1
|
de Assis Santos VP, Rocha-Junior WGP, Luz JGC. Effects of light-emitting diode (LED) therapy on sensory changes in the inferior alveolar nerve after surgical treatment of mandibular fractures: a randomized controlled trial. Oral Maxillofac Surg 2024; 28:185-193. [PMID: 36348150 DOI: 10.1007/s10006-022-01127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE A randomized controlled trial was performed to evaluate the effects of light-emitting diode (LED) therapy on sensory changes in the inferior alveolar nerve after surgical treatment of mandibular fractures. METHODS Patients admitted with surgically treated mandibular fractures between January 2018 and December 2019 were evaluated. Personal data, fracture location, fracture type, and dislocation degree were obtained. The cases were randomly allocated into two groups: LED therapy (LEDT) (57 points of 660 nm and 74 points of 850 nm, 6.4 mV/cm2, and 7.64 J) with the use of a prototype device and control (CTRL). For 6 months, tactile and thermal tests were used in the mental region. Data were analyzed using the Mann─Whitney U test and likelihood ratio test (p ≤ 0.050). RESULTS The study included 42 patients, 25 of whom had bilateral fractures and 17 had unilateral fractures, totaling 67 fractures. The mean values of the tactile and thermal sensitivity tests were lower in the LEDT group in all evaluation periods. There was a significant difference between the groups in the parasymphysis location, displacement < 5 mm, and intraoral access. Sensory changes were observed in 68.7% of all fractures upon admission, with 91.2% in the LEDT group and 78.8% in the CTRL group demonstrating complete remission during the final period of the study. CONCLUSION LED photobiomodulation accelerated the process of sensory change remission. There was an influence of the fracture location, degree of displacement, and surgical access, with a better response in the LEDT group.
Collapse
Affiliation(s)
- Vinícius Paes de Assis Santos
- Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
2
|
Benassi CM, de Assis Santos VP, Spagnol G, Ferraz EP, Luz JGC. The profile of patients with maxillofacial trauma due to interpersonal violence treated in a hospital emergency room. Dent Traumatol 2024; 40:35-43. [PMID: 37694974 DOI: 10.1111/edt.12886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
AIM This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil. MATERIAL AND METHODS Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050). RESULTS During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures. CONCLUSION Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV.
Collapse
Affiliation(s)
- Camila Maciel Benassi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Paes de Assis Santos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
| | - Guilherme Spagnol
- Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
| | - Emanuela Prado Ferraz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Avelino SG, de Assis Santos VP, Palmieri CF, Luz JGC. Characteristics and management of teeth in the line of mandibular fractures treated with internal fixation. Dent Traumatol 2023; 39:25-30. [PMID: 36214744 DOI: 10.1111/edt.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/06/2022] [Accepted: 08/14/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND/AIMS The ideal management of teeth in the line of mandibular fractures is unclear and controversial. The aim of this study was to analyze the characteristics and management of teeth in the line of mandibular fractures treated with open reduction and internal fixation. MATERIAL AND METHODS Medical records of patients with mandibular fractures in the symphysis, body and angle regions seen between July 2019 and January 2021 were evaluated. Personal data, etiology, location of fractures, characteristics of the teeth involved in the fracture lines and management were collected. The relationship between the fracture lines and the periodontium was classified according to Kamboozia & Punnia-Moorthy. Fractures were divided into two groups according to the management of the tooth in the fracture line: removal and retention. The likelihood ratio test was used (p < .050). RESULTS During the study period, 52 patients with mandibular fractures were seen, of which 42 patients (83.3% men) with a mean age of 29.6 years and 54 fractures were included. The most frequent location was the angle of the mandible (41.3%) (p < .001). The removal group represented 35.2% of the fractures, and the retention group represented 64.8%. The most frequently removed tooth was the third molar (p < .001), and the most frequent classification of dental involvement in the fracture line was type II (p = .047). There was no correlation between age, gender, or etiology and the management of the teeth involved. CONCLUSION The retention of teeth in the fracture line predominated, and the third molar in angle fractures was the most often removed tooth when the fracture line followed the root surface but did not cross the apical region, probably due to the greater frequency of this type of relationship between the fractures and the periodontium.
