Eduardo Sant’Ana

An orthodontic-surgical approach to Class II subdivision malocclusion treatment

Despite the different orthodontic approaches to Class II subdivision malocclusions one has also to consider the skeletal components before undertaking any treatment protocol. Significant involvement of the skeletal structures may require a combined surgical orthodontic treatment, which has remained stable for more than four years, as illustrated in this case report.

Computerized Cephalometric Study of the Pharyngeal Airway Space in Patients Submitted to Orthognathic Surgery

IntroductionPharynx is a muscular organ with is sustained by craniofacial bones. It is divided into nasal, oral and hipopharynx, and can be considered as a tube that serves both respiratory and digestive systems. Its anatomical morphology permits that factors facilitate its obstruction, leading to the sleep apnea syndrome. One of the treatment consists of surgical mandibular advancement, increasing pharyngeal dimensions. The aim of this study was evaluate the cephalometric changes in the pharyngeal airway space after orthognathic surgery procedures for correction of mandibular prognathism.Materials and MethodsPre and post-operative cephalometric analysis was performed on 19 patients submitted to mandibular setback by mandibular bilateral sagittal split osteotomy associated with maxillary advancement by Le Fort I osteotomy, using the Dolphin Imaging 10.0 software.ResultsResults did not reveal statistically significant changes in the upper (nasopharyngeal), middle (oropharyngeal) and lower (hypopharyngeal) airway spaces, but showed increase in the nasal pharynx due the maxillary advancement and a lower position of the hyoid bone due the mandibular setback.DiscussionMaxillomandibular orthognathic surgery for correction of mandibular prognathism does not seem to statistically significantly change the pharyngeal airway space, but it increases the maxillary airway.ConclusionIt seems to be important to consider the double jaw surgery in cases of mandibular prognathism, aiming prevention of a possible reduction of whole upper airway.

Avaliação radiográfica da localização de caninos superiores não irrompidos

A erupcao ectopica e a impaccao de caninos superiores sao problemas bastante comuns na populacao. A excelencia do tratamento ortodontico traduz-se na correcao da oclusao, harmonia do sorriso, saude periodontal e estabilidade pos-tratamento. Para obtermos tais condicoes, a manutencao dos caninos e fundamental. Portanto, o objetivo deste estudo foi avaliar radiograficamente a localizacao de caninos superiores nao irrompidos utilizando-se radiografias panorâmicas. Foram selecionadas setenta radiografias panorâmicas de pacientes com impaccao uni ou bilateral de caninos, candidatos a tratamento cirurgico. Para determinacao da posicao espacial dos caninos superiores nao irrompidos foram selecionados metodos descritos na literatura e uma avaliacao proposta neste trabalho. A localizacao de caninos nao irrompidos e fundamental para estabelecer o plano de tratamento, auxiliando no acesso cirurgico e na direcao das forcas ortodonticas a serem aplicadas no dente impactado. Os pacientes que tiveram suas radiografias utilizadas neste estudo serao tratados pelas disciplinas de Ortodontia e Cirurgia, com exodontia do canino ou exposicao cirurgica para colagem do dispositivo de tracionamento associada ao tratamento ortodontico corretivo.

Rare enlargement of the genial tubercles. Enlargement of genial tubercles.

Genial tubercles usually are small bony protuberances on the lingual aspect of the mandible symphysis. Conversely, this case shows 3D tomographic reconstruction images of genial tubercles as an oversized projection causing pain and discomfort to the patient.

Histologic and tomographic analyses of the temporomandibular joint after mandibular advancement surgery: study in minipigs

OBJECTIVE The aim was to elucidate the changes occurring in temporomandibular joint (TMJ) after surgical mandibular advancement with different fixation materials: bicortical screws and miniplates. STUDY DESIGN Eighteen minipigs were randomly divided into 3 groups: group I (control), nonoperated animals; group II, animals submitted to surgical advancement surgery and osteosynthesis by bicortical screws; and group III, animals submitted to surgical advancement surgery and osteosynthesis by miniplates. Four months after the surgeries, TMJs were collected and histologically prepared after computerized tomography (CT) scanning for the blind detection of erosion, flattening, and osteophyte. RESULTS The CT analysis revealed significant alterations in the shape of the condyles (erosion: P = .0010; flattening: P < .0001) for group II compared with groups I and III. Descriptive histologic analysis was compatible with the CT findings. CONCLUSIONS The results indicated that bicortical screw fixation resulted in more pronounced condylar alterations in the shape of the condyles than miniplate osteosynthesis. However, further clinical studies are necessary to confirm these data.

