Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29.242
Filtrar
1.
Compend Contin Educ Dent ; 41(7): 384-386, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687383

RESUMO

The design and development of today's dental implants has been an evolving process based on scientific research, clinician input, and manufacturer ingenuity. Newer tapered implants with aggressive thread designs allow for placement at greater torque values than in the past, with high levels of initial stability even in situations with low-density or compromised bone. Modern implants are designed for patient cases involving extraction, immediate placement, and immediate load, as well as cases with less-than-ideal bone volume and quality. Contemporary implant body and platform design strongly considers minimizing bone trauma and crestal bone loss while maintaining gingival architecture. Even the most advanced implant design, however, can only function well when the implant is placed in healthy surrounding bone. Current thought leans toward the notion that implant bed preparation is as important as the implant itself. This article discusses the rationale behind the influence of these modern-day factors in immediate loading and aims to assist clinicians in decision making regarding appropriate selection of implants, instrumentation, and clinical procedures.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Gengiva , Humanos , Osteotomia , Torque
2.
Stomatologija ; 21(1): 28-32, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706344

RESUMO

Clear cell odontogenic carcinoma (CCOC) is an uncommon condition that has been considered malignant since 2005. The clinical presentation usually involves an asymptomatic swelling, which typically affects the anterior mandible in middle-aged women; it has neither clinical nor radiological defining features. Immunohistochemical analysis usually aids diagnosis, as clear cells are also associated with other clear cell carcinomas and benign tumors. Radical surgery is the gold standard of treatment and usually needs microsurgical reconstruction with bone transference for restoration of facial anatomy and adequate function.  We present the case of a young woman with CCOC whose tumor removal and reconstructive surgery were planned virtually and assisted by intraoperative navigation. The novelty of the reconstructive procedure was the replacement of the fibula cutting guides for intraoperative navigation of the osteotomies. We present a brief review of CCOC and the benefits of using computer-assisted surgery (CAS) in high-complexity cases like this one.


Assuntos
Adenocarcinoma de Células Claras , Tumores Odontogênicos , Feminino , Humanos , Mandíbula , Pessoa de Meia-Idade , Osteotomia
3.
Bone Joint J ; 102-B(7_Supple_B): 122-128, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32600203

RESUMO

AIMS: Earlier studies dealing with trends in the management of osteonecrosis of the femoral head (ONFH) identified an increasing rate of total hip arthroplasties (THAs) and a decreasing rate of joint-preserving procedures between 1992 and 2008. In an effort to assess new trends in the management of this condition, this study evaluated the annual trends of joint-preserving versus arthroplasties for patients aged < or > 50 years old, and the incidence of specific operative management techniques. METHODS: A total of 219,371 patients with ONFH were identified from a nationwide database between 1 January 2009 and 31 December 2015. The mean age was 54 years (18 to 90) and 105,298 (48%) were female. The diagnosis was made using International Classification of Disease, Ninth revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) procedure codes. The percentage of patients managed using each procedure during each year was calculated and compared between years. The trends in the use of the types of procedure were also evaluated. RESULTS: The rate of joint-preserving procedures was significantly higher in patients aged < 50 years compared with those aged > 50 years (4.93% vs 1.52%; p < 0.001). For the overall cohort, rates of arthroplasty were far greater than those for joint-preserving procedures. THA was the most commonly performed procedure (291,114; 94.03%), while osteotomy (3,598; 1.16%), partial arthroplasty (9,171; 2.96%), core decompression (1,200; 0.39%), and bone graft (3,026; 0.98%) were performed markedly less frequently. The annual percentage of patients managed using a THA (93.56% to 89.52%; p < 0.001), resurfacing (1.22% to 0.19%; p < 0.001), and osteotomy (1.31% to 1.05%; p < 0.001) also decreased during the study period. CONCLUSION: We found that patients with ONFH have been most commonly managed with non-joint-preserving procedures. Our findings provide valuable insight into the current management of this condition and should increase efforts being made to save the hip joint. Cite this article: Bone Joint J 2020;102-B(7 Supple B):122-128.


