Darceny Barbosa

A ancoragem sempre foi uma das limitações da ortodontia e em quase toda terapia ortodôntica há necessidade de obtê-la. Com a descoberta da ósteo integração surgiu um novo modelo de ancoragem, a esquelética. Numa ancoragem esquelética extra alveolar o posicionamento mais oblíquo dos miniparafusos pode aumentar os riscos de deformação. O objetivo deste trabalho foi analisar, num estudo in vitro, o desempenho mecânico nos torques de inserção e remoção e observar se o tipo de liga e as angulações de inserção influenciam na utilização destes miniparafusos em posições extra alveolares. Foram utilizados 40 miniparafusos de diâmetro e comprimento semelhantes (2,0x12mm), porém de ligas diferentes (20 de aço e 20 de titânio), todos inseridos por um torquímetro digital em cortical óssea sintética de poliuretano (40PCF). As inserções foram feitas em duas angulações, uma a 30º e outra de 60º para 30º. Após obtenção dos dados, os mesmos foram submetidos à análise estatística de variância, Equaçõe...

The present study aimed to establish the profile of patients who underwent orthognathic surgery in a private clinic by evaluating their demographic characteristics, their facial types, and aspects related to the surgical procedures that were performed. The sample consisted of 419 medical records from male and female patients aged 15 to 62 years who underwent orthognathic surgery between 2001 and 2011. A single examiner collected data by evaluating a database of information extracted from medical records, particularly radiographic and photographic analyses. The following criteria were evaluated: gender, age, skin color, type of orthognathic surgery, type of associated temporomandibular joint (TMJ) surgery, complications, and recurrences. Seventeen patients were rejected because they had incomplete records. The average age of the patients was 28.5 years old; most were females (255 patients) and faioderm (295 patients). The most prevalent facial pattern was Pattern III (n = 166, 41.3%). Orthognathic surgery that affected the maxilla, jaw, and chin was the most prevalent type (n = 199, 49.5% of cases). A genioplasty was performed concurrently with combined surgeries and single-jaw surgery in 76.86% of patients (n = 309). TMJ surgery was performed concomitantly with orthognathic surgery in 4% of cases (n = 16). The most common postoperative complication was infection/inflammation (n = 12). We concluded that there was a higher frequency of orthognathic surgery among women and young people, the brunette skin phenotype was prevalent, and most patients had a combination of maxillary and mandibular problems.

Estagiária da Disciplina de Cirurgia e Traumatologia Bucomaxilofacial da Faculdade de Odontologia - Universidade Federal de ss Ubcrlándia e Pós Graduanda em Cirurgia pela FOP (Unicamp). Professora Adjunto do Departamento de Diagnóstico e Cirurgia - ...

Oral surgery to remove pyogenic granuloma in a high-risk patient is reported. A 47-year-old man with gastroesophageal reflux disease, diabetes mellitus II, dyslipidemia, and chronic coronary insufficiency (myocardial infarction within 2 years) with episodes of unstable angina was submitted to an excisional biopsy of hemorrhagic lesion in the lingual right mandibular gingiva. During dental treatment, the arterial blood pressure, oxygen saturation, heart rate, and electrocardiogram were monitored. Local anesthesia was performed with 0.45 ml of 3% prilocaine with 0.03 IU/ml felypressin. The anticoagulant therapy was not interrupted. No local or systemic complications were noticed during or after the surgery.

Introdução: As soluções anestésicas têm características próprias em relação a propriedades como latência, potência e tempo de ação. Muitos autores demonstraram a superioridade da difusão de soluções de articaína a 4%, embora haja controvérsias na literatura científica sobre essa questão. Objetivo: O objetivo do presente estudo foi comparar a capacidade de induzir a anestesia da mucosa palatina e a eficácia anestésica após o bloqueio do nervo alveolar superior posterior de duas soluções anestésicas: articaína a 4% com epinefrina 1:100.000 e lidocaína a 2% com epinefrina 1:100.000. Mé- todos: Esse experimento original foi um estudo transversal, duplo-cego, randomizado, com dezoito voluntários saudáveis, com idades entre 14 e 26 anos, com indicação de extração de terceiro molar superior impactado. A capacidade de difusão e a eficácia das soluções anestésicas foram verificadas pela Escala de 11 Pontos em Caixa, e o grau de ansiedade foi avaliado pela Escala de Ansiedade Dental de Corah....

