A perda óssea após a extração dentária representa um grande desafio para a odontologia, sobretudo em casos de limitações de quantidade óssea para a instalação de implantes e reabilitações protéticas, em razão da reabsorção significativa do rebordo alveolar. Estudos indicam que cerca de 60% da largura e 40% da altura do osso podem sofrer redução, nos primeiros seis meses pós-extração. Essa perda pode ser agravada por técnicas exodônticas traumáticas e fatores locais, o que tem impulsionado a busca por estratégias regenerativas, dentre elas destaca-se a Regeneração Óssea Guiada - ROG. Diante a importância do conhecimento sobre as ROGs, é objetivo deste estudo revisar a literatura acerca da eficácia da ROG na preservação das dimensões dos rebordos alveolares pós-extração, com ênfase nas paredes vestibulares e linguais. A abordagem da ROG envolve o uso de diversos materiais biocompatíveis, como o polipropileno, colágeno, dentre outros, os quais apresentam propriedades favoráveis à estabilização do coágulo e capacidade de osteopromoção, facilitando também a remodelação óssea. Para essa revisão, foram selecionados artigos científicos pesquisados nas bases PubMed, Scopus, Web of Science e Google Acadêmico, utilizando palavras-chave relacionadas à regeneração óssea e à utilização de barreiras ou membranas biocompatíveis, selecionando estudos que detalhassem métodos e resultados clínicos ou experimentais relevantes relacionados ao uso de membranas ou barreiras na preservação das dimensões do alvéolo pós-extração. A análise qualitativa dos dados evidenciou contribuições da ROG para a manutenção do rebordo alveolar e, consequentemente possibilitando um melhor leito para instalação de implantes e reabilitações protéticas. EFFICACY OF GUIDED BONE REGENERATION (GBR) IN PRESERVING THE VERTICAL AND HORIZONTAL DIMENSIONS OF ALVEOLAR RIDGES: INTEGRATIVE REVIEW ABSTRACT Bone loss following tooth extraction poses a major challenge for dentistry, particularly when limited bone volume restricts implant placement and prosthetic rehabilitation because of significant alveolar ridge resorption. Systematic reviews report that the crest may lose nearly half its original width and several millimetres of height within the first months after extraction. This loss can be aggravated by traumatic extraction techniques and local factors, prompting the development of regenerative strategies such as Guided Bone Regeneration (GBR). This study aimed to review the literature on the efficacy of GBR in preserving the vertical and horizontal dimensions of post‑extraction alveolar ridges, with emphasis on the buccal and lingual walls. GBR uses barrier membranes to maintain the blood clot and prevent soft‑tissue invasion; biocompatible materials such as polypropylene and collagen membranes show clot‑stabilising and osteopromotive properties. For this review, scientific articles were retrieved from PubMed, Scopus, Web of Science and Google Scholar using keywords related to bone regeneration and the use of biocompatible barriers or membranes; studies detailing relevant clinical or experimental methods and results on alveolar socket preservation were selected. Qualitative analysis of the data demonstrated that GBR contributes to maintaining the alveolar ridge, thus creating a better bed for implant placement and prosthetic rehabilitation. Keywords: preservation; membrane; barrier; alveolus.

