RESUMO
Mandibular trauma is a common problem encountered by the craniofacial surgeon. Fractures in the edentulous mandible represent only 3% of these injuries, and optimal management is controversial. This problem is further compounded by malunion and malocclusion when fracture lines heal in incorrect positions. Even with recent advances in imaging and hardware systems, they remain difficult problems that often require multiple operations to obtain satisfactory results. We present a 69-year-old man with an edentulous mandibular fracture and concomitant malocclusion after a series of unsuccessful operations. By using computer-assisted design and manufacturing technology, we were able to plan osteotomies for correct anatomic positioning, which restored dental occlusion and facial aesthetics. A follow-up at 6 months postoperatively revealed a stable and anatomic reconstruction.
Assuntos
Desenho Assistido por Computador , Fraturas Mal-Unidas/cirurgia , Arcada Edêntula , Fraturas Mandibulares/cirurgia , Reconstrução Mandibular/métodos , Acidentes por Quedas , Idoso , Fraturas Mal-Unidas/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Arcada Edêntula/diagnóstico por imagem , Arcada Edêntula/cirurgia , Masculino , Fraturas Mandibulares/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Healthcare has a major impact on climate change, and surgery is among the most energy-intensive hospital practices. Although most Americans believe climate change is happening, little is known regarding public awareness of the impact of healthcare on climate change and how this may impact perceptions of plastic surgery. Methods: A cross-sectional survey was administered to adults in the United States using Amazon Mechanical Turk in December 2021 to assess public perceptions of climate change, healthcare, and plastic surgery. Incomplete responses were excluded from analysis. Multivariable logistic regression models were used to determine predictors of responses. Results: There were 890 complete responses. Most participants strongly agreed or agreed that climate change is happening (89%). Fewer believed that healthcare has an impact on climate change (62%), with greater odds among respondents with an associate's degree or higher (odds ratio 2.8, P < 0.001). After they were given information about the impact of healthcare on climate change, most respondents were more worried about the effects of cosmetic plastic surgery (64%). Many respondents would be willing to engage in personal climate change mitigation measures if undergoing surgery and pay higher professional fees to support sustainable hospital practices. Conclusions: Most Americans believe climate change is happening, but fewer believe healthcare has an impact on climate change. Knowledge regarding the impact of healthcare and surgery on climate change may make patients more worried about the effects of plastic surgery on climate change, but patients may be willing to personally mitigate climate impacts of surgery.