Quality of Life and Maxillary Defects: A Cross-Sectional Study / Calidad de Vida y Defectos Maxilares: Un Estudio Transversal

ABSTRACT: There has been little discussion about the quality of life of patients with maxillary defects. This article evaluates the issues related to the condition. We performed a cross-sectional study of patients with maxillary defects from referral centers in Brazil. To avoid subject burden, a questionnaire was developed, based on questions from seven instruments, which dealt with domains and conclusions that were similar to those from other studies. The predictor variable was the patients' score for each question. The outcome measure was the presence of the best-ranked items on the questionnaire as the impact factor. Six experts assessed these items and suggested which questions to include or exclude. Patients scored each item according to its occurrence and importance. Descriptive statistics and the items' rank according to the impact factor were computed to determine whether there is a comprehensive instrument available. Thirteen patients and six professionals were included in this study. The patients' age ranged from 24 to 72 years (mean (standard deviation, SD), 50.41 (14.46) years). We obtained a 60-item instrument from the selected questionnaires and subject interviews. Only 12 (37.5 %) out of the 32 best-rated items were verified by the existing instruments, two (6.25 %) were suggested by professionals and 18 (56.25 %) were conclusions from other studies. To the best of our knowledge, this is the first study to provide many features related to the quality of life in patients with maxillary defects.

RESUMEN: Existe escasa discusión en la literatura sobre la calidad de vida de los pacientes con defectos maxilares. Este artículo evalúa los problemas relacionados con esta condición. Realizamos un estudio transversal de pacientes con defectos maxilares de centros de referencia en Brasil. Se desarrolló un cuestionario basado en preguntas de siete instrumentos, que trataba sobre dominios y conclusiones similares a las de otros estudios. La variable de estimación fue la puntuación de los pacientes para cada pregunta. La medida de resultado fue la presencia de los elementos mejor clasificados en el cuestionario como factor de impacto. Seis expertos evaluaron estos ítems y sugirieron qué preguntas incluir o excluir. Los pacientes puntuaron cada ítem según su ocurrencia e importancia. Se calcularon las estadísticas descriptivas y la clasificación de los ítems según el factor de impacto, para determinar si existe un instrumento completo. Trece pacientes y seis profesionales fueron incluidos en este estudio. La edad de los pacientes osciló entre 24 y 72 años [media (desviación estándar), 50,41 (14,46) años]. Obtuvimos un instrumento de 60 ítems de los cuestionarios y entrevistas de temas seleccionados. Solo 12 (37,5 %) de los 32 ítems mejor calificados se verificaron de acuerdo a los instrumentos existentes, dos (6,25 %) fueron sugeridos por profesionales y 18 (56,25 %) fueron conclusiones de otros estudios. De acuerdo a nuestro conocimiento, este es el primer estudio que proporciona características relacionadas con la calidad de vida en pacientes con defectos maxilares.

[Masticatory system and maxillofacial prosthesis: From pathology to function recovering]. / Appareil manducateur et prothèse maxillo-faciale : de la pathologie à la fonction retrouvée.

Maxillofacial prosthesis (MFP) can be defined as the art and science of esthetic and functional reconstruction of the facial bones, art because it uses hand-crafted and empirical rules, science because of its technical rigorism and its integration in medicine. MFP aims to multidisciplinary rehabilitate patients presenting with cutaneous and underlying structures defects, It also allows for functional speech and swallowing rehabilitation related to temporo-mandibular joint disorders. Whatever the origin, (traumatic, infectious ortumoral), surgical treatment of these TMJ disorders is usually not indicated in first-line. Functional treatment is often sufficient if started early in an observant patient. The aim of our article was to present the different types devices available for the rehabilitation of the masticatory system according to pathology. The first part will treat about the preservation of the TMJ range of motion in a preventive way. A second part will treat about the possibilities to recover the range of motion in a curative way. A third part will treat about mandibular reposition. At last, we will focus on the devices allowing for mandibular kinetic rehabilitation in adults and in a special pediatric case.

Influence of adding nanoparticles on the hardness, tear strength, and permanent deformation of facial silicone subjected to accelerated aging.

STATEMENT OF PROBLEM: The efficiency of adding nanoparticles to silicone protection has proven to prevent color degradation. However, reports of other physical property changes in facial silicone are scarce. PURPOSE: The purpose of this in vitro study was to evaluate the influence of adding nanoparticles on the hardness, tear strength, and permanent deformation of a facial silicone. MATERIAL AND METHODS: Specimens were made for each test, with 140 for the hardness test, 140 for the permanent deformation test, but 280 for the rupture test. This higher number was due to the fact that the first 140 specimens were ruptured and unusable after the initial reading. ZnO, BaSO4, and TiO2 nanoparticles at concentrations of 1% and 2% of silicone were used, as well as specimens without nanoparticles that consisted of only oil paint and of only silicone. Outcomes were measured before and after 1008 hours of accelerated aging. Data were analyzed by nested analysis of variance (ANOVA) and Tukey honest significant differences test (α=.05). RESULTS: Results showed that the presence of nanoparticles influenced the properties of the assessed groups. The nanoparticles decreased hardness values. The highest values of tear strength were observed for the groups with addition of BaSO4. The 1% ZnO group without oil paint showed the lowest values of permanent deformation. CONCLUSIONS: Based on the findings of this in vitro study, the use of ZnO nanoparticles is recommended, since they did not negatively affect the properties of the materials evaluated.

