Osteomas são neoplasias benignas que se caracterizam pela proliferação de osso maduro compacto ou esponjoso. Os locais de ocorrência mais frequentes são a mandíbula e os seios paranasais. O objetivo desse artigo é relatar diagnóstico e o tratamento cirúrgico de um osteoma periférico mandibular em paciente não sindrômico. O caso em estudo é o de um Paciente do gênero masculino, 40 anos, ASA I, procurou o serviço de Cirurgia Bucomaxilofacial do Hospital Universitário Oswaldo Cruz – PE com queixa de aumento de volume intraoral em região anterior de mandíbula, firme a palpação, bem delimitada e com cerca de 2cm. Após exame físico a hipótese diagnóstica levantada foi osteoma e torus mandibular. A proposta cirúrgica planejada foi acesso intra-oral, exérese da lesão, osteoplastia mandibular e encaminhamento do material colhido para análise histopatológica para confirmação do diagnóstico. A análise histopatológica confirmou a hipótese diagnóstica de osteoma périférico. O paciente foi acompanhado no pós-operatório e após 6 meses do procedimento cirúrgico não foi observado sinais de recidiva.

Background The aim of this study was to compare the anti-inflammatory effects of dexamethasone and etoricoxib after third molar extraction. Material and Methods A prospective, randomized, controlled, split-mouth study was conducted. 19 volunteers were allocated randomly to receive 90mg etoricoxib 1 hour prior to the procedure or 4mg intramuscular dexamethasone immediately after anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on immediate postoperative, at 72 hours and 7 days after surgery to measure postoperative facial swelling by use of linear measurements, interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Descriptive statistics and the independent-samples t-test were used to compare the two groups at P < 0.05. Results Dexamethasone was effective in the control roasted edema for measurements of the mandibular angle - wing of the nose and mandibular angle - labial commissure 72 hours after surgery. And for the measurement mandibular angle - mentum, in the time of 72 hours and 7 days. There was no statistically significant difference in relation to pain and trismus. Conclusions Considering significant results for some measures of the variable edema for the group that used intramuscular dexamethasone and the difference without statistical significance between groups for the other variables studied, we seem to reflect the intramuscular indication of the corticosteroid in a single dosage in relation to the use of etoricoxib as pre-emptive medication. Key words:Corticosteroids, COX-2 selective, third-molar surgery.

Os defeitos mandibulares devido à ressecção de lesão óssea interferem a harmonia e estética facial comprometendo a qualidade de vida dos pacientes. Grandes defeitos exigem planejamento minucioso, principalmente quando lançamos mão de enxertos e placas de reconstrução, evitando assim resultados insatisfatórios ou até mesmo sequelas. Apesar de algumas classificações dos defeitos mandibulares vêm sendo discutidas ao longo dos anos, ainda não há um protocolo definido para reconstrução mandibular. O uso de prototipagem na Cirurgia Bucomaxilofacial tem se tornado cada vez mais frequente; a precisão da reconstrução, diminuição do tempo de cirurgia reflete em recuperação mais rápida do paciente. Mesmo com a ferramenta da prototipagem, grandes lesões e perdas ósseas permanecem como grande desafio ao cirurgião.  O objetivo deste trabalho é relatar um caso clínico de reconstrução mandibular no qual houve a necessidade de ser tratado com remoção de placa de reconstrução e nova reabilitação cirúrgica do paciente.Descritores: Mandíbula; Reconstrução Mandibular; Modelos Biológicos.ReferênciasSantos LCS, Seixas AM, Barbosa B, Cincura RNS. Adaptação de placas reconstrutivas: uma nova técnica. Rev Cir Traumatol Buco-Maxilo-Fac. 2011;11(2):9-14.Lin PY, Lin KC, Jeng SF. Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg. 2011;2011:824251.Martins Jr. JC, Keim FS. Uso de prototipagem no planejamento de reconstrução microcirúrgica da mandíbula. Rev Bras Cir Craniomaxilofac. 2011;14(4):225-28.Montoro JR, Tavares MG, Melo DH, Franco Rde L, Mello-Filho FV, Xavier SP, Trivellato AE, Lucas AS. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Braz J Otorhinolaryngol. 2008;74(1):155-57.Nóia CF, Ortega-Lopes R, Chaves Netto HDM, Nascimento FFAO, Sá BCM. Desafios na reconstrução mandibular devido a lesões extensas ou traumatismos. Rev Assoc Paul Cir Dent. 2015;69(2):158-63.Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-6.Rana M, Warraich R, Kokemüller H,  Lemound J,  Essig H, Tavassol F et al. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period. Head Neck Oncol. 2011;3:23.Fariña R, Alister JP, Uribe F, Olate S, Arriagada A. Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm. Plast Reconstr Surg Glob Open. 2016;4(8):e845.Fariña R, Plaza C, Martinovic G. New transference technique of position of mandibular reconstructing plates using stereolithographic models. J Oral Maxillofac Surg. 2009;7(11):2544-48.Mooren RE, Merkx MA, Kessler PA, Jansen JA, Stoelinga PJ. Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients. J Oral Maxillofac Surg. 2010;68(10):2459–67.Brown JS, Barry C, Ho M, Shaw R.A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1):23-30Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg. 1991;117(7):733-44.Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand JP, Wax MK. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm. JAMA Facial Plast Surg. 2015;17(5):367-73.Wei FC, Celik N, YangWG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37-42.Li BH, Jung HJ, Choi SW, Kim SM, Kim MJ, Lee JH. Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation. J Craniomaxillofac Surg. 2012;40(8):293-300.

