Designing maxillofacial prosthesis for bone reconstruction: an overview

A cranio-maxillofacial region contains several bones and serves to protect and support the area, from the brain to the masticatory system. In this paper the clinical and research aspects of craniomaxillofacial biomaterials have been highlighted to serve as a guide into the wide world of their reconstructions. After a quick look into the anatomy, the review focuses on the causes of large bone defects in this region, and how they influence the designing process of the implant. Since it is a large area to unfold, only the maxillary, the mandible and the temporomandibular joints are highlighted. Understanding the biomechanics of mandible and temporomandibular joints is quite important, as it strongly influences the choice of the biomaterial. Thus, the latest techniques implemented to understand the biomechanics of the mandible are also highlighted. Via the finite element analysis, a simulation can help to identify the forces and the movements of the mandible and to predict the possible outcome of the implantation influencing the choice of the biomaterial.

Effectiveness of Physical Therapy in the Correction of the Functional Status of the Temporomandibular Joint in Arthrosis

The purpose of the study was to evaluate the effect of a physical therapy program on the state of functioning of the maxillofacial region in patients with arthrosis of the temporomandibular joint. Materials and methods. The study involved 33 people with arthrosis of the temporomandibular joint of the II-III degrees, which were divided into 2 groups – control and main. The control group consisted of 18 people who received arthrosis therapy only with non-steroidal anti-inflammatory drugs. The main group consisted of 15 people who additionally underwent the developed program of physical therapy (therapeutic exercises, massage, post-isometric relaxation, kinesiotaping of the masticatory muscles, neck muscles, cervical-collar zone; paraffin therapy course for the temporomandibular joint area, patient education). Complaints of patients, the intensity of pain in the temporomandibular joint on a visual analogue scale, the amount of mouth opening were determined, and auscultation of the joint was performed. Results and discussion. After the completion of the treatment course (for patients of the control group) and physical therapy (for the patients of the main group), pain in the temporomandibular joint did not manifest itself at rest and during movement. This is explained, in particular, by the fact that the basis of conservative treatment of arthrosis is the use of non-steroidal anti-inflammatory drugs with analgesic effects. At the same time, the usage of physical therapy, in comparison with medications, in the main group was statistically significant (p <0.05) in relation to control patients, it improved the functional activity of the jaw area and the functioning of the temporomandibular joint, which was manifested by a decrease in the number of persons with complaints of pathological sounds during jaw movements and their auscultatory detection, discomfort when chewing, as well as an increase in the magnitude of opening the mouth. Restoration of the condition of patients with diseases of the maxillofacial region, and, in particular, the temporomandibular joint, is an urgent problem not only for dentists, but also for specialists in the field of rehabilitation, in particular, physical therapists. The objectives of physical therapy in patients with arthrosis of the temporomandibular joint are to reduce the load on the joint, eliminate and reduce pain, synovitis, myalgia, improve joint function, stimulate and activate metabolic processes in cartilaginous and bone tissues, normalize blood flow, and thus improve quality of life. Conclusion. Physical therapy means improve the functional ability of the temporomandibular joint in the complex recovery of patients with arthrosis statistically significantly better than monotherapy with non-steroidal anti-inflammatory drugs

