Rafael Manfro

Treatment for ectopic third molar in the subcondylar region planned with cone beam computed tomography: a case report.

B S hird molar removal is among the most common urgical procedures performed around the world. evertheless, few cases of ectopic third molar in the ubcondylar region of the mandible have been reorted. Considering the rarity of this condition, the tiology and management remain unclear. In the past few years, a dental 3-dimensional (3D) one beam volumetric imaging system has been introuced because of the treatment complications and atient morbidity associated with complex impacted hird molars. We report the case of an ectopic hird molar in the condylar region and describe a implified intraoral surgical technique for tooth reoval, which was possible because of the virtual mage model produced by the cone beam system.

Severely resorbed mandible treated by soft tissue matrix expansion (tent pole) grafts: case report.

The functional rehabilitation for severely resorbed mandibles has been a challenge for dentists and oral surgeons. We present a 2-year follow-up case of severely resorbed mandibles successfully treated by soft tissue matrix expansion and cranial bone graft with nonremovable screw-retained acrylic resin prosthesis supported by 4 dental implants.

Comparative study of immediately inserted dental implants in sinus lift: 24 months of follow-up

Objectives: The primary aim of this study is to evaluate the success rate of immediately inserted dental implants in sinus lift and the secondary aim is to assess the reliability of performing simultaneous surgery for sinus lift, grafting and implant placement in situations of very low residual bone heights (<4 mm) in the posterior maxillae. Materials and Methods: A series of consecutive patients who sought dental implant rehabilitation were included in this study. The sinus lift cases were selected and divided into two groups based on the maxillary alveolar height, ≥4 mm of radiographically measurable bone height (Group 1) and < 4 mm of bone height (Group 2). Results: A total of 13 implants were installed in Group 1, whereas 8 implants were installed in Group 2. The success rate for dental implants in the sinus lifts reached 95.2% after a period of 24 months of evaluation, at 100% for Group 1 (bone height ≥ 4 mm) and 87.5% for Group 2 (bone height with < 4 mm). Besides the differences between the percentages of success, statistical differences were not reached when the groups were compared (Fishers exact test, P = 0.38). Conclusions: Despite the limitations of this study, including its low number of participants, the results indicate that simultaneous surgery for sinus lifting, grafting and dental implants in posterior maxillae with very low bone heights (<4 mm) can be performed safely, although with lower success rates than found in patients with higher residual bone heights (>4 mm).

Impact of Dentofacial Deformity on Quality of Life: Age and Gender Differences Evaluated Through OQLQ, OHIP and SF36

ABSTRACT Objectives The aim of this study was to verify the impact of dentofacial deformity on quality of life and explore gender and age differences. Material and Methods The impact of dentofacial deformity (DD) on quality of life was evaluated through questionnaires; Short Form Health Survey (SF36), Oral Health Impact Profile Questionnaire (OHIP), Orthognathic Quality of Life Questionnaire (OQLQ) and a single question answered by a Visual Analogue Scale. Results Significant differences between male and female patients were observed in domains of OQLQ (oral function, P = 0.006; awareness of facial deformity, P = 0.018; and facial aesthetics, P < 0.001) and OHIP (physical pain, P = 0.006; psychological discomfort, P = 0.007; psychological disability, P = 0.006; and handicap, P = 0.01). Conclusions The impact of dentofacial deformity was more pronounced in female Brazilian population. Age of patients with dentofacial deformity produced impacts over quality of life in different ways and according to the applied questionnaire and the interaction between age and gender may also produce different impacts in patients with dentofacial deformity. The domains of Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile Questionnaire and Short Form Health Survey showed unaccepted distances in the pattern of answer rising doubts of their ability to assess quality of life as a generic and broad concept. There is a necessity to create a single quality of life instrument capable to measure impacts with sensitivity and specificity and from a generic concept to condition-specific health problem.

Mandibular Fracture in A Patient Treated with A Protocol Prosthesis after 3 Years of Function due to Biomechanical Complications - Clinical Case Report

The article presentsa case of mandible fracturecaused by the lossof an implantina protocolprosthesis increasingcantilever, causingbone lossaround the implant. The fracturewas treatedbyrigid fixation, fourimplantsanda new prosthesis. The authors discuss the possible causes and prevention of this complication.

Predicting Pain After Tooth Extraction: Pain Prediction Index

AIMS To identify relevant variables that may predict pain after routine extraction of erupted teeth, to construct a Pain Prediction Index (PPI) based on these variables, and to verify how these variables are related by using valid structural equation modeling (ie, path analysis). METHODS This study was designed as an observational prospective study for postoperative memory of pain after dental extraction of erupted teeth. Data from a total of 781 surgical procedures related to dental extractions were included. Pain was self-reported by the patients and was evaluated by a verbal category scale (VCS) on the seventh postoperative day. The database was searched for predictive variables that were significantly (P < .05) associated with postoperative pain. RESULTS Pain was scored by patients as none in 65.4% of cases (511); light in 22.9% (179); moderate in 11% (86); and severe in 0.6% (5). Seven predictive variables were strongly related to postoperative pain: gender (female); age (younger than 33); number of extracted teeth (three); surgical technique (surgical flap, ostectomy, or teeth sectioning); number of local anesthetic cartridges (more than three); time in surgery (greater than 25 minutes); and any surgical complications. These variables were used to compose the PPI. The retained PPI classified 66.3% of the patients correctly for both pain and no pain; however, when more than three points were scored on the PPI, it correctly predicted pain in 55.6% of cases. CONCLUSION The present study identified seven predictive variables that were strongly related to postextraction pain and documented that the PPI could correctly predict pain in the majority of patients.

Rehabilitation of a Severely Resorbed Posterior Mandible with 4-mm Extra-Short Implants and Guided Bone Regeneration: Case Report with 3-year Follow-up

Alveolar bone resorption has been a major challenge for implant placement in regions limited by anatomical structures. New alternatives have been introduced with the inclusion of extra-short implants in dentistry. The association of guided bone regeneration (GBR) with the use of extra-short implants might be a viable alternative for regions with limited bone height. This case report aimed to present the rehabilitation of a patient with severe mandibular bone resorption in the posterior region. The association of GBR with the use of extra-short implants was a viable alternative after a 3-year follow-up.