Hemimandibular hyperplasia was first described in 1836 by Adams as a disorder that causes condylar hyperplasia, deforming facial asymmetry and has an unknown etiology. The objective of this study was to report a patient with surgical correction through orthognathic surgery and high condilectomy for the treatment of hemimandibular hyperplasia. The patient complained of pain and cracking in the right temporomandibular joint region and was dissatisfied with the aesthetic appearance of the face. Virtual planning was done for bimaxillary orthognathic surgery and preparation of prototyped surgical guides. Stereolithographic models were used for the preparation of the acrylic guides of the osteotomies for the high condilectomy and the contour of the mandibular base. Orthognathic surgery resulted in the maxillary repositioning with correction of the inclination of the occlusal plane, reduction of the height of the ramus and right mandibular body and class I dental attachment. Mandibular contour osteotomy was performed with acrylic guide in the basilar. The condilectomy was performed by endaural access. In 2-year follow-up, there are no signs of recurrence.

Purpose Wound closure technique is an operative factor that influences early post-operative complications after third molar surgery. This study investigates and compared the effectiveness of two closure techniques, primary closure and healing by second intention of the oblique incision on postsurgical discomfort after mandibular third molar surgery. Materials and methods This is a prospective, randomized, double-blind, split mouth controlled trial. Surgical sites were divided into two groups Control group received simple sutures in both alveolar crest incision and oblique incision and intervention group received simple sutures in alveolar crest incision, while the oblique incision healed by second intention. All the patients were instructed to measure pain according to visual analogue scale (VAS) in postoperative period, swelling, mouth opening was assessed at 72h and 7 days after surgery. The wound healing was assessed on day 7. Results Thirty-five patients, who had bilateral impacted third molars of similar surgical difficulty, were recruited. Thirty-one successfully completed the study. Patients in the second intention group had significantly less pain at 24h (p < 0.27). and 48h (< 0.001), had significantly less swelling (< 0.001) and trismus (< 0.001) and patients submitted to primary closure had a better evaluation of the Landry index (p < 0.001). Conclusion Healing by second intention of the oblique relaxing incision by partial surgical wound closure, in our study, were superior to the primary closure in reduction of post-operative pain, swelling and trismus. Trial registration This trial is registered at Brazilian Registry of Clinical Trials–ReBEC -UTN: RBR-5fxbqsf (https://ensaiosclinicos.gov.br/rg/RBR-5fxbqsf).