Introduccion: Este estudio evaluo histologicamente dos disenos de implantes: un diseno clasico de rosca, frente a otro especificamente disenado para la formacion de un lecho de cicatrizacion, con dos protocolos de fresado. Material y metodos: Se insertaron cuarenta implantes dentales (4,1 mm de diametro) con dos macro-geometrias diferentes en la tibia de 10 perros Beagle, y se registro el maximo torque de insercion. Las tecnicas de perforacion fueron: hasta 3,75 mm (grupo normal); y hasta 4,0 mm de diametro (grupo sobrefresado) para ambos disenos de implantes. A las 2 y 4 semanas, se recuperaron las muestras y se procesaron para analisis histomorfometrico . Para el torque y el CHI (contacto hueso-implante) y la FAOO (fraccion de area osea ocupada), se empleo un modelo general lineal incluyendo la tecnica de instrumentacion y el tiempo en vivo de forma independiente. Resultados: El torque de insercion registrado para cada diseno de implante y grupo de fresado, disminuyo significativa...

The bisphosphonates (BFs) as a drug-related inhibition of bone resorption consecrates its to the treatment of patients with osteoporosis and cancer with bone metastases, which culminated with its expanded use. This study aims to explain the importance of identifying patients who make use of BFs thereby contributing to the adequate knowledge on risks related to these complications affecting patients. This study focuses on the clinical use of BFs, the risks it represents to the facial bones, considered its characteristics as well as the importance of diagnosing patients who use these drugs, in order to conduct them on the proper dental treatment to be held initially, and thus, to contribute to the reduction of complication that means an unforeseeable and devastating consequences for the patients.

The high survival clinical success rates of osseointegration are requisites for establishing a long-term biomechanical fixation and load-bearing potential of endosseous oral implants. The objective of this preclinical animal study was to evaluate the effect of surface microtopography and chemistry on the early stages of biomechanical rigidity with a sandblasted, dual acid-etched surface, with or without an additional chemical modification (SAE-HD and SAE, respectively), in the tibia of Beagle dogs. Two pairs of implants, with the same macrogeometry but different surface technology ((a) dual acid-etched surface treatment with hydrochloric and sulfuric acid followed by microwave treatment and insertion in isotonic saline solution to increase hydrophilicity (SAE-HD) (test, n = 12) and (b) dual acid-etched surface (SAE) (control, n = 12)), were installed bilaterally in the proximal tibia of six Beagle dogs. In order to determine the effect of surface modification on biomechanical fixati...

The deleterious effects of ionizing radiation on the growth plate continue to be cause for concern. This study evaluated the ionizing radiation effects on bone development and growth plate in the tibia of rats. All animals were submitted to ionizing radiation on the left leg. The animals were divided into two groups and euthanized 30 and 60 days after radiation. The tibiae were removed and separated into groups: control 30 days, irradiated 30 days, control 60 days and irradiated 60 days. Animals in each group (n = 7) were used for macroscopic and histological analysis. The irradiated tibiae showed arrested growth, angular deformity and limb length discrepancy when compared with nonirradiated tibiae. There was statistical difference between control and radiation groups in all the parameters analyzed, except in the lateral‐medial thickness of the distal epiphysis. Histological analysis showed evident changes in the growth plate, which was thicker in the Groups irradiated for 30 days, ...

O objetivo deste trabalho foi analisar in vitro o efeito de três superfícies de titânio disponíveis comercialmente: usinada (USI), ataque ácido (AA) e bioanodizada com CaP (BIO), sobre a viabilidade e adesão celulares, bem como sobre a secreção das interleucinas IL-1β e IL-12 por osteoblastos hFOB 1.19. A viabilidade foi determinada pelo método colorimétrico MTT-Formazan após 1, 7 e 14 dias de cultura. Nos períodos de 7 e 14 dias, a adesão celular foi avaliada por meio da contagem de núcleos marcados por Hoechst ao microscópio confocal. Os sobrenadantes de 1, 7 e 14 dias de cultivo foram submetidos ao teste ELISA Sanduíche para dosagem de IL-1β e IL-12. Após 1 dia de cultura, USI apresentou maior número de células viáveis, sendo estatisticamente diferente apenas do grupo AA (p<0,001). Após 7 dias, houve aumento significativo na viabilidade para AA e BIO quando comparados a USI (p=0,047 e p=0,003, respectivamente), o que não permaneceu aos 14 dias, período no qual nenhuma diferenç...