Collapse
Affiliation(s)
- Sabrina Gardiano Avelino
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Paes de Assis Santos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
| | - Celso F Palmieri
- Department of Oral & Maxillofacial Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
4
|
Rosin FCP, Borges G, Pelissari C, Buck MGT, Dos Santos AF, Rodrigues L, Luz JGC, Corrêa L. Effect of chronic ethanol ingestion on dendritic cell population during oral mucosal repair: An experimental study. Eur J Oral Sci 2022; 130:e12865. [PMID: 35482465 DOI: 10.1111/eos.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study was to analyze the effect of chronic ethanol ingestion on dendritic cell repopulation during the repair process of rat oral mucosa and in the rat spleen by analyzing the immunohistochemical expression of dendritic cell markers. Wistar rats ingested 20% ethanol solution for 28 days; a surgical wound was performed on the rat tongue after this period. The repair process and the number of CD1a+, CD11c+, and CD207+ cells in the regions adjacent to the wound were determined at day 1, 3, and 7 following the wound as well as in the rat spleen. The wound-only group (no ethanol exposure) had complete reepithelization after 7 days, but this did not occur in the ethanol + wound group at this time point. The inflammatory infiltrate was significantly reduced in animals exposed to ethanol, which also showed significantly lower counts of CD1a+, CD11c+, and CD207+ cells than the wound-only group at all experimental time points. In addition, ethanol exposure also resulted in lower densities of CD11c+ and CD207+ cells in the rat spleen. In conclusion, chronic ethanol intake had a negative impact on dendritic cell numbers, a fact that may contribute to delay in oral mucosa repair.
Collapse
Affiliation(s)
| | - Giuliana Borges
- General Pathology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cibele Pelissari
- Oral Pathology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | - Lucimar Rodrigues
- Oral Surgery Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Gualberto C Luz
- Oral Surgery Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciana Corrêa
- General Pathology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Rodrigues L, Leite-de-Lima NS, Landes C, Luz JGC. Changes in admission laboratory tests in patients with maxillofacial fractures and the influence of dento-alveolar trauma. Dent Traumatol 2020; 36:291-297. [PMID: 31901212 DOI: 10.1111/edt.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 12/27/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM There are few studies in the literature evaluating possible alterations in laboratory tests in patients with maxillofacial fractures. The aim of this study was to analyze the changes in admission laboratory tests of patients with maxillofacial fractures with indications for surgical treatment, including the influence of dento-alveolar trauma. MATERIAL AND METHODS Data from complete blood counts, blood coagulation tests, blood chemistries, and urinalysis results were obtained. The occurrence of concomitant dento-alveolar trauma was noted. The medical records were also re-evaluated later to verify the treatment outcome and the occurrence of complications. Statistical analyses were performed using the likelihood-ratio test to verify significant changes in the evaluated parameters (P ≤ .050). RESULTS There was a prevalence of males (78%) with a mean age of 35.9 years. Lower erythrocyte counts, hemoglobin levels, and/or hematocrit were observed in males with associated fractures and with simultaneous dento-alveolar fractures. Higher mean neutrophil, segmented neutrophil, and lymphocyte counts were observed in patients with simultaneous dento-alveolar trauma. A higher mean activated partial thromboplastin time (aPTT) ratio was also observed. Lower potassium levels were observed for patients in the fourth decade of life. Higher leukocyte counts not associated with trauma were observed in the urinalysis results of females and in the group of patients aged 20 or younger. Verification of treatment outcome showed two cases of infections and two cases that needed re-operation after mandible fractures. These four cases showed no significant changes in laboratory tests regarding the predisposition for complications. CONCLUSION Patients with maxillofacial fractures had neutrophilia, increased aPTT, and non-traumatic leukocyturia. There was an influence of associated fractures and dento-alveolar trauma on the decrease in red blood cell parameters, neutrophilia, and lymphocytosis and of age on hypokalemia.