Assuntos
Necrose da Cabeça do Fêmur/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia/estatística & dados numéricos , Artroplastia de Quadril/métodos , Artroplastia de Quadril/estatística & dados numéricos , Transplante Ósseo/estatística & dados numéricos , Bases de Dados Factuais , Descompressão Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia/estatística & dados numéricos , Estudos Retrospectivos , Estados Unidos , Adulto Jovem
4.
Stomatologiia (Mosk) ; 99(3): 47-51, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608949

RESUMO

Correction of the lower jaw contours is one of the most popular tasks in aesthetic maxillofacial surgery. There are many reduction operations aimed at changing the shape of the lower jaw. However, augmentation mandible plasty is mainly associated with the use of synthetic implants. In 2013, A. Triaca published a paper «chin wing technique¼ in detail, which we used as a prototype. In this article, we will present the technique and experience of using osteoplastic three-dimensional mandible plasty, which has a number of special features: the increase in the bigonial width is due to the median vertical osteotomy of the free lower edge of the lower jaw, followed by lateralization of the distal parts of the lower fragments, osteosynthesis is performed using the original trapezoidal titanium mini-plate. Since 2018 30 patients have been operated on with different variants of the anatomy of the lower jaw with requirements for increasing the projection of the chin, increasing the width of the lower third of the face and changing the contour of the mandible. The mandible plasty proposed by us allows us to achieve good aesthetic results and can replace the use of synthetic implants.


Assuntos
Estética Dentária , Procedimentos Cirúrgicos Reconstrutivos , Face , Humanos , Mandíbula/cirurgia , Osteotomia
5.
Orv Hetil ; 161(30): 1260-1265, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32653869

RESUMO

Surgical guides and three-dimensional (3D) planning softwares used in everyday dental implantology open new possibilities in other fields of dentistry. While using the operation microscope in endodontic microsurgery provides more precise apicectomy, there is still no consent on the exact localisation and size of the bony window to be prepared for this surgery. Our aim is to describe a new, guided endodontic microsurgery method when osteotomy and apicectomy are planned in a 3D software and performed with a trephine bur. Based on data from Cone Beam Computed Tomography, planning of the surgical guide was performed with a 3D planning software (Smart Guide, dicomLAB, Hungary) in order to define the size of the bony window, the angulation and the depth of the trephine bur during the apicectomy. After preparing a mucoperiosteal flap, with the help of the dentally supported surgical guide, the trephine bur removes the cortical bone and the apex of the root simultaniously. Following the modern microsurgical protocol, after performing the ultrasonic retrograde preparation, mineral trioxide aggregate (ProRoot MTA; Dentsply Maillefer, Ballaigues, Switzerland) is placed as a retrograde filling to close the resected area. After the uneventful healing period, a complete bony regeneration can be seen on the 1-year follow up X-ray. The patient is symptom-free. This technique is considered to be faster and more precise than the non-guided endodontic microsurgery carried out without the utilization of a trephine bur. Orv Hetil. 2020; 161(30): 1260-1265.


Assuntos
Apicectomia/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/cirurgia , Endodontia/métodos , Microcirurgia/métodos , Osteotomia/métodos , Impressão Tridimensional , Materiais Restauradores do Canal Radicular , Tratamento do Canal Radicular/métodos , Compostos de Alumínio , Compostos de Cálcio , Cavidade Pulpar/diagnóstico por imagem , Combinação de Medicamentos , Humanos , Hungria , Óxidos , Radiografia Dentária , Silicatos , Dente , Resultado do Tratamento , Procedimentos Cirúrgicos Ultrassônicos
6.
Zhonghua Wai Ke Za Zhi ; 58(7): 551-554, 2020 Jul 01.
Artigo em Chinês | MEDLINE | ID: mdl-32610426

RESUMO

As an effective way to reconstruct the spinal alignment, osteotomy has been widely used to reconstruct the sagittal alignment of spine and achieved significant results.In order to avoid the secondary sagittal disequilibrium caused by the inaccurate osteotomy angle, it is very important to make an appropriate operation plan before the operation and evaluate the osteotomy angle accurately.At present, scholars have proposed different targets for sagittal reconstruction of the spine with different patients and diseases.They also proposed various prediction methods of osteotomy angle according to different reconstruction standards and principles, as well as the selection of osteotomy sites and methods.In this paper, the preoperative evaluation of the osteotomy angle was reviewed in terms of the target of sagittal reconstruction, the prediction of osteotomy angle and the selection of osteotomy method and osteotomy site.


