Maxillofacial surgery: maxillary osteosynthesis craneomaxillofacial CMS-titanium plates

2000 ◽  
Vol 13 (03) ◽  
pp. 119-122 ◽  
Author(s):  
M. A. Vallés ◽  
J. L. Vérez-Fraguela
Keyword(s):  
Soft Tissue ◽  
Clinical Case ◽  
Maxillofacial Surgery ◽  
Small Mass ◽  
Intermaxillary Fixation ◽  
Le Fort ◽  
Type Iii ◽  
Soft Tissue Covering ◽  
Maxillary Fracture

SummaryA maxillary fracture is presented which we classified as Le Fort Type III. Treatment was by the application of two craniomaxillofacial CMS titanium plates placed intrabuccally and paramedially on both sides of the palatal suture.This technique was used as an alternative to the classical treatment using interdental wires or intermaxillary fixation.A clinical case was diagnosed with a craniofacial fracture caused from being bitten by another dog. This was successfully treated using CMS titanium plates. Many methods exist for maxillofacial fixation, from the cyanocrylates to interdental wires, etc. The indications for these plates are similar to other methods of fixation. Due to their small mass they are ideal for use in fragile bones with little soft tissue covering.

Cervicofacial Emphysema Secondary to Facebow Injury: A Case Report

2009 ◽  
Vol 33 (4) ◽  
pp. 333-336
Author(s):  
Marco Cicciù ◽  
Giovanni Battista Grossi ◽  
Mario Beretta ◽  
Davide Farronato ◽  
Concetta Scalfaro ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Subcutaneous Emphysema ◽  
Clinical Case ◽  
Dental Procedure ◽  
Life Threatening ◽  
Facial Area ◽  
Orthodontic Device ◽  
Physical Findings

Aim: To report the clinical case of a child with facial and periorbital emphysema caused by an orthodontic device. Case report: An 11-year-old child presented to our clinic showing moderate swelling of the left facial area. Based on his dental history, physical findings, and instrument examinations, the diagnosis of cervicofacial emphysema was established, caused by disengagement of the facebow. One week later, all swelling and crepitus had disappeared without complications. Most patients who develop subcutaneous emphysema after a dental procedure have only moderate local swelling, which normally resolves spontaneously and without complications within a week. However, the spread of large amounts of air into the deeper spaces may cause life-threatening sequelae. Conclusions: Orthodontists should be aware that the use of extraoral traction applied via a facebow can cause soft tissue injures and emphysema of the cervicofacial region. It is important to avoid misdiagnosis and to appropriately inform patient and parents about this condition.

1239 Postoperative Complication Rate of Facial Injury Repairs Treated by Maxillofacial On-Call Team: Surgical Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
General Anaesthetic ◽  
Facial Injury ◽  
Postoperative Complication Rate ◽  
Female Ratio ◽  
Facial Injuries

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.

scholarly journals A CLINICAL CASE OF REMOVING A RESIDUAL FOREIGN BODY FROM THE LEFT SUPRACLAVICULAR REGION

2017 ◽  
Vol 4 (3) ◽  
pp. 120-122
Author(s):  
V.V. Boyko ◽  
V.V. Makarov ◽  
A.L. Sochnieva ◽  
V.V. Kritsak
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Soft Tissue ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Life Quality ◽  
The Other ◽  
Practical Case ◽  
The One

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.

scholarly journals TRIGEMINO CARDIAC REFLEX IN ORAL & MAXILLOFACIAL SURGERY – A REVIEW

2021 ◽  
pp. 1-2
Author(s):  
Venu Sameera Panthagada ◽  
Ravi Raja Kumar Saripalli ◽  
Manoj Kumar Kanta
Keyword(s):  
Trigeminal Nerve ◽  
Preventive Measures ◽  
Pressure Effect ◽  
Maxillofacial Surgery ◽  
Strabismus Surgery ◽  
Effective Management ◽  
Le Fort ◽  
Le Fort I ◽  
Maxillary Tuberosity

