Auremir Rocha Melo

Current Approach in the Management of Patients With Foreign Bodies in the Maxillofacial Region

The aim of the present study was to describe and discuss the gamut of current diagnostic and therapeutic modalities regarding impacted foreign bodies in the head and neck region, addressing xeroradiography, magnetic resonance imaging, computed tomography, and ultrasonography as diagnostic aids and stressing the importance of a multidisciplinary team in the treatment of such injuries. Considerations are also offered on the different types and forms of presentation of foreign bodies that may be impacted in the maxillofacial region and specific treatment methods.

Eficácia da laserterapia nas disfunções têmporo-mandibulares: estudo controle

UNLABELLED Temporomandibular dysfunction is characterized by the presence of painful joint/muscular symptoms muscle in the face. The main justification for the use of lasers in laser therapy dysfunction is its analgesic effect, which was observed in most studies in the literature. AIM We evaluated the effectiveness of laser therapy in the treatment of temporomandibular disorders. METHODS 50 volunteers with temporomandibular disorders were divided into two groups (control and experimental) had amplitudes of movements of mouth opening, right and left laterality recorded before and after laser application. Was also recorded, the score the individual gave to pain by visual analog scale and, through physical examination, the pain points. We used the AsGaAl laser with a 40mW power, with 80J/cm(2) for 16 seconds at four selected points for just one session with reassessment after a week. STUDY DESIGN Clinical. RESULTS It was noted that laser therapy increased the mean amplitude of mandibular movements (p = 0.0317) and decreased significantly (43.6%) the pain intensity measured by the visual analog scale. CONCLUSIONS The laser decreases the painful symptoms of the patient after application through its analgesic and/or a placebo effect.

Impacted foreign bodies in orbital region: review of nine cases

Orbital injuries with a foreign body may result in severe structural and functional damage to the eye or orbital contents. Management and prognosis depend on the composition and location of the foreign body and whether there is secondary infection. Metallic objects and glass are the most frequently encountered and well-tolerated, whereas organic foreign bodies can elicit an inflammatory reaction and lead to serious complications. Despite the modern imaging methods, it is often difficult to identify and locate organic intraorbital foreign bodies. This paper presents a review of nine cases of impacted foreign bodies in the orbital region and discusses the diagnosis and treatment of this kind of injury. The following data were collected: age, gender, etiology of injury, occurrence of fracture, anatomical location of fracture, type of object, signs and symptoms, type of imaging exam used, approach, transoperative complication and occurrence of death. Foreign body injuries in the orbital region can be treated with a combination of clinical suspicion, basic knowledge and diagnostic tests and depend on the skill and experience of the surgeon, thereby decreasing the surgical risk of iatrogenic injury in relation to the inherent risk of retaining an organic intraorbital foreign body.

Fracture of the Atrophic Mandible: Case Series and Critical Review

PURPOSE Atrophic mandible fracture is common among elderly patients. Such fractures present management difficulties related to anatomic and physiologic alterations in this population. The purpose of this study was to evaluate the results of this type of fracture treatment and to realize a critical review of literature on the subject. PATIENTS AND METHODS The sample was obtained from records of patients of Restauração Hospital (Recife, Brazil) who underwent surgical treatment of atrophic mandible fracture between 2006 and 2009. Data, such as etiology, location, and degree of displacement of the fractures, as well as access, type of fixation used, and the presence of postoperative complications, were analyzed. RESULTS Successful bone union was achieved in 100% of cases. Complications were related to those patients treated with reconstruction plates (2.4 mm). CONCLUSIONS Open reduction and internal fixation with miniplates seem a feasible option for primary treatment of atrophic mandible fractures without comminution or loss of substance. The level of scientific evidence for the treatment of atrophic mandible fractures is low.

Tooth embedded in tongue following firearm trauma: report of two cases

Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.

Evaluation of fixation techniques with titanium plates and Kirschner wires for zygoma fractures: preliminary study.