Os medicamentos anticoagulantes desempenham um papel fundamental no tratamento de diversas condições associadas ao risco trombótico, como doença arterial coronariana e trombose venosa, embora seu principal efeito adverso seja o risco de hemorragia. Neste estudo, foi focalizada a avaliação de várias medicações anticoagulantes, incluindo ácido acetilsalicílico (Aspirina®, Tromalyt®), clopidogrel (Plavix®, Iscover®), antagonistas da vitamina K como Varfarina (Varfarine®, Marevan®), e NOACs como Dabigatrana (Pradaxa®), Rivaroxabana (Xarelto®), Edoxabana (Lixiana®) e Apixabana (Eliquis®). Foi destacada a importância do planejamento individualizado no tratamento odontológico desses pacientes.O objetivo deste estudo foi apresentar protocolos seguros disponíveis para o manejo odontológico de pacientes em uso de anticoagulantes orais. Foi realizada uma revisão de literatura integrativa, selecionando criteriosamente artigos nacionais e internacionais para analisar a influência desses medicamentos em procedimentos cirúrgicos orais. Foram encontradas divergências entre os autores, alguns sugerindo que a suspensão da medicação não é viável devido aos riscos, enquanto outros enfatizam a abordagem individualizada, suspendendo a medicação caso necessário, em conjunto com o médico. Concluiu-se que o número de pacientes em uso de anticoagulantes está em ascensão e, portanto, é crucial que os cirurgiões-dentistas estejam preparados para fornecer atendimento seguro, minimizando assim o risco de complicações hemorrágicas. Anticoagulant medications play a fundamental role in the treatment of several conditions associated with thrombotic risk, such as coronary artery disease and venous thrombosis, although their main adverse effect is the risk of hemorrhage. In this study, we focused on the evaluation of several anticoagulant medications, including acetylsalicylic acid (Aspirin®, Tromalyt®), clopidogrel (Plavix®, Iscover®), vitamin K antagonists such as Warfarin (Warfarine®, Marevan®), and NOACs such as Dabigatran (Pradaxa®), Rivaroxaban (Xarelto®), Edoxaban (Lixiana®) and Apixaban (Eliquis®). The importance of individualized planning in the dental treatment of these patients was highlighted. The objective of this study was to present safe protocols available for the dental management of patients using oral anticoagulants. An integrative literature review was carried out, carefully selecting national and international articles to analyze the influence of these medications on oral surgical procedures. Disagreements were found between authors, with some suggesting that suspending medication is not feasible due to the risks, while others emphasize an individualized approach, suspending medication if necessary, together with the doctor. It was concluded that the number of patients using anticoagulants is on the rise and, therefore, it is crucial that dental surgeons are prepared to provide safe care, thus minimizing the risk of bleeding complications. Los medicamentos anticoagulantes juegan un papel fundamental en el tratamiento de varias afecciones asociadas al riesgo trombótico, como la enfermedad arterial coronaria y la trombosis venosa, aunque su principal efecto adverso es el riesgo de hemorragia. En este estudio, nos centramos en la evaluación de varios medicamentos anticoagulantes, incluido el ácido acetilsalicílico (Aspirin®, Tromalyt®), clopidogrel (Plavix®, Iscover®), antagonistas de la vitamina K como warfarina (Warfarine®, Marevan®) y NOAC. como Dabigatrán (Pradaxa®), Rivaroxaban (Xarelto®), Edoxaban (Lixiana®) y Apixaban (Eliquis®). Se destacó la importancia de la planificación individualizada en el tratamiento odontológico de estos pacientes, el objetivo de este estudio fue presentar protocolos seguros disponibles para el manejo odontológico de pacientes que utilizan anticoagulantes orales. Se realizó una revisión integradora de la literatura, seleccionando cuidadosamente artículos nacionales e internacionales para analizar la influencia de estos medicamentos en los procedimientos quirúrgicos bucales. Se encontraron desacuerdos entre los autores, algunos sugieren que suspender la medicación no es factible debido a los riesgos, mientras que otros enfatizan un enfoque individualizado, suspendiendo la medicación si es necesario, junto con el médico. Se concluyó que el número de pacientes que utilizan anticoagulantes está en aumento y, por lo tanto, es crucial que los cirujanos dentistas estén preparados para brindar una atención segura, minimizando así el riesgo de complicaciones hemorrágicas.

Background: Bleeding control is considered one of the general foundations of any surgical procedure, including tooth extractions. In this scenario, hemostasis can be achieved using collagen membranes and sponges. Lumina Coat® collagen membrane, made of freeze-dried bovine type-1 collagen, and Hemospon® sponge, made of freeze-dried porcine gelatine, both absorbable, are widely used in dentis-try and have been scientifically proven to help with post-extraction hemostasis. Objective: This prospective split-mouth clinical study aimed to compare and describe the bleeding, soft tissue healing, and pain control after tooth extractions using the Lumina Coat® membrane or the Hemospon® sponge. Methods: Thirty-two alveoli were included in this study. After the extractions, the sockets were filled with two types of material: Hemospon® collagen sponge (control group) and Lumina Coat® collagen membrane (test group). The participants were assessed after 30 minutes, 24, and 48 hours to examine the bleeding and then instructed to return after 7 days for clinical assessment of soft tissue healing and suture removal. The appraisal of the soft tissue healing and bleeding used scores from 0 to 3; pain control was assessed using the VAS pain analog scale. The data obtained was expressed as the mean and standard deviation. The data was analyzed using Prism 9 (GraphPad software). Results: In the more extended postoperative period, the pain scores were lower in both groups. The initial scores for the Lumina Coat group were 2.20, while the Hemospon group had an average score of 2.80. At 7 days, both groups had an average score of 0.25 (p>0.05). The bleeding scores were higher in both groups in the early postoperative periods; Lumina Coat group had an average bleeding score of 1.35, whereas the Hemospon group had an average score of 1.65, and went through a reduction until the 24 hours, evolving to complete cessation of bleeding after this period. There was a statistically significant difference between the Lumina Coat group (average 0.75) and Hemospon (average 1.20) at 30 minutes post-operatively, where a significant decrease in the bleeding score was observed in the Lumina Coat group. Both groups' healing scores were higher in the initial postoperative period, reducing after 7 days. There was a statistically significant difference between the Lumina Coat group (average 0.35) and Hemospon (average 0.80) at 2 days post-operatively, where a significant decrease in the healing score was observed in the Lumina Coat group. Conclusion: Both materials were effective for controlling pain, bleeding, and providing soft tissue healing. However, the Lumina Coat group had positive results compared to Hemospon in reducing bleeding and healing scores.