Assuntos
Osteotomia/métodos , Curvaturas da Coluna Vertebral/cirurgia , Coluna Vertebral/cirurgia , Humanos , Osteotomia/efeitos adversos , Cuidados Pré-Operatórios
7.
Medicine (Baltimore) ; 99(26): e20517, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590733

RESUMO

Literature regarding the value of pre-operative nasal methicillin resistant Staphylococcus aureus (MRSA) swabs to predict surgical site infections (SSIs) in children undergoing lower extremity surgery is limited. The purpose of our study was to determine if pre-operative nasal MRSA swab results were predictive of SSI development in children undergoing a femoral varus derotational osteotomy (VDRO).Patients who underwent VDRO between 2004-2016 were reviewed to determine pre-operative MRSA colonization rates and SSI devolvement rates. Patients with less than 1 year of follow-up, previous history of infections, or absent pre-operative MRSA swab were excluded. SSI rates of patients with negative MRSA and positive MRSA swab result were compared using the Fisher exact test. Aside from contact isolation precautions, no other changes in treatment were made during inpatient hospital course based on positive pre-operative nasal MRSA swab results.247 patients met the inclusion criteria (mean age: 9.3 ±â€Š3.6 years, 62% male). There were 242 (98%) patients with a negative MRSA swab and 5 (2%) patients with a positive MRSA swab. Out of the 242 patients with a negative MRSA swab, 4 developed an SSI. Of the patients with positive MRSA swab results, 0% (0/5) developed an SSI compared to 1.7% (4/242) of negative MRSA swab results who developed an SSI. Results indicated no significant difference in SSI development rates between the groups (P = 1.00).In this series of children undergoing VDRO surgery, the results of a pre-operative MRSA nasal swab had no relationship to SSI incidence and no impact on clinical patient care. Pre-operative MRSA nasal swabs appear to be of limited benefit for routine pre-operative screening in this patient population.Level III, retrospective comparative.


Assuntos
Portador Sadio , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Cavidade Nasal/microbiologia , Osteotomia , Infecção da Ferida Cirúrgica/epidemiologia , Criança , Feminino , Fêmur/cirurgia , Seguimentos , Humanos , Masculino , Cuidados Pré-Operatórios , Infecções por Pseudomonas/epidemiologia , Estudos Retrospectivos , Infecções Estafilocócicas/epidemiologia , Infecção da Ferida Cirúrgica/microbiologia
8.
Compend Contin Educ Dent ; 41(6): 331-335, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32551715

RESUMO

This case series demonstrates internal maxillary sinus elevation and placement of 37 posterior implants in 34 private practice patients using sequential motorized expander burs exclusively to infracture the sinus border and embed bone graft material (allograft or xenograft) for vertical augmentation. With this technique, manual osteotome/malleting was completely avoided, improving surgical control and the patient experience. Sinus borders were lifted by a mean of 3.92 mm in ridges that had an average residual height of 7.52 mm. All implants achieved high insertion torque values (≥90 Ncm), obtained primary stability, and were successfully restored without complications. Anecdotally, the type of bone graft used did not appear to influence the outcome.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Transplante Ósseo , Implantação Dentária Endo-Óssea , Humanos , Maxila/cirurgia , Seio Maxilar/cirurgia , Osteotomia , Torque
9.
Zhonghua Wai Ke Za Zhi ; 58(6): 420-424, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498479

RESUMO

High tibial osteotomy (HTO) is an effective treatment for knee osteoarthritis. With the application of bi-planer open wedge osteotomy high tibial osteotomy and new angular stable locking plates, HTO has become more accuracy, minimally invasive and standard, achieved satisfactory long-term treatment outcome. The indications of HTO are expanding. We need to comprehensively consider whether the patient has varus deformity, the location and severity of the deformity, the stage of osteoarthritis, age and the demand of activity, as well as individual factors such as weight, gender, bone condition and joint activity, and strive to give the best individualized treatment to osteoarthritis patients in different stages.


