Publications by authors named "Osvaldo Magro Filho"

48 Publications

An Old Method as an Aid on the Novel Coronavirus.

J Craniofac Surg 2020 Oct 20. Epub 2020 Oct 20.

Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), São Paulo, Brazil.

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http://dx.doi.org/10.1097/SCS.0000000000007206DOI Listing
October 2020

Comparative Evaluation of Bone Repair with Four Different Bone Substitutes in Critical Size Defects.

Int J Biomater 2020 23;2020:5182845. Epub 2020 May 23.

Oral and Maxillofacial Surgery, Diagnostic and Surgery, Aracatuba School of Dentistry, Sao Paulo State University (UNESP), Aracatuba, Sao Paulo, Brazil.

This study evaluated the osteoconductive potential of four biomaterials used to fill bone defects. For this, 24 male Albino rabbits were submitted to the creation of a bilateral 8 mm calvarial bone defect. The animals were divided into four groups-bovine hydroxyapatite, Bio-Oss® (BIO); Lumina-Bone Porous® (LBP); Bonefill® (BFL); and an alloplastic material, Clonos® (CLN)-and were euthanized at 14 and 40 days. The samples were subjected to histological and histometric analysis for newly formed bone area. Immunohistochemical analysis for Runt-related transcription factor 2 (Runx2), vascular endothelial growth factor (VEGF), and osteocalcin (OC) was performed. After statistical analysis, the CLN group showed greater new bone formation (NB) in both periods analyzed ( < 0.05). At 14 days, the NB showed greater values in BIO in relation to LBP and BFL groups; however, after 40 days, the LBP group surpassed the results of BIO ( < 0.001). The immunostaining showed a decrease in Runx2 intensity in BIO after 40 days, while it increased for LBP ( < 0.05). The CLN showed increased OC compared to the other groups in both periods analyzed ( < 0.05). Therefore, CLN showed the best osteoconductive behavior in critical defects in rabbit calvaria, and BFL showed the lowest osteoconductive property.
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http://dx.doi.org/10.1155/2020/5182845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262656PMC
May 2020

Strategy for Optimizing Airway Volume With Genioglossal Advancement Using Cutting Guide in the Treatment of Obstructive Sleep Apnea.

J Craniofac Surg 2020 Mar/Apr;31(2):558-561

Oral and Maxillofacial Surgery, Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of Dentistry, Araçatuba.

The genioglossus advancement muscle is a technique used to treat obstructive sleep apnea and depends on the precise location of the muscle insertion into the geniotubercle. The aim of this article was to present a case report about a 38-year-old male patient with obstructive sleep apnea even after undergoing uvulopalatopharyngoplasty and mentoplasty. A maxillo-mandibular advancement and genioglossus was proposed, for this a virtual planning of the surgical guide was done using a specialized software. The great advantage is to reduce the osteotomy by focusing precisely on the insertion of the muscle. The cutting guide facilitated the surgical procedure in all aspects and brought safety.
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http://dx.doi.org/10.1097/SCS.0000000000006083DOI Listing
July 2020

The Role of MicroRNAs in the Osseointegration Process.

Int J Oral Maxillofac Implants 2019 March/April;34(2):397-410

Regulation of cellular function is key to bone formation at endosseous implant surfaces. Osseointegration was "discovered" prior to the discovery of genetic regulation of osteoinduction or characterization of mesenchymal stem cells. Understanding osseointegration in cellular and molecular terms has benefited from genome-wide characterization of this healing process at endosseous implants in vivo. These in vivo studies also demonstrate a role for osteoprogenitor cells and cells involved in immune regulation and osteoclastogenesis. The identification of noncoding RNAs, including microRNAs, as key factors controlling cell function has highlighted the role of microRNAs in cell differentiation control. This review summarizes emerging in vitro and in vivo investigations emphasizing the role of microRNAs in the osseointegration process. Many microRNAs influence key osteoinductive pathways controlling Osterix, runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein (BMP)/SMAD function. Others influence the monocyte/macrophage lineage. While significant progress has been made in elucidating the mechanisms associated with the regulation of surface modulation of osteoblast differentiation by microRNAs, knowledge gaps are evident in the identification and characterization of microRNAs linked to osseointegration. Given existing knowledge regarding the varied expression of microRNAs and their role in inflammation, it is important to understand how microRNA expression may influence the process of bone accrual at implant surfaces during osseointegration.
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http://dx.doi.org/10.11607/jomi.6581DOI Listing
April 2019

Evaluation of condylar resorption rates after orthognathic surgery in class II and III dentofacial deformities: A systematic review.

