Tony Santos Peixoto

Reduction and fixation of unstable fractures of the zygomatic arch: Report of a series of cases

Background: This study evaluated a series of cases of fracture in the zygomatic arch with displacement of the fractured segment. Materials and Methods: This prospective cohort study was conducted between May 2008 and February 2009. The study sample which consist of 10 patients of both genders with fractures in the zygomatic arch. The collection instrument included a specific sheet with data concerning the patient′s age, cause, side of the fracture, type of treatment performed, recurrence and presence of lesions in the facial nerve. The radiographic indices of Waters and Hirtz were used. The data were presented by means of descriptive statistics (absolute and percentage distributions). Results: Most of the patients were male (90.0%), the most frequent etiology was a motorcycle accident (70.0%) and the left side was more affected (60.0%). There was no recurrence in any of the patients examined; however, 1 patient had a lesion in the facial nerve. The treatment performed for all patients was reduction and fixation with titanium miniplates. Conclusion: Fractures in the zygomatic arch are more frequent in young male individuals and the most common cause is a motorcycle accident, with the use of miniplates constituting an effective treatment without recurrence.

Analysis of survival rates and prognostic factors among patients with oral squamous cell carcinoma

Aim: The aim of the study was to estimate global and accumulated survival rates as well as prognostic factors among patients with oral squamous cell carcinoma (OSCC). Subject and methods: Data from the previous 5 years were extracted from patient charts at a cancer reference center. The occurrence of death resulting from the malignant tumor in patients with a diagnosis of OSCC was the dependent variable. The independent variables were tumor site, degree of cell differentiation, clinical staging, data of histopathological determination of OSCC, socio-demographic characteristics, smoking habit and treatment modality. Kaplan-Meier survival curves were created. Differences were analyzed using the log-rank and Wilcoxon tests. The Cox regression model was employed to evaluate factors associated with survival, with the calculation of hazard ratios (HR) (α = 5%). Results: The global survival rate was 57%. The stage of the tumor exercised a direct influence on accumulated survival. In the first year of evaluation, the survival rate of patients in stages I and II was 92.6%. The Cox regression analysis revealed the following variables to be significantly associated with survival: T classification of the clinical staging (HR = 2.283; 95% CI: 1.115–4.673) and degree of tumor invasion (HR = 1.834; 95% CI: 1.041–3.232). Conclusion: Clinical stage and degree of tumor invasion are important prognostic factors for OSCC.

Odontoma associated with impacted mandibular canine: surgically guided eruption

Odontoma is the most common type of odontogenic tumor and is most often diagnosed in the second decade of life. This benign tumor has a slow growth and is asymptomatic, which favors its persistence in the bone until some clinical sign emerges or the tumor or be detected in a routine radiograph. The aim of this case report was to present a clinic case of a 13-year-old male, who presented delayed exfoliation of the mandibular right primary canine. The radiographic exam revealed a radiopaque image in the anterior region of the mandible produced by structures that resembled the formation of teeth surrounded by a radiolucent area. Adjacent to the tumor, the impacted mandibular right canine was identified with deviation of its eruption axis. The clinical diagnosis was compound odontoma. Treatment consisted of the removal of the tumor and the surgically-assisted eruption of the tooth without orthodontic traction. After three years of follow up, the patient has exhibited positive results. It is possible to surgically assist the eruption of an impacted tooth, with a deviated axis, associated with an odontoma through the removal of the tumor and of the physical barrier (ostectomy) without orthodontic traction.

Unusual facial lipoma

Lipoma e uma neoplasia mesenquimal benigna de tecido mole constituida de celulas adiposas maduras, estando no grupo dos tumores benignos mais comuns. No entanto, e relatada como incomum na cavidade oral, representando de 15 a 20% dos casos envolvendo a regiao de cabeca e pescoco, e de 1 a 5% de todos os neoplasmas benignos da cavidade oral. Quanto as suas caracteristicas clinicas, apresentam um crescimento lento, indolor, associado a uma massa submucosa amarelada, podendo nao se apresentarem bem delimitados. Os lipomas pelo seu crescimento medio de 0,5 a 2cm, podem atingir tamanhos exuberantes em seu maior diâmetro. A excisao cirurgica e o tratamento de escolha, sendo raras as recidivas. O presente relato apresentado refere-se a uma paciente de 74 anos de idade, sexo feminino, apresentando um lipoma de grande extensao em regiao geniana-masseterica direita, nao usual com a apresentacao clinica dos lipomas que ocorrem na face. A paciente foi submetida a remocao completa da lesao, sendo acompanhada por 6 meses, sem sinais de recidiva.