scholarly journals Bioabsorbable Osteofixation Materials for Maxillofacial Bone Surgery: A Review on Polymers and Magnesium-Based Materials

Biomedicines ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 300
Author(s):  
Sung-Woon On ◽  
Seoung-Won Cho ◽  
Soo-Hwan Byun ◽  
Byoung-Eun Yang
Keyword(s):  
Clinical Application ◽  
Animal Studies ◽  
Trauma Surgery ◽  
Polymeric Materials ◽  
Rigid Fixation ◽  
Facial Skeleton ◽  
Physical Strength ◽  
Bone Surgery ◽  
Metal Materials ◽  
Skeletal Reconstruction

Clinical application of osteofixation materials is essential in performing maxillofacial surgeries requiring rigid fixation of bone such as trauma surgery, orthognathic surgery, and skeletal reconstruction. In addition to the use of titanium plates and screws, clinical applications and attempts using bioabsorbable materials for osteofixation surgery are increasing with demands to avoid secondary surgery for the removal of plates and screws. Synthetic polymeric plates and screws were developed, reaching satisfactory physical properties comparable to those made with titanium. Although these polymeric materials are actively used in clinical practice, there remain some limitations to be improved. Due to questionable physical strength and cumbersome molding procedures, interests in resorbable metal materials for osteofixation emerged. Magnesium (Mg) gained attention again in the last decade as a new metallic alternative, and numerous animal studies to evaluate the possibility of clinical application of Mg-based materials are being conducted. Thanks to these researches and studies, vascular application of Mg-based biomaterials was successful; however, further studies are required for the clinical application of Mg-based biomaterials for osteofixation, especially in the facial skeleton. The review provides an overview of bioabsorbable osteofixation materials in maxillofacial bone surgery from polymer to Mg.

Atypical Form of Cervicofacial Actinomycosis Involving the Skull Base and Temporal Bone

2018 ◽  
Vol 128 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Adam McCann ◽  
Sameer A. Alvi ◽  
Jessica Newman ◽  
Kiran Kakarala ◽  
Hinrich Staecker ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skull Base ◽  
Temporal Bone ◽  
Soft Tissues ◽  
Trauma Surgery ◽  
Oral Antibiotic ◽  
Facial Skeleton ◽  
Atypical Form ◽  
Unsuccessful Treatment ◽  
The Right

Background: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. Methods: Case report with literature review. Results: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. Conclusions: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.

scholarly journals Influence of two-body abrasion and heat intensity on metal and non-metal materials used in agriculture

2016 ◽  
Vol 61 (No. 1) ◽  
pp. 40-46
Author(s):  
P. Valášek ◽  
J. Kejval ◽  
M. Müller ◽  
J. Cieslar
Keyword(s):  
Cast Iron ◽  
Abrasive Wear ◽  
Agricultural Production ◽  
Elevated Temperatures ◽  
Polymeric Composite ◽  
Polymeric Materials ◽  
Metallic Material ◽  
Composite Systems ◽  
Metal Materials ◽  
Materials Used

In the agro-complex, as well as in other sectors, the use of polymeric materials is one possible way forward in the innovation and development of machines and their parts. However, machine products place high demands on the materials from which they are made. Polymeric materials are currently able to compete in certain areas where metallic material would traditionally be used; however, one of their limiting characteristic is their ability to withstand elevated temperatures. This paper describes the hardness of polymeric materials when influenced by heat, generated during the double body abrasion. The paper also describes the abrasive wear of both polymers and polymeric composite systems, as well as cast iron, used in agricultural production. Heat intensity during the two-body abrasion results in a 28% fall of the composite systems hardness, to 18% fall of the Polyamid 6 hardness and to 13% fall of the Murtfeld hardness.

scholarly journals Preoperative Planning of Virtual Osteotomies Followed by Fabrication of Patient Specific Reconstruction Plate for Secondary Correction and Fixation of Displaced Bilateral Mandibular Body Fracture

