1,721,004 research outputs found
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
Parotid glands tumours: overview of a 10-years experience with 282 patients, focusing on 231 benign epithelial neoplasms
No full textSalivary gland tumours are uncommon, representing less than 6% of head and neck neoplasm. Pleomorphic adenoma is the most common benign epithelial salivary gland neoplasm, comprising 50%-74% of all parotid tumours. It is followed by Warthin's tumour (4-14%). The authors retrospectively reviewed 282 eligible patients surgically treated for parotid gland tumours in the last 10 years, focusing on 231 benign epithelial neoplasms. Clinical and diagnostic findings, surgical treatment and surgical outcome were discussed. The diagnosis of a parotid gland neoplasm must be considered in any patient presenting with a lump near the mandible. Smoking habit is important in Warthin's tumour pathogenesis. Fine needle aspiration citology (FNAC) can't lead alone to histological diagnosis. Only surgery can give histological certainty of benignity, thus preventing malignant degeneration, lump infection or risk of size-dependent surgical complications. Conservative formal parotidectomy appears to be the treatment of choice. Tumour pseudopodia and capsule ruptures are recognised factors involved in pleomorphic adenoma recurrences but also tumour multicentricity might play an important role
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
Anchilosi monolaterale dell’articolazione temporo-mandibolare in età di crescita: Descrizione di un caso clinico.
No full textGenioplasty: 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
Reduction and augmentation genioplasty in orthognathic surgery
No full textOrthognathic surgery is indicated in craniofacial malformations in order to re-establish occlusal relations through the placement of maxillo-mandibular bone bases, allowing the balance of stomatognathic system and its neuromuscular and articular components. Genioplasty has esthetic aims and finds its application in craniofacial malformations, especially in teeth-skeletal ones and mandibular asymmetry. There are two kinds of genioplasty: reduction and augmentation. The choice of the surgical technique to adopt depends on the malformation. Complications related to this surgery are: alloplastic implants migration in augmentation genioplasty with prosthesis; infections and abscesses; falling of plaques and screws used to fix the replaced fragment. In this study, the authors, make a retrospective evaluation of patients undergone genioplastic surgery, treated in the Maxillo-Facial ward of the Umberto I Policlinic in Rome
Orbital floor restoration
No full textOrbital blow-out fractures reconstruction aims to restore the continuity of the orbital floor, to provide support of orbital contents and prevent soft tissues' fibrosis. Different materials have been tested over the years to reach this purpose. Traditionally, autogenous grafts have been used as the material of choice; in recent years alloplastic materials have gained popularity because of their availability and ease of use. The purpose of this study was to review materials used in orbital floor reconstructive surgery at the Department of Maxillo-Facial Surgery of University of Rome '' La Sapienza '', with emphasis on their biocompatibility, their shaping features, and mechanical properties. This report presents the results obtained by the application of these products on 379 patients who underwent surgical treatment for blow-out fractures from 1995 to 2003: the diagnosis of fracture of the orbital floor was based on clinical symptoms and CT axial scanning through coronal reconstruction. Followup period spanned from 1 to 8 years
Etiology and incidence of zygomatic fracture: a retrospective study related to a series of 642 patients
No full textBACKGROUND AND OBJECTIVES: The aim of this paper is to investigate epidemiological data (age, gender), sites, etiology and surgical approach of zygomatic fracture. MATERIALS AND METHODS: A 9 years retrospective clinical and epidemiologic study evaluated 642 patients treated for zygomatic fracture. There were 569 men and 77 women. The age range was 2 to 86 years with 205 (31.9%) in the 21 to 30 years age group. A number of parameters, including age, gender, cause of injury, site of injury, treatment modalities were evaluated. RESULTS: There were 552 (86%) zygoma fractures and 90 (14%) zygomatic arch fractures. The left zygoma was involved in 309 cases (56%); the right zygoma was involved in 243 cases (44%). Concerning the zygomatic arch, the left side was involved in 43 cases (48%) and the right side in 47 cases (52%). 7% of the patients were younger than 9 years old, about 70% between 10 and 39 years, and 18% between 40 and 59 years, while 4% were older than 60 years. Causes of zygoma fracture were traffic accidents in 151 (26%), assault in 117 (20%), accidental falls in 105 (19%), sports injuries in 56 (10%), home injuries in 45 (8%), work accidents in 34 (6%). Causes of zygomatic arch fractures 28 (29.1%) were assaults in 28 (29.1%), traffic accidents in 20 (21.5%), sports injuries in 14 (15.8%), accidental falls in 11 (14%), domestic accidents in 8 (8.8%) and work accidents in 4 (5%). The access to the fronto-zygomatic suture (74.6%) and the maxillary vestibular approaches (66.8%) were the commonest method of reduction of zygomatic fracture. About arch fractures, the Gillies temporal approach was the most used method of reduction (94.4%). CONCLUSIONS: The findings, compared with similar studies reported in the literature, support the view that the highest prevalence is in young male patients and, concerning cause, traffic accidents and assault are the most frequent
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
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