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1.
Medicine (Baltimore) ; 99(31): e21537, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756204

RESUMO

In head and neck surgery where the oropharyngeal area is the operative field, postoperative respiratory depression and upper airway obstruction are common. Therefore, supplemental oxygen is administered to prevent severe postoperative early hypoxemia. However, a high concentration of oxygen increases the likelihood of secondary complications, such as carbon dioxide (CO2) narcosis. Nasal high-flow (NHF) therapy generates high flows (≤60 L/min) of heated and humidified gas delivered via nasal cannula and provides respiratory support by generating positive airway pressure, clearance of dead space and reduction of work of breathing. This study aims to determine whether the postoperative hypoxemia and hypercapnia can be prevented by NHF without the requirement of supplemental oxygen. The study will recruit adult patients undergoing planned oral surgery under general anesthesia at Nagasaki University Hospital. It is a randomized parallel group comparative study with 3 groups: NHF with room air only and no supplemental oxygen, no respiratory support, and face mask oxygen administration. The study protocol will begin at the time that the patient is returned to the general ward and will finish 3 hours later. The primary endpoint is the time-weighted average of transcutaneous O2 over the 180 minutes and secondary endpoints are the time-weighted average of transcutaneous CO2 (tcpCO2), SpO2, and respiratory rate, incidence rate of marked hypercapnia (tcpCO2 ≥60 mm Hg for 5 minutes or longer), incidence rate of moderate hypercapnia (tcpCO2 ≥50 mm Hg for 5 minutes or longer) and the percentage of time that SpO2 is <90%. Included also is a group in which the postoperative management is performed only by spontaneous breathing without performing respiratory support such as oxygen administration, to investigate the efficacy and necessity of conventional oxygen administration. This exploratory study will investigate the use of NHF without supplemental oxygen as an effective respiratory support during the acute postoperative period. TRIAL REGISTRATION:: The study was registered the jRCTs072200018. URL https://jrct.niph.go.jp/latest-detail/jRCTs072200018.


Assuntos
Anestesia Geral/métodos , Hipercapnia/prevenção & controle , Hipóxia/prevenção & controle , Procedimentos Cirúrgicos Bucais/métodos , Oxigenoterapia/métodos , Cânula , Humanos , Oxigênio/sangue , Oxigenoterapia/efeitos adversos , Período Pós-Operatório , Projetos de Pesquisa
2.
Ann R Coll Surg Engl ; 102(7): 532-535, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32538126

RESUMO

INTRODUCTION: Available data suggest that the two-week wait referral pathway is ineffective at expediting diagnosis of cancer due to large numbers of inappropriate referrals. This study aimed to compare the referral pathway of 125 patients who had undergone primary surgery for oral and oropharyngeal cancer with 100 who had been two-week wait referrals. MATERIALS AND METHODS: This was a case note review. RESULTS: Of the 125 patients who underwent surgery; 47 (38%) were referred via the 2WW pathway. GPs had referred 25 (53%) of the 47 patients and general dental practitioners 22 (47%). The tumour stage was similar regardless of referral pathway (two-week wait or routine). GPs recognised that the two-week wait pathway was needed in 49% of the patients they had referred, whereas the equivalent figure for GDPs was 40%. Of the 100 2WW patients, 52 were biopsied. Of these, nine (9%) were diagnosed with a malignancy. GPs referred 61% of the 100 two-week wait patients and accurately diagnosed five of the cancers (although two were basal cell carcinomas), general dental practitioners the remainder (including one basal cell carcinoma). Overall, 41% of the patients referred on the two-week wait pathway by GPs needed a biopsy, compared with 69% of those referred by general dental practitioners. CONCLUSIONS: While the criteria for referral on the two-week wait pathway lack discrimination and the majority of referrals proved benign, nearly 40% of surgically treated patients were referred via this pathway, suggesting that it does serve a useful purpose. More patients with cancer were referred by GPs, but more two-week wait referrals by general dental practitioners warranted biopsy.


