to prevent risks or complications. Durante la consulta odontológica, los pacientes a menudo presentan ansiedad y medicación exacerbada, especialmente en los procedimientos quirúrgicos. Estas reacciones pueden promover cambios sistémicos, como presión arterial alta, desmayos y convulsiones. El objetivo de este estudio fue evaluar el nivel de ansiedad de los pacientes durante el procedimiento de extracción del tercer molar inferior, buscando parámetros indicativos de posibles complicaciones y, al mismo tiempo, contribuir a un procedimiento seguro y menos incómodo para el paciente. Se seleccionaron 40 pacientes que requerían la extracción del tercer molar inferior. El estudio contaba con un evaluador para controlar las variables sistémicas -presión arterial, saturación de oxígeno, frecuencia respiratoria y cardíaca- mientras el mismo cirujano realizaba los procedimientos quirúrgicos, utilizando siempre la misma técnica quirúrgica para todos los pacientes. En la anamnesis y al final de la cirugía, los pacientes respondieron a un cuestionario de escala visual analógica (EVA) sobre la ansiedad. Los resultados mostraron que de las cuatro variables observadas durante la cirugía, sólo la saturación de oxígeno no presentó una variación estadísticamente significativa durante el procedimiento. Todos los demás mostraron cambios, especialmente durante el uso de la alta rotación. Se puede concluir que la ansiedad, el miedo y el estrés mostraron influencia en los factores sistémicos durante el procedimiento de exodoncia. Indicando la importancia de una cuidadosa anamnesis y conocimiento de las enfermedades sistémicas del paciente antes de iniciar cualquier cirugía, previniendo riesgos o complicaciones. Durante a consulta odontológica, os pacientes frequentemente apresentam ansiedade e medo exacerbado, especialmente em procedimentos cirúrgicos. Essas reações podem promover alterações sistêmicas, como pressão arterial elevada, desmaios e convulsões. O objetivo deste estudo foi avaliar o nível de ansiedade dos pacientes durante o procedimento de extração do terceiro molar inferior, buscando parâmetros indicativos de possíveis complicações e, ao mesmo tempo, contribuindo para um procedimento seguro e menos desconfortável para o paciente. Foram selecionados 40 pacientes que necessitavam de extração do terceiro molar inferior. O estudo teve um avaliador para monitorar as variáveis sistêmicas - pressão arterial, saturação de oxigênio, frequência respiratória e cardíaca - enquanto o mesmo cirurgião realizava os procedimentos cirúrgicos, utilizando sempre a mesma técnica cirúrgica para todos os pacientes. Na anamnese e no final da cirurgia, os pacientes responderam a um questionário de escala visual analógica (EVA) sobre ansiedade. Os resultados demostraram que para as quatro variáveis observadas durante a cirurgia, apenas a saturação de oxigênio não apresentou uma variação estatisticamente significativa durante o procedimento. Todas as outras apresentaram alterações, principalmente durante o uso da alta rotação. Conclui-se que a ansiedade, medo e estresse mostraram influências sobre os fatores sistêmicos durante o procedimento de exodontia. Indicando a importância de uma anamnese cuidadosa e o conhecimento das doenças sistêmicas do paciente antes de iniciar qualquer cirurgia, prevenindo riscos ou complicações.

Purpose: The maxillary advancement using Le Fort I osteotomy directly affects in the positioning of the upper lip (UL) and the nasolabial angle (NLA), which plays an important role in facial expression and aesthetics, because of this, the aim of this study was to evaluate the ability of Dolphin Imaging 11.8 software in predicting changes to the UL position and NLA in patients undergoing maxillary advancement. Materials and Methods: It was a retrospective cohort study. Predictive and final tracings using pre- and postoperative Cone beam computed tomography (CBCT) of 24 patients undergoing maxillary advancement, regardless of mandibular movement, were compared. Whether the amount of advancement changes this predictability was also analyzed. The predictive and the 12-month postoperative data were evaluated using Dolphin Imaging 11.8 software and compared. Student t test was used to get the results. Results: The vertical analysis of the incisal tip and cementoenamel junction of the upper central incisor (UCI) and of the UL were statistically significant ( P = .001 for all). The horizontal measurements of the same variables ( P = .238, P = .516, P = .930, respectively) and the NLA ( P = .060) showed no statistical significance. The amount of advancement did not interfere with the variables analyzed, except for the exposure ( P = .009) and inclination of the UCI ( P = .010). Conclusion: It was concluded that the amount of maxillary advancement does not interfere with the UL prediction; the prediction capacity of the software was good for the horizontal measurements, but had a significant error index for vertical measurements.

Objective To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap. Methodology For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the “distance” tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered. Results The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained. Conclusions Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.

Introdução: As fraturas faciais podem provocar alterações estéticas e funcionais, além de outras complicações. Objetivo: Verificar a incidência do trauma facial dos indivíduos atendidos no período de janeiro de 2015 a julho de 2017 em um hospital público de Bauru/SP. Métodos: Um total de 509 fraturas faciais de 441 indivíduos foram analisadas por meio da coleta de dados dos prontuários do sistema eletrônico do hospital. Os dados coletados foram sexo, idade, etiologia do trauma, localização anatômica das fraturas e tipo de tratamento escolhido para cada caso. Resultados: O sexo masculino foi o mais afetado (79,36%), com idade média de 32 anos. A causa mais comum foi a agressão física (32,87%), seguida por acidentes de trânsito (24,04%). O tipo de tratamento de primeira escolha foi a redução aberta com fixação interna estável. Conclusão: As fraturas nasais foram as prevalentes no grupo de indivíduos estudado, tendo acometido, principalmente, homens vítimas de agressão física.

