Abstract The aim of this study was to conduct a systematic review of the literature regarding the use of Piezosurgery instead of conventional rotary instruments in the extractions of lower third molars. Material and method: An electronic databases search was performed in PubMed, ISI Web of Knowledge, Science Direct in the last eight years, using the keywords; third molar, osteotomy, surgical instruments, maxillofacial surgery. Results: Twenty six articles were selected after applying inclusion and exclusion criteria. Articles that evaluated the perioperative time, facial edema, postoperative pain and amount of analgesics used, were selected, and a common variable in the studies was the longest working time during the procedures performed with piezoelectric devices. Conclusion: According to the evidence found, most studies have associated the use of Piezosurgery for extractions of third molars with less facial post-operative oedema. However piezosurgery has a longer greater intra-operative time, which can increase post-operative pain and presence of trismus.

Resumen El objetivo de este estudio fue realizar una revisión sistemática de la literatura con relación al uso de piezocirugia comparado con instrumentos rotatorios convencionales en las exodoncias de los terceros molares inferiores. Material y método: Se realizó una búsqueda electrónica en las bases de datos: PubMed, ISI Web of Knowledge, Science Direct en los últimos 8 años, utilizando las palabras claves; tercer molar, osteotomía, instrumentos quirúrgicos, cirugía maxilofacial. Resultados: se seleccionaron veintiseis artículos después de aplicar los criterios de inclusión y exclusión. Se seleccionaron artículos que evaluaron el tiempo transoperatório, edema facial, dolor posoperatorio y cantidad de analgésico ingerida, una variable común en los estudios fue el mayor tiempo de trabajo durante los procedimientos realizados con dispositivos piezoeléctricos. Conclusión: de acuerdo con las evidencias encontradas, la mayoría de los estudios relacionaron el uso de piezocirugia para exodoncias de terceros molares inferiores con menor edema facial posoperatorio, sin embargo los procedimientos realizados con piezocirugia representan mayor tiempo transoperatório, lo que puede aumentar el dolor posoperatorio y la presencia de trismus.

The calcifying epithelial odontogenic tumour is a rare benign odontogenic neoplasm that accounts for approximately 1% of all odontogenic tumours. They are mainly located in the premolar/molar mandibular region, and are associated with an unerupted molar tooth. We present a literature review of the clinical, radiographic, pathological findings and treatment options of the calcifying epithelial odontogenic tumour, as well as describing the case of an calcifying epithelial odontogenic tumour associated with an impacted right mandibular in a 32-year-old male patient, who was treated conservatively, without no sign of recurrence of the lesion after five years.

El tumor epitelial odontogénico calcificante corresponde a menos de 1% de todos los tumores odontogénicos de origen ectodérmica, afectando principalmente la región posterior de la mandíbula, relacionada muchas veces a un diente molar retenido. En este artículo son realizadas las consideraciones en relación a las características clínicas, radiográficas, histopatológicas y sobre las modalidades de tratamiento del tumor epitelial odontogénico calcificante por medio de una revisión de literatura, siendo relatado la asociación de un tumor de este tipo a un canino inferior retenido, en un paciente de género masculino, de 32 años de edad, tratado de forma conservadora y en el cual no se observó recurrencia de la lesión después de 5 años de acompañamiento.

OBJETIVO: avaliar a aplicabilidade de um padrão cefalométrico norte-americano em pacientes brasileiros submetidos à cirurgia ortognática, por meio da comparação dos traçados cefalométricos pós-tratamento ortodôntico-cirúrgico de 29 pacientes que passaram por cirurgia de maxila e mandíbula, com o padrão cefalométrico utilizado como orientação para o planejamento dos casos. MÉTODOS: os traçados foram gerados pelo programa Dolphin Imaging 9.0 a partir de telerradiografias em norma lateral digitalizadas, nas quais foram marcados 48 pontos de referência dentários, ósseos e tegumentares. Assim, obteve-se 26 grandezas cefalométricas lineares e angulares para posterior comparação com os valores normativos, considerando-se o dimorfismo sexual e as eventuais modificações feitas no planejamento em virtude de necessidades individuais de cada caso e das possíveis diferenças étnico-raciais. Os dados da amostra foram confrontados com o padrão por meio da comparação das médias e desvios-padrão pelo teste "t" de Student. RESULTADOS: para os homens, as médias da amostra foram significativamente diferentes do padrão em cinco das grandezas estudadas; enquanto, para as mulheres, nove apresentaram diferenças estatisticamente significativas. No entanto, apesar da similaridade das médias na maioria das medidas em ambos os gêneros, os dados mostraram grandes variações individuais. CONCLUSÕES: a análise dos resultados obtidos sugere que o padrão cefalométrico norte-americano empregado é aplicável como referência para o planejamento de casos ortodôntico-cirúrgicos de pacientes brasileiros, desde que se atente às variações individuais de acordo com as necessidades de cada paciente.

