The aim of this research was to analyzed the tension in osteosynthesis screw used for fixation of sagittal split ramus osteotomy (SSRS). Was used two model of SSRS made in photoelastic resin; in one of them was include a basilar osteotomy and the another one only SSRS without basilar osteotomy; for both system was used inverted L osteosynthesis with 13 mm screw of 2.0 system. Posteriorly, the hemimandible was installed in Instrom machine with a vertical load of 1 mm/min until the displacement of 3 mm; the load point was on first molar. The fringe distribution show more tension in the screw close to osteotomy in both groups; when SSRS was united to basilar osteotomy was produced a inferior distribution of force and in the SSRS without basilar osteotomy group was maintained a distribution into the oblique line. It's was conclude that both mandibular osteotomies was efficient in load distribution and was not observed important differences between screw related to distribution of load.

El objetivo de esta investigación es identificar las tensiones presentes en tornillos de osteosíntesis utilizados en la fijación de la osteotomía sagital de rama mandibular (OSRM). Se utilizaron dos modelos de OSRM realizados con resina fotoelástica donde el grupo 1 presentaba una osteotomía basilar recta mientras que el grupo 2 presentaba una osteotomía basilar angulada; en ambos se utilizo el sistema de L invertido para la osteosíntesis con tornillos 2.0 de 13 mm de longitud. Posteriormente el sistema fue instalado en un pilar sobre la maquina Instrom, donde se aplico una carga vertical de 1 mm/minuto hasta conseguir el desplazamiento de 3 mm; el punto de carga estuvo en la fosa central del primer molar. La distribución de franjas mostro mayor tensión en el tornillo mas próximo de la osteotomía en ambos grupos; en el grupo 2 se produjo una diseminación de fuerzas levemente hacia la basilar y en el grupo 1 se mantuvo la diseminación a través de la línea oblicua. Se puede concluir que ambas osteotomías mandibulares son eficientes en la distribución de cargas y que no se observan diferencias cualitativas entre tornillos en términos de cantidad de diseminación de energía.

AIM: To biomechanically analyze two fixation techniques in polyurethane hemi-mandibular body fractures, using a universal testing machine. METHODS: The study employed 10 polyurethane hemi-mandible replicas, which simulated simple fractures of the mandibular body, divided into two groups: one group comprised 5 hemi-mandibles with two 2.0 mm system plates in the tension and compression zones, while the other group contained 5 hemi-mandibles with an Erich bar and a 2.0 mm system plate in the tension and neutral zones, respectively. Data were analyzed statistically by the Student's t-test (α=0.05) RESULTS: The test results indicated that the fixation using 2.0 mm system plates offered significantly more resistance to the loads and presented significantly larger displacement compared to the fixation using just one 2.0 mm system plate and the Erich bar. CONCLUSIONS: It may be concluded that the use of two plates in the 2.0 mm system had greater mechanical strength than a single 2.0 mm plate combined with an Erich bar. Clinically, it is known that both techniques can provide good results, but patients receiving the combination of Erich bar and one plate are required to be more cooperative during the postoperative period, especially with respect to the prescribed diet in order to avoid failures in this system.

In the international literatura exist some information related to temporomandibular joint (TMJ) involvement in condylar fracture malunion; the treatment is variated being executed with a bone reconstruction, ramus vertical osteotomy or condilar plate. This case demonstrates that TMJ replacement with prosthetic joint is technically possible and appropriate in the case of malunion of condylar fracture.

