José Luis Muñante-Cárdenas

Pattern and treatment of facial trauma in pediatric and adolescent patients.

Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.

Mandibular fractures in a group of Brazilian subjects under 18 years of age: A epidemiological analysis

OBJECTIVE This study showed a retrospective analysis of the etiology, incidence and treatment of maxillofacial injuries in a pediatric and adolescent population of the State of Sao Paulo. METHODS We analyzed 2986 medical records of victims of facial trauma under 18 years, treated between 1999 and 2008 by the Department of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas, Sao Paulo - Brazil. During this period, 757 patients under 18 were victims of maxillofacial trauma, of which, 112 patients had 139 lines of fracture in the mandible. The most affected age group were male adolescents. RESULTS The bicycle accidents constituted the main etiology (34.82%). The conservative treatment was used in 51% of cases, and 49% received surgical treatment. Only 5 cases of postoperative complications were identified. CONCLUSION The incidence of trauma and mandible fractures in pediatric and adolescent patients was high in the area of study. Bicycle accidents and falls being the main etiological factors. The group of adolescents was most affected. The conservative and surgical treatment was used almost in the same proportion.

Etiology, treatment, and complications of mandibular fractures.

AbstractThe objective of this retrospective study was to evaluate some epidemiological characteristics, surgical treatment methods, and complications of cases involving mandibular fractures. Records from 119 patients treated for mandibular fractures between January 2006 and December 2011 were analyzed.We find mandibular fractures mostly affect Caucasian (72.2%) men (80.7%). The mean age of the patients was 28.1 years. Road traffic accidents (RTA) caused the most fractures (49.5%), followed by physical violence, including gunshot wounds (21%). Motorcycle accidents were the most common cause of RTA (76.2%). The most affected mandibular regions were the parasymphysis (26.9%) and the mandible angle (25.1%). Both surgical and nonsurgical treatments were applied (90.4% and 9.6%, respectively). The most common surgical approach was the intraoral (64.9%), using the 2.0-mm fixation system (88.0%). Complications such as postoperative infections, malocclusion, and paresthesia occurred in 36 patients (30.2%).This research revealed interesting features about the etiology of mandibular fractures that were mostly associated with RTA. Severity of the trauma and noncompliance of the patients were factors that contributed to the development of postoperative complications.

Biomechanical comparison of four mandibular angle fracture fixation techniques.

The aim of this study was to make a comparison of the biomechanical behavior of four different internal fixation systems for mandibular angle fractures. A total of 40 polyurethane mandible replicas were employed with different fixation methods: group 1SP, one 2.0-mm four-hole miniplate; group 2PPL, two 2.0-mm four-hole parallel miniplates; group 3DP, one 3D 2.0-mm four-hole miniplate; and group 3DPP, one 3D 2.0-mm eight-hole miniplate. Each group was subjected to incisal or homolateral molar region loading. The load resistance values were measured at load application causing tip displacement of 1, 3, and 5 mm, and at the time at which the system achieves its maximum strength (MS). Means and standard deviations were compared among groups using analysis of variance and the Tukey test. Group 2PPL showed higher strength for all the displacements. For incisal loading, no statistically significant differences were found between groups 1SP, 3DP, and 3DPP. For molar loading, group 1SP and 3DPP showed statistically significant differences. For MS testing, group 1SP and 2PPL showed statistically significant differences in incisal loading; group 1SP and 3DP showed no statistically significant differences; and group 3DPP showed lower values of strength. Two parallel miniplates provide the most favorable mechanical behavior under the conditions tested.

Tratamiento Quirúrgico de Caninos Mandibulares Bilaterales Transmigrados

La migracion de caninos inferiores es un fenomeno poco comun. Su incidencia es menor que incluidos maxilares y son frecuentemente encontrados en jovenes. Solamente caninos, segundos premolares y terceros molares incluidos migran a lugares ectopicos en su desarrollo y dientes incluidos ectopicos son, en la mayoria de los casos, asintomaticos. La etiologia es compleja y poco descrita en la literatura. Un canino es considerado un diente migrado cuando, horizontalmente, mas de la mitad del diente atraviesa la linea mediana. Este articulo reporta un caso clinico, con tratamiento quirurgico de exodoncia de caninos bilaterales incluidos, horizontalmente en la region de la sinfisis. Se observo que la exodoncia es la conducta operatoria mas frecuente, presentando en este caso buenos resultados.

El Área Cervical de Implantes Dentales Presenta Mayor Formación Ósea que el Área Apical en Diferentes Condiciones de Diseño y Carga: Resultados Preliminares

Los implantes dentales han evolucionado de forma sustancial en los ultimos 40 anos; sin embargo, dudas sobre las caracteristicas de la reparacion osea continuan toda vez que nuevos disenos y nuevos metodos quirurgicos son aplicados. El objetivo de esta investigacion es evidenciar la presencia de tejido mineralizado en diferentes regiones del implante. Se elaboro un estudio basado en un modelo de restauracion inmediata, aplicado en la mandibula de 7 canes machos. Se realizaron las exodontias de los premolares mandibulares y, despues de 3 meses de recuperacion, se instalaron 2 implantes endoseos bilaterales, siendo uno de tipo conico y otro de tipo cilindrico. Despues de dos periodos de sacrificio se realizo una evaluacion histomorfometrica en los cortes seleccionados. Los resultados se presentan de forma porcentual estableciendo comparaciones entre las areas cervical, media y apical. Los implantes de morfologia conica sometidos al modelo de restauracion inmediata, presentaron mayor formacion osea en todos los niveles evaluados. En todas las condiciones de trabajo el area cervical presento mayor presencia de tejido mineralizado que el area apical. Concluimos que el modelo de restauracion inmediata no es un obstaculo para la instalacion de la secuencia apropiada de reparacion osea y que diferentes factores deben estar asociados a la mayor formacion osea presente en el area cervical de los implantes dentales.

Análisis Químico y Topográfico de la Superfície de Implantes Dentarios Mediante Espectroscopia de Fotoelectrones y Microscopía Electrónica de Barrido: Estudio Preliminar

The aim of this study was to analyze the chemical composition and surface topography of commercially pure titanium implants, obtained from three trademarks frequently used in dentistry. There were nine titanium implants of the following systems: As Technology, Neodent and Sistema Nacional de Implantes. These materials were divided into three groups, with three implants in each group. Photoelectron Spectroscopy Excited by X-ray (XPS) was used to determine the chemical composition, while to characterize the surface topography we used Scanning Electron Microscopy (SEM). Titanium, carbon, silicon and oxygen were identified in all samples analyzed. Other contaminants were: silicon, aluminum, sulfur, lead, phosphorus, calcium, sodium and nitrogen. We identified impurities on the surface of all implants analyzed. We consider necessary to development more studies relating the presence and concentration of these elements with the osseointegration process.