OBJECTIVES: To study the applicability of a North American cephalometric standard to Brazilian patients subjected to orthognathic surgery by comparing the post-surgical/orthodontic treatment cephalometric tracings of 29 patients who had undergone surgery of the maxilla and mandible with the cephalometric standard used as guidance in planning the cases. METHODS: The tracings were generated by the Dolphin Imaging 9.0 computer program from scanned lateral cephalograms in which 48 dental, osseous and tegumentary landmarks were defined. Thus, were obtained 26 linear and angular cephalometric measurements to be compared with normative values, considering sexual dimorphism and possible modifications to the treatment plan to meet the individual needs of each case, as well as any possible ethnic and racial differences. The sample data were compared with the standard using Student's t-test means and standard deviations. RESULTS: The results showed that for males, the sample means were significantly different from the standard in five of the measurements, while for women, nine were statistically different. However, despite the similarity of the means of most measurements in both genders, the data showed marked individual variations. CONCLUSIONS: An analysis of the results suggests that the North American cephalometric standard is applicable as a reference for planning orthodontic-surgical cases of Brazilian patients, provided that consideration is given to variations in the individual needs of each patient.

Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.

Embora a expansão rápida da maxila possa ser considerada um procedimento ortodôntico eficaz e amplamente utilizado na correção da deficiência transversa maxilar em crianças e pacientes adolescentes jovens, seu prognóstico não se apresenta muito favorável na correção dessa condição oclusal em pacientes adultos ou no final da adolescência. Nesses pacientes, a correção da deficiência transversa pode ser realizada com sucesso através da intervenção cirúrgica, seja por meio da expansão assistida ou da osteotomia multissegmentada da maxila.

Although the maxillary expansion may be considered a orthodontic procedure efficient and widely used in the maxillary transverse deficiency correction in children and young adolescent patients, its prognostic is not very favorable in the correction of this occlusal condition in adults or patients in the adolescence end. In these patients the correction of this transverse deficiency may be successfully conducted by means of the surgical intervention, either through the assisted expansion or the multi-segmented maxillary osteotomy.

OBJETIVO: ciente de que a cirurgia ortognática moderna se preocupa em planejar e diagnosticar os casos clínicos utilizando medidas obtidas de grandezas do perfil tegumentar dos pacientes - com o auxílio de imagens digitais empregadas em softwares de planejamento -, no presente estudo foi proposto aferir as medidas de brasileiros leucodermas de descendência européia e compará-las com as medidas já padronizadas por Arnett, com o intuito de criar novas medidas a serem seguidas por brasileiros que utilizam o software de predição cirúrgica Dolphin Imaging 9.0. MÉTODOS: foram utilizadas radiografias cefalométricas de 31 pacientes com oclusão Classe I de Angle e harmonia facial. Todas as radiografias foram digitalizadas e inseridas no software Dolphin 9.0 e 16 pontos de tecido mole e 22 pontos do esqueleto facial foram marcados, seguindo-se exatamente as marcações da análise de Arnett e McLaughlin presentes no programa. RESULTADOS: os resultados obtidos foram avaliados estatisticamente e mostram que o perfil do brasileiro é quase totalmente diferente do perfil norte-americano, exceção feita a apenas quatro pontos para os homens e outros quatro para as mulheres. Os brasileiros apresentam uma face menos protruída, um perfil mais convexo e menor proeminência do queixo do que o grupo controle. CONCLUSÃO: esses dados mostram a necessidade de se realizar algumas mudanças nas grandezas numéricas para que um perfeito diagnóstico e planejamento possam ser realizados em brasileiros, criando assim o padrão do perfil facial do brasileiro leucoderma de descendência européia.

