Plasma electrolytic oxidation (PEO) has been a promising surface coating with better mechanical and antimicrobial parameters comparing to conventional treatment surfaces. This study evaluated the peri-implant bone repair using (PEO) surface coatings compared with sandblasted acid (SLA) treatment. For this purpose, 44 Wistar rats were ovariectomized (OVX-22 animals) or underwent simulated surgery (SS-22 animals) and received implants in the tibia with each of the surface coatings. The peri-implant bone subsequently underwent molecular, microstructural, bone turnover, and histometric analysis. Real-time PCR showed a higher expression of osteoprotegerin (OPG), receptor activator of nuclear kappa-B ligand (RANKL), and osteocalcin (OC) proteins in the SLA/OVX and PEO/SS groups (p < 0.05). Computed microtomography, confocal microscopy, and histometry showed similarity between the PEO and SLA surfaces, with a trend toward the superiority of PEO in OVX animals. Thus, PEO surfaces were shown to be promising for enhancing peri-implant bone repair in ovariectomized rats.
Posterior mandible region is considered a highly predicable place for primary stability during dental implant placement. Although, this region can present a significant decrease in bone density, which can lead to implant dislocation during insertion. The present case reports an unusual dislocation of dental implant in a 59 old healthy patient's mandible and a secure solution for this kind of complication. During the drilling, bone quality type IV was observed. In sequence, implant was abruptly inserted in the perforation site and dropped into the bone marrow. Panoramic radiograph showed the implant inside bone marrow, close to mandibular base. The implant was removed through the surgical site. The screw of the implant prosthesis transfer was used to reach the displaced implant. A second implant with the same dimensions as the first one, differing by the external hexagon, was inserted into the same implant site. Therefore, the authors strongly recommend the use of the presented technique prior to osteotomy on mandibular body, reserving the second in the impossibility of reaching the internal connection of the displaced implant.
The management of patients with neurodegenerative conditions such as Alzheimer's disease presents a challenge in promoting oral health, which is mainly linked to the motor and cognitive limitations that these individuals have, making them susceptible to the development of a series of oral diseases, such as oral myiasis. The presence of larvae in the oral cavity in patients with Alzheimer's disease seems to be related to poor oral hygiene condition, to the long periods that the patient remains immobile and with the mouth ajar, facilitating the deposition of eggs. Therefore, this study aimed to report a clinical experience of a patient with Alzheimer's disease in an advanced stage and with manifestation of oral myiasis on the oral floor, vestibule bottom and inserted gum. The 81-year-old patient was debilitated, bedridden, unable to perform his activities alone, was taken to the emergency room by his caregiver, who reported having noticed the presence of larvae in the oral cavity. The patient was hospitalized and immediately administered Ivermectin, ceftriaxone and clindamycin. On the second day of hospitalization, he presented a systemic worsening due to bronchoaspiration, requiring immediate removal of the larvae under local anesthesia. Only after significant improvement in the general condition, thorough surgery was performed to debridement of the injured areas and remnants of larvae. After hospital discharge with 2-month follow-up, the patient did not have any complications related to his oral health, demonstrating that periodic follow-up to debilitated patients is an important tool for preventing opportunistic manifestations such as oral myiasis.
As infecções odontogênicas podem evoluir rapidamente e oferecer grande risco de morte, visto que comumente são associadas à extensas deteriorações dos tecidos, além da sua localização, em íntimo contato com estruturas anatômicas importantes como vias aéreas, podendo levar a sua obstrução. Dessa forma, objetiva-se relatar, possíveis dificuldades do manejo de um paciente, devido ao quadro de Angina de Ludwig e consequente desvio de vias aéreas, e também a importância da abordagem multidisciplinar médico-odontológica. Paciente do sexo masculino, 33 anos de idade, queixando-se de dor em região de terceiro molar inferior direito, com evolução de uma semana, com edema extraoral que progredia gradativamente, foi submetido à drenagem ainda no pronto-atendimento, em seguida a equipe procedeu com sua internação, no dia seguinte, o paciente foi levado ao centro cirúrgico para realização de nova drenagem, e exodontia de elementos dentários associados a infecção. No momento de intubação houve dificuldade para mesma devido ao deslocamento da língua, que impossibilitava a adequada passagem do tubo, direcionando o tratamento para uma traqueostomia. É imprescindível que seja realizada a remoção da causa, para que haja a sua regressão e frente a necessidade cirúrgica, é fundamental que na avaliação pré-operatória, a equipe médica avalie os possíveis comprometimentos de via aérea que possam culminar em dificuldades para a intubação. Não há um consenso a respeito da melhor conduta para intubação em quadros de angina devido a grande variedade de situações clínicas, entretanto, há a necessidade de uma abordagem multidisciplinar médico-odontológica para que seja possível uma abordagem rápida e precisa.
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