J Craniomaxillofac Surg 2018 Apr 21;46(4):668-673. Epub 2018 Feb 21.

São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.

The purpose of this study was to perform a systematic review of morphological alterations in the condyles after orthographic surgery involving a sagittal split ramus osteotomy (SSRO), with or without surgery on the maxilla. Searches were performed on three databases and registered in the PROSPERO. The selected studies fulfilled the criteria established by the following PICO model: (1) population: individuals with skeletal dentofacial deformities (class II or III facial patterns), without asymmetry; (2) intervention: orthognathic surgery for mandibular setback using an SSRO, with or without a Le Fort I osteotomy, and fixed with bicortical screws or plates and screws; (3) comparison: orthognathic surgery for mandibular advancement using an SSRO, with or without a Le Fort I osteotomy, and fixed with plates and screws or bicortical screws; and (4) outcome: condylar resorption rate and relapse. Initially, 1,371 articles were identified and 636 articles were screened after elimination of duplicates, and 6 articles were selected for qualitative analysis based on the inclusion and exclusion criteria. Five studies had data regarding the rate of condylar resorption, varying from 0.0% to 4.2%. In conclusion, condylar resorption and relapses were present in a small percentage of patients studied.
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http://dx.doi.org/10.1016/j.jcms.2018.02.002DOI Listing
April 2018

Modulation of Micro RNA Expression and Osteoblast Differentiation by Nanotopography.

Int J Oral Maxillofac Implants 2018 Mar/Apr;33(2):269-280

Purpose: This study evaluated the expression pattern of micro RNAs (miRNAs) on a surface with nanotopography compared with a smooth surface (control).

Materials And Methods: Human mesenchymal stem cells (hMSCs) were plated on different surfaces and compared at 3, 7, and 14 days for alkaline phosphatase (ALP) activity, expression of genes (osterix [OSX], runt-related transcription factor 2 [RUNX2], bone morphogenetic protein 2 [BMP2], and ALP), and expression of miRNAs. Western blot was also used to detect osteogenic proteins (BMP2, OSX, and osteocalcin [OCN]). Scanning electron microscopy of cells plated onto the surfaces was obtained.

Results: ALP activity on different surfaces was significantly greater in the nanotopography surface. At day 14, there was a 3.5-fold and a 9-fold increase for the RUNX2 and OSX genes, respectively. BMP2 and ALP also increased by fourfold and sevenfold compared with the control. Protein levels for OSX and BMP2 were also upregulated compared with the control group. Using RNA sequencing technology (RNA-Seq), a total of 117 miRNAs were found to be differentially expressed comparing the control (day 7) with the nanosurface (day 14). Forty-five miRNAs were upregulated, and 72 were downregulated. Several of the miRNAs that were differently expressed regulate osteogenic genes. For example, hsa-miR-135b-5p targets OCN, BSP, RUNX2, COL15A1, and OSX; hsa-miR-122-5p targets OPN; hsa-miR-196a-5p targets BMP4; hsa-miR-26b-5p targets BMP2; and hsa-miR-148b-3p targets OPN.

Conclusion: Surfaces with nanotopography have the potential to improve the osseointegration response in order to reduce the osseointegration time and also increase bone formation around the implants, improving areas with low bone quality. Within the limitation of this study, nanotopography surfaces affected MSC differentiation to osteoblasts. Several miRNAs were differentially regulated by surface topography. These miRNAs could be related to the differentiation response to help control the osseointegration process.
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http://dx.doi.org/10.11607/jomi.5372DOI Listing
July 2018

Bone regeneration with recombinant human bone morphogenetic protein 2: a systematic review.

J Maxillofac Oral Surg 2018 Mar 16;17(1):13-18. Epub 2016 Dec 16.

Quixadaense Post Graduate School, Rodrigues Junior Street, Number 1034, Quixadá, Ceara CEP 63900-000 Brazil.

Aim: The aim of this work was to perform a systematic literature review on the clinical application of rhBMP-2 in bone reconstruction prior to placing implants.

Materials And Methods: A PUBMED search was made about the subject and nine clinical trials were selected according to strict inclusion criteria.

Results: Overall success rates of bone regeneration with rhBMP-2 was 81.4% and success of implants placed was 87.4%. Most frequent adverse events were pain, edema and erythema.

Conclusion: It was concluded that the treatment with rhBMP-2 foi satisfactory in most cases and the placement of dental implants in the bone regenerated with rhBMP-2 is feasible.
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http://dx.doi.org/10.1007/s12663-016-0988-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772021PMC
March 2018

Surgical Reconstruction of Lower Face Degloving.

