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1.
Stomatologiia (Mosk) ; 99(3): 47-51, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608949

RESUMO

Correction of the lower jaw contours is one of the most popular tasks in aesthetic maxillofacial surgery. There are many reduction operations aimed at changing the shape of the lower jaw. However, augmentation mandible plasty is mainly associated with the use of synthetic implants. In 2013, A. Triaca published a paper «chin wing technique¼ in detail, which we used as a prototype. In this article, we will present the technique and experience of using osteoplastic three-dimensional mandible plasty, which has a number of special features: the increase in the bigonial width is due to the median vertical osteotomy of the free lower edge of the lower jaw, followed by lateralization of the distal parts of the lower fragments, osteosynthesis is performed using the original trapezoidal titanium mini-plate. Since 2018 30 patients have been operated on with different variants of the anatomy of the lower jaw with requirements for increasing the projection of the chin, increasing the width of the lower third of the face and changing the contour of the mandible. The mandible plasty proposed by us allows us to achieve good aesthetic results and can replace the use of synthetic implants.


Assuntos
Estética Dentária , Procedimentos Cirúrgicos Reconstrutivos , Face , Humanos , Mandíbula/cirurgia , Osteotomia
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 338-342, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32573145

RESUMO

Adequate bone volume is the primary condition for successful dental implants. However, sufficient bone volume is often encountered in the vertical direction, but the bone volume in the buccolingual direction is insufficient, making it less suitable to be implanted. If the traditional spitting technique is used in the mandible, fracture and necrosis can easily occur in the labial (buccal) bone plate due to the absence of elasticity, thick cortical bone, poor blood supply, and anastomotic branch. The two-stage ridge splitting technique can be used in patients with narrow alveolar ridge in the mandible. This study summarizes the principles and conditions of application, operational points, clinical efficacy, and analysis of the causes of buccal bone plate absorption.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Implantes Dentários , Processo Alveolar , Transplante Ósseo , Implantação Dentária Endo-Óssea , Humanos , Mandíbula/cirurgia
3.
Artigo em Inglês | MEDLINE | ID: mdl-32559036

RESUMO

This case report describes the minimally invasive full fixed rehabilitation of a totally edentulous severely atrophic mandible. The patient refused to undergo any other treatment, from the reconstructive surgery to the removable prosthesis, and asked for a fixed minimally invasive solution in the shortest possible time. Considering that the posterior mandibular bone was inadequate in height and that the interforaminal bone was only 4.3 to 5 mm in height, the patient received four 4-mm-ultrashort implants in the interforaminal area that were immediately loaded. Within all the limitations of this case report this procedure in this specific case appears successful through 2 years of loading.


Assuntos
Implantes Dentários , Arcada Edêntula/cirurgia , Atrofia , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Mandíbula/cirurgia , Resultado do Tratamento
4.
J Biol Regul Homeost Agents ; 34(1 Suppl. 2): 7-11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32270662

RESUMO

The rehabilitation of the edentulous mandible is a relatively common clinical problem and dentatl implants are popular medical device routinely use in daily practice. Recently a new type of two-piece spiral implants has been introduced in the market. Here a retrospective study is reported. A total of 54 two-piece implants were inserted in mandible in the period between June and December 2017, 30 in female and 24 in males. The median age was 53 ± 8. Implants replaced 11 incisors, 6 cuspids, 23 premolars and 14 molars. Implant' length was 10 mm, 11,50 mm and 13 mm in 16, 19 and 19 cases, respectively. Implant' diameter was 3.3 mm, 3.75 mm and 4.2 mm in 22, 13, 19 cases, respectively. Twenty two fixtures were placed in totally edentulous patient and 32 in partially edentulous subjects. There were 4 single crowns, 28 implants bearing two or greater bridges, 4 removable dentures and 18 supporting Toronto bridge. The overall mean follow-up was 13 ± 2 months. One implant was lost so that survival rate (SVR) was 98.15%. Then peri-implant bone resorption (success rate, SCR) was used to investigate peri-implant bone stability. No implant have a crestal bone resorption greater than 1.5 mm so that the implants studied are reliable devices for oral rehabilitation with a very high SCR and SVR.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Mandíbula/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
5.
J Biol Regul Homeost Agents ; 34(1 Suppl. 2): 13-17, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32270663