Von Recklinghausen's Disease -Diagnosis from Oral Lesion: Neurofibromatosis I

A 35 years-old male patient was referred to your Institution due to a nodule on the palate with more than 15 years of evolution. In general physical examination noticed the presence of papules and cafe au lait (coffee with milk) pigmentation in many parts of the body. Intra oral examination found a swelling in the hard palate and resilient on palpation, asymptomatic with three centimeters of diameter. Incisional biopsy was performed and the diagnosis was neurofibroma. Complete resection of the lesion was performed confirming the initial diagnosis. The general clinical findings and the presence of neurofibroma confirmed the diagnosis of Von Recklinghausens disease. This paper emphasizes the important role of the dentist in diagnostic and follow-up of the Von Recklinghausens disease.

A bizarre extraoral fistula with intraoral manifestations

An 89 year old male patient was referred because of a 30 year old fistula. During exam we noticed skin attachments in the alveolar border. Periapical and occlusal radiographs were taken and they revealed bone loss. We surgically removed the fistula in order to improve mouth conditions and also to cosmetically improve his face. At the microscope we noticed hair follicles, sebaceous and sweat glands. The diagnosis was of fistula in a regression stage.

Lingual Short Split: A Bilateral Sagittal Split Osteotomy Technique Modification

The technique of sagittal split osteotomy of the mandibular ramus is an established technique that has been evolving over the years, with significant improvements regarding stability, better bone contact between the segments, and possibilities of osteosynthesis. However, paresthesia is common in the postoperatory, sometimes permanent, and undesirable fractures in the subcondylar region can occur leading to longer operative time and extraoral scars. The short lingual split technique is an easy technique that simplifies the horizontal osteotomy of the ramus and decreases the risk of undesirable fractures with a neurosensitive recovery of patients in a much shorter time because of minor trauma and nerve manipulation during the execution.

Outcomes in Surgical Treatment of Mucocele in Frontal Sinus

Abstract The aim of the study was to correlate several studies dating from 1997 to 2015 to identify the most effective treatments for mucocele in the frontal sinus (with/without other paranasal sinuses), considering successful outcomes and recurrence. We aimed to conduct a literature review for articles published between 1997 and 2015. For this, we accessed articles in the SciELO database, as well as LILACS, PubMed, and Google Scholar databases. Were identified 32 work-related injuries in the paranasal sinuses; 2 of these were not related to mucoceles or mucopyocele, 4 had no relation to the frontal sinus, 9 were related to the frontal sinus and other paranasal sinuses, 4 were related to mucocele associated with other sinuses, and 13 involved only the frontal sinus. Endoscopic techniques decrease intra- and postoperative morbidity, reducing the operative time, allow a larger view of the lesion and surrounding anatomical structures, and decrease chances of recurrence. Thus, the successful outcomes have been beneficial to both the surgeon and the patient.

Moodle: Teaching Strategies in Distance Education in Oral Medicine

Objective. The current model of education has been suffering changes, undergoing renovations, and seeking using and enjoying increasingly technological resources, as, for example, the Learning Management System (LMS). One of the most used LMS platforms is the Modular Object Oriented Dynamic Learning Environment (Moodle). This article proposes to demonstrate how Moodle platform was introduced in the subject of Stomatology through a clear and objective methodology. Study Design. In six months, 49 undergraduate students enrolled in stomatology subject accessed Moodle platform 2067 times and performed 02 evaluation exams at Discipline of Stomatology. Statistical analysis was performed by paired t-test (comparison between number of access times before the first evaluation and number of access times before the second evaluation), Wilcoxon test (student’s grade on the first and second evaluation), and Pearson correlation test (correlation between the number of access times before the first evaluation and the first grade, correlation between the number of access times before the second evaluation and the second grade, and correlation between the variation of the number of access times and the variation of the student’s grade). Results and Conclusion. The digital platform Moodle was associated with better grade for those students who access it for more times () and was able to supply the needs of the students and help them to obtain information about the subject during the entire semester (6 months).