Assuntos
Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Neoplasias Orofaríngeas/cirurgia , Encaminhamento e Consulta , Listas de Espera , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Fatores de Tempo , Resultado do Tratamento
3.
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
4.
J Craniofac Surg ; 31(2): 542-548, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977715

RESUMO

PURPOSE: Try to apply augmented reality (AR) technique which based on visual recognition artificial marks in the treatment of unilateral Orbitozygomatic Maxillary complex fractures (OZMF), and to explore the feasibility and the application value of the AR for assisting the oral and maxillofacial surgery (OMFS) treatment. METHODS: Based on the AR application JSARToolKit developed on the web, and combining with the self-designed tooth-borne type visual recognition artificial marks to display three-dimensional (3D) image of the region of interest (ROI), virtually designed the position and direction of plate on the jaw and helped OZMF surgery. According to some results to evaluate the postoperative effects, such as imaging, occlusion, facial appearance recovery, patients' satisfaction and operation time. RESULTS: The AR achieved the 3D image of ROI in real time, satisfied information enhancement of real scene, broadened the surgeon's horizons and improved the 3D recognition ability of maxillofacial tissue. After operation, patients had no discomforts, fracture reduction were well healed through imaging examination, and the titanium plate position was consistent with the preoperative planning. What is more, patients' facial appearance and occlusal function recovered well, significantly shorten the intraoperation time. CONCLUSION: Augmented reality technology is an effective method for OZMF treatment but there are still many technical difficulties which need to be get over, and its application in maxillofacial surgery and relevant basic theories are both worth further exploring.


Assuntos
Fraturas Maxilares/cirurgia , Adulto , Realidade Aumentada , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Fraturas Maxilares/diagnóstico por imagem , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Cirurgia Assistida por Computador/métodos , Cirurgia Bucal
5.
Ann R Coll Surg Engl ; 102(1): 9-13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31755732

RESUMO

INTRODUCTION: An increasing number of patients are taking oral antiplatelet agents. As a result, there is an important patient safety concern in relation to the potential risk of bleeding complications following major oral and maxillofacial surgery. Surgeons are increasingly likely to be faced with a dilemma of either continuing antiplatelet therapy and risking serious haemorrhage or withholding therapy and risking fatal thromboembolic complications. While there are national recommendations for patients taking oral antiplatelet drugs undergoing invasive minor oral surgery, there are still no evidence-based guidelines for the management of these patients undergoing major oral and maxillofacial surgery. METHODS: MEDLINE and EMBASE databases were searched to retrieve all relevant articles published to 31 December 2017. FINDINGS: A brief outline of the commonly used antiplatelet agents including their pharmacology and therapeutic indications is discussed, together with the haemorrhagic and thromboembolic risks of continuing or altering the antiplatelet regimen in the perioperative period. Finally, a protocol for the management of oral and maxillofacial patients on antiplatelet agents is presented. CONCLUSIONS: Most current evidence to guide decision making is based upon non-randomised observational studies, which attempts to provide the safest possible management of patients on antiplatelet therapy. Large randomised clinical trials are lacking.


Assuntos
Anticoagulantes/administração & dosagem , Procedimentos Cirúrgicos Bucais/métodos , Inibidores da Agregação de Plaquetas/administração & dosagem , Administração Oral , Anticoagulantes/farmacologia , Tempo de Sangramento , Perda Sanguínea Cirúrgica/prevenção & controle , Substituição de Medicamentos , Quimioterapia Combinada , Humanos , Procedimentos Cirúrgicos Ortognáticos/métodos , Segurança do Paciente , Inibidores da Agregação de Plaquetas/farmacologia , Fatores de Risco , Tromboembolia/prevenção & controle
6.
Oral Maxillofac Surg Clin North Am ; 32(1): 83-88, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685346

RESUMO

Patients and orthodontists seek to reduce treatment time in braces. Rapid canine retraction through dentoalveolar distraction osteogenesis is one of several treatment approaches to reduce treatment in braces. This article provides an overview of technique of dentoalveolar distraction osteogenesis to accomplish rapid canine retraction and associated outcomes. When this treatment protocol is implemented well, rapid canine retraction is achieved predictably with minimal side effects. Although current evidence suggests that adverse sequelae, such as root resorptions and pulp devitalization, are rare, prospective clinical studies that are adequately powered and documenting long-term follow-up of these outcomes are lacking.


