The brown tumor is a presentation of osteitis fibrosa cystica that represents a serious complication of renal osteodystrophy, mainly affecting the hands, feet, and craniofacial region. Secondary hyperparathyroidism is a common complication of chronic kidney failure. A clinical case of a 32-year-old woman with chronic kidney disease dependent on hemodialysis is presented, who was evaluated in 2018 for a palatal and vertebral tumor, later did not attend controls and was reassessed in 2020, where it was evidenced the development of secondary hyperparathyroidism and brown tumor in the calvarium, vertebra at the C7 level, maxilla and mandible, diagnosis confirmed by incisional biopsy together with clinical history, radiographic and laboratory tests that included serum levels of calcium, alkaline phosphatase, parathyroid hormone and phosphorus.

Facial trauma (FT) due to vehicular accident is considered worldwide as a high impact event. The World Health Organization (WHO) in 2013, reports that every year 50 million people suffer from trauma due to a vehicle accident. The objective is to determine the prevalence of FT due to vehicular accident with the data obtained in the main hospitals of the larges population cities in Ecuador and carry out an epidemiological framework in 2017 Were included 762 patients with facial trauma admitted to the emergency area of the 11 most representative hospitals in 8 Cities of Ecuador in 2017. The prevalence of Facial trauma in Ecuador was 3%. There was a predominance o male with 77.60%. Regarding the age, young adults (20-44 years) with 61.81% was the most prevalent. According to the type of vehicle, there was a predominance in cars with 58%. The upper third was the most affected with 46%. In conclusion, Ecuador needs to take measures to strengthen road safety in order to create strategies to reduce current statistics and avoid this seriou problem that entails serious injuries, disability or even death.

Two anatomical structures are described in the nasolabial angle: the anterior nasal spine and the depressor septi nasi muscle, which maintain a certain ba- lance between them. Changes of its morphology cause unsightly situations. Between January 2014 and December 2018, of the 200 patients was submitted to rhinoplasty, 79 of them had variations in the nasolabial angle, which were classified into three grades. As results, 50% (n = 39) was in the level 1, 40% (n=32) in the level 2 and 10% (n = 8) in the level 3. Surgeries were performed with specific technique for each group. The surgery focused on the anterior nasal spine and the depressor septi nasi muscle. Aesthetic ba- lance was recovered in the nasolabial angle.

Craniofacial profile, maxilla-mandibular relations, dento- alveolar bone discrepancies, skeletal maturation and dental asymmetries are important elements of an orthodontic and orthognathic diagnosis and treatment planning. For proper position and angulation of teeth, orthognathic surgery aims to correct dental crowding, spacing, misalignment and rotations of teeth, via tooth/teeth extractions for example, as part of the umbrella orthodontic and orthognathic interventional treatment plan. Indeed, exodontia is often needed to relieve moderate to severe crowding (arch- length discrepancies) and create the needed space for the proper alignment of the dentition and eventual functional occlusion. Herein, first and second premolar extractions are often prescribed, preferably when other methods have been exhausted. Yet the discussion regarding the use of premolar extractions is not whether exodontia should be performed, yet rather what malocclusion class, tooth-size and tooth-space discrepancy (including bi- maxillary protrusion and severe crowding in maxilla and mandible) indicate premolar extractions, when the intervention should be done, and whether to extract the first or second premolar. Therefore, in this article we highlight the premolar exodontia considerations for orthodontic and orthognathic treatment planning (pre-treatment) via discussing the basic mechanics and advantages of intra-/inter-arch movements. This is followed by presenting clinical cases exhibiting the incorporation of premolar extractions in (a) pre-surgical orthodontic treatment; (b) surgical plan and intervention; and (c) post-surgical outcome and prognosis. Alternative techniques and treatment options useful in tackling skeletal and dental malocclusion, including lateral body and sub-apical osteotomy(ies), that might consider integrating first and second premolar extractions, are also presented, herein.

The aim of the classic transcutaneous lower blepharoplasty was to eliminate the herniated lower fat packages; however, fat removal can generate a sunken or cadaverous-looking eye and, in turn, the transcutaneous approach is associated with a higher rate of retractile-type scarring complications. The transconjunctival approach with the fat pad transposition technique has been our technique of choice in the surgical treatment of aging in the lower eyelid. Indications,

The craniofacial structures are most crucial aspect of a person's appearance from an aesthetic standpoint even in children too. Defects in this area cause visible malformations in patients, which are both physically and psychologically damaging. Although advances in grafting and tissue transfer procedures have improved surgical outcomes, we still have limitations in our ability to entirely regenerate missing or faulty tissue. Tissue engineering therapies based on the supporting action of biomaterials combined with the synergistic action of osteo-inductive chemicals and recruited stem cells that can be driven to the process of bone regeneration have emerged. The goal of this narrative review is to highlight the approaches for reconstructing craniofacial bone deformities for child patients.