A reabilitação de maxilas atróficas sempre foi um desafio para o cirurgião dentista, e a utilização de implantes zigomáticos tem se popularizado como uma alternativa de tratamento à reconstrução alveolar. O presente trabalho realizou uma revista da literatura buscando complicações trans e pós-cirúrgicas mais comuns relacionadas à cirurgia de implantes zigomáticos. Foi realizada busca na base de dados PubMed por artigos publicados entre 2010 e 2015, sendo encontrados 92 artigos. Destes, foram selecionados estudos que atendessem aos critérios de inclusão e exclusão. Doze dos 92 artigos foram selecionados para revisão, somando um total de 5.425 implantes zigomáticos instalados. Artigos que consideraram apenas as complicações protéticas não foram selecionados. As complicações pós-operatórias relatadas foram: 162 casos de sinusites (2.98%), 129 de infecção dos tecidos moles (2.37%), 16 parestesias (0.29%), 21 fístulas orosinusais (0.38%), 2 enfisemas subcutâneos (0.036%), 1 penetração da cavidade orbital (0.018%), 9 de dor persistente (0.16%), 5 exposições do implante (0.092%) e 16 falhas de osseointegração (0.29%). Artigos de casos clínicos, com um grupo amostral pequeno, relataram ausência de complicações clínicas. O follow-up variou de 1 a 7 anos. A complicação mais frequente é a sinusite maxilar, e a técnica de fixação zigomática pode incorrer em inúmeras complicações se o cirurgião for inexperiente e/ou não tiver bom conhecimento anatômico da região. Faltam estudos com casos controle que discussão as complicações trans e pós-operatórias.

Aim: Orthognathic surgery aims to correct facial skeletal deformities and the correct condylar positioning is very important for stable results. The aim of the present study was to verify the occurrence of changes in the postoperative condylar positioning in artificial skulls with a skeletal Class II maxillomandibular relationship submitted to bilateral sagittal split osteotomy when the method of cephalometric data transfer was used. Methods: Ten skeletal Angle class II polyurethane skulls were used with metallic markers in the articular surfaces of the temporomandibular joint and mandibular condyles. The skulls were submitted to preoperative and postoperative cone beam computed tomography before and after the bilateral sagittal split osteotomy. To verify the condylar positioning, measurements between the distances of the markers at the temporal bones and mandibular condyles were taken in the coronal and sagittal views by the DISTANCE tool of the iCat Vision software. All measurements were obtained by one examiner in the preoperative and postoperative CBCTs, tabulated and submitted to statistical analysis by the Wilcoxon test with a level of significance of 5% (p

The maxillary sinuses are the largest of the paranasal sinuses. They consist of pneumatized bilateral cavities, lined by respiratory mucosa, identical to the nasal mucosa, consisting of pseudostratified epithelium, with hair cells and goblet cells, producing mucus. Radiographically, the maxillary sinus is seen as a radiolucent area, ovoid or rounded, with a well-defined contour, delimited by a continuous radiopaque line or with small interruptions and radiolucency similar to that of the orbit. When a change in the maxillary sinus is suspected, images of the sinus are usually found, the presence of septa, thickening of the mucosa, or polyps. Sinusitis is the main pathology of the maxillary sinus, being of multifactorial etiology, and may be due to anatomical, environmental factors or viral, bacterial, or fungal infections. The diagnosis of sinusitis is clinical, but it can be confirmed by imaging exams such as panoramic radiography or cone beam computed tomography (CBCT). Case Presentation: In this case of a 21-year-old patient treated by the FOB-USP Surgery team, due to the proximity of the third molar to the maxillary sinus, a cone-beam scan was performed in which bubbles were noted on the surface of the maxillary sinus content. The image is compatible with sinusitis however, the presence of bubbles is a very unusual image in this type of alteration of the maxillary sinus. Conclusions: CT images with fluid levels and bubbles on their surface, although uncommon in dental practice, are characteristic of acute sinusitis and the dentist must have this knowledge for the correct diagnosis of maxillary sinusitis. Los senos maxilares son los más grandes de los senos paranasales. Consisten en cavidades bilaterales neumatizadas, revestidas por mucosa respiratoria, idéntica a la mucosa nasal, estando constituidas por epitelio pseudoestratificado, con células ciliadas y caliciformes, productoras de moco. Radiográficamente, el seno maxilar se ve como un área radiolúcida, ovoide o redondeada, de contorno bien definido, delimitado por una línea radiopaca continua o con pequeñas interrupciones y radiolucidez similar a la de la órbita. Cuando se sospecha un cambio en el seno maxilar, suelen encontrarse imágenes del seno en las imágenes, presencia de septos, engrosamiento de la mucosa o pólipos. La sinusitis es la principal patología del seno maxilar, siendo de etiología multifactorial, que puede deberse a factores anatómicos, ambientales o infecciones virales, bacterianas o fúngicas. El diagnóstico de sinusitis es clínico, pero puede confirmarse mediante pruebas de imagen como la radiografía panorámica o la tomografía computarizada de haz cónico (CBCT). El objetivo de este estudio es presentar un Caso Clínico de un paciente de 21 años tratado por el equipo de Cirugía FOB-USP, debido a la proximidad del tercer molar al seno maxilar, se le realizó un escaneo de haz cónico en el que se notaron burbujas en la superficie del maxilar. contenido de los senos nasales. La imagen es compatible con sinusitis, sin embargo, la presencia de burbujas es una imagen muy inusual en este tipo de alteración del seno maxilar. Os seios maxilares são os maiores dos seios paranasais. Consistem em cavidades bilaterais pneumatizadas, revestidas por mucosa respiratória, idêntica à mucosa nasal, sendo constituídas por epitélio pseudoestratificado, com células ciliadas e caliciformes, produtoras de muco. Radiograficamente, o seio maxilar é visto como uma área radiolúcida, de forma ovoide ou arredondada, com contorno bem definido, delimitado por linha radiopaca contínua ou com pequenas interrupções e radiolucidez semelhante à da órbita. Quando se tem suspeita de alteração no seio maxilar, geralmente são encontrados, nas imagens, velamento do seio, presença de septos, espessamento da mucosa ou pólipos. A sinusite é principal patologia do seio maxilar, sendo de etiologia multifatorial, podendo se dever a fatores anatômicos, ambientais ou infecções virais, bacterianas ou fúngicas. O diagnóstico da sinusite é clínico, porém pode ser confirmado por exames de imagem como radiografia panorâmica ou tomografia computadorizada de feixe cônico (TCFC). Presentamos um Caso Clinico caso de um paciente de 21 anos, atendido pela equipe de Cirurgia da FOB-USP, devido a proximidade do terceiro molar com o seio maxilar foi realizada tomografia de feixe cônico na qual foram notadas bolhas na superfície do conteúdo do seio maxilar. A imagem é compatível com sinusite, entretanto a presença de bolhas é uma imagem bastante inusitada nesse tipo de alteração do seio maxilar.