RESUMO

Oral rehabilitation by means dental implants has high standards of success. Recently, a new type of two-pieces spiral implants has been introduced in the market. Since few reports focus of the efficacy of this medical device as a reliable tool for oral rehabilitation, here a retrospective study is reported. In the period June-December 2017 one hundred and two spiral fixtures were inserted, half in females and 51 in males. The median age was 56 ± 8 (min-max 36-73 years). Forty-eight implants were inserted in upper jawbone and 54 in mandible. Two implants were lost and thus survival rate (SVR) is 99.9%. Then peri-implant bone resorption was used to investigate the clinical success (success rate, SCR) over time. No implants have a crestal bone resorption greater than 1.5 mm in the first year follow up. No studied variable has an effect on clinical outcome. In conclusion the studied implants have high SCR and SVR so that they are good tools for oral rehabilitation.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Mandíbula/cirurgia , Maxila/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
6.
Clin Ter ; 171(2): e110-e113, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32141481

RESUMO

Osteoradionecrosis (ORN) is a well-recognized, debilitating complication of radiotherapy for patients with head and neck cancer. There is no universally accepted treatment for ORN of the jawbones. We report on a case of refractory mandibular ORN treated by sequestrectomy of mandible and autogenous transplantation of fat graft combined with platelet-rich fibrin (PRF). Improved perfusion was observed using the laser Doppler flowmetry. This case highlights the use of autogenous free fat graft and PRF as an adjunct therapy to sequestrectomy in the management of ORN.


Assuntos
Tecido Adiposo/transplante , Doenças Mandibulares/terapia , Osteorradionecrose/terapia , Fibrina Rica em Plaquetas , Terapia Combinada , Humanos , Masculino , Mandíbula/cirurgia , Doenças Mandibulares/cirurgia , Pessoa de Meia-Idade , Fatores de Risco , Cicatrização
7.
Niger J Clin Pract ; 23(2): 205-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32031095

RESUMO

Aim: The aim of this retrospective study is to determine the level of visibility of the lingual foramen in panoramic radiography using cone-beam computed tomography (CBCT) as a reference tool. Method: A total of 200 patients (111 females and 89 males) were included in the study. Cross-sectional CBCT images of the mandible in the midline were used to locate and define the orifice and diameter of each lingual canal that was detected. The appearance of the lingual foramen in the anterior mandible in panoramic radiography was assessed using a five-point ordinal scale. Descriptive statistics including tables and graphs were used. The correlation between CBCT and panoramic radiography findings were analyzed using Chi-square tests. Results: The lingual foramen was found to be located most frequently in the mandibular midline, above the genial tubercle (78.5%). A narrow-diameter type was found to occur most frequently (56.5%). A prominent genial tubercle was the most commonly found type (57.5%). The lingual foramen could be definitively identified in panoramic radiographs in only 8 cases (4%), while a high degree of probability was found in 25 cases (12.5%). The lingual foramen appears wider and therefore more distinctive in panoramic radiographs when the angulation of the lingual canal is less than 20° to the ground plane. Conclusions: Radiological evaluation with panoramic radiographs alone may lead to inadequate assessments prior to surgical procedures involving the anterior mandible. Clinicians may consider using three-dimensional imaging for procedures with a risk of hemorrhagic and neurosensory complications such as dental implant placement in the anterior mandible.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional , Mandíbula/diagnóstico por imagem , Nervo Mandibular/diagnóstico por imagem , Radiografia Panorâmica/métodos , Adulto , Biometria , Estudos Transversais , Implantes Dentários , Feminino , Humanos , Masculino , Mandíbula/inervação , Mandíbula/cirurgia , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Adulto Jovem
8.
Niger J Clin Pract ; 23(2): 240-245, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32031100

