This research study aimed at reviewing, in the literature, the aspects related to the buccal fat pad structure, named the Bichat Ball, evaluating the anatomy of the area, the buccal fat pad clinical applications and the possible complications of its surgical removal, as well as reporting a series of cases that presented such complications. The most important anatomical structures surrounding the buccal fat pad and that are frequently involved in surgical complications are the parotid gland duct, the facial nerve branches, the blood vessels and the muscular tissues. In Dentistry, the buccal fat pad clinical application has an aesthetic purpose and it can be removed or repositioned. The removal occurs to avoid intra-oral trauma, "nibbling", and the pedicle repositioning occurs for protection or to be used as a graft. The complications of the surgical removal of the buccal fat pad are not frequent, however, hematoma, infection, facial nerve and facial vessel injuries may occur. Therapies involved in it include drug therapy, drainage, laser therapy and compresses. RESUMOEste trabalho teve por objetivo levantar na literatura aspectos referentes ao corpo adiposo bucal denominado de Bola de Bichat quanto à anatomia da área, as aplicações clínicas da referida gordura e as possíveis complicações cirúrgicas da remoção da mesma, e relatar uma série de casos de remoção estética do corpo adiposo bucal que tiveram complicações. As estruturas anatômicas mais importantes que circundam o corpo adiposo bucal e estão muitas vezes envolvidas nas complicações da cirurgia de remoção são os ductos da glândula parótida, ramos do nervo facial, vasos sanguíneos e tecidos musculares. As aplicações clínicas do corpo adiposo bucal na área da odontologia são para fins estéticos removendo ou reposicionando-o, remoção para evitar trauma intra-oral, "mordiscamento", devido ao seu volume e reposicionamento pediculado para proteger ou usar como enxertia. Complicações do procedimento cirúrgico de remoção do corpo adiposo bucal não são frequentes, no entanto, hematoma, infecção, lesão do nervo facial, lesão dos vasos faciais podem vir a ocorrer. E as terapêuticas envolvidas nesta eventualidade compreendem terapêutica medicamentosa, drenagem, laser terapia e compressas.Termos de indexação: Tecido adiposo. Odontologia. Face. Cirurgia geral.
The aims of this study were to identify (1) patient-related factors (sex, age, craniofacial pattern and smoking habit), (2) miniscrews implants (MSI)-related factors (length and diameter) and (3) location-related factors [bone (maxilla or mandible) and area (buccal, lingual and alveolar ridge)] that may be associated with MSI loss of stability. A total of 1356 MSI were installed in 570 patients (423 females and 147 males) with mean age of 42.7 during a 10-year period and were clinically evaluated once a month until the end of the proposed movement. Length (5, 7, 9 and 11 mm) and diameter (1.3, 1.4 and 1.6 mm) of the MSI were selected according to insertion site. The evidence of clinical mobility during treatment or fracture during insertion was considered as failure. A total success rate of 89.1% was observed. There was no statistically significant difference in loss of stability when considering age, sex, craniofacial pattern or smoking habit. Considering diameter, there was no statistically significant difference (p = 0.645), but the shorter miniscrews (5 mm) showed higher failure rates (p < 0.001) than the longer ones. There were more loses (p < 0.001) in the mandible than in the maxilla, but the area (buccal, lingual or alveolar ridge) did not interfere in the results (p = 0,421). It can be concluded that MSIs are effective for skeletal anchorage in orthodontics. Patient-related factors, such as sex, age, smoking habit and craniofacial pattern, did not affect MSI success. However, the use of shorter MSIs (5 mm) was inversely proportional to failure probability, and loss of stability was greater in the mandible.
This study proposed to evaluate the precision of Nicodemo, Moraes and Médici method and the method proposed by Demirjian and compare both methodologies in relation to the efficiency and applicability in the Brazilian population. The sample consisted of 124 panoramic radiographs of subjects in the age group from 7 to 16 years old, 66 patients female and 58 male. For the comparison of the genders in relation to the average percentage difference, the t-Student test was considered. In average the method of Nicodemo, Moraes and Médici presented for the female gender an estimated result 14.7% lower than the real age. For the male gender the estimative obtained was that for each year of variation of the real age the method of Nicodemo estimates a variation of 0.48 years, with a confidence interval of 95% given by (0.43; 0.54). For the method of Demirjian the result was that for each year of variation of the real age the method of Demirjian estimates a variation of 1.00 year, with a confidence interval of 95% given by (0.85; 1.15) for the male gender and 0.96 years, with a confidence interval of 95% given by (0.84; 1.08) for the female gender. It is concluded that the Method of Nicodemo, Moraes and Médici tends to underestimate the real age and that as the real age increases this underestimate becomes higher. Now, the method of Demirjian tends to overestimate the real age in 8.2 months for the male gender and in 7.1 for the female one in average.
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