Assuntos
Procedimentos Cirúrgicos Bucais/métodos , Procedimentos de Ancoragem Ortodôntica , Desenho de Aparelho Ortodôntico , Osteogênese por Distração/métodos , Osteotomia/métodos , Técnicas de Movimentação Dentária/métodos , Humanos , Maxila , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Aparelhos Ortodônticos , Procedimentos Cirúrgicos Ortognáticos , Estudos Prospectivos , Resultado do Tratamento
7.
Isr Med Assoc J ; 12(21): 806-811, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31814344

RESUMO

BACKGROUND: Untreated dental caries or even dental manipulations, such as a tooth extraction, might cause direct spread of an odontogenic infection and consequently the development of life-threatening conditions such as deep neck infections (DNI). The most common source of DNI is of odontogenic origin (38.8-49%). Abscess formation or cellulitis can lead to life-threatening complications, despite new diagnostic imaging technology and widespread availability of antibiotics. OBJECTIVES: To demonstrate the dangers of DNI, which can create life-threatening situations. METHODS: Five cases of DNI of odontogenic origin, which were referred to the oral and maxillofacial surgery unit, are presented. RESULTS: Clinical manifestations included trismus, dysphagia, dysphonia, dyspnea, and infection symptoms. In all cases, computed tomography confirmed diagnosis and extent of abscess. Complications included mediastinitis, respiratory distress, osteomyelitis of the jaws, and in rare cases the mandibular condyle. Treatment included securing the airway, immediate surgical drainage, removal of the infection source, and antibiotic therapy. All patients were discharged in stable and improved condition. CONCLUSIONS: DNI treatment on an emergency basis requires proper diagnosis and effective management. To confirm diagnosis and prevent serious complications, it is essential for physicians to recognize the spaces of the head and neck that are likely to be affected by DNI.


Assuntos
Abscesso , Antibacterianos/administração & dosagem , Celulite (Flegmão) , Cárie Dentária/complicações , Drenagem/métodos , Pescoço , Procedimentos Cirúrgicos Bucais/métodos , Extração Dentária/efeitos adversos , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/fisiopatologia , Abscesso/cirurgia , Adulto , Idoso , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/etiologia , Celulite (Flegmão)/fisiopatologia , Celulite (Flegmão)/cirurgia , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/terapia , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Pescoço/patologia , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
8.
Biomed Res Int ; 2019: 3295756, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886202

RESUMO

Platelet-rich fibrin (PRF) is an autologous platelet concentrate that consists of cytokines, platelets, leukocytes, and circulating stem cells. It has been considered to be effective in bone regeneration and is mainly used for oral and maxillofacial bone. Although currently the use of PRF is thought to support alveolar ridge preservation, there is a lack of evidence regarding the application of PRF in osteogenesis. In this paper, we will provide examples of PRF application, and we will also summarize different measures to improve the properties of PRF for achieving better osteogenesis. The effect of PRF as a bone graft material on osteogenesis based on laboratory investigations, animal tests, and clinical evaluations is first reviewed here. In vitro, PRF was able to stimulate cell proliferation, differentiation, migration, mineralization, and osteogenesis-related gene expression. Preclinical and clinical trials suggested that PRF alone may have a limited effect. To enlighten researchers, modified PRF graft materials are further reviewed, including PRF combined with other bone graft materials, PRF combined with drugs, and a new-type PRF. Finally, we will summarize the common shortcomings in the application of PRF that probably lead to application failure. Future scientists should avoid or solve these problems to achieve better regeneration.


Assuntos
Processo Alveolar , Regeneração Óssea/efeitos dos fármacos , Transplante Ósseo , Procedimentos Cirúrgicos Bucais , Osteogênese/efeitos dos fármacos , Fibrina Rica em Plaquetas , Processo Alveolar/metabolismo , Processo Alveolar/patologia , Processo Alveolar/cirurgia , Animais , Transplante Ósseo/classificação , Transplante Ósseo/métodos , Humanos , Procedimentos Cirúrgicos Bucais/classificação , Procedimentos Cirúrgicos Bucais/métodos
9.
Cient. dent. (Ed. impr.) ; 16(3): 201-207, sept.-dic. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-185995