Collapse
Affiliation(s)
- Lucimar Rodrigues
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de São Paulo - USP, São Paulo, Brazil
| | - Nayara Stefany Leite-de-Lima
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de São Paulo - USP, São Paulo, Brazil.,Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
| | - Constantin Landes
- Department of Oral, Craniomaxillofacial and Plastic Facial Surgery, Sana Hospital Offenbach, Frankfurt Am Main, Germany
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de São Paulo - USP, São Paulo, Brazil
| |
Collapse
|
6
|
de Freitas Rodrigues A, de Oliveira Martins D, Chacur M, Luz JGC. The effectiveness of photobiomodulation in the management of temporomandibular pain sensitivity in rats: behavioral and neurochemical effects. Lasers Med Sci 2019; 35:447-453. [PMID: 31292820 DOI: 10.1007/s10103-019-02842-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 07/04/2019] [Indexed: 12/14/2022]
Abstract
This study analyzed the effects of photobiomodulation (PBM) with low-level laser therapy on nociceptive behavior and neuronal activity in the trigeminal nucleus after experimental unilateral temporomandibular joint (TMJ) disc injury. The animals were divided into 4 groups (n = 10 each): group 1, surgical injury of the articular disc and PBM; group 2, sham-operated subjected to PBM; group 3, surgical injury of the articular disc; and group 4, control (Naïve). Ten sessions of PBM were performed using GaAs laser with a wavelength of 904 nm, power of 75 W pico, average power of 0.043 W, area of the beam of 0.13 cm2, duration of the pulses of 60 nseg (in the frequency of 9500 Hz), energy density of 5.95 J/cm2, energy per point of 0.7 J, and power density of 333.8 mW/cm2, and the irradiation was done for 18 s per point. Neuropathic symptoms were evaluated using the von Frey test. Trigeminal ganglion samples underwent immunoblotting to examine the expression of substance P, vanilloid transient potential receptor of subtype-1 (TRPV-1), and peptide related to the calcitonin gene (CGRP). There was a total decrease in pain sensitivity after the second session of PBM in operated animals, and this decrease remains until the last session. There was a significant decrease in the expression of SP, TRPV-1, and CGRP after PBM. Photobiomodulation therapy was effective in reducing nociceptive behavior and trigeminal nucleus neuronal activity after TMJ disc injury.
Collapse
Affiliation(s)
- Alex de Freitas Rodrigues
- Laboratory of Functional Neuroanatomy of Pain, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - Daniel de Oliveira Martins
- Laboratory of Functional Neuroanatomy of Pain, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marucia Chacur
- Laboratory of Functional Neuroanatomy of Pain, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
| |
Collapse
|
7
|
D’ávila RP, Espinola LVP, de Freitas PM, Silva AC, Landes C, Luz JGC. Longitudinal evaluation of the effects of low-power laser phototherapy on mandibular movements, pain, and edema after orthognathic surgery. J Craniomaxillofac Surg 2019; 47:758-765. [DOI: 10.1016/j.jcms.2019.01.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/28/2018] [Accepted: 01/28/2019] [Indexed: 10/27/2022] Open
|
8
|
Carvalho PH, Saavedra MDSFA, Ballester RY, Luz JGC. Biomechanical Evaluation of the Sheep Mandible as a Model for Studying Fixation Methods. INT J MORPHOL 2018. [DOI: 10.4067/s0717-95022018000300926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
9
|
Meira JBC, Landgraf H, Shinohara EH, Luz JGC, Ballester RY. A new way of evaluating the biomechanics of the mandible with freedom in three axes in space: Technical note. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2018. [DOI: 10.1016/j.ajoms.2018.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
10
|
Camino Junior R, Moraes RB, Landes C, Luz JGC. Comparison of a 2.0-mm locking system with conventional 2.0- and 2.4-mm systems in the treatment of mandibular fractures: a randomized controlled trial. Oral Maxillofac Surg 2017; 21:327-334. [PMID: 28608261 DOI: 10.1007/s10006-017-0636-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 05/29/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE A comparative study of the use of the 2.0-mm locking fixation system with conventional systems in the treatment of mandibular fractures was performed. METHODS For this study, 87 consecutive patients with 112 mandibular fractures were randomized to receive either 2.0-mm locking plates (n = 45) or conventional 2.0- or 2.4-mm plates (n = 42) and had a minimum follow-up of 6 months. Fractures were classified based on the degree of displacement and complexity. Statistical analyses were used to verify possible differences between the groups when separately compared unfavourable and favourable cases (p ≤ 0.050). RESULTS Despite randomization, systemic diseases were more frequent in the 2.0-mm locking group in favourable cases. Substance abuse occurred predominantly in the 2.0-mm locking group, in unfavourable and favourable fractures. There were more cases of complex fractures in the conventional group in unfavourable cases. One case involving a major postoperative complication occurred in the locking group (2.2%) and three cases occurred in the conventional group (7.1%) but with no significant difference between groups. In this study, there were no major differences between conventional and locking 2.0-mm locking systems with regard to the outcome of treated mandibular fractures, showing that both are adequate as long as the criteria of their indication and requirements for installation are met. CONCLUSIONS It was concluded that the 2.0-mm locking fixation system can replace conventional systems in the treatment of mandibular fractures; in addition, this approach was effective in the treatment of unfavourable fractures that typically require the 2.4-mm conventional system.
