scholarly journals Labial Repositioning Using Print Manufactured Polymethylmethacrylate- (PMMA-) Based Cement for Gummy Smile

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Patricia Freitas de Andrade ◽  
Jonathan Meza-Mauricio ◽  
Ricardo Kern ◽  
Marcelo Faveri
Keyword(s):  
Postoperative Complications ◽  
Bone Growth ◽  
Surgical Intervention ◽  
Upper Lip ◽  
Anterior Process ◽  
Patient Reported ◽  
Maxillary Molar ◽  
The One ◽  
Pmma Cement ◽  
Gummy Smile

Treating patients with excessive gingival display (EGD) to provide them with a pleasant smile is a challenge to periodontists. A gummy smile can be due to excessive vertical bone growth, dentoalveolar extrusion, short upper lip, upper lip hyperactivity, or altered passive eruption (APE). In addition, many patients have a lack of lip support due to marked depression of the anterior process of the maxilla. In these cases, lip repositioning using polymethylmethacrylate (PMMA) cement could be performed. This article describes a case of EGD with subnasal depression. In the clinical examination, the presence of a marked subnasal depression was found, in which the upper lip lodged during a spontaneous smile. In addition to this, gingival exposure extending from the maxillary molar on one side of the mouth to the one on the opposite side was also found during the spontaneous smile. Therefore, the periodontal surgical intervention proposed consisted of performing a procedure to fill the subnasal depression with PMMA cement. This article describes a digital approach to plan the use of PMMA cement in lip repositioning in a patient with gummy smile and subnasal depression. The patient reported no postoperative complications. Six months after the surgery, the patient revealed a more harmonious smile than before, with reduction in the gingival exposure and new adequate support for and repositioning of the upper lip.

scholarly journals Smile — one of the important elements of face aesthetics

2019 ◽  
Vol 2 (2) ◽  
pp. 101-110
Author(s):  
Patrycja Przybylska ◽  
Tomasz Siniecki ◽  
Teresa Matthews‑Brzozowska
Keyword(s):  
Botulinum Toxin ◽  
Maximum Effect ◽  
Upper Lip ◽  
First Case ◽  
Patient Reported ◽  
Levator Labii Superioris ◽  
The Face ◽  
Gummy Smile

The harmony of the smile depends not only on the dentition, but also on the gum tissue, which excessively exposed can negatively affect aesthetics of the smile. Exposure of a small amount of gum during a smile is acceptable however a smile in which the exposure of the gum is more than 2 mm is considered an aesthetic defect called gummy smile. Among the causes of gingival smile listed are: shortened or hyperactive upper lip muscles (levator labii superioris, levator labii superioris alaeque nasi, zygomatic minor muscles), vertical maxillary excess, extrusion of alveolar ridges, altered passive eruption. In the case of hyperactive upper lip muscles, botulinum toxin can be used — this procedure was used in the described cases, and the effects were assessed using the FotoMedicus system and measurements of gingival exposure. In first case Bocouture botulinum toxin was administered on both sides, 4 units bilaterally in the levator labii superioris muscle and 2 units into levator anguli oris muscle. In total, 12 units were given. During the follow‑up the patient reported the start of the effect from the 5th day after the supply with the maximum effect after 12 days. A 6 mm correction of gummy smile was achieved. In the second case 4 units of botulinum toxin were applicated bilaterally into levator labii superioris alaeque nasi muscle. A 3 mm correction of gummy smile was achieved. The aesthetics of the face in a smile definitely improved in both men.

scholarly journals Cost Determinants of Continuum-Care Episodes for Hip Fracture

2021 ◽  
Vol 14 ◽  
pp. 117863292199112
Author(s):  
Davide Golinelli ◽  
Erik Boetto ◽  
Antonio Mazzotti ◽  
Simona Rosa ◽  
Paola Rucci ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Replacement ◽  
Surgical Intervention ◽  
Administrative Databases ◽  
Intermediate Care ◽  
Organizational Setting ◽  
Linear Regression Models ◽  
Healthcare Facilities ◽  
The One ◽  
Acute Rehabilitation

