1,720,986 research outputs found
Conservative treatment: Oxygen-Ozone therapy
No full textAlthough surgery combined with antibiotic therapy forms the basis of most BIONJ treatment protocols, this approach is not always effective. Therefore, some authors have advocated bio-stimulation, such as achieved with oxygen-ozone therapy, to improve local repair mechanisms
Variations of the gonial angle in vertical surgical reduction of the maxillary-mandibular complex
No full textFrom an esthetic point of view, the mandibular or gonial angle plays an important role in ensuring a harmonious facial profile. The purpose of this study was to analyze the values of the mandibular angle in relation to variations of the vertical and sagittal positions of the jaw. The study was carried out on a sample of 42 patients who underwent surgery for maxillary-mandibular repositioning, advancing or raising the jaw, after a Le Fort I osteotomy and bilateral sagittal osteotomy of the jaw according to the technique described by Obwegeser-Dal Pont. In all patients, the maxillary bone was raised with a discrepancy of at least 3 mm between the anterior and posterior portions (favoring the latter) as a result of (clockwise) rotation of the bispinal plane. The data, obtained by means of cephalometric analysis according to the method of Ricketts, showed how changes in the gonial angle differed between patients who require correction of an open-bite and those who do not. In particular, in patients without an open-bite, advancement of the maxilla limited the opening of the angle. Similarly, in patients with an open-bite, the tendency to form an open gonial angle can usually be corrected by the association of advancement of the maxilla whenever possible
Variation of the upper airways in pediatric patients with OSAS and retrusion of the midface
No full textIn pediatric patients, the incidence of Sleep-Disorder breathing (SDB) is 2% for OSAS and 7-8% for snoring. Snoring, sleep apnea and the development of neurocognitive and behavioral disorders represent the main symptoms. In these children, snoring is noisy and is present for the greater part of sleep. Accurate diagnosis and treatment protocol is critical for a child with OSAS as it is associated to complications as: pulmonary hypertension, chronic pulmonary heart disease, low height-weight development, behavioral problems, reduced school performance, bedwetting and daytime sleepiness or irritability. For this reason, over the years different surgical techniques were developed to solve the clinical symptoms evident on the polysomnographic test. In this paper, the authors report the experience at the Department of Cranio-Maxillo-Facial Surgery, Policlinico Umberto I, "Sapienza" Universita di Roma, in the treatment of pediatric patients with OSAS and midface retrusion
Atypical localization and atypical magnetic resonance imaging findings of a paraganglioma at the mouth mucosa.
No full textWe present a case of a paraganglioma located at the cheek. The benign nature of the lesion was certainly suggested by the patient's anamnesis, ecotomography, and needle biopsy; nevertheless, before the excision, the surgeon requested magnetic resonance imaging with contrast stain only to better evaluate the relationship between the lesion and the surrounding structures and not to have a precise diagnosis.Under magnetic resonance examination by using T1, T2, and T1 before and after contrast sequences, it showed an aspect different from the conventionally described features for this kind of lesion. After excision, the mass showed a yellowish color and a liquid content. Histologic examination described it as having the features of a glomus tumor
A rare complication of craniofacial fibrous dysplasia
No full textFibrous dysplasia is a rare disease, the cause of which in not entirely known. The most common clinical manifestations of fibrous dysplasia of the temporal bone are the presence of two different pathologic disorders: morphologic and functional. In this study, a rare complication of fibrous dysplasia with temporal localization is examined, and includes a description of a clinical case considered by the authors to be emblematic both for the rarity of the area involved and for the peculiarity of the initial manifestations
Bisphosphonate-related osteonecrosis and metastasis within the same site of the jaw
No full textOsteonecrosis of the jaw (ONJ) is a well known complication in patients treated with bisphosphonates (BPs) for skeletal metastasis and multiple myeloma (MM). Few oncologic patients under treatment with BPs and with ONJ and metastasis or MM at the same site of the jaw have been described. We report here on a 54-year old white female who was treated with intra-venous zoledronic acid for skeletal metastasis of breast cancer who developed ONJ. Because of a fracture at the site of ONJ, resection of the affected segment was performed. Although metastasis was not suspected by pre-operative image analysis, histological examination revealed syncronous osteonecrosis and breast cancer metastasis in the resected mandibular segment. This case highlights that, in oncologic patients treated with BPs, ONJ may hide malignancy and that histology is the unique tool by which the diagnosis of either osteonecrosis or malignancy or both can be made definitely
Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction
No full textTemporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities
Ozone therapy in the treatment of avascular bisphosphonate-related jaw osteonecrosis
No full textAvascular osteonecrosis of the jaw (ONJ) may occur as a consequence of several conditions, even including chemotherapy treatment in patients affected by tumors or osteoporosis. We report our clinical experience in treating bisphosphonate-induced ONJ with a therapeutic methodology that includes ozone therapy as a new and original approach for the clinical management of maxillary necrotic lesions. Of 58 patients with ONJ observed at our department, 33 gave their informed consent to be part of the research and were treated according to a therapeutic approach, which included noninvasive surgery associated with pre-and postsurgical cycles of ozone therapy consisting of eight sessions lasting 3 minutes each besides antibiotic and antifungal therapies. Outcomes showed how ozone therapy increases the benefits of surgical and pharmacologic treatments, increasing the complete healing of the lesions with the disappearance of symptoms and brings cases of lesion progression down to zero. In conclusion, ozone therapy is a reliable presidium in treatment of ONJ; its benefits are remarkable and improve significantly the outcomes of the surgical approach
Ozone therapy in extractive surgery on patients treated with bisphosphonates
Full text linkIt is certain that oral extractive surgery is a remarkable trigger to avascular osteonecrosis of the jaw in patients treated with pyrophosphate analogous. This acquisition limits the use of endo-oral surgery in those patients, even when they have already developed the lesions. In this study, we present the results obtained in a group of 15 patients deriving from a 33-patient cluster with osteonecrosis of the jaw in treatment at our department with a new protocol based on ozone therapy. The object of this article is to demonstrate how dental extraction becomes possible in a patient with avascular bisphosphonate-related jaw osteonecrosis or in those who simply received pyrophosphate analogous when proper treatment with ozone therapy has been done
Genioplasty: our experience
No full textAim. The aim of this study was to demonstrate how orthognatic surgery aids to cure many skull and face abnormalities and to help re-establishing the correct occlusive relation thanks to the repositioning of the maxillo-mandibular skeleton basis.
Methods. The studied included 157 male patients and 286 female patients, with an average age of 23 years. The sample series was divided according to specific pathologies. All patients underwent surgical procedures.
Results and conclusions. The experience shows that genioplasty has been successfully introduced in orthognathic surgical therapeutic procedures, for dental-skeleton abnormalities and mandibular asymmetries treatment
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