Collapse
Affiliation(s)
- Rubens Camino Junior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, São Paulo, SP, 02036-021, Brazil.,Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil
| | - Rogério Bonfante Moraes
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, São Paulo, SP, 02036-021, Brazil
| | - Constantin Landes
- Department of Oral, Craniomaxillofacial and Plastic Facial Surgery, Sana Hospital Offenbach, Frankfurt Am Main, Germany
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, São Paulo, SP, 02036-021, Brazil. .,Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil.
| |
Collapse
|
11
|
Yamamoto MK, Novelli MD, Corrêa L, de Sousa SCM, Luz JGC. Evaluation of the Effect of Platelet-Rich Plasma on Alveolar Wound Healing in Rats. INT J MORPHOL 2017. [DOI: 10.4067/s0717-95022017000100041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
12
|
Mancini JCMA, Garcia MRT, de Oliveira IRS, de Freitas RR, Luz JGC. Analysis of the blood supply to the post-fracture edentulous mandible: study by colour Doppler sonography. Oral Maxillofac Surg 2016; 20:417-424. [PMID: 27695992 DOI: 10.1007/s10006-016-0583-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/19/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE This study assessed the arterial blood supply to the mandible of edentulous patients treated for mandibular fractures using colour Doppler ultrasound. METHODS The blood supply of edentulous patients surgically treated for mandibular fractures (group A) and edentulous fracture-free individuals (group B) was assessed. Only the fractured sides were evaluated in the first group (N = 17), whereas each side was evaluated in the second group (N = 20). The arterial flow of six sites was assessed. The systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI), acceleration and flow direction of each artery were obtained. Additionally, the presence of local vascular obstructive factors was evaluated. The differences between groups were analysed using the Kruskal-Wallis test, which was complemented by the Mann-Whitney test, for correlations between the degree of alveolar atrophy and the study factors (p < 0.050). RESULTS There was a significant decrease in the flow of certain arteries, especially the submental (SPV, p = 0.007, PI, p = 0.022, and acceleration, p = 0.015), in the fracture group. The facial artery in both groups showed lower values related to local obstructive factors (SPV, p = 0.001, FDV, p = 0.040, and PI, p = 0.030). The submental artery flow was higher (SPV, p = 0.006, and FDV, p = 0.009) in non-atrophic individuals. CONCLUSIONS There was a decreased flow mainly in the submental artery, but there were no cases of major vascular injury in edentulous patients treated for mandibular fractures.
Collapse
Affiliation(s)
- Júlio Cezar M A Mancini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil
| | | | | | | | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil.
