Emanuel Dias de Oliveira e Silva

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.

Comparative analysis of preemptive analgesic effect of tramadol chlorhydrate and nimesulide following third molar surgery

The aim of this prospective, randomized, controlled, paired trial was to perform a comparative analysis of the preemptive analgesic effect of nimesulide and tramadol chlorhydrate during third molar surgery. The study was carried out between March and November 2009, involving 94 operations in 47 male and female patients with bilateral impacted lower third molars in comparable positions. The sample was divided into two groups. Group A received an oral dose of 100 mg of nimesulide 1 h prior to surgery. Group B received an oral dose of 100 mg of tramadol chlorhydrate 1 h prior to surgery. The following aspects were evaluated in the postoperative period: adverse effects of the drugs; amount of rescue medication used (acetaminophen 750 mg); and pain 5, 6, 24, 36, 48, 60, 72 and 84 h after surgery using a visual analog pain scale. Peak pain occurred 5 h after surgery in both groups, with a mean pain score of 2.3 in Group A and 3.0 in Group B; this difference did not achieve statistical significance (p > 0.141). Based on the sample studied, nimesulide and tramadol chlorhydrate demonstrate similar preemptive analgesic effects when used in lower third molar surgeries.

Influence of helmet use in facial trauma and moderate traumatic brain injury victims of motorcycle accidents

Objective The objective of this research was to study the influence of the use of helmet in facial trauma victims of motorcycle accidents with moderate traumatic brain injury. Methods We retrospectively reviewed the incidence of facial injuries in helmeted and nonhelmeted victims with moderate traumatic brain injury at a referral trauma hospital. Results The sample consisted of 272 patients predominantly men (94.5%) and between 21 and 40 years old (62.9%). The majority of patients were using helmet (80.1%). The occurrence of facial fractures was most frequent for zygomatic bone (51.8%), followed by mandible (18.8%) and nasal bones (9.2%). Conclusions Individuals in the most productive age group are most affected, which causes a great loss to financial and labor systems. It is important to take measures to alert the public regarding the severity of injuries likely to occur in motorcycle-related accidents and ways to prevent them.

Mandibular osteomyelitis and fracture in a patient with pyknodysostosis.

Pyknodysostosis is a rare, recessive, hereditary, autosomal disease belonging to the group of bone dysplasias. Complications such as osteomyelitis and fractures of the mandible are not uncommon and appear in the most varied forms. We report a case of chronic osteomyelitis with subsequent mandible fracture, which was successfully treated with the use of a reconstruction plate and antibiotic therapy. This article outlines the clinical and radiographic characteristics of this condition based on the clinical case described and proposes an approach regarding the best form of treatment. Considering the risks of fracture subsequent to removal of the graft from long bones as well as the presence of chronic infection, difficult-to-defeat infection, and bone contact on the compression band, the best choice is a more conservative treatment.

Fracture of the Coronoid Process, Sphenoid Bone, Zygoma, and Zygomatic Arch After a Firearm Injury

A rare case of fracture of the coronoid process, sphenoid bone, zygoma, and zygomatic arch caused by a firearm is described. A 25-year-old man was hit in the face with a bullet, resulting in restricted mouth opening, difficulty chewing, and pain when opening the mouth. The clinical examination revealed a perforating wound in the right parotid region. A computed tomographic scan revealed a comminuted fracture of the left coronoid process with the bullet stopping in the intact left coronoid process. Treatment was bilateral coronoidectomy associated with speech therapy and was successful. Details of the clinical signs, computed tomography, treatment, and follow-up are presented.

Intraoral approach for removal of large sialolith in submandibular gland.

Sialolithiasis is a benign pathology that occurs most frequently in the submandibular salivary gland due to its anatomic features. Depending on the size and degree of calcification, a sialolith can be visible in radiographic examinations. Patients commonly experience pain and/or edema when the ducts are obstructed. The authors report two cases of sialolithiasis of the submandibular gland after searching for the source of swelling in the submandibular region. The diagnosis was confirmed by clinical and tomographic examinations. Despite the considerable size of the sialoliths, treatment consisted of the removal of the calcified mass using an intraoral surgical approach. The prognosis is often good and there is generally no recurrence of the condition.

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.

One-stage treatment of hemimandibular hyperplasia.

Abstract Hemimandibular hyperplasia (HH) is a rare, self-limiting process manifesting between the first and third decades of life. HH causes facial asymmetry and derangement of the occlusion. Management involves resection of the condylar head and orthognathic surgery. This paper describes the case of a 38-year-old woman with spontaneous onset HH over a span of approximately 30 years. The condition was managed with resection of the condyle with simultaneous orthognathic surgery. The patient is currently satisfied with her appearance and function, and there are no signs of recurrence after 2 years.

Iatrogenic infection in dermoid cysts of the floor of the mouth

Doctoral degree in oral pathology, Rio Grande do Norte Federal University (UFRN). Adjunct professor of oral pathology, Pernambuco Dentistry School (FOP), UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco - FOP).Pernambuco University (Universidade de Pernambuco - UPE).Send correspondence to: Thiago de Santana Santos - Faculdade de Odontologia, Universidade de Pernambuco - Av. General Newton Cavalcanti, 1650. CEP: 54753-220. Camaragibe, PE, Brazil. Phone: (+55 81) 345828 - Fax: (+55 81) 34582867 - E-mail: thiago.ctbmf@yahoo.com.brPaper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on May 4, 2010; and accepted on July 20, 2010. cod. 7063

Adenoid cystic carcinoma of mandible

Specialist in oral and maxillofacial surgery and trauma, head of the residence program in oral and maxillofacial surgery and trauma, Oswaldo Cruz University Hospital - HUOC/UPE.Pernambuco Dentistry School (Faculdade de Odontologia de Pernambuco or FOP), University of Pernambuco (UPE).Send correspondence to: Faculdade de Odontologia de Pernambuco - FOP/UPE - Av. General Newton Cavalcanti, 1650, Camaragibe - PE. CEP: 54753-220.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on July 13, 2010; and accepted on September 18, 2010. cod. 7201