RESUMO
Down syndrome, known as trisomy 21, is the most common chromosomal disorder. The disorder affects mental and systemic development as well as oral structure, including dental anomalies, high susceptibility of periodontal disease, and poor quality of alveolar bone. This report presents a case of dental rehabilitation by means of dental implants of a patient with Down syndrome. Two titanium dental implants were placed in the maxilla, and three titanium dental implants were installed in the mandible. One implant was lost during the osseointegration period. The prosthetic rehabilitation was performed with implant-retained maxillary and mandibular overdentures with the Locator attachment system. After a 2-year follow-up period, the patient was doing well, and all implants were clinically stable with no signs of bone loss or inflammation. The present study emphasizes that implant-retained overdentures with Locator attachment system could be a therapeutic option even for patients with Down syndrome. This therapy prevents crestal bone loss around the implants, improves functional and esthetic outcomes, and provides optimum oral hygiene for patients with mild mental impairment. Careful patient selection and education of patients and caregivers are essential considerations for a successful and safe treatment with dental implants in Down syndrome patients.
Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Síndrome de Down/complicações , Adulto , Perda do Osso Alveolar/complicações , Perda do Osso Alveolar/terapia , Feminino , Humanos , Arcada Parcialmente Edêntula/complicações , Arcada Parcialmente Edêntula/terapia , Periodontite/complicações , Periodontite/terapia , Radiografia PanorâmicaRESUMO
The most important objectives in restoring the maxillofacial patient are the restoration of function and psychological improvement through esthetics. Acquired maxillary and mandibular defects due to significant trauma or surgery represent a major challenge for the clinician and patient. Dental implant-retained prostheses represent a well-documented and reliable treatment option and can also help patients with maxillofacial defects by eliminating denture instability and improving function. Full-arch fixed dental hybrid prostheses provide functional and psychological advantages and also reduce the load on vulnerable soft and hard tissues in the reconstruction area. Two clinical reports are presented describing the prosthetic rehabilitation using dental implant-supported fixed hybrid prostheses with clinical and radiographic follow-up of 3 years.
Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Humanos , Arcada Parcialmente Edêntula/reabilitação , Masculino , Pessoa de Meia-IdadeRESUMO
Patients with ectodermal dysplasia (ED) experience several problems caused by abnormal development and functioning of the head and neck region. In addition to developmental nasal cartilage abnormalities and absence of sweat glands, hair, and eyebrows, edentulism or developmental disorders of teeth (cone-shaped teeth) are commonly observed in these types of patients. ED is also characterized by underdeveloped alveolar ridges, a decreased occlusal vertical dimension, reduced salivary secretion, and dry oral mucosa, which make prosthetic rehabilitation difficult. Few studies of intraosseous dental implant-retained prostheses have described adverse effects on craniofacial growth and esthetic and functional disadvantages, while some researchers have described the advantages of this treatment option as an alternative option in these cases. Due to the associated alveolar bone deficiency, dental mini-implant therapy may be a treatment option for these patients; however, there are isolated cases in the literature regarding the rehabilitation of ED patients with mini-implant-supported overdentures. This clinical report describes the rehabilitation of a 6-year-old child with ED using a maxillary removable partial prosthesis and a mini-implant-retained mandibular overdenture. The clinical and radiographic findings of this prosthetic rehabilitation during the 6-year follow-up are also presented.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Criança , Planejamento de Prótese Dentária , Prótese Parcial Removível , Displasia Ectodérmica/complicações , Humanos , Arcada Edêntula , Masculino , MandíbulaRESUMO
PURPOSE: Hyaluronic acid (HA) injections and occlusal splints have been suggested in the treatment of temporomandibular joint (TMJ) derangements, but no sufficient data are available from controlled clinical trials comparing HA injection with another treatment modality. This study compared the effectiveness of a single HA injection, a double HA injection, and splint therapy for the treatment of TMJ disc displacement with reduction (DDR). MATERIALS AND METHODS: A prospective clinical trial was designed. The study sample included patients with TMJ DDR. The primary predictor variable was treatment method. Patients were divided into 4 groups: control, single HA injection, double HA injection, and stabilization splint therapy. Patients were randomly assigned to 1 of 3 treatment groups. The control group was self-selected. The primary outcome variable was pain at rest and during mastication. The secondary outcome variables were TMJ noise, quality of life, and level of jaw movements. Clinical symptoms and jaw movements were evaluated at baseline and at 6-month follow-up. Descriptive, comparative, correlation, and multivariate analyses were conducted. RESULTS: The sample included 51 patients (66 TMJs) 18 to 48 years old. All treatment groups showed significant improvement compared with baseline values for pain, TMJ noise, quality of life, and maximum mouth opening (MMO) at 6-month follow-up (P < .05). However, the 2 HA injection groups indicated superior improvement for pain, MMO, and quality of life compared with the stabilization splint group (P < .05). CONCLUSIONS: The results of this study showed that HA injection and stabilization splinting are acceptably successful treatment modalities to alleviate the clinical signs and symptoms of TMJ DDR.