Many factors affect the healthcare costs and outcomes in patients with hip fracture (HF). Through the construction of a Continuum-Care Episode (CCE), we investigated the costs of CCEs for HF and their determinants. We used data extracted from administrative databases of 5094 consecutive elderly patients hospitalized in 2017 in Emilia Romagna, Italy, to evaluate the overall costs of the CCE. We calculated the acute and post-acute costs from the date of the hospital admission to the end of the CCE. The determinants of costs by type of surgical intervention (total hip replacement, partial hip replacement, open reduction, and internal fixation) were investigated using generalized linear regression models. Regardless of the type of surgical intervention, hospital bed-based rehabilitation in public or private healthcare facilities either followed by rehabilitation in a community hospital/temporary nursing home beds or not were the strongest determinants of costs, while rehabilitation in intermediate care facilities alone was associated with lower costs. CCE’s cost and its variability is mainly related to the rehabilitation setting. Cost-wise, intermediate care resulted to be an appropriate setting for providing post-acute rehabilitation for HF, representing the one associated with lower overall costs. Intermediate care organizational setting should be privileged when planning integrated care HF pathways.

scholarly journals Complicated Diverticular Disease

2020 ◽  
Author(s):  
Kathleen M. Coakley ◽  
Bradley R. Davis ◽  
Kevin R. Kasten
Keyword(s):  
Postoperative Complications ◽  
Diverticular Disease ◽  
Surgical Intervention ◽  
Management Strategies ◽  
Significant Risk ◽  
Complicated Diverticulitis ◽  
Careful Attention ◽  
Correct Treatment ◽  
Treatment Paradigm ◽  
Colonic Diverticular Disease

AbstractThe modern management of colonic diverticular disease involves grouping patients into uncomplicated or complicated diverticulitis, after which the correct treatment paradigm is instituted. Recent controversies suggest overlap in management strategies between these two groups. While most reports still support surgical intervention for the treatment of complicated diverticular disease, more data are forthcoming suggesting complicated diverticulitis does not merit surgical resection in all scenarios. Given the significant risk for complication in surgery for diverticulitis, careful attention should be paid to patient and procedure selection. Here, we define complicated diverticulitis, discuss options for surgical intervention, and explain strategies for avoiding operative pitfalls that result in early and late postoperative complications.

scholarly journals Treatment of End-Stage Hallux Rigidus and Impact of Arthrodesis versus Arthroplasty on Patient Reported Outcomes

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze
Keyword(s):  
Patient Reported Outcomes ◽  
Surgical Intervention ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Significant Difference ◽  
Patient Reported ◽  
Outcome Scores ◽  
Vas Scores ◽  
End Stage

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a degenerative disease of the first metatarsophalangeal joint. Severe, end-stage hallux rigidus can become debilitating with surgical intervention becoming necessary once conservative measures and shoe modifications have failed. Joint salvage procedures include metatarsal phalangeal (MTP) arthrodesis and MTP arthroplasty. The purpose of this study was to assess for differences in patient reported outcomes in two cohorts who underwent fusion or joint reconstruction. Methods: This study was a retrospective review of prospectively collected data of 385 patients from an academic medical institution. Patients who underwent surgical intervention from July 2015 to November 2016 were identified based on CPT codes for MTP arthrodesis (28750) and arthroplasty (28293). We extracted outcome scores including SF12-M, SF12-P, FAAM, and VAS scores. Exclusion criteria included poly-trauma, revision procedures, and lack of pre and post-operative outcome scores. Mann- Whitney t-test was performed using GraphPad Prism version 7.0b for Mac to compare procedure groups, with significance define by a p-value of 0.05. Results: A total of eighteen patients met the inclusion criteria, with 6 who underwent arthroplasty and 12 arthrodesis. The average age was 63.7 amongst the cohort, with a total of 16 female and 2 males. Patients who underwent arthrodesis had better outcomes across all parameters. When comparing preoperative and postoperative scores, arthrodesis patients showed greater improvement of SF12-M (arthrodesis 9 vs arthroplasty -2, p=0.05), and SF12-P (9 vs -16, respectively p=0.05) scores. Arthroplasty patients were more likely to have a decrease in their SF-12 scores. VAS scores and FAAM scores showed no statistical difference between the two cohorts. Postoperative VAS scores were worse in 33% of arthroplasty patients despite surgical intervention, compared to 10% of arthrodesis patients. Conclusion: Our results suggests that both procedures provide a statistically significant difference in pain with several patients having a Global Rate of Change that is “very much better”. However, fusion of the metatarsophalangeal joint results in improved pain and functional outcomes for patients with severe hallux rigidus. These findings are consistent with current reports in the literature, which are mostly case series reports. Larger studies are needed to provide appropriate power and better support the findings of this study.

