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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.

Wound closure technique is an operative factor that influences early post-operative complications after third molar surgery. This study investigates and compared the effectiveness of two closure techniques, primary closure and healing by second intention of the oblique incision on postsurgical discomfort after mandibular third molar surgery. This is a prospective, randomized, double-blind, split mouth controlled trial. Surgical sites were divided into two groups Control group received simple sutures in both alveolar crest incision and oblique incision and intervention group received simple sutures in alveolar crest incision, while the oblique incision healed by second intention. All the patients were instructed to measure pain according to visual analogue scale (VAS) in postoperative period, swelling, mouth opening was assessed at 72h and 7 days after surgery. The wound healing was assessed on day 7. Thirty-five patients, who had bilateral impacted third molars of similar surgical difficulty, were recruited. Thirty-one successfully completed the study. Patients in the second intention group had significantly less pain at 24h (p < 0.27). and 48h (< 0.001), had significantly less swelling (< 0.001) and trismus (< 0.001) and patients submitted to primary closure had a better evaluation of the Landry index (p < 0.001). Healing by second intention of the oblique relaxing incision by partial surgical wound closure, in our study, were superior to the primary closure in reduction of post-operative pain, swelling and trismus. This trial is registered at Brazilian Registry of Clinical Trials-ReBEC -UTN: RBR-5fxbqsf (https://ensaiosclinicos.gov.br/rg/RBR-5fxbqsf).

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.

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.

Background Granular Cell Odontogenic Fibroma (GCOF) is a rare odontogenic neoplasm reported over time with different names. The purpose of this study is to review all available data on the GCOF in the scientific literature, with a summary of all reported cases and a report of a new case. Methods This review was conducted following the PRISMA guidelines. An electronic search was performed up to November 2022. Results Thirty-nine studies reporting fifty-three cases were included. GCOF is a rare neoplasm among the odontogenic tumors, with a higher prevalence in women of the middle-aged and white population. This lesion occurs mostly on the posterior region of the mandible. Furthermore, based on clinical, radiographic, and histopathologic features, conservative treatment was the most reported choice with recurrence reported in two cases. Conclusion GCOF remains controversial due to the still unsolved histogenesis.

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.

Introdução: Biópsia excisional é a remoção cirúrgica completa de uma lesão com objetivo de diagnóstico histopatológico e/ou tratamento definitivo. Objetivo: Descrever os passos a serem seguidos no procedimento cirúrgico de biopsia excisonal. Materiais e Métodos: Foi realizada uma revisão de literatura sobre o assunto, sendo ilustrado a partir do procedimento realizado na clínica da Universidade de Pernambuco Campus Arcoverde. Resultados: Na anamnese, a paciente do sexo feminino apresentou hipertensão arterial e uma pápula em língua, com aproximadamente 0,4 cm. Após a preparação do campo e da mesa cirúrgica foi realizada a assepsia do rosto e da cavidade oral. A anestesia realizada em pontos do dorso de língua permitiu a demarcação da lesão antes das incisões. A língua da paciente foi contida com fio de sutura. Foram realizadas duas excisões com a lâmina de bisturi para remoção da lesão, após a sua remoção foi armazenada em um pote com formol a 10%, devidamente identificado com os dados da paciente e encaminhado para o laboratório com a ficha contendo as informações sobre a lesão. Conclusão: O cirurgião-dentista deve estar apto para realização de uma biopsia, seguindo todas as etapas, desde a anamnese até o encaminhamento da lesão para o laboratório.