In reconstructive procedures harvested bone grafts are often temporarily stored in extraoral media while the recipient site is prepared. The aim of the present study was to analyze histomorphometrically osteocytes in calvarial bone grafts stored in either physiologic saline solution or platelet-poor plasma (PPP). Calvarial bone fragments were obtained from 12 rabbits and fixed immediately in formalin (control) or stored in PPP or in saline solution for 30 minutes prior to fixation. All specimens were decalcified and embedded in glycol methacrylate. A differential osteocyte count (normal osteocytes, abnormal osteocytes, and empty lacunae) was performed for the sections and submitted to analysis of variance (ANOVA) and the Fisher least-square-difference (LSD) test. P < .05 was considered significant. The histomorphometric analysis demonstrated statistically significant differences among the groups (control, PPP, saline) for all analyzed parameters (P < .05). The median number of...

Nitric oxide has an important effect on host immune response. However, little has been studied in relation to its potential as a possible diagnostic tool in peri-implant disease. The present study analyzed nitrite levels in the peri-implant sulcular fluid (PISF) of implants with mucositis and the correlation of these nitrite levels with clinical parameters using a simplified fluid collection methodology. Twenty-five partially edentulous patients showing peri-implant mucositis were evaluated, and the peri-implant status was determined based on current clinical parameters: probing depth (PD) and bleeding on probing (BOP). The sulcular fluid (SF) around teeth (control) and implants were collected, and the nitrite levels were evaluated using the Griess method. The mean probing depth (mm) was significantly higher (P < .0001) in implants (2.852 ± 0.6484) than in control teeth (1.585 ± 0.3636). The mean total nitrite level (μM) was statistically higher (P = .0069) in implants with mucos...

To evaluate the bone healing of defects filled with particulate bone graft in combination with platelet-rich plasma (PRP), added with a mixture of calcium chloride and thrombin or just calcium chloride. Two 5-mm bone defects were created in the calvaria of 24 rabbits. Each defect was filled with particulate bone graft and PRP. In one defect the PRP was activated by a mixture of calcium chloride and thrombin; in the other, PRP was activated by calcium chloride only. The animals were euthanized 1, 2, 4, and 8 weeks after the surgeries, and the calvaria was submitted to histologic processing for histomorphometric analysis. The qualitative analysis has shown that both defects presented the same histologic characteristics so that a better organized, more mature, and well-vascularized bone tissue was noticed in the eighth week. A good bone repair was achieved using either the mixture of calcium chloride and thrombin or the calcium chloride alone as a restarting agent of the coagulation pr...

Few studies have evaluated the effects of titanium (Ti) surface modifications on polymorphonuclear neutrophils (PMNs). Human PMNs' viability and release of key mediators-such as IL1β, IL6, TNFα, IL12, IL10, IL4, TGFβ1, IL8, IP-10, and Mig-were evaluated on three different Ti surface treatments: (1) machined Ti; (2) alumina-blasted and acid-etched Ti (AB/AE); and (3) calcium phosphate coating of 300-500 nm by ion beam onto the AB/AE Ti surface (CaP). A polystyrene surface was used as a negative control. The PMNs were purified from whole human blood and cultured for 6 h. Cell viability was determined by flow cytometry, and the supernatant was evaluated to determine the levels of cytokines and chemokines. Results showed that the percentage of viable cells was significantly lower on the CaP surface compared to the control (p < 0.05) relative to the other groups. No differences in the levels of IL8, MIG, and IP10 were detected between groups. Significantly higher levels of IL1β (p = 0.046) and TNFα (p = 0.016) were detected for the CaP surfaces compared to AB/AE surface only. The levels of IL4, IL10, and TGFβ1 secreted from the PMNs in the CaP group were significantly lower than in the control and machined groups (p < 0.05) that were statistically comparable to AB/AE. Overall, the addition of a thin CaP coating to the AB/AE Ti surface influenced…

Copyright © 2013 Fernando P. S. Guastaldi et al.is is an open access article distributed under theCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in anymedium, provided the originalwork is properly cited. e surface energy of the implant surface has an impact on osseointegration. In this study, 2 surfaces: nonwashed resorbable blasting media (NWRBM; control) andAr-based nonthermal plasma 30 days (Plasma 30 days; experimental), were investigated with a focus on the surface energy. e surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and the chemistry by X-ray photoelectron spectroscopy (XPS). Five adult beagle dogs received 8 implants (

