Factors associated with the diagnosis, aetiology, and treatment of mandibular fractures occurring during the postoperative period following the removal of a lower third molar are discussed. The following databases were searched using specific key words: PubMed/MEDLINE, LILACS, Embase, and Scopus. The search yielded 124 cases. Sex, age, side, tooth position and angulation, bone impaction, relationship between the tooth and the inferior alveolar nerve, local pathological conditions, aetiology of the fracture, symptomatology, and time between surgery and fracture, as well as any displacement of the fracture and the treatment of the fracture, were evaluated. Data were tabulated and the χ statistical test was applied (P<0.05). Male patients aged >35 years, with teeth in positions II/III and B/C, complete bony impaction, and local bone-like alterations, were found to have a higher frequency of fracture and pericoronitis (P<0.05). Late fractures generally occurred between the second and fourth postoperative weeks (P<0.05). They were generally not displaced and the typical treatment was the non-surgical approach (P<0.05). It is concluded that the risk of mandibular fracture after extraction is associated with excessive ostectomy and/or local alterations. At-risk patients should be thoroughly briefed on the importance of a proper postoperative diet.

This study assessed the impact of oral and maxillofacial trauma and surgical treatment on the quality of life of patients. The study included 66 patients (age range 18-65 years) with facial fractures; 33 required surgical treatment and 33 required conservative (non-surgical) treatment. Quality of life was evaluated by applying the Oral Health Impact Profile questionnaire (OHIP-14) immediately after diagnosis of the trauma (T1), 30 days after surgery or trauma (T2), and 90 days after surgery or trauma (T3). For the control group (conservative treatment), there was a change in quality of life at T1 and T2. A change in quality of life was found for all of the surgical patients, regardless of the type of fracture and the observation period analyzed. There was no statistical difference when T1, T2, and T3 were compared in cases of zygomatic, Le Fort I, and nasal fractures, however there was an improvement in the quality of life of patients with mandibular fractures (P=0.0102) and multiple facial fractures (P=0.0097) at T3. Facial trauma caused the greatest impact on the quality of life of surgical patients at T1. The surgical treatment significantly improved quality of life for patients with mandibular and multiple facial fractures.

ResumoO objetivo desta pesquisa foi analisar o conhecimento, opinião, acompanhamento e a execução do cirurgião-dentista na Odontologia Hospitalar. Foram aplicados 500 questionários a cirurgiões-dentistas na cidade de Araçatuba do estado de São Paulo. Os resultados demonstraram que 49% dos profissionais nunca tiveram a experiência no âmbito hospitalar e 64% afirmaram que este conteúdo é carente como parte integrante do currículo de graduação. Outro resultado foi de que 46% dos entrevistados não têm interesse ou não acham necessário atuar dentro do hospital e 24% acreditam que esse atendimento seja feito somente por especialistas. Pode-se sugerir que há carência de conhecimento sobre Odontologia Hospitalar, assim o cirurgião-dentista deve ser instruído desde a sua formação acadêmica para a inserção na equipe hospitalar.Palavras-chave: conhecimento; Odontologia, hospital. AbstRAct Level of knowledge of dentists about Hospital Dental Care Introdução AOdontologia Hospitalar pode ser definida como prática de atividades que visam melhorar a saúde geral e a qualidade de vida dos pacientes hospitalizados. O tratamento integral do paciente é fundamental para que a equipe multidisciplinar atue de forma eficiente e segura, permitindo melhor desempenho no compromisso de melhora do quadro clínico do paciente internado (1).Inúmeras pesquisas comprovam a relação entre doenças bucais e sistêmi-cas, mostrando que dependendo da condição bucal pode haver foco de disseminação de micro-organismos patogênicos com efeito metastático (2, 3). Deste modo, o tratamento odontológico contribui significativamente com a prevenção e/ou melhora da condição sistêmica, principalmente em paciente hospitalizado (4, 5).As doenças infecciosas na cavidade bucal estão intimamente relacionadas com alterações na resposta imunológica, falta de higiene oral, desnutrição severa, tabagismo, alcoolismo e diabetes, os quais podem aumentar a susceptibilidade ao desenvolvimento de gengivite, periodontite e doenças respiratórias (6,7,8). Além disso, o comprometimento da resposta imune local e sistêmica facilita a colonização da cavidade oral por micro-organismos superinfectantes, como as bactérias entéricas e pseudomonas (9, 10).Os procedimentos realizados em ambiente hospitalar requerem uma equipe multiprofissional da área da saúde, considerando a complexidade do ser humano, principalmente do indivíduo hospitalizado. Sendo assim, um único profissional não é capaz de realizar de forma segura o diagnóstico e o plano de tratamento do paciente hospitalizado (11). Desta forma, percebe-se a importância da abordagem integral dos indivíduos hospitalizados, indicando que nenhuma profissão da área da saúde atua isoladamente.Partindo do exposto mostra-se a importância das faculdades de Odontologia abordarem este tema pouco abordado na grade curricular durante a graduação. Como futuro profissional da área da saúde, o aluno de graduação, durante sua formação acadêmica, deve ser incentivado e preparado para o manejo do paciente em âmbito hospitalar.Muitos dos profissionais da...

Sialolithiasis of the salivary gland is a benign pathology that occurs most frequently in the submandibular gland because of its anatomic features. Depending on the sialolith size and calcification degree, it can be visible in radiographic examinations. Commonly, patients may experience pain and/or edema, when the ducts are obstructed. The authors report the case of sialolithiasis of the submandibular gland in a 42-year-old, female, white-skinned patient, noticed during routine dental examination. Following diagnosis confirmed by clinical and radiographic examinations, the treatment plan consisted of surgery for removal of the calcified mass. The prognosis is often good, and generally there is no recurrence.

Background As third molar surgery is the most commonly procedure performed in Dentistry and has been accompanied by serious postoperative disorders such as pain, edema and trismus, the study aimed to evaluate if ultrasound device would be able to reduce such postoperative features. The aim of this study was to assess the effects of soft tissue flap elevation, osteotomy and odontosection using piezosurgery versus conventional technique in mandibular third molar extractions. Material and Methods Twenty patients with impacted mandibular third molars underwent tooth extractions using two different methods. Ten patients were included in the Piezo Flap Group (PFG - the flap was elevated using piezosurgery) and ten patients were part of the Piezo Ostectomy Group (POG - osteotomy and odontosection were carried out with ultrasound tips). The contralateral tooth was included in the Control Group (CG - conventional technique). The patients were evaluated at postoperative periods of 1, 3, 7 and 14-days. The measured parameters were duration of surgery, pain, trismus and swelling. Results The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). There was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG ( p >0.05). There was a statistically significant difference in swelling between the PFG and POG, presenting less swelling at the 3-day postoperative period ( p =0.038; p <0,05). However, for the remaining analyzed periods there was no difference ( p >0.05). Conclusions Piezosurgery for tissue elevation of the surgical flap, osteotomy and dental sectioning in mandibular third molar extraction surgery promoted less edema in the early postoperative stages in mandibular third molar extractions despite the longer surgical duration. Key words: Third molar, piezosurgery, flap, exodontia, ostectomy.