2016 ◽  
Vol 9 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Andreas Thor
Keyword(s):  
Trauma Surgery ◽  
Computer Software ◽  
Open Bite ◽  
Patient Specific ◽  
Facial Skeleton ◽  
Reconstruction Plate ◽  
Virtual Planning ◽  
Patient Specific Implants ◽  
Body Fracture ◽  
Mandibular Body

This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible. After segmentation, the mandible was virtually rotated back into position and the open bite was closed. A patient specific mandibular reconstruction plate was outlined and fabricated from the new virtual situation and the plate was thereafter installed utilizing the preoperative plan. Osteotomy- and drill-guides was used and thus simplified the surgery resulting in uneventful healing. Virtual planning and patient specific implants and guides were valuable in this case of secondary reconstructive trauma surgery.

scholarly journals Clinical Application of Antibacterial Hydrogel and Coating in Orthopaedic and Traumatology Surgery

Gels ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 126
Author(s):  
Daniele De Meo ◽  
Giancarlo Ceccarelli ◽  
Giancarlo Iaiani ◽  
Federico Lo Torto ◽  
Diego Ribuffo ◽  
...  
Keyword(s):  
Polylactic Acid ◽  
Antibiotic Treatment ◽  
Clinical Application ◽  
Trauma Surgery ◽  
Treatment Strategies ◽  
Current Evidence ◽  
Acid Base ◽  
Prevention And Treatment ◽  
Local Antibiotic ◽  
Periprosthetic Infections

Implant related infection is one of the most frequent complications in orthopaedic and trauma surgery. Local antibiotic treatment strategies are becoming part of the prevention and treatment methodology for this fearful complication. To date, there are two coatings available on the market, both with a polylactic acid base. Current evidence supports the use of these types of coatings in the prophylaxis of periprosthetic infections and fracture-related infections. However, their therapeutic use has been less investigated. The purpose of this article is to summarise recent evidence relating to the clinical application of antibacterial hydrogels and coatings in orthopaedic and traumatology surgery and indicating which future applications may benefit from it.

scholarly journals Nasal Fractures: The Role of Primary Reduction and Secondary Revision

2019 ◽  
Vol 35 (06) ◽  
pp. 590-601 ◽  
Author(s):  
Weitao Wang ◽  
Thomas Lee ◽  
Scott Kohlert ◽  
Sameep Kadakia ◽  
Yadranko Ducic
Keyword(s):  
Rigid Fixation ◽  
Open Rhinoplasty ◽  
Facial Skeleton ◽  
Acute Setting ◽  
Nasal Bones ◽  
Secondary Deformity ◽  
Primary Reduction ◽  
Nasal Trauma ◽  
Nasal Fractures

AbstractThe nasal bones are among the most commonly fractured bones in the facial skeleton. Proper management of nasal trauma acutely is important in minimizing secondary deformities and impaired function with nasal airway obstruction. Septal hematoma, if present, should be drained right away. Acutely closed nasal reduction and limited septoplasty can be performed. Unrecognized septal fracture may play a role in the failure of closed nasal reduction of fractured nasal bones. Complex nasoorbitoethmoid fractures are approached openly and treated with rigid fixation. Primary use of open rhinoplasty in an acute setting is debated, and there are no clearly accepted indications for timing, patient selection, and surgical technique. However, open septorhinoplasty is more commonly used in a delayed fashion to provide definitive correction of any residual cosmetic or functional problems. Recent algorithms provide a systematic approach to nasal trauma and may improve secondary deformity rates following closed reduction.

