Jimmy Charles Melo Barbalho

Recurrence rate following treatment for primary multicystic ameloblastoma: systematic review and meta-analysis.

Opinions regarding the treatment of multicystic ameloblastoma are divergent due to its benign nature and the high rate of recurrence if not adequately excised. The aim of the present study was to perform a systematic review of the literature for a qualitative and quantitative assessment of studies addressing primary multicystic ameloblastoma with regard to treatment and recurrence. Searches were conducted of the Ovid Medline and Embase databases for articles published up to January 2014. Based on predefined eligibility criteria, studies were selected in a two-stage screening process conducted by two independent reviewers. Quality assessment of the selected articles was performed using the modified criteria of the Agency for Healthcare Research and Quality. The meta-analysis was performed using Review Manager (RevMan) software. Statistical heterogeneity was investigated by performing a χ(2) test at the 5% significance level (P<0.05) and determining I(2). The relative risk of recurrence was 3.15-fold greater (95% confidence interval 1.98-5.00) when conservative treatment was performed on primary multicystic ameloblastoma in comparison to radical treatment (P<0.00001 for treatment effect; I(2)=0% and P=0.48 for heterogeneity). The findings justify the treatment of primary multicystic ameloblastoma with bone resection.

Treatment of Pseudoaneurysm of Internal Maxillary Artery: A Case Report

Pseudoaneurysms are rare lesions secondary to blunt or penetrating trauma, temporomandibular joint surgery, or orthognathic surgery. Nonsurgical interventions are the treatment of choice for pseudoaneurysms. In the case reported here, endovascular injection of acrylic glue was successful in the treatment of a pseudoaneurysm of the internal maxillary artery secondary to fracture of the zygomatic bone.

Effects of co-administered dexamethasone and nimesulide on pain, swelling, and trismus following third molar surgery: a randomized, triple-blind, controlled clinical trial

This study aimed to determine the effect of the co-administration of dexamethasone 8mg and nimesulide 100mg given 1h before mandibular third molar surgery. A prospective, randomized, triple-blind, split-mouth clinical trial was developed at the study institution in Pernambuco, Brazil. A pilot study was first performed (95% confidence interval, 80% test power, and 5% error), and a sample of 40 patients aged between 18 and 40 years was selected. The patients were randomized and divided into two groups: dexamethasone+placebo and dexamethasone+nimesulide. The following parameters were evaluated: pain (visual analogue scale), total number of rescue analgesics taken, time taken to first rescue analgesic consumption, oedema, trismus, and patient satisfaction. The paired t-test and the Wilcoxon test were used to compare means. Statistically significant differences were found between the groups in pain values at 2, 4, and 12h postoperative, and in the total number of rescue analgesics and time taken to first rescue analgesic ingestion (P<0.05), with results in favour of dexamethasone+nimesulide administration. Oedema and trismus were similar in the two treatment groups and decreased over time postoperatively. The co-administration of dexamethasone and nimesulide reduces pain intensity and the need for rescue medication after third molar surgery.

Temporal Approach to Removal of a Large Orbital Foreign Body.

Accidents with firearms can result in extensive orbital trauma. Moreover, gun parts can come loose and impale the maxillofacial region. These injuries can cause the loss of visual acuity and impair eye movements. Multidisciplinary treatment is required for injuries associated with this type of trauma. Computed tomography with three-dimensional reconstruction is useful for determining the precise location and size of the object lodged in the facial skeleton, thereby facilitating the planning of the correct surgical approach. The temporal approach is a fast, simple technique with few complications that is indicated for access to the infratemporal fossa. This article describes the use of the temporal approach on a firearm victim in whom the breech of a rifle had impaled orbital region, with the extremity lodged in the infratemporal fossa.