Osteoma is a benign tumor that often affects the maxillofacial region. It exhibits slow growth and remains asymptomatic for prolonged time and may cause facial asymmetry or functional disorders when it reaches vast proportions. When osteomalacia is diagnosed it is important to check about Gardner’s Syndrome because up to 90% of patients with this syndrome may present skeletal abnormalities and osteomas. The objective of this paper is to report a case of a 54-year-old woman that related an 8-year evolution of a volume increase in the face. Clinical examination showed facial asymmetry and presence of nodular lesion located in the left region of the mandibule, painless and hard on palpation. Panoramic radiography showed radiopaque image limited to the left mandibular body and angle, suggestive of osteoma. Gastrointestinal review was requested and discarded intestinal polyps and Gardner’s Syndrome. The patient was submitted to excisional biopsy and microscopic examination of the tumor that confirmed the diagnosis of osteoma. Osteoma needs special attention due to the possible association with malignant lesions intestine and also by psychological and functional problems, when it reaches great proportions.

This paper aims to report a case of radicular displacement to the submandibular space and to review the literature seeking reports of dental displacements / fragments published in the period from 2007 to 2017 in PubMed evidencing risk factors, prevention and forms of treatment. In this article a case of displacement of dental fragments to the submandibular space with immediate removal is reported. The third molar or its roots displacement into facial spaces is a rare situation. The preoperative surgical planning is fundamental to avoid this type of complication. The association of (1) good surgical planning, (2) surgical technique utilization and adequate instruments, and (3) the surgeon experience are determining factors to avoid the occurrence of this complication. Keywords: Molar, Third. Surgery, Oral. Intraoperative Complications. ResumoA extração de terceiros molares é o procedimento cirúrgico mais frequente nos consultórios odontológicos. Como qualquer cirurgia, existe a possibilidade de complicações trans e pós-operatórias. O deslocamento desses dentes ou fragmento dentário para espaços faciais é raro, com frequência extremamente baixa. Este trabalho tem como objetivo relatar um caso de deslocamento radicular para o espaço submandibular e revisar a literatura buscando relatos de deslocamentos dentários/fragmentos publicados no período de 2007 a 2017 no Pubmed evidenciando fatores de risco, prevenção e formas de tratamento. Nesse artigo nós relatamos um caso de deslocamento de um fragmento radicular para o espaço submandibular, sendo este removido imediatamente. O deslocamento do terceiro molar ou de fragmentos radiculares para os espaços faciais é raro. A avaliação pré-operatória é fundamental para evitar esse tipo de complicação. A associação entre (1) planejamento cirúrgico correto, (2) utilização de técnica e materiais corretos e (3) experiência do profissional, são fatores determinantes para evitar esse tipo de complicação. Palavras-chave: Dente Serotino. Cirurgia Bucal. Complicações Intraoperatórias.

Made available in DSpace on 2019-10-03T17:31:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2019. Added 1 bitstream(s) on 2019-10-04T16:20:44Z : No. of bitstreams: 1 S1806-83242019000100242.pdf: 1151972 bytes, checksum: 8abaa23ea42538cd707e918a3ff5808b (MD5) Abstract The present study aimed to investigate the use of platelet-rich plasma (PRP) on tooth extraction sites in rats treated with bisphosphonates. Thirty Albinus Wistar male rats were administered 0.035 mg/kg zoledronic acid intravenously for 8 weeks, divided into four administrations with a 2-week interval between each application, after which their upper right central incisors were extracted to induce the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The samples were divided into the following two groups: Group 1 (G1) underwent marginal resection of BRONJ followed by the use of PRP, while Group 2 (G2) underwent resection of BRONJ but without the use of PRP. The treatment groups were evaluated after 14, 28, and 42 days. Clinical, microtomographic, microscopic, and immunohistochemical (IHC) evaluations were performed. Microtomography results revealed no significant difference between the groups (p