The growing demand for implant-supported rehabilitative prosthetic treatments has reinforced the need to optimize biomechanical performance, particularly regarding force distribution. This study aimed to evaluate the stress distribution generated by different configurations of full-arch implant-supported prostheses using three-dimensional finite element analysis. Two mandibular models were created using SolidWorks 2010 (SolidWorks Corp., Waltham, MA, USA) and Rhinoceros^® 3D 4.0 (NURBS Modeling for Windows, USA). Each model represented a mandible restored with a full-arch fixed prosthesis supported by external hex implants (4.0 × 13.0 mm; Master, Conexão Sistemas de Prótese, São Paulo, Brazil) placed in the interforaminal region, differing only in implant angulation. Model 1 included four implants positioned perpendicular to the alveolar ridge, whereas Model 2 represented the All-on-Four configuration with distal implants tilted at 30°. The prosthesis was modeled in acrylic resin with a NiCr metal framework. The geometries were exported to FEMAP 11.0 for mesh generation. Axial loading of 300 N was applied bilaterally (75 N per tooth), and oblique loading of 150 N was applied unilaterally (75 N per tooth) on the first premolars and first molars. Obtained using NEiNastran^® 9.2 showed that the tilted-implant model exhibited higher stress concentrations under both loading conditions. The All-on-Four configuration generated the highest stress levels, particularly around the distal implants. The null hypothesis of this study was that there would be no difference in stress distribution among full-arch implant-supported prostheses supported by straight implants and those rehabilitated according to the All-on-Four concept with tilted distal implants.

A implantodontia moderna vem sendo marcada pela busca de soluções cada vez mais personalizadas e biomiméticas, capazes de aliar previsibilidade funcional e excelência estética. Nesse contexto, os implantes root-analogue (RAI) emergem como alternativa inovadora, uma vez que replicam fielmente a morfologia radicular natural e permitem instalação imediata após a exodontia, com o objetivo de preservar a arquitetura alveolar e os tecidos moles peri-implantares. O presente trabalho apresenta uma revisão narrativa de literatura baseada em dezessete artigos publicados entre 2004 e 2025, que exploram desde aplicações clínicas iniciais até o desenvolvimento de novas tecnologias digitais e biomateriais aplicados à implantodontia personalizada. Os estudos analisados destacam avanços relevantes no uso de sistemas CAD/CAM, impressão 3D e materiais como titânio, zircônia, PEEK e policaprolactona, evidenciando que a personalização é uma tendência irreversível na área. Embora as taxas de sobrevivência dos RAI relatadas em curto prazo sejam encorajadoras, as evidências disponíveis ainda se concentram em séries de casos e acompanhamentos limitados, carecendo de ensaios clínicos robustos e de longo prazo. Conclui-se que os implantes root-analogue apresentam grande potencial clínico e estético, mas permanecem em caráter experimental, devendo sua ampla incorporação à prática clínica depender da consolidação científica futura.

Mandibular fractures are among the most common injuries in maxillofacial trauma, generally associated with high-energy accidents, such as motorcycle accidents. Due to its anatomical position and mobility, the mandible is particularly susceptible to direct impacts. The diagnosis of these fractures is based on clinical evaluation combined with imaging studies, with computed tomography (CT) being the gold standard. Treatment varies according to the complexity of the case, with open reduction and internal fixation being widely used because it provides stability and early functional recovery. The aim of this study is to report on a clinical case of a right mandibular angle fracture resulting from a motorcycle accident. A 25-year-old male patient presented with pain, limited mouth opening, edema, and malocclusion. A CT scan confirmed the diagnosis. The surgical procedure was performed under general anesthesia, with reduction and internal fixation of the fracture using two 2.0-system titanium plates and screws, combined with intraoperative maxillomandibular block. The postoperative course was satisfactory, without complications, with progressive improvement in mandibular function. It is concluded that the surgical approach employed proved effective, promoting adequate bone stability and functional recovery, reinforcing its indication for mandibular fractures with displacement.