Bone harvest of mandibular symphysis has been used in maxillofacial reconstruction procedures. The aim of this research was to establish the presence of bone repair into osseous defect caused by removal of bone. Thirty patient s, 2 female and 8 male, ranging between 21 and 65 years of age underwent surgery for chin bone harvest and alveolar reconstruction. The surgery was performed by two maxillofacial surgeons and the patients were evaluated with lateral radiography in the pre-operatory stage, in early post-operatory and in late post-operatory stages. Horizontal and vertical measures of bone defect were realized; the dates were analyzed by Student t test with a value of p<0.05. After bone harvest, a vertical defect of 12.80 ±1.99 was observed and a horizontal defect of 8.33 ± 1.77 was observed. After one year the defect decreased to 32.8% in vertical evaluation, and 50.3% in the horizontal evaluation with a statistical significance (p<0.05) in relation to the early post-operatory stage. Therefore, we conclude that in bone repair of mandibular symphysis defect is close to 30 50% in a one-year follow-up.

El retiro de hueso de sínfisis mandibular ha sido utilizado ampliamente para diferentes procedimientos reconstructivos maxilofaciales. El objetivo de esta investigación fue establecer la existencia de la reparación ósea en el defecto creado en sínfisis debido al retiro de hueso. Treinta pacientes (22 mujeres, 8 hombres) de entre 21 y 65 años fueron operados para retirar hueso de mentón que fue posteriormente aplicado en reconstrucción ósea alveolar; las cirugías fueron realizadas por dos cirujanos maxilofaciales y los pacientes fueron evaluados con telerradiografías en la etapa preoperatoria, postoperatoria inmediata (PIn) y postoperatoria tardía (PTar), donde se realizaron medidas horizontales y verticales del defecto óseo; los valores fueron estudiados con la prueba t de Student con valor de p<0,05. Luego del retiro óseo se observó un defecto vertical promedio de 12,80±1,99 y horizontal de 8,33±1,77; luego de un año, se obtuvo una disminución de 32,8% en el sentido vertical y 50,3% horizontal, presentando significancia estadística en relación al PIn. Se concluye que existe reparación ósea del defecto originado en sínfisis siendo próximo al 30%-50% en la evaluación de un año posterior a la cirugía.

OBJETIVO: analisar 3 tamanhos de elásticos ortodônticos de látex (1/8", 3/16" e 5/16"), todos classificados como de força pesada pelos seus fabricantes (Dental Morelli, 3M Unitek Corporation e American Orthodontics). MÉTODOS: através de um dispositivo desenvolvido, os elásticos foram distendidos a 26mm (simulação da posição de repouso da mandíbula) e imersos em saliva artificial a uma temperatura de 37ºC. A cada minuto foram alongados a 44mm (simulação de movimentos mandibulares) e após 1 segundo voltavam a 26mm. Foram realizadas leituras em intervalos de tempos variados. Nos períodos considerados como horários das refeições (3 vezes ao dia), os elásticos eram retirados do dispositivo e guardados em uma caixa acrílica; e, no período considerado noturno, o dispositivo pneumático era desligado e os elásticos ficavam estirados em 26mm. RESULTADOS: a degradação maior da força ocorreu nas primeiras 2 horas para toda a amostra. CONCLUSÕES: concluiu-se que os elásticos apresentaram diferenças estatisticamente significativas em relação à espessura e à largura; e que os elásticos 1/8" devem ser trocados, pelo menos, a cada 24 horas e os elásticos 3/16" e 5/16" podem ser trocados a cada 72 horas, caso se deseje níveis de força próximos aos iniciais.

AIM: To analyze 3 sizes of latex orthodontics elastics (1/8", 3/16" and 5/16"), all classified as heavy force by their manufacturers, of the following commercial brands: Dental Morelli, 3M Unitek Corporation and American Orthodontics. METHODS: Through a developed device, the elastics bands were distended 26mm (position of rest of the mandible) and submerged in artificial saliva to 37ºC. Every minute they were prolonged to 44mm (simulation of mandibular movements) and after 1 second they returned to 26mm. Measurements were accomplished in intervals of varied times. In the periods considered as meals time (3 times a day), the elastics bands were removed of the device and kept in an acrylic box, and in the period considered as nocturne the pneumatic device was turned off and the elastics bands were stretched in 26mm. RESULTS: The larger force degradation happened in the first 2 hours for the whole sample. CONCLUSION: the elastics bands presented significant statistic differences in relation to thickness and width; and the 1/8" elastics bands should be changed at least every 24 hours and the 3/16" and 5/16" elastic bands can be changed every 72 hours, if force levels similar to the initials are desired.