RETROSPECTIVE ANALYSIS OF ACUTE LYMPHADENITIS OF THE MAXILLOFACIAL REGION AND NECK IN CHILDREN

Дети с острыми формами лимфаденитов челюстно-лицевой области составляют большую часть пациентов поликлиник и профильных стационаров. Зачастую они имеют недооцененную клиническую картину, общее состояние, распространенность и динамику острого воспалительного процесса, требуя хирургического вмешательства. Допущенные ошибки приводят к удлинению сроков лечения и иногда угрозе для жизни. Для раннего выявления показаний для госпитализации и помощи практикующим врачам в алгоритме действий проведен анализ случаев острых лимфаденитов лица и шеи в детском возрасте. На основе ретроспективных данных осуществлена систематизация лимфаденитов челюстно-лицевой области по клиническим формам и распределении частоты встречаемости, возрасту, анатомической принадлежности, выделены основные изменения гематологических показателей. Определена корреляция температурной кривой, этиологические причины возникновения лимфаденитов и основные микробиологические возбудители гнойных форм лимфаденитов лица и шеи у детей. На основании полученных данных нами разработаны и предложены критерии дифференциальной диагностики разных клинических форм лимфаденита, что поможет врачу с постановкой предварительного диагноза, или дифференциальной диагностике, на этапе поликлиники или на догоспитальном приёме. Данные критерии помогут сократить сроки лечения детей в стационаре и не допустить развития тяжелых осложнений Children with acute forms of lymphadenitis of the maxillofacial region make up the majority of patients in polyclinics and specialized hospitals. They often have an underestimated clinical picture, general condition, prevalence and dynamics of an acute inflammatory process, requiring surgical intervention. Mistakes lead to lengthening of treatment and sometimes life-threatening. For early detection of indications for hospitalization and assistance to practitioners in the algorithm of actions, an analysis of cases of acute lymphadenitis of the face and neck in childhood was carried out. On the basis of retrospective data, the systematization of lymphadenitis of the maxillofacial region by clinical forms and distribution of frequency of occurrence, age, anatomical affiliation was carried out, the main changes in hematological parameters were highlighted. The correlation of the temperature curve, the etiological causes of the occurrence of lymphadenitis and the main microbiological pathogens of purulent forms of lymphadenitis of the face and neck in children were determined. Based on the data obtained, we have developed and proposed criteria for the differential diagnosis of various clinical forms of lymphadenitis, which will help the doctor with a preliminary diagnosis, or differential diagnosis, at the stage of the polyclinic or at the pre-hospital admission. These criteria will help to shorten the period of hospital treatment for children and prevent the development of severe complications

Juvenile Ossifying Fibroma of a 15-Year-old Girl: A Case Report

Juvenile ossifying fibroma is a locally aggressive, benign fibro-osseous tumor. It usually occurs in young children and arises in the maxillofacial region. It has a high recurrence rate. This pathology would be diagnosed and treated as early as possible because of its rapidly progressive and osteolytic nature which may complicate the surgical removal if left untreated over a long period. The present case is diagnosed as Juvenile ossifying fibroma involving the maxilla causing facial deformity, proptosis, and nasal obstruction in a 15-year-old female child.

Evaluation of the accuracy of ultrasonography compared to histopathological findings in diagnosis of infectious maxillofacial swellings.

Objective: To evaluate the accuracy of ultrasonography in diagnosis of infectious maxillofacial/swelling. Study Design: Simple Cross Sectional study. Setting: Outpatient Department of Oral and Maxillofacial Surgery Unit, Punjab Dental Hospital, Lahore. Period: February 2016 to August 2016. Material & Methods: Conducted on 100 patients. The patients were evaluated with the ultrasound diagnostic modality. The ultrasound interpretation of all the cases was done and best possible diagnosis was made and recorded regarding diagnosis of infectious maxillofacial swellings. The incisional biopsy of every patient was done for histopathology. All findings of ultrasound and histopathology were entered to a proforma. Results: The average age of the patients was 35.81±14.31 years. In this study, 63% patients were males and 37% were females. Out of 100 patients, 70(70%) patients had infectious swelling while 30(30%) did not have infectious swelling. The sensitivity of ultrasonography was calculated as 84.72%, specificity was 67.86%, positive predictive value was 87.14%, negative predictive value was 63.33% and diagnostic accuracy was noted as 80% taking histopathology as gold standard. Conclusion: It was concluded from results of this study that ultrasonography has enough diagnostic accuracy to diagnose infectious swellings of maxillofacial region.

The Role of Immune Microenvironment in Maxillofacial Bone Homeostasis

Maxillofacial bone defects are common medical problems caused by congenital defects, necrosis, trauma, tumor, inflammation, and fractures non-union. Maxillofacial bone defects often need bone graft, which has many difficulties, such as limited autogenous bone supply and donor site morbidity. Bone tissue engineering is a promising strategy to overcome the above-mentioned problems. Osteoimmunology is the inter-discipline that focuses on the relationship between the skeletal and immune systems. The immune microenvironment plays a crucial role in bone healing, tissue repair and regeneration in maxillofacial region. Recent studies have revealed the vital role of immune microenvironment and bone homeostasis. In this study, we analyzed the complex interaction between immune microenvironment and bone regeneration process in oral and maxillofacial region, which will be important to improve the clinical outcome of the bone injury treatment.