Bruno Tochetto Primo

Septic arthritis of the temporomandibular joint.

Abstract Septic arthritis of the temporomandibular joint is a rare acute infectious disease that requires attention from physicians and, once misdiagnosed, can have several implications for a patient. The most common microorganisms related to this disease are Staphylococcus aureus, Neisseria, Haemophilus influenzae, and Streptococcus. The infection of the joint may be caused by a direct spread of a local infection or by hematogenous inoculation from a distant focus. General predisposing factors, such as immunodepression, can eventually be found. The aim of the current study was to report a case in which a patient with an articular infection resulting from hematogenous dissemination from a distant site was successfully treated using joint drainage and systemic antibiotics. Secretion culture from the temporomandibular joint space was positive for S. aureus. After 1 month of antimicrobial therapy, the patient was asymptomatic and mandibular function was normal. Literature related to this topic was reviewed and discussed.

Effect of partially selective cyclooxygenase-2 inhibitor in the removal of third molars.

AbstractA randomized, double-blind clinical trial was carried out involving 25 patients scheduled for the removal of symmetrically positioned lower third molars in separate procedures. Either 100 mg of nimesulide or 7.5 mg of meloxicam was administered 1 hour before surgery and every 12 hours after surgery for 2 days. Evaluations were carried out in the preoperative period as well as on the second and seventh days after surgery. Objective and subjective parameters were recorded for comparison purposes. The patients having received nimesulide had less of a need for additional pain medication in the first 48 hours and had lower pain scale values (P < 0.05). There was less trismus in the meloxicam group (P > 0.05). Postoperative swelling was lower in the nimesulide group (P < 0.05). All measurements on the second day were lower in the nimesulide group (P < 0.001), and only one of these parameters was lower on the seventh day in the nimesulide group, distance from the lower edge of the tragus to the lip commissure on the operated side (P = 0.009, P < 0.001) compared with another group. Nimesulide proved effective in controlling pain and swelling after surgical removal of the lower third molars, with few adverse effects. Meloxicam proved effective in diminishing trismus.

Treatment of Zygomatic-Orbital Complex Fracture Through Transconjunctival Approach

Fractures of the zygomatic-orbital complex have been described as common in the midface traumas. The surgical approach election is an important decision when there is a risk of interference to function, aesthetics or an association of both. The pursuit of techniques that offer adequate visualization of the interested area associated with low morbidity has been responsible for the development of new techniques and materials. The better approach still remains with a lot of controversy among different authors. However, the transconjunctival incision can be considered in access fractures of the zygomatic-orbital complex. The purpose of this study is report a case of performing transconjunctival approach associated with lateral canthotomy to treatment of zygomatic-orbital complex fractures caused by sports trauma of a 34 years-old male patient.

REMOÇÃO TARDIA DE TERCEIRO MOLAR SUPERIOR DESLOCADO PARA A FOSSA INFRATEMPORAL

A remocao de terceiros molares superiores impactados e um procedimento comumente realizado pelo cirurgiao dentista e geralmente associado com pouca morbidade e complicacoes. Uma complicacao raramente reportada e o deslocamento do dente para a fossa infratemporal. Diferentes formas de manejo cirurgico sao encontradas na literatura. O tratamento recomendado inclui a remocao cirurgica imediata se possivel, o acompanhamento ou a remocao em um segundo momento cirurgico. O objetivo do trabalho e relatar a remocao de um dente da fossa infratemporal. Paciente do genero masculino, 14 anos foi encaminhado ao Servico de Cirurgia e Traumatologia Buco-maxilo-faciais para remocao de terceiros molares. Durante a remocao do terceiro molar superior direito (18) houve o deslocamento do mesmo para a fossa infratemporal. No momento o paciente e o responsavel foram avisados da situacao. Optou-se pela remocao do dente em um segundo momento. Apos quatro meses, o procedimento cirurgico foi realizado sob anestesia local atraves de incisao com eletrocauterio sobre o ponto de palpacao dentario que estava localizado em fundo de vestibulo. O dente encontrava-se envolto por fibras musculares que foram dissecadas permitindo a remocao do dente. O paciente encontra-se sem queixas funcionais. Em nova radiografia panorâmica foi possivel observar a completa remocao do dente.