Assuntos
Ácido Hialurônico/uso terapêutico , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Viscossuplementos/uso terapêutico , Adolescente , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Placas Oclusais , Medição da Dor , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/fisiopatologiaRESUMO
To assess the effectiveness of a dental instrument for reduction of isolated zygomatic arch fractures. Two patients were admitted to our clinic representing isolated unilateral zygomatic arch fracture. The common presenting complaints were pain, swelling and difficulty in mouth opening. Fractures were confirmed with plain radiography and computerized tomography. The fractures were reduced with upper buccal sulcus approach by dental instrument. Patients achieved satisfactory maximum mouth opening within 10 days. At follow up after 6 months, there was complete healing without any complication. This procedure is cost effective, time saving, safe and effective to manage isolated zygomatic arch fractures under local anaesthesia with satisfactory outcomes.
Assuntos
Redução Fechada/métodos , Instrumentos Odontológicos , Zigoma/cirurgia , Fraturas Zigomáticas/cirurgia , Redução Fechada/instrumentação , Humanos , Radiografia , Tomografia Computadorizada por Raios X , Zigoma/diagnóstico por imagem , Fraturas Zigomáticas/diagnóstico por imagemRESUMO
OBJECTIVE: To evaluate the effects of osteoformin on mineralisation and quality of the new bone formation during rapid distraction osteogenesis. METHODS: This multi-centre study was conducted at the Karadeniz Technical University, Middle East Technical University and Selcuk University. The experimental study was conducted from January 2010 to September 2012 and comprised New-Zealand rabbits that were randomly divided into three groups. In group I distraction rate was 1 mm/day while in groups II and III distraction rates were 2mm/day and 1 mm/day. In groups I and II 100µg/kg osteoformin was injected after the latency period. Distraction region was evaluated by radiological, histomorphometrical and dual energy X-ray absorptiometry analyses. SPSS 17 was used for statistical analysis. RESULTS: There were 18 rabbits with each of three groups having 6(33.3%). Accelerated bone healing was noted in groups I and II compared with group III (p<0.05). No significant differences were indicated between groups I and II (p>0.05). CONCLUSIONS: Local injection of osteoformin was effective in the craniomaxillofacial distraction osteogenesis in rabbits. Further experimental studies are recommended before using osteoformin on humans.
Assuntos
Regeneração Óssea/efeitos dos fármacos , Consolidação da Fratura/efeitos dos fármacos , Mandíbula , Osteogênese por Distração/métodos , Peptídeos/administração & dosagem , Absorciometria de Fóton/métodos , Animais , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Modelos Animais de Doenças , Mandíbula/diagnóstico por imagem , Mandíbula/metabolismo , Mandíbula/cirurgia , Coelhos , Radiografia/métodos , Resultado do TratamentoRESUMO
For placement of a temporomandibular joint prosthesis, preauricular and retromandibular approaches are used. The main complication of the retromandibular approach is marginal mandibular nerve damage. In this technical study, the retromandibular subparotideomasseteric fascial approach is introduced as an alternative to avoid the complications of the conventional retromandibular approach.
Assuntos
Fasciotomia , Prótese Mandibular , Glândula Parótida/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , HumanosRESUMO
This study aimed to analyze the possible association of miR-30a-5p, miR-30e-5p, and miR-34a-5p identified as potential candidate miRNAs in schizophrenia, with the COMT gene. Candidate miRNAs were obtained from the TargetScan database. The SH-SY5Y human neuroblastoma cell line was used as a cellular model for schizophrenia. miR-30a-5p, miR-30e-5p, and miR-34a-5p mimics were transfected into the SH-SY5Y cell line. Total RNA was isolated from transfected cells and RNA-IP samples and reverse transcripted for miRNA and mRNA analysis. RT-qPCR and western blot were performed to observe changes in expression levels of COMT. RNA-immunoprecipitation was performed to determine RNA-protein interactions after mimic transfection. In the study, it was observed that COMT gene expression levels decreased significantly after miR-30a-5p and miR-34a-5p expressions, whereas increased significantly as a result of miR-30e-5p transfection. RNA-IP data have shown that the amount of COMT pulled down by Ago2 was increased after miR-30a-5p and miR-34a-5p transfections. RNA-IP results revealed that miR-30a-5p and miR-34a-5p are direct targets for the COMT gene.