J Craniofac Surg 2016 Oct;27(7):e683-e685

*University of Ribeirao Preto, UNAERP, Ribeirao Preto, São Paulo†University Center Unichristus, Fortaleza‡University of Sao Paulo, Bauru§University of the State of São Paulo, UNESP, Araçatuba, Brazil.

One of the most impressive soft tissue injuries is the facial degloving, normally associated with industrial machines and traffic accidents. This injury is characterized by the separation of the skin and cartilage from the bones, compromising the soft tissues correlated in the trauma area, nerves, and blood vessels. A 28-year-old patient, male, was referred to Araçatuba's Santa Casa Hospital, after a motorcycle accident, hitting his face on the sidewalk. The patient was conscious, oriented, denying fainting and unconsciousness during the accident, and complaining of pain in the nasal region of the face. The suture of wounds was performed using 5-0 absorbable sutures for muscle planes, and reconstruction of the septum and nasal cartilages. The skin was sutured with interrupted stitches using 6-0 nylon. After reducing the edema, a slight increase in alar base was observed. Subsequently, the alar base cinch suture was performed aiming to bring the alar bases to a measure of 34.0 mm in diameter. As a conclusion, the knowledge of the anatomy of the region involved, the healing of tissues, and suture techniques for the facial region process were critical to the successful treatment. The evaluation of the alar base in degloving cases can involve aesthetic features.
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http://dx.doi.org/10.1097/SCS.0000000000003067DOI Listing
October 2016

Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child.

J Craniofac Surg 2016 Sep;27(6):e567-8

*Surgery and Integrated Clinic Department, Araçatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba †School of Post-graduate Quixadaense (EQUIP), Quixadá, Brazil.

Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.
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http://dx.doi.org/10.1097/SCS.0000000000002871DOI Listing
September 2016

The Use of Foley Catheter for Treatment of Unstable Fracture Zygomatic Arch.

J Craniofac Surg 2016 Jun;27(4):1012

*School of Postgraduate Quixadaense (EQUIP), Quixadá †Department of Surgery and Integrated Clinic ‡Araçatuba Dental School, São Paulo State Univ Estadual Paulista-UNESP Araçatuba Dental School, Araçatuba, Brazil.

The isolated zygomatic arch fractures represent 21% of zygomatic-maxillary fractures and the falls is the main etiology. This type of fracture is easily reduced through several methods and the most used is the reduction through the surgical temporal approach of Gillies. The present patient illustrates the success treatment of a patient with isolated zygomatic arch fracture which a Foley catheter was used to stabilize the fracture reduction.
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http://dx.doi.org/10.1097/SCS.0000000000002668DOI Listing
June 2016

Retrieval of a Broken Dental Needle Close to the Facial Artery After Cervical Migration.

J Craniofac Surg 2016 Jun;27(4):e338-40

*School of Post-graduate Quixadaense (EQUIP), Quixadá †Department of Surgery and Integrated Clinic, Aracatuba Dental School, São Paulo State Univ Estadual Paulista "Julio de Mesquita Filho"-UNESP, Aracatuba ‡Faculty of Medicine, University Brasília-UnB, Brasília, Brazil.

Use of imaging tools like digital C-arm, tridimensional tomography, and navigational surgery has proven its value to the surgical removal of broken needles. A 32-year-old patient was referred for evaluation of a fractured needle during inferior alveolar nerve block attempt few days before. The patient complained of a pricking sensation at the injured area while moving the neck. A contrasted computed tomography was performed for further evaluation of the needle toward the vascular network of the neck, showing a close location by the left facial artery, parallel to the styloid process of the temporal bone. The needle was then released from the underlying tissues and retrieved. Although considered a rare intercurrence, there are still reports of breaking needles during dental anesthesia. Such reports are almost always related to inferior alveolar nerve blocks, associated with the use of short, thin needles, and after multiple bending movements before the insertion of the needle in the tissues. Accurate image examinations such as contrasted computed tomography are of great importance for planning the surgical removal, especially in patients of migration next to important vessels of the neck.
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http://dx.doi.org/10.1097/SCS.0000000000002507DOI Listing
June 2016

Bilateral Incomplete Cleft Lip.

J Craniofac Surg 2016 May;27(3):e288-9

*Quixadaense Post Graduate School†Albert Sabin Infant Hospital, Ceara‡Araçatuba Dental School, UNESP, Araçatuba, Brazil.