RESUMO

Aims: Le Fort I (LI) osteotomy has been used for the correction of dento-facial deformities of the midface. The aim of this study was to determine the effects of advancement and impaction of the maxilla with LI osteotomy on the nasal cavity and septum. Patients and Methods: In this study, 40 adult patients, 23 females and 17 males (mean age 20.52 ± 4.4 years), who underwent single-piece LI advancement and impaction surgery combined with a bilateral sagittal split osteotomy (BSSO) were included. Posterior-anterior (PA) and lateral cephalometric radiographs taken before surgery (T0) and at least three months after surgery (T1) were evaluated. The superior and anterior movements of maxilla, changes of the nasal cavity, nasal septum and maxillo-mandibular parameter were measured on the cephalometric radiographs. Treatment changes were statistically analyzed using paired sample t-test, and Pearson correlation analysis was applied for the determination of the relationship between variables. Results: There was no statistically significant change in the deviation parameters (P > 0,05). However, a statistically significant decrease was found for left and right nasal cavity heights after LI osteotomy (P < 0.05). Furthermore, no significant correlation was found between septal deviation angle and extent of maxillary movement (P > 0.05). Positive correlation was found between nasal cavity width and amount of maxillary impaction. (P < 0.05). Conclusion: The influence of maxillary impaction with LI osteotomy on nasal septum deviation was not found significant but maxillary impaction with LI osteotomy significantly increased the nasal cavity width.


Assuntos
Mandíbula/cirurgia , Maxila/cirurgia , Septo Nasal/diagnóstico por imagem , Deformidades Adquiridas Nasais/etiologia , Cirurgia Ortognática/métodos , Osteotomia de Le Fort/métodos , Complicações Pós-Operatórias , Adolescente , Feminino , Humanos , Masculino , Cavidade Nasal , Septo Nasal/cirurgia , Osteotomia de Le Fort/efeitos adversos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
9.
Medicine (Baltimore) ; 99(3): e18875, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011513

RESUMO

RATIONALE: In surgery of the lower jaw, the application of computer-assisted navigation is complicated and challenging due to the mobile nature of the mandible. In this study, we presented a computer-assisted navigation surgery for removal of the foreign body in the lower jaw with a mandible reference frame, basing on the strategy that the mandible is independent as an entity. PATIENT CONCERNS: A 41-year-old male patient, identified as having a broken fissure bur that displaced into the mandibular lingual soft tissue, was referred to our department. The fissure bur broke accidentally and then displaced into the soft tissue when the patient underwent extraction of the left mandibular impacted third molar. DIAGNOSIS: A metallic foreign body in the left lower jaw, confirmed by orthopantomography. INTERVENTIONS: A computer-assisted navigation surgery with a customized mandible reference frame. OUTCOMES: The broken bur was removed successfully. Satisfactory wound healing and mouth opening was achieved, without postoperative complications. LESSONS: Surgeons should be alert to the presence of broken bur in the lower jaw and avoid its displacement into deep facial space, and computer-assisted navigation with a mandible reference frame is recommended for removal of the foreign body in the lower jaw.


Assuntos
Corpos Estranhos/cirurgia , Mandíbula/cirurgia , Cirurgia Assistida por Computador , Adulto , Corpos Estranhos/diagnóstico por imagem , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Radiografia Panorâmica
10.
Medicine (Baltimore) ; 99(2): e18069, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914012

RESUMO

This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.The incisive foramen (IF) was measured 20.55 ±â€Š2.81 mm to margo inferior of incisor, and 45.27 ±â€Š5.27 degree from the axial midline. The greater palatine foramen located 43.17 ±â€Š2.55 mm from the IF, while 21.08 ±â€Š3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ±â€Š5.74 mm from the IF and 20.05 ±â€Š3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ±â€Š1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ±â€Š2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ±â€Š1.86 mm, while it became 13.00 ±â€Š2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ±â€Š3.22 mm. It turned out to be 25.78 ±â€Š5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ±â€Š3.06 mm from the upper margin of the second premolar to the MF.The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Mandíbula/anatomia & histologia , Forame Mentual/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/cirurgia , Criança , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Forame Mentual/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
11.
Orv Hetil ; 161(2): 67-74, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31902234