RESUMO
PURPOSE: The present study examined the formation and density of new bone after sinus membrane elevation, with and without bone grafting, and evaluated the bone formation at the apices of the implants with these 2 different maxillary sinus floor elevation techniques. MATERIALS AND METHODS: In a prospective randomized controlled study design, patients requiring reconstruction of their atrophic maxilla were included and divided randomly into grafted and nongrafted groups. Implants were inserted in each group by way of sinus membrane elevation. The formation and density of new bone were evaluated using cone beam computed tomography, performed preoperatively and 1 week, 3 weeks, and 6 months postoperatively. RESULTS: A total of 24 implants were placed in 14 patients, with all implants maintaining stability during 6 months of follow-up. New bone formation was determined in both groups using radiography. No significant differences were found between the 2 groups in terms of new bone density preoperatively nor at 1 week or 3 months postoperatively. However, the density of bone in the nongrafted group was higher than that in the grafted group 6 months after surgery. CONCLUSIONS: These results suggest that the simple elevation of the sinus membrane without bone grafting material can lead to bone formation around implants and that the newly formed bone in the nongrafted group was denser than that in the grafted group.
Assuntos
Transplante Ósseo/métodos , Osteogênese/fisiologia , Levantamento do Assoalho do Seio Maxilar/métodos , Implantes Absorvíveis , Adulto , Idoso , Idoso de 80 Anos ou mais , Atrofia , Densidade Óssea/fisiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Implantes Dentários , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Membranas Artificiais , Pessoa de Meia-Idade , Mucosa Nasal/diagnóstico por imagem , Mucosa Nasal/patologia , Osseointegração/fisiologia , Estudos Prospectivos , Transplante Homólogo , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: Papillon-Lefèvre syndrome is a rare autosomal recessive genetic disorder characterized by palmar-plantar hyperkeratosis, with rapidly progressive periodontitis and premature loss of both deciduous and permanent teeth. This article presents the prosthetic rehabilitation of a patient with Papillon-Lefèvre syndrome with dental implants. MATERIALS AND METHODS: Twelve titanium implants were installed in the mandible and maxilla in an 18-year-old male patient with Papillon-Lefèvre syndrome. RESULTS: At 3 years follow-up, all implants were clinically stable and no pain or infection was found. The patient continues to be seen at regular follow-up visits. CONCLUSION: Twelve-implant installation in Papillon-Lefèvre syndrome with 3 years' follow-up has not claimed before. We not only successfully treated our patient functionally and esthetically with dental implant rehabilitation, but also provided psychological benefits to the patient.
Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Doença de Papillon-Lefevre/reabilitação , Perda de Dente/reabilitação , Adolescente , Implantação Dentária Endóssea/métodos , Prótese Total , Seguimentos , Humanos , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Osseointegração/fisiologia , Planejamento de Assistência ao PacienteRESUMO
The use of serological tests containing multiple immunodominant antigens rather than single antigens have the potential to improve the diagnostic performance in Cystic Echinococcoses (CE) as a complement tool to clear the inconclusive imaging data. Here, we comparatively evaluated the diagnostic value of Hydatid Fluid (HF) and the recently described recombinant multi-epitope antigen DIPOL in IgG-ELISA in a clinically defined cohort of CE patients. The serum samples from 149 CE patients were collected just before surgical or Percutaneous- Aspiration- Injection- Reaspiration (PAIR) procedures. Additionally, serum samples of patients with other parasitic infections (n=49) and healthy individuals (n=21) were also included in the study as controls. To investigate the association between the genotype of the parasite and DIPOL, cyst materials from 20 CE patients were sequenced. In terms of overall sensitivity, HF was higher than DIPOL (82.55%,78.52%, respectively). However, while the sensitivity of HF was higher than DIPOL in patients with active and transitional cysts (83.3%, 75.4%, respectively), sensitivity of DIPOL in inactive cysts was higher compared to HF (95.6%, 78.3%, respectively). The sensitivity of DIPOL depending on cyst stage was statistically significant (P= 0.041). In terms of specificity, DIPOL was found to be better than HF (97.71%, 91.43%, respectively). By genotyping, the majority of 20 patients showed G1 genotype (80%). All patients harboring G3 and G1/G3 cyst genotypes were positive with both antigens, while 87.5% of patients with G1 genotype were seropositive with HF and 75% with DIPOL. The overall sensitivity and high specificity of DIPOL suggest that this recombinant protein containing immunodominant epitopes is a potential substitute for the HF by serological tests for the diagnosis of CE.
