Introduction: The principle of piezosurgery is electrification by pressure. When electrical voltage is applied to certain materials, such as quartz and Rochelle salts, it causes the materials to expand and contract, producing ultrasonic vibrations. This device uses ultrasonic vibrations of 60-210μm/s at 24-36kHz to selectively remove bone, with minimal damage to soft tissue such as blood vessels and nerves. It also provides excellent visibility due to its cavitation effect. Piezosurgery uses low-frequency ultrasonic vibration for osteotomies, minimizing the risk of damage to soft tissues (nerves, vessels and mucosa). Micrometric vibration ensures precise cutting action and allows operational control, increasing safety in anatomical areas that are difficult to access. Objective: The objective of this article is to present an ultrasonic tip geometry capable of providing a smaller contact area, less effort, reduced heat generation, faster cutting and shorter surgical time.

Introdução: Os lipomas são tumores benignos compostos por tecido adiposo maduro, sendo os tumores mesenquimais mais comuns.Este artigo objetiva apresentar os aspectos clínicos, diagnósticos e terapêuticos dessas lesões, com base em um relato de caso clínico. Metodologia: elaborado conforme o CARE Statement, baseado em análise retrospectiva de dados clínicos e exames, com consentimento do paciente e aprovação ética segundo a Declaração de Helsinque e a Resolução CNS nº 466/2012. Relato de Caso: Um paciente masculino, de 51 anos, procurou atendimento com queixa de aumento de volume na região bucal esquerda, com lesão localizada no masseter esquerdo. A ultrassonografia indicou um nódulo com características sugestivas de lipoma. A hipótese diagnóstica foi confirmada por biópsia excisional, que revelou a presença de lipoma. A excisão cirúrgica foi realizada com sucesso, sem complicações no pós-operatório. Discussão: Apesar de sua raridade na face, os lipomas tem apresentação clínica clássica com crescimento lento, indolor e móvel. A localização em áreas profundas ou adjacentes a estruturas nobres pode dificultar a identificação precoce. O diagnóstico clínico, quando combinado com exames de imagem, é essencial para o planejamento cirúrgico. A tomografia e a ultrassonografia, como neste caso, são fundamentais para caracterizar as lesões. A excisão completa é o tratamento de escolha, com baixos índices de recorrência. Conclusão: A avaliação clínica minuciosa, aliada ao uso de exames complementares e uma abordagem cirúrgica bem planejada, é fundamental para o sucesso do tratamento. A excisão completa do lipoma garante um prognóstico favorável, com mínima chance de recorrência.

Introdução: O neurofibroma é um tumor benigno de origem nas células de Schwann, com ocorrência rara na cavidade oral, especialmente no assoalho da língua. Sua identificação é importante devido às semelhanças com outras lesões submucosas e ao potencial comprometimento funcional. O presente artigo tem como objetivo apresentar um estudo de caso de Neurofibroma em assoalho de língua. Materiais e Métodos: Trata-se de um estudo de caso baseado na análise de prontuário, exames clínicos e histopatológicos. Os dados foram coletados no ambulatório de Cirurgia e Traumatologia Bucomaxilofacial do Conjunto Hospitalar de Sorocaba, mediante aprovação do Comitê de Ética e consentimento informado da paciente. Resultados: Paciente do sexo feminino, 51 anos, apresentou lesão bilateral no assoalho lingual, de aproximadamente 5 cm, fibrosa e pediculada. A biópsia incisional confirmou o diagnóstico de neurofibroma. Foi realizada excisão cirúrgica completa com sucesso, sem recidiva após seis meses de acompanhamento pós-operatório. Discussão: Apesar da raridade do neurofibroma no assoalho da língua, sua inclusão no diagnóstico diferencial é essencial. A confirmação por histopatologia e imunohistoquímica (proteína S-100 positiva) é indispensável. A excisão cirúrgica representa o tratamento de escolha, com baixos índices de recidiva e boa recuperação funcional. Conclusão: O diagnóstico precoce e a abordagem cirúrgica adequada são fundamentais para o controle do neurofibroma lingual. O caso reforça a importância da suspeição clínica e do seguimento multidisciplinar no manejo dessas lesões raras.

Background: The piezoelectric saw is a technology used in osteotomies, providing precise and minimally invasive cuts, especially in areas close to vital structures. Despite its advantages, limitations such as prolonged surgical time and restrictions in use for larger bones have motivated the development of ultrasonic tips with more efficient geometries. Methods: A laboratory trial was conducted with 40 ultrasonic tips (n = 40), divided into 2 groups: the test group (n = 20), with an ultrasonic tip featuring a multidirectional angular cutting-tooth geometry, and the control (n = 20), with a straight-tooth ultrasonic tip. Two operators performed standardized osteotomies on synthetic bone blocks, with monitoring of variables including cutting time (in seconds), maximum block and blade temperature (in °C), and bone mass loss (in grams). Sample randomization was block-based, and blade coding ensured operator and evaluator blinding. Results: The results showed a statistically significant reduction of approximately 26% in cutting time with the multidirectional ultrasonic tips (Test = 52.85 s; Control = 71.55 s; p < 0.001), regardless of the operator. No significant differences were observed between groups regarding maximum bone temperature (Test = 30.45 °C; Control = 29.40 °C; p = 0.337), blade temperature variation (Test = 5.30 °C; Control = 4.10 °C; p = 0.337), overall temperature variation (Test = −0.19 °C; Control = 0.06 °C; p = 0.285), or bone mass loss (Test = 0.1355 g; Control = 0.0350 g; p = 0.387). A significant interaction between operator and blade type in some variables, such as bone temperature variation (p = 0.001), reinforces the influence of technical experience on the results. Conclusions: The multidirectional angular geometry of the ultrasonic tip significantly improves cutting efficiency without compromising thermal safety, representing a promising advancement for optimizing osteotomies in surgical settings. The use of this new geometry may enhance productivity, particularly in complex procedures, and deserves future clinical investigation to expand its applicability across different surgical specialties, including orthopedics.

Objectives: The aim of this study was to compare the stiffness-related mechanical response and peak von Mises stress distribution of low-profile 2.4 mm mandibular reconstruction systems (a conventional reconstruction plate, a 3D grid-type plate, and a customized plate) in a virtual atrophic mandible model with a 5 cm segmental defect. Materials and Methods: A CT-based three-dimensional mandible model was created and instrumented with three plate configurations (G1–G3). Linear static finite element analyses were performed under a 300-N masticatory load combined with literature-based muscle force vectors. Peak von Mises stresses were recorded for plates and screws, and the locations of maximum stress concentration were identified. Results: Peak plate stress was highest in the conventional reconstruction plate (G1: 695.5 MPa), followed by the 3D grid-type plate (G2: 595.6 MPa), and lowest in the customized plate (G3: 185.2 MPa). The peak screw stress was 692.9 MPa (G1), 898.0 MPa (G2), and 595.6 MPa (G3). The 3D grid-type plate increased construct stiffness but shifted stress concentration toward the mandibular angle and adjacent screws, whereas the customized plate reduced the peak plate stress and limited the extent of the high-stress region across the defect. Conclusions: Within the limitations of a linear static FEA (stiffness/stress distribution rather than failure load or fatigue resistance), the customized plate (G3) demonstrated the most favorable biomechanical performance (lowest peak plate stress). The 3D grid-type plate (G2) reduced peak plate stress compared with the conventional design (G1) but produced the highest peak screw stress. Practical considerations such as manufacturing lead time and resource requirements may favor off-the-shelf plates; however, a formal cost or operative-time analysis was not performed.