| |
Collapse
|
13
|
Rodrigues ADF, Kondo CA, Procópio ASF, Luz JGC. Helkimo and Craniomandibular Indices in the Classification of Temporomandibular Disorders. A Comparative Study. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/24708593.2016.1251999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alex de Freitas Rodrigues
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, São Paulo, SP, Brazil
| | - Camila Assanoma Kondo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, São Paulo, SP, Brazil
| | - Antonio Silvio F. Procópio
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, São Paulo, SP, Brazil
| | - João Gualberto C. Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, São Paulo, SP, Brazil
| |
Collapse
|
14
|
Oliveira-Campos GH, Lauriti L, Yamamoto MK, Júnior RC, Luz JGC. Trends in Le Fort Fractures at a South American Trauma Care Center: Characteristics and Management. J Maxillofac Oral Surg 2016; 15:32-7. [PMID: 26929550 DOI: 10.1007/s12663-015-0808-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/13/2015] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess the trends in Le Fort (maxillary) fractures in patients seen at a South American trauma care center based on the characteristics and management of these. MATERIALS AND METHODS Of all patients with facial fractures seen at a trauma hospital during a six-year period, 50 (6.6 %) presented with Le Fort fractures. Medical charts were reviewed for characteristics presented and management performed. To improve the analyses, computed tomography and intraoperative findings were used. Statistical analyses involved descriptive statistics and the likelihood ratio test. RESULTS The fractures were Le Fort II (52 %), Le Fort I (22 %), Le Fort type-associated (20 %) and Le Fort III (6 %). Male patients (90 %) in their third decade of life (38 %) were more frequent (p = 0.022). Traffic accidents (56 %) were the major etiologic factor (p = 0.048). There were 1.4 additional facial fractures per patient, with predominance of zygoma fractures (36.5 %). Most of the cases were managed by open reduction (60 %) (p = 0.015) with the subciliary approach (42.7 %) (p = 0.001). The 1.5-mm system was the most used fixation and the zygomaticomaxillary suture the most frequent location (p = 0.001). CONCLUSION the most common patient with a Le Fort fracture is an adult male, with a Le Fort II fracture due to a traffic accident requiring surgical fixation on zygomaticomaxillary suture.
Collapse
Affiliation(s)
| | - Leandro Lauriti
- Surgery Sector, Nove de Julho University, São Paulo, SP Brazil
| | - Marcos Kazuo Yamamoto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-900 Brazil
| | - Rubens Camino Júnior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-900 Brazil
| | - João Gualberto C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo - USP, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-900 Brazil
| |
Collapse
|
15
|
Seignemartin CP, Miranda ME, Luz JGC, Teixeira RG. Understandability of Speech Predicts Quality of Life Among Maxillectomy Patients Restored With Obturator Prosthesis. J Oral Maxillofac Surg 2015; 73:2040-8. [PMID: 26003777 DOI: 10.1016/j.joms.2015.04.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE Maxillary malignant tumor resection by maxillectomy might lead to defects that can be repaired by prosthetic obturation. The aim of this study was to associate quality of life (QoL) and the Obturator Functioning Scale (OFS) with functional performance and salivary flow rate in Brazilian patients rehabilitated with an obturator prosthesis. PATIENTS AND METHODS This retrospective cross-sectional study included patients who underwent surgical resection with or without radiotherapy or without chemotherapy and the rehabilitation with an obturator prosthesis at the Fundação Oncocentro de São Paulo (São Paulo, Brazil). The predictor variables were Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) domains and clinical evaluation of salivary flow rate. The outcome variables were overall scores obtained by the University of Washington QoL Scale (UWQOL) and the OFS. Sociodemographics (gender and age) and clinical characteristics (postoperative radiotherapy, tumor stage, classification of maxillary defect, tooth in maxilla, and type of obturator) also were evaluated. Univariate and multivariate analyses were performed to determinate whether PSS-HN domains and salivary flow were predictors of overall QoL and overall OFS. RESULTS The sample was composed of 73 patients with a mean age of 62 years and 51% were men. According to the PSS-HN domains, some patients (5%) always ate alone, 87% reported that speech is usually or always understandable, and 56% had no dietary restrictions. Sixty-one patients (65%) reported some degree of hyposalivation. The mean overall QoL score was 76.5 (standard deviation, 5.3). Patients with compromised PSS-HN domains had significantly worse overall UWQOL scores (P = .001, P < .001, and P = .006, respectively). In multiple regression analyses, understandability of speech was the only predictor of overall QoL scores. CONCLUSION The results of this study showed that understandability of speech was the only predictor of overall QoL scores.
