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1.
Pan Afr Med J ; 38: 257, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34104305

RESUMEN

Orofacial clefts are common congenital malformations. Tessier's classification system is the most widely used; it consists of 30 variants including median mandibular clefts (Tessier's cleft No. 30). They can be isolated or associated with cleft of the lower lip, tongue or more rarely, of the sternum. They are very rare, less than 70 cases (all types taken together) have been reported in the literature. We here report an exceptional case of mandibular and sternal cleft with literature review.


Asunto(s)
Mandíbula/anomalías , Anomalías Musculoesqueléticas/diagnóstico por imagen , Esternón/anomalías , Anomalías Múltiples/diagnóstico por imagen , Femenino , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Esternón/diagnóstico por imagen , Adulto Joven
2.
Niger J Clin Pract ; 24(6): 866-873, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34121735

RESUMEN

Aim: To evaluate the effect of prosthetic framework material and cantilever length on peri-implant strain in mandibular all-on-four implant-supported prostheses with different types of arch antagonist forces. Materials and Methods: Models simulating a completely edentulous mandibular arch fabricated in heat-cured acrylic resin were used. On the acrylic models, four implants were placed at regions 34, 32, 42, and 44 simulating all-on-four implant placements. Implant-supported screw-retained fixed prosthesis frameworks were fabricated using three different materials (cobalt-chromium, zirconia, and polyetheretherketone) and with three different cantilever lengths (zero mm, 15 mm, and 25 mm). Strain gauges were attached on the model at the buccal and lingual positions of each implant. Forces simulating opposing natural dentition, conventional complete denture, and the parafunctional habit were applied to the models. The peri-implant strain in each strain gauge was recorded. Results: Least peri-implant strains (67 microstrains) were observed when forces simulating conventional complete dentures were applied on the models and the highest peri-implant strains (9091 microstrains) were observed when forces simulating parafunctional habit were applied. One-way ANOVA test followed by Tukey's post hoc analysis was performed to compare the mean deformation scores between different materials at 50 N load. The level of significance [P-value] was set at P < 0.05. Tests showed significant differences between zero mm and the other types in all the different materials, and also between 1.5 x AP and 2.5 x AP for Zirconia and Peek material at P = 0.02 & P = .008, respectively. The results showed that the type of framework material, cantilever length, and occlusal forces from the opposing arch influence the peri-implant strain in the bone in all-on-four implant-supported prostheses. Conclusion: Rehabilitation of a single, completely edentulous arch with implant-supported prostheses should consider the situation of the opposing arch. The choice of framework material, as well as the cantilever length, should be altered based on the forces from the opposing arch.


Asunto(s)
Implantes Dentales , Dentadura Completa , Resinas Acrílicas , Fuerza de la Mordida , Tornillos Óseos , Prótesis Dental de Soporte Implantado , Humanos , Mandíbula/cirugía
3.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(5): 754-759, 2021 May 20.
Artículo en Chino | MEDLINE | ID: mdl-34134964

RESUMEN

OBJECTIVE: To investigate the anatomy of the perforator vessels of the deep circumflex iliac artery (DCIA) and the techniques for repairing mandibular complex defect using chimeric deep circumflex iliac artery perforator flap (DCIAPF). OBJECTIVE: We analyzed the origin, distribution, number and courses of the perforator vessels of the DCIA, and measured the outside diameters of the vessels at the origin in 6 adult cadaveric specimens (12 sides) with latex perfusion. From July, 2018 to September, 2019, based on the results of anatomical study and imaging findings and using the digital surgical guide plate, we harvested DCIAPF from 4 patients for repairing mandibular body or angle defects and oral soft tissue defects. OBJECTIVE: The perforating vessels of the DCIA included abdominal muscular branches, osteomusculocutaneous branches and terminal musculocutaneous branches. The abdominal muscle branches originated from the DCIA inguinal segment in 4 and from both the inguinal and iliac segments in 2 of the specimens. The osteomusculocutaneous branches all originated from the internal iliac crest in 75% and from both the inguinal and internal iliac crest segments in 25% of cases; the inguinal segment gave rise to only one perforating branch. The number of the musculocutaneous perforating branches was 1 (58.3%) or 2 (41.7%). In the 4 patients undergoing mandibular reconstruction, the DCIAPF survived in all cases with good recovery of the donor site wound. Satisfactory facial appearance with good oral morphology and occlusal relationship was achieved at 1 month postoperatively in all the patients. None of the patients experienced obvious functional abnormalities at the donor site, and imaging examination confirmed successful reconstruction of the oromandibular defects in all the cases. OBJECTIVE: A good understanding of the anatomic characteristics of the perforator vessels of the DCIA combined with imaging examinations and digital surgery technology facilitates the harvest of DCIAPF for repairing mandibular body or angle defects complicated by oral soft tissue defects.


