Buccal fat pad removal to improve facial aesthetics : an established technique?

Buccal fat pad (BFP) is a singular structure between the facial muscles. Its removal may enhance the zygomatic prominences resulting in an inverted triangle of beauty. Objective: The aim of this study was to perform a systematic review of literature about BFP removal for facial aesthetic improvement. In order to answer the following research question: What are the indications, complication types and rates, surgical techniques and outcomes of the technique? The initial search in Pubmed, Scopus, and Cochrane databases recognized 220 articles. The final review included eight of them. None of the included studies were clinical trials. BPF removal was performed by intraoral incision or associated with the face lift procedure. In 71 patients submitted to the procedure and evaluated about complications, only 8.45% presented minor complications. Parotid duct and facial nerve injuries were not found. No study evaluated facial aging and long-term effects, therefore the harmless effect of the procedure to those features is not clear. Although it is not a novel procedure, there is a lack of information about long-term outcomes. Thus, controlled clinical studies should be performed to achieve adequate clinical evidence of those aspects

Effects of ionizing radiation on cortical bone microarchitecture: specific related alterations over time

Possui versão em CDFAPEMIG - Fundação de Amparo a Pesquisa do Estado de Minas GeraisTrabalho de Conclusão de Curso (Graduação)This study aimed to evaluate the cortical bone microarchitecture in rabbit tibias at intervals 7, 14 and 21 days after ionizing irradiation. Twelve adult male New Zealand rabbits were treated with a single radiation dose of 30Gy. The animals were randomly divided into 4 groups: Control (no radiation), Ir7, Ir14 and Ir21 days. Computadorized microtomography was used to analyze the microarchitecture of the cortical bone. The following parameters were used: cortical thickness (CtTh), bone volume (BV), total porosity (Ct.Po), intracortical porosity (CtPo (cl)), fractal dimension (FD) and degree of anisotropy (Ct.DA). One-way analysis of variance (ANOVA) was performed for all data followed by Tukey and Dunnet tests. The cortical thickness was different (p <0.01) between the control and irradiated groups, with thicker cortex to Ir 7 days. There was no difference between groups for total porosity, however, intracortical porosity revealed significance difference (p <0.001) between the irradiated groups and the control group, with a lower value for Ir7 days. The number of bone channels, fractal dimension and degree of anisotropy did not show significant difference between groups. The bone volume was lower in the Ir14 group in relation to control. In this way, the microarchitecture of the cortical bone can be affected by radiotherapy and the effects appear to be time-dependent. Cortical parameters found in the group Ir21 days were similar to the control group, suggesting that the cortical bone return to the regular conformation after 21 days

Addition of zirconium oxide to Biodentine increases radiopacity and does not alter its physicochemical and biological properties

Objectives: To evaluate the radiopacity of Biodentine (BD) and BD associated with 15% calcium tungstate (BDCaWO4) or zirconium oxide (BDZrO2), by using conventional and digital radiography systems, and their physicochemical and biological properties. Materials and Methods: Radiopacity was evaluated by taking radiographs of cement specimens (n=8) using occlusal film, photostimulable phosphor plates or digital sensors. Solubility, setting time, pH, cytocompatibility and osteogenic potential were also evaluated. Data were analyzed using one-way ANOVA and Tukey post-test or two-way ANOVA and Bonferroni post-test (α=0.05). Results: BD radiopacity was lower than 3 mm Al, while BD ZrO2 and BD CaWO4 radiopacity was higher than 3 mm Al in all radiography systems. The cements showed low solubility, except for BDCaWO4. All cements showed alkaline pH and setting time lower than 34 minutes. MTT and NR assays revealed that cements had greater or similar cytocompatibility in comparison with control. The ALP activity in all groups was similar or greater than the control. All cements induced greater production of mineralized nodules than control. Conclusions: Addition of 15% ZrO2 or CaWO4 was sufficient to increase the radiopacity of BD to values higher than 3 mm Al. BD associated with radiopacifiers showed suitable properties of setting time, pH and solubility, except for BDCaWO4, which showed the highest solubility. All cements had cytocompatibility and potential to induce mineralization in Saos-2 cells. The results showed that adding 15% ZrO2 increases the radiopacity of BD, allowing its radiography detection without altering its physicochemical and biological properties