Patients with cleft palate and cleft lip have severe functional and aesthetic problems, if this deformity is not treated properly and in time, can also cause psychological and aesthetic problems to the patients. This study reports a case of a 22-year-old patient with incomplete bilateral cleft lip, addressing aspects related to the diagnosis, treatment planning, surgical technique, and postoperative follow-up of the patient. Surgical treatment of cleft lip and cleft palate consists of suturing the lip and the palate, and aims not only the aesthetic restoration, but also the recovery of the phonation, mastication and respiration, as well as a normal psychosocial development.
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http://dx.doi.org/10.1097/SCS.0000000000002531DOI Listing
May 2016

Evaluation of Patients' Satisfaction after Class III Orthognathic Surgery.

J Clin Diagn Res 2015 Oct 1;9(10):ZC23-7. Epub 2015 Oct 1.

Faculty of Dentistry of Araçatuba, Department of Dental Materials and Prosthodontics, UNESP - Univ Estadual Paulista, Brazil .

Background: Well-planned orthognathic surgery improves psychological health, aesthetics and function of patients.

Aim: The present study aimed to investigate patients' satisfaction after orthognathic surgery by means of a satisfaction questionnaire before and after surgery.

Materials And Methods: A total of 29 patients was selected (17 women and 12 men), with a mean age of 28 years, randomly selected from a private clinic at Araçatuba - São Paulo by two investigators. Anamnesis and clinical examination were performed. Subjects with facial deformities submitted to orthodontic treatment before and after orthognathic surgery with a minimum post-surgery period of 6 months, answered a satisfaction questionnaire composed of 10 questions regarding dental and facial aesthetics. In this study, the maximum satisfaction score was 10.

Results: Regarding aesthetics, two satisfaction parameters were investigated: dental and facial. For all indices, the average satisfaction was up to score 7.

Conclusion: According to the results, it can be concluded that orthognathic surgery has been an effective treatment for dentofacial deformities, aesthetics and functional problems, what was verified by pre and postoperative questionnaire application.
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http://dx.doi.org/10.7860/JCDR/2015/14633.6587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625329PMC
October 2015

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

Bone repair of surgical defects filled with autogenous bone and covered with demineralized bone matrix membrane or polytetrafluoroethylene membrane in rats.

Int J Oral Maxillofac Implants 2015 Mar-Apr;30(2):442-9

Purpose: The aim of this study was to evaluate the behavior of a demineralized bone matrix membrane and a polytetrafluoroethylene (PTFE) membrane in the process of bone repair of surgical defects filled with autogenous bone in rats.

Materials And Methods: Sixty rats weighing approximately 250 g each were selected and separated into three groups: control group without membrane, demineralized bone matrix membrane group, and PTFE membrane group. Bilaterally, surgical defects of 2 mm in diameter were prepared in the tibiae. The defect in the left tibia was filled with particulate autogenous bone collected during the creation of the two defects and was left uncovered (control) or was covered with the membranes investigated by the present study. At 10 or 60 days postoperatively, the rats were euthanized and the left tibiae were submitted to routine laboratory processing for histomorphometric analysis. All groups were evaluated separately on the 10th and 60th days after surgery. The Kruskal-Wallis test was used for group comparison.

Results: The membrane-treated defects showed a delay in healing. Sites treated with demineralized bone matrix membrane showed, as early as day 10, more newly formed bone and slow replacement until day 60. At day 60, the sites covered with demineralized bone matrix membrane and with synthetic membrane showed statistically significant results.

Conclusion: The demineralized bone matrix membrane proved to be biocompatible. In terms of newly formed bone area, both membranes showed similar performance.
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http://dx.doi.org/10.11607/jomi.3568DOI Listing
January 2016

Posterior partially edentulous jaws, planning a rehabilitation with dental implants.

World J Clin Cases 2015 Jan;3(1):65-76

Douglas R Monteiro, Emily V F Silva, Eduardo P Pellizzer, Osvaldo Magro Filho, Marcelo C Goiato, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, Univ Estadual Paulista (UNESP), São Paulo 16015-050, Brazil.

Aim: To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning.

Methods: An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review.

Results: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters.

Conclusion: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.
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http://dx.doi.org/10.12998/wjcc.v3.i1.65DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295221PMC
January 2015

Evaluation of the presence of VEGF, BMP2 and CBFA1 proteins in autogenous bone graft: histometric and immunohistochemical analysis.

J Craniomaxillofac Surg 2014 Jun 7;42(4):333-9. Epub 2013 Aug 7.

Dental School of Araçatuba, University of State of São Paulo "Júlio de Mesquita Filho" - UNESP, Rua José Bonifácio, 1193, CEP 16015-050 Araçatuba, SP, Brazil.

