A multidisciplinary approach to the comprehensive treatment of edentulous patients with perioral wrinkles of the skin

Objectives: The purpose of this study was to comparative analysis of effectiveness of isolated use of intradermal injections of modified hyaluronic acid (Hyalorepair 04) and its combination with platelet-rich autologous plasma in edentulous patients with perioral wrinkles of the skin. Materials and Methods: A total of 56 patient’s presence of perioral wrinkles of the skin participate in the study after dental implant prosthodontics rehabilitations. They were randomly divided into 2 groups in accordance with the applied therapy method (29 isolated implementation of modified hyaluronic acid bio-repairing and 27 bio-repairing combined with autologic plasmotherapy). Treatment included implant-prosthetic rehabilitation followed by hyaluronic acid injections in order to correct cheek-zygomatic sulcus, nasolabial folds and marionette wrinkles. Preparations in an amount from 1 to 4 ml were injected into the face area, depending on the zones to be corrected at the request of the patients. Results: The complex treatment restored the aesthetic profile of the face and oral cavity and increased the effectiveness of the chewing function. On M03 and M05, 2/3 of patients had significant improvement as assessed by physician and patient according to GAIS. Most of the patients also showed significant improvement at visit M12. Conclusion: A multidisciplinary approach to the treatment of edentulous patients with perioral wrinkles increases the functional and aesthetic effect of the treatment. Implementation of combined of bioreparation and autologous plasmotherapy is significantly more effective comparatively to the isolated implementation of modified hyaluronic acid. Keywords: Facial Esthetic; Implant-Prosthetic Rehabilitation; Hyaluronic Acid

Spectacular Effect of Massive Facial Angiofibromas Removal With a Carbon Dioxide Laser as a Manifestation of a Tuberous Sclerosis Complex

Introduction: Tuberous sclerosis complex (TSC) is a rare, genetic disease which leads to neurological, cardiological, nephrological, ophthalmic, pulmonary and skin disorders. Case Presentation: Here, we describe a case of a 64-year-old man with the presence of giant angiofibromas located on his chin and nasolabial folds which caused inconvenience and unaesthetic appearance. All angiofibromas were removed with the use of a CO2 laser. The patient was extremely satisfied with the obtained result. No side effects were observed after a 6-month follow-up. Conclusion: Despite the fact that giant facial angiofibromas may be troublesome not only for patients but also for medical doctors, adequate CO2 laser usage with local anesthesia and control of massive bleeding is a promising treatment option for patients with TSC.

Transient symptomatic zinc deficiency in an exclusively breastfed infant

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 μg/dL; normal range (NR) >60 μg/dL), normal plasma zinc levels in the mother (111.3 μg/dL; NR 68–120 μg/dL) and lower than the normal range of zinc levels in breast milk (270μg/L; NR 1000–2500 μg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.

Patient Satisfaction with Absorbable Anchoring Facial Threads

This study aimed to evaluate satisfaction in terms of facial appearance, quality of life, and adverse effects in patients undergoing the facial thread lifting procedure using the absorbable facial threads anchored on the superficial and deep temporal fascias. The charts of patients for whom facial anchored thread lifting was performed using absorbable threads between February 2017 and September 2019 were reviewed. Demographic data including age and gender as well as data from the Face-Q scales were collected. Descriptive analysis was made for the adverse effects 1 week after the procedure. The mean value of adverse effects scales was compared 1 and 2 weeks after the procedure and also the mean values of facial appearance and quality-of-life scales were compared at baseline, 6 months, and 12 months after the procedure. All recruited subjects were females with a mean age of 43.42 years. There was a statistically significant decrease in the rate of adverse effects following the procedure between the first and second week. The mean difference in patients' perceived age 6 and 12 months after the procedure was statistically significant when compared with baseline. The psychological distress significantly decreased and the psychological function improved 6 and 12 months after the procedure. The overall satisfaction with facial appearance increased significantly after 6 months with a mean of 20.08. This was maintained at 12 months. The satisfaction in skin appearance, cheeks, nasolabial folds, marionettes, lower face, and jawline appearances improved significantly 6 months after the procedure. This was also maintained at 12 months. Face lifting using the polycaprolactone threads anchored on the temporalis fascia showed a significant improvement in the quality of life and facial appearance. The adverse effects are tolerable starting 2 weeks after the procedure.