Collapse
Affiliation(s)
| | - Milton E Miranda
- Professor, Prosthodontic Department, School of Dentistry, São Leoplodo Mandic, Campinas, Brazil
| | - João Gualberto C Luz
- Full Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rubens G Teixeira
- Professor, Department of Surgery and Traumatology, School of Dentistry, São Leopoldo Mandic, Campinas, Brazil
| |
Collapse
|
16
|
Toledo LG, Cavalcanti SCXB, Corrêa L, Luz JGC. Effects of injury or removal of the articular disc on maxillomandibular growth in young rats. J Oral Maxillofac Surg 2014; 72:2140-7. [PMID: 25438273 DOI: 10.1016/j.joms.2014.06.445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 06/14/2014] [Accepted: 06/19/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE This study analyzed the effects of injury and removal of the articular disc on maxillomandibular growth in young rats. MATERIALS AND METHODS Thirty 1-month-old male Wistar rats were divided into 3 groups: injury, removal, and sham operated. Unilateral injury of the articular disc, removal of the articular disc, or only surgical access was performed. The animals were sacrificed at 3 months of age. Specimens were submitted to radiographic incidences and cephalometric mensurations were performed using a computer system. Data were subjected to statistical analyses among groups and between sides in each group. RESULTS There were degenerative changes of the condylar process in the injury and removal groups. Significant differences between sides were observed for length of the premaxilla, height of the mandibular body, and length of the mandible. Concomitant group comparisons showed significant differences in the height of the mandibular body (P = .003) and the length of the mandible (P = .001). There were important decreases to the height of the mandibular body and mandibular length in the injury group, whereas there was an important decrease only for the length of the mandible in the removal group. Specific measurements of mandibular ramus structures exhibited differences between the injury and sham-operated groups and between the removal and sham-operated groups. CONCLUSION Experimental injury and removal of the articular disc during the growth period in rats had deleterious effects on ramus structures and induced asymmetry of the mandible, with worse outcomes resulting from injury to the articular disc.
Collapse
Affiliation(s)
- Leandro Giuseppim Toledo
- Research Fellow, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | - Luciana Corrêa
- Associate Professor, Department of General Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - João Gualberto C Luz
- Full Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| |
Collapse
|
17
|
Camino Junior R, Naclerio-Homem MG, Cabral LM, Luz JGC. Cervical Necrotizing Fasciitis of Odontogenic Origin in a Diabetic Patient Complicated by Substance Abuse. Braz Dent J 2014; 25:69-72. [DOI: 10.1590/0103-6440201302336] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/28/2014] [Indexed: 11/22/2022] Open
Abstract
Cervical necrotizing fasciitis (CNF) is an uncommon, potentially fatal soft tissue infection with rapid progression characterized by necrosis in the subcutaneous tissue and fascia. A case of CNF of odontogenic origin in a diabetic patient, complicated by alcohol dependence and tobacco abuse, is presented with a literature review. The emergency procedure comprised hydration, colloid administration, glycemic control and broad spectrum antibiotic therapy, followed by aggressive surgical debridement. Necrosis in the platysma muscle was verified by histopathologic analysis. Reconstructive surgery was performed after suppressing the infection, and the wound was closed with an autologous skin graft. The patient had a long hospital stay, in part because the substance abuse led to a difficult recovery. The principles of early diagnosis, aggressive surgical debridement, broad-spectrum antibiotic therapy and intensive supportive care in the treatment of CNF were confirmed in the present case. It was concluded that given the occurrence of CNF in the presence of diabetes mellitus and abuse of substances such as alcohol and tobacco, the health care professional should consider a stronger response to treatment and longer hospitalization.