RESUMO

Gorlin-Goltz syndrome is an autosomal dominant hereditary disease. Its leading symptoms include keratocysts of the jaws, multiple basal cell carcinomas, skeletal abnormalities, intracranial calcifications and dyskeratosis of the soles and palms. One of the most common and often firstly discovered symptoms is the single or multiplex keratocysts of the jaws. The authors present a case of a child, diagnosed in their orthodontic department. Despite the rare occurrence of the disease, an early detection is important, especially in young patients. Regular follow-up and timely care for patients may avoid life-threatening malformations and radical surgical treatments. Orv Hetil. 2020; 161(2): 67-74.


Assuntos
Síndrome do Nevo Basocelular/diagnóstico , Calcinose , Disceratose Congênita , Procedimentos Cirúrgicos Bucais/métodos , Administração Oral , Síndrome do Nevo Basocelular/cirurgia , Síndrome do Nevo Basocelular/terapia , Criança , Seguimentos , Humanos , Mandíbula/cirurgia , Braquetes Ortodônticos
12.
J Craniofac Surg ; 31(2): e156-e161, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977697

RESUMO

The term osteomyelitis of the jaws identifies different pathological patterns characterized by the involvement of the cortical bone and bone marrow in osteoarticular infections.At the head and neck level, the segment most affected by osteomyelitis is the mandible and in most of the cases the cause of the infection is bacterial, as a result of pulp or periodontal infections, post-extraction alveolitis, foreign bodies and fractures. The mandibular PCO often presents with an insidious onset, without a striking acute phase, and it is characterized by recurrent episodes of pain, swelling, lockjaw, latero-cervical lymphadenopathy, without signs of suppuration.Three patients have been collected and recorded for the study.The authors believe that in the more advanced cases of PCO in adult patients, in which the mandibular bone appears almost entirely sclerotic and deformed, and that are not responsive to pharmacological therapy or to conservative surgical therapies such as decortication, it is necessary to perform a complete removal of the portion affected by osteomyelitis, with lower alveolar nerve preservation and contextual reconstruction with free microvascular bone flap.Our review aims to describe the clinico-pathological features of a rare pathological entity, propose a surgical treatment algorithm using computer-aided-design/computer-aided manufacturing technology and review the existing literature.


Assuntos
Doenças Maxilomandibulares/cirurgia , Mandíbula/cirurgia , Osteomielite/cirurgia , Adulto , Doença Crônica , Desenho Assistido por Computador , Feminino , Retalhos de Tecido Biológico/cirurgia , Humanos , Doenças Maxilomandibulares/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Reconstrução Mandibular , Osteomielite/diagnóstico por imagem , Adulto Jovem
13.
J Craniofac Surg ; 31(1): e81-e82, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31652213

RESUMO

The authors report a rare case of intraosseous hemangioma of the mandible in a 14-year-old male. Surgical intervention with embolization is as important as histological and radiological examination to reduce the bleeding complication. Magnetic resonance angiography is paramount of importance in these lesions to detect the supplier arteries.