Surface analytical studies of maxillofacial implants: influence of the preoperational treatment and the human body on the surface properties of retrieved implants.

In the present work, surface analytical investigation of unimplanted as well as retrieved pyrolytic carbon-covered carbon/carbon composite implants and Ti osteosynthesis plates is reported. The Ti plates were covered by a 200-nm-thick, anodically and thermally formed TiO2 layer. Our results suggest that although the oxide layer on the Ti miniplates remained stable during the time spent in the human body, there is still material transport between the implant and the human body. In case of the carbon/carbon composite implants, damage of the carbon fibers constituting the material was found on one side of the sterile implant and attributed to the manufacturing process. The NaCl crystals originally present on the surface of the sterile material disappeared during the time spent in the human body. As a result of the interaction with the human body, a new surface layer (mainly constituted of carbon) appeared on the implant. The results indicate that both the time spent in the human organism and the preparation of the implants before operation can have detectable effects on the investigated surface properties. Surface analytical investigations could therefore provide information not only about the biocompatibility of these materials but also about the effect of their treatment before operation.

Fibroma osificante / Ossifying fibroma

El trabajo del equipo multidisciplinario fue el camino para obtener las ventajas biológicas, psicológicas, cosméticas y funcionales. La prótesis interna fue importante para mantener la simetría de la cara; el obturador sostuvo el colgajo palatino en su lugar manteniendo su nutrición y la vitalidad del mismo. Después de este tratamiento, el paciente se recuperó totalmente y no tuvo secuelas psicológicas ya que nadie podía percibir su defecto

Functional assessment testing for maxillofacial prosthetics.

STATEMENT OF PROBLEM: The health industry is now concerned with treatment outcomes and accountability to patients, payers, and referral sources. PURPOSE: The purpose of this study was to identify the functional tests that are available to maxillofacial prosthodontists and to provide a list of those tests that are applicable in treatment and documentation. METHODS: Functional assessment may be used to justify reimbursement on the basis of payer guidelines, define eligibility for service, and judge quality and effectiveness of care. Currently, most maxillofacial prosthodontists do not use functional assessment. A literature search resulted in a list of 125 available tests. On the basis of that list a questionnaire was submitted to speech-language pathologists and occupational therapists to identify which tests are being used by them. This article discusses a historic overview of assessment testing and the need for functional assessment testing by the maxillofacial prosthodontist. RESULTS: Outcome measurements used by other members of the rehabilitation team are discussed and summarized, and those useful for the maxillofacial prosthodontist are suggested.

Hydroxyapatite-based porous aggregates: physico-chemical nature, structure, texture and architecture.

At the request of medical teams from the maxillofacial sector, a highly porous ceramic support based on hydroxyapatite of around 70-80% porosity was produced with a pore size distribution similar to bone texture (< 10 microns, approximately 3 vol%; 10-150 microns, approximately 110 vol%; > 150 microns, approximately 86 vol%). The ceramic substrates were conceived not only as a fillers for bone cavities, but also for use as drug dispensers and as supports to host cells to produce particular therapeutic agents. A method is suggested to obtain a substrate of high porosity, exploiting the impregnation of spongy substrate with hydroxyapatite ceramic particles. X-ray and scanning electron microscopy analyses were carried out to evaluate the nature of the new ceramic support in comparison with the most common commercial product; pore size distribution and porosity were controlled to known hydroxyapatite ceramic architecture for the different possible uses.

[Possibilities of improving surface properties of medical implants 1]. / Lehetöségek az orvosi implantátumok felületi tulajdonságainak javítására (1. rész).

The work is planned in three parts. The first reviews the various modification of the surface-treatment procedures for medical implants. A separate section deals with procedures involving the application of material or the removal of material, and those is which material is not applied or removed. Special consideration is paid to the surface-treatment procedures for facial or mandibular implants, and techniques involving calcium phosphate and hydroxylapatite coatings.

[Evaluation of the properties of siloxane materials and products used for endoprosthesis in reconstructive maxillofacial surgery]. / Otsenka svoistv siloksanovykh materialov i izdelii iz nikh, primeniaemykh dlia éndoprotezirovaniia v cheliustno-litsevoi khirurgii.

Methods of estimating the resistance to thread-induced breakage, static bending and puncturing are developed and recommended for including into normative and technical documentation (NTD) for maxillofacial implants with regard to the State standard 12.4.118-82. That was made for wider and more reliable estimation of properties of the materials, used in maxillofacial surgery, in addition to routine methods of estimation of physical and mechanical properties of rubber. Special NTD-recommended methods of bone endoprostheses estimation are developed.