2013 Jul-Sep; Vol 4, No 3
Associated Injuries in Patients with Maxillofacial Trauma at the Hospital São Vicente de Paulo, Passo Fundo, Brazil
J Oral Maxillofac Res 2013 (Jul-Sep);4(3):e1
Objectives: This study aimed to identify the occurrence, type and severity of body injuries associated in patients with facial trauma, referred to the Hospital São Vicente de Paulo (HSVP) in the city of Passo Fundo - RS, Brazil.
Material and Methods: The study analyzed medical records of 1385 patients who were treated in the Department of Oral and Maxillofacial Surgery at HSVP during the period from 1991 to 2010.
Results: According to the results of this study we observed that 35% of cases of facial fractures were associated with a body injury. It was recorded a higher incidence of facial fractures in the male population (82.6%), aged between 20 and 39 years. The main etiologic factors for this association were car accidents, falls and assaults. Most fractures were recorded in the mandible and the main body injury found was the abrasion associated in some region of the body, however, when considering fractures of the face middle third the main body injury was more associated with cranioencephalic trauma.
Conclusions: Concomitant injuries in areas other than the face should be expected first and foremost after high-speed trauma mechanisms and in association with severe facial fractures. The results underscore the importance of multiprofessional collaboration in diagnosis and sequencing of treatment who have sustained facial fractures.
Keywords: maxillofacial injuries; traumatology; multiple trauma; epidemiology.
The Effects on Absorbed Dose Distribution in Intraoral X-ray Imaging When Using Tube Voltages of 60 and 70 kV for Bitewing Imaging
J Oral Maxillofac Res 2013 (Jul-Sep);4(3):e2
Objectives: Efforts are made in radiographic examinations to obtain the best image quality with the lowest possible absorbed dose to the patient. In dental radiography, the absorbed dose to patients is very low, but exposures are relatively frequent. It has been suggested that frequent low-dose exposures can pose a risk for development of future cancer. It has previously been reported that there was no significant difference in the diagnostic accuracy of approximal carious lesions in radiographs obtained using tube voltages of 60 and 70 kV. The aim of this study was, therefore, to evaluate the patient dose resulting from exposures at these tube voltages to obtain intraoral bitewing radiographs.
Material and Methods: The absorbed dose distributions resulting from two bitewing exposures were measured at tube voltages of 60 and 70 kV using Gafchromic® film and an anatomical head phantom. The dose was measured in the occlusal plane, and ± 50 mm cranially and caudally to evaluate the amount of scattered radiation. The same entrance dose to the phantom was used. The absorbed dose was expressed as the ratio of the maximal doses, the mean doses and the integral doses at tube voltages of 70 and 60 kV.
Results: The patient receives approximately 40 - 50% higher (mean and integral) absorbed dose when a tube voltage of 70 kV is used.
Conclusions: The results of this study clearly indicate that 60 kV should be used for dental intraoral radiographic examinations for approximal caries detection.
Keywords: dental radiography; dental digital radiography; bitewing radiography; radiation dosage; radiographic image enhancement.
Efficacy of Platelet-Rich-Plasma (PRP) and Highly Purified Bovine Xenograft (Laddec®) Combination in Bone Regeneration after Cyst Enucleation: Radiological and Histological Evaluation
J Oral Maxillofac Res 2013 (Jul-Sep);4(3):e3
Objectives: The purpose of the present study was to evaluate the efficacy of adding platelet-rich plasma (PRP) to a new highly purified bovine allograft (Laddec®) in the bone regeneration of cystic bony defects augmented following cystectomy.
Material and Methods: Study sample included 20 patients undergoing cystectomy in which the bone defect was filled with PRP and Laddec®. All patients were examined with periapical radiographs before operation and at follow-up. After 3 months, at re-entry surgery for implant placement, bone core was taken for histological and histomorphometric analysis.
Results: The postoperative successive radiographs showed a good regeneration of bone in the height of bony defects with application of PRP to bone graft. By the first postoperative month, about 48% of the defect was filled, which gradually increased in each month and showed about 90% of defect-fill by 6 months. Histological and histomorphometric analysis, showed a significant presence of bone tissue and vessels, with newly formed bone in contact with anorganic bone particles. The mean volume of vital bone was 68 ± 1.6% and the mean percentage of vital bone was 48 ± 2.4%. The mean percentage of inorganic particles in tissues was 20 ± 1.2% of the total volume. All the samples analyzed did not evidence the presence of inflammatory cells.
Conclusions: The results of this study showed how the use of Laddec® in association with platelet-rich plasma allows bone regeneration and has a potential for routine clinical use for regeneration of cystic bony defects.
Keywords: platelet-rich plasma; sintered bovine bone true bone ceramics; cystectomy; histology; xenograft.
Developing a New Appliance to Dissipate Mechanical Load on Teeth and Improve Limitation of Vertical Mouth Opening
J Oral Maxillofac Res 2013 (Jul-Sep);4(3):e4
Objectives: The principle of leverage to superpose the convex surfaces of two shells was applied to develop a device for treating limitation of mouth opening and called it the "shell-shaped mouth opener" and analyzed pressure on the teeth with the TheraBite® appliance and the shell-shaped mouth opening appliance.
Material and Methods: To compare the TheraBite® appliance and the shell-shaped mouth opening appliance, pressure on the teeth in the dentition model with both devices was analyzed using the Inastomer® flexible conductive sensor.
Results: The load was better dispersed to each tooth in the shell-shaped mouth opening appliance in the all quadrants compared to the TheraBite® appliance.
Conclusions: The present study revealed that the shell-shaped mouth opening appliance which was originally invented in our lab, dissipated the mechanical load on teeth more evenly than the TheraBite® appliance.
Keywords: mouth rehabilitation; dental stress analysis.
Intranasal Midazolam May Prevent Gagging Reflex: a Case Report
J Oral Maxillofac Res 2013 (Jul-Sep);4(3):e5
Background: Gagging can become a conditioned response that makes dental treatment difficult or impossible for both the individual and the dentist. The aim of this study is to report a 50 year old female and two children (15 and 11 years old) with exaggerated gag reflex referred to Faculty of Dentistry of Selçuk University.
Methods: During obtaining records, taking impression procedure was elicited the patients’ hypersensitive gagging reflex. Therefore, it was decided to administer intranasal midazolam to facilitate the taking of accurate dental impressions. After given verbal information about the procedure, 2.5 mg intranasal midazolam (Demizolam, Dem Medikal, Istanbul) were applied incrementally in both nostrils.
Results: Five minutes later; patients had no gagging reflex and allowed the clinician to take satisfying impressions. No serious adverse effects were observed and the patients remained cooperative during the entire procedure which was completed to the full satisfaction of all involved. The short absorption time and the fast relief process of anaesthetics transferred to the systemic circulatory system are important advantages of nasal application.
Conclusions: Intranasal midazolam may be very useful for the treatment of gag reflex probably effecting on the depression of upper airway reflex sensitivity.
Keywords: dental impression technique; dental anesthesia; gagging; midazolam.