Explore the vast range of titles available.

Unfavorable fractures are among the most challenging complications in sagittal split ramus osteotomy (SSRO), potentially increasing surgical morbidity and compromising postoperative outcomes. The preoperative identification of anatomical risk factors through imaging can enhance surgical planning and prevent such events. This study aims to investigate the anatomical factors associated with lingual fracture patterns in SSRO using multislice computed tomography. This retrospective case-control study included 180 mandibular rami from patients who underwent SSRO at a Clinical Research Center for Oral and Maxillofacial Surgery. Fractures were classified according to Plooij (2009), with Types 3 and 4 grouped as cases and Types 1 and 2 as controls. Linear measurements of mandibular ramus thickness, the distance between the mandibular canal and the buccal cortical bone, as well as parameters related to the mandibular lingula were analyzed. The case group showed significantly thinner mandibular bone (p < 0.001) and a shorter canal-cortical distance (p = 0.013), suggesting a direct association between these anatomical variables and unfavorable fracture patterns. Bonferroni post hoc analysis revealed no significant difference between fracture patterns Type 3 and Type 4 (p = 1.000), supporting their grouping in a single analytical category. The presence of third molars was not significantly associated with fracture patterns (p > 0.05). These results underscore the importance of anatomical parameters in predicting the risk of unfavorable fractures. Specifically, reduced bone thickness and proximity of the mandibular canal play a crucial role in the occurrence of unfavorable SSRO fractures. Preoperative evaluation using computed tomography is essential to optimize surgical planning and minimize complications. However, given the limitations of retrospective designs potential biases are acknowledged, and further prospective studies are needed to confirm these findings and improve risk assessment in SSRO.

Objectives: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD) in subjects with skeletal class II dentofacial deformity referred for orthognathic surgery, as well as to elucidate its association with sociodemographic and psychosocial features. Methods: This was a cross-sectional study using the Research Diagnostic Criteria for Temporomandibular Disorders. The sample comprised class II skeletal patients referred to an Oral and Maxillofacial Surgery center in the Brazilian Northeast. Results: Seventy-three subjects were enrolled and completed the data collection, which consisted of a physical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders and facial analysis. Women represented 82.2% of the sample. Among the assessed subjects, 68.5% were already undergoing orthodontic treatment, and the mean overjet of patients was 6.97 mm. The prevalence of TMD in this sample was 46.6%, with muscular disorders being the most common. Patients with an anteroposterior discrepancy greater than 7 mm showed a higher occurrence of TMD (p = 0.017). Conclusion: This study demonstrated a high prevalence of TMD in skeletal class II patients referred for orthognathic surgery, especially in those with a pronounced overjet, being Group I (muscular disorders) and Group III (degenerative disorders) the most prevalent.

Background Dysregulation of the MAPK pathway appears to exert a pivotal role in the pathogenesis of ameloblastomas, since BRAF p.V600E has been reported in over 65% of the tumors. Therefore, the purpose of this study was to investigate whether the BRAF p.V600E is related to biological behavior and disease-free survival in patients with conventional ameloblastomas. Methods This is a retrospective cohort study based on the STROBE ( Strengthening the Reporting of Observational Studies in Epidemiology ) recommendations. The study population consisted of individuals treated for conventional ameloblastomas. Clinical, imaging, histomorphological, immunohistochemical (Ki67 and CD138/syndecan-1), and molecular BRAF p.V600E mutation analyses were performed. Bivariate statistical analysis was performed through chi-square and Fisher’s exact tests. Kaplan–Meier analysis with log-rank test and Cox proportional hazards regression were used to identify predictors of disease-free survival, with a significance level of 5%. Results Forty-one individuals were included, with a male-to-female ratio of 1.15:1. BRAF p.V600E mutation was identified in 75.6% of the tumors. No association between the BRAF mutational status and other clinical, imaging, histomorphological, and immunohistochemical variables was observed. Only the initial treatment modality was significantly associated with a better prognosis in univariate ( p  = 0.008) and multivariate ( p  = 0.030) analyses, with a hazard ratio of 9.60 (95%IC = 1.24–73.89), favoring radical treatment. Conclusion BRAF p.V600E mutation emerges as a prevalent molecular aberration in ameloblastomas. Nevertheless, it does not seem to significantly affect the tumor proliferative activity, CD138/syndecan-1-mediated cell adhesion, or disease-free survival outcomes.

