RESUMO Este relato de caso clínico descreve a reabilitação com implantes para o tratamento da reabsorção radicular patológica devido à movimentação ortodôntica inadequada em espaço protético reduzido, por meio implante imediato e carga imediata, pela técnica da cirurgia guiada por computador e uso da própria coroa dentária, em paciente de 21 anos. A exodontia atraumática dos incisivos laterais superiores direito e esquerdo foi realizada, em seguida realizou-se a instalação imediata dos implantes osseointegráveis, utilizando a técnica de cirurgia guiada por computador. Os próprios dentes da coroa foram usados na reabilitação estética e funcional imediata. A conclusão do tratamento resultou em sucesso funcional e estético com acompanhamento de 27 meses sem intercorrências. Os procedimentos incluídos neste complexo tratamento de reabilitação na zona estética foram adequados e essenciais para a manutenção do contorno e espessura dos tecidos moles e duros garantindo a excelência na reabilitação.

ABSTRACT This clinical report describes the implant rehabilitation for the treatment of pathological roots resorption due to inadequate orthodontic movement in prosthetic space reduced by means of load and immediate implants, computer-guided surgery and use of the own tooth crown in a 21-year-old-patient. The atraumatic exodontics of the right and left upper lateral incisors was performed, and then immediate placement of osseointegrated implants using the computer guided surgery technique. The crown teeth itself was used in the immediate aesthetic and functional rehabilitation. Completion of the treatment resulted in a functional and aesthetic successful outcome and a 27 months follow-up presented uneventful. The procedures included in this complex rehabilitation treatment in the esthetic zone were appropriate and essential for the maintenance of the soft and hard tissues contour and thickness ensuring the excellence in rehabilitation.

ABSTRACT Purpose To evaluate the influence of bioactive glass and photobiomodulation therapy (PBMT) in calvarial bone repair process in rats submitted to zoledronic acid therapy. Methods Twenty-four rats were selected and treated with the dose of 0.035 mg/kg of zoledronic acid every two weeks, totalizing eight weeks, to induce osteonecrosis. After the drug therapy, surgical procedure was performed to create 5-mm diameter parietal bone defects in the calvarial region. The rats were then randomly assigned to groups according to the following treatments: AZC: control group, treated with blood clot; AZBIO: bone defect filled with bioactive glass; AZL: treated with blood clot and submitted to PBMT; and AZBIOL: treated with bioactive glass S53P4 and submitted to PBMT. Tissue samples were collected and submitted to histomorphometric analysis after 14 and 28 days. Results At 14 days, bone neoformation in the AZBIO (52.15 ± 9.77) and AZBIOL (49.77 ± 13.58) groups presented higher values (p ≤ 0.001) compared to the AZC (23.35 ± 10.15) and AZL groups (23.32 ± 8.75). At 28 days, AZBIO (80.24 ± 5.41)still presented significant higher bone recovery values when compared to AZC (59.59 ± 16.92)and AZL (45.25 ± 5.41) groups (p = 0.048). In the 28-day period, the AZBIOL group didn’t show statistically significant difference with the other groups (71.79 ± 29.38). Conclusions The bioactive glass is an effective protocol to stimulate bone neoformation in critical defects surgically created in rats with drug induced osteonecrosis, in the studied periods of 14 and 28 days.

RESUMO Objetivo: A avaliação pré-operatória é de fundamental importância para a prevenção das complicações cirúrgicas pós-operatórias. O objetivo do presente estudo foi estabelecer um perfil quantitativo e qualitativo das enfermidades sistêmicas e relaciona-las com complicações cirúrgicas pós-operatórias em pacientes submetidos exodontia. Métodos: Para isso foram coletados dados de 992 prontuários de paciente submetidos a exodontias no período de 2010 a 2015, por meio da análise minuciosa da ficha de anamnese. Os dados obtidos foram tabulados e transformados em porcentagem, para facilitar a discussão e comparação com os relatos da literatura. Resultados: No total de prontuários analisados, 559 apresentaram alterações sistêmicas, o que corresponde a 56,3%. Dentre elas, houve uma maior prevalência de pacientes com hipertensão (24%), tabagismo (20%) e diabetes (11%). As complicações mais frequentes foram dor (34%), inflamação (19,8%) e hemorragia (13,2%). Considerando-se a prevalência de doenças relacionadas à idade, a faixa etária de menor de 20 anos (4.7%), 20 a 29 (11.3%), 30 a 39 (16.8%), 40 a 44 (10%), 45 a 49 (10.9%), 50 a 54 (12.3%), 55 a 59 (12.9%), 60 a 64 (10.4%), 65 a 69 (4.8%), e maiores de 70 anos (5.9%). Relacionando as alterações sistêmicas com as complicações, dentre os pacientes hipertensos que apresentaram complicações (n=11), a dor foi a mais prevalente (45,4%). Já nos fumantes (n=15) a complicação mais comum foi a inflamação exacerbada (33,3%). Nos diabéticos com presença de complicações (n=8), 50% foram diagnosticados com alveolite. Conclusão: Com base na metodologia estudada foi possível concluir que houve relação das complicações pós-operatórias e alterações sistêmicas, sendo as principais dor-hipertensão, inflamação-tabagismo e alveolite-diabetes.

