Publications by authors named "Marcelo Rodrigues Azenha"

9 Publications

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Can diagnostic changes caused by cone beam computed tomography alter the clinical decision in impacted lower third molar treatment plan?

Dentomaxillofac Radiol 2020 Nov 25:20200412. Epub 2020 Nov 25.

Integrated Dental Clinic, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.

Objectives: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs).

Methods: Sets of panoramic (PAN) - cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations.

Results: Percentage agreement and McNemar test compared PAN CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images.

Conclusions: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.
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http://dx.doi.org/10.1259/dmfr.20200412DOI Listing
November 2020

Evaluation of Crystallized Biosilicate in the Reconstruction of Calvarial Defects.

J Maxillofac Oral Surg 2015 Sep 10;14(3):659-65. Epub 2015 Mar 10.

Dentistry School of Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil.

Introduction: The objective of this study was to assess the bone repair process of crystallized Biosilicate in surgically created defects on rats' calvaria. This biomaterial was recently developed for odontological use.

Materials And Methods: We used fifteen rats (rattus norvegicus albinus, Wistar), and two 5 mm surgical defects were performed on each of them; the defects were made with trephine drill on the calvarium region prior to the biomaterial placement. Groups were divided as follows: Group 1-defect filled with clot; Group 2-defect filled with crystallized Biosilicate. After 7, 14 and 28 days the animals were killed, the parts were retrieved and slides were prepared for histological studies.

Results: Bone formation was satisfactory in all groups, with direct contact between biomaterial surface and bone and absence of infection signs. The 28 days periods showed better results, and statistically significant difference between Clot Group (90.2 %) and Biosilicate (58 %; p = 0.002) was seen, regarding presence of bone tissue on the surgical defects.

Conclusion: Our study revealed that defects filled with clot present better results on bone formation compared to crystallized Biosilicate, which is considered a biocompatible material with favorable osteoconductive properties.
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http://dx.doi.org/10.1007/s12663-015-0755-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511902PMC
September 2015

Retained third molars removal in a severely resorbed edentulous mandible. A case report.

Braz Dent J 2013 Sep-Oct;24(5):532-6

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.
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http://dx.doi.org/10.1590/0103-6440201302018DOI Listing
November 2015

Accidents and complications associated to third molar surgeries performed by dentistry students.

Oral Maxillofac Surg 2014 Dec 27;18(4):459-64. Epub 2013 Dec 27.

Faculdade de Odontologia de Ribeirão Preto (FORP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil,

Objective: The aim of this work is to demonstrate the accidents and complications rates on third molars surgeries performed by senior dentistry students.

Methods: A retrospective study of 122 patient charts submitted to third molars surgeries was done. Patient age, gender, dental in arch position, and accidents/complications were considered with the charts presenting incomplete dates being excluded from the study. After all, 88 patients (210 surgeries) were included.

Results: The majority of the patients were female (70.4 %), with the average age of 24 years. Mandibular molars represented more than half of the surgical procedures (56.2 %), with teeth at vertical position the most found (60.3 %). The cases of accidents and complications totalized 10.4 % of all performed procedures, being hemorrhage (1.9 %), root fractures (1.9 %), and maxillary tuberosity fracture (1.9 %) the most found. Suture dehiscence (1.4 %), dry socket (1.4 %), oroantral communications (0.9 %), paresthesia (0.9 %), and infection (0.4 %) were also observed.

Conclusions: Surgeons' inexperience was not considered a determinant factor to modify the rates of accidents and complications at third molars surgeries when compared to previous works developed by experienced surgeons. It is important to highlight the necessity of the students' knowledge of the most adequate treatments of each of the accidents and complications.
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http://dx.doi.org/10.1007/s10006-013-0439-9DOI Listing
December 2014

A retrospective study of oral manifestations in patients with paracoccidioidomycosis.

Braz Dent J 2012 ;23(6):753-7

Department of Stomatology, Ribeirão Preto Dental School, USP - University of São Paulo, Ribeirão Preto, SP, Brazil.

South American blastomycosis, paracoccidioidomycosis (Pb mycosis) or Lutz disease is an endemically fungal infection in Latin America. It is caused by the dimorphic fungus Paracoccidioides brasiliensis and may cause oral mucosal lesions. The incidence of Pb mycosis oral lesions was evaluated in patients assisted at a Brazilian Dental School's Specialized Oral Diagnosis Service with special focus on the different clinical forms of these lesions, its location, patients' occupation, deleterious habits, and diagnosis methodology. Students' and professionals' initial diagnoses were compared with the definitive diagnosis. Lesions were detected 31 cases (18 patients). The results show that 88.8% of the patients were male with a mean age of 50 years and 39% work(ed) with activities related to agriculture. As much as 88.9% were smokers and 72.2% were alcohol users. Exfoliative cytology was performed in 66.6% of the patients. Oral mucosa (30%), gingiva (16.6%) and lips 16.6% were the most common sites of Pb mycosis oral lesions. Comparing the initial with the definitive diagnosis made by the professionals their accuracy was 33% (6 out of 18 patients). Students' diagnosis was more accurate demonstrating 72.5% of initial correct diagnosis (13 out of 18). Statistical analysis by ANOVA (α=0.05, SPSS WIN) demonstrated a significant difference between the diagnosis of Pb mycosis made by students and professionals when considering initial diagnosis and final diagnosis (after histopathological analysis) (p=0.25). Incisional biopsy and exfoliate cytology are efficient for an early diagnosis of this disease in mouth. Students' training in diagnosis of oral pathologies to recognize lesions is urgent to improve public health.
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http://dx.doi.org/10.1590/s0103-64402012000600021DOI Listing
January 2014

Multiple brain abscess from dental origin: case report and literature review.

