Caracterización de los pacientes con defectos bucomaxilofaciales atendidos en el Policlínico Universitario Julio Antonio Mella / Characterization of the patients with oral-maxillofacial defects attended in the University Polyclinic Julio Antonio Mella

Fundamento: las lesiones del macizo cráneofacial existen desde la evolución misma del hombre, lo que ha traído por consiguiente la necesidad de crear medios para enmascarar los defectos o restaurar el órgano perdido. Objetivo: caracterizar los pacientes con defectos bocomaxilofacial. Métodos: se realizó un estudio observacional, descriptivo y transversal desde enero del 2015 hasta mayo de 2018 en pacientes con defectos bucomaxilofaciales atendidos en el departamento de prótesis estomatológica del Policlínico Universitario Julio Antonio Mella de la Provincia Camagüey. El universo lo constituyeron 13 pacientes mayores de 20 años de edad de ambos sexos remitidos del Hospital Universitario Manuel Ascunce Domenech y Hospital Provincial Docente Oncológico María Curie.Resultados: respecto a los pacientes con defectos maxilofaciales rehabilitados según edad y sexo, fue más frecuente el sexo masculino y el grupo de 60 a 79 años. Según tipo y causa del defecto, fue superior el nasal y la oncológica con siete pacientes. Según tipo de defecto bucomaxilofacial y experiencia protésica, primó el defecto nasal, así como la experiencia protésica favorable en ocho pacientes. Conclusiones: los pacientes masculinos predominaron, junto con los mayores de 60 años. Los defectos bucomaxilofaciales más rehabilitados fueron los nasales y de origen oncológicos. Hubo un alto índice de experiencia favorable con el uso de las prótesis(AU)

Background: the injuries of the solid craniofacial exist from evolution of the man, which has brought therefore the need to create means to mask defects or to restore the lost organ. Objective: to characterize the patients with oral-maxillofacial defects.Methods: an observational, descriptive and transverse study was carried out from January, 2015 to May, 2018, in patients with oral-maxillofacial defects attended in the department dentistry prosthesis of the University Polyclinic Julio Antonio Mella of the city of Camagüey. The universe was constituted by 13 patients older than 20 years of age of both sexes cross-referred of the University Hospital Manuel Ascunce Domenech and Provincial University Oncological Hospital María Curie. Results: in relation to the patients with maxillofacial defects rehabilitated according to age and sex, prevailed the group 60 to 79 years, as well as the masculine sex. According to type and etiology of the defect, the nasal and the oncological was a superior with 7 patients respectively. According to type of defect oral-maxillofacial and prosthetic experience, the type of nasal defect had priority as well as the prosthetic favorable experience in 8 patients. Conclusions: the masculine patients predominated along with the older than 60 years old. The oral-maxillofacial defects most rehabilitated were the nasal and those of oncological causes. There was a tall index of favorable experience with the use of the prostheses (AU)

Availability of cosmetic treatment using novel cosmetics-based material on patients with craniofacial concavity.

PURPOSE: Patients treated with maxillofacial prosthetics often experience emotional problems because of the remaining facial skin concavity such as a surgical scar. In such cases, cosmetic treatment can potentially correct their skin tone imperfections and deformities. This study aimed to evaluate the clinical availability of novel cosmetics-based material for craniofacial small concavity by initiating a cosmetic treatment in a preliminary case. METHODS: Eighteen patients with aesthetic problems such as craniofacial deformities, small defects, and concavities on their faces underwent cosmetic treatment that was performed by makeup practitioners. Data were collected from the patient's charts and a survey questionnaire. A visual analog scale was used to conduct a survey regarding the satisfaction levels of the patients following cosmetic treatment with a novel cosmetics-based material. The cosmetic treatment was performed for a concavity on the left midface of a 67-year-old woman with partial maxillectomy. The novel cosmetics-based material was manufactured from a semi-translucent oil base. RESULTS: The satisfaction level of the patient increased after undergoing the cosmetic treatment. Regarding clinical applications, the novel cosmetics-based material can help reduce their cosmetic disturbance and restore the small deformity. CONCLUSIONS: These results suggest that the cosmetic treatment with the novel cosmetics-based material can be used as a subsidiary method for facial prostheses or an independent new method for correcting patients' small craniofacial concavity and for reducing visible deformity.