Biomateriais a base de quitosana na correção de defeitos ósseos críticos criados em calvaria de ratos: avaliação radiográfica

OBJETIVO: Este estudo avaliou através de imagens radiográficas digitais, a ação de biomateriais de quitosana e de cloridrato de quitosana, com baixo e alto peso molecular, utilizados na correção de defeitos ósseos de tamanho crítico (DOTC)em calvária de ratos. MATERIAL E MÉTODO: DOTCs com 8 mm de diâmetro foram criados cirurgicamente na calvária de 50 ratos Holtzman. Em 10 animais o defeito foi preenchido foram preenchidos com coágulo sanguíneo (controle negativo). Os 40 animais restantes foram divididos de acordo com o biomaterial utilizado no preenchimento do defeito (quitosana de baixo peso e de alto peso molecular, e cloridrato de quitosana de baixo e de alto peso molecular), e foram avaliados em dois períodos experimentais (15 e 60 dias), totalizando 5 animais/biomaterial/período de avaliação. RESULTADO: A avaliação radiográfica foi feita utilizando duas radiografias digitais do crânio do animal: uma tomada logo após o defeito ósseo ser criado e a outra no momento do sacrifício. Nessas imagens, foi avaliada a densidade óssea radiográfica inicial e a final na área do defeito, que foram comparadas. As análises na densidade óssea radiográfica indicaram aumento da densidade óssea radiográfica dos DOTCs tratados para todos os biomateriais testados, em ambos os períodos. Resultados semelhantes foram encontrados no grupo controle. CONCLUSÃO: Conclui-se que os biomateriais de quitosana testados não foram capazes de aumentar a densidade radiográfica em DOTC realizados em calvária de ratos

Solubility and bacterial sealing ability of MTA and root-end filling materials

Objective To evaluate solubility and sealing ability of Mineral Trioxide Aggregate (MTA) and root-end filling materials. Material and Methods The materials evaluated were: MTA, Calcium Silicate Cement with zirconium oxide (CSC/ZrO2), and zinc oxide/eugenol (ZOE). Solubility test was performed according to ANSI/ADA. The difference between initial and final mass of the materials was analyzed after immersion in distilled water for 7 and 30 days. Retrograde cavities in human teeth with single straight root canal were performed by using ultrasonic tip CVD 9.5107-8. The cavities were filled with the evaluated materials to evaluate sealing ability using the bacterial leakage test with Enterococcus faecalis. Bacterial leakage was evaluated every 24 hours for six weeks observing the turbidity of Brain Heart infusion (BHI) medium in contact with root apex. Data were submitted to ANOVA followed by Tukey tests (solubility), and Kruskal-Wallis and Dunn tests (sealing ability) at a 5% significance level. Results For the 7-day period, ZOE presented highest solubility when compared with the other groups (

Analysis of bone dimensional stability after two-stage maxillary sinus floor augmentation with autogenous bone versus bovine bone mineral combined with autogenous bone chips:results from a 1-year multicenter split-mouth randomized controlled trial

Objective: To compare the dimensional stability of augmented bone following maxillary sinus floor augmentation (MSFA) using autogenous bone (AB) alone or bovine bone mineral combined with locally harvested AB chips (BBM), one year after implant loading. Material and methods: A secondary analysis of a split-mouth, multicenter randomized controlled trial was conducted among 20 patients (40 implants). CBCT/CTs were used to measure bone height (buccal and palatal aspects) and bone area at the implant center at two time points: before implant placement (4–6 months post-MSFA, T1) and 12 months post-implant loading (T2). Residual bone height and sinus width at 1, 5, and 10 mm from the crest were also recorded. Linear regression models with generalized estimating equations were used to assess the influence of graft material (AB and BBM), initial graft dimensions and sinus width on dimensional changes. Results: Adjusted regression models showed that AB-treated sites experienced significantly greater reductions in graft height (mean difference at buccal sites: -1.76 mm [95 % CI, -0.86 to -2.65]; p-value = &lt;0.001); mean difference at palatal sites: -1.82 mm [95 % CI -0.75 to -2.88]; p = 0.001; and bone area (mean difference –17.80 mm² [95 % CI –6.61 to –28.99]; p = 0.002) compared to BBM. Greater initial graft height and area were associated with reduced dimensional changes (p &lt; 0.001) especially when using BBM. Sinus width, measured 10 mm from the crest, was modestly but significantly associated with changes in bone height (p = 0.020), but not with changes in bone area (p = 0.147). Conclusion: MSFA using BBM combined with autogenous bone chips resulted in greater dimensional stability compared to AB alone. Clinical implications: BBM combined with autogenous bone chips better preserved graft dimensions than AB alone.</p