Assuntos
Hemangioma/cirurgia , Mandíbula/cirurgia , Crânio/anormalidades , Coluna Vertebral/anormalidades , Malformações Vasculares/cirurgia , Adolescente , Embolização Terapêutica , Hemangioma/patologia , Humanos , Masculino , Mandíbula/patologia , Procedimentos Cirúrgicos Reconstrutivos , Crânio/patologia , Crânio/cirurgia , Coluna Vertebral/patologia , Coluna Vertebral/cirurgia , Malformações Vasculares/patologia
14.
J Craniofac Surg ; 31(1): 222-225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31633663

RESUMO

INTRODUCTION: Mandibular distraction osteogenesis (MDO) is an effective treatment for severe micrognathia, as it helps to avoid tracheostomy but has some adverse effects on the temporomandibular joint (TMJ). TMJ ankylosis is a serious condition leading to feeding difficulties and growth impairment, and could result in worse consequences in cases with micrognathia who already have limited growth potential. Here, we aimed to report on cases with TMJ ankylosis-a rare but devastating complication of MDO. In total, we described 3 syndromic cases with TMJ ankylosis that developed after MDO and reviewed the associated literature. MATERIAL AND METHODS: We retrospectively enrolled 3 patients who presented with TMJ ankylosis following MDO at the Oral and Maxillofacial Surgery Department of the University Hospital of Lille, France. RESULTS: All 3 patients had craniofacial syndrome with micrognathia. MDO was performed at least twice in each case, and the 3 patients developed subsequent TMJ ankylosis. They all presented with TMJ ankylosis and micrognathia in our Department. DISCUSSION: MDO leads to a certain amount of stress on the TMJ, and in cases with congenital TMJ deformation, such stress could lead to TMJ ankylosis. To our knowledge, 12 cases of TMJ ankylosis after MDO have been described in studies involving 309 patients while it is not reported in other publications. They were all syndromic patients. Thus, TMJ health should be carefully monitored during and after MDO to avoid TMJ ankylosis, and alternative treatments such as costochondral grafts should be considered.


Assuntos
Anquilose/cirurgia , Mandíbula/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Anquilose/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Micrognatismo/diagnóstico por imagem , Micrognatismo/cirurgia , Osteogênese por Distração , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Resultado do Tratamento
15.
J Craniofac Surg ; 31(1): e84-e89, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31634311

RESUMO

Agnathia-otocephaly complex (AOC) is a rare malformation complex of the first pharyngeal arch that is characterized by agnathia/dysgnathia, microstomia, aglossia/hypoglossia and variable displacement of the ears. Only 11 post-infancy patients with severe AOC have been described in the literature, and the incidence of this malformation complex is estimated to be 1 per 70,000 births. In this brief clinical study, the authors describe the case of an 18-year-old female diagnosed with AOC who underwent a 3-step mandibular distraction protocol with an external distraction device. The surgical protocol the authors used was unique in that we first placed a tissue expander in the submental area to enlarge the skin envelope in an effort to mitigate skeletal relapse from soft tissue forces. Furthermore, the way in which the authors slowed the activation of the distraction device to allow for soft tissue healing behind the pins was a novel component of the patient's treatment. The 3-step mandibular distraction protocol the authors present in this study increased the length of the mandible by 20 mm, and nearly doubled the size of the patient's mandible from an initial volume of 3.62 cm to a post-operative volume of 6.89 cm. Future surgeries will aim to improve the function of our patient's expanded mandible. Most important of all, the surgical treatment authors are presenting led to a significant improvement in our patient's physical appearance and 3d quality of life.


Assuntos
Anormalidades Craniofaciais/cirurgia , Anormalidades Maxilomandibulares/cirurgia , Mandíbula/cirurgia , Adolescente , Anormalidades Craniofaciais/diagnóstico por imagem , Feminino , Humanos , Anormalidades Maxilomandibulares/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Osteogênese por Distração , Qualidade de Vida
16.
J Craniofac Surg ; 31(1): 303-305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31634314