Objective: To verify the rate of systemic changes observed in individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the Undergraduate Dentistry course at the Faculty of Dentistry of Bauru (FOB-USP). Methodology: a retrospective study of the medical records of individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the third and fourth years of the Dentistry course at FOB-USP, from January 1, 2015, to June 30, 2017. Data collection was performed based on information from the anamnesis obtained during the initial care of the patients and recorded in the medical records. The selected data were name, age, address, diagnosed systemic disease, current and/or past medical treatments, proposed surgical treatment, and, if there was, patient return after medical treatment for surgery. The medical records of individuals under the age of 18, patients who did not have any systemic changes, or those with systemic changes observed outside the initial care period were excluded. RESULTS: The sample consisted of 266 medical records and 119 of these were from individuals who had systemic changes (44.7%), with systemic arterial hypertension being the most common (33.1%), followed by diabetes mellitus (17.8%). Conclusion: the high prevalence of individuals with systemic alterations and who require dental surgical intervention was proven, which implies the need for a correct anamnesis and preoperative evaluation so that these cases are managed to avoid trans and/or post-operative, systemic, and/or local. Objetivo: verificar la tasa de cambios sistémicos observados en individuos atendidos en las clínicas de Cirugía y Traumatología Oral y Maxilofacial de la carrera de Pregrado en Odontología de la Facultad de Odontología de Bauru (FOB-USP). Metodología: estudio retrospectivo de las historias clínicas de los individuos atendidos en las consultas de Cirugía y Traumatología Oral y Maxilofacial del tercer y cuarto año de la carrera de Odontología en la FOB-USP, del 1 de enero de 2015 al 30 de junio de 2017. Se realizó recolección de datos. basado en información de la anamnesis obtenida durante la atención inicial de los pacientes y registrada en la historia clínica. Los datos seleccionados fueron nombre, edad, dirección, enfermedad sistémica diagnosticada, tratamientos médicos actuales y / o pasados, tratamiento quirúrgico propuesto y, en su caso, retorno del paciente después del tratamiento médico para la cirugía. Se excluyeron las historias clínicas de personas menores de 18 años, pacientes que no presentaron cambios sistémicos o aquellos con cambios sistémicos observados fuera del período inicial de atención. Resultados: la muestra estuvo constituida por 266 historias clínicas, de las cuales 119 correspondieron a individuos con alteraciones sistémicas (44,7%), siendo la hipertensión arterial sistémica la más frecuente (33,1%), seguida de la diabetes mellitus (17,8%). Conclusión: se ha comprobado la alta prevalencia de individuos con alteraciones sistémicas y que requieren intervención quirúrgica dental, lo que implica la necesidad de una correcta anamnesis y evaluación preoperatoria, para que estos casos sean manejados con el fin de evitar complicaciones trans y / o postoperatorias, sistémica y / o local. Objetivo: verificar o índice de alterações sistêmicas observadas nos indivíduos atendidos nas clínicas de Cirurgia e Traumatologia Bucomaxilofacial do curso de Graduação em Odontologia, da Faculdade de Odontologia de Bauru (FOB-USP). Metodologia: estudo retrospectivo dos prontuários dos indivíduos atendidos nas clínicas de Cirurgia e Traumatologia Bucomaxilofacial do terceiro e quarto anos do curso de Odontologia da FOB-USP, no período de 1 de janeiro de 2015 a 30 de junho de 2017. A coleta dos dados foi realizada a partir das informações da anamnese obtida durante o atendimento inicial dos pacientes e anotadas nos prontuários. Os dados selecionados foram nome, idade, endereço, doença sistêmica diagnosticada, tratamentos médicos atuais e/ou pregressos, tratamento cirúrgico proposto e, se houve, retorno do paciente após tratamento médico para realização da cirurgia. Foram excluídos os prontuários dos indivíduos com idade inferior a 18 anos, pacientes que não apresentaram nenhuma alteração sistêmica ou aqueles com alterações sistêmicas observadas fora do período de atendimento inicial. Resultados: a amostra foi composta por 266 prontuários e 119 desses eram de indivíduos que apresentaram alterações sistêmica (44,7%), sendo a hipertensão arterial sistêmica a mais comum (33,1%), seguida pela diabetes mellitus (17,8%). Conclusão: comprovou-se a alta prevalência de indivíduos portadores de alterações sistêmicas e que necessitam de intervenção cirúrgica Odontológica, o que implica na necessidade de uma correta anamnese e avaliação pré-operatória, para que esses casos sejam manejados de forma a evitarmos complicações trans e/ou pós-operatórias, sistêmicas e/ou locais.

It is necessary to preserve height and thickness of the alveolar bone to facilitate rehabilitation with osteointegratable implants or simply to maintain bone integrity after extraction. Biomaterials associated with resorbable or non-resorbable membranes, when placed in the region of the socket, may contribute to avoid this unwanted reabsorption. Objective The objective of this study was to evaluate the distance of the crest of alveolar ridge to the cementoenamel junction (CEJ) of the lower second molars and the bone density of the third molar socket filled with Gen-Tech®, 5 years after an exodontia using cone beam computed tomography (CBCT) to visualize the central region of the sockets, without overlapping of the buccal and lingual cortical bones. Material and Methods A total of 12 individuals from an initial group of 39 patients submitted to extraction of the unruptured lower third molars and grafting of an association of inorganic bovine bone matrix, organic bovine bone matrix, collagen and bone morphogenetic proteins (BMP) (Gen-Tech®) on one side and the contralateral sockets filled only by clot, returned to control after 5 years, and were submitted to CBCT. The distance from the crest of alveolar bone to the CEJ and the bone density (BD) were measured using the i-CAT Vision Software. Results The results showed that the distance from the crest of alveolar bone to the CEJ in the control group was similar to that observed before the exodontia; in the experimental group, this distance was smaller. Considering the BD measurement, a significantly higher density was observed in the experimental group (p

PURPOSE To evaluate if an inorganic graft applied before implant insertion interferes with osseointegration. MATERIALS AND METHODS The bilateral mandibular incisors of 12 rabbits were extracted. One of the sockets was randomly filled with an inorganic xenogenic bone graft, whereas the remaining socket was allowed to heal naturally and served as a control. After 60 days, titanium implants were inserted into healing areas. The animals were killed 60 days after. Bone depositions were marked with fluorochrome oxytetracycline, alizarin, and calcein and evaluated using confocal laser scanning microscopy. Bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were analyzed. Data were compared statically by paired t tests, one-way ANOVA, and Bonferroni post hoc tests (α = 0.05). RESULTS No differences between the control and experimental groups in bone deposition for each marker, in either the BIC or BA analysis were observed. The bone deposition marked by alizarin (14-21 days) was the highest, followed by oxytetracycline (0 and 7 days) and calcein (45 and 52 days) in both groups (P < 0.05). CONCLUSION The bone healing or the course of osseointegration was not impaired by the use of an inorganic xenogenic graft before insertion of a titanium implant.

Background It is expected that 40% to 60% of initial alveolar bone volume will be lost up to 6 months after tooth extraction. OsteoScafTM (TRT, Toronto, ON, Canada) (poly (DL-lactide-co-glycololide/calcium phosphate [PLGA/CaP] scaffold) is a novel bone substitute material and represents a promising alternative for maintaining alveolar bone integrity in this clinical scenario. Purpose Here it was hypothesized that OsteoScaf would reduce alveolar bone lost after tooth extraction in patient, acting as a clot-retention device. Material and Methods A total of 10 patients (32 sockets) were included in the study, of which 16 sockets were grafted with OsteoScaf and 16 were used as control (coagulum alone). Cone beam computed tomography (CBCT) was performed both immediately following extraction and also at 120 days postoperatively, at which time biopsy samples were also harvested for histological analyses. Results Quantitative analysis of CBCT showed less bone resorption in the OsteoScaf groups, being 10.5% to 14.4% less bone lost in the center of the socket, 15.4% in the buccal region, and 12.6% in the palatal. Qualitative histological analysis showed new bone tissue in direct apposition to the scaffold – demonstrating its osteoconductive nature. Conclusion OsteoScaf diminished the expected bone lost during the postextraction remodeling of the alveolar bone ridge at 120 days postextraction.