Trigemino cardiac reflex (TCR) which was originally called as OCCULOCARDIAC REFLEX is a physiological response due to the pressure effect on the largest cranial nerve, the trigeminal nerve. Oral and maxillofacial procedures can induce the development of this reflex. TCR is a triad of bradycardia , bradypnea and gastric motility changes due to the efferent activation of the vagal nerve in response to the pressure distribution in Trigeminal nerve. TCR may be generated as a result of procedures or conditions that increase intraocular pressure, strabismus surgery, nasal packing after rhinoplasty, the reduction of zygoma and zygomatic arch fractures, elevation of bone flap or osteotomies, reflection of a palatal flap for removal of a mesiodens, during Le Fort I downfractures, sagittal split ramus retraction, midface disimpaction, cutting maxillary tuberosity, and temporomandibular joint arthroscopy. The purpose of this paper is to discuss the pathophysiology and to review the main risk factors , treatment, prevention and management with emphasis on the role of maxillofacial surgeons and attending anesthetist. Maxillofacial surgeons should be familiar with presentations, preventive measures for the effective management of this complication.

scholarly journals Interrelation between facial soft tissue lessions, underlying fracture patterns and treatment of zygomatic bone trauma: a 10 year retrospective study

2020 ◽  
Author(s):  
Juncar Raluca Iulia ◽  
Paul Andrei Tent ◽  
Juncar Mihai ◽  
Arghir Ioan Anton ◽  
Arghir Cristina Oana ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Fractures ◽  
Maxillofacial Surgery ◽  
Fracture Pattern ◽  
Oral And Maxillofacial Surgery ◽  
Facial Soft Tissue ◽  
Nominal Data ◽  
Correct Treatment ◽  
Zygomatic Bone ◽  
Zygomatic Fracture

Abstract Background: The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. We will use these results in order to improve the diagnosis and the establishment of correct treatment of this pathology. Methods: A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Statistical analysis was performed with the MedCalc Statistical Software version 19.2 (MedCalc Software bvba, Ostend, Belgium;53 https://www.medcalc.org; 2020). Nominal data were expressed as frequency and percentage. The comparisons of the frequencies of a nominal variable among the categories of another nominal variable were made using the chi-square test. Multivariate logistic regressions were used in order to establish the independent association between variables and lacerations/excoriations. After using the Bonferroni correction for multiple comparisons, a value of p<0.025 was considered statistically significant.Results: The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n=179 (73.9%), closed n=179 (73.9%) and complete n=219 (90.5%). Hematoma was the most frequent associated soft tissue lesion n=102 (42.1%) regardless of the fracture pattern (p=1.000). Complete zygomatic fracture (OR – 2.68; p=0.035) and fractures with displacement (OR – 3.66; p=0.012) were independently associated with the presence of laceration. Fractures with displacement (OR – 7.1; p=0.003) were independently associated with the presence of excoriation. The most frequent type of treatment applied was Gillies reduction (61.9%), followed by ORIF (30.9%). The most frequent postoperative complication was malunion secondary to Gillies treatment (4,6%). Conclusions: Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. In the case of displaced, open or comminuted fractures we achieved the best results secondary to ORIF treatment method, while in the case of non-displaced and closed fractures, the best results achieved were secondary to conservative treatment.

scholarly journals Histological characterization of denticulate palatal plates in an Early Permian dissorophoid

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3727 ◽  
Author(s):  
Bryan M. Gee ◽  
Yara Haridy ◽  
Robert R. Reisz
Keyword(s):  
Soft Tissue ◽  
Histological Analysis ◽  
External Morphology ◽  
Tooth Replacement ◽  
Simple Description ◽  
Pulp Cavity ◽  
Histological Data ◽  
Tissue Implantation ◽  
Soft Tissue Covering