Collapse
|
18
|
Rodrigues L, Corrêa L, Luz JGC. Healing of displaced condylar process fracture in rats submitted to protein undernutrition. J Craniomaxillofac Surg 2011; 39:73-8. [DOI: 10.1016/j.jcms.2010.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 02/19/2010] [Accepted: 03/09/2010] [Indexed: 11/16/2022] Open
|
19
|
Moraes RB, Landes CA, Luz JGC. Fixation of mandibular fractures with plates or miniplates: prospective study. Minerva Stomatol 2010; 59:159-166. [PMID: 20360663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM The choice of a more adequate internal fixation system in the treatment of mandibular fractures still originates controversy in the literature. The purpose of this study was to evaluate the effectiveness of internal fixation systems in the fixation of mandibular fractures, comparing indications and postoperative results between 2.4-mm plates and 2.0-mm miniplates. METHODS A total of 42 consecutive patients with 71 mandibular fractures that had undergone either 2.4-mm plates (N.=20) or 2.0-mm miniplates (N.=22) were prospectively analyzed. Patients had a minimum follow-up of 6 months. Statistical analyses were made in the comparison between systems. RESULTS There was no significant difference in the choice of systems as to age and characteristics of the fractures, but in patients with systemic diseases or chronic substance abuse, as well as in exposed fractures, with more frequency of 2.4-mm plates. 2.0-mm miniplates presented better recovery of jaw opening in the postoperative period. Temporary facial nerve deficit was observed exclusively in the case of extraoral approach. Both systems presented low rate of complications which required reoperation, however 2.0-mm miniplates presented better efficacy when compared to 2.4-mm plates. CONCLUSION In conclusion, 2.0-mm miniplates should be always used when possible in the fixation of mandibular fractures, respecting their contraindications.
Collapse
Affiliation(s)
- R B Moraes
- Department of Oral and Maxillofacial Surgery, University of São Paulo, São Paulo, Brazil
| | | | | |
Collapse
|
20
|
Abstract
OBJECTIVE To evaluate, histologically and by optical densitometry of radiographs, the healing of a critical-sized defect in the rat mandible filled with iliac graft. MATERIALS The study was conducted on 25 adult Wistar rats. With the rats under general anesthesia, a bicortical critical-sized osseous defect was created in the right mandibular ramus and filled with autogenous iliac crest graft. The animals were divided into 5 groups, with 5 rats in each. They were sacrificed after 1, 7, and 14 days, and 1 and 3 months. The mandibles were removed, fixed in formalin, and radiographed. The right hemi-mandibles were decalcified, and sections were cut and stained with hematoxylin and eosin. RESULTS Initially, an acute inflammatory process was noted along the graft that was tightly fitted to the defect. Subsequently, intense bone neoformation from external corticals and in the inner spaces of the graft was observed, while medullar spaces were occupied by granulation tissue and osteoblasts. There was remodelation of the receptor site, with a decrease in the graft volume and medullary space, as well as cancellous bone replaced by compact bone. Later, the receptor site was similar to the normal mandible, and only devitalized remnants of corticals of the graft were found. Optical densitometry of radiographs revealed statistically significant differences between experimental and control sites. CONCLUSIONS This experimental model is valuable in the study of bone healing. The study showed that autogenous iliac graft promoted healing of the critical-sized defect of the mandible with complete bony remodeling.
Collapse
Affiliation(s)
- Rogerio S Jorge
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil
| | | | | |
Collapse
|
21
|
Teixeira VCB, Teixeira ACB, Luz JGC. Skeletal changes after experimentally displaced condylar process fracture in growing rats. J Craniomaxillofac Surg 2006; 34:220-5. [PMID: 16638638 DOI: 10.1016/j.jcms.2006.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2004] [Accepted: 01/16/2006] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Fractures of the mandibular condyle are common. A potential for growth disturbances in young individuals has been reported; however, there are few experiments studying such consequences. Skeletal changes after fracture of the condyle in the growing period were analysed in this study. MATERIAL Fifty young Wistar rats weighing 100g were used. Under general anaesthesia unilateral fracture dislocations of the condylar process were induced surgically in the experimental group (n=25), while only surgical access was performed in the sham-operated group. The animals were sacrificed at 3 months of age. The mandibles were disarticulated, and radiographs were taken (axial skulls and lateral hemimandibles). Cephalometric evaluations were made using a computer system. Statistical tests were applied between groups and contralateral sides in each group. RESULTS There were atrophy and degenerative change of the fractured condylar process. There was also a significant difference in the height of the mandibular body and in the length of anterior and posterior maxilla. CONCLUSION It was concluded that an experimental fracture of the mandibular condyle during the growing period in rats induced degenerative changes of the condyle as well as an asymmetry of the mandible, affecting height of the body, also leading to consequences in the maxilla.