OBJECTIVE The aim of the present study was to assess the quality of treatment using two reduction and fixation techniques for zygoma fractures. PATIENTS AND METHODS A randomized clinical trial was carried out involving a sample of 10 patients with Knight and North type III, IV and V zygoma fractures divided into two groups. One group underwent the closed reduction technique and fixation with Kirschner wire and the other group underwent the open reduction technique and fixation with titanium plates. The groups were submitted to subjective evaluation based on the patients perception of areas of deformity and paresthesia as well as the measurement of range of mouth opening and pain upon mouth opening in the preoperative (T0) and postoperative (T1) periods. The assessment of bone reduction quality was performed using quantifiable points (lateral wall of the orbit, anteroposterior projection of the zygoma and ocular globe projection), measured based on tomographic images. RESULTS Seventy percent of the patients remained with paresthesia and 20% remained with the complaint of deformity at T1. Mouth opening range increased in both groups at T1. In the overall sample, mean total disjunction of the lateral wall of the orbit and the difference in the anteroposterior projection of the zygoma were reduced between T0 and T1 (4.36 mm to 1.25 mm and 6.94 mm to 2.86 mm, respectively). There was also a reduction in ocular globe projection in both groups between T0 and T1. CONCLUSIONS Both techniques achieved adequate reduction of zygoma fractures in the postoperative period.

Cervical-thoracic facial necrotizing fasciitis of odontogenic origin

Doctoral de gree in oral and maxillofacial surgery and trauma, Pernambuco Dentistry School (FOP), UPE. Staff of the Oral and Maxillofacial Surgery and Trauma Unit, Hospital da Restauracao, Recife, PE.Restauracao Hospital (Hospital da Restauracao).Send correspondence to: Rua Dr. Geraldo de Andrade, 101, apto. 104. Espinheiro, Recife - PE. CEP: 52021-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 17, 2010; and accepted on July 12, 2010. cod. 7090

Recurrent dislocation: scientific evidence and management following a systematic review

Recurrent mandibular dislocation is a rare condition that can have a negative impact on quality of life. Different surgical techniques are employed in the treatment of this condition, and the demand for maximum healthcare quality has contributed to the implementation of evidence-based clinical practice. The objective of this study was to determine the level of scientific evidence in articles reporting open surgical treatment for recurrent mandibular dislocation. A comprehensive search strategy was conducted to locate relevant articles in the PubMed and Web of Science databases on open surgical treatment for recurrent mandibular dislocation published between January 1974 and August 2014. These were classified into one of the five established levels/sublevels of evidence: the level of evidence was determined based on the classification proposed by the Oxford Centre for Evidence-Based Medicine. One hundred and fourteen articles were identified, 91 of which were excluded based on the eligibility criteria. Thus, 23 articles were selected for inclusion in the review. All of the selected articles were rated as level 4 (low quality) regarding the level of evidence. The present review revealed that articles on open surgical treatment for recurrent mandibular dislocation exhibit a low level of scientific evidence. Thus, further studies on this topic with greater methodological rigour are needed.

Case ReportCervical-thoracic facial necrotizing fasciitis of odontogenic origin

Doctoral de gree in oral and maxillofacial surgery and trauma, Pernambuco Dentistry School (FOP), UPE. Staff of the Oral and Maxillofacial Surgery and Trauma Unit, Hospital da Restauracao, Recife, PE.Restauracao Hospital (Hospital da Restauracao).Send correspondence to: Rua Dr. Geraldo de Andrade, 101, apto. 104. Espinheiro, Recife - PE. CEP: 52021-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 17, 2010; and accepted on July 12, 2010. cod. 7090

Bilateral mandibular dentigerous cysts: a case report

Dentigerous cysts are frequently found in the maxilla. After radicular cysts, dentigerous cysts are those most commonly diagnosed, accounting for 20% of all jaw cysts. They are often asymptomatic and diagnosed incidentally during routine examinations. Clinical complications such as dental displacement, ectopic eruption, dental impaction, adjacent tooth root resorption, cortical expansion with facial asymmetry, paresthesia, pathological fracture, and even malignant transformation may occur. Despite these classical features, definitive diagnosis must always be based on histological examination. Most dentigerous cysts are solitary. The aim of this article is to report a case of bilateral mandibular dentigerous cysts in a non-syndromic patient and, through a literature review, present the available treatment modalities used successfully in this case.