AIM: Considering that modern orthognathic surgery is mainly concerned in planning and diagnosing clinical cases by the use of patients' soft tissue measurements obtained from digital images used in planning software, the aim of this study is to establish Caucasian Brazilians measures and to compare them to the standard North American measures. METHODS: For this, a total of 31 Angle's Class I patients not previously submitted to orthodontic treatment and presenting harmonious facial features were invited to participate in the study as volunteers. The patients were initially photographed in frontal and lateral views and, afterwards, cephalograms were obtained. The images were digitized, adjusted and indexed in Dolphin's image software. In order to precede cephalometric analysis, a total of 16 soft tissue profile points and 22 hard tissue profile points were demarcated, accordingly to American original measurements used in Dolphin's digital image program. After, all cephalograms were again evaluated to determine intra-examiner error according to paired Student's t test. Mean and standard error measures were obtained and compared to American measures by unpaired Student's t test with 95% of confidence level. RESULTS: The results obtained have shown that all measurements, except for 4 points in male and 4 points in female, are significantly different between Brazilian and American samples. Data show that Brazilians' soft tissue profile is almost completely different from American's, with a less protrusive face, shorter chin projection and a more convex profile. CONCLUSION: This suggests the necessity of performing some changes in numerical values to obtain an ideal diagnosis and planning of orthognathic surgery in Brazilians.

This article reports the case of a 19-year-old young man with Class III malocclusion and posterior crossbite with concerns about temporomandibular disorder (TMD), esthetics and functional problems. Surgical-orthodontic treatment was carried out by decompensation of the mandibular incisors and segmentation of the maxilla in 4 pieces, which allowed expansion and advancement. Remission of the signs and symptoms occurred after surgical-orthodontic intervention. The maxillary dental arch presented normal transverse dimension. Satisfactory static and functional occlusion and esthetic results were achieved and remained stable. Three years after the surgical-orthodontic treatment, no TMD sign or symptom was observed and the occlusal results had not changed. When vertical or horizontal movements of the maxilla in the presence of moderate maxillary constriction are necessary, segmental LeFort I osteotomy can be an important part of treatment planning.

INTRODUÇÃO: o ensaio em modelos de gesso tem grande importância para o planejamento em cirurgia ortognática. OBJETIVO: neste artigo, será apresentado, passo-a-passo, uma técnica de cirurgia de modelos iniciando pela mandíbula, destacando aspectos importantes e as vantagens deste procedimento.

INTRODUCTION: The cast surgery has great importance in orthognatic surgery treatment planning. AIM: In this article, a step by step lower model surgery will be presented, emphasizing important details and advantages of this procedure.

OBJETIVOS: avaliar a confiabilidade na identificação de marcadores observados em radiografias PA. METODOLOGIA: em 3 crânios humanos secos procedeu-se à instalação de aparelhos expansores do tipo Hyrax, nos quais adaptaram-se marcadores nos acessórios ortodônticos. RESULTADOS: a comparação estatística dos 27 cefalogramas confeccionados revelou para as medidas angulares valores dos erros com pequenas variações, entretanto os menores erros foram encontrados para as medidas lineares entre os marcadores. Deste modo, conclui-se que a pouca variabilidade na identificação dos marcadores demonstrou sua confiabilidade para o uso em estudo com telerradiografias PA.Os erros para as medias angulares atribui-se às dificuldades na determinação de estruturas anatômicas. CONCLUSÃO: os marcadores avaliados neste estudo parecem prestarem-se como estruturas confiáveis em telerradiografias PA utilizadas em pesquisas longitudinais.

AIM: to evaluate the reliability in the identification of the markers observed in frontal Cephalometric x-rays. METHODS: in 3 dry humans skull were adapted expansor appliances, in which markers were attached at orthodontics brackets and tubes. RESULTS: the statistical comparison of the 27 postero-anterior cephalograms revealed that the angular measures showed small variations; however the smallest error were for the lineal measures among the markers. CONCLUSION: the markers demonstrated its reliability for the use in longitudinal researches with frontal cephalometric x-rays.

Double lip is a developmental abnormality which may occur either isolated or as a component of Ascher´s syndrome. A case of congenital double lip associated to hemangiomas and enlargement of the thyroid is reported. The oral and facial hemangiomas were excised under local anesthesia. Surgical reconstruction of the upper lip was done in order to reduce the interference with speech and mastication. The recognition and treatment of these abnormalities are discussed.

Labio doble es una alteración del desarrollo que puede producirse aislada o como un componente del síndrome de Ascher. Se publica un caso de labio doble congénito asociado a hemangiomas y agrandamiento de glándula tiroides. Los hemangiomas orales y faciales fueron extirpados bajo anestesia local. La reconstrucción quirúrgica del labio superior fue hecha para reducir la interferencia con el habla y la masticación. Se discute el reconocimiento y tratamiento de estas alteraciones.