O relacionamento entre os atores do sistema supletivo de assistência à saúde no Brasil é caracterizado por uma complexa trama de conflitos de interesse e de poder, que podem ser analisados à luz da teoria da agência. Ela emprega elementos da ciência econômica, principalmente das teorias do consumidor e do funcionamento de mercado, conjuntamente com idéias derivadas dos estudos organizacionais e comportamentais, faz uma divisão entre os agentes econômicos em principais e agentes. Analisando o mercado de assistência supletiva, pode-se constatar que ele possui inúmeros atores, que exercem ao mesmo tempo papéis de agentes e principais. É justamente dessa dualidade de papéis que surgem grande parte dos conflitos, e, através de diversos mecanismos de regulação, tenta-se reduzir os custos de agência derivados dos conflitos de interesse que são a causa principal dos problemas de agência dentro desse setor.

The relationship between the actors of the supplementary healthcare system in Brazil is characterized by complex conflicts of interests and power struggles, which can be analyzed by the agency theory. This theory - combining elements of economic sciences, mainly consumer and market theories, with ideas derived from organizational and behavioral studies - divides the economic agents in principals and agents. The analysis of the supplementary healthcare market reveals its many actors play simultaneously the roles of agent and principal. This duality of roles is the root of most conflicts, originating several regulation mechanisms which try to reduce agency costs derived from conflicts of interests that are the main cause of this sector's agency issues.

O diagnóstico da discrepância de tamanho dentário de Bolton é de fundamental importância para a boa finalização do tratamento ortodôntico. Por meio da medição dos dentes, com o auxílio de um paquímetro digital e a inserção dos valores no programa de computador desenvolvido e apresentado pelos autores, o trabalho do ortodontista fica mais simples, pois não é necessário realizar nenhum cálculo matemático ou auxiliar-se de nenhuma tabela de valores, eliminando-se a probabilidade de erros. Além disso, o programa apresenta a localização da discrepância por segmento - total, anterior e posterior - e individual - por elemento dentário, permitindo assim maior precisão na planificação das estratégias para a resolução dos problemas, caminhando para um tratamento ortodôntico de sucesso.

The diagnosis of the Bolton’s Tooth Size Discrepancy is of fundamental importance for the good orthodontics finalization. Through the measurement of the teeth with the aid of a digital caliper and the insert of the values in the computer program developed by the authors and which that it will be presented in this article, the orthodontist’s work is simpler, because it is not necessary to accomplish any mathematical calculation or to aid of any table of values, eliminating the probability of mistakes. Besides, the program presents the location of the discrepancy for segment - overall, anterior and posterior - and individual - for dental element, allowing larger precision in the planning of the strategies for the resolution of the problems and walking for a success orthodontic treatment.

A tomada de decisão é certamente a atividades mais freqüente que encontramos dentro das empresas. Algumas dessas decisões são de grande relevância, outras nem tanto. A determinação da localização é certamente uma das escolhas que tem maior impacto nos resultados. Apesar disso, os tomadores de decisões das empresas ainda não utilizam métodos científicos na hora de escolher a localização de suas instalação. Dessa forma, o objetivo deste artigo é apresentar alguns dos problemas enfrentados e os métodos hoje disponíveis que podem ser utilizados nesses momentos nas empresas.

The decision process is on of the most frequent actitivites that we can be found in the companies. Some of this decisions are very important, other, not so much. The determination of the localization of a firm is one of the decisions that has the biggest impact in the results. Althought all this arguments, the responsible people for this decisons in the companies do not use a cientifical method when deciding where to install theirs units. In this way, the aim of this article is presenting some of the problems faced and the methods avaliable nowadays that can be used in this critical moments in the companies.