Assuntos
Aprendizado Profundo , Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Tíbia/cirurgia , Humanos , Articulação do Joelho/cirurgia
10.
Zhonghua Wai Ke Za Zhi ; 58(6): 425-429, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498480

RESUMO

High tibial osteotomy(HTO) is an effective method for the treatment of knee osteoarthritis by transferring the weight bearing line to the lateral tibial plateau, which can significantly reduce the pressure and cartilage lesion of medial knee compartment.However, under- and over-correction of weight bearing line can lead to early postoperative failure.It is necessary to define the standard of axis correction, make correct preoperative plan, ensure the accuracy of operation and consider the risk factors of under- and over-correction of axis.With the advent of the era of intelligent medicine, the application of patient-specific instrumentation technology based on three dimention printing and navigation technology will help to achieve the precise control of axial alignment in high tibial osteotomy.


Assuntos
Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Osteotomia/tendências , Tíbia/cirurgia , Mau Alinhamento Ósseo/etiologia , Mau Alinhamento Ósseo/prevenção & controle , Humanos , Articulação do Joelho/cirurgia , Extremidade Inferior/cirurgia , Osteotomia/efeitos adversos , Cirurgia Assistida por Computador
11.
Zhonghua Wai Ke Za Zhi ; 58(6): 435-440, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498482

RESUMO

Objective: To investigate the sagittal and torsional changes in the tibia after a medial open wedge high tibial osteotomy (OWHTO) and their correlation with the corrective angle of proximal tibial coronal plane. Methods: A prospective analysis was conducted on patients who underwent OWHTO at Department of Orthopaedic Surgery, Beijing Chaoyang Emergency Medical Center from March 2019 to July 2019.The operation were performed by the same surgeon. X-ray and CT were performed before and 3 days after the operation. The mechanical axis angle (mFTA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS) and tibial torsion angle (TTA) were measured and compared by paired t-test. Pearson correlation coefficient was used to analyze the correlation between the changes of PTS and TTA and the correction angle of MPTA. Results: A total of 13 patients (19 knees) were recruited. There were 9 males (13 knees) and 4 females (6 knees), aged (39.4±14.4) years (range:20 to 60 years). The mFTA improved from (8.1±2.8) degrees preoperatively to (-1.4±1.6) degrees postoperatively (t=14.819, P=0.000). The MPTA was changed from (81.1±2.4) degrees pre-operatively to (90.4±3.4) degrees postoperatively (t=-15.579, P=0.000). The PTS decreased from (79.6±3.2) degrees to (76.8±3.1) degrees (t=9.709, P=0.000). The differences of mFTA, MPTA and PTS were statistically significant. There was no significant difference in TTA between before and after operation ((28.2±1.5) ° vs. (27.3±6.3) °,t=1.925, P=0.070). There was no correlation between the correction angle of MPTA and the change of PTS and TTA (r=0.384, P=0.105; r=0.321, P=0.181). Conclusions: Even if the intra-operative measures were used to control tibial slope, the PTS still increased significantly after OWHTO, while the TTA has no significant change. No correlation was seen between the change of sagittal and torsional and the corrective angle of proximal tibial coronal plane.


Assuntos
Artropatias/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Osteotomia/métodos , Tíbia/diagnóstico por imagem , Anormalidade Torcional/diagnóstico por imagem , Adulto , Feminino , Humanos , Artropatias/cirurgia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia/efeitos adversos , Período Pós-Operatório , Estudos Prospectivos , Tíbia/cirurgia , Anormalidade Torcional/etiologia , Adulto Jovem
12.
Zhonghua Wai Ke Za Zhi ; 58(6): 447-451, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498484