The risk of fracture or strain in mini-screws is higher if diameter, length, type of alloy or insertion angle is selected inappropriately. The aims of this study were to test the structural resistance of two types of orthodontic mini-screws –one made of stainless steel and another of titanium– from an international brand and to evaluate the efficacy of two other titanium miniscrews of Brazilian origin, during an extra-alveolar anchorage procedure. The mini-screws analyzed were: Bomei stainless steel and Bomei titanium / Taiwan, Morelli titanium and Neodent titanium/ Brazil. Experiments were conducted on pig mandibles to simulate the process of extra-alveolar anchorage. Two insertion processes were used: Direct at 30º, and Indirect, starting at 60º and ending at 30º with gradual continuous movement. Strain was evaluated using Optical and Scanning Electron Microscopy. Data were evaluated using Kruskal-Wallis non-parametric statistical analysis and post hoc Tamhane test. Significant st...

Snakebite is an important public health problem because of its incidence, morbidity, and mortality. It may be related to climatic factors and rural habits. Snakes of the genus Bothrops are responsible for most snakebites in Brazil. The venom of these snakes has peculiar characteristics, with important proteolytic, coagulant, and hemorrhagic actions, leading to local and systemic alterations. Initial manifestations include local tissue injury, pain, swelling, bleeding, and bullous lesions that can progress to abscesses or tissue necrosis. Systemic manifestations should be carefully evaluated especially for the probability of hemorrhagic events such as epistaxis, gingivorrhagia, hematuria, and hemoptysis. Knowing the clinical manifestations of snakebites, as well as the adequate treatment, is essential. Efficient and rapid diagnosis can minimize victims’ injuries and the probability of death. The present study reports the clinical case of bleeding at a distant site from the initial si...

The aim of this preclinical in vivo study was to compare histologically and histomorphometrically osseointegration of dual acid-etched vs. hydrophilic implants. Two pairs of implants (Neodent, Curitiba, Brazil), with same macrogeometry but different surface technology (i) dual acid-etched surface (SAE) treatment with hydrochloric and sulfuric acid followed by microwave treatment and insertion in isotonic saline solution to increase hydrophilicity (SAE-HD) (test, n = 12); (ii) dual SAE (control, n = 12) were installed bilaterally in the proximal tibia of six beagle dogs. Histologic and histomorphometric evaluation was performed after 2 and 4 weeks in vivo, on non-decalcified sections. Percentages of bone-to-implant contact (BIC) and bone density (BD) were estimated and tested for significant differences with the Wilcoxon signed-rank test for paired samples (P < 0.05). In general, new bone formation along and in contact with the implant surface could be observed irrespective of the...

The objective of this study was to evaluate, in a rat model, the effect of hyperbaric oxygen (HBO) on the healing of normal bone on day 7. Forty male rats were used, equally divided into two groups based on treatment and time of sacrifice: the control group had bone defects created; and the HBO group had bone defects and received HBO. HBO sessions were conducted daily, at 2.5 atmosphere absolute for 90 minutes, and the animals were euthanized after 1, 3, 5, or 7 days. Bone density, bone neoformation, and expression of Runt-related transcription factor 2 (Runx2) and tartrate-resistant acid phosphatase were evaluated. Computed tomography analysis revealed significant differences only at 3 days (P=.01) between the control and HBO groups. HBO treatment accelerated the initial events of bone repair, resulting in improved bone neoformation. Increased expression of Runx2 was observed, especially on days 5 and 7 in the HBO group, although not significantly. There was no significant difference (P=.74) in the number of tartrate-resistant acid phosphatase-positive osteoclasts between the control and HBO groups on day 7. These results suggest that exposure to HBO enhances bone anabolism, reduces inflammation, and accelerates bone healing, with positive results in bone neoformation. Therefore, the aim of this study was to evaluate the effect of HBO on the healing of experimental defects created in normal bone, on the first 7 days, in a rat model.