State of the art in the treatment of mandibular fractures caused by firearms: case report

Injuries to the face represent a significant risk to the health of the individual, mainly because of its significance, both functional, because it houses sensory organs and part of the respiratory and digestive systems, as well as esthetic. In this scenario, gunshot wounds in this location cause great concern on account of the magnitude of the damage, and the Oral and Maxillofacial Surgery and Traumatology team must act so that the treatment enables the rehabilitation of the patient in the shortest possible time, with a minimum of complications and sequelae. The objective of this study is to report a clinical case of a 19-year-old female patient with a comminuted fracture of the mandible body caused by a firearm projectile, treated immediately with stable internal fixation using the 2.00 mm plate-screw system for simplification of the fracture and a 2.4 mm reconstruction locking-plate on the bone gap. Relevant aspects of the surgical technique and tactics are reviewed and long-term follow-up of the patient is presented. Indexing terms: Firearms. Internal fixation of fractures. Mandible. Therapeutics.

Septic arthritis of the TMJ: a case report

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition; thus, reports in the specialized literature are still scarce. The TMJ may be affected by extension of a local infectious process, by post-traumatic hematoma, or secondarily, by hematogenous spread. Septic arthritis is more common in the large joints, with the knee and hip most frequently affected. It is characterized by insidious onset and a marked inflammatory process, and is monoarticular in 80% of cases. The present report describes the case of a 6-year-old boy with a history of rheumatoid arthritis who presented with pain, swelling, and redness in the right TMJ region, as well as limited jaw opening, closure, and lateral excursion bilaterally. The differential diagnosis and treatment of this rare clinical entity are described. Aspects concerning antibiotic therapy and imaging studies are also addressed.

Glove perforations after dental care

OBJETIVO: Avaliar as perfuracoes que acometem as luvas cirurgicas e de procedimentos apos o uso no tratamento odontologico.METODOS: Foram analisados 279 pares de luvas, sendo 36 pares de luvas cirurgicas e 243 pares de luvas de procedimentos, utilizados na pratica odontologica nas especialidades de Cirurgia, Dentistica, Endodontia, Odontopediatria, Periodontia e Protese. Para analise das luvas, foi utilizada uma solucao de fuccina basica diluida em agua, cada luva foi preenchida com 500 ml de solucao, seguida de compressao manual na altura do punho da luva por dois minutos. A analise estatistica foi realizada pelo metodo do Qui-quadrado, adotando-se como nivel de significância 5%.RESULTADOS: Dos 279 pares de luvas analisadas, 106 pares tiveram perfuracoes, o que corresponde a 38%. A mao que mais sofreu perfuracoes foi a mao dominante, e a regiao mais acometida foi a regiao digital. Observou-se que a maioria dos procedimentos realizados durou mais de 40 minutos, e que houve uma maior frequencia de procedimentos realizados na area da Dentistica.CONCLUSAO: Conclui-se que houve um considerado numero de perfuracoes presentes nas luvas analisadas, o que pode contribuir para um maior risco de infeccao cruzada para academicos e pacientes.

Pseudo-ankylosis caused by osteoma of the coronoid process.

Osteoma of the coronoid process is a rare, slow-growing tumor that can lead to restrictive mandibular movements. This paper describes a case of osteoma of the right coronoid process in a 45-year-old woman who reported progressive facial asymmetry and the loss of mandibular movements. Aspects regarding the differential diagnosis, treatment, surgical access, possible complications and postoperative follow up of the case are also discussed. The osteoma of the coronoid process is a benign tumor that can reach a significant size, causing an increase in volume, facial asymmetry, limited mouth opening and fracture of the zygomatic complex in some cases. The combination of extraoral and intraoral accesses is useful in the case of large tumors of difficult access, such as in this case reported.Osteoma of the coronoid process is a rare, slow-growing tumor that can lead to restrictive mandibular movements. This paper describes a case of osteoma of the right coronoid process in a 45-year-old woman who reported progressive facial asymmetry and the loss of mandibular movements. Aspects regarding the differential diagnosis, treatment, surgical access, possible complications and postoperative follow up of the case are also discussed. The osteoma of the coronoid process is a benign tumor that can reach a significant size, causing an increase in volume, facial asymmetry, limited mouth opening and fracture of the zygomatic complex in some cases. The combination of extraoral and intraoral accesses is useful in the case of large tumors of difficult access, such as in this case reported.