RESUMO

Introducción: El empleo de dientes autógenos, como material de injerto, es una opción terapéutica actual en casos de regeneración ósea. Su obtención se ha facilitado con la introducción de dispositivos capaces de procesar los dientes. El objetivo de este trabajo es realizar, a propósito de un caso clínico, una revisión de la literatura sobre el uso de dientes autólogos como material de injerto óseo y los dispositivos para su procesamiento. Caso clínico: Paciente varón de 18 años que acude a consulta presentando un cordal inferior retenido. El diagnóstico determinó la necesidad de extraer el diente y se informó al paciente de la posibilidad de utilizarlo como material de regeneración ósea. Tras la exodoncia, el diente procesado con el dispositivo Tooth Transformer(R) (Imbiodent), fue utilizado como material de injerto autólogo. El postoperatorio no presentó ninguna complicación y la evaluación radiográfica, tras 8 días y tras 10 semanas, mostró una evolución favorable del tratamiento. Discusión: La dentina desmineralizada es un material orgánico cuyo potencial reside en los factores de crecimiento que contiene para estimular la formación y reparación ósea. No obstante, no existe consenso sobre el grado de desmineralización o tamaño de partícula ideal. La reciente introducción de dispositivos, capaces de procesar dientes, facilita la obtención de un material de injerto dental para su uso en terapias de regeneración ósea. Conclusión: El uso de dientes autólogos constituye una alternativa prometedora en el campo de los injertos óseos. La técnica de transformación del diente es sencilla con el empleo de los dispositivos actuales


Introduction: The use of autogenous teeth, as graft material, is a current therapeutic option in cases of bone regeneration. Its obtention has been facilitated by the introduction of devices capable of processing teeth. The aim of this article is to perform, based on a clinical case, a review of the literature about the use of autologous teeth as bone graft material and the devices for its processing. Clinical case: Male patient, 18 years of age, who comes to the dental office presenting a lower wisdom retained. Extraction of the tooth was determined by diagnosis and the patient was informed about the possibility of using it as bone regeneration material. After the extraction, the tooth was processed by the Tooth Transformer(R) (Imbiodent) device and was used as autologous graft material. No postoperative complications were presented and the radiographic evaluation, at 8 days and 10 weeks, showed a favorable evolution of the treatment. Discusion: Demineralized dentin is a organic material whose potential relies in the growth factors it contains to stimulate bone formation and repair. However, there is no consensus on the degree of demineralization or the ideal particle size. The recent introduction of devices, capable of processing teeth, enables the obtention of a dental graft material for bone regeneration therapies. Conclusion: The use of autologous teeth is a promising alternative in the bonev grafts field. The technique of tooth transformation is simple with the use of the current devices


Assuntos
Humanos , Masculino , Adolescente , Regeneração Óssea , Polpa Dentária/citologia , Dentina , Carga Imediata em Implante Dentário/métodos , Transplante Ósseo/métodos , Procedimentos Cirúrgicos Reconstrutivos , Desmineralização do Dente , Esmalte Dentário/química , Procedimentos Cirúrgicos Bucais/métodos
10.
Cient. dent. (Ed. impr.) ; 16(3): 209-216, sept.-dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185996

RESUMO

Antecedentes: La técnica de elevación de suelo del seno maxilar con osteótomos (OSFE) consiste en la realización de un lecho en la cresta ósea por don-de se despega y eleva la membrana de Schneider usando los osteótomos con el fin de colocar implantes de una manera menos invasiva, reduciendo el tiempo de la cirugía y disminuyendo las molestias postoperatorias. Hay diferentes factores a la hora de realizar la técnica, como es la cantidad de hueso residual que posee el maxilar atrófico o el tipo de injerto que se va a situar en el seno. El objetivo principal es evaluar la tasa de supervivencia de los implantes colocados de manera simultánea en maxilares atróficos de ≤ 5 mm RBH (hueso residual) y sin colocación de injerto en la cavidad sinusal. Material y métodos: El estudio consiste en una revisión sobre la realización de elevaciones crestales ≤ 5 mm de hueso residual sin el uso de injertos. Para ello hemos analizado 7 estudios, 2 RCT (en-sayos clínicos aleatorizados), 3 estudios retrospectivos y 2 estudios prospectivos. Resultados: Se produjeron 24 perdidas de implantes, siendo 17 tempranas (antes del año) en 379 implantes colocados. Obteniendo tasas de supervivencia de entre 91,4% al 100% en los respectivos estudios analizados. La pérdida ósea marginal del grupo injerto y grupo no injerto era similar. La ganancia ósea sinusal era mayor en el grupo injerto que en el grupo no injerto. Conclusiones: La tasa de supervivencia de la elevación crestal con colocación simultánea de implantes ≤ 5 mm de hueso residual sin colocación de injerto, mostró ser un tratamiento seguro y eficaz, aunque se necesitan más estudios al respecto