Asunto(s)
Colgajo Perforante , Procedimientos Quirúrgicos Reconstructivos , Adulto , Humanos , Arteria Ilíaca/cirugía , Ilion , Mandíbula/cirugía , Colgajo Perforante/cirugía
4.
J Craniomaxillofac Surg ; 49(6): 435-442, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33934974

RESUMEN

We aimed to compare the reliability of the surgery-first approach and the traditional orthodontic-first approach for the correction of facial asymmetry based on the new classification of facial asymmetry. Patients with facial asymmetry who underwent orthognathic surgery between January 2016 and January 2019 were included. Cephalometric changes and relapse ratios were analyzed 12 months before and after surgery. Patients were divided into horizontal and vertical asymmetry groups based on the asymmetry vector, and subgroup analysis was conducted. The surgery-first approach without presurgical orthodontic treatment and the orthodontic-first approach showed a similar degree of asymmetry correction and skeletal stability. The relapse ratios of the maxilla height in the surgery-first and orthodontic-first groups were 0.25 ± 0.21 and 0.27 ± 0.25, respectively (p = 0.63), the relapse ratios of the maxilla width were 0.31 ± 0.32 and 0.21 ± 0.2, respectively (p = 0.14), the mandibular height relapse ratios were 0.34 ± 0.58 and 0.29 ± 0.36, respectively (p = 0.69), and the mandibular width relapse ratios were 0.12 ± 0.22 and 0.26 ± 0.31, respectively (p = 0.058). The treatment period of the surgery-first group (18.5 ± 5.3 months) was significantly shorter than that of the orthodontic-first group (22.9 ± 7.5 months, p = 0.024). Among the surgery-first group, patients with vertical asymmetry (15.0 ± 3.2 months) had a shorter treatment than those with horizontal asymmetry (21.6 ± 6.8 months, p = 0.006). Although contesting traditional standards is always challenging, the surgery-first orthognathic approach may lead to a new era in traditional orthognathic approaches. This new classification of facial asymmetry could be useful and practical when treating patients with facial asymmetry regardless of the etiology.


Asunto(s)
Maloclusión de Angle Clase III , Procedimientos Quirúrgicos Ortognáticos , Cefalometría , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/cirugía , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Reproducibilidad de los Resultados , Resultado del Tratamiento
5.
J Craniomaxillofac Surg ; 49(6): 443-448, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33941436

RESUMEN

The aim of this study was to explore how mandibular distraction osteogenesis influences morphological changes in the oropharynx and laryngopharynx. This was a retrospective study of airway parameter measurements in CFM patients undergoing mandibular distraction osteogenesis treatment. The indication for surgical treatment was the obvious facial asymmetry. Mimics 17.0 (Materialise Inc., Belgium) was used to build 3D models of the oro- and laryngopharynx. The minimum cross-sectional area (CSA), mean CSA, volume, length, and surface area were measured in the 3D models. All data were entered into SPSS v. 23.0 (SPSS Inc. USA), with statistical differences assessed pre- and postoperatively using the Wilcoxon test. Thirty-two patients diagnosed with CFM were included in this study. Five were classified as type IIa, 21 as type IIb, and six as type III, using the Pruzansky-Kaban classification. The average age of the patients was 8.34 years; 14 were females and 18 were males. The average traction time was 35.59 days and the average length of traction was 35.81 mm. The total volume of the airway was significantly increased after MDO (p = 0.001). In the oropharynx and laryngopharynx segments, the mean CSA, minimum CSA, and surface area were statistically significantly different. According to the results, expansion of oropharynx and laryngopharynx were evident after MDO. Mandibular distraction osteogenensis (MDO) can expand the volume of the oropharynx and laryngopharynx. Therefore, MDO can be considered a clinically useful treatment for changing the structure of the oropharynx and laryngopharynx.


Asunto(s)
Síndrome de Goldenhar , Osteogénesis por Distracción , Bélgica , Niño , Femenino , Síndrome de Goldenhar/diagnóstico por imagen , Síndrome de Goldenhar/cirugía , Humanos , Masculino , Mandíbula/cirugía , Estudios Retrospectivos
6.
Gerodontology ; 38(2): 228-231, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34013564

RESUMEN

OBJECTIVE: To present a feasible treatment method for fractures of severely atrophic mandibles in high-risk patients undergoing general anaesthesia (GA). CASE REPORT: A 77-year-old man presented with bilateral unfavourable fractures in an atrophic mandible. Pre-anaesthetic consultation revealed that the patient was at high risk for GA due to significant medical comorbid conditions of the patient, such as advanced age, chronic obstructive respiratory disease, diabetes mellitus and atherosclerosis. Thus, a modified treatment, consisting of open reduction and internal fixation using a combination of reconstruction plates and miniplates via an extraoral approach, was planned under local anaesthesia. The patient tolerated the surgical procedure well, without the need for sedation, and uneventful healing was achieved during postoperative period. CONCLUSION: Local anaesthesia may be considered as the anaesthetic technique of choice when managing atrophic mandible fractures to reduce the risk of complications and shorten the time needed for recovery, especially in elders with significant medical comorbidities.


Asunto(s)
Fracturas Mandibulares , Anciano , Anestesia Local , Placas Óseas , Fijación Interna de Fracturas , Humanos , Masculino , Mandíbula/cirugía , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/cirugía
7.
Medicine (Baltimore) ; 100(20): e25974, 2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34011085

RESUMEN

ABSTRACT: Nerve injury especially inferior alveolar nerve (IAN) is the one of the complications that occur when the mandibular third molar (M3) is extracted and in case of high risk patients, coronectomy might be an alternative to tooth extraction. The purpose of this retrospective study was to analyze root migration and its influencing factors at 6 months after coronectomy in both 2- and 3-dimensions using periapical view and cone-beam computed tomography (CBCT). We analyzed 33 cases of root remnant after coronectomy and measured the amount of migration in CBCT. The following factors that could possibly affect root migration were also analyzed: age, gender, number of M3 roots, shape of M3s, Pell, and Gregory classification, mesiodistal (MD) angulation, buccolingual (BL) angulation, contact point with the second molar, root curvature, and complete removal of the coronal portion. Migration of greater than 2 mm was found in 64% of the roots in the 2-dimensional (2D) analysis, and the average root migration was 4.11 mm in the 3-dimensional (3D) analysis. The factors affecting migration were the root morphology, complete removal of the coronal portion, impaction depth, and MD angulation in the 2D analysis, and MD and BL angulation in the 3D analysis. Ensuring sufficient space for root migration especially considering angulation, depth and complete removal of the coronal portion might be important factors after coronectomy of the M3. Root remnant after coronectomy of M3 may migrate in young patients who has sufficient empty coronal space and this may reduce the nerve damage by the separation of IAN and M3.


Asunto(s)
Lesiones del Nervio Mandibular/prevención & control , Tercer Molar/cirugía , Procedimientos Quirúrgicos Orales/efectos adversos , Migración del Diente/etiología , Diente Impactado/cirugía , Adulto , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/inervación , Mandíbula/cirugía , Nervio Mandibular/diagnóstico por imagen , Lesiones del Nervio Mandibular/etiología , Persona de Mediana Edad , Tercer Molar/diagnóstico por imagen , Estudios Retrospectivos , Corona del Diente/cirugía , Migración del Diente/diagnóstico , Raíz del Diente/diagnóstico por imagen , Adulto Joven
8.
Swiss Dent J ; 131(4): 349-352, 2021 Apr 06.
Artículo en Francés | MEDLINE | ID: mdl-33789418

RESUMEN

Bone resorption is a consequence of the loss of a tooth. Alveolar ridge resorption can restrict the volume of bone available for the positioning of a dental implant. Bone graft is a routinely performed procedure in order to increase this volume and provide an adequate situation for the replacement of the tooth. However, autogenous bone is the gold standard for this procedure, xenogenous bone is a good alternative. It presents reliable results and a low complication rate. In this article, we describe the case of an infection resulting in a facial skin fistula following a guided bone regeneration. A 52-year-old woman visited a maxillofacial unit with complaints of persistent swelling of the right cheek, associated to a facial skin fistula. She had a history of xenograft with OsteoBiol Gen-os©, performed at a dental office nine months earlier. Clinical examination and computed tomography suggested that there was a migration process of the bone substitute inside the cheek, which had led to the infection with a facial skin fistula. Loss of stability of the bone graft and particular anatomy of the posterior region of the mandible could explain the migration of the particles and the formation of the fistula.


Asunto(s)
Aumento de la Cresta Alveolar , Fístula Cutánea , Regeneración Ósea , Fístula Cutánea/diagnóstico por imagen , Fístula Cutánea/etiología , Fístula Cutánea/cirugía , Implantación Dental Endoósea , Femenino , Humanos , Mandíbula/cirugía , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/terapia
9.
Shanghai Kou Qiang Yi Xue ; 30(1): 93-96, 2021 Feb.
Artículo en Chino | MEDLINE | ID: mdl-33907788

RESUMEN

PURPOSE: To investigate the effect of vascularized free fibular flap in repairing segmental mandibular defects. METHODS: Eighty patients with segmental mandibular defects treated in our hospital from June 2015 to May 2018 were enrolled. Both groups of patients were operated by the same group of medical staff with more than 5 years of clinical experience. Patients were divided into 2 groups using a random number table method, 40 in each group. Patients in the control group underwent non-vascularized iliac bone graft while patients in the experimental, group underwent vascularized free fibular bone flap repair. The graft survival, pain, quality of life, negative emotions and complications were compared between the two groups using SPSS 22.0 software package. RESULTS: There was no significant difference in the scores of the proximal gingival papilla, distal gingival papilla, labial margin and labial margin (P>0.05). The gingival texture, color score and total score of the root surface of the experimental group were significantly higher than the control group (P<0.05). The scores of VAS, anxiety and depression in both groups were significantly decreased after operation, but the decrease in the experimental group was greater(P<0.05). Physical function, psychological and social function, life quality of the two groups were significantly increased, but the increase of the experimental group was greater (P<0.05).Three cases (7.5%) developed complications in the control group, including 1 case of pneumonia, 1 case of infection and 1 case of wound recurrence. Two cases(5%) in the experimental group developed of complications, including 1 case of wound recurrence and 1 case of pneumonia, the difference was not statistically significant (P>0.05). CONCLUSIONS: Repair of mandibular segmental defect with vascularized free fibular bone flap can significantly improve the overall effect, relieve pain and negative emotion, improve quality of life of patients and decrease incidence of complications.


Asunto(s)
Colgajos Tisulares Libres , Procedimientos Quirúrgicos Reconstructivos , Trasplante Óseo , Peroné/cirugía , Humanos , Mandíbula/cirugía , Calidad de Vida
10.
Am J Orthod Dentofacial Orthop ; 159(6): 743-749, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33795190

RESUMEN

INTRODUCTION: The purpose of this study was to assess the stability of changes in the upper airways 4 years after orthognathic surgery in patients with skeletal Class II malocclusion. METHODS: A retrospective clinical study was conducted including 33 cone-beam computed tomography images from 11 patients (average age of 35.91 years) followed up longitudinally for 4 years. The airways were measured with the help of the Dolphin Imaging software (Dolphin Imaging and Management Systems, Chatsworth, Calif) at 3 points: T1 (preoperative), T2 (6 months after surgery), and T3 (4 years after surgery). The parameters assessed were surface area (SA), minimum axial area, and volume (VOL) of the pharyngeal airway space. The times were compared using analysis of variance and Tukey's test. Pearson's analysis was performed to assess the correlation with surgical changes and age (P <0.05). RESULTS: Four years after operating on the airway spaces, the means of SA and VOL were significantly higher than those observed before the surgery (P <0.05). The means at 6 months were intermediate, with no significant difference before the surgery and 4 years after it (P >0.05). There was no significant correlation of the changes in SA, VOL, and minimum axial area with the amount of mandibular advancement, counterclockwise rotation of the occlusal plane, and age of the patient (P >0.05). CONCLUSIONS: Four years after mandibular advancement surgery in patients with skeletal Class II malocclusion, the increases in the airways remained stable.


Asunto(s)
Avance Mandibular , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Cefalometría , Tomografía Computarizada de Haz Cónico , Estudios de Seguimiento , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Faringe/diagnóstico por imagen , Estudios Retrospectivos
11.
Am J Orthod Dentofacial Orthop ; 159(6): 836-851, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33840530

RESUMEN

Interdisciplinary treatment for patients with Treacher Collins syndrome is challenging because of the rarity of the condition and the wide variety of phenotypic expression. A 23-year-old male was diagnosed with Treacher Collins syndrome with a history of severe obstructive sleep apnea. He presented with a Pruzansky-Kaban classification grade I mandible, skeletal type II pattern with a hyperdivergent mandibular plane, severe convex profile, and Class II malocclusion with a missing mandibular incisor. Improvement of facial esthetics was achieved by a combination of orthodontics, mandibular distraction osteogenesis, and 2-jaw maxillomandibular advancement surgery. Presurgical orthodontic treatment involved permanent tooth extraction to relieve severe crowding, and Class III mechanics were employed to increase overjet. Correction of mandibular hypoplasia by increasing ramal height and the mandibular length was done by intraoral mandibular distraction osteogenesis. Counterclockwise rotation of the mandibular plane angle and a Class III occlusion with negative overjet were achieved after mandibular distraction osteogenesis. A postdistraction posterior open bite was maintained with a biteplane during the consolidation period. Subsequently, 2-jaw orthognathic surgery was performed. LeFort I osteotomy was done for maxillary advancement to correct an anterior crossbite, eliminate canting, and reestablish occlusal contact at the mandibular occlusal plane. Bilateral sagittal split ramus osteotomy was done to correct the residual mandibular deviation. A genioplasty was also performed to improve chin projection. Postoperatively, the oropharyngeal airway was enlarged. The patient's facial profile and obstructive sleep apnea problem were improved as a result of advancement and counterclockwise rotation of the maxillomandibular complex.


Asunto(s)
Disostosis Mandibulofacial , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Osteogénesis por Distracción , Adulto , Cefalometría , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Disostosis Mandibulofacial/complicaciones , Disostosis Mandibulofacial/cirugía , Adulto Joven
12.
Quintessence Int ; 52(6): 538-546, 2021 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-33880908

RESUMEN

An orthodontic extraction technique with a ramus mini-screw was used to remove a deeply impacted mandibular third molar contacting the inferior alveolar nerve, avoiding damage to the inferior alveolar nerve and relieving postsurgery inflammation. Case presentation: A 24-year-old man was required to extract impacted third molars for orthodontic treatment. Panoramic radiographs and CBCT images showed that his mandibular left third molar penetrated into the inferior alveolar nerve canal and a distomolar was inverted and impacted distally to the third molar. The distomolar was directly removed and the impacted third molar was extruded with the aid of a ramus mini-screw. After 4 months of traction, the mandibular left third molar was successfully moved away from the inferior alveolar nerve canal. No nerve injury occurred after the surgical extraction and the patient was very satisfied with the treatment outcome. Conclusion: Orthodontic extraction, with the aid of ramus mini-screws, is a safe, effective, and efficient technique for the removal of high-risk impacted molars contacting the inferior alveolar nerve. (Quintessence Int 2021;52:538-546; doi: 10.3290/j.qi.b1244345).


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Adulto , Tornillos Óseos , Humanos , Masculino , Mandíbula/cirugía , Nervio Mandibular , Diente Molar , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Radiografía Panorámica , Extracción Dental , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Traumatismos del Nervio Trigémino/prevención & control , Adulto Joven
13.
Biomed Res Int ; 2021: 5586498, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33791365

RESUMEN

Purpose: This study investigated the relationship between the shortest buccal bone marrow of the ramus and skeletal patterns. Materials and Methods: Using cone-beam computed tomography data (specifically, the A point-nasion-B point (ANB) angle), we divided patients into three groups as follows: skeletal class I (0° < ANB < 4°), class II (ANB: ≥4°), and class III (ANB: ≤0°). Sixteen vertical sections in the coronal plane were taken starting from slice 0 (original intact mandibular canal) anteriorly at 2 mm intervals to slice 15 (30 mm). The thickness of the mandible (M) and shortest buccal bone marrow (SBM) were measured. The data of SBM were divided into two groups (SBM ≥ 1 mm and SBM < 1 mm). For each skeletal pattern, an SBM value < 1 mm was considered to indicate a high possibility of postoperative nerve paresthesia and bad split. Results: The three skeletal pattern groups also did not significantly differ in their M values for all sections. The mean SBM values of class III (0.91-2.11 mm) at 6-16 mm anterior to the mandibular foramen were significantly smaller than those of class II (1.53-3.17 mm). Comparing the occurrence ratio of SBM < 1 mm, the highest and lowest probabilities in class III (55% and 21.7%, respectively) were significantly larger at 6-20 mm anterior to the mandibular foramen than those in class II (28.3% and 5%, respectively). Conclusion: Class III had a significantly shorter SBM distance and higher SBM occurrence probability than class II at the mandibular ramus region, implying that class III participants are more likely than class II participants to have nerve paresthesia and bad split after sagittal split ramus osteotomy.


Asunto(s)
Médula Ósea , Tomografía Computarizada de Haz Cónico , Mandíbula , Osteotomía Sagital de Rama Mandibular , Adulto , Médula Ósea/diagnóstico por imagen , Médula Ósea/cirugía , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía
14.
Artículo en Inglés | MEDLINE | ID: mdl-33924711

RESUMEN

The aim of this study was to show the clinical outcomes of the immediate loading of implants inserted by guided surgery in edentulous mandible patients. Edentulous mandible patients were diagnosed with oral examination, cone beam computerized tomography and diagnostic casts for intermaxillary relations and treated with 8-10 implants for rehabilitation with guided surgery and immediate loading. After flapless surgery, implants were loaded with an immediate acrylic temporary prosthesis. After a period of six months, a ceramic definitive full-arch prosthesis was placed. A total of 22 patients (12 females and 10 males) were treated with 198 implants. Eleven patients (50%) had a previous history of periodontitis. Six patients (27.3%) were smokers. The follow-up was 84.2 ± 4.9 months. Clinical outcomes showed a global success rate of 97.5% of implants. Five implants were lost during the healing phase with provisional prosthesis. Twenty-two fixed full-arch rehabilitations were placed in the patients over the 193 remaining implants. Mean marginal bone loss was 1.44 mm ± 0.45 mm. Six patients (27.3%) showed some kind of mechanical prosthodontic complication. Eighteen (9.3%) of the 193 remaining implants were associated with peri-implantitis. The antecedents of peri-implantitis are critical elements for the survival of the implants. The loss of implants was significant in patients who smoked up to 10 cigarettes, compared to non-smokers. Peri-implantitis is one of the key elements in the long-term follow-up of implants and it was more manifest in smoking patients, and in those with a history of peri-implantitis. Marginal bone loss was more significant in smokers. Full-arch rehabilitation is presented as a predictable alternative with minor fatigue problems that are easily solvable.


Asunto(s)
Diagnóstico Bucal , Prótesis e Implantes , Anciano , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/cirugía , Resultado del Tratamiento
15.
Orthod Fr ; 92(1): 37-65, 2021 Mar 01.
Artículo en Francés | MEDLINE | ID: mdl-33792545

RESUMEN

The discussion on whether to extract or not is still a source of debate. However, primacy must be given to the diagnosis based on a dental, skeletal, aesthetic and functional assessment. The therapeutic means are intended to achieve the goals resulting from this diagnosis which are the only way to individualize the treatment plan according to the patient. Symphyseal distraction is a surgical procedure intended to increase the mandibular bone base at the symphysis level and then allow an ideal positioning of the mandibular incisor. After explaining the procedure to integrate this intervention in the treatment plan, the author studied in 25 clinical cases the displacement of the mandibular incisor according to the initial crowding and the increase of the distance between the mandibular cuspids before and after bone distraction. Symphyseal distraction is an effective alternative to the treatment of dental crowding to the mandible by helping to restore nasal breathing by its association with maxillary disjunction while respecting of physiology and balance facial.


