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Traqueotomías en pacientes críticos durante la pandemia por COVID-19. Estudio preliminar de nuestra experiencia en el Hospital La Paz de Madrid COVID-19大流行期间危重患者的气管切开术。初步研究我们在马德里拉巴斯医院的经验
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/RECOM.2020.1150/2020
J. Vera, J. Carretero, Jorge Guiñales Díaz de Cevallos, Pedro Garrido Ortega, Jorge Noguera Tomás, J. M. M. Caro, T. G. Otero, M. J. M. Soto, Albert Malet Contreras, Celia Sánchez Gallego-Albertos, J. C. A. Iglesias, M. J. Martín, J. Elizalde, Miguel Burgueño García
The outbreak caused by the SARS-CoV-2 virus is currently very active in Spain. Many infected people still require to be hospitalized. Around 10-15 % of hospitalized patients require intensive care, where they are intubated for a prolonged period, needing tracheotomies some weeks after the intubation. We will be conducting an observational study of the tracheotomies performed by our oral and maxillofacial Department to COVID-19 patients on intensive care units between March 17th and April 17th, 2020. This study will be analyzing the patients’ epidemiological and clinical aspects, surgical technique employed, surgical time, type of cannula used, postoperative complications and the patients’ clinical monitoring. A total of 22 patients underwent open elective tracheotomy. There were twenty-two males and three females aged between 40 and 77 (mean: 64,9 years-old). In all cases tracheotomy was carried out due to pulmonary process caused by COVID-19 bilateral pneumonia. Two patients presented pneumothorax in the immediate postoperatory care as a complication, one perished during the procedure and another did so after arriving to the Intensive Care Unit after the tracheotomy surgery. Even though tracheotomy is a ruled surgical technique, the special characteristics of COVID-19 patients make of this procedure a critical situation, mainly due to lung instability and quick desaturation of the patients. This requires the surgery to be carried out by experienced physicians in order to reduce operative time and to be able to react to any eventualities that may arise.
由SARS-CoV-2病毒引起的疫情目前在西班牙非常活跃。许多感染者仍然需要住院治疗。大约10- 15%的住院病人需要重症监护,他们需要长时间插管,在插管后几周需要气管切开术。我们将对2020年3月17日至4月17日期间我院口腔颌面科对重症监护病房新冠肺炎患者进行气管切开术的观察性研究。本研究将分析患者的流行病学和临床情况、手术技术、手术时间、使用的套管类型、术后并发症和患者的临床监测情况。22例患者行择期气管切开手术。男性22人,女性3人,年龄介乎40至77岁(平均64.4岁)。所有病例均因COVID-19双侧肺炎引起的肺过程而行气管切开术。2例患者术后立即出现并发症气胸,1例在手术过程中死亡,1例在气管切开术后到达重症监护病房后死亡。尽管气管切开术是一种常规手术技术,但COVID-19患者的特殊特点使得该手术情况危急,主要是由于患者肺部不稳定和快速去饱和。这就要求由经验丰富的医生进行手术,以减少手术时间,并能够对可能出现的任何意外情况作出反应。
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引用次数: 0
Enfermedad ampollosa autoimnume de cavidad oral: Pénfigo Vulgar. A propósito de un caso clínico. 口腔自身免疫性水疱病:寻常天疱疮。关于一个临床病例。
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1078/2019
Esther Gala
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引用次数: 0
¿Es el desplazamiento discal sinónimo de patología articular temporomandibular? Correlación clínico-radiológica y prevalencia de trastornos internos en sujetos voluntarios asintomáticos. 椎间盘移位是颞下颌关节病理的同义词吗?无症状志愿者的临床-放射学相关性和内部疾病患病率。
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1133/2020
D. González-Ballester, Raúl González-García, Agustín García Nogales, Carlos Moreno García, F. M. Gil
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引用次数: 3
Use of tongue flap as alternative for the closure of Palatinal fistulas in patients with sequela of palatoplasty. 舌瓣在腭成形术后遗症腭瘘修补中的应用。
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1100/2019
D. Barazarte, R. Muñoz, J. Golaszewski, Bricelys Pulgar, L. Moro, A. Maldonado
Aims: A retrospective study was conducted in the Department of Oral and Maxillofacial Surgery Dr. Atilio Perdomo; Ángel Larralde Hospital, CaraboboVenezuela, which describes the procedure and protocol of the postoperative period of patients operated on multiple occasions for the closure of palatal fistulas. Material and methods: A total of 20 patients treated for palatal fistulas were included in this study, in the period between 2014-2018. Patients with presence of sequelae of palatal fistulas, large fistulas with inadequate local scars, presence of oronasal communication and hypernasal resonance were considered. Patients were evaluated during the first 24 hours, 21 days and 6 months. Results: A total of 20 patients (12 men and 8 women) with palatal fistulas were treated with tongue flap, aged between 25 and 40 years. In the postoperative period, patients reported 58% of cases, mild pain. The most frequent clinical signs during the postoperative period were presented in 60% of the patients, showing headache, passive bleeding, severe pain. No significant changes in lingual motility. Acoustic analysis of the 6month late postoperative control voice, presented favorable changes in the intonation line, showing its continuity. All remaining cases showed satisfactory cure, and donor site morbidity was minimal. Conclusions: The tongue flaps are an excellent alternative for closing large or recurrent palatal fistulas, due to their versatility and excellent vascularity of the area. However, the design and the delicate manipulation of the flap are also decisive.