ABSTRACT Objective: The preoperative evaluation is essential to prevent postoperative surgical complications. The present study aimed to establish quantitative and qualitative profiles of systemic disorders and relate them to postoperative surgical complications in patients subjected to dental extraction Methods: Data were collected from the medical records of 992 patients subjected to dental extractions from 2010 to 2015 through a detailed analysis of anamnesis files. The data collected were tabulated and converted to percentages to facilitate the discussion and comparison with reports in the literature Results: From all the medical records analyzed, 559 presented systemic changes, which corresponds to 56.3%. Among them, there was a higher prevalence of patients with hypertension (24%), smoking habits (20%), and diabetes (11%). The most frequent complications were pain (34%), inflammation (19.8%), and hemorrhage (13.2%). The prevalence of diseases related to age shows patients under the age of 20 (4.7%), 20 to 29 (11.3%), 30 to 39 (16.8%), 40 to 44 (10%), 45 to 49 (10.9%), 50 to 54 (12.3%), 55 to 59 (12.9%), 60 to 64 (10.4%), 65 to 69 (4.8%), and older than 70 years old (5.9%). As for systemic changes with complications, hypertensive patients with complications (n=11) showed higher prevalence of pain (45.4%), the most common complication in smokers (n=15) was exacerbated inflammation (33.3%), and 50% of diabetic patients with complications (n=8) were diagnosed with alveolitis Conclusion: The method studied allowed concluding there was a relationship between postoperative complications and systemic changes, and the main ones were pain-hypertension, inflammation-smoking, and alveolitis-diabetes.

ABSTRACT: Aim: This study aimed to report the clinical case of an immediate implant-supported rehabilitation in infected alveolar socket with buccal bone resorption and apical periodontitis in the teeth 42 and 43. Case Report: The patient was rehabilitated with implants associated with guided bone regeneration and immediate provisionalization. After 4 months, the custom molding was made in order to receive the metal-ceramic prosthesis. The follow-up lasted 24 months and there was no painful symptomatology, infection, implant mobility or marked peri-implant bone loss in this period. Conclusion: Therefore, the placement of immediate implants on fresh infected alveolar sockets is viable for the implant-supported rehabilitation.

ABSTRACT: Ameloblastoma is a rare tumor that affects the maxillomandibular region. Surgical resection is often indicated, and oral rehabilitation becomes a challenge. This study aims to report on the mandibular rehabilitation with implant supported prosthesis using immediate loading with subsequent resection. A patient with a confirmed diagnosis of multicystic ameloblastoma in the left jaw underwent a partial resection of the mandible and a reconstruction with a titanium plate. After 2 years of follow-up with clinical examinations and imaging testing and with no signs of recurrence, the patient underwent the technique of immediate load implants, rehabilitating the mandible with an implant supported fixed prosthesis and the maxilla with a conventional complete denture. During the seven years of follow-up with the patient, there was no sign of recurrence of ameloblastoma. The rehabilitation with oral implants under immediate loading demonstrated to be successful, and the cemented cylinder technique used in this study coupled with passivity showed a favorable prognosis for the longevity of implants.

Dental implant fixation techniques are widely studied in order to reduce surgical morbidity. Computer-guided flapless surgery has been considered an efficient alternative that presents several advantages and some limitations. This technique allows the virtual planning and simulation of the prosthetic-surgical treatment that can help predict the difficulties and limitations in order to reduce possible errors. In addition to the prosthetic predictability, computer-guided surgery enhances accuracy and reduces surgical morbidity. Thus, the aim of this study was to report on a 7-year follow-up of immediately loaded implants inserted into an edentulous maxilla using virtual planning and flapless surgery.

Las técnicas de fijación del implante dental se estudian ampliamente para reducir la morbilidad quirúrgica. La cirugía sin flapless guiada por ordenador ha sido considerada como una alternativa eficiente con varias ventajas y algunas limitaciones. Esta técnica permite la planificación virtual y simulación del tratamiento protésico quirúrgico con la predicción de las dificultades y limitaciones para reducir posibles errores. Además de la previsibilidad de prótesis, la cirugía guiada por ordenador mejora la precisión y reduce la morbilidad quirúrgica. Por lo tanto, el objetivo de este estudio fue reportar a 5 años de seguimiento de los implantes de carga inmediata insertados en un maxilar desdentado utilizando la planificación virtual y la cirugía sin colgajo. El presente caso prospectivo informó el éxito del tratamiento y destacó la importancia de la planificación, lo que justifica el costo de esta tecnología.

