Subject(s)
Black People , Nasal Cartilages/surgery , Rhinoplasty/methods , Adult , Esthetics , Ethnicity , Female , HumansABSTRACT
Autogenous bone remains the gold standard for preimplant bone-grafting procedure. When important volumes must be grafted with cancellous bone, the calvarial-harvesting site must still be considered, due to the quality of this membranous bone and the safety of the procedure if the surgeon is experimented. To simplify the procedure, the author proposes calvarial-bone harvesting under local anesthesia with a mini-bone plane. This technique remains very comfortable for the patient and also safe because of the almost complete preservation of the outer calvarial table.
Subject(s)
Bone Transplantation/methods , Oral Surgical Procedures, Preprosthetic/methods , Skull/surgery , Tissue and Organ Harvesting/methods , Craniotomy/methods , Humans , Maxillary Sinus/surgeryABSTRACT
Distal extremity of lower limb sustains the complications of loss of tissue: problem of coverage (cutaneous and tendon necrosis, osteoarticular infection. The whole point of the surgery is to fight against the infection by repeated debridments, against the deformations or their correction by early osteosynthesis (pins and external fixation). The coverage is very important in this treatment: either with Vacuum-Assisted Closure (VAC) and skin graft or fasciocutaneous flap. In spite of this management, the after-effects are important although the conservative treatment is the determining factor of satisfaction.
Subject(s)
Fractures, Bone/surgery , Leg Injuries/surgery , Plastic Surgery Procedures , Surgical Flaps , Adult , Aged , Aged, 80 and over , Debridement , Female , Foot Injuries/diagnostic imaging , Foot Injuries/surgery , Fracture Fixation, Internal , Fractures, Bone/etiology , Humans , Leg Injuries/etiology , Male , Middle Aged , Patient Satisfaction , RadiographySubject(s)
Alveolar Ridge Augmentation/methods , Anodontia/rehabilitation , Dental Implantation, Endosseous/methods , Dental Prosthesis, Implant-Supported , Malocclusion, Angle Class III/surgery , Adolescent , Anodontia/complications , Bone Transplantation , Humans , Male , Malocclusion, Angle Class III/complications , Osteotomy, Le FortSubject(s)
Rhytidoplasty/methods , Face/surgery , Female , Humans , Middle Aged , Neck/surgery , Rejuvenation , Skin Aging , Social IsolationSubject(s)
Oral Medicine/organization & administration , Surgery, Oral/organization & administration , Dental Implantation/education , France , Humans , Internship and Residency , Oral Medicine/education , Oral Medicine/standards , Specialties, Dental , Surgery, Oral/education , Surgery, Oral/standardsSubject(s)
Facial Muscles/surgery , Fasciotomy , Rhytidoplasty/methods , Cheek/surgery , Female , Follow-Up Studies , Humans , Lipectomy , Middle Aged , Neck/surgery , Surgical FlapsSubject(s)
Alveolar Ridge Augmentation/methods , Mandible/surgery , Osteogenesis, Distraction , Bicuspid , Humans , Molar , Vertical DimensionSubject(s)
Lip/injuries , Lip/surgery , Oral Surgical Procedures/methods , Adult , Humans , Male , Plastic Surgery Procedures/methodsABSTRACT
When it is necessary to increase the vertical height of the residual alveolar ridge, alveolar distraction osteogenesis has numerous advantages compared to other preprosthetic surgical procedures. It is frequently used for this purpose in the anterior region because of the obvious accessibility. The authors present a clinical case of edentulous posterior mandible, with insufficient vertical alveolar bone height, treated by alveolar distraction osteogenesis leading to three titanium fixtures. They explain their choice and discuss the preliminary results.
Subject(s)
Alveolar Process/surgery , Alveoloplasty/methods , Jaw, Edentulous/surgery , Mandible/surgery , Osteogenesis, Distraction/methods , Vertical Dimension , Alveolar Process/abnormalities , Alveolar Process/diagnostic imaging , Dental Implants , Female , Humans , Jaw, Edentulous/diagnostic imaging , Mandible/diagnostic imaging , Middle Aged , Radiography , Titanium/therapeutic useABSTRACT
The vascularized free fibular graft has been used in mandibular reconstructive surgery since 1975. This technique has been progressively developed, and it is now the procedure of choice for mandibular reconstruction although in certain postoperative circumstances it can be difficult if not impossible to monitor bone vitality. However, bone vascularization can be detected by dynamic magnetic resonance imaging (MRI), as this technique has been experimentally and clinically validated in the early diagnosis of osteonecrosis. The aim of this study was to evaluate the efficacy of MRI for the postoperative monitoring of vascularized free fibular grafts in human mandibular reconstruction. Dynamic contrast-enhanced MRI was used to study the variation in contrast over time following injection of gadolinium contrast medium, and to evaluate the degree of bone marrow perfusion of the fibular graft. This variation in signal intensity was visualized in the form of a curve, i.e., a perfusion curve for the bone marrow region. An examination was performed in three patients at different postoperative times and under different conditions. In one case, MRI confirmed the presence of fibula blood supply in spite of the necrosis of the adjacent fascio-adipose layer. In this article, the methodological difficulties have been discussed, particularly as regards data processing, and the present results have been compared with the findings in the literature. Dynamic MRI is a simple, reliable, non-invasive technique and its use in the postoperative monitoring of bone marrow perfusion and vascularized free fibular grafts permits a determination of the status of the latter following surgery, i.e., whether there is an adequate blood supply or not.