目的:对口腔颌面外科Atilio Perdomo医生进行回顾性研究;Ángel Larralde医院,CaraboboVenezuela,其中描述了多次手术关闭腭瘘的患者术后的程序和方案。材料与方法:本研究纳入2014-2018年共20例接受腭瘘治疗的患者。考虑存在腭瘘后遗症,局部疤痕不足的大瘘,存在口鼻通讯和高鼻共振的患者。分别在治疗前24小时、21天和6个月对患者进行评估。结果:用舌瓣治疗腭瘘患者20例(男12例,女8例),年龄25 ~ 40岁。术后,58%的患者报告有轻微疼痛。60%的患者术后最常见的临床症状为头痛、被动出血、剧烈疼痛。舌运动无明显变化。术后6个月晚期对照声的声学分析显示,语调线变化良好,表现出连续性。所有剩余病例均表现出满意的治愈,供体部位发病率极低。结论:舌瓣是闭合大的或复发的腭瘘的一个很好的选择,因为舌瓣的多功能性和良好的血管分布。然而,皮瓣的设计和精细操作也是决定性的。
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引用次数: 1
Enfisema subcutáneo como complicación de procedimientos de cirugía oral. Avería del instrumental utilizado 皮下肺气肿是口腔外科手术的并发症。使用过的仪器故障
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1104/2019
Alberto Cuevas Queipo de Llano, F. M. Gil, Manuel Moreno Sánchez, Carlos Moreno García
Instrucciones de citación para el artículo / Citation instructions for the article: Cuevas Queipo de Llano Alberto, Monje Gil Florencio, Moreno Sanchez Manuel, Moreno García Carlos. Enfisema subcutáneo como complicación de procedimientos de cirugía oral. Avería del instrumental utilizado / Subcutaneous emphisema after surgical third molar extraction: medical instruments failure. j.maxilo 2020. doi: 10.20986/recom.2020.1104/2019.
文章引用说明:Cuevas Queipo de Llano Alberto, Monje Gil Florencio, Moreno Sanchez Manuel, Moreno garcia Carlos。皮下肺气肿是口腔外科手术的并发症。手术第三磨牙拔牙后使用的器械故障/皮下震颤:医疗器械故障。j.maxilo 2020年。doi: 10.20986 / recom.2020.1104/2019。
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引用次数: 0
Acoustic analysis of cry in with cleft palate patients. 腭裂患者哭声的声学分析。
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1154/2020
Bricelys Pulgar, J. Golaszewski, R. Muñoz, D. Barazarte, A. Maldonado
Introduction: Crying in newborns and infants is a functional expression of biological interest. Through, acoustic analysis of crying, results of a primary palatoplasty can be evaluated in patients with cleft palate before development of speech, is objective, non-invasive, quick and simple tool for vocal exploration. The objective is to determine Fundamental Frequency (F0) of spontaneous crying in patients with pre and postoperative cleft palate, and compare with healthy control group through PRAAT software, in period between 2017 and 2019. Materials and methods: A sample of 16 patients from 18 to 30 months of age with cleft palate was obtained. Recordings were made of spontaneous pre and postoperative crying, and healthy control group; later were digitally recorded, and analyzed through PRAAT Software. Results: 56.2 % were female and 43.7 % were male, witn average age of 25.8 months. Primary palatoplasty was performed using Veau Wadrill technique and Furlow technique. F0 of crying was Pitch average value 349.125 Hz preoperative and Pitch average postoperative control 369.775 Hz. More acute crying emissions were observed in postoperative period (p < 0.000), presenting similar values with control group (p < 0.000). Conclusion: Fundamental frequency (F0) was determined in patients with cleft palate, they presented a significant increase of 15,5 % in postoperative controls of primary palatoplasty, similar to healthy control group.
