Walter Cristiano Gealh

Osseointegrated Implant Fracture: Causes and Treatment

Despite its high success rate, therapy with osseointegrated dental implants is not free of complications. Among the problems that may occur is fracture of implants, which, albeit a rare phenomenon, may lead to unpleasant clinical outcomes for the patient, as well as for the clinician. Thus, it is paramount to know the factors related to the biological processes involved in maintenance of osseointegration and biomechanics applied to dental implants to prevent such complications, as well as treatment options available to deal with the problem. Therefore, the objectives of this work were to investigate the literature to identify causative factors that may lead to fracture of dental implants and to discuss available procedures.

Treatment of oral myiasis caused by Cochliomyia hominivorax: two cases treated with ivermectin

The term myiasis is applied to the injurious action that larvae of certain diptera cause to the organism of vertebrate animals in the living or dead tissue in which they grow. Because of its great destructive potential, appropriate and preventative treatment are necessary. Among the sites of infestation, the human mouth is a common site, mainly in tropical countries. We present two cases of oral myiasis caused by Cochliomyia hominivorax spp. Ivermectin is an extremely effective semi-synthetic macrolides, in the treatment of this condition.

Piezosurgery Applied to Implant Dentistry: Clinical and Biological Aspects

Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery.

Comparative Study of the Mechanical Resistance of 2 Separate Plates and 2 Overlaid Plates Used in the Fixation of the Mandibular Condyle: An In Vitro Study

PURPOSE The objective of this study was to carry out a comparative evaluation of the mechanical resistance of 2 rigid internal fixation techniques for fractures of the mandibular condyle using miniplates. MATERIALS AND METHODS Forty polyurethane resin replicas of human hemimandibles were used. The hemimandibles were sectioned to simulate a high subcondylar fracture and then stabilized with 2 fixing techniques using 2.0-mm system plates and screws. The fixation techniques were 2 separate 4-hole plates with 8 screws, and 2 overlaid 4-hole plates with 4 screws. Each system was submitted to load tests, with the application of the load in mediolateral and anteroposterior directions in an Instron 4411 universal assay machine (Instron, Norwood, MA). RESULTS Load values and peak displacement were measured. Means and standard deviations were evaluated by analysis of variance (P < .05) and Tukey tests, in which it was verified that the antero-posterior peak load value was affected by the arrangement of the plates on the models, although no differences were observed between the groups for the mediolateral peak load. The arrangement of the plates did not have any influence on peak displacement. Similarly, the final value of the mediolateral load was not affected by the arrangement of the plates on the model. CONCLUSION The experimental model with 2 separate plates was statistically superior to the model with 2 overlaid plates only in relation to anteroposterior peak load. Despite showing superiority in mediolateral peak load and peak displacement, there was no statistical difference between the groups for these parameters.

Different Surgical Approaches for Multiple Fractured Atrophic Mandibles

Atrophic edentulous mandible fractures in geriatric patients have low incidence but present several biological and biomechanical peculiarities that produce a nonunion rate of around 20%. Surgical extraoral approaches for internal fixation of these fractures can be transcervical or by one or two submandibular incisions. Two patients sustaining multiple fractures in atrophic edentulous mandible are presented: the first patient was 72-years-old, treated by two submandibular incisions, and the second was 81-years-old, treated by transcervical approach. We discuss the advantages and drawbacks of each approach and their indications according to the Luhr et al (1996) atrophy index.

Utilization of surgical trepan for the obtainment of calvarial autogenous bone graft in maxillary reconstructions

Maxillomandibular reconstructions are traditionally performed by means of autogenous bone grafts collected from intraoral donor areas and extraoral donor areas such as clavicle, iliac bone, rib, and tibia. The calvarial bone has been studied as an alternative donor area, with a low incidence of complications and minimal postoperative morbidity. Complications such as dural lacerations associated with cerebrospinal fluid leakage and extradural and subdural bleeding were minimized due to the use of surgical trepan, allowing the diploic layer delimitation before the osteotomy, preserving the internal calvarial cortical. The purpose of this article is to suggest a new technique for the obtainment of calvarial bone grafts with surgical trepan.

Radiographic and Clinical Evaluations of the Zygomatico-maxillary Complex Fractures Treated by 2.0 Miniplates System

Las fracturas del complejo cigomaticomaxilar son las segundas mas frecuente del territorio facial. De acuerdo con la complejidad anatomica, existen muchos informes en la literatura sobre este trauma, principalmente relacionadas con el tratamiento de estas fracturas. El proposito de esta investigacion fue evaluar clinica y radiograficamente la estabilidad de las fracturas cigomaticas unilaterales tratadas por reduccion quirurgica y fijadas en dos puntos por fijacion interna estable. Veinte pacientes con fracturas cigomaticas fueron evaluados y comparados con veinte pacientes sin fracturas. En el grupo experimental, los resultados mostraron que no hubo diferencias estadisticamente significativas entre los datos obtenidos del perimetro y el area de los lados tratados y contralaterales. Al comparar estos datos con el grupo de control las diferencias no fueron estadisticamente significativas. Tambien se realizo una comparacion de la distancia entre el hueso nasal y la prominencia cigomatica en todos los grupos, estos resultados tambien fueron satisfactorios.