1,721,002 research outputs found
Chin Wing Osteotomy for Bilateral Goldenhar Syndrome Treated by "Chin Wing Mentoplasty": Aesthetic, Functional, and Histological Considerations
Full text linkVarious treatment strategies have been proposed to perform the aesthetic surgical correction of asymmetric deformities of the mandible. These techniques range from relatively simple to complex procedures including bimaxillary surgery associated with complex mandibular osteotomies. The authors describe a patient with grade III Goldenhar syndrome, treated by a "chin wing" mentoplasty as described by Triaca. These situations are classically treated with a bilateral sagittal splint osteotomy (BSSO) in combination with mentoplasty. However, because of a good occlusion with Angle's class I relation, slight imbalance of the occlusal plane with good function of the mouth opening, the patient refused to be treated with a BSSO, hence, a chin wing mentoplasty was performed. Size and stability of bone regeneration were evaluated by histological examination and dynamic-volume computed tomography (CT). Mature bone in the grafted areas was detected by histology and CT scan with stable results and a significant increase of facial aesthetics 1 year after surgery. The authors also demonstrated that the chin wing technique provided a little but significant breathing improvement as detected on CT scans and lateral X-ray cephalograms by measuring the breathing area. Chin wing mentoplasty is a moderately invasive technique that is able to improve the aesthetics of the face and patient breathing
Ridge expansion by flapless split crest and immediate implant placement: Evolution of the technique
No full textVarious treatment strategies and techniques have been proposed to perform alveolar bone augmentation; most common are guided bone regeneration, split crest, and autologous bone grafting. All of these techniques are reported to possess bone regenerative properties of osteoinduction and osteoconduction in relation to regenerated bone survival. Split crest resulted to be one of the most reliable bone augmentation techniques. In this study, we describe a new flapless-modified split crest technique on 4 patients to optimize the bone regeneration with bone augmentation implant insertion in 1 single stage. The rationale of this technique is to obtain a proper buccal cortex expansion preserving its vascular supply and avoiding periosteal elevation for better cortical bone preservation. The main advantages of this technique consist in a single surgical stage without donor sites, vascular periosteal preservation of vestibular cortical walls, preservation of alveolar bone height avoiding bone loss after implant kit drilling, and preservation of proper cortical thickness on both sides, thereby saving periosteal nourishment on the vestibular side. Indication for this technique could be extended to almost every implant insertion for alveolar height saving at drilling time for implant insertion, because of the alveolar crest shape
A Patient With a Rare Single Mandibular Localization of Non-Hodgkin B-Cell Lymphoma: Early Differential Diagnosis With Dental Lesions
Full text linkCondylar Fractures: Multistep Surgical Planning by Mini-Invasive Approach, Patient Series
No full textPurpose: Surgical treatment for condylar fractures is a challenging procedure most debated in scientific literature without a broad consensus on the selection of surgical techniques to be used and relative indications.The goal of this work is to propose a multistep surgical planning for condylar fractures based on an effective mini-invasive approach and safe procedure aimed to avoid as much as possible skin incision in the aesthetic areas of the face and neck, to decrease the risk of facial nerve injury. Methods: Ten patients with dislocated condylar neck fractures and sub-condylar fractures were included in this study.All the patients were studied with radiological images, computed tomography scans with three-dimensional reconstructions preoperatively and immediate postoperatively.Patients were evaluated pre- and post-operatively for dental occlusion, bone fragment alignment after reduction and after fixation, facial nerve functionality, skin scarring, temporomandibular joint functionality, temporomandibular joint symptomatology, and patient satisfaction. Results: Results were satisfactory for different parameters evaluated. No significant complications resulted in follow-up, particularly for facial nerve injury. By using this multistep procedure with each stage functional to the following one, the authors achieved satisfactory results following treatment of dislocated condylar fractures
Necrotizing odontogenic fasciitis of head and neck extending to anterior mediastinum in elderly patients: innovative treatment with a review of the literature
No full textBackground: Necrotizing fasciitis (NF) of odontogenic origin affecting the head and neck region is a rare but serious clinical condition, which, if diagnosed late, can lead to a fatal outcome. The early diagnosis of necrotizing fasciitis can be difficult. Delay in diagnosis leads to increase in the area of necrosis with a resulting increase in cosmetic deformity and life-threatening complication. In this study, we present two cases of elderly patients with aggressive NF affecting the neck and anterior mediastinum, which were of odontogenic origin. Methods: In the two patients selected necrotic skin and soft tissue were removed and wide exposure was achieved with debridement of the neck at the level of the affected layer of superficial cervical fascia. Saline solution was used as irrigation to treat the patients with acute necrotizing fasciitis. Difficulties in managing this condition with NF extent to deep anterior mediastinum is related to clavicle osteotomy or thoracotomy need with high surgical risks. In our technique, by gentle suction in anterior mediastinum, necrotic tissue resection was possible without any osteotomy need. Conclusions: Suctioning resection technique associated with hyperbaric, metabolic rebalance, and amino acid support in association with three types antibiotic therapy are fundamental points for correct therapy strategy, leading to full recovery and healing of NF patients even if in very unfavorable conditions. Multidisciplinary approach is paramount for proper treatment of this disease
A new technique for palatal reconstruction using a local flap with screw fixation after ablative surgery
No full textOBJECTIVES This study wants to show the cases of two patients who underwent a new reconstruction technique for wide palate defects through the use of a local flap. MATERIALS AND METHODS The technique avoided the need to make any skin incision and helped to preserve the aesthetics of the face and skull. Two patients with non-painful tumors of the palate with a histopathological diagnosis of pleomorphic adenoma underwent the procedure. The tumors were resected via an intra-oral approach combined with a Le Fort I osteotomy in one case, reconstructed by local flap fixed by screws. RESULTS Complete anatomical and functional reconstruction was achieved, without any postoperative complications. It was possible to completely resect the tumor mass with adequate excision of the margin, with good safety in terms of bleeding risks because of the direct view of the surgical resection field. Even in Le Fort I access case, good flap nourishment was achieved for firm flap fixation by screws. CONCLUSIONS With this original technique, it was possible to achieve complete recovery of the palatine vault without any need of different area flaps. In this way we also avoided any skin incision in the face and skull areas that could affect the patient's social life
Use of autologous platelet-rich plasma (PRP) in periodontal defect treatment after extraction of impacted mandibular third molars
No full textThe extraction of mesioangular impacted third molars may cause multiple periodontal
defects at the distal root of the second molar. Platelet-rich plasma (PRP) is a material containing many autologous growth factors that may be used in repairing and preventing periodontal complications at the distal root of the second molar adjacent to the extracted third molar
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