Background: The osteotome maxillary sinus floor elevation technique (OSFE) consists in the realization of a bed at the top of the ocean where the Schneider’s membrane is detached and raised using the osteotomes in order to place implants in a lesser invasive manner, reducing the time of surgery and reducing postoperative discomfort. There are different factors when performing the technique, such as the amount of residual bone that has the maximum flow type or the type of injection that will be placed in the breast. The main objective is to evaluate the survival rate of implants placed simultaneously in atrophic maxillae of ≤ 5 mm RBH (residual bone) and without graft placement in the sinus cavity. Material and methods: The study consists of a systematic review approach on the performance of crestal elevations ≤ 5 mm of residual bone without the use of grafts. This analysis is based on 7 studies, 2 RCT (randomized clinical trials), 3 retrospective studies and 2 prospective studies. Results: There were 24 implants lost, 17 in the short-term (prior to a year) from the 379 implants placed. Obtaining survival rates of between 91.4% to 100% for the cases analyzed. The marginal bone loss of the injected group and non-injected group was similar. Sinus bone gain was greater in the group that participated in the non-graft group. Conclusions: The survival rate of crestal elevations with the simultaneous placement of implants ≤ 5 mm of residual bone was a safe and effective work, although greater detailed investigations are required


Assuntos
Humanos , Taxa de Sobrevida , Implantação Dentária/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Atrofia/terapia , Transplante Ósseo/métodos , Implantes Dentários/normas , Materiais Biocompatíveis , Materiais Dentários , Transplante Ósseo/estatística & dados numéricos , Procedimentos Cirúrgicos Bucais/métodos
11.
Cient. dent. (Ed. impr.) ; 16(3): 217-221, sept.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185997

RESUMO

Las malformaciones dentales son defectos formativos causados por alteraciones genéticas durante la morfogénesis den-tal. Pueden ser provocados por factores de índole hereditario, sistémico, traumático o local. Dentro de estas anomalías se encuentra el taurodontismo. Éste se caracteriza por presentar una alteración de la morfología dentaria en la que la porción coronaria del órgano dentario se encuentra alargada con una cámara pulpar ensanchada, a expensas de la porción radicular, disminuyendo la longitud y por tanto, produciéndose una migración apical de la furca del diente. El objetivo del presente artículo es describir las anomalías de forma dentaria y más concretamente el manejo clínico del paciente con taurodoncia en la clínica dental. Para ello se presenta el caso clínico de un paciente de 18 años de edad que acude al Hospital Universitario de la Princesa de Madrid para valorar la exodoncia de dos molares localizados en el primer y cuarto cuadrante. Tras un diagnóstico clínico y radiológico apropiado, se procedió a la exodoncia de los mismos


Dental anomalies are formative defects caused by genetic disturbances during tooth morphogenesis, can be caused by factors of a hereditary, systemic, traumatic or local nature. One such anomaly is taurodontism. It is characterized by pulp chamber enlargement, which may approximate of the root apex, with the body of the tooth enlarged at the expense of the roots and apically displaced furcation areas.The aim of this case report is to describe the abnormalities of tooth shape and particularly the management in the dental clinic of patients with taurodontism. For this purpose a case of a eighteen years patient visiting the Hospital Universitario de la Princesa of Madrid to assess the extraction of two molars located in the first and fourth quadrants. After a proper clinical and radiological diagnostic we proceeded to the extraction


Assuntos
Humanos , Masculino , Adolescente , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/terapia , Má Oclusão/diagnóstico por imagem , Cirurgia Bucal/métodos , Procedimentos Cirúrgicos Bucais/métodos , Radiografia Panorâmica
12.
Cir. plást. ibero-latinoam ; 45(4): 349-354, oct.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-186018

RESUMO

Introducción y objetivo: La rinoplastia estética es uno de los procedimientos quirúrgicos más desafiantes, en donde converge una estructura tridimensional compuesta de tejido óseo, cartilaginoso y tegumentario, que debe ser interpretada y modificada como un todo para la obtención de un resultado óptimo. La técnica A-GI-VA nos abre una ventana nueva para evaluar la anatomía nasal, principalmente los cartílagos nasales, sus relaciones entre sí y su disposición anatómica exacta, indispensable para el buen tratamiento de los mismos. Material y método: Realizamos tomografías axiales computarizadas con reconstrucción tridimensional mediante tomógrafo helicoidal de múltiples cortes para analizar la estructura de los cartílagos nasales y su relación con la piel. Resultados: Identificamos con precisión los componentes osteocartilaginosos de la nariz como ayuda en la planificación de la cirugía nasal. Conclusiones: Mediante la utilización de la técnica A-GI-VA podemos determinar con precisión la estructura nasal para su posterior clasificación y/o tratamiento