Clinical Experience with Osteosynthesis of Subcondylar Fractures of the Mandible using Delta Plate

2016 ◽  
Vol 6 (1) ◽  
pp. 63-66
Author(s):  
Shailesh Nareshkumar Kokal ◽  
Suraj Arjun Ahuja ◽  
Nareshkumar T Kokal ◽  
Haemant A Baonerkar
Keyword(s):  
Clinical Experience ◽  
Mandibular Condyle ◽  
Rigid Fixation ◽  
Controversial Issues ◽  
Facial Skeleton ◽  
Present Case Report ◽  
The Past ◽  
Subcondylar Fracture ◽  
Open Treatment ◽  
Fixation Techniques

ABSTRACT Mandibular condyle fractures are one of the most frequent injuries of the facial skeleton. The option for open treatment of mandibular condyle fractures has become more favorable since osteosynthesis materials were developed in the past few decades. However, the rigid fixation techniques of treating condyle fractures remain one of the controversial issues in maxillofacial trauma. Several techniques and plate types such as adaption miniplates, minidynamic compression plates, resorbable plates, and double plates have been evaluated biomechanically in various experimental and clinical studies. The present case report is to evaluate the clinical use of indigenously developed titanium delta-shaped miniplate in open reduction and internal fixation of subcondylar fracture. How to cite this article Kokal SN, Ahuja SA, Kokal NT, Baonerkar HA. Clinical Experience with Osteosynthesis of Subcondylar Fractures of the Mandible using Delta Plate. J Contemp Dent 2016;6(1):63-66.

Letters to the Editor

PEDIATRICS ◽  
1971 ◽  
Vol 47 (1) ◽  
pp. 154-155
Author(s):  
Richard E. Kravath
Keyword(s):  
Sodium Chloride ◽  
Sodium Bicarbonate ◽  
Clinical Application ◽  
Animal Studies ◽  
Sodium Bicarbonate Solution ◽  
Physiological Effect ◽  
Body Water ◽  
Letters To The Editor

Dr. Harris brings up some important points and correctly is concerned about the clinical application of animal studies. The solution of sodium chloride that we used has an osmolality about 2.8 times higher than the sodium bicarbonate solution in common usage. This difference in concentration does not have a proportionate physiological effect since the shifts in body water produced by a given amount of solute are not linearly related to its osmolality. Four milliliters of a 2.5 M solution contains 10 mEq, while it takes 11.1 ml of a 0.9 M solution to contain the same amount.

scholarly journals THE SEMI-RIGID INDIVIDUAL FUNCTIONAL BANDAGES AS A FINAL STAGE IN THE TREATMENT OF THE TIBIAL BONE NONUNIONS AFTER TREATMENT WITH RING FIXATORS

2020 ◽  
pp. 87-100
Author(s):  
A.K. Rushay ◽  
O.O. Martynchuk ◽  
M.V. Baida ◽  
A.A. Jaghdal
Keyword(s):  
Positive Result ◽  
Medical Care ◽  
Final Stage ◽  
Evaluation System ◽  
High Efficiency ◽  
Polymeric Materials ◽  
Ilizarov Method ◽  
Rigid Fixation ◽  
Functional Evaluation ◽  
Tibial Bone