RESUMO

The aim of this study was to investigate whether it is possible to pull the platysma effectively in the medial or lateral direction (medial platysmaplasty and lateral platysmaplasty) and to explore the anatomical basis of those findings.Six hemifaces from 3 fresh cadavers were dissected. After skin removal, the platysma was pulled upward and in the medial or lateral direction with the ulnar side of the palm. Its mobility was checked. In 2 volunteers, using wooden bar, the skin overlying platysma was pulled in superomedial and superolateral direction.The platysma ran diagonally from the acromio-deltoid region to the perioral and submental area. In all hemifaces, the platysma was attached to the mandible along its course. The platysma inserted into the mandibular body. At its medial portion (approximately halfway medially from the mentum to the angle; 4-5 cm), the attachment was so firm that it could not be moved horizontally. The posterolateral portion of the platysma was indirectly attached to the mandible and movable. In cadaver, platysma did not move much when it was pulled in the medial direction. In the lateral direction, however, platysma did move well. In living body, when skin overlying platysma was pulled in superomedial direction and superolateral direction, 3 points marked on mandibular border moved about 1.5-2.0 cm and 2.0-2.5 cm respectively.It is thought that medial platysmaplasty can correct anterior neck deformities and redistribute neck skin mainly in the submental area, while that lateral platysmaplasty can pull the cheek skin in superolateral direction.


Assuntos
Ritidoplastia , Adulto , Cadáver , Queixo/cirurgia , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Pescoço/cirurgia
17.
J Craniofac Surg ; 31(1): 150-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31794444

RESUMO

BACKGROUND: Mandibular distraction with horizontal osteotomy of the ramus and vertical distraction vector has successfully treated airway obstruction in young Pierre Robin patients. Placing the osteotomy just above the dentoalveolar plane can minimize damage to the inferior alveolar nerve. This study maps the position of the mandibular foramen relative to the height of the dentoalveolar plane to demonstrate the safety of this technique in Pierre Robin neonates. METHODS: Retrospective review of 3D CT scans of Pierre Robin patients was performed with inclusion criteria: ≤1 year of age, bilateral micrognathia requiring surgical intervention for airway (ie, tracheostomy versus mandibular distraction), no prior mandible surgery, and pre-operative 3D CT study. Demographic information collected included: age at CT scan, age at surgery, and genetic diagnosis. Using the 3D study of each patient's right mandible, a line at the level of the mandibular dentoalveolar plane was drawn across the lingual surface of the ramus and the distance to the mandibular foramen at a length perpendicular to the dentoalveolar plane line was then measured. RESULTS: Fifteen patients were included in the study (at least 9 Pierre Robin). Average age at time of CT scan was 71.4 days old. The mandibular foramen was below the level of the dentoalveolar plane in all cases at an average distance of 4.7 mm. Average ramus height 46.2±13.4 CONCLUSIONS:: The dentoalveolar plane was consistently above the mandibular foramen in all patients. Thus, the horizontal corticotomy at a level just above the mandibular dentoalveolar plane spares the inferior alveolar nerve in neonatal Pierre Robin patients undergoing vertical vector mandibular distraction.


Assuntos
Mandíbula/cirurgia , Osteotomia/métodos , Síndrome de Pierre Robin/cirurgia , Obstrução das Vias Respiratórias , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Micrognatismo/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
18.
J Craniofac Surg ; 31(1): 274-277, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31794447

RESUMO

In 2016, water lines at a children's dental clinic in Orange County, California were contaminated with Mycobacterium abscessus (MA), a non-tuberculosis rapidly-growing mycobacterium, leading to the largest MA outbreak ever reported. Mandatory reporting and active case finding directed by the Public Health Department was conducted in collaboration with community Pediatric Infectious Disease physicians for patients who underwent dental pulpotomies at the contaminated Dental Clinic from January 1 to September 6, 2016. Seventy-one cases (22 confirmed and 49 probable) were identified. One case that required extensive debridement and reconstruction of the mandible is presented in detail. CT maxillofacial demonstrated osteomyelitis extending from the right mandibular angle to the left ramus with multifocal periapical lucencies. CT chest and neck revealed numerous pulmonary nodules and bilateral cervical lymphadenopathy. Extraction of several involved teeth, bilateral selective neck dissection, and extensive mandibular debridement was performed, followed by mandibular stabilization with a custom pre-bent 2.0-mm locking plate. CT images 1-year post-operative showed clearance of infection and sufficient bony stability. Subsequent removal of hardware and bone grafting was performed and the patient is doing well. In the event of a future odontogenic mycobacterium outbreak, the experience at our institution can inform multidisciplinary treatment approaches. Prophylactic extraction of primary teeth that received pulpotomies with contaminated water should be performed. Early and thorough debridement of affected bone, including enucleation of secondary teeth, should be performed if necessary for early source control.