Botox A Injection Compared with Modified Lip Repositioning Surgery in the Treatment of Adult Patients with Gummy Smile Due to Hypermobile Upper Lip

2021 ◽  
Vol 5 (3) ◽  
pp. 142-153
Author(s):  
Zainab Abdel-Rhman Mohammed ◽  
Mohammed Abd Al-Alim Bushnak ◽  
Manal Yahia Foda ◽  
Dalia El Boghdady
Keyword(s):  
Adult Patients ◽  
Upper Lip ◽  
Gummy Smile

Non-syndromic double upper lip with triple frena: cosmetic cheiloplasty

2021 ◽  
Vol 14 (9) ◽  
pp. e243156
Author(s):  
Monika Gupta ◽  
Harshita Vig ◽  
Yajas Kumar ◽  
Aliza Rizvi
Keyword(s):  
Psychological Distress ◽  
Present Article ◽  
Surgical Management ◽  
Surgical Intervention ◽  
The Other ◽  
Upper Lip ◽  
Lower Lip ◽  
Facial Anomaly ◽  
The Aesthetic ◽  
Functional Problems

Double lip or macrocheilitis is a rare facial anomaly, mostly congenital in origin. It commonly involves the upper lip than the lower lip. It may occur in isolation or as part of the Ascher’s syndrome. It results due to deposition of excessive areolar tissue and non-inflammatory hyperplasia of labial mucosa gland of pars villosa. It may be acquired as a result of injury to the lips or lip-biting habit. The double lip becomes conspicuous when the lips are retracted during smiling resulting in the characteristic ‘cupid’s bow’ appearance. This disfigurement can pose aesthetic and functional problems and may result in psychological distress. A surgical intervention is must for restoration of functions and to address the aesthetic concerns. The present article reports a case of non-syndromic double upper lip with triple labial frena and its surgical management with laser on one side and with scalpel on the other side.

Nephrometric score based on 3D modeling (3D nephrometry score) for the probability prediction of intra- and postoperative complications for kidney surgery

2021 ◽  
pp. 039156032110364
Author(s):  
Georgiy Andreevich Mashin ◽  
Vasiliy Vladimirovich Kozlov ◽  
Denis Vladimirovich Chinenov ◽  
Yaroslav Nikolaevich Chernov ◽  
Alexandra Vladimirovna Proskura ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
3D Modeling ◽  
Roc Analysis ◽  
Linear Models ◽  
Surgical Intervention ◽  
Renal Tumors ◽  
Discriminant Functions ◽  
Nephrometry Score ◽  
Probability Prediction

Aim: The purpose of the study is the development and evaluation of the informativeness of the author’s 3D nephrometric score application to predict the probability of intraoperative and postoperative complications in kidney operations. Material and methods: The study includes 264 patients who underwent surgical treatment of renal tumors, before that CT and 3D modeling were carried out. All patients underwent an analysis of the surgical intervention complexity on the C-index, PADUA, R.E.N.A.L., and developed 3D nephrometric score. To determine the set of variables that allow to classify patients, the method of discriminant analysis was used to predict the nature, volume of blood loss, duration of ischemia, and the number of complications. The sensitivity and specificity of the predictors were estimated with the help of ROC analysis. Results: Indicators have been established to classify patients according to the probability of complications, the amount of blood loss and the duration of ischemia during surgery for kidney cancer. We have created linear models that predict the development of bleeding during surgery, the volume of blood loss of more than 200 ml and the duration of ischemia more than 20 min, as well as the likelihood of complications using discriminant functions. The proposed author’s nephrometric score exceeds the capabilities of C-index, PADUA, R.E.N.A.L in many ways in blood loss and time of ischemia predicting, which allows us to recommend it for the assessment of resectability in kidney operations.

