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The prosthetic rehabilitation of an atrophic mandible is usually unsatisfactory due to the lack of support tissues, mainly bone and keratinized mucosa for treatment with osseointegrated implants or even conventional prosthesis. The prosthetic instability leads to social and functional limitations and chronic physical trauma decreasing the patient's quality of life. A 53-year-old female patient sought care at our surgical service complaining of impairment of her masticatory function associated with the instability of the lower total prosthetic denture. The clinical and complementary exams revealed edentulism in both arches, while the mandibular arch presented severe reabsorption resulting in denture instability and chronic trauma to the oral mucosa. The proposed treatment plan consisted in the mandibular rehabilitation with osseointegrated implants and fixed Brånemark's protocol prosthesis after mandibular reconstruction applying the modified visor osteotomy technique. The proposed technique offered predictable results for reconstruction of the severely resorbed edentulous mandible and posterior rehabilitation with osseointegrated implants.

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Introduction: Facial fractures can result in limitation of mouth opening range, which consequently leads to functional impairments. Objective: To identify the influence of facial fractures and their corrective surgery on mouth opening range. Material and methods: Consecutive patients submitted to maxillofacial surgery had their mouth opening range measured at four different moments: preoperative (T0), immediate post-operative (within 24 hours after operation) (T1), one-week post-operative (T2) and one-month postoperative (T3). Eighteen subjects composed the sample, majorly represented by male gender, fractures caused by direct trauma as in traffic accidents, age among 21-30 years old and presenting mandible fracture. Results: Mouth opening at T0 demonstrated a mean value of 26.63 mm, T1 decreased to a mean of 22.59 mm, T2 mean value evolved to 26.42 mm and T3 displayed mean value of 34.57 mm. Statistical evaluation demonstrated overall significance for the comparison among all different periods, particularly for isolated mandible fractures, except between T0 and T2. Conclusion: It can be suggested that fracture itself and surgery for its correction have a negative effect on mouth opening range; however, the capacity of mouth opening presents signs of recovery since the first post-operative week, with notable progression until one month after surgery.

Odontogenic cysts are benign non-neoplastic lesions that originate from epithelial cells Arachnida-Araneae) community in the process of the teeth development. Among them, the odontogenic keratocyst is a developmental cyst characterized by its epithelium of parakeratinized stratified and aggressive squamous cells as well as infiltrative behavior. Thus, the objective of this study was to describe a clinical case of surgical treatment of odontogenic keratocysts in a 52-year-old female patient, who presented for the treatment of a large lesion in a region of the left mandibular body and angle. After incisional biopsy and installation of a decompression device, the histopathological diagnosis of odontogenic keratocyst was obtained. Subsequently to a period of 9 months with the decompression device in place, a decrease of the lesion was noticed, thus allowing intervention to be performed the excision of the lesion. Thus, the patient was subjected, under general anesthesia, to enucleation of the lesion as the main treatment, with complementary maneuvers of peripheral ostectomy and application of Carnoy solution over the remaining bone bed. After an outpatient follow-up of 16 months, no signs of recurrence of the lesion were observed. The proposed treatment was efficient in removing the keratocyst with minimal surgical morbidities. In conclusion, the treatment protocol was effective and conservative in the surgical management of the lesion, allowing rapid recovery and return of the  function.       Keywords: Bone Cysts. Decompression. Dental Care. ResumoCistos odontogênicos são lesões benignas não-neoplásicas que tem por origem células remanescentes epiteliais do processo de formação do órgão dental. Dentre elas, o queratocisto odontogênico é um cisto de desenvolvimento caracterizado por seu epitélio de células escamosas estratificadas paraqueratinizadas, pelo comportamento agressivo e infiltrativo. Sendo assim, o objetivo desse estudo foi descrever um caso clínico de tratamento cirúrgico do queratocisto odontogênico em uma paciente do gênero feminino de 52 anos de idade, que compareceu para o tratamento de uma lesão de grande porte em região de corpo e ângulo mandibulares à esquerda. Após biópsia incisional e instalação de um dispositivo descompressivo, obteve-se o diagnóstico histopatológico de queratocisto odontogênico. Posteriormente a um período de 9 meses com o dispositivo de descompressão em posição, notou-se uma diminuição da lesão, permitindo assim a execução de intervenção para exérese da lesão. Assim, a paciente foi submetida, sob anestesia geral, à enucleação da lesão como tratamento principal, com manobras complementares de ostectomia periférica e aplicação de solução de Carnoy sobre o leito ósseo remanescente. Após um acompanhamento ambulatorial de 16 meses, não foi observado nenhum sinal de recorrência da lesão. O tratamento proposto foi eficiente em remover o queratocisto com as mínimas morbidades cirúrgicas. Concluindo, o protocolo de tratamento foi efetivo e conservador no manejo cirúrgico da lesão, permitindo rápida recuperação e retorno da função. Palavras-chave: Cistos Ósseos. Descompressão. Assistência Odontológica.