Assuntos
Mandíbula/cirurgia , Reconstrução Mandibular , Mycobacterium abscessus , Osteomielite/cirurgia , Transplante Ósseo , Pré-Escolar , Desbridamento , Humanos , Masculino , Pescoço , Osteomielite/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
J Endod ; 46(1): 29-33, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735361

RESUMO

INTRODUCTION: Altered sensation is a rare but disturbing adverse event after mandibular premolar and molar periapical surgery procedures, and its incidence is not known. The aim of this study was to determine the incidence of altered sensation after periapical surgery procedures in mandibular premolars and molars. METHODS: This retrospective study includes patients who received periapical surgery in endodontic clinics of a university hospital in the United States. Data were obtained by review of the records for patients who met the inclusion criteria, and statistical analysis of possible predictive factors was performed using the 2-tailed Fisher exact test (α = 0.05). RESULTS: Sixty-two patients (63 teeth, 13 premolars and 50 molars) met the inclusion and exclusion criteria and were analyzed in the study. The first follow-up visit occurred 3 to 37 days after surgery. Altered sensation was observed in 9 patients. Observation of altered sensation was significantly higher (odds ratio = 7.19) after premolar surgeries (5/13) compared with molar surgeries (4/50). CONCLUSIONS: Despite the limited size and retrospective nature of this study, it was concluded that the incidence of altered sensation after periapical surgery appears to be relatively high (14%), with a higher incidence found in premolars compared with molars.


Assuntos
Dente Pré-Molar , Mandíbula , Dente Molar , Transtornos das Sensações , Dente Pré-Molar/cirurgia , Humanos , Incidência , Mandíbula/cirurgia , Dente Molar/cirurgia , Estudos Retrospectivos , Sensação , Transtornos das Sensações/etiologia
20.
Biomed Res Int ; 2019: 8962730, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31828142

RESUMO

Objective: The aim of the study is to evaluate the effects of multilaminated small intestinal submucosa (mSIS) combined with bone substitute material to repair peri-implant defects during guided bone regeneration procedures. Methods: Twelve implants were placed in bilateral lower premolars of three beagle dogs, and a peri-implant buccal bone defect (3 mm width and 4 mm height) was created at each implant site. A total of 12 sites were filled with a particulate bone substitute material and then randomly divided into three treatment groups: covered by mSIS membrane (mSIS group), covered by collagen membrane (BG group), and no treatment (control group), each group of four sites. After 12 weeks of healing, all of the animals were euthanized and dissected blocks were obtained for micro-computed tomography (micro-CT) and histological analyses. Results: Micro-CT results revealed similar horizontal width of augmented tissue and new bone formation between mSIS and BG groups (P < 0.05). Histological analyses revealed that the differences in horizontal widths of newly formed bone and bone-to-implant contact between mSIS and BG groups were not significant (P > 0.05). All of these parameters were significantly different from those in the control group (P < 0.05). Conclusions: These findings confirmed that mSIS combined with the bone substitute material enhanced bone regeneration in peri-implant defects, in a manner similar to that of a collagen membrane.


Assuntos
Processo Alveolar/cirurgia , Regeneração Óssea , Substitutos Ósseos , Mandíbula/cirurgia , Processo Alveolar/diagnóstico por imagem , Animais , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Substitutos Ósseos/química , Substitutos Ósseos/farmacologia , Cães , Mucosa Intestinal/química , Intestino Delgado/química , Masculino , Mandíbula/diagnóstico por imagem , Suínos , Microtomografia por Raio-X
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