新生儿和婴儿的哭泣是生物学兴趣的一种功能性表达。通过哭声的声学分析,对尚未发育言语的腭裂患者进行一期腭裂成形术的效果进行评价,是客观、无创、快速、简便的语音探查工具。目的是在2017 - 2019年期间,通过PRAAT软件确定腭裂术前和术后患者自发哭泣的基本频率(F0),并与健康对照组进行比较。材料与方法:选取18 ~ 30月龄腭裂患者16例。记录患者术前、术后自发性哭闹及健康对照组;并通过PRAAT软件进行数字记录和分析。结果:女性56.2%,男性43.7%,平均年龄25.8个月。采用Veau Wadrill技术和Furlow技术进行初级腭成形术。F0为术前基音平均值349.125 Hz,术后基音平均值369.775 Hz。术后急性哭闹发生率增高(p < 0.000),与对照组相似(p < 0.000)。结论:测定了腭裂患者的基本功频率(F0),在一期腭裂术后对照组中,基本功频率(F0)明显增加了15.5%,与健康对照组相似。
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引用次数: 0
Comparison of the outcomes of unilateral orbital fracture repair with and without surgical navigation system: our experience in La Paz University Hospital 应用与不应用导航系统治疗单侧眼眶骨折的疗效比较:我们在拉巴斯大学医院的经验
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1135/2020
Celia Sánchez Gallego Albertos, J. C. Carretero, Miguel Burgueño García
Introduction: Restoration of normal orbital volume and globe position following traumatic injury is often difficult. Intraoperative navigation has emerged as a tool to allow the visualization of the implant position intraoperatively, by means of the planification in the preoperative computed-tomographic scan (CT scan). Objectives: The aim of this study was to compare the postoperative changes in orbital volume between two groups of study: one group that underwent surgical intervention before the implementation of intraoperative navigation (control group), and other group of patients which had undergone surgery with the aid of a navigation system (Software iPlan CMF version 3.0.5, Brainlab®, Feldkirchen, Germany) (navigation group). Another endpoint of our study was to determine it the presurgical planification and intraoperative navigation aided to position the implant. For that purpose, we determined the implant position with respect to the orbital floor and medial orbital wall and compared it between both groups of study. As secondary endpoints, we compared the rate of postoperative outcomes and reintervention rate between both groups. Materials and methods: A retrospective cohort study was designed. We selected a total of 35 consecutive orbital operations for unilateral orbital fractures performed between 2015 and 2018 at the Department of Oral and Maxillofacial Surgery in La Paz Hospital (Madrid), Spain. We collected information regarding: demographic data, cause of the fracture, time elapsed between diagnosis and surgical treatment, symptoms at diagnosis (diplopia, globe projection, ocular motility impairment), radiological findings (affected wall, muscular entrapment, herniation of the periorbital structures), and outcomes after surgical treatment (diplopia, globe position, ocular motility impairment, reintervention). By means of the iPlan CMF software, the orbital volume was determined in the preoperativeand postoperative CT scan. The plate position was determined by measuring the distance between the plate and the orbital rim, the distance between the plate and the residual posterior intact bony ledge and the distance between the plate and the medial orbital wall. Measurements were performed automatically in the three planes of space, although we used the sagital plane to measure the distance between the plate and the orbital rim and between the plate and the residual posterior intact bony ledge. To measure the distance between the plate and the medial orbital wall we used the axial plane. Results: After surgery, we observed that abnormal globe position was significatively less frequent in the navigation group than in the control group (p = 0.029). The reoperation rate was 11 % in the navigation group and 35% in the control group (p = 0.071). Mean orbital volume of the unaffected orbit was 29.32 ± 2.64 cm3 in the navigation group and 28.64 ± 2.68 cm3 in the control group. Mean orbital volume of the affected orbit was 34.19 ± 3.67 cm3 in t