As exostoses caracterizam-se por crescimentos ósseos benignos que afetam comumente a maxila e a mandíbula. Classificam-se em vestibulares, palatinas, solitárias e subpônticas reacionais. Exostoses vestibulares são raras, acometendo apenas 1 em cada 1.000 adultos na população. Apesar de assintomáticas, seu diagnóstico é facilmente realizado por meio de exame clínico, pelo aumento do volume ósseo local. Sua radiopacidade pode ser percebida nas radiografias. Histologicamente apresentam uma massa densa de osso cortical lamelar com uma pequena quantidade de medula óssea. Objetivo: Tendo em vista sua raridade, o presente artigo objetiva relatar um caso de exostoses múltiplas e descrever o tratamento cirúrgico realizado. Relato de caso: Paciente homem, leucoderma, 44 anos de idade, apresentando múltiplas exostoses em maxila e lesões ulceradas que, juntas, comprometiam o uso de prótese e o exercício de hábitos funcionais, como a mastigação de alimentos mais rígidos. O tratamento de escolha foi a excisão das protuberâncias mediante intervenção cirúrgica, possibilitando uma boa cicatrização óssea e pós-operatório satisfatório. Conclusão: As exostoses múltiplas dos maxilares são condições ósseas benignas raras, com etiologia incerta. Seu tratamento cirúrgico está indicado nos casos em que há prejuízo nas funções do sistema estomatognático, apresentando bons resultados estéticos e funcionais, com mínimas chances de recidiva.

Mycobacterium tuberculosis é a principal bactéria patogênica causadora da doença sistêmica granulomatosa crônica, a tuberculose (TB). Embora a TB pulmonar seja a mais prevalente, ela também pode apresentar-se de forma extrapulmonar nas vias hematológica e linfática em casos em que a resposta imunológica está reduzida. Objetivo: Relatar um caso clínico de tuberculose ganglionar em paciente pediátrico. Material e métodos: Trata-se de uma abordagem descritiva e qualitativa, com observação direta das informações do paciente para o diagnóstico e devido tratamento. Relato de caso: Paciente feminino, 4 anos, deu entrada no Hospital da Restauração – Governador Paulo Guerra, Recife (PE), com história de aumento de volume sintomático ao toque em região submandibular direita relacionado a exodontia recente do dente 85. Ao exame físico não foram identificados focos de infecção intrabucal dignos de nota e a paciente foi internada para investigação clínica. Os exames de imagem mostraram uma área indicativa de trajeto fistuloso. Foram prescritos sete dias de antibiótico (ceftriaxona e metronidazol) sem sucesso, sendo necessário substituir para clindamicina. A paciente foi submetida a procedimento de exérese de lesão tecidual sob anestesia geral, e o material foi enviado para exame histopatológico com laudo compatível com processo granulomatoso tuberculoide. Solicitou-se teste para micobactérias, sendo positivo. Quatro meses após a remoção da lesão, a paciente encontra-se em acompanhamento clínico, sem sinal de recidiva. Discussão: As crianças e os indivíduos imunossuprimidos são mais susceptíveis a tuberculose extrapulmonar, sendo os linfonodos cervicais os sítios mais acometidos. Conclusão: Apesar da dificuldade de diagnóstico, em virtude da sintomatologia inespecífica, principalmente em crianças, são imprescindíveis o rápido diagnóstico e o manuseio terapêutico, resultando em melhores taxas de prognóstico favorável.

Introdução: Mycobacterium tuberculosis é a principal bactéria patogênica causadora da doença sistêmica granulomatosa crônica, a tuberculose (TB). Embora a TB pulmonar seja a mais prevalente, ela também pode apresentar-se de forma extrapulmonar nas vias hematológica e linfática em casos em que a resposta imunológica está reduzida. Objetivo: Relatar um caso clínico de tuberculose ganglionar em paciente pediátrico. Material e métodos: Trata-se de uma abordagem descritiva e qualitativa, com observação direta das informações do paciente para o diagnóstico e devido tratamento. Relato de caso: Paciente feminino, 4 anos, deu entrada no Hospital da Restauração - Governador Paulo Guerra, Recife (PE), com história de aumento de volume sintomático ao toque em região submandibular direita relacionado a exodontia recente do dente 85. Ao exame físico não foram identificados focos de infecção intrabucal dignos de nota e a paciente foi internada para investigação clínica. Os exames de imagem mostraram uma área indicativa de trajeto fistuloso. Foram prescritos sete dias de antibiótico (ceftriaxona e metronidazol) sem sucesso, sendo necessário substituir para clindamicina. A paciente foi submetida a procedimento de exérese de lesão tecidual sob anestesia geral, e o material foi enviado para exame histopatológico com laudo compatível com processo granulomatoso tuberculoide. Solicitou-se teste para micobactérias, sendo positivo. Quatro meses após a remoção da lesão, a paciente encontra-se em acompanhamento clínico, sem sinal de recidiva. Discussão: As crianças e os indivíduos imunossuprimidos são mais susceptíveis a tuberculose extrapulmonar, sendo os linfonodos cervicais os sítios mais acometidos. Conclusão: Apesar da dificuldade de diagnóstico, em virtude da sintomatologia inespecífica, principalmente em crianças, são imprescindíveis o rápido diagnóstico e o manuseio terapêutico, resultando em melhores taxas de prognóstico favorável.