RESUMO

Objective: To analyze the incidence of recent complications in patients with osteoarthritis of the knee (OA) after medial opening wedge high tibial osteotomy(MOWHTO) and its influence on clinical effect. Methods: The clinical data of 131 patients with knee OA who received MOWHTO at Department of Sports Medicine and Arthroscopy,Tianjin Hospital from April 2017 to September 2018 were analyzed retrospectively. There were 75 males and 56 females, aged (62.8±5.1) years (range:48 to 70 years). Complications and clinical outcomes of patients were recorded and the proximal medial angle of tibia (MPTA), the International Knee Documentation Committee Subjective Knee Form (IKDC), the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Knee Injury and Osteoarthritis Outcome score(KOOS) were collected before and 1 year after operation and compared between complication group and non-complication group. Data were analyzed by paired-samples t test, independent samples t test and χ(2) test. Results: The follow-up time was (18.5±3.4) months (range:13 to 22 months). Complications occurred in 22 patients(16.8%), including 8 cases(6.1%) of hematoma, 5 cases(3.8%) of neurosensory abnormality, 4 cases(3.1%) of intramuscular venous thrombosis, 2 cases(1.5%) of deep venous thrombosis, 3 cases(2.3%) of loss of correction angle, 3 cases(2.3%) of superficial infection, 2 cases(1.5%) of deep infection, 2 cases(1.5%) of delayed union of fracture, 1 case(0.8%) of postoperative stiffness, 1 case (0.8%) of hinge point cortex fracture. There were no significant difference in MPTA ((86.5±2.0)° vs. (86.7±2.1)°, t=-0.41, P=0.68) , IKDC ((86.4±4.8) vs.(85.5±6.9), t=0.74, P=0.50) , WOMAC ((87.7±6.5) vs. (86.1±5.8), t=1.16, P=0.25). There were no significant difference in knee scores except for the KOOS pain score ((79.4±4.4) vs. (87.2±5.9), t=-5.90, P<0.01) and sports and recreation score ((83.2±3.0) vs. (88.0±4.7), t=-6.14, P<0.01) . Conclusion: Short-term complications of MOWHTO can be managed appropriately through early diagnosis and individualized treatment and have no significant negative effect on knee function recovery of patients.


Assuntos
Osteoartrite do Joelho/cirurgia , Osteotomia/efeitos adversos , Tíbia/cirurgia , Idoso , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia/métodos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do Tratamento
13.
Orthop Clin North Am ; 51(3): 345-360, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32498953

RESUMO

Lower extremity deformities in children rely on osteotomies for correction. Percutaneous osteotomies offer a method for cutting bone that is advantageous for soft tissue healing. These low-energy osteotomies preserve the blood supply to bone, which maximizes the ability of bone to heal. Some of these techniques are technically demanding and should be performed first with an experienced operator. The key to maintaining safety in these osteotomies is to remain in a subperiosteal location. The categories of percutaneous osteotomy include multiple drill hole osteotomy, corticotomy, and Gigli saw osteotomy. This article discusses the advantages and indications for each type of osteotomy.


Assuntos
Osso e Ossos/anormalidades , Osso e Ossos/cirurgia , Anormalidades Musculoesqueléticas/cirurgia , Osteotomia/métodos , Criança , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
14.
Orthop Clin North Am ; 51(3): 403-422, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32498959

RESUMO

This article presents the indications, contraindications, preoperative surgical planning, surgical technique, and postoperative management of some of the most common percutaneous procedures in orthopedic foot and ankle surgery. The background of each procedure also is presented, supported by the latest in published literature to educate surgeons. Such topics include percutaneous bunionectomy, lesser toe deformity and bunionette correction, calcaneal osteotomy, cheilectomy, and first metatarsophalangeal joint arthrodesis.


Assuntos
Ossos do Pé/cirurgia , Procedimentos Ortopédicos/métodos , Tornozelo/diagnóstico por imagem , Tornozelo/cirurgia , Artrodese/efeitos adversos , Artrodese/métodos , Pé/diagnóstico por imagem , Pé/cirurgia , Ossos do Pé/diagnóstico por imagem , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Ortopédicos/efeitos adversos , Osteotomia/efeitos adversos , Osteotomia/métodos , Falanges dos Dedos do Pé/diagnóstico por imagem , Falanges dos Dedos do Pé/cirurgia
15.
Arthroscopy ; 36(6): 1665-1669, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32503776

RESUMO

A high tibial osteotomy (HTO) that is used to correct varus malalignment, such as with medial arthrosis or before cartilage restoration or posterolateral reconstructions, represents an important and required surgery for clinical success. A major problem that occurs with HTO planning is that the preoperative measurements, with either lower limb supine or standing weight-bearing radiographs, will invariably show abnormal medial or lateral tibiofemoral compartment opening resulting from soft-tissue laxity or injury. It is imperative that this tibiofemoral joint opening be accounted for in the osteotomy correction calculations. There are well-described methods available that affect operative planning, such as the use of preoperative stress radiographs to determine the millimeters of tibiofemoral opening or closure. The use of intraoperative fluoroscopy with application of axial loading to the lower limb and verification of closure of the tibiofemoral joint is recommended. A careful fluoroscopic examination of the tibiofemoral compartments allows a final adjustment of the osteotomy correction and confirms the final weight-bearing line percent measurement and limb alignment. Postoperative radiographs are required to detect outliers resulting from unexpected soft-tissue laxity or inadequate correction.