Assuntos
Equinococose , Echinococcus granulosus , Animais , Anticorpos Anti-Helmínticos , Antígenos de Helmintos/genética , Equinococose/diagnóstico , Ensaio de Imunoadsorção Enzimática , Epitopos/genética , Humanos , Sensibilidade e Especificidade , Testes SorológicosRESUMO
OBJECTIVES: Paraoxonase (PON1) is a high-density lipoprotein (HDL)-associated esterase that hydrolyses lipoperoxides. PON1 serves as a protective factor against oxidative modification of LDL, suggesting that it may play an important role in the prevention of atherosclerotic process. Research has focused on two polymorphisms: leucine (L allele) to methionine (M allele) substitution at codon 55, and glutamine (A allele) to arginine (B allele) substitution at codon 192. STUDY DESIGN: We examined amino acid changes at codon 55 and 192 in the PON1 gene by polymerase chain reaction and using restriction enzymes in 120 patients (92 men, 28 women; mean age 48.2+/-4.3 years) with premature coronary artery disease (CAD) and in 102 healthy subjects (80 men, 22 women; mean age 46.8+/-5.2 years) with no history of CAD and a normal electrocardiogram. RESULTS: Distribution of genotypes in the patient and control groups at codon 55 were 6.7% and 4.9% for MM, 46.7% and 29.4% for LM, 46.7% and 65.7% for LL, respectively. The frequency of genotypes at codon 192 were as follows: 4.2% and 2% for RR, 40% and 35.3% for QR, and 55.8% and 62.8% for QQ, respectively. While the frequency of PON1 55M allele was higher in the CAD group (0.3 vs. 0.2), PON1 192R allele frequency did not differ (p>0.05). There was a significant relationship between the PON1 M/L55 polymorphism and CAD (p=0.017), whereas the R/Q192 polymorphism was not associated with CAD (p=0.445). CONCLUSION: These data suggest that the PON1 M/L55 polymorphism shows a significant relationship with CAD and the Q/R192 polymorphism is not a major risk factor causing susceptibility to CAD in our population.
Assuntos
Substituição de Aminoácidos , Arildialquilfosfatase/genética , Doença das Coronárias/genética , Adulto , Arginina/genética , Códon/genética , Doença das Coronárias/enzimologia , Primers do DNA , Feminino , Frequência do Gene , Genótipo , Glutamina/genética , Humanos , Leucina/genética , Masculino , Metionina/genética , Pessoa de Meia-Idade , Polimorfismo GenéticoRESUMO
OBJECTIVES: This study evaluated the failure and complication rates of sedation in ambulatory patients undergoing oral and maxillofacial surgery. MATERIALS AND METHODS: This retrospective cohort study was carried out among 619 patients who had undergone maxillofacial surgical procedures under intravenous sedation with midazolam and fentanyl. Each patient's age, American Society of Anesthesiologists (ASA) classification, systemic condition, surgical procedure, complications, and failures were recorded for evaluation. RESULTS: A total of 400 patients with ASA I, 199 with ASA II, and 20 with ASA III between the ages of 9 months and 84 years were included in the study. The most common systemic disorders in our patients were mental retardation (35%), hypertension (19%), and epilepsy (15%). Evaluation of the cases revealed 9 complications (1.4%) and 9 sedation failures (1.4%). The complications were bradycardia, postoperative agitation and hallucination, drug reaction, vomiting and nausea, desaturation, and hypotension. CONCLUSIONS: Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Anestesia/normas , Hipnóticos e Sedativos/administração & dosagem , Cirurgia Bucal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sociedades Médicas , Adulto JovemRESUMO
A total of 21 patients including 13 females and 8 males who presented at the Microbiology and General Surgery Departments of the Atatürk Research and Training Hospital with complaints of liver cystic hydatid disease have been included in this study. Albendazole was administered to these cystic hydatid patients before and after surgery. The aim of this study was to investigate the probable genotoxic effects of albendazole. SCE testing was applied to the blood samples taken from patients after the treatment and the mutagenic effect of albendazole was investigated by comparison with the control group. Student t- test was used for the statistical analysis of the results.