Introduçâo: As atividades esportivas podem expor os seus praticantes a risco de lesôes e traumas na regiáo de cabeça e pescoço independentemente do tipo de esporte e modalidade esportiva. As injurias orofaciais incluem os traumatismos ósseos, dentarios e de tecidos moles da regiáo buco-maxilo-facial. Objetivo:Realizar urna busca na literatura sobre a ocorrência de injurias orofaciais associadas à prática esportiva, evidenciando as modalidades desportivas que apresentam maior risco e as regioes anatómicas mais frequentemente acometidas. Materials e métodos: Foi realizada urna pesquisa ñas bases de dados da Biblioteca Virtual em Saude (BVS) e PubMed corn os descritores \"injurias orofaciais\" e \"esporte\". Resultados: As injurias orofaciais foram mais frequentes no sexo masculino. As modalidades desportivas que envolvem luta foram as que apresentaram maior risco para as injurias orofaciais. Identificou-se também uma maior ocorrência de injurias em atletas profissionais em relaçâo aos atletas amadores. As laceraçôes facíais foram o tipo de injuria mais frequente em todos os estudos,seguidas dos traumas dentoalveolares. Equipamentos de proteçâo foram eficazes na reduçâo de morbidade. Conclusâo: Devido ao risco de injurias em estruturas importantes da regiâo orofacial, faz-se necessario incentivar os atletas a usar os equipamentos de proteçâo, independentemente do tipo de prática esportiva.

ObjectivesThe aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD) in subjects with skeletal class II dentofacial deformity referred for orthognathic surgery, as well as to elucidate its association with sociodemographic and psychosocial features.MethodsThis was a cross-sectional study using the Research Diagnostic Criteria for Temporomandibular Disorders. The sample comprised class II skeletal patients referred to an Oral and Maxillofacial Surgery center in the Brazilian Northeast.ResultsSeventy-three subjects were enrolled and completed the data collection, which consisted of a physical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders and facial analysis. Women represented 82.2% of the sample. Among the assessed subjects, 68.5% were already undergoing orthodontic treatment, and the mean overjet of patients was 6.97 mm. The prevalence of TMD in this sample was 46.6%, with muscular disorders being the most common. Patients with an anteroposterior discrepancy greater than 7 mm showed a higher occurrence of TMD (p = 0.017).ConclusionThis study demonstrated a high prevalence of TMD in skeletal class II patients referred for orthognathic surgery, especially in those with a pronounced overjet, being Group I (muscular disorders) and Group III (degenerative disorders) the most prevalent.

The aim of the present study was to compare hemodynamic changes using midazolam 7.5 mg and diazepam 10.0 mg during the surgical removal of symmetrically positioned third molars. A prospective, randomized, double-blind, clinical trial was carried out involving 120 patients divided into three groups: Group 1 (diazepam and placebo), Group 2 (midazolam and placebo), and Group 3 (diazepam and midazolam). Each subject underwent two surgeries on separate occasions under local anesthesia. The following parameters were assessed at five different times (T0, T1, T2, T3, and T4): systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively); heart rate (HR); oxygen saturation (SpO 2 ); rate pressure product (RPP); and pressure rate quotient (PRQ). Statistically significant differences were found regarding heart rate at T2 and T3 ( p  < 0.005) in Group 2, with a higher rate occurring during midazolam administration. Moreover, significant differences in rate pressure product were found at T2, T3, and T4 in this group, with higher values also occurring during midazolam administration. In Group 3, significant differences in diastolic blood pressure were found at T3 and T4, with higher values occurring during diazepam administration, whereas a higher heart rate occurred at T3 with midazolam. Midazolam 7.5 mg and diazepam 10.0 mg exert an influence on some hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar surgery.

Leisure activities are known to be especially important for the health of people with disabilities. In Belém, PA, an Amazonian city in Brazil, a nonprofitable organization has promoted leisure ridings in bicycles for those people in Utinga State Park, a large green area for physical and leisure activities. The handcrafted bikes have a sidecar attached for users with disabilities which are ridden by trained volunteers. Since such bikes have been empirically manufactured, they require some minor improvements in safety, comfort, and handling, and verification of structural strength. Therefore, ergonomic, modal, and forced vibration analyses assessed the user’s comfort and safety and a structural analysis with the use of strain gauges evaluated the bicycle’s structural strength. Initially, a numerical modal analysis was performed using the finite element method, and the modal model obtained was validated by an experimental modal analysis employing shaker excitation. ISO-2631-based evaluations of forced vibration and human body comfort were conducted regarding whole-body vibration in vehicles and mechanical equipment. Vibration measurements at the position of the rider and sidecar occupant were obtained during rides on the bicycle and, according to the results, in general, when subjected to loads, the bicycle showed low stress levels far from the yield stress of the material, promoting an excellent safety factor in relation to its structural integrity. The modal, comfort, and forced vibration analyses revealed a mode of vibration in the sidecar that caused discomfort to the back of the users. Ergonomics analysis pointed out changes in the handlebars, the bicycle seat, the coupling between the sidecar and the bike, and the dimensions of the sidecar will provide greater comfort and safety. This paper presents and discusses the proposed modifications to both bicycle and sidecar.