To evaluate the amount of bone matrix in autogenous block bone grafts that were fixed with or without perforation of the receptor bed. Twelve rabbits received two 5-mm circular osteotomies each in the anterior parietal region. The bone was removed, perforated, and fixed by a titanium screw in the adjacent area, 3 mm from the border of the osteotomies. On the contralateral side, six perforations were made in the receptor site before the graft was fixated by the titanium screw. After 28 days, the animals were sacrificed and specimens were prepared for histologic study. Sections were analyzed with regard to the total area of the graft and the percentages of bone matrix in the graft, interface, and receptor bed. Analyses using the Wilcoxon test (P<.05) were performed. No statistically significant differences were found between the groups with or without perforations to the area of the graft (P=.85) or the percentage of hard tissue in the grafts (P=.53), the interface (P=.65), or the ...

The surface energy of the implant surface has an impact on osseointegration. In this study, 2 surfaces: nonwashed resorbable blasting media (NWRBM; control) and Ar-based nonthermal plasma 30 days (Plasma 30 days; experimental), were investigated with a focus on the surface energy. The surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and the chemistry by X-ray photoelectron spectroscopy (XPS). Five adult beagle dogs received 8 implants (n=2per surface, per tibia). After 2 weeks, the animals were euthanized, and half of the implants (n=20) were removal torqued and the other half were histologically processed (n=20). The bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were evaluated on the histologic sections. The XPS analysis showed peaks of C, Ca, O, and P for the control and experimental surfaces. While no significant difference was observed for BIC parameter (P>0.75), a higher level for torque (P<0.02) and BAFO parameter (P<0.0...

The objective of this histologic study was to determine the effect of three drilling protocols (oversized, intermediate, and undersized) on biologic responses to a single implant type at early healing periods (2 weeks in vivo) in a beagle dog model. Ten beagle dogs were acquired and subjected to surgeries in the tibia 2 weeks before euthanasia. During surgery, each dog received three Unitite implants, 4 mm in diameter by 10 mm in length, in bone sites drilled to 3.5, 3.75, and 4.0 mm in final diameter. The insertion torque was recorded during surgery, and bone-to-implant contact (BIC), and bone area fraction occupied (BAFO) measured from the histology. Each outcome measure was compared between treatment conditions with the Wilcoxon signed-rank test. Bonferroni-corrected statistical significance was set to 95%. Insertion torque increased as an inverse function of drilling diameter, as indicated by significant differences in torque levels between each pair of conditions (P = 0.005). B...

INTRODUCTION: Extraction of third molars can rarely provoke post-operative complications, such as temporomandibular joint disorders (TMDs). OBJECTIVE: Although the literature presents a series of discussions of the clinical evidence related to this subject, in this report, we present an uncommon case of a patient submitted for the extraction of third molars who presented, in postoperative monitoring, with recurrent bilateral condylar luxation. CONCLUSION: Due to this critical condition, the patient was successfully treated by bilateral eminectomy.

Reconstruction of mandibular defects after tumor resection is a challenge to the head and neck surgeon because of associated functional and esthetic problems. The intention of mandibular reconstructive surgery is to achieve maximum possible functionality, which means the restoration of masticatory function and speech with a good esthetic result. Hyperbaric oxygen therapy (HBO) is already a well-accepted adjunct in the treatment of extensive bone defects. It has been shown to enhance osteogenesis and improve soft tissue wound healing in a variety of circumstances. The following case report describes a 29-year-old woman who was diagnosed with mandibular ameloblastoma. The treatment of choice is resection with mandibular base maintenance. The patient underwent 10 sessions of hyperbaric oxygen therapy and subsequent nonvascularized iliac crest graft. Six months after, mandibular reconstruction is possible to observe the preservation of mandibular contouring and facial esthetics. A panor...

Esse artigo tem como objetivo apresentar o projeto, a construção e os resultados obtidos no estudo da osseointegração com um torquímetro de alta precisão. Esse torquímetro, especialmente desenvolvido para este tipo de pesquisa, pode ser usado para desenvolver pesquisas odontológicas da osseointegração de implantes dentários. Os implantes foram feitos em sete coelhos que foram avaliados após 21 e 42 dias. Alguns coelhos sofreram estimulações ultra-sônicas em seus implantes, enquanto outros foram analisados sem se submeterem a estas estimulações. Os resultados mostraram o bom funcionamento do torquímetro e que o torque para remover o implante do coelho é diretamente proporcional ao tempo de osseintegração e que as estimulações ultra-sônicas podem influenciar o torque necessário para remover o implante em alguns casos.