Summary. The tibia non-unions after fractures require complex and durable treatment. One of the most common methods of variable osteosynthesis is the Ilizarov method. The long period of treatment causes the development of bone reaction to the immersion parts of the ring fixation (RF), osteoporosis, and as a result - reduction of the rigidity of the "fixator - bone fragments" system. All this is the basis for the application of the final stage of low-traumatic methods of fragments fixation with external bandages. Objective. The task of the study is to improve the results of tibial bone non-unions treatment after changeable osteosynthesis with ring fixators, based on the application of external individual fixation with semi-rigid bandages at the final stage of treatment. Material and methods. In our study, we had 36 patients with tibial bone non-unions under observation which have been treated with changeable osteosynthesis with RF. For the sake of prevention of displacement of the fragments, deformation of the regenerate, treatment of tissues inflammation in the area of pins implantation after disassembly of the Ilizarov device; and for the early rehabilitation of the calf functions - used individual semi-rigid fixation system Scotchcast/Softcast. The system allowed to create atraumatic conditions for regeneration and consolidation, full loading of the limb, its full usage during walking. The combination of rigidity (Sotshstast) and elasticity (Softstast) in the system of semi-rigid fixation with polymeric materials allowed the circular rounds of Softstast to change the shape of the bandage. In point of this, we were offered a method of pneumatic massage, which provided massage during the immobilization stage of treatment. Conducting kinesiotherapy and massage therapy was supplemented by medicament therapy. Results. The assessment also took into consideration the structure of non-unions with the Non-Union Scoring System - NUSS scale. The distribution of patients according to the total NUSS score indicated a very complex contingent of victims with a low probability of obtaining good results. Patients who needed standard methods of treatment, with a high probability of obtaining a positive result, were not observed; all required specialized treatments with the likelihood of achieving a positive result. In 20 cases, there was a need for complex specialized medical care with a possible positive result. 2 observation cases showed that even complex specialized medical care did not guarantee a positive result. Evaluation of the results of treatment of the victims with tibial bone non-unions after fractures were performed using the Modified Functional Evaluation System by Karlstrom-Olerud. Good results were obtained in 20 patients (30.45 ± 0.88 points, p <0.001) - 55.6%. Satisfactory results were observed in 7 patients (28.0 ± 0.125 points, p <0.001) - 19.4%. Moderate function impairment (4 patients - 13.9%) was 22.0 ± 1.323 p p <0.001. Poor, unsatisfactory results were observed in 1 case (2.8%); excellent functional status - 3 (8.3%). Conclusions. The usage of semi-rigid fixation systems at the final stage of treatment of tibial non-unions after osteosynthesis with ring fixators should be considered reasonable and safe. The results of the treatment of 36 patients with tibial bone non-unions with preliminary fixation by ring fixators according to the Ilizarov method, using semi-rigid fixation systems at the final stage of treatment -indicate high efficiency.

scholarly journals Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Usman Khan ◽  
Sebastian Haupt ◽  
Matthew Rigby ◽  
S. Mark Taylor ◽  
Martin Corsten ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Island Flap ◽  
Rigid Fixation ◽  
Facial Skeleton ◽  
First Case ◽  
Skin Cancers ◽  
Facial Defects ◽  
History Of ◽  
The Right ◽  
Submental Island Flap

Abstract Background The submental island flap (SIF) is a reliable option for reconstructing defects in the facial region and offers several advantages when compared to free-flap alternatives. While the reconstructive applications of the SIF have been demonstrated in the lower face, there are limited reports on its utility as a composite flap for reconstructing defects of the upper facial skeleton. To our knowledge, we report the first cases of composite (osteocutaneous) SIFs used for reconstruction of complex facial defects involving the zygoma and lateral orbit respectively. Case presentations Three consecutive cases are presented. All were performed following resection of skin cancers with invasion of the upper facial skeleton. The first case was a 68-year-old male with a longstanding history of non-melanoma skin cancers who presented with a 7 cm recurrent basal cell carcinoma (BCC) with bicortical invasion of the left zygoma. The second case was an 88-year-old female with several squamous cell carcinomas (SCC), including a dominant 7.1 cm SCC on the right temple with orbital invasion. A third case was a 75-year-old immunosuppressed male with a 6.5 cm SCC of the right cheek with invasion of the orbit and zygoma following prior resection as well as high dose radiotherapy. The operative management of all cases involved harvesting the SIF on its vascular pedicle alongside the inferior portion of the mandible with rigid fixation to address the bony defects. The first case was robust throughout adjuvant radiotherapy with no flap complications after 2 year follow up. The second patient received adjuvant radiation therapy to an area that was previously radiated. Although the flap remained viable for a year, the patient experienced delayed soft tissue loss over the bony segment and eventual devitalization of the distal flap. The third case achieved a satisfactory result with no complications. Conclusions Our case series outlines a unique application of the composite (osteocutaneous) submental island flap (SIF) for reconstruction of complex facial defects involving the upper facial skeleton. The osteocutaneous SIF should be used with caution in patients receiving adjuvant radiotherapy who have a history of previous radiation to the same or overlapping field. Graphical abstract

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