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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.

Abstract ObjectivesTo evaluate the effect of a collagen sponge containing simvastatin on socket healing in terms of bone microarchitecture through tomographic analysis, pain, and swelling after impacted third molar extraction.Materials and methodsIn this single-blind, split-mouth, randomized clinical trial, 29 patients undergoing impacted third molar extraction were allocated into two groups: (i) test group, a collagen sponge containing simvastatin was inserted within the sockets; and (ii) control group, in which sockets retained the clot. Bone volume (BV), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp), and gray scale were evaluated using cone beam computed tomography (CBCT) acquired immediately postoperative and 3 months after surgery. Pain, swelling, and wound healing were evaluated using the 10-point visual analogue scale, three extra-oral reference measurements, and the Landry index.ResultsIn total, 22 participants remained in the study; no loss-to-follow-up was related to the intervention. BV and BV/TV were significantly higher at 3 months postoperatively in the test group compared with the control group and were correlated with greater bone trabeculation. Pain, edema, and the Landry index revealed a greater inflammatory response in the test group during early repair. Simvastatin contributed to bone healing, with no adverse effects or postoperative complications.ConclusionsThe absorbable collagen sponge containing simvastatin improved BV, BV/TV, and trabecular bone, indicating the potential of this drug to induce the formation of autogenous bone.Clinical relevanceIntraosseous statins represent a promising, low-cost, and easy-to-use alternative for alveolar ridge preservation and bone regeneration.Trial registrationBrazilian Registry of Clinical Trials (REBEC), No. RBR-523N7R.

Cryosurgery is a treatment modality consisting in the destruction of tissue by the application of extremely low temperatures. This causes irreversible damage to cellular metabolism, leading to tissue destruction within minutes, a mechanism that may be beneficial when used in diseased tissues. Because cryosurgery is effective, simple, and easy to perform, it has been used in the treatment of lesions in both medical and dental fields. This technique provides many advantages, such as easy operation, absence of intraoperative bleeding, and low infection rate. We report the case of a patient with a hemangiomatous lesion of the oral cavity who was treated with liquid nitrogen spray cryosurgery, with successful results at 18-month follow-up.

Introduction Subcutaneous emphysema in the cervical region is a well-documented event that may occur secondary to tonsillectomy, dental treatment, oropharyngeal barotraumas, scaling and root planning therapy, punch biopsy, endotracheal intubation, orthognathic surgery, extraction of impacted teeth, or after maxillofacial trauma. After trauma episodes, subcutaneous emphysema may be caused by a maxillary antral wall fracture that occurs when air pressure is introduced into the fascial planes of the connective tissue. Retropharyngeal emphysema is a severe condition associated with traumatic aerodigestive tract injury and may be associated with life-threatening situations requiring prompt attention and diagnosis in order to prevent serious consequences. Case report We reported a case of cervicofacial and retropharyngeal emphysema in a 54-year-old patient who stated concerns after blowing his nose several times after a traumatic episode involving orbitozygomatic region. During the patient’s hospital course, his airway remained stable, and he was discharged from the hospital 7 days later with a prognosis of full recovery, excellent occlusion and facial appearance, and complete resolution of subcutaneous emphysema.

Objectives Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin’s impact on alveolar bone regeneration and determine its level of support for clinical applications. Materials and methods This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. Results Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. Conclusions Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. Clinical relevance This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF Registry protocol osf.io/q3bnf

Objective To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. Materials and methods A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO 2 )], and sedation assessed by the Ramsay scale. Results A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group ( p  < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points ( p  < 0.05) and a significant reduction in HR at two different time intervals ( p  = 0.003 and p  = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO 2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group ( p  < 0.05). There were no significant postoperative adverse effects. Conclusions Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. Clinical relevance The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. Trial registration Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.

Abstract ObjectivesTo evaluate the efficiency of maxillomandibular advancement using aggregated individual patient data from multiple studies.Materials and methodsThis overview was structured according to the PICO strategy. It adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and was recorded on the international prospective register of systematic reviews (PROSPERO-CRD42020206135). Searches were conducted in the PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, and Cochrane databases for studies published until January 1, 2021. Data from the included studies were collected by one author, while another reviewed the compilation.ResultsTwelve systematic reviews were included. The outcome measures studied were the apnea–hypopnea index, respiratory disturbance index, mean oxygen saturation, lowest oxygen saturation, sleepiness data, posterior air space, sella-nasion point A angle, sella-nasion point B angle, surgical success, and surgical cure in patients who underwent surgery. The AMSTAR scale presented moderate evaluations, with grades varying between 6 and 10 points. The Glenny scale revealed that the study selection did not include all languages. Only three reviews identified quality assessments conducted by at least two reviewers and only five related possible searches for unpublished data.ConclusionsBimaxillary advancement surgery improved respiratory indicators, sleepiness data, and increased upper airway size. However, it is necessary to standardize the surgical criteria to establish measurable efficiency of the procedure.Clinical relevanceThis overview makes a critical analysis of the results of the selected systematic reviews with the aim of presenting the most clinically relevant data on the maxillomandibular advancement for treating obstructive apnea syndrome, with a focus on improving respiratory, anatomical, and quality of life indices. There are no overviews that approach this theme from a well-structured perspective.

Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a complex disease with multifactorial etiology. It is marked by the occurrence of apnea and hypopnea events caused by repeated obstructions of the upper airways. OSAHS is strongly associated with obesity, and the prevalence of this disease in morbidly obese patients is very high. Nevertheless, not all patients with OSAHS are obese, and for this reason, there may be other anatomical predispositions to airway collapse. In obese patients, fatty deposition in the parapharyngeal region results in airway reduction and predisposes to airway collapse, worsened by neurologic loss of the normal dilator muscle tone of the neck. However, in nonobese patients, specific craniofacial characteristics such as posterior air pharyngeal space, tongue length, hyoid position, and maxillomandibular deficiencies may predispose some people to develop OSAHS. Treatment strategies for OSAHS patients vary from clinical treatment with continuous positive airway pressure, oral appliances, or medications for mild and moderate OSAHS patients, bariatric surgery for severe obese OSAHS patients to maxillomandibular advancement for obese or nonobese OSAHS patients.

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.

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.