Fusion is the union of two developing dental germs, resulting in a single large dental structure. It involve two normal dental germs or the germ of a normal tooth with a germ of a supernumerary one. Supernumerary teeth are additional teeth of the normal series which may occur in any region of the dental arch, althoug they are more common in the maxilla than in the mandible. This article presents a case of fusion between a third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan´s radiographic technique, but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography which provides precise three-dimensional information, was used to determinate the fusion diagnosis and also to help in the surgical planning.

The block anesthesia of the greater palatine foramen (GPF) is largely used in minor oral surgeries, periodontics and general dentistry. Furthermore, the area of the GPF serves as a donor of soft tissue graft. So, the aim of this study was to evaluate the position and characteristics of the GPF in Brazilian patients using cone beam computed tomography (CBCT) providing anatomical information for the greater palatine nerve block anesthesia and indicate site to collect palatal donor tissue. Fifty CBCT exams of Brazilian patients with a mean age of 35.8 years (27 male/23 female) were evaluated. All patients had erupted first, second and third upper molars. A total of 100 GPF were evaluated bilaterally. The GPFs were assessed regarding position, diameter and distances to the midline maxillary suture (MMS) and to alveolar ridge (AR). Guidelines were drawn in the CBCT axial image depicting all molar interproximal surfaces, bilaterally. The guidelines were located between first, second and third molar and in the center of the second and third, performing five guidelines in each side. These guidelines and the molars were landmarks to assess the GPF anatomic position. From the 100 GPF analyzed, 92 were located in the third molar region (24 male/22 female). The 92 GPF were distributed as 47 in the left side and 45 in the right side. The average GPF diameter and the distance to both the AR and the MMS were 3.1 mm; 7.9 and 15.3 mm, respectively. Within the limits of this study, we concluded that the in Brazilian patients studied, the GPF location was more closely related to third molar. Therefore, whenever the third molar is erupted, it could be used as landmark for successful GPN block anesthesia. Moreover, harvesting palatal mucosa graft around the third molar should be done cautiously to prevent damage to the GPF vascular-nerve complex.

OBJETIVOS: avaliar a confiabilidade na identificação de marcadores observados em radiografias PA. METODOLOGIA: em 3 crânios humanos secos procedeu-se à instalação de aparelhos expansores do tipo Hyrax, nos quais adaptaram-se marcadores nos acessórios ortodônticos. RESULTADOS: a comparação estatística dos 27 cefalogramas confeccionados revelou para as medidas angulares valores dos erros com pequenas variações, entretanto os menores erros foram encontrados para as medidas lineares entre os marcadores. Deste modo, conclui-se que a pouca variabilidade na identificação dos marcadores demonstrou sua confiabilidade para o uso em estudo com telerradiografias PA.Os erros para as medias angulares atribui-se às dificuldades na determinação de estruturas anatômicas. CONCLUSÃO: os marcadores avaliados neste estudo parecem prestarem-se como estruturas confiáveis em telerradiografias PA utilizadas em pesquisas longitudinais.AIM: to evaluate the reliability in the identification of the markers observed in frontal Cephalometric x-rays. METHODS: in 3 dry humans skull were adapted expansor appliances, in which markers were attached at orthodontics brackets and tubes. RESULTS: the statistical comparison of the 27 postero-anterior cephalograms revealed that the angular measures showed small variations; however the smallest error were for the lineal measures among the markers. CONCLUSION: the markers demonstrated its reliability for the use in longitudinal researches with frontal cephalometric x-rays.

A erupção ectópica e a impacção de caninos superiores são problemas bastante comuns na população. A excelência do tratamento ortodôntico traduz-se na correção da oclusão, harmonia do sorriso, saúde periodontal e estabilidade pós-tratamento. Para obtermos tais condições, a manutenção dos caninos é fundamental. Portanto, o objetivo deste estudo foi avaliar radiograficamente a localização de caninos superiores não irrompidos utilizando-se radiografias panorâmicas. Foram selecionadas setenta radiografias panorâmicas de pacientes com impacção uni ou bilateral de caninos, candidatos a tratamento cirúrgico. Para determinação da posição espacial dos caninos superiores não irrompidos foram selecionados métodos descritos na literatura e uma avaliação proposta neste trabalho. A localização de caninos não irrompidos é fundamental para estabelecer o plano de tratamento, auxiliando no acesso cirúrgico e na direção das forças ortodônticas a serem aplicadas no dente impactado. Os pacientes que tiveram suas radiografias utilizadas neste estudo serão tratados pelas disciplinas de Ortodontia e Cirurgia, com exodontia do canino ou exposição cirúrgica para colagem do dispositivo de tracionamento associada ao tratamento ortodôntico corretivo. Ectopic eruption and the impaction of upper canines are problems quite commonly presented by the population. An excellent orthodontic treatment encompasses occlusal correction, smile harmony, periodontal health and posttreatment stability. Such conditions can be obtained upon the due maintenance of the canines, therefore, the aim of this study is to assess the radiographic localization of non-erupted upper canines using panoramic radiographs. In this study, seventy panoramic radiographs of patients presented with uni or bilateral canine impaction, applying for surgical treatment, were selected. Methods described in the literature and an evaluation proposed in this work were chosen to determine the spatial position for non-erupted upper canines. The localization of non-erupted canines is fundamental to establish the treatment plan, aiding in the surgical access and in the direction of orthodontic forces to be applied on the impacted tooth. The patients whose radiographs were utilized in this study will be treated at the Orthodontics and Surgery Departments, by means of surgeries for canine exodontics or surgical exposure for the bonding of a wire traction device, associated with corrective orthodontic treatment.