Assuntos
Osteoartrite do Joelho , Tíbia , Fluoroscopia , Humanos , Articulação do Joelho , Osteotomia
16.
Med Oral Patol Oral Cir Bucal ; 25(4): e461-e467, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32388527

RESUMO

BACKGROUND: As third molar surgery is the most commonly procedure performed in Dentistry and has been accompanied by serious postoperative disorders such as pain, edema and trismus, the study aimed to evaluate if ultrasound device would be able to reduce such postoperative features. The aim of this study was to assess the effects of soft tissue flap elevation, osteotomy and odontosection using piezosurgery versus conventional technique in mandibular third molar extractions. MATERIAL AND METHODS: Twenty patients with impacted mandibular third molars underwent tooth extractions using two different methods. Ten patients were included in the Piezo Flap Group (PFG - the flap was elevated using piezosurgery) and ten patients were part of the Piezo Ostectomy Group (POG - osteotomy and odontosection were carried out with ultrasound tips). The contralateral tooth was included in the Control Group (CG - conventional technique). The patients were evaluated at postoperative periods of 1, 3, 7 and 14-days. The measured parameters were duration of surgery, pain, trismus and swelling. RESULTS: The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). There was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG (p>0.05). There was a statistically significant difference in swelling between the PFG and POG, presenting less swelling at the 3-day postoperative period (p=0.038; p<0,05). However, for the remaining analyzed periods there was no difference (p>0.05). CONCLUSIONS: Piezosurgery for tissue elevation of the surgical flap, osteotomy and dental sectioning in mandibular third molar extraction surgery promoted less edema in the early postoperative stages in mandibular third molar extractions despite the longer surgical duration.


Assuntos
Osteotomia , Dor Pós-Operatória , Retalhos Cirúrgicos , Dente Impactado , Edema , Humanos , Dente Serotino , Boca , Estudos Prospectivos , Extração Dentária , Trismo
17.
Orthopade ; 49(6): 547-560, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32399741

RESUMO

Fractures and osteotomies are characterized by a structural discontinuity of the affected bone with formation of a gap. If bone healing does not lead to an osseous bridging of the fragments within a time period of 6 months a nonunion (pseudarthrosis) occurs. In this stage spontaneous bone healing is unlikely in the future without any intervention. Pseudarthrosis is classified into hypertrophic and atrophic types. Moreover, the differentiation between aseptic and septic conditions, the size of the defect, the local blood supply and the mechanical stability are crucial for treatment planning. The type of pseudarthrosis and the accompanying comorbidities can be classified in scoring systems and influence the selection of the treatment procedure. The operative principles aim at the vitalization of atrophic bone parts, achieving sufficient stabilization and cures the infection, whereas nonoperative measures are primarily supportive measures. The foundation of successful treatment is the minimization of individual risk profiles and sufficient patient compliance.


Assuntos
Fraturas Ósseas/cirurgia , Osteotomia , Pseudoartrose , Fixação Interna de Fraturas , Humanos , Cooperação do Paciente
20.
Clin Sports Med ; 39(3): 623-636, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32446579

RESUMO

The elbow joint consists of the humeroulnar, humeroradial, and proximal radioulnar joints. Elbow stability is maintained by a combination of static and dynamic constraints. Elbow fractures are challenging to treat because the articular surfaces must be restored perfectly and associated soft tissue injuries must be recognized and appropriately managed. Most elbow fractures are best treated operatively with restoration of normal bony anatomy and rigid internal fixation and repair and/or reconstruction of the collateral ligaments. Advanced imaging, improved understanding of the complex anatomy of the elbow joint, and improved fixation techniques have contributed to improved elbow fracture outcomes.


Assuntos
Articulação do Cotovelo/lesões , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Redução Aberta , Placas Ósseas , Ligamentos Colaterais/lesões , Ligamentos Colaterais/cirurgia , Articulação do Cotovelo/anatomia & histologia , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/diagnóstico por imagem , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Olécrano/lesões , Olécrano/cirurgia , Redução Aberta/instrumentação , Redução Aberta/métodos , Osteotomia , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA