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3.
Artigo em Inglês | MEDLINE | ID: mdl-33359102

RESUMO

PURPOSE: Successful orthognathic surgery is fundamentally based on accurately carrying out the intended surgical plan intraoperatively. The purpose of this study was to evaluate the accuracy of bone-borne patient-specific maxillary cutting guides and 3-dimensional (3D)-printed plates in repositioning the maxilla during bimaxillary orthognathic surgery. MATERIALS AND METHODS: This was a retrospective case series consisting of patients who had undergone Le Fort I osteotomy with a patient-specific cutting guide and 3D-printed plate as well as a bilateral sagittal split osteotomy and had 6-week postoperative cone-beam computed tomography studies. The primary outcome variable was the difference between the position of the postoperative maxilla and the virtually planned maxilla measured at 10 landmarks in 3 dimensions. Other study variables included the preoperative diagnosis and planned surgical movement at each landmark. Descriptive statistics were tabulated, and bivariate analyses were performed. RESULTS: A total of 10 patients were included in this study. The mean age was 25.7 ± 8.1 years, and there were 5 female patients. The median planned surgical movement was 0.350 mm on the x-axis (right-left), 3.750 mm on the y-axis (anterior-posterior), and 1.704 mm on the z-axis (superior-inferior). The median absolute discrepancy between the postoperative position and the planned position on the x-axis, y-axis, and z-axis was 0.638, 0.798, and 0.481 mm, respectively. There was no significant difference in the discrepancies between the x-axis and y-axis (P = .575), x-axis and z-axis (P = .332), and y-axis and z-axis (P = .114). CONCLUSIONS: Using a patient-specific cutting guide and 3D-printed plate when performing Le Fort I osteotomy allows for accurate 3-dimensional positioning of the maxilla in accordance with the surgical plan.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31326348

RESUMO

Before the introduction of the vaccine, mumps was the most common salivary gland disease and was one of the most common infectious diseases in children globally. Following the introduction of the mumps vaccine in 1967, the disease was almost nonexistent in the United States and was only found to occur in nonvaccinated patients, and even then, it did not present in epidemic portions because of the extent of vaccination in the population at large. Beginning in the early 2000s, viral mumps began to present itself in vaccinated populations, and currently, outbreaks are continuing to increase in number. This article presents information on the various outbreaks, a review of the virus and the disease, including symptoms and comorbidities, and new recommendations for management. Dental practitioners should be aware of the increasing incidence and prevalence of this disease, be able to recognize it, and make appropriate referrals for management.


Assuntos
Vacina contra Caxumba , Vírus da Caxumba , Caxumba , Criança , Surtos de Doenças , Humanos , Caxumba/epidemiologia , Vírus da Caxumba/patogenicidade , Estados Unidos , Vacinação
8.
J Craniofac Surg ; 27(7): 1795-1798, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27548828

RESUMO

The recent advances seen in computer technologies and biomaterials have changed the approach to craniomaxillofacial surgery. In this report, the authors describe the technique of using a resorbable containment system for bone graft in a large mandibular reconstruction patient. The authors provide a patient report with a 1-year follow-up.


Assuntos
Implantes Absorvíveis , Materiais Biocompatíveis , Neoplasias Mandibulares/cirurgia , Reconstrução Mandibular/métodos , Telas Cirúrgicas , Adulto , Feminino , Humanos , Neoplasias Mandibulares/diagnóstico , Desenho de Prótese , Tomografia Computadorizada por Raios X
9.
Dent Clin North Am ; 60(2): 435-43, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27040294

RESUMO

Saliva is one of the most versatile, multifunctional substances produced by the body and has a critical role in the preservation of the oropharyngeal health. It comprises a serous and mucinous component and is secreted by the major salivary glands. The mucins in the saliva serve to protect and lubricate the hard and soft tissues of the mouth, protecting them from chemical and mechanical damage. Hyposalivation can be managed by various salivary substitutes, peripheral sialagogues, and central sialagogues.


Assuntos
Saliva/fisiologia , Xerostomia/etiologia , Humanos , Saliva/metabolismo , Glândulas Salivares , Xerostomia/terapia
10.
Oral Maxillofac Surg Clin North Am ; 26(1): 75-81, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24287195

RESUMO

Although the cause and molecular pathways of Sjögren's syndrome are still unknown, basic, clinical, and translational science have started to identify linkages to other known processes. With the advent of newer, more sensitive, and more accurate chemokine, cytokine, and genetic analysis, the molecular progression of the disease may be understood. The modern technology of sialoendoscopy to treat obstructive sialoadenitis from mucous plugging, and the addition of rituximab to current chemotherapy, have allowed patients with Sjögren's syndrome to have a better quality of life and, if they develop lymphomatous changes, a significant increase in their disease remission and survival rate.


Assuntos
Doenças das Glândulas Salivares/fisiopatologia , Síndrome de Sjogren/fisiopatologia , Biópsia , Progressão da Doença , Endoscopia , Humanos , Linfoma/mortalidade , Linfoma/fisiopatologia , Linfoma/terapia , Qualidade de Vida , Fatores de Risco , Doenças das Glândulas Salivares/terapia , Taxa de Sobrevida
12.
Mil Med ; 174(8): 817-20, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19743736

RESUMO

OBJECTIVE: To examine patient preference regarding physician attire and whether perception of medical competence was influenced by the physician's clothing style. METHODS: New patients presenting to the OB/GYN clinic at the Naval Medical Center Portsmouth were asked to complete a survey regarding patient preference for physcian attire and any effect on their comfort or confidence in the physician. RESULTS: Surveys were collected over a 2-month period. Completed surveys (328) were analyzed with the following results: 86% had no preference whether the physician wore a white coat, 61% preferred scrubs, 13% were uncomfortable talking to a doctor about general topics, and 16% were uncomfortable talking about sexual, psychological, or personal topics based on physician attire. In a comparison between active duty women and dependent wives, a significantly greater number of dependent wives reported the physician attire having no influence on their comfort level discussing general topics with their physician (p = 0.037) or about sexual, psychological, or personal topics (p = 0.035). No difference was seen between groups in the preference to wear a white coat (p = 0.196) or other attire (p = 0.088) or of an influence of the doctors' clothing on the patient's confidence in the doctors' abilities (p = 0.063). CONCLUSION: Overall, female patients in a military setting do not have a preference for specific physician attire and attire does not influence their perception of the doctor's competence. However, a greater number of dependent wives report physician attire has no influence on their comfort level discussing both general and personal topics when compared with active duty women. This finding highlights the unique role of the military uniform in the eyes of active duty women and their potential discomfort in discussing personal medical issues with a physician in military uniform.


Assuntos
Vestuário , Militares , Medicina Naval , Preferência do Paciente/estatística & dados numéricos , Papel do Médico , Padrões de Prática Médica/estatística & dados numéricos , Percepção Social , Adolescente , Adulto , Intervalos de Confiança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Estados Unidos , Adulto Jovem
14.
Oral Maxillofac Surg Clin North Am ; 21(3): 323-9, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19608048

RESUMO

Obstructive disease and chronic infections often are managed by extirpative gland surgery. With the advent of new technology and better understanding of salivary physiology, minimally invasive surgical techniques provide the opportunity for safer and less invasive surgery in alternative care settings and the prospect for gland sparing and restoration of normal function. This article describes techniques for managing acute and chronic salivary gland infections using sialoendoscopy.


Assuntos
Endoscopia/métodos , Doenças das Glândulas Salivares/cirurgia , Cateterismo/instrumentação , Humanos , Litotripsia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos , Cálculos das Glândulas Salivares/cirurgia , Sialadenite/cirurgia
15.
Oral Maxillofac Surg Clin North Am ; 21(3): 359-62, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19608053

RESUMO

Salivary gland infections arise from a wide variety of etiologies: bacteria, localized viruses, systemic viruses, autoimmune diseases, secondary to sialoliths and strictures, and congenital disorders. When dealing with these entities, the diagnosis of the majority of them can be made quickly, although some of the rarer diseases are more difficult to recognize, particularly when they have a more obvious secondary bacterial infection. This article presents six cases and describes their management.


Assuntos
Doenças das Glândulas Salivares/diagnóstico , Adolescente , Idoso , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Caxumba/diagnóstico , Parotidite/diagnóstico , Cálculos das Glândulas Salivares/diagnóstico , Sialadenite/diagnóstico
16.
Anesth Prog ; 54(3): 115-7, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17900210

RESUMO

Dapsone is a leprostatic agent commonly prescribed for the management of leprosy, malaria, and the immunosuppression-induced infections of Pneumocystis carinii and Toxoplasma gondii. In susceptible patients, methemoglobinemia, a potentially life-threatening event, can occur. We report a case of dapsone-induced methemoglobinemia which was observed during general anesthesia for the management of a fractured mandible. The pathophysiology, diagnosis, and management of dapsone-induced methemoglobinemia will be discussed.


Assuntos
Anestesia Geral/efeitos adversos , Dapsona/efeitos adversos , Hansenostáticos/efeitos adversos , Metemoglobinemia/induzido quimicamente , Feminino , Humanos , Fraturas Mandibulares/cirurgia , Metemoglobinemia/diagnóstico , Pessoa de Meia-Idade
17.
J Oral Maxillofac Surg ; 65(9): 1751-7, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17719393

RESUMO

PURPOSE: This article describes a new endoscopic approach for orbital floor fractures, reduction, and fixation and reports the clinical results. PATIENTS AND METHODS: Ten patients who sustained either a comminuted or trap door orbital floor fracture were treated in 2 medical centers following the same surgical protocol. The indications for orbital reconstruction were limited eye movement, diplopia, and significant enophthalmos. The new approach is discussed in detail. RESULTS: All patients healed uneventfully. No major complications were noted in the postoperative period, and good functional and esthetic results were obtained. CONCLUSIONS: Our results demonstrate that endoscopic intraoral plating is a safe and effective procedure for treating orbital floor fractures.


Assuntos
Placas Ósseas , Fraturas Cominutivas/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Fraturas Orbitárias/cirurgia , Adolescente , Adulto , Protocolos Clínicos , Endoscopia , Humanos , Masculino , Pessoa de Meia-Idade
18.
J Am Dent Assoc ; 138 Suppl: 15S-20S, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17761841

RESUMO

BACKGROUND: The objective of this literature review is to summarize information about the etiology, diagnosis, oral sequelae and treatment of dry mouth in elderly patients. TYPES OF STUDIES REVIEWED: The authors conducted a comprehensive review of the English-based scientific literature from the past 10 years. They selected the studies on the basis of clinical investigations to provide an objective assessment of dry mouth problems among older people. RESULTS: Dry mouth (salivary hypofunction, xerostomia) is a common problem among older people. It causes significant oropharyngeal disorders, pain and an impaired quality of life. Dry mouth has many causes, from local salivary disorders to a plethora of medications and medical conditions. Treatments are designed to correct the underlying cause and/or to enhance salivation with topical and systemic stimulants. Early intervention for dry mouth problems helps prevent the deleterious consequences of this disorder in elderly people. CLINICAL IMPLICATIONS: Clinicians must be aware of dry mouth problems in older patients, and they should be prepared to provide a diagnosis and administer treatment to protect a patient's oropharyngeal health and quality of life.


Assuntos
Saúde Bucal , Xerostomia , Idoso , Humanos , Xerostomia/diagnóstico , Xerostomia/epidemiologia , Xerostomia/etiologia , Xerostomia/terapia
19.
J Am Dent Assoc ; 137(10): 1394-400, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17012718

RESUMO

BACKGROUND: During the last 13 years, there has been a growing interest in and use of minimally invasive treatment techniques. Salivary gland endoscopes provide an accurate means of diagnosing and providing minimally invasive surgical treatment for salivary gland diseases. METHODS: The authors review the relevant literature and provide the history of sialoendoscopy. They also report on the treatment methods they use, including instruments and techniques, and their experiences. RESULTS: The authors' overall success rate for parotid endoscopic sialolithotomy is 86 percent, and their overall success rate for submandibular endoscopic sialolithotomy is 89 percent. Their success rate for treating strictures is 81 percent. CLINICAL IMPLICATIONS: The endoscopic technique opens new horizons in the field of salivary gland diseases. Salivary gland stones and sialadenitis no longer are absolute indications for sialadenectomy. Owing to growing experience and surgical skills, new endoscopic techniques are in clinical use, and there is constant improvement in endoscopic treatment success rates. CONCLUSIONS: Sialoendoscopy is a promising new method for use in the diagnosis, treatment and postoperative management of sialadenitis, sialolithiasis and other obstructive salivary gland diseases.


Assuntos
Endoscopia/métodos , Doenças das Glândulas Salivares/diagnóstico , Constrição Patológica/diagnóstico , Constrição Patológica/cirurgia , Endoscópios , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/cirurgia , Doenças das Glândulas Salivares/cirurgia , Sialadenite/diagnóstico , Sialadenite/cirurgia , Resultado do Tratamento
20.
N Y State Dent J ; 72(6): 22-7, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17203851

RESUMO

Gravidity is defined as the development of the young in utero. It initiates hormonal, psychological and physiological changes in the female patient, providing the dentist with many questions about the management of these patients. These physiologic alterations, as well as the embryologic development of the fetus, will be discussed along with the treatment alterations that should be considered. The changes are often subtle, but can lead to disastrous complications if proper precautions are not taken. Conversely, appropriate management of routine and dental emergencies can be denied by the practitioner because of misconceptions about pregnancy and fetal tolerance. Anesthetic and pharmacology of agents used in dentistry in treating the pregnant patient will be reviewed.


Assuntos
Assistência Odontológica/métodos , Gravidez , Analgésicos/efeitos adversos , Anestésicos Locais/efeitos adversos , Antibacterianos/efeitos adversos , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos
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