Treatment of inflammatory diseases of the female genitalia with iontophoresis

1927 ◽  
Vol 23 (4) ◽  
pp. 425-429
Author(s):  
N. S. Utochnikova
Keyword(s):  
Young Women ◽  
Surgical Intervention ◽  
Inflammatory Diseases ◽  
The Other ◽  
Female Genitalia ◽  
Physical Methods ◽  
Surgical Methods ◽  
The One ◽  
Methods Of Treatment ◽  
Female Genital

The treatment of inflammatory diseases of the female genitalia has long been one of the most important tasks of the gynecologist. With the development of surgery, surgical methods of treatment began to be applied: exudates were removed, the uterus and inflamed appendages were extirpated, etc.; but the danger of surgical intervention on the one hand, and on the other - the severe consequences of removal of organs such as ovaries, especially in young women - forced gynecologists to spend much effort in discovering and improving non-operative methods of treatment of inflammatory diseases of the female genital parts. Among these methods, physical methods such as water, mud, light baths, massage, etc., as well as those related to electricity have long been prominent.

Methylphenidate Treatment of Bulimia Nervosa after Surgery*

1989 ◽  
Vol 34 (8) ◽  
pp. 824-826 ◽  
Author(s):  
Edward Messner
Keyword(s):  
Postoperative Complications ◽  
Bulimia Nervosa ◽  
Emotional State ◽  
Safety And Efficacy ◽  
Patient Reported

Methylphenidate (MPT) was prescribed four days after an uncomplicated appendectomy in a 27 year old woman who had suffered from bulimia nervosa (BN) for at least nine years. Before the onset of appendicitis, her bingeing and self-induced vomiting had occurred several times daily. With MPT the patient reported a calm emotional state and an absence of temptation to binge or to induce vomiting. Previously published reports of treatment of BN with MPT could not be found. This may be the first. Vulnerability to surgical disorders and to postoperative complications as well as the safety and efficacy of MPT in patients suffering from BN deserve further study.

scholarly journals Prevention of pain syndrome and immediate postoperative complications in the surgical treatment of chronic hemorrhoids

2020 ◽  
pp. 68-71
Author(s):  
V. N. Ishchenko ◽  
A. E. Krasnobaev ◽  
A. A. Grigoryuk
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Surgical Intervention ◽  
Pain Syndrome ◽  
Modified Technique ◽  
Postoperative Urinary Retention ◽  
Clinical Comparison ◽  
Suggested Technique

Objective: To assess the efficacy of hemorrhoidectomy with Milligan-Morgan technique in the author’s modification.Methods: Results of surgical treatment of 558 patients aged 21–72 years with complicated hemorrhoids of III–IV stage were analyzed. The group of clinical comparison (207 patients) was operated according to standard scheme, the main group (351 patients) – according to author’s technology with modified technique for treating the hemorrhoid bolus using betamethasone.Results: When using the author’s technique, a more significant decrease in postoperative pain syndrome severity was achieved: injection analgesics were not required already in a day, and after 6 days the pain syndrome was stopped in all cases. Only three patients (0.9%) demonstrated an acute urinary retention up to two days. The group of clinical comparison maintained a longterm (up to three months) pain syndrome; postoperative urinary retention was registered in 38 cases (18.4%); 9 patients (4.3%) developed blood loss in the area of surgical intervention.Conclusions: Suggested technique of surgical treatment for hemorrhoids is quite effective, simple and can be implemented in any surgical inpatient facility. 

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