外伤性损伤后眶体积和眶位置的恢复通常是困难的。术中导航已经成为一种工具,通过术前计算机断层扫描(CT扫描)的平面化,术中可以看到植入物的位置。目的:本研究的目的是比较两组患者术后眼眶体积的变化:一组患者在实施术中导航前进行手术干预(对照组),另一组患者在导航系统的帮助下进行手术(软件iPlan CMF版本3.0.5,Brainlab®,Feldkirchen,德国)(导航组)。我们研究的另一个目的是确定手术前的平坦和术中导航是否有助于植入物的定位。为此,我们确定了植入物相对于眶底和眶内壁的位置,并在两组研究中进行了比较。作为次要终点,我们比较了两组的术后转归率和再干预率。材料和方法:设计回顾性队列研究。我们选择了2015年至2018年在西班牙拉巴斯医院(马德里)口腔颌面外科连续进行的35例单侧眶骨折手术。我们收集了以下信息:人口统计数据、骨折原因、诊断和手术治疗之间的时间、诊断时的症状(复视、眼球突出、眼球运动障碍)、影像学表现(受累壁、肌肉卡压、眶周结构突出)和手术治疗后的结果(复视、眼球位置、眼球运动障碍、再干预)。通过iPlan CMF软件在术前和术后CT扫描中确定眼眶体积。通过测量钢板与眶缘之间的距离、钢板与残余后完整骨突之间的距离以及钢板与眶内壁之间的距离来确定钢板的位置。测量是在三个空间平面上自动进行的,尽管我们使用矢状面来测量钢板与眶缘之间以及钢板与残余后完整骨突之间的距离。为了测量板与眶内壁之间的距离,我们使用轴向面。结果:术后导航组地球仪位置异常发生率明显低于对照组(p = 0.029)。导航组的再手术率为11%,对照组为35% (p = 0.071)。导航组正常眼眶平均体积为29.32±2.64 cm3,对照组为28.64±2.68 cm3。导航组患眶平均体积为34.19±3.67 cm3,对照组为32.78±3.09 cm3。导航组平均重建眶容积为29.47±2.75 cm3,对照组平均重建眶容积为28.88±3.72 cm3。两组间未受影响侧和重建侧的平均体积缩小和平均体积差异无显著性差异。残后完整骨突处从板到眶底的平均距离差异有统计学意义(p = 0.001),导航组较差。结论:与常规手术相比,术中导航在眶内骨折中有效地改善了钢板在眶底残余后完整骨嵴中的定位,减少了眼内陷等并发症。此外,与传统手术相比,术中导航的使用似乎降低了再干预率。两种方法似乎都能很好地解决眼眶体积的恢复问题。
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引用次数: 0
Estudio sobre la prevalencia del trastorno interno de la ATM y otros nuevos hallazgos 颞下颌关节内侧紊乱患病率及其他新发现的研究
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1194/2020
R. G. Garcı́a
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引用次数: 0
Aquel año que cambió el mundo 那一年改变了世界
Q4 Dentistry Pub Date : 2020-01-01 DOI: 10.20986/recom.2020.1237/2020
R. G. Garcı́a
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引用次数: 0
Efecto comparativo del método de fractura mecánica y el método de corte en la viabilidad de las células de la pulpa dental humana de las 24 horas postexodoncia 机械断裂法和切割法对人牙髓细胞拔牙24小时活力的比较影响
Q4 Dentistry Pub Date : 2019-12-01 DOI: 10.20986/recom.2019.1023/2019
Xiomara Flores-Cóndor, Esperanza R. Ayón-Haro
ABSTRACT Aim: In biomaterials and tissue engineering studies, dental pulp cells are used to regenerate or replace deficiencies of bone tissue in the oral cavity. To evaluate its clinical potential, cell culture models are employed, in which different extraction methods of the dental pulp are applied. Mainly, the tooth is broken by fracture mechanics and the cutting method to obtain the dental pulp. However, it is not clear yet which method is the most convenient. Therefore, the purpose of this study was to compare the effect of two methods of fracture mechanical and cutting methods on the dental pulp cell viability. Methodology: Dental pulp tissue was removed of fully developed and healthy teeth of 32 patients between 18 to 40 years, through two techniques: the methods of fracture mechanics (group 1) and cutting (group 2). To determine the cell viability, trypan blue dye was used. The cells were counted in the microscope, blue stained cells (dead) and birefringent (living). Results: Using the mechanical fracture method, 87.72 % of cell viability was obtained. While with the cutting method was achieved a lower viability 83.59 %. There was a significant difference (p = 0.006) when analyzing the data (n = 16 per group) under t-Student test. Conclusions: The use of mechanical fracture method for the extraction of the dental pulp tissue allows to obtain higher percentages of cell viability compared to cutting method.
摘要目的:在生物材料和组织工程研究中,牙髓细胞被用来再生或替代口腔中缺乏的骨组织。为了评估其临床潜力,采用细胞培养模型,采用不同的牙髓提取方法。主要是通过断裂力学和切削法使牙齿断裂,得到牙髓。然而,目前尚不清楚哪种方法最方便。因此,本研究的目的是比较断裂机械和切割两种方法对牙髓细胞活力的影响。方法:采用断裂力学法(1组)和切割法(2组)两种方法,对32例年龄在18 ~ 40岁之间发育完整的健康牙齿进行牙髓组织切除。采用台锥蓝染色测定细胞活力。在显微镜下计数细胞,蓝色染色细胞(死亡)和双折射细胞(活)。结果:采用机械断裂法,细胞存活率达87.72%。而采用切削法获得的存活率较低,为83.59%。在t-Student检验下分析数据(n = 16 /组),差异有统计学意义(p = 0.006)。结论:与切割法相比,采用机械断裂法提取牙髓组织可获得更高的细胞存活率。
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引用次数: 1
期刊
Revista Espanola de Cirugia Oral y Maxilofacial
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