Background and objective: Aesthetic rhinoplasty is one of the most challenging surgical procedures, where a bony and a cartilaginous framework covered by skin meet into a tridimensional structure that must be interpreted and modified as one to obtain a successful result. Methods: A regular 3D CT scan of the maxillofacial area with shaded surface display (SSD) technique is used to get a precise evaluation of the nasal cartilages and their relationship with the skin. Results: We obtained a greater detail of the nasal structure, both of its components: bone cartilage in order to improve nasal surgery planning. Conclusions: The A-GI-VA technique allows us to depict the nasal anatomy and determine a better surgery planning


Assuntos
Humanos , Angiografia por Tomografia Computadorizada/métodos , Imageamento Tridimensional/métodos , Rinoplastia , Interpretação de Imagem Assistida por Computador/métodos , Cartilagens Nasais/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais/métodos , Seios Paranasais/diagnóstico por imagem
13.
Biomed Res Int ; 2019: 2010453, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687380

RESUMO

Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area. These bacteria are also responsible for the majority of inflammatory complications after third molar removal. The key to success of antibacterial treatment in both cases is the use of an appropriate antibacterial agent. The aim of the study was to evaluate the susceptibility profile of bacteria isolated from material collected from patients with intraoral odontogenic abscesses. The test material consisted of swabs taken from the odontogenic abscesses, after their incision and drainage. Another swab was collected from the lesion area, 10 days after the initial visit. Results were compared with an identical study conducted on a control group of healthy patients, who had undergone third molar removal. Bacteria identified in this study consisted of aerobic and anaerobic strains, both Gram-positive and Gram-negative. According to the EUCAST guidelines, none of the tested antibiotics was recommended for all identified bacteria. The percentage of bacterial strains sensitive to amoxicillin and clavulanic acid was 78.13% and 81.48% in the study and control groups, respectively, whereas, the percentage of those sensitive to clindamycin was 96.43% and 80.00%, respectively. For Gram-negative aerobic bacteria, gentamicin and ciprofloxacin were among medications affecting all cultured species. 100.00% of strains were found to be susceptible to these antibiotics. Statistically significant relationship between the presence of Gram-negative aerobic strains and the occurrence of complications was found. In the case of the most frequently occurring bacteria in the study, amoxicillin with clavulanic acid and clindamycin were shown to be very effective. In cases of severe purulent odontogenic inflammations, it is recommended to use a combination of antibiotics. Amoxicillin with ciprofloxacin and clindamycin with cefuroxime seem to be the proper choices based on the results of this study.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Inflamação/tratamento farmacológico , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Adulto , Amoxicilina/uso terapêutico , Infecções Bacterianas/microbiologia , Ácido Clavulânico/uso terapêutico , Clindamicina/uso terapêutico , Feminino , Humanos , Inflamação/microbiologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Pacientes Ambulatoriais
14.
Otolaryngol Pol ; 73(5): 18-24, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31701903

RESUMO

INTRODUCTION: The aim of the study was to assess the effectiveness of surgical treatment of patients with Eagle's syndrome, taking into account both early and late results. MATERIAL AND METHODS: The study group consisted of 15 patients who underwent resection of the styloid process due to Eagle syndrome in the period of 2005-2017. During the follow-up visit, the patients were asked to fill in a post-operative questionnaire that compared the pre-operative symptoms and their severity with the patients' current health condition. The VAS pain scale was used to assess each symptom, and the Laitinen scale was used to assess the quality of life. Data from patients' medical records were also included. The results of the surveys were subjected to statistical analysis. RESULTS: The study showed that in 11 out of 15 cases there was a significant improvement in the level of pain (70.5% on average) and an improvement in quality of life (on average 65%) comparing to the pre-operative condition. The Wilcoxon test for binding pairs, the Mann-Whitney test, the Kruskal-Wallis test and the Spearman correlation coefficient were used in the statistical analysis. There were statistically significant correlations between the recorded improvement rate and the length of the resected styloid process and its setting. DISCUSSION: The study proved that resection of prolonged styloid process from extraoral approach in most cases is an effective method of treatment of Eagle syndrome, that carries low risk of complications.