Aims: The purpose of this study was to evaluate the expression of proteins that participate in the osteoinduction stage (VEGF, BMP2 and CBFA1) of the process of bone regeneration of defects created in rat calvariae and filled with autogenous bone block grafts.

Materials And Methods: 10 adult male rats (Rattus norvegicus albinus, Wistar) were used, who received two bone defects measuring 5 mm each in the calvariae. The bone defects constituted two experimental groups (n = 10): Control Group (CONT) (defects filled with a coagulum); Graft Group (GR) (defects filled with autogenous bone removed from the contralateral defect). The animals were submitted to euthanasia at 7 and 30 days post-operatively.

Results: Quantitative analysis demonstrated significantly greater bone formation in Group GR, but the presence of the studied proteins was significantly greater in the CONT Group in both time intervals of observation.

Conclusion: It was not possible in this study in cortical bone block groups to detect the osteoinductive proteins in a significant amount during the repair process.
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http://dx.doi.org/10.1016/j.jcms.2013.05.022DOI Listing
June 2014

Incomplete mandibular fracture after lateralization of the inferior alveolar nerve for implant placement.

J Craniofac Surg 2013 May;24(3):e222-4

Department of Surgery-Universidade do Sagrado Coração (USC), Bauru, Brazil.

Purpose: The present case describes an inferior alveolar nerve lateralization for implant placement that caused mandible fracture a few days after surgery.

Clinical Report: In this case, a 56-year-old female patient who had a severely atrophied jaw and showing bone height less than 7 mm from the bone crest and the mandibular canal was submitted to surgery lateralization of the inferior alveolar conducted with piezzo. Even with all postoperative care, the patient suffered an incomplete fracture of the mandible a few days after lateralization of the inferior alveolar nerve for implant placement. The patient was treated with soft diet and medications for pain and antibiotics, besides removing the implant associated with the fracture.

Conclusion: It is suggested that this procedure may be conducted in 2 operative periods: firstly, the lateralization of the inferior alveolar; and secondly, after a period of 3 months, the implant placement in a situation of more bone stability.
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http://dx.doi.org/10.1097/SCS.0b013e318286992eDOI Listing
May 2013

Comparative study of the healing process when using Vicryl®, Vicryl Rapid®, Vicryl Plus®, and Monocryl® sutures in the rat dermal tissue.

Oral Maxillofac Surg 2013 Dec 28;17(4):293-8. Epub 2012 Dec 28.

Department of Pathology and Clinical Propedeutics, School of Dentistry of Araçatuba, São Paulo State University- UNESP, São Paulo, Brazil,

Introduction: Various types of sutures are available in the market with different constitutions. However, there is a lack of research to assess and quantify the behavior of these materials.

Resources And Materials: This study comes benchmark wires polyglactin 910 (Vicryl®), irradiated polyglactin 910 (Vicryl Rapid®), polyglactin 910 treated with triclosan (Vicryl Plus®), and poliglecaprone 25 (Monocryl®). For this, we used 40 rats that were divided into two groups, underwent two skin incisions longitudinal 2-cm long. In Group A, simple interrupted sutures using irradiated polyglactin 910 on the right and left side of polyglactin 910, and in group B, polyglactin 910 with triclosan on the right and the left poliglecaprone 25 were made. At 2, 7, 14, and 28 days after surgery, the ten animals were killed per period, and the samples were processed for histomorphologic and histometric analysis.

Conclusions: The results demonstrated that the wire poliglecaprone 25 showed better biological response, with less inflammatory infiltrates and rapid organization of connective tissue.
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http://dx.doi.org/10.1007/s10006-012-0380-3DOI Listing
December 2013

Comparative in vivo study of commercially pure Ti implants with surfaces modified by laser with and without silicate deposition: biomechanical and scanning electron microscopy analysis.

J Biomed Mater Res B Appl Biomater 2013 Jan 22;101(1):76-84. Epub 2012 Oct 22.

Department of Surgery and General Clinic, Araçatuba Dental School, Univ Estadual Paulista Júlio de Mesquita Filho, UNESP, Brazil.