A erupção ectópica e a impacção de caninos superiores são problemas bastante comuns na população. A excelência do tratamento ortod��ntico traduz-se na correção da oclusão, harmonia do sorriso, saúde periodontal e estabilidade pós-tratamento. Para obtermos tais condições, a manutenção dos caninos é fundamental. Portanto, o objetivo deste estudo foi avaliar radiograficamente a localização de caninos superiores não irrompidos utilizando-se radiografias panorâmicas. Foram selecionadas setenta radiografias panorâmicas de pacientes com impacção uni ou bilateral de caninos, candidatos a tratamento cirúrgico. Para determinação da posição espacial dos caninos superiores não irrompidos foram selecionados métodos descritos na literatura e uma avaliação proposta neste trabalho. A localização de caninos não irrompidos é fundamental para estabelecer o plano de tratamento, auxiliando no acesso cirúrgico e na direção das forças ortodônticas a serem aplicadas no dente impactado. Os pacientes que tiveram suas radiografias utilizadas neste estudo serão tratados pelas disciplinas de Ortodontia e Cirurgia, com exodontia do canino ou exposição cirúrgica para colagem do dispositivo de tracionamento associada ao tratamento ortodôntico corretivo.Ectopic eruption and the impaction of upper canines are problems quite commonly presented by the population. An excellent orthodontic treatment encompasses occlusal correction, smile harmony, periodontal health and posttreatment stability. Such conditions can be obtained upon the due maintenance of the canines, therefore, the aim of this study is to assess the radiographic localization of non-erupted upper canines using panoramic radiographs. In this study, seventy panoramic radiographs of patients presented with uni or bilateral canine impaction, applying for surgical treatment, were selected. Methods described in the literature and an evaluation proposed in this work were chosen to determine the spatial position for non-erupted upper canines. The localization of non-erupted canines is fundamental to establish the treatment plan, aiding in the surgical access and in the direction of orthodontic forces to be applied on the impacted tooth. The patients whose radiographs were utilized in this study will be treated at the Orthodontics and Surgery Departments, by means of surgeries for canine exodontics or surgical exposure for the bonding of a wire traction device, associated with corrective orthodontic treatment.

This study aimed to evaluate the possibility of detecting the zygomaticofacial foramen (ZFF) in cone-beam computed tomography (CBCT).This study evaluated ZFFs in 151 macerated skulls (302 zygomatic bones, ZBs) by physical inspection, in which the presence and diameters of the ZFFs were determined. These data were compared with the CBCT images of the skulls to determine the accuracy of CBCT in detecting ZFFs. The diameters were measured by insertion of steel wires with known thicknesses into the ZFFs. The CBCT images were acquired by an i-CAT Classic® (International Imaging Sciences, Hatfield, PA) connected to a workstation (Model ITOX Midtower Workstation; Imaging Sciences International®) with a 20-inch Eizo monitor. The images were generated in coronal, sagittal and axial slices to evaluate the best tomographic plane for ZFF visualization.The incidence of ZFF found by physical inspection was one foramen in 44% of ZBs (n = 133), two foramina in 28% (n = 86), three foramina in 8% (n = 24) and four foramina in 1% (n = 2). ZFF was absent in 19% (n = 57) of ZBs. The average diameter was 0.57 mm (± 0.27 mm). All foramina were observed in all tomography images.This preliminary study supports the conclusion that a CBCT scan has excellent accuracy in evaluating ZFFs.

This study evaluated the biomechanical and microscopic response of previously grafted bone to titanium implants. The lower incisors of 16 rabbits were surgically extracted, and bilateral perforations communicating with the remaining sockets were created distally. A socket/perforation defect on each mandible was chosen at random to be immediately filled with a xenogenic graft, whereas the contralateral perforation was left to heal naturally and served as a paired control. After 60 days, titanium implants were installed in the previously operated areas. After periods of 2 and 6 months, the animals were killed, and the force necessary to retrieve implants as well as the bone-implant contact (BIC) and bone mass (BM) were quantified and statistically compared by 2-way analysis of variance and Tukey's test (α = .05). No significant differences in removal torque were observed, either by time or by treatment condition. Differences in BIC and BM between experimental and control groups were not statistically significant through the intervals studied (P < .05). The presence of a xenogenic graft did not influence the microscopic tissue response to titanium implants or fixation into newly formed or mature bone.

Dry socket is one of the most studied complications in dentistry, and a great number of studies have searched for an effective and safe method for its prevention and treatment. One of the great clinical challenges since the first case was reported has been the inconsistency and differences in the various definitions of dry socket and the criteria used for diagnosis. The pathophysiology, etiology, prevention, and treatment of dry socket are very important in the practice of oral surgery. The aim of the present report was to review and discuss each aspect.

The objective of this study was to evaluate the long-term influence of xenogenic grafts on bone crestal height and radiographic density following extraction of teeth. The right and left third lower molars of 22 patients were surgically extracted, and one randomly chosen socket was filled with a xenogenic graft (Gent-Tech). The contralateral molar was left to heal naturally, serving as a paired control. Digital intraoral radiographies were taken at surgery and 2, 6, and 24 months after, to evaluate bone density (BD) and alveolar bone crest to cementoenamel junction distance. The data obtained were subjected to two-way analysis of variance and Tukey's test (α = 0.05). The significant decrease in cementoenamel junction distance observed for both groups was limited to the first 6 months. BD values increased significantly in the first 6 months, with no alterations observed up to 24 months for both groups. BD was higher for the experimental group at all time points (p < 0.05). Socket grafting with the xenogenic materials tested did not changed bone crestal height and bone radiographic density in the long term.

The pathogenesis of alveolitis is not well known and therefore experimental situations that mimic some features of this disease should be developed. OBJECTIVE: In this study, the evolution of the experimentally induced infection in rat sockets is characterized, which leads to clinical signs of suppurative alveolitis with remarkable wound healing disturbs. MATERIAL AND METHODS: Non-infected (Group I) and experimentally infected sockets in Rattus novergicus (Group II) were histometrically evaluated regarding the kinetics of alveolar healing. In addition, the characterization of the present bacteria in inoculation material and the serum levels of C-reactive protein (CRP) were performed. The detected species were Capnocytophaga ochracea, Fusobacterium nucleatum ss nucleatum, Prevotella melaninogenica, Streptococcus anginosus, Treponema socranskii and Streptococcus sanguis. RESULTS: All experimentally infected rats developed suppurative alveolitis, showing higher levels of CRP in comparison to those non-infected ones. Furthermore, infected rats presented a significant delayed wound healing as measured by the histometric analysis (higher persistent polymorphonuclear infiltrate and lower density of newly formed bone). CONCLUSION: These findings indicate that rat sockets with experimentally induced infection produced higher levels of serum CRP, showing the potential of disseminated infection and a disturb in the alveolar repair process in an interesting experimental model for alveolitis studies.