Collapse
Affiliation(s)
- Vanessa C B Teixeira
- Department of Oral and Maxillofacial Surgery, University of São Paulo, São Paulo, Brazil
| | | | | |
Collapse
|
22
|
Luz JGC, Rodrigues L. Changes in hemoglobin and hematocrit levels following orthognathic surgery of the mandible. Bull Group Int Rech Sci Stomatol Odontol 2004; 46:36-41. [PMID: 15646393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Red blood cell mass has been shown to recover rapidly with great decreases, as occurs in orthognathic surgery. However, blood loss during bilateral sagittal split osteotomy is considered minimal. The purpose of this study was to verify changes in hemoglobin (Hb) and hematocrit (Ht) levels following orthognathic surgery of the mandible. Data from 12 patients with a mean age of 27.5 years, from both genders, that were submitted to bilateral sagittal split osteotomy in the prognathism reduction were evaluated. No patient received blood transfusion during the procedure nor postoperatively. Procedures were performed by the same surgeon, with the use of reciprocating and sagittal saws. Levels of Hb and Ht were obtained in preoperative, one day postsurgery, and one, three and six weeks postoperatively. Statistical analyses were used to verify the difference in each group, and between periods. Patients lost a mean decrease in Hb of 2.0 g/dl, and in Ht of 5.2%. There was significant difference as to the levels of Hb (p=0.002) and Ht (p=0.010). These levels presented significant changes from immediate postoperative to six weeks for Hb, and to three weeks for Ht. It was concluded that a slow recovery of hemoglobin and hematocrit levels occurred following orthognathic surgery of the mandible.
Collapse
Affiliation(s)
- J G C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil.
| | | |
Collapse
|
23
|
Luz JGC, Rodrigues L, Chilvarquer I, Soler JMP. Mineralization of stylohyoid ligament complex in patients with temporomandibular disorders and asymptomatic individuals: a comparative study. J Oral Rehabil 2003; 30:909-13. [PMID: 12950972 DOI: 10.1046/j.1365-2842.2003.00933.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The incidence of mineralization of the stylohyoid ligament complex, according to radiographic findings, was analysed in a group of patients with temporomandibular disorders (TMD), and compared with that of a control group of asymptomatic individuals (AI). Both groups were similar considering the prevalence of the female gender as well as the distribution of cases according to age. 'Elongated' was the most frequent radiographic appearance in both groups; 'partially mineralized' was the most frequent radiographic pattern in the TMD group; and the lower ramus was the most frequent location of mineralization in both groups. When comparing between groups and according to each class, there was only one significant difference in radiographic appearance, 'pseudoarticulated' being more frequent in the TMD group. We can conclude that the occurrence and characteristics of mineralization of stylohyoid ligament complex were similar in TMD patients and AIs.
Collapse
Affiliation(s)
- J G C Luz
- Departments of Oral and Maxillofacial Surgery and Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | | | | |
Collapse
|
24
|
Luz JGC, Miyazaki LT, Rodrigues L. Verification of the symmetry of the mandibular ramus in patients with temporomandibular disorders and asymptomatic individuals: a comparative study. Bull Group Int Rech Sci Stomatol Odontol 2002; 44:83-7. [PMID: 12784583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Some studies have reported that mandibular ramus asymmetries are more pronounced in patients with temporomandibular disorders. The symmetry of the mandibular ramus was verified in a group of patients with temporomandibular disorders and compared with that of a control group of asymptomatic individuals. Heights of the mandibular ramus and of the condyle and gonial angles were measured from panoramic radiographs. In the comparison of numerical values between dysfunction and asymptomatic groups there was no significant difference; when comparing sides within each group, there was a significant difference in gonial angle in the asymptomatic group. Using the formula: (R-L)/(R+L) x 100%, in the comparison between groups, there was a significant difference as to condylar height. With a subdivision in each group, having the value of 3% to calculated symmetry as a reference, there was no significant difference between groups. Comparing gender or age intervals in both groups, there was no significant difference. It was concluded that there was significant difference in calculated symmetry only as to condylar height between disorder patients and asymptomatic individuals.
Collapse
Affiliation(s)
- J G C Luz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil
| | | | | |
Collapse
|