Necesidades de aprendizaje sobre rehabilitación bucomaxilofacial en residentes y especialistas de Neurocirugía / Learning necessities about bucco-maxillo-facial rehabilitation in residents and Neurosurgery specialists

Fundamento: la prótesis bucomaxilofacial comprende la rehabilitación morfofuncional de las estructuras intrabucales y parabucales por medios artificiales. Objetivo: identificar las necesidades de aprendizaje y las insuficiencias en el desarrollo de habilidades sobre rehabilitación bucomaxilofacial en residentes y especialistas de Neurocirugía. Métodos: se realizó una investigación descriptiva transversal en el Hospital Universitario Arnaldo Milián Castro de Villa Clara, entre enero-mayo de 2014. Se utilizaron métodos teóricos: analítico-sintético, histórico-lógico e inductivo-deductivo; empíricos: análisis documental del programa de la especialidad de Neurocirugía y el plan de superación de los últimos 5 años, y encuesta en forma de cuestionario de respuestas breves al total de la población de estudio y de entrevista a los 5 especialistas en Neurocirugía.Resultados: el plan de estudio trata los contenidos de rehabilitación bucomaxilofacial insuficientemente y en las formas de postgrado no se brinda superación sobre el tema en los últimos 5 años; la mayoría de los encuestados declara tener carencias de conocimientos en esta modalidad terapéutica. La generalidad no conoce la constitución del equipo multidisciplinario que incide en la rehabilitación de los pacientes e incluso muy pocos han visitado el centro especializado existente en la provincia. Todos abogaron por una modalidad de postgrado donde se apropien de los contenidos necesarios. Conclusiones: se constataron insuficiencias sobre rehabilitación bucomaxilofacial en residentes y especialistas en Neurocirugía, lo cual demostró que es necesario fortalecer su preparación para conformar un equipo multidisciplinario de gran complejidad como lo necesita esta modalidad terapéutica(AU)

Oral rehabilitation with implant-based prostheses of two adult patients treated for childhood rhabdomyosarcoma.

BACKGROUND: Rhabdomyosarcoma is the most common malignant tumor in the nasal and paranasal sinus area at childhood. Multimodal treatment for this disorder has severe side effects due to normal tissue damage. As a result of this treatment, facial growth retardation and oral abnormalities such as malformation of teeth and microstomia can cause esthetic and functional problems. CASE REPORTS: Two cases are presented of patients with severe midfacial hypoplasia and reduced oral function as a result of treatment of rhabdomyosarcoma of the nasopharyngeal and nasal-tonsil region. With a combined surgical (osteotomy, distraction osteogenesis, implants) and prosthetic (implant-based overdenture) treatment, esthetics and function were improved.

Review of methods used in the reconstruction and rehabilitation of the maxillofacial region.

Maxillofacial and dental defects often have detrimental effects on patient health and appearance. A holistic approach of restoring lost dentition along with bone and soft tissue is now the standard treatment of these defects. Recent improvements in reconstructive techniques, especially osseointegration, microvascular free tissue transfer, and improvements in bone engineering, have yielded excellent functional and aesthetic outcomes. This article reviews the literature on these modern reconstructive and rehabilitation techniques.

Masticatory dysfunction in persons with Down's syndrome. Part 2: management.

The functional and anatomical characteristics of Down's syndrome have direct repercussions on oral health; orofacial dysfunction results and feeding and swallowing are impaired. These problems have been described in an earlier article. Different techniques are proposed for the prevention of the development of orofacial dysfunction in Down's syndrome. In particular, early myofunctional therapy coupled with appliance wear has been shown to be successful over the long term when multidisciplinary management is possible. Functional or conventional orthodontic treatment may be successful for older children when performed concurrently with the use of appropriate behaviour management techniques. More recently, techniques for the compensation of masticatory dysfunction in adults have been proposed, although further research is necessary to confirm their efficacy. The aim of this second article was to review techniques for the prevention, treatment and compensation of orofacial dysfunction in persons with Down's syndrome from birth to adulthood.

Post-operative re-construction of dentoalveolar tissue and the mandible and maxillae using prosthetic therapy.