A 15-year-old white female sought our institution complaining of a chirping noise during speech and swallowing. The noise was spontaneous, perceptible, and enhanced when hard suction on the anterior palate was performed. The patient reported no trauma, infection, or other clinical feature related to the noise. Clinical examination showed 2 small grooves on both sides of the midline, lateral to the incisive papilla. The left groove was visually deeper. Careful probing with a gutta-percha cone revealed the existence of a communication on this side extending from the mouth to the nasal cavity, which was confirmed clinically and radiographically. Probing was not possible on the right side. The diagnosis was unilateral patent nasopalatine duct, which was surgically treated. We report here a new case of patent nasopalatine duct and also present a review of the pertinent literature.

Primary failure of eruption represents a cessation of tooth eruption before emergence not due to a physical barrier or abnormal position and has no systemic cause. This failure of tooth eruption is rare phenomenon and it has not been associated with alterations of dental follicle. This case report describes a permanent right first molar with primary failure of eruption at the inferior border of the mandible presenting microscopic, clinical and radiographic findings compatible with follicular cystic lesion. The follicular tissues of this molar showed microscopic aspects of inflammation. Thus, pericoronal tissues surrounding long-term unerupted teeth with primary failure of eruption has potential to develop into odontogenic cysts. The lesion presented herein probably arose in association with a periodontal pocket mesial to the adjacent second molar, representing an atypical inflammatory follicular cyst. This case shares etiological, radiological and microscopic features with the usual form of the inflammatory follicular cyst associated with infected primary teeth, except for the infection pathways reaching the tooth follicle. The controversies regarding the terminology for this cyst are discussed. A falha primária de erupção é caracterizada pelo não irrompimento de um dente sem que haja impedimento mecânico ou que o dente esteja em posição anormal ou devido à causas sistêmicas. É um fenômeno raro e não foi associado com alterações do folículo dentário. Este relato descreve um caso de falha primária de erupção de um primeiro molar inferior direito permanente, localizado na base da mandíbula, que apresenta achados clínicos, radiográficos e microscópicos compatíveis com cisto folicular. O folículo pericoronário deste molar apresentou aspectos microscópicos de inflamação. Assim como os tecidos pericoronários dos dentes não irrompidos, a longo prazo, os folículos pericoronários dos dentes com falha primária de irrompimento têm o potencial para desenvolver cistos odontogênicos. Esta lesão provavelmente surgiu em associação com uma bolsa periodontal na mesial do segundo molar adjacente, caracterizando um cisto folicular inflamatório atípico. Este caso apresenta características etiológicas, radiográficas e microscópicas comuns nos cistos foliculares inflamatórios associados a dentes decíduos infectados, com exceção das infecções que alcançam o folículo. São discutidas ainda as controvérsias relativas à terminologia deste cisto.

OBJETIVOS: avaliar a confiabilidade na identificação de marcadores observados em radiografias PA. METODOLOGIA: em 3 crânios humanos secos procedeu-se à instalação de aparelhos expansores do tipo Hyrax, nos quais adaptaram-se marcadores nos acessórios ortodônticos. RESULTADOS: a comparação estatística dos 27 cefalogramas confeccionados revelou para as medidas angulares valores dos erros com pequenas variações, entretanto os menores erros foram encontrados para as medidas lineares entre os marcadores. Deste modo, conclui-se que a pouca variabilidade na identificação dos marcadores demonstrou sua confiabilidade para o uso em estudo com telerradiografias PA.Os erros para as medias angulares atribui-se às dificuldades na determinação de estruturas anatômicas. CONCLUSÃO: os marcadores avaliados neste estudo parecem prestarem-se como estruturas confiáveis em telerradiografias PA utilizadas em pesquisas longitudinais. AIM: to evaluate the reliability in the identification of the markers observed in frontal Cephalometric x-rays. METHODS: in 3 dry humans skull were adapted expansor appliances, in which markers were attached at orthodontics brackets and tubes. RESULTS: the statistical comparison of the 27 postero-anterior cephalograms revealed that the angular measures showed small variations; however the smallest error were for the lineal measures among the markers. CONCLUSION: the markers demonstrated its reliability for the use in longitudinal researches with frontal cephalometric x-rays.

The procedure of maxillary sinus lifting using autogenous bone was considered the reference standard choice for oral rehabilitation in cases of severe atrophic maxilla. However, it is not always a viable option, due to the limitations or morbidity caused by grafting techniques. This has led to the development of bone substitutes, which have been elaborated and improved. Choosing the best biomaterial becomes difficult due to the wide variety of bone substitutes. The aim of this article is to present some of these materials that are reported in the current scientific literature for maxillary sinus lifting.