Denticles are small, tooth-like protrusions that are commonly found on the palate of early tetrapods. Despite their widespread taxonomic occurrence and similar external morphology to marginal teeth, it has not been rigorously tested whether denticles are structurally homologous to true teeth with features such as a pulp cavity, dentine, and enamel, or if they are bony, tooth-like protrusions. Additionally, the denticles are known to occur not only on the palatal bones but also on a mosaic of small palatal plates that is thought to have covered the interpterygoid vacuities of temnospondyls through implantation in a soft tissue covering; however, these plates have never been examined beyond a simple description of their position and external morphology. Accordingly, we performed a histological analysis of these denticulate palatal plates in a dissorophoid temnospondyl in order to characterize their microanatomy and histology. The dentition on these palatal plates has been found to be homologous with true teeth on the basis of both external morphology and histological data through the identification of features such as enamel and a pulp cavity surrounded by dentine. In addition, patterns of tooth replacement and ankylosis support the hypothesis of structural homology between these tiny teeth on the palatal plates and the much larger marginal dentition. We also provide the first histological characterization of the palatal plates, including documentation of abundant Sharpey’s fibres that provide a direct line of evidence to support the hypothesis of soft tissue implantation. Finally, we conducted a survey of the literature to determine the taxonomic distribution of these plates within Temnospondyli, providing a broader context for the presence of palatal plates and illustrating the importance of maintaining consistency in nomenclature.

scholarly journals Effect of Le Fort I Maxillary Advancement and Clockwise Rotation on the Anteromedial Cheek Soft Tissue Change in Patients with Skeletal Class III Pattern and Midface Deficiency: A 3D Imaging-Based Prediction Study

2020 ◽  
Vol 9 (1) ◽  
pp. 262
Author(s):  
Hsin-Chih Lai ◽  
Rafael Denadai ◽  
Cheng-Ting Ho ◽  
Hsiu-Hsia Lin ◽  
Lun-Jou Lo
Keyword(s):  
Soft Tissue ◽  
Orthognathic Surgery ◽  
Class Iii ◽  
Le Fort ◽  
Skeletal Class ◽  
Tissue Change ◽  
Maxillary Advancement ◽  
Soft Tissue Change ◽  
Mass Position ◽  
Le Fort I

Patients with a skeletal Class III deformity may present with a concave contour of the anteromedial cheek region. Le Fort I maxillary advancement and rotational movements correct the problem but information on the impact on the anteromedial cheek soft tissue change has been insufficient to date. This three-dimensional (3D) imaging-assisted study assessed the effect of surgical maxillary advancement and clockwise rotational movements on the anteromedial cheek soft tissue change. Two-week preoperative and 6-month postoperative cone-beam computed tomography scans were obtained from 48 consecutive patients who received 3D-guided two-jaw orthognathic surgery for the correction of Class III malocclusion associated with a midface deficiency and concave facial profile. Postoperative 3D facial bone and soft tissue models were superimposed on the corresponding preoperative models. The region of interest at the anteromedial cheek area was defined. The 3D cheek volumetric change (mm3; postoperative minus preoperative models) and the preoperative surface area (mm2) were computed to estimate the average sagittal movement (mm). The 3D cheek mass position from orthognathic surgery-treated patients was compared with published 3D normative data. Surgical maxillary advancement (all p < 0.001) and maxillary rotation (all p < 0.006) had a significant effect on the 3D anteromedial cheek soft tissue change. In total, 78.9%, 78.8%, and 78.8% of the variation in the cheek soft tissue sagittal movement was explained by the variation in the maxillary advancement and rotation movements for the right, left, and total cheek regions, respectively. The multiple linear regression models defined ratio values (relationship) between the 3D cheek soft tissue sagittal movement and maxillary bone advancement and rotational movements of 0.627 and 0.070, respectively. Maxillary advancements of 3–4 mm and >4 mm resulted in a 3D cheek mass position (1.91 ± 0.53 mm and 2.36 ± 0.72 mm, respectively) similar (all p > 0.05) to the 3D norm value (2.15 ± 1.2 mm). This study showed that both Le Fort I maxillary advancement and rotational movements affect the anteromedial cheek soft tissue change, with the maxillary advancement movement presenting a larger effect on the cheek soft tissue movement than the maxillary rotational movement. These findings can be applied in future multidisciplinary-based decision-making processes for planning and executing orthognathic surgery.

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