Eduardo Dias-Ribeiro

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical‐histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow‐up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.

Anesthetic efficacy of inferior alveolar nerve block plus buccal infiltration or periodontal ligament injections with articaine in patients with irreversible pulpitis in the mandibular first molar

OBJECTIVE We compared the anesthetic efficacy of inferior alveolar nerve block (IANB) plus buccal infiltration (BI) and IANB plus periodontal ligament (PDL) articaine injections in patients with irreversible pulpitis in the mandibular first molar. STUDY DESIGN Fifty-seven volunteers, patients with irreversible pulpitis in the mandibular first molar admitted to the Department of Stomatology, Second Affiliated Hospital, Sun Yat-Sen University, randomly received conventional IANB, containing 1.7 mL 4% articaine/HCl with 1:100,000 epinephrine, plus either BI or PDL injections containing 0.4 mL articaine/HCl with 1:100,000 epinephrine. The patients recorded the pain of the injections and endodontic access on a Heft-Parker visual analog scale (VAS). RESULTS According to the VAS scores, all patients experienced no or mild pain with BI and PDL injections after the application of IANB. Anesthetic success occurred in 81.48% for IANB plus BI (IANB/BI) compared with 83.33% for IANB plus PDL injection (IANB/PDL injection). None of the observed differences between the 2 groups was significant (P > .05). CONCLUSION Both injection combinations resulted in high anesthetic success in patients with irreversible pulpitis in the mandibular first molar.

Impacted Lower Third Molar Fused with a Supernumerary Tooth —Diagnosis and Treatment Planning Using Cone‐Beam Computed Tomography

This paper reported a case of fusion between an impacted 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 Donovans 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. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone‐beam computed tomography.

Comparison of Buccal Infiltration of 4% Articaine With 1 : 100,000 and 1 : 200,000 Epinephrine for Extraction of Maxillary Third Molars With Pericoronitis: A Pilot Study

We compared the buccal infiltration of 4% articaine with 1 : 100,000 or 1 : 200,000 epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with pericoronitis. Group 1 (15 patients) received 4% articaine with 1 : 100,000 epinephrine and group 2 (15 patients) received 4% articaine with 1 : 200,000 epinephrine by buccal infiltration. None of the patients in group 1 reported pain, but 3 patients in group 2 reported pain, which indicated a need for a supplementary palatal injection. The palatal injections were all successful in eliminating the pain. Two additional patients in group 2 experienced pain when the suture needle penetrated their palatal mucosa. Based on these results, 4% articaine with 1 : 100,000 epinephrine was found to be more effective for the removal of upper third molars in the presence of pericoronitis than 4% articaine hydrochloride with 1 : 200,000 epinephrine when only a buccal infiltration was used.

Orthognathic surgery in patients with cleidocranial dysplasia.

The aim of this study was to report the orthodontic-surgical approach of a 21-year-old female patient diagnosed with cleidocranial dysplasia. An orthognathic surgery was performed in the maxilla and mandible during the same procedure to correct an existing dentofacial deformity (class III malocclusion). In addition, malar prostheses were used to correct midface deficiency. After surgical intervention, orthodontic treatment continued in order to promote stability, function, and aesthetics. Cases of cleidocranial dysplasia treated with the defined criteria can bring aesthetic and functional benefits to the patient.

Prevalência das posições de terceiros molares retidos em radiografias panorâmicas: estudo retrospectivo no sertão nordestino

O estudo avaliou o posicionamento dos terceiros molares inclusos segundo as classificacoes de Winter e Pell e Gregory, bem como avaliar a prevalencia por genero e faixa etaria. Foi realizado um estudo documental, retrospectivo, descritivo, atraves de analises de radiografias ortopantomograficas que fazem parte do banco de dados da Clinica Radiologica de Patos, Patos, Paraiba, Brasil. Foram analisadas 100 radiografias pertencentes a pacientes entre 20 e 40 anos, das quais 63% pertenciam ao genero feminino e 44% correspondia a faixa etaria de 20 a 25 anos. Foram observados 270 dentes inclusos, sendo 112 na maxila e 158 na mandibula. Com relacao a classificacao de Winter, a posicao mais prevalente na maxila foi vertical, ja na mandibula foi mesioangular. Considerando a classificacao de Pell e Gregory, quando avalia a profundidade, a posicao mais presente foi a posicao B, e quanto a borda anterior do ramo da mandibula a classe II. A prevalencia do terceiro molar incluso foi maior no genero feminino, na faixa etaria de 20 a 25 anos, com relacao a maxila, a posicao que prevaleceu foi a vertical e na mandibula foi a mesioangular e a posicao B e classe II. Descritores: Classificacao; Dente Impactado; Dente Serotino.

Orthognathic Surgery in Patients With Large Condylar Destructions.

Condylar resorption is understood as changes in shape and volume of the condylar bone, due to local, systemic, and iatrogenic factors. The occurrence of condylar resorption after orthognathic surgery can occur when the condylar repositioning in mandibular fossa is performed improperly. In addition, systemic diseases such as osteoarthritis and rheumatoid arthritis seem to influence this process. The aim of this study was to report 3 cases of patients with severe condylar alterations, submitted to orthognathic surgery for treatment of dentofacial deformities. Considerations regarding the diagnosis, surgical planning (counterclockwise rotation), surgical techniques (bilateral sagittal split osteotomy, bimaxillary osteotomies, rigid fixation, maxillomandibular fixation period), and results (short terms) are discussed.

Comparative Evaluation of Facial Profile Normality Standards in Brazilian-Northeast and in Brazilian-Southeast Female Patients.

Sun Yat-sen University, Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospita

Lower third molar fused with a supernumerary tooth: diagnosis and treatment planning using Cone-Beam Computed Tomography

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.