Assuntos
Ossificação Heterotópica/psicologia , Ossificação Heterotópica/cirurgia , Qualidade de Vida/psicologia , Índice de Gravidade de Doença , Osso Temporal/anormalidades , Adulto , Dor Facial/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Ossificação Heterotópica/fisiopatologia , Medição da Dor , Osso Temporal/fisiopatologia , Osso Temporal/cirurgia
15.
Cienc. tecnol. salud ; 6(2): 149-157, jul dic 2019.
Artigo em Espanhol | LILACS | ID: biblio-1095877

RESUMO

La recesión gingival (RG) es un problema de salud bucodental frecuente que aumenta con la edad, predispone a hipersensibilidad dentaria, caries radicular, inflamación gingival y efectos antiestéticos. El objetivo de este ensayo clínico aleatorizado fue evaluar comparativamente el efecto clínico del recubrimiento radicular utilizando la técnica estenopéica Pinhole con colágeno y la técnica estenopéica Pinhole modificada al incorporarle plasma rico en fibrina (PRF). Veintiséis participantes sistémicamente sanos, con diagnóstico de RG grado I de Miller, fueron reclutados y seguidos por 6 meses después de la cirugía. Los parámetros clínicos registrados fueron nivel de inserción clínica (NIC), RG y banda de encía queratinizada. Los participantes fueron asignados aleatoriamente a un grupo en quienes se utilizó PRF con 14 participantes, tratando 36 piezas dentales, y otro grupo en quienes se utilizó membrana de colágeno con 12 participantes, tratando 35 piezas dentales. Los resultados muestran un logro de ganancia en el NIC en ambos grupos, (M = 45.24 %, DE = 17.37 %) en el grupo PRF y (M = 47.37 %, DE = 15.67 %) en el grupo colágeno, diferencia que no fue significativa (p = .59). En ambos grupos existió un aumento significativo en la banda de encía queratinizada (p < .01). El uso de PRF como material de relleno al realizar la técnica estenopéica genera resultados similares al ser comparado con la técnica convencional que utiliza colágeno. Al presentar un menor costo el PRF aumenta las posibilidades que más personas tengan acceso al tratamiento.


Gingival recession (GR) is a frequent oral health disease that increases with age and may increase risk of dental hypersensitivity, root decay, gingival inflammation and aesthetic problems. The aim of this randomized clinical trial was to compare clinical parameters of dental root coverage using Pinhole technique with collagen and modi¬fied Pinhole technique using platelet-rich fibrin (PRF). Twenty-six participants, systemically healthy, with Miller class I GR diagnosis, were recruited and measured at baseline and after 6 months follow-up. Clinical parameters measured included clinical attachment level (ICL), GR and keratinized gingival width (KGW). All participants were randomly assigned to a group using PRF, with 14 participants and 36 teeth treated, and other group using collagen, with 12 participants and 35 teeth treated. Both PRF group and collagen group gained ICL, (M = 45.24 %, SD = 17.37 %) in PRF group and (M = 47.37 %, SD = 15.67 %) in collagen group, with no statistically significant difference (p = .59). Both groups gained KGW (p < .01). Use of PRF as filled material by using Pinhole technique resulted in similar clinical improvements compare to collagen as filled material. Considering that PRF is cheaper than collagen, it increases chances that people can have access to treatment.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Tratamento do Canal Radicular/métodos , Fibrina/administração & dosagem , Procedimentos Cirúrgicos Bucais/métodos , Retração Gengival/cirurgia , Colágeno
16.
Cir Pediatr ; 32(4): 207-211, 2019 Oct 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31626407

RESUMO

OBJECTIVE: Palatal fistula after the repair of cleft palate appears in 7.7-35% of patients. We present two cases of palatal fistula, detailing a multi-layer repair with an interpositional collagen graft. MATERIAL AND METHODS: Patient 1: girl with a cleft palate operated using a Furlow technique. A reintervention was performed due to a Pittsburgh type III fistula. Patient 2: male with cleft palate operated using a Furlow technique. A reintervention was performed due to a type V fistula. RESULTS: We used a multilayer repair with a local rotational flap and the interposition of a collagen matrix between the nasal and oral layers. The suture was reinforced with a fibrin hemostatic adhesive. No recurrence of the fistula after 2 years. CONCLUSIONS: The three-layer closure is simple, safe, effective and avoids refistulizations. Interpositional grafts of a resorbable collagen membrane provide a "scaffold" for tissue growth, revascularization and epithelialization of the mucosa.


