Anibal Henrique Barbosa Luna

Rehabilitation of severely resorbed edentulous mandible using the modified visor osteotomy technique

The prosthetic rehabilitation of an atrophic mandible is usually unsatisfactory due to the lack of support tissues, mainly bone and keratinized mucosa for treatment with osseointegrated implants or even conventional prosthesis. The prosthetic instability leads to social and functional limitations and chronic physical trauma decreasing the patients quality of life. A 53-year-old female patient sought care at our surgical service complaining of impairment of her masticatory function associated with the instability of the lower total prosthetic denture. The clinical and complementary exams revealed edentulism in both arches, while the mandibular arch presented severe reabsorption resulting in denture instability and chronic trauma to the oral mucosa. The proposed treatment plan consisted in the mandibular rehabilitation with osseointegrated implants and fixed Brånemarks protocol prosthesis after mandibular reconstruction applying the modified visor osteotomy technique. The proposed technique offered predictable results for reconstruction of the severely resorbed edentulous mandible and posterior rehabilitation with osseointegrated implants.

Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemars test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

Spontaneous Eruption of Premolar Associated with a Dentigerous Cyst

Dentigerous cyst (DC) is the second most common odontogenic cyst with greater incidence in young patients. It presents as a unilocular, asymptomatic radiolucency involving the crown of an impacted tooth, commonly noticed in X-rays to investigate absence, wrong tooth position, or delay in the chronology of eruption. Decompression/marsupialization (D/M) is the most implemented treatment, especially when preserving the tooth involved is advised. The aim of this study is to discuss the DC characteristics that contribute to spontaneous eruption of premolars, by reporting the case of a conservative treatment of DC. This eruption depends on factors such as age, angulation of inclusion, rate of root formation, depth of inclusion, and eruption space. This paper reports the case of a 10-year-old patient with a radiolucent lesion diagnosed as DC involving element 35, which erupted as a result of treatment. The patient was observed during 1 year and 6 months.

Ganhos funcionais mensurados pelo MBGR e impacto na qualidade de vida em sujeito submetido à cirurgia ortognática: relato de caso

The proposed theme is Speech Therapy Intervention before and after orthognathic surgery. Evaluation (through MBGR Protocol of Orofacial Myofunctional Evaluation with scores) and speech therapy intervention were performed in the preoperative (three months) and postoperative periods, started on the 20th day (for three months) after the surgeons liberation. In addition, it was investigated the impact of dentofacial deformity in the patients life quality through the Oral Health Impact Profile - reduced version. In the preoperative evaluation, Simultaneous bilateral chewing, presence of noise in the temporomandibular joint and unsystematic lip closure were found while performing the function. During swallowing, there was contraction of the perioral muscles and presence of residues after this function. It was found, in speech, distortion in the /r/ sound. There was pain on palpation in the masticatory muscles and decreased tone in the perioral and masticatory muscles. It was found high impact on quality of life, totaling 32 points. In the evaluation after speech therapy intervention, improvement was observed in the chewing functions (pre: 4 points, post: 1 point), swallowing (pre: 14, post: 5), breathing (pre: 3, post: 1) and speech (pre: 7, post: 1), muscle mobility (pre: 8, post: 1), tonicity of the muscles (pre: 5, post: 0) and pain on palpation (pre: 10, post: 2). There was improvement in the posture of the lips and significant improvement in quality of life, from 32 to 8 points. It was found an improvement in the physiology of the stomatognathic functions, decreased pain on palpation, balance in tone, muscle mobility and improved quality of life.

Clinical, tomographic and histopathological aspects of the nasopalatine duct cyst

A 41-year-old female leukoderma patient was referred bythe orthodontist with a suspected maxillary injury. Thepatient had no complaints, and reported 11/21 extrac-tions due to caries as a child. On physical examination,no facial asymmetry was noted mucosae were intact(Fig. 1A). Computed tomography (CT) showed a sin-gle hypodense and well-delineated lesion, approximately1.0 cm×0.7 0.8 in size, following thecourse ofnasopalatineduct(Fig.1B).Excisionalbiopsywasperformed(Fig. 1C), and thespecimen was sent to Oral Pathol-ogy Laboratory, where a cystic cavity lined by thin columnarpseudostratified epithelium, consisting of one to three celllayers and a dense fibrous cystic capsule, was observedon microscopic examination (Fig. 1D). A predominantlymononuclear inflammatory infiltrate was evident in the cystlumen. From the clinical, tomographic, and histopatholog-ical findings, the diagnosis of nasopalatine duct cyst was