OBJECTIVE: To determine the range of ablative surgery and rehabilitative procedures performed on maxillofacial structures. DESIGN: A retrospective descriptive study. SETTING: University of Nairobi Dental Teaching Hospital. SUBJECTS: Patients operated on at the institutions theatre, and followed up at the University of Nairobi Dental Teaching Hospital Oral Surgery Outpatient Clinic during the period February 1996, August 1998. RESULTS: Forty four patients underwent ablative surgery during the study period. Complete records were available for 38 patients, 27 females and 11 males aged 10 to 79 years (mean 32.6 years). Surgical procedures performed included: partial mandibulectomy, marginal mandibular resection, subtotal maxillectomy, sequestrectomy and enucleation. Six (15.8%) patients who underwent mandibular resection had rigid bone plating. Five (13.2%) patients who had maxillary involvement were given surgical obturators post-operatively with one receiving a complete denture after full recovery. A total of 22 (57.9%) patients who would have reaped benefits from prostheses therapy received none. Individual patient follow-up periods ranged from seven days for two patients who had cyst enucleation to two years for three cases with ameloblastoma, and two cases with squamous cell carcinoma. CONCLUSION: It is concluded that prosthetic rehabilitation of patients undergoing extensive surgery at the University of Nairobi Dental Teaching Hospital is largely inadequate.

Orofacial development in children with Down's syndrome 12 years after early intervention with a stimulating plate.

BACKGROUND: Orofacial regulation therapy for children with Down's syndrome was introduced to Europe in Munich in 1978. Since then, many clinical studies have provided scientific evidence that this therapeutic approach enhances the orofacial function and facial appearance of children with trisomy 21. Only few long-term results have been published to date. PATIENTS AND RESULTS: In the present study, 20 children with trisomy 21 were examined more than 12 years after starting treatment in infancy with a Castillo Morales stimulating plate. The follow-up examination showed that the improved orofacial appearance resulting from the early treatment had remained stable in most cases. Although the mechanical stimulus of the stimulating plate was absent during the follow-up period, some patients revealed a lip and tongue posture superior to that recorded at baseline. CONCLUSION: According to the results of the present study, the orofacial status in early childhood is decisive for the subsequent development of the orofacial region and the long-term stability of the achieved improvements: Children with a pronounced orofacial dysfunction showed a greater stimulation-plate-induced improvement than those with initially moderate orofacial findings. This observation was confirmed by the findings of the 12-year follow-up: Children with Down's syndrome and initially slight orofacial impairment displayed only slight improvements or unchanged findings.

Development of a new poly(dimethylsiloxane) maxillofacial prosthetic material.

Maxillofacial prosthetic materials are used to rehabilitate patients suffering from acquired or congenital facial disfigurement. Silicone rubber materials [poly(dimethylsiloxane) rubbers] are the materials of choice. However, current formulations have inadequate mechanical properties, in particular, tear strength. The purpose of this study was to formulate a new poly(dimethylsiloxane) material with improved mechanical properties in comparison to commercially available materials. The formulations developed were based on condensation chemistry containing a hydroxy-end-blocked poly(dimethylsiloxane), hydrophobic silica filler, silane cross-linking agents, and a tin catalyst. The following parameters were varied in order to formulate improved materials: (a) bimodal polymeric mix (i.e., ratio of high- and low-molecular-weight polymers); (b) silica filler type and quantity. By varying these parameters a formulation was developed with a base polymer mix of 80%:20% high- to low-molecular-weight polymers into which 20% w/w filler was added. This formulation had a tear strength of 22.23 +/- 1.6 m N/mm compared to the commercial materials having tear strengths in the range 4.53-17.63 N/mm.

Factores de riesgo que inciden en las anomalías dentomaxilofaciales / Risk factors that influence upon the dentomaxillofacial anomalies

Se realizó un estudio longitudinal de control ortodóncico en la escuela primaria Frank País García en pacientes que recibieron atención estomatológica en la Clínica de Especialidades de Bayamo. Se controlaron 140 niños que estaban en dentición mixta temprana (de 6 a 9 años) y se seleccionaron los que según criterio del profesional se le detectaron factores de riesgo de anomalía dentomaxilofacial o estuvieron afectados por esta, quedando la muestra constituida por 105 niños. Los resultados evidenciaron que 75 por ciento de los pacientes estudiados estuvieron afectados por factores de riesgo, siendo los que más incidieron los hábitos seguidos de la higiene bucal deficiente y la caries dental(AU)

It was performed a longitudinal research of orthodontic control at Frank Pais Garcia elementary school in patients who received stomatological care in the clinic of specialties of Bayamo. There were controlled 140 children who were in early mixed dentition (from 6 to 9 years old) and there were selected the ones according to the criteria of the professional risk factors of dentomaxillofacial anomalies, or that were affected by this condition, leaving the sample made up of 105 children. The results showed that 75 percent of the studied patients were affected by risk factors, being the most impacted habits followed by poor oral hygiene and dental caries(EU)