A doença de von Willebrand (DvW) é uma coagulopatia hereditária. Não há predileção por sexo. Clinicamente caracteriza-se por hemorragias mucocutâneas, sobretudo nasais, menorragias e hemorragias pós-trauma. Este artigo relata um caso clínico de DvW em paciente de 52 anos de idade, leucoderma, do sexo masculino, que apresentou extensa hemorragia em bordo lateral de língua após ferimento lacerante, além de descrever alguns aspectos clínicos, patológicos e terapêuticos da DvW. Após repetidas tentativas de sutura do ferimento e reposição dos fatores de coagulação, optou-se pela ligadura da artéria carótida externa ipsilateral ao ferimento, com resolução favorável do caso, notando-se bom aspecto cicatricial 2 meses após a ligadura. Este caso reforça que é de extrema importância a realização de anamnese criteriosa, buscando-se identificar possíveis distúrbios hemorrágicos prévios ou antecedentes familiares.

The von Willebrand disease (vWD) is a hereditary coagulopathy. There is no gender predilection. Clinically characterized by mucocutaneous bleeding, especially nose bleeding, menorrhagia and bleeding after trauma. This article reports a case of a 52-year-old Caucasian male patient with vWD, who presented with extensive bleeding in the tongue after a lacerating injury caused by accidental biting, and describes some clinical, pathological and treatment aspects of vWD. After repeated attempts to suture the wound and replace clotting factors, a decision was made to perform the ligature of the external carotid artery ipsilateral to the injury. There was favorable resolution of the case, with a good aspect of the scar 2 months after ligation. This case reinforces that it is extremely important to make a thorough review of medical history of all patients, searching for possible bleeding disorders or previous family history.

OBJETIVO: a proposta desse trabalho foi analisar a fidelidade dos traçados predictivos realizados para cirurgias ortognáticas, por meio de análise cefalométrica do pré e pós-operatório de sete dias, em pacientes submetidos à correção de deformidade mandibular. MÉTODOS: foram utilizadas telerradiografias cefalométricas de perfil de 17 pacientes submetidos à cirurgia ortognática de mandíbula. Foram realizados traçados cefalométricos do pré e do pós-operatório de 7 dias com marcação dos pontos côndilo (Co), pogônio (Pog), goníaco (Go), mento (Me), ponto B (B) e incisivo (I). A análise foi baseada na diferença obtida pela sobreposição dos traçados pré-operatório, predictivo e pós-operatório. Os pontos foram projetados em um plano cartesiano para medição das suas distâncias em milímetros. Os dados obtidos foram submetidos à análise estatística por meio do teste t de Student pareado (± = 0,05). RESULTADOS: no eixo horizontal, foi observada diferença média, entre a mudança planejada e a obtida nos traçados cefalométricos pós-operatórios, estatisticamente significativa nos pontos Pog (p = 0,014) e I (p = 0,008). No eixo vertical, não verificou-se diferença estatística significativa para os pontos cefalométricos marcados (p > 0,05). CONCLUSÕES: o traçado predictivo contribuiu para a avaliação pré-operatória do paciente e, consequentemente, para a otimização do tratamento. Entretanto, ele não se mostrou totalmente fiel nos casos analisados, com leve subestimação das alterações esqueléticas horizontais. Essas alterações devem ser consideradas no planejamento e acompanhamento pós-operatório dos pacientes submetidos à cirurgia ortognática em mandíbula.

OBJECTIVE: The purpose of this study was to assess the accuracy of cephalometric prediction tracings-performed for orthognathic surgery-by means of the cephalometric analysis of preoperative and seven-day postoperative tracings, in patients subjected to correction of mandibular deformities. METHODS: The lateral cephalograms of 17 patients who had been submitted to mandibular orthognathic surgery, three years earlier, were used. Cephalometric tracings were performed in the preoperative and seven-day postoperative periods and the following landmarks were traced: condyle (Co), pogonion (Pog), gonial (Go), menton (Me), B (B) and incisor (I). The analysis was based on the difference obtained by superimposing preoperative, prediction and postoperative tracings. The landmarks were projected onto a Cartesian plane for measuring distances between points in millimeters. The data were statistically analyzed using the paired Student t test (a = 0.05). RESULTS: A statistically significant mean difference was observed between the planned change and the change effectively achieved in the postoperative cephalometric tracings for points Pog (p = 0.014) and I (p = 0.008) on the horizontal axis. No statistically significant difference was found for the aforementioned cephalometric points on the vertical axis (p > 0.05). CONCLUSIONS: Cephalometric prediction tracings contributed to the preoperative evaluation of the patients and consequently to treatment optimization. However, they was not entirely reliable in these cases due to a slight underestimation of horizontal skeletal changes. These changes should be considered in planning and postoperative follow-up of patients subjected to orthognathic surgery in the mandible.