Assuntos
Fissura Palatina/cirurgia , Fístula/cirurgia , Doenças da Boca/cirurgia , Palato Mole , Complicações Pós-Operatórias/cirurgia , Pré-Escolar , Colágeno , Feminino , Seguimentos , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Bucais/métodos , Retalhos Cirúrgicos , Tecidos Suporte
17.
Blood Transfus ; 17(5): 357-367, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31577533

RESUMO

BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate the benefit of platelet rich plasma (PRP) in oral surgery. MATERIALS AND METHODS: We performed a systematic search of the literature. The GRADE system was used to assess the certainty of the body of evidence. RESULTS: We found 21 randomised controlled trials that met our inclusion criteria: 12 studies included patients with periodontal defects, five studies focused on healing of extraction sockets, three studies on sinus lift augmentation, and one study on periapical osseous defects. However, for the quantitative synthesis (meta-analysis), we evaluated "periodontal defects" studies only, since for other clinical contexts the number of studies were too low and the procedural heterogeneity was too high to allow pooling of data. PRP-containing regimens were compared to non-PRP-containing regimens. Primary outcomes for the evaluation of periodontal defects were probing depths, clinical attachment level, gingival recession, and radiographic bone defect. It is not usually clear whether or not the use of PRP compared to controls affects "probing depth" at long-term follow up; the between group differences were small and unlikely to be of clinical importance (i.e., very low quality of evidence). For the other outcomes analysed ("clinical attachment levels", "gingival recession", "bony defect"), we observed a very slight marginal clinical benefit of PRP compared to controls. The available evidence for these comparisons was rated as low quality as most of the studies selected showed inconsistency, imprecision, and risk of bias. DISCUSSION: Evidence from a comparison between the use in oral surgery of PRP-containing regimens compared to other regimens not-containing PRP was of low quality. The results of the meta-analysis, limited to studies in patients with periodontal defects, document that PRP was slightly more effective compared to controls not-containing PRP.


Assuntos
Procedimentos Cirúrgicos Bucais/métodos , Plasma Rico em Plaquetas , Humanos , Doenças Periodontais/cirurgia , Plasma Rico em Plaquetas/metabolismo , Resultado do Tratamento , Cicatrização
19.
Oral Maxillofac Surg Clin North Am ; 31(4): 561-567, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31473064

RESUMO

Advances in technology and specialized instrumentation allow surgeons to study, refine, and modify minimally invasive surgery (MIS) to replace standard operations. This has occurred across many surgical specialties. The benefits of MIS include less swelling, less pain, shorter hospital stay, and faster return to daily activities. Oral and maxillofacial endoscopic techniques are used for access to the ramus condyle unit, maxillary sinus, zygoma, orbit, temporomandibular joint, and salivary ductal system. Although endoscopic techniques are also used in facial cosmetic surgery, this discussion focuses on noncosmetic procedures.


Assuntos
Endoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Procedimentos Cirúrgicos Reconstrutivos/métodos
20.
Autops. Case Rep ; 9(3): e2018086, July-Sept. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1021057

RESUMO

Fibrous dysplasia (FD) is part of a rare group of bone dysplasia. It exhibits benign behavior and can lead to osteolytic lesions, deformities, and fractures. The treatment is challenging, and accurate removal of the lesion is necessary to restore function and esthetics. Here we present two cases of FD where virtual planning with presurgical computed tomography (CT) was used for the production of a surgical guide for bone contouring. First, CT image reconstruction was performed to mirror the patient's original anatomy. Then, three surgical guides that determined the area and depth of bone wear were prepared and used in the relevant sequence during the actual surgeries, which were successfully performed in both patients. This technique is termed the template guide holes (TGH) technique. The findings from this report suggest that presurgical virtual planning and guide preparation allows direct and objective measurement of the level of bone wear and improves the functional and esthetic outcomes of surgery for FD. In particular, the TGH technique is safe and allows adequate preoperative surgical simulation, reduces the surgical duration, and increases the predictability of the final result.


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , /cirurgia , Tomografia Computadorizada Quadridimensional
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