Associação entre displasia e inflamação em queilite actínica

INTRODUCTION: Actinic cheilitis may undergo malignant transformation to squamous cell carcinoma. Furthermore, there is evidence that inflammatory components may be involved in this process, hence the importance of studies involving cellular atypia and chronic inflammation in this lesion. OBJECTIVE: The aim of this study was to evaluate the histological features of actinic cheilitis considering the degree of dysplasia, the intensity of inflammatory infiltrate and the possible correlation between the variables. MATERIAL AND METHODS: We selected 45 paraffin blocks of lesions with clinical and histopathological diagnosis of actinic cheilitis that enabled histopathological evaluation. The histopathological analysis was performed and the dysplasias and inflammatory infiltrates were classified into mild, moderate and severe. Data were analyzed through descriptive statistics, chi-square test and Analysis of variance (ANOVA), considering p < 0.05. RESULTS: 59.5% (27) of cases of actinic cheilitis showed some degree of dysplasia, from which 40% (18) presented mild dysplasia, 11.1% (5) moderate and 8.4% (4) severe. Squamous cell carcinoma occurred in 20% (9) of the specimens. All cases showed some degree of inflammation, from which 48.9% (22) showed mild inflammatory infiltrate, 20% (9) moderate and 31.1% (14) intense. There was a statistically significant association between the degree of dysplasia and the intensity of inflammatory infiltrate, namely ANOVA p = 0.000 and chi-square p = 0.004. CONCLUSIONS: The results indicate that the occurrence of dysplasia and squamous cell carcinoma are common in actinic cheilitis and the inflammatory process was closely related to the progression of epithelial atypia.

Clinical and immunohistochemical study of melanotic neuroectodermal tumor of infancy in the maxilla

RESUMO O tumor neuroectodermico melanocitico da infância e uma neoplasia rara e de crescimento rapido. Neste estudo, relata-se o caso de uma paciente do sexo feminino de 6 meses de idade, que apresentou tumefacao na regiao anterior de maxila. A reconstrucao tomografica revelou area unilocular hipodensa e expansiva associada ao incisivo central superior direito deciduo. Realizou-se biopsia incisional, considerando as hipoteses diagnosticas de cisto dentigero, tumor odontogenico adenomatoide, tumor neuroectodermico melanocitico da infância e rabdomiossarcoma. Microscopicamente, a lesao revelou populacao [...]

Quality of life after orthognathic surgery: a case report

Mailing address: Giorvan Alves Rua Josemar Rodrigues de Carvalho, 245 apto 901 João Pessoa, PB, Brasil CEP:58037-415 E-mail: anderson_ufpb@yahoo.com.br ABSTRACT This case study aims to describe the effects of orthognathic surgery on the quality of life of a patient with class III dentofacial deformity. The protocols Oral Health Impact Profile, short version, and Orthognathic Quality of life Questionnaire were applied before and after orthognathic surgery to measure the quality of life of a subject. The data were collected from a clinical case report. We observed that, by the Oral Health Impact Profile, the quality of life was not affected by dentofacial deformity (score = 1), and that there was a 30-day postoperative score increase (score = 9), indicating a worsening of quality of life and an improvement after 90 days (score = 4). On the other hand, by the Orthognathic Quality of life Questionnaire, it was noticed that dentofacial deformity negatively affected the patient’s quality of life (score = 34), and that there was a progressive improvement in scores after surgery, i.e., from score 15 to 2, showing a positive impact on quality of life. The orthognathic surgery positively influenced the patient’s quality of life, requiring the application of specific protocols that accurately measure the impacts of the procedure on the individual’s life.

Adenomatoid odontogenic tumor simulating periapical cyst: case report

ABSTRACT The adenomatoid odontogenic tumor is a benign, non-invasive tumor and has a slow growth. Its preferred location is the anterior maxillary area, most often causing root displacement, more rarely resorption and mostly affects young women. Being asymptomatic, this injury is discovered upon routine radiographic examination, in which, in most cases, a unilocular, radiolucent image is observed and it may have some degree of calcification within the lesion. This work aims to report the case of a 14-year-old patient who attended the Lauro Wanderley University Hospital (UFPB), complaining of increased volume over a period of 8 months, in the region of non-vital tooth 21. The CT scan showed well-delimited unilocular, radiolucent lesion, with buccal cortex resorption. The proposed treatment plan involved enucleation, followed by peripheral ostectomy and bone graft with alloplastic materials. Because of its benign character, encapsulated and slow growing, the treatment of choice for adenomatoid odontogenic tumor is conservative, the surgical enucleation of the injury being advocated. The excised piece was sent for histopathological analysis, where the AOT diagnosis was confirmed. After 7 months, new bone formation was observed without signs of recurrence.

Failure of Osseointegrated Dental Implant After Alveolar Nerve Transposition: A Report of an Unusual Complication and Surgical Management

Purpose: To describe an unusual case of mandibular fracture after osseointegrated dental implant removal placed after inferior alveolar nerve transposition. Report of Case: The patient underwent inferior nerve transposition for implant placement due to lack of interarch space. Two months after metal-ceramic crowns installation, the patient began to complain of pain in the region of the implant. In an attempt to remove the implant, there was a fracture of the implant, and only two third of it was removed, leaving only the apical portion of the implant in the mandible. The patient opted for the total removal of implant. At 15 days of follow-up, the patient returned with mandibular fracture, which was treated through an internal fixation with a titanium reconstruction plate of 2.0-mm thickness with locking screws. Conclusion: The inferior alveolar nerve transposition may represent the only rehabilitation option, especially in cases where there is insufficient bone remaining for installation of short implants with reduced interarch space.