The purpose of this study was to evaluate commercially pure titanium implant surfaces modified by laser beam (LS) and LS associated with sodium silicate (SS) deposition, and compare them with machined surface (MS) and dual acid-etching surfaces (AS) modified. Topographic characterization was performed by scanning electron microscopy-X-ray energy dispersive spectroscopy (SEM-EDX), and by mean roughness measurement before surgery. Thirty rabbits received 60 implants in their right and left tibias. One implant of each surface in each tibia. The implants were removed by reverse torque for vivo biomechanical analysis at 30, 60, and 90 days postoperative. In addition, the surface of the implants removed at 30 days postoperative was analyzed by SEM-EDX. The topographic characterization showed differences between the analyzed surfaces, and the mean roughness values of LS and SS were statistically higher than AS and MS. At 30 days, values removal torque LS and SS groups showed a statistically significant difference (p < 0.05) when compared with MS and AS. At 60 days, groups LS and SS showed statistically significant difference (p < 0.05) when compared with MS. At 90 days, only group SS presented statistically higher (p < 0.05) in comparison with MS. The authors can conclude that physical chemistry properties and topographical of LS and SS implants increases bone-implant interaction and provides higher degree of osseointegration when compared with MS and AS.
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http://dx.doi.org/10.1002/jbm.b.32818DOI Listing
January 2013

The success rate of immediate implant placement of mandibular molars: a clinical and radiographic retrospective evaluation between 2 and 8 years.

Clin Oral Implants Res 2013 Jul 30;24(7):806-11. Epub 2012 Mar 30.

Department of Dentistry, State University of Maringá, Maringá, Brazil.

Background: Dental implants, indicated for re-establishing both mastigatory and aesthetic functions, can be placed in the sockets immediately after tooth extraction. Most studies investigate the anterior and upper regions of the dental arch, whereas few examine longitudinal appraisal of immediate implant installation in the mandibular molar region.

Objective: The aim of this retrospective study was to evaluate the success rate of immediate dental implants placement in mandibular molars within a follow-up period as long as 8 years.

Materials And Methods: Seventy-four mandibular molar implants after non-traumatic tooth extraction between 2002 and 2008 were examined in the study. All implants were evaluated radiographically immediately after prosthesis placement, 1 year after implantation, and by the end of the experimental period, in 2010. Clinical evaluation was done according to [Albrektsson et al. (1986) The International Journal of Oral & Maxillofacial Implants, 1, 11-25] success criteria for marginal bone loss. The mean bone losses, calculated as the difference between the final evaluation measures and those taken by the end of the first year of implant, were compared using Kruskal-Wallis test with a significance level of 5%.

Results: All implants presented clinical and radiographic stable conditions, that is, 100% success rate. Significant bone loss was not found between final evaluation and that of the first functional year (P > 0.05).

Conclusion: Immediate implant placement of mandibular molars proved to be a viable surgical treatment given the high success rate up to 8 years after implantation.
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http://dx.doi.org/10.1111/j.1600-0501.2012.02461.xDOI Listing
July 2013

Intraoral approach to zygomatic fracture: modified technique for infraorbital rim fixation.

J Craniofac Surg 2012 Mar;23(2):537-8

Division of Oral and Maxillofacial Surgery, Araçatuba Dental School, University of the State of São Paulo, Araçatuba, Brazil.

The intraoral approach to zygomatic fracture treatment was introduced by Keen in 1909. This technique allows both an adequate visualization of the zygomaticomaxillary buttress and intraoral reduction of zygomatic arch fractures. Similar techniques have been published over the last 30 years. The aim of this study was to describe a modification of the Keen technique that promotes adequate visualization of the infraorbital rim and permits reduction and fixation of this region in cases of zygomatic fractures. The present technique has several advantages such as that (a) only 1 incision is necessary to approach the zygomaticomaxillary buttress and infraorbital rim, (b) it optimizes surgical time, and (c) it avoids periorbital scars.
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http://dx.doi.org/10.1097/SCS.0b013e3182418ea6DOI Listing
March 2012

Evaluation of bone heating, immediate bone cell viability, and wear of high-resistance drills after the creation of implant osteotomies in rabbit tibias.

Int J Oral Maxillofac Implants 2011 Nov-Dec;26(6):1193-201

Universidade Estadual Paulista, Araçatuba Dental School, Brazil.

Purpose: The purpose of this study was to evaluate the influence of reusing high-resistance drills on bone heating, immediate bone cell viability, and drill wear after performing implant osteotomies in rabbit tibias.

Materials And Methods: Two hundred sequential implant osteotomies were created in the superior tibial cortex of 12 White male rabbits. Six groups were established (G1 to G6) according to the number of osteotomies performed with each drill (0, 10, 20, 30, 40, and 50). Drilling began with a spear drill, followed by 2.0-mm, 2.8-mm, 3.0-mm, and 3.15-mm helical drills. The receptor beds were collected for immunohistochemical analysis, thermal changes were quantified, and the drills were subjected to scanning electron microscopy analysis.