According to the American Academy of Cranio-Maxillo-Facial Surgeons (AACMFS: American Academy of Cranio-Maxillo-Facial Surgeons, visit: https:/ /aacmfs.org/), reconstructive surgery implies surgery that seeks to rebuild, restore, or return to normality the hard and soft tissues of the cranio-maxillo-facial region that have become abnormal, dysfunctional or deformed due to an event. This event may be caused by trauma, tumor resection, or the result of a disease process. Cranio- maxillo-facial reconstructive surgery (including oral and dental) returns almost to normal those tissues and structures/body parts that were previously within the normal range, before the event. This contrasts with aesthetic and cosmetic surgery, for example, which seeks to improve an already normal facial or body appearance (also performed by some cranio-maxillo-facial surgeons). Therefore, reconstructive surgery is an integral part of cranio-maxillo-facial surgery and encompasses a wide range of interventional surgical procedures. Here, to rehabilitate patients with bone defects of critical size, for example, surgical reconstructions are required. However, surgical techniques are not enough. Successful bone reconstruction in the oral and maxillofacial region, using modern bone tissue engineering techniques, is applicable but requires innovative future research focusing on cells, grafts, growth factors, signaling pathways, and defect improvement. , as well as the vascularization of the graft. This brief communication attempts to provide some critical insights, highlighting recent advances, challenges and opportunities for research, development and innovation in this ever-growing and impactful area (quality of life) with a focus on system engineering. craniofacial bone tissue.

Ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor with a high prevalence in the first decade of life. It has a predilection for the male sex and is frequently located in the posterior area of the mandible. We present the case of a 6 year old boy who during his routine dental care was found to have a radiographic finding in the left mandibular angle, a lesion with defined limits and mixed density containing tooth germ 3.7, clinically with a discrete increase in left hemifacial volume, normal mucosa and asymptomatic. Surgical intervention was performed according to clinical and radiographic criteria, under diagnostic hypothesis of AFO, performing complete excision of the lesion, germ extraction and curettage of the area. The histopathological diagno- sis showed ameloblastic fibro-odontoma, without ruling out the possibility of being an odontoma in formation. The controversy of this entity and its current classification is discussed, because it is considered by some authors as an ameloblastic fibro-odontoma, by others as an odontoma in formation or a transition of both. The importance of periodic check-ups associated with it is also emphasized.

Most dentomaxillary abnormalities (DMA) are produced or favored by harmful oral habits (HOH), altering the neuromuscular balance. Myofunctional therapy (OMT) has been suggested as an adjunctive therapy, so this research focuses on the effect of OMT in DMA and to know the effect of orofacial myofunctional therapy (OMT) in children with HOH and its influence in development of dentomaxillary anomalies. A research in five databases was performed (Scopus, Pubmed, Cochrane, Scielo and EBSCO) with language restrictions (English, Portuguese, Spanish). Publications between January 2010 to June 2020 were included. From an initial search of 676 articles, 14 studies were selected according to the inclusion criteria, which showed changes in patients who received myofunctional therapy in the resolution of DMA. 85% of the selected publications reported positive changes to eliminate the harmful oral habits using orofacial myofunctional therapy. 42% of these studies reported a decrease in the recurrence of craniofacial alterations through myofunctional therapy. OMT is effective for patients with atypical swallowing and lingual interposition. However, HOH such as oral breathing, finger sucking, amongst others, had no conclusive statements, as the level of evidence obtained regarding these HOH was moderate, in addition to constituting a limited number of publications related to this topic.

The aim was to summarize the evidence on the effectiveness and safety of platelet-rich fibrin (PRF) use for patients undergoing third molar surgery. Eligible studies were randomized controlled trials (RCT) that evaluated the use of PRF in third molar surgery. Searches in CENTRAL, MEDLINE, Embase, LILACS, the International Clinical Trials Registry Platform, ClinicalTrials.gov and grey literature were performed. Two reviewers evaluated potentially eligible studies and extracted data. We performed meta-analyses using random-effect models and assessed overall certainty using GRADE. Search strategy yielded 134 studies. We included 28 RCTs, 24 were assessed quantitatively. Overall risk of bias was low for 10,4 % of the outcomes. Recent RCTs generated pooled statistically significant results for the use of PRF in: alveolar osteitis (RR=0.39, IC95 % 0.21 to 0.72); postoperative pain day 1 (SMD=1.19, 95 %CI 1.89 to 0.48) and day 3 (SMD=1.31, 95 %CI 2.07 to 0.55); soft tissue healing day 7 (SMD=0.17, 95 %CI 1.61 to 1.27); oedema day 3 (SMD=1.95, 95 %CI 3.45 to 0.45); and wound infection (RR=0.29, 95 %CI 0.06 to 1.37). Contrasting previous reviews, PRF benefited bone healing at month 2 (SMD=5, 95 %CI 1.02 to 8.98). Certainty of evidence increased from previous reviews to moderate for alveolar osteitis and pain day 3. All other outcomes remained with low and very low confidence in results, thus, the use of PRF may result in little to no difference for these. No adverse events were reported. Recent RCTs have improved the precision and potency of previous reviews’ results, increasing their certainty. PRF likely reduces the risk of alveolar osteitis and pain at day 3 after third molar surgery. Regarding oedema, trismus, infection, soft tissue and bone healing, certainty of evidence remains very uncertain due to small samples and high or unclear risk of bias. Thus, further well-designed RCTs are needed to confirm and expand these results.