A 42 year old patient was referred to the Department of Oral and Maxillofacial Surgery of the Federal University of Uberlândia, for treatment of mandibular fractures (condyles and symphysis), a victim of a run over. The symphysis was surgically approached, using as surgical access the pre-existing laceration in the submental region. Five days after discharge, the patient returned with dehiscence of the wound and physical examination showed infestation by larvae in the symphysis. Mechanical removal and debridement were performed under local anesthesia, where plate exposure was noted. The patient underwent oral ivermectin therapy, intravenous antibiotic therapy and a thorough debridement was performed under general anesthesia due to the invasion of deep spaces in the supra-hyoid region. After 2 weeks, it presented with purulent drainage at the site. The miniplates were replaced by a 2.4 mm reconstruction plate and antibiotic therapy was maintained. Due to the social risk, the patient remained hospitalized for 45 days, when he was discharged with outpatient return, but did not attend the returns.
Background. The beta-2 adrenergic receptor is expressed by neoplastic cells and is correlated with a wide spectrum of tumor cell mechanisms including proliferation, apoptosis, angiogenesis, migration, and metastasis. Objectives. The present study aimed to analyze the expression of the beta-2 adrenergic receptor (β2-AR) in tumor-free surgical margins of oral squamous cell carcinomas (OSCC) and at the invasive front. Sixty-two patients diagnosed with OSCC, confirmed by biopsy, were selected for the study. The clinicopathological data and clinical follow-up were obtained from medical records and their association with β2-AR expression was verified by the chi-square test or Fischer's exact test. To verify the correlation of β2-AR expression in tumor-free surgical margins and at the invasive front of OSCCs, Pearson's correlation coefficient test was applied. Results. The expression of β2-AR presented a statistically significant correlation between the tumor-free surgical margins and the invasive front of OSCC (r = 0.383; p = 0.002). The immunohistochemical distribution of β2-AR at the invasive front of OSCC was also statistically significant associated with alcohol (p = 0.038), simultaneous alcohol and tobacco consumption (p = 0.010), and T stage (p = 0.014). Conclusions. The correlation of β2-AR expression in OSCC and tumor-free surgical margins suggests a role of this receptor in tumor progression and its expression in normal oral epithelium seems to be constitutive.
A atrofia mandibular ocorre em virtude de diversos fatores como periodontite, lesões periapicais, perda dentária precoce, uso de próteses mal adaptadas que promovem a reabsorção óssea ao longo do tempo. Esta condição proporciona fragilidade à estrutura óssea remanescente e susceptibilidade á fraturas. As fraturas de mandíbula atrófica configuram-se um desafio ao Cirurgião Buco-Maxilo-Facial em virtude de diversas peculiaridades no manejo do tratamento e reabilitação oral. O tratamento de escolha para pacientes com fratura de mandíbula atrófica é o cirúrgico, que objetiva reduzir e imobilizar os segmentos da fratura, de modo a restaurar a estética e a função. Deste modo, uma avaliação individualizada deve ser realizada na busca da melhor biomecânica do material de osteossíntese a ser utilizado, pois uma adequada estabilidade pode ser conseguida através de diversos métodos de fixação. O objetivo deste trabalho é relatar um caso clínico de um paciente do gênero masculino, vítima de acidente com animal de grande porte evoluindo com fratura bilateral de corpo de mandíbula atrófica. Optou-se pela realização do tratamento cirúrgico da fratura com simplificação dos cotos ósseos da fratura com uso de miniplacas e posterior instalação de placa do sistema load-bearing evoluindo no período pós-operatório sem intercorrências.
A síndrome respiratória aguda grave (SARS-CoV-2) é uma doença respiratória infecciosa com taxas de morbidade e mortalidade significativas evoluindo no ano de 2020 como uma Pandemia. A odontologia é classificada na categoria de alto risco devido a maioria dos procedimentos gerarem aerossóis e a Cirurgia oral e maxilofacial é a especialidade odontológica que desempenhando funções tanto no âmbito hospitalar quanto no âmbito ambulatorial. O objetivo do presente trabalho é fazer um análise da gestão, riscos e perspectivas da cirurgia oral e oral e cirurgia maxilofacial em tempos de pandemia de COVID-19, visto que as cirurgias eletivas devem ser suspensas e as urgências priorizadas com o principal objetivo do gerenciamento dos risco para evitar o contágio em cuidado de emergência porém, quanto as pespectivas futuras é imprescindivel a adaptação desses profissionais a nova realidade de atendimento em virtude de diversas procedimentos realizados serem de caracter de urgência e emergência.
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