Results: A high degree of correlation between drill wear and number of osteotomies was observed (Pearson correlation coefficient, r = 0.984). Spear drills underwent twice as much deformation as helical drills. The bone heating analysis concluded that there was no statistically significant relationship between the number of osteotomies and bone heating (P > .05), but there were greater thermal changes during drilling with the spear drill than during drilling with helical drills (ratio 3:1). Immunohistochemical analysis showed a physiologic balance of osteoprotegerin and RANKL (receptor activator of nuclear factor κB ligand) immunolabeling in all groups; however, there was greater immunolabeling of all proteins in group G6 (50 osteotomies).

Conclusions: The tested drills did not cause significant bone heating after being reused 50 times; however, they caused more tissue trauma in the 50th osteotomy. Worn drills that are reused may be expected to cause excessive damage to the bone tissue and could adversely affect the osseointegration process.
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July 2012

Maxillary bone defect reconstruction using porous polyethylene implants.

J Craniofac Surg 2011 Nov;22(6):2337-40

Department of Surgery and Integrated Clinics, School of Dentistry, Univiversidade Estadual Paulista, Araçatuba, Araraquara, São Paulo, Brazil.

Purpose: The aim of this study was to evaluate the bone repair process in the maxillary sinus in monkeys treated with high-density porous polyethylene (Medpor)

Methods: Four capuchin monkeys (Cebus apella) were submitted to bilateral horizontal osteotomies in the anterior wall of the maxillary sinus and divided into 2 groups: control group, left side with no implants, and porous polyethylene group, right side with Medpor. After a period of 145 days after implant placement, the maxillae were removed for histologic and histometric analyses.

Results: Bone repair in osteotomized areas took place by connective tissue in 58.5% and 58.7% in the control group and the porous polyethylene group, respectively. In the contact surface with Medpor, bone repair occurred in 41.3%.

Conclusions: Medpor was not reabsorbed within the period of this study and allowed bone repair surrounding it. The porous polyethylene constitutes a feasible alternative for bone defect reconstruction.
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http://dx.doi.org/10.1097/SCS.0b013e318232a81cDOI Listing
November 2011

Oral rehabilitation after surgical removal of pleomorphic adenoma.

J Craniofac Surg 2011 Nov;22(6):1996-9

Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University–UNESP, São Paulo, Brazil.

Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. The treatment of choice for most of maxillary tumors is surgical through either a total or partial maxillectomy. However, surgical defects caused by such type of treatment lead to both clinical and psychologic disorders for the patient. The immediate oral rehabilitation using interim palate obturator after maxillectomy provides optimization on the healing process, recovers the stomatognathic functions after surgery, and avoids psychosocial sequelae for the patients. This clinical report aimed to present the rehabilitation with immediate palate obturator of a patient who underwent a partial maxillectomy due to a hard palate pleomorphic adenoma of minor salivary glands. We report the clinical importance of the prosthetic rehabilitation and the improvements on both quality of life and stomatognathic functions of this patient. It can be concluded that the immediate rehabilitation of the patient after partial maxillectomy by using an interim palate obturator was a great option and provided clinical benefits in the immediate postoperative period, improving the patient’s quality of life, allowing the patient’s reinsertion into society, and reducing the surgical treatment sequelae.
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http://dx.doi.org/10.1097/SCS.0b013e31823195fbDOI Listing
November 2011

Histomorphometric analysis of the repair process of autogenous bone grafts fixed at rat calvaria with cyanoacrylate.

J Appl Oral Sci 2011 Oct;19(5):529-34

Araraquara Dental School, Univ. Estadual Paulista, Rua Humaitá 1680, Araraquara, SP, Brazil.

Objective: The purpose of this study was to perform histological and histometric analyses of the repair process of autogenous bone grafts fixed at rat calvaria with ethyl-cyanoacrylate adhesive.

Material And Methods: Thirty-two rats were divided into two groups (n=16), Group I - Control and Group II - Adhesive. Osteotomies were made at the right parietal bone for graft obtainment using a 4-mm-diameter trephine drill. Then, the bone segments were fixed with the adhesive in the parietal region of the opposite side to the donor site. After 10 and 30 days, 8 animals of each group were euthanized and the calvarias were laboratorially processed for obtaining hematoxylin and eosin-stained slides for histological and histometric analyses.

Results: An intense inflammatory reaction was observed at the 10-day period. At 30 days, this reaction was less intense, despite the presence of adhesive at the recipient-site/graft interface. Graft incorporation to the recipient site was observed only at the control group, which maintained the highest graft size at 10 and 30 days.