PURPOSE: To evaluate two treatment modalities of dry socket in rats and to discuss the first findings of the molecular analysis in this experimental model. METHODS: 84 rats underwent a tooth extraction were divided in 4 groups: I-uninfected socket (control), II-infected socket without any treatment, III-infected socket treated with irrigation of 2% sodium iodide and 3% hydrogen peroxide solution, IV-infected socket submitted to curettage, irrigation with physiological saline solution and fulfilled with metronidazole paste as base. The groups were subdivided in postoperative sacrifice periods: 6/15/28 days. A quantitative and a qualitative microscopic analysis was performed. Also, a quantitative analysis was performed using a RealTimePCR to evaluate the genes expression in the wound healing: Collagen Type I/COL-I, vascular endothelial growth factor/VEGF, osteocalcin/OCN, alkaline phosphatase/ALP, runt-related transcription factor 2/RUNX2 and tumor necrosis factor alpha/TNF-α. RESULTS: The group I showed higher bone formation, followed by groups IV, III, II respectively. The group II presented higher inflammatory infiltrate and the wound healing was delayed compared with other groups. It was obtained a significant positive correlation between bone neoformation and the expression of OCN and RUNX2, inflammatory infiltrate with TNF-α and a negative correlation between bone neoformation and TNF-α. CONCLUSION: No significant difference was found between the treatments. OBJETIVO: Avaliar duas modalidades de tratamento da alveolite em ratos e discutir os primeiros achados de uma análise molecular neste modelo experimental. MÉTODOS: 84 ratos foram submetidos a uma extração dentária e foram divididos em quatro grupos: I- alvéolo não infectado (controle), II- alvéolo infectado sem tratamento, III- alvéolo infectado tratado com irrigação de iodeto de sódio a 2% e solução de peróxido de hidrogênio a 3%, IV- alvéolo infectado submetido à curetagem, irrigação com solução salina fisiológica e preenchimento com pasta a base de metronidazol. Os grupos foram subdivididos em períodos de sacrifício pós-operatório: 6/15/28 dias. Uma análise quantitativa e qualitativa microscópica foi realizada. Além disso, uma análise quantitativa foi realizada utilizando RealTimePCR para avaliar a expressão de genes no reparo alveolar: o colágeno tipo I / COL-I, o fator de crescimento endotelial vascular / VEGF, osteocalcina / OCN, fosfatase alcalina / ALP, fator de transcrição runt relacionados 2 / RUNX2 e fator de necrose tumoral alfa / TNF-α. RESULTADOS: O grupo I mostrou maior formação óssea, seguido pelos grupos IV, III, II, respectivamente. O grupo II apresentou maior infiltrado inflamatório e a cicatrização foi atrasada em comparação com outros grupos. Foi obtida uma correlação positiva entre a neoformação óssea e a expressão de OCN e RUNX2, infiltrado inflamatório com TNF-α e uma correlação negativa entre a neoformação óssea e TNF-α. CONCLUSÃO: Nenhuma diferença significativa foi encontrada entre os tratamentos.

A Cirurgia Ortognática melhora a estética e a função. Porém em alguns casos, podem ocorrer alterações do volume condilar após o procedimento e ainda são controversos os fatores que levam à essas alterações. Já está definido na literatura que existem fatores fisiológicos que predispõem às remodelações condilares, porém ainda é necessário avaliar a influência de outros fatores, como: o tipo de má oclusão que o paciente apresenta; o tipo de osteotomia realizado; o método de osteossíntese; o planejamento cirúrgico adotado; entre outros. Dentre esses, ainda não há um consenso sobre a osteossíntese mais adequada, já que alguns autores afirmam que dependendo da técnica utilizada, pode ocorrer um estresse na região condilar, acelerando o processo de remodelação ou até mesmo reabsorção condilar. O presente estudo teve como objetivo avaliar dois métodos de fixação da osteotomia sagital bilateral de mandíbula, sendo: 1) técnica híbrida e; 2) fixação com duas placas retas com parafusos monocorticais, e verificar se há relação desses fatores com a remodelação condilar. Para isso foram utilizadas tomografias computadorizadas de feixe cônico e aferidas as medidas lineares dos espaços articulares (Espaço articular anterior; espaço articular superior; espaço articular posterior; espaço articular medial) e o volume condilar pré e pós cirurgia ortognática, utilizando o software Dolphin Imaging 11.9 e ITK-Snap nos tempos pré-operatório e com um ano de pós-operatório. Foram selecionados 30 pacientes com má oclusão do tipo Classe II, sendo que 14 foram fixados utilizando a técnica híbrida e 16 a fixação com duas placas e parafusos monocorticais e 31 pacientes com má oclusão do tipo Classe III, sendo 16 com fixação hibrida e 15 com fixação com duas placas. As medições foram realizadas por dois examinadores previamente calibrados. Com esse estudo foi possível concluir que não houve diferença estatisticamente significante entre os côndilos mandibulares direito e esquerdo em todas as variáveis analisadas. Além disso, não foi encontrada nenhuma correlação entre os gêneros e os tipos de má-oclusão com a reabsorção condilar após a cirurgia ortognática, porém foi encontrado que a rotação anti-horária, promoveu uma maior taxa de reabsorção condilar que a rotação horária. Além disso, o software ITK- Snap, que é um software gratuito, apresentou excelente confiabilidade nos resultados apresentados quando comparado ao software Dolphin Imaging na aferição do volume condilar. Orthognathic Surgery improves esthetics and function. However, in some cases, postoperative condylar volume changes can occur and the factors that lead to these changes are still controversial. It is already defined in the literature that there are physiological factors that predispose to condylar remodeling, but it is necessary to evaluate the influence of other factors, such as: the type of malocclusion that the patient presents; the type of osteotomy performed; the osteosynthesis method; the surgical planning adopted; among others. Among these, there is no consensus on the most appropriate osteosynthesis, since some authors claim that depending on the osteosynthesis used, a stress may occur in the condylar region, accelerating the remodeling process or even condylar resorption. The present study aimed to evaluate two methods of fixation of bilateral sagittal mandibular osteotomy: 1) hybrid technique and; 2) fixation with two straight plates with monocortical screws, and verify if there is a relationship between these factors and condylar remodeling. Cone-beam computed tomography was used for this and the linear measurements of the joint spaces were measured (anterior joint space; superior joint space; posterior joint space; medial joint space) and condylar volume before and after orthognathic surgery, using Dolphin Imaging 11.9 and ITK-Snap software in the preoperative and one year postoperatively. Were selected 30 patients with Class II malocclusion, 14 of which were fixed using the hybrid technique and 16 were fixed with two monocortical plates and screws and 31 patients with Class III malocclusion, 16 with hybrid fixation and 15 with two plates fixation. Measurements were performed by two previously calibrated examiners. With this study, it was possible to conclude that there is no statistically significant difference between the right and left mandibular condyles in all analyzed variables. In addition, no correlation was found between genders and types of malocclusion with condylar resorption after orthognathic surgery, but it was found that counterclockwise rotation promoted a higher rate of condylar resorption than clockwise rotation. In addition, the ITK-Snap software (a free software) showed excellent reliability in the results presented when compared to the Dolphin Imaging software in the measurement of condylar volume.