Immediate loading over lower prosthesis in edentulous mandibles: comparison between two types of prosthetic connection

ABSTRACT Objective: This study evaluated two implant-abutment connection systems under immediate loading of lower prosthesis in edentulous mandibles. Methods: Seventy-two implants placed in 18 patients were analyzed. The parameters evaluated included probing depth, stability of implants and perimplant bone loss, which were measured immediately when installing the prosthesis and after 3 and 6 months. All data underwent statistical analysis (T-Test and ANOVA, 5% significance level). Results: Implants with Morse cone connections showed smaller, statistically significant probing depth values for all periods (0.68/1.19/1.31), when compared to the external hexagon connections (1.08/1.52/1.64). A statistically significant difference was observed between baseline, 3 months (p&lt;0.01 for Morse cone; p&lt;0.001 for external hexagon) and 6 months (p&lt;0.001 for both connections). When periods were considered there was a statistically significant difference in Implant Stability Quotient ISQ values between baseline and 6 months for both prosthetic connections. Conclusion: Immediate loading of the lower prosthesis is a viable option for the treatment of edentulous mandibles and that the external hexagon or Morse cone connections do not interfere with the success of the implants in a short-term evaluation.</jats:p

Dentale Magnetresonanztomo-graphie: Praxisnahe Fallbei-spieleund Bewertung von Vor-und Nachteilen in der Zahnme-dizin und Mund-, Kiefer-und Gesichtschirurgie

Dental magnetic resonance imaging (MRI) has long been perceived as overly complex, costly, and limited in availability. Despite the numerous advantages of this radiation-free, non-invasive procedure for soft tissue diagnostics in the head and neck region, its imaging capabilities for hard tissue, such as bones and teeth, have thus far remained limited in comparison to conventional X-ray technology. In recent years, however, technological advances have led to a notable enhancement in the image quality and the range of applications of dental MRI. This article presents a comprehensive review of the current literature on the utilization of dental MRI for dentomaxillofacial conditions. The article focusses on novel MRI protocols that have been specifically developed to address the inherent challenges associated with imaging the head and neck region. It also considers the latest technological advances, including innovative coils and the use of low and high-field MR systems. The practical case studies are from the fields of conservative dentistry, prosthodontics, orthodontics, oral surgery, and maxillofacial surgery, demonstrating the theoretical concepts and emphasizing the clinical advantages of dental MRI. In conclusion, dental MRI can be a valuable complement to and, in certain cases, a true alternative to X-ray-based procedures

Effect of an acid diet allied to sonic toothbrushing on root dentin permeability: an in vitro study

This study quantified alterations in root dentin permeability after exposure to different acid beverages. Twenty-five third molars were sectioned below the cementoenamel junction, the root segment was collected, and the pulp tissue was removed. The root segments were connected to a hydraulic pressure apparatus to measure the permeability of root dentin after the following sequential steps, with 5 specimens in each: 1) phosphoric acid etching for 30 s (maximum permeability), 2) root planning to create new smear layer, 3) exposure to different acid substances for 5 min (orange, cola drink, vinegar, white wine, lemon juice), 4) toothbrushing with sonic toothbrush for 3 min, 5) toothbrushing with sonic toothbrush plus dentifrice for 3 min. Considering step I as 100%, the data were converted into percentage and each specimen was its own control. Data were analyzed statistically by Kruskal-Wallis and Dunn's post test at 5% significance level. All acidic substances increased dentin permeability significantly after scraping (p<0.05). Toothbrushing after exposure to acid substances decreased dentin permeability and the association with dentifrice accentuated the decrease (p<0.05), except for the specimens treated with cola drink. Thus, it may be concluded that all tested acid fruit juices increased dentin permeability, and toothbrushing with or without dentifrice can decrease root dentin permeability after dentin exposure to acid diet.Department of Oral Diagnosis and Surgery Araraquara Dental School São Paulo State University, Araraquara, SPDepartment of Oral Diagnosis and Surgery Araraquara Dental School São Paulo State University, Araraquara, S