Conclusions: Although the fragment was stable, the presence of adhesive in Group II did not allow graft incorporation to the recipient site, determining a localized, discrete and persistent inflammatory reaction.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984202PMC
http://dx.doi.org/10.1590/s1678-77572011000500016DOI Listing
October 2011

Unilateral facial paralysis caused by Ramsay Hunt syndrome.

J Craniofac Surg 2011 Sep;22(5):1961-3

Department of Surgery and Integrated Clinic, UNESP, Araçatuba Dental School, São Paulo, Brazil.

The Ramsay Hunt syndrome is a rare disease caused by an infection of the geniculate ganglion by the varicella-zoster virus. The main clinical features of the syndrome are as follows: Bell palsy unilateral or bilateral, vesicular eruptions on the ears, ear pain, dizziness, preauricular swelling, tingling, tearing, loss of taste sensation, and nystagmus. We describe a 23-year-old white woman, who presented with facial paralysis on the left side of the face, pain, fever, ear pain, and swelling in the neck and auricular region on the left side. She received appropriate treatment with acyclovir, vitamin B complex, and CMP nucleus. After 30 days after presentation, the patient did not show any signs or symptoms of the syndrome. At follow-up at 1 year, she showed no relapse of the syndrome.
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http://dx.doi.org/10.1097/SCS.0b013e31822ea828DOI Listing
September 2011

Occurrence of odontogenic infections in patients treated in a postgraduation program on maxillofacial surgery and traumatology.

J Craniofac Surg 2011 Sep;22(5):1689-94

Department of Surgery and Integrated Clinic, Dental School of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil.

This study assessed the occurrence and characteristics of oral and maxillofacial infections in patients treated at a Brazilian oral and maxillofacial emergency service during a 7-year period. The clinical files of all patients treated at the Oral and Maxillofacial Surgery and Traumatology Service of the Araçatuba Dental School, São Paulo State University, Brazil, between 2002 and 2008 were reviewed. From a population of 3645 patients treated in this period, the study sample consisted of 93 subjects who presented odontogenic infections. Data referring to the patients' sex, age, medical history, and the etiology, diagnosis, complications, drug therapy/treatment, and evolution of the pathologic diseases were collected and analyzed using the Epi Info 2000 software. Of these patients, 54 were men (58.1%) and 39 were women (41.9%). Most patients were in the 31- to 40-year-old (20.7%) and 21- to 30-year-old (19.6%) age groups. The most frequent etiology was pulp necrosis due to caries (80.6%). Regarding the treatment, antibiotics were administered to all patients, surgical drainage was done in 75 patients (82.4%), and 44 patients (47.3%) needed hospital admission. First-generation cephalosporin alone or combined with other drugs was the most prescribed antibiotic (n = 26) followed by penicillin G (n = 25). Most patients (n = 85, 91.4%) responded well to the treatment. Five cases had complications: 3 patients needed hospital readmission, 1 case progressed to descending mediastinitis, and 1 patient died. Odontogenic infections can be life-threatening and require hospital admission for adequate patient care. Complications from odontogenic infections, although rare, may be fatal if not properly managed.
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http://dx.doi.org/10.1097/SCS.0b013e31822e5c8dDOI Listing
September 2011

Foreign body in preauricular region.

J Craniofac Surg 2011 Jul;22(4):1531-3

Department of Oral and Maxillofacial Surgery, Graduation and Post-Graduation Course, School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil.

Foreign bodies, although they are often found throughout the body, to a lesser degree in the face, still constitute a diagnostic challenge for the trauma surgeon. Its removal means danger of damaging important facial anatomic structures, even if its exact position from the image data was known. So, the objective is to describe a clinical report of a patient (42 years of age, male sex) who experienced falling to the ground, attended by the Department of Surgery and Traumatology Bucco-Maxillo-Facial Surgery, Faculty of Dentistry of Araçatuba, São Paulo State University, and 2 days after the trauma, he reported difficulty in mouth opening and pain. After clinical evaluation, we observed the presence of injury in the left preauricular region already in the process of healing. During the intraoral physical examination, a limitation of the mouth opening was noted. Radiographic posteroanterior and profile of the face showed 2 radiopaque foreign bodies in the left side, lying apparently at the region of the mandibular condylar process. Under local anesthesia, foreign body removal was carried from there with access to it through the preexisting facial injury. Further clinical examinations showed an improvement in mouth opening, absence of pain complaints, and/or functional complaints.
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http://dx.doi.org/10.1097/SCS.0b013e31821da1e6DOI Listing
July 2011