RESUMO Osteorradionecrose dos maxilares é uma das complicações mais sérias da radioterapia para o tratamento de tumores de cabeça e pescoço. O manejo da osteorradionecrose continua sendo discutido e há poucos relatos de casos descrevendo modalidades de tratamento conservadoras. Este artigo apresenta um caso de osteorradionecrose na mandíbula de um paciente de 58 anos de idade, após a realização de exodontia e explora uma modalidade de tratamento conservador com um follow-up de três anos. Foram combinadas antibioticoterapia e irrigação diária utlizando clorexidina. Após três anos é possível observar a resolução do caso em imagens de tomografia computadorizada de feixe cônico e reconstruções 3D. As imagens evidenciam remodelação óssea após este período de acompanhamento e sem a presença de osso exposto. Pode-se concluir que a terapia proposta resultou em sucesso e o paciente continua em acompanhamento periódico.

ABSTRACT Osteoradionecrosis of jaws is one of the most serious complications of radiation therapy for head and neck malignancies. The management of osteoradionecrosis continues to be debated and there are few cases which can be resolved with conservative management. This paper presents a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man and highlights the conservative therapeutic management and 3-year follow-up period. We combined a conservative nonoperative therapy, including long-term antibiotic therapy and daily irrigation with chlorhexidine mouthrinses in a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man. At the follow-up, clinical aspect was resolved. A CBCT scan image and a three-dimensional (3D) reconstructed image revealed bone remodeling in a 3-year follow-up period .No sign of exposed bone could be seen. Follow-up 3 years later revealed that the conservative management posed was successful for osteoradionecrosis and the patient is currently under regular review.

Abstract The aim of this study was to assess the presence, location and, multiplanar distance of the canalis sinuosus (CS) between the incisive foramen and the anterior maxillary alveolar ridge using cone beam computed tomography (CBCT). Therefore, 500 CBCT maxillary images obtained from male and female patients aged 20 to 80 years were selected to assist in the dental treatment. Low-quality tomographic images were discarded. All images were captured with the i-CATTM Classic tomograph and assessed using the XoranCatTM software. The axial sections were analyzed at the incisive foramen in order to verify the CS presence in laterality and location. Furthermore, linear measurements of the nasal cavity floor, buccal cortical bone, and alveolar ridge crest were made. All the collected data were statistically analyzed. Results show a variation of the CS in relation to the classification and distance of anatomical structures, but no significant difference between the right and left sides. It should be highlighted that CBCT is necessary before invasive procedures in order to preserve important anatomical structures. In conclusion, the location of the CS varies in relation to the alveolar ridge crest and buccal cortical bone, assuming that it is going to be located by the upper lateral incisor palatine.

Abstract Aim: To determine the prevalence and classification of bifid mandibular canals using cone beam computed tomography (CBCT). Methods: The sample comprised 300 CBCT scans obtained from the Radiology and Imaging Department database at São Leopoldo Mandic Dental School, Campinas, SP, Brazil. All images were performed on Classic I-Cat(r) CBCT scanner, with standardized voxel at 0.25 mm and 13 cm FOV (field of view). From an axial slice (0.25 mm) a guiding plane was drawn along the alveolar ridge in order to obtain a cross-section. Results: Among 300 patients, 188 (62.7%) were female and 112 (37.3%) were male, aged between 13 to 87 years. Changes in the mandibular canal were observed in 90 patients, 30.0% of the sample, 51 women (56.7%) and 39 men (43.3%). Regarding affected sides, 32.2% were on the right and 24.5% on the left, with 43.3% bilateral cases. Conclusions: According to the results obtained in this study, a prevalence of 30% of bifid mandibular canals was found, with the most prevalent types classified as B (mesial direction) and bilateral.

OBJETIVO: Comparar o crescimento ântero-posterior da maxila e da mandíbula entre pacientes com fissura unilateral completa de lábio e palato reparada e pacientes que não apresentavam nenhuma alteração craniofacial. MÉTODOS: Foram selecionadas 46 telerradiografias cefalométricas em norma lateral de pacientes com fissura unilateral completa de lábio e palato que foram submetidos às cirurgias primárias de correção durante a infância (grupo de estudo). A amostra do grupo controle foi composta por 46 telerradiografias cefalométricas em norma lateral de pacientes sem nenhuma alteração craniofacial e que apresentavam valores para os ângulos SNA e SNB dentro dos valores pré-estabelecidos de normalidade. O gênero e as faixas etárias entre 6 e 9 anos dos pacientes foram pareados e comparados em ambos os grupos. A comparação entre os dois grupos foi realizada por meio dos ângulos SNA, SNB e ANB. Aplicou-se a análise de variância (ANOVA), considerando-se o nível de significância de 5%. RESULTADOS: Observou-se diferença significativa entre os grupos de pacientes com fissura reparada e controle (p<0,0001), ou seja, o grupo com fissura reparada apresentou menor média de SNA e SNB em todas as idades. Para o ângulo ANB, o grupo com fissura reparada apresentou maior média em todas as faixas etárias (p<0,05). CONCLUSÃO: Pode-se concluir que o grupo de pacientes com fissura unilateral completa de lábio e palato reparada nas faixas etárias estudadas e em ambos os gêneros apresentaram maxila e mandíbula retruídas em uma relação esquelética de Classe II em relação ao grupo controle.

OBJECTIVE: To compare the craniofacial features of Brazilian children who had received surgery for unilateral complete cleft lip and palate compared with non-cleft group. METHODS: Craniofacial features were evaluated on lateral cephalometric radiographs. 46 patients with unilateral complete cleft lip and palate were divided by gender and matched at ages 6, 7, 8 and 9. They were compared with 46 non-cleft children, equally divided by gender and matched the same age groups. All comparisons were carried out by means of the Angles SNA, SNB and ANB. The findings were analyzed on the basis of the two-way Analysis of Variance (ANOVA) with p <0.05 significance level. RESULTS: Both the angle SNA and SNB in the cleft group had a lower average in both genders and all age groups compared with the non-cleft group (p<0.0001). The average values of ANB were significantly higher in the cleft group (p<0.05) both in males and females and in all age groups studied. CONCLUSION: Children who had received surgery for unilateral complete cleft lip and palate during childhood had maxillary and mandibular retrusion and a class II skeletal pattern in relation to non-cleft group.