Oral Maxillofac Surg 2012 Dec 8;16(4):393-7. Epub 2011 Dec 8.

School of Dentistry at Araçatuba, Sao Paulo State University, Araçatuba, SP, Brazil.

Background: Brain abscess of dental origin is a rare situation and deserves attention due to its high mortality rate even when adequate treatment is done. Few reports are available when dental origin is the main cause of this infection.

Case Report: We present the case of a 70-year-old man diagnosed with cerebral abscess caused by apical lesions located at superior and inferior teeth. The three lesions containing pus were drained from anterior and posterior brain region and the laboratory evaluation revealed the presence of Streptococcus viridians and Bacteroides. Postoperative period was uneventful with excellent recovery after 1 year of surgery. Final diagnosis was able to be done due to excellent image exams availability like computer tomography and magnetic resonance using diffusion and perfusion techniques.

Discussion: The early detection of this pathology with the correct diagnosis essential to give the patient the best treatment including antimicrobial drugs and drainage is of extreme importance.
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http://dx.doi.org/10.1007/s10006-011-0308-3DOI Listing
December 2012

Bone response to biosilicates with different crystal phases.

Braz Dent J 2010 ;21(5):383-9

Department of Oral and Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil.

The aim of this study was to investigate the histological and histomorphometrical bone response to three Biosilicates with different crystal phases comparing them to Bioglass 45S5 implants used as control. Ceramic glass Biosilicate and Bioglass 45S5 implants were bilaterally inserted in rabbit femurs and harvested after 8 and 12 weeks. Histological examination did not revealed persistent inflammation or foreign body reaction at implantation sites. Bone and a layer of soft tissue were observed in close contact with the implant surfaces in the medullary canal. The connective tissue presented few elongated cells and collagen fibers located parallel to implant surface. Cortical portion after 8 weeks was the only area that demonstrated significant difference between all tested materials, with Biosilicate 1F and Biosilicate 2F presenting higher bone formation than Bioglass 45S5 and Biosilicate vitreo (p=0.02). All other areas and periods were statistically non-significant (p>0.05). In conclusion, all tested materials were considered biocompatible, demonstrating surface bone formation and a satisfactory behavior at biological environment.
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http://dx.doi.org/10.1590/s0103-64402010000500001DOI Listing
June 2011

Retropharyngeal and cervicofacial subcutaneous emphysema after maxillofacial trauma.

Oral Maxillofac Surg 2011 Dec 31;15(4):245-9. Epub 2010 Jul 31.

Morphology, Stomatology and Physiology Department, University of São Paulo, Av. Do Café, s/n Jd. Monte Alegre, 14040-904, Ribeirão Preto, São Paulo, Brazil.

Introduction: Subcutaneous emphysema in the cervical region is a well-documented event that may occur secondary to tonsillectomy, dental treatment, oropharyngeal barotraumas, scaling and root planning therapy, punch biopsy, endotracheal intubation, orthognathic surgery, extraction of impacted teeth, or after maxillofacial trauma. After trauma episodes, subcutaneous emphysema may be caused by a maxillary antral wall fracture that occurs when air pressure is introduced into the fascial planes of the connective tissue. Retropharyngeal emphysema is a severe condition associated with traumatic aerodigestive tract injury and may be associated with life-threatening situations requiring prompt attention and diagnosis in order to prevent serious consequences.

Case Report: We reported a case of cervicofacial and retropharyngeal emphysema in a 54-year-old patient who stated concerns after blowing his nose several times after a traumatic episode involving orbitozygomatic region. During the patient's hospital course, his airway remained stable, and he was discharged from the hospital 7 days later with a prognosis of full recovery, excellent occlusion and facial appearance, and complete resolution of subcutaneous emphysema.
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http://dx.doi.org/10.1007/s10006-010-0246-5DOI Listing
December 2011

Management of Bell"s palsy: a report of 2 cases.

J Can Dent Assoc 2008 Nov;74(9):823-7

Department of oral pathology, Bauru School of Dentistry, University of São Paulo, Porto Velho, RO, Brazil.

Bell"s palsy is a neuropathy of the peripheral seventh cranial nerve, resulting from traumatic, compressive, infective, inflammatory or metabolic abnormalities or it can be idiopathic. HIV, Epstein-Barr virus and hepatitis B virus have been suspected as initiating organisms, but herpes simplex virus is the most frequently implicated. This report describes 2 cases of Bell"s palsy in children that were managed with antiviral agents. Both patients experienced complete recovery within 28 days; after 1 year follow-up, no recurrence was observed and both patients have normal facial movement. Differential diagnosis is essential to guide the treatment plan in Bell"s palsy. Special attention should be given to children with respect to prescription of medications that can cause important side effects.
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November 2008