Asunto(s)
Maloclusión , Osteogénesis por Distracción , Humanos , Incisivo , Maloclusión/cirugía , Mandíbula/cirugía , Estudios Retrospectivos
16.
Stomatologiia (Mosk) ; 100(2): 64-72, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33874664

RESUMEN

The aim of this study is to develop algorithms for the treatment of patients with class II malocclusion and incisor protrusion using the combination of bracket system, functional fixed telescopic appliance (FFTA) and skeletal anchorage, which allows to achieve effective dentoalveolar compensation of skeletal forms of class II malocclusion. MATERIALS AND METHODS: Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. RESULTS: As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. CONCLUSION: The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.


Asunto(s)
Maloclusión Clase II de Angle , Cirugía Ortognática , Adolescente , Adulto , Algoritmos , Cefalometría , Humanos , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/cirugía , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Adulto Joven
17.
Stomatologiia (Mosk) ; 100(2): 90-96, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33874668

RESUMEN

Correction of disorders during transformation into one of the most difficult tasks, both in orthodontics and in maxillofacial (orthognathic) surgery. This article presents two clinical cases of median osteotomy/ostectomy. The stages of operations are described. Surgical technique of transversal correction by osteotomy/ ostectomy is presented. Operation is combined with bilateral retromolar osteotomy. Three dimensional fragments moving helps to change lower jaw shape. Indications for this surgical manipulation: one or two side cross-bite, discrepancies between size of teeth and length of alveolar bone (lower macrognathia, microdentia, extra-teeth, huge diastema), asymmetry of mandible.


Asunto(s)
Maloclusión , Procedimientos Quirúrgicos Reconstructivos , Cefalometría , Humanos , Maloclusión/cirugía , Mandíbula/cirugía , Osteotomía
19.
Am J Orthod Dentofacial Orthop ; 159(6): 852-865.e5, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33906776

RESUMEN

A 13-year-old growing female patient presented with hemimandibular hyperplasia of the right side, Class III hypodivergent skeletal pattern, and severe facial asymmetry. Corrective surgery was deferred until her growth had been completed. When the patient was 16 years old, a low condylectomy was performed on the hyperplastic side of her mandible to prevent its progressive condylar hyperplasia, while simultaneous orthodontic camouflage treatment was performed with the intrusion of the maxillary right posterior teeth using temporary skeletal anchorage devices without additional orthognathic surgery. A low condylectomy caused anterior and lateral open bite after the downward and backward movement of the chin, which improved Class III appearance. The intrusion of the maxillary right posterior teeth followed by compensating extrusion of the mandibular posterior teeth contributed to improve the patient's facial asymmetry with correction of the transverse occlusal plane and lip canting. After 30 months of treatment, an acceptable esthetic outcome and functional occlusion were achieved. The treatment results were well maintained for 1-year retention.


Asunto(s)
Mordida Abierta , Métodos de Anclaje en Ortodoncia , Adolescente , Cefalometría , Estética Dental , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/cirugía , Femenino , Humanos , Hiperplasia , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Técnicas de Movimiento Dental , Resultado del Tratamiento
20.
J Laryngol Otol ; 135(4): 348-354, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33818328

RESUMEN

OBJECTIVE: To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management. METHODS: Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared. RESULTS: Duration of surgery and hospital stay were significantly longer for transmandibular surgery. Tracheostomy and nasogastric feeding tube rates were similar, but time to decannulation and to oral feeding were longer in the transmandibular surgery group. Transmandibular surgery more frequently required flap reconstruction and had a greater complication rate. Negative margins were fewer in the lateral pharyngotomy group than in the transoral laser microsurgery and transmandibular surgery groups. CONCLUSION: In comparison with transmandibular surgery, transoral laser microsurgery and lateral pharyngotomy were associated with fewer complications and faster functional recovery. Lateral pharyngotomy had a higher rate of positive margins than transoral laser microsurgery, with a consequently greater need for adjuvant therapy. Many patients are nonetheless unsuitable for transoral surgery. All these factors should be considered when deciding on oropharyngeal cancer surgical treatment.


Asunto(s)
Terapia por Láser/métodos , Mandíbula/cirugía , Microcirugia/métodos , Neoplasias Orofaríngeas/cirugía , Faringectomía/métodos , Carcinoma de Células Escamosas de Cabeza y Cuello/cirugía , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Resultado del Tratamiento
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