Oral and Maxillofacial Surgery Cases最新文献

Purpose

to describe a surgical treatment of a case in vertical posterior maxillary alveolar ridge excess and to perform a literature review of various surgical options.

Methods

we described a patient treated with a Le Fort I and a posterior maxillary segmental osteotomy (PMSO) for prosthodontic rehabilitation. A literature review on surgical treatments in posterior maxillary alveolar ridge excess is performed on Scopus, Embase, Pubmed and Cochrane with specific keywords.

Results

the case described is finally rehabilitated with implants in the mandible according to a correct Spee curve and occlusal plane. 49 articles describe surgical procedures of vertical posterior maxillary alveolar ridge excess. Only two reviews are described.

Discussion

literature has paid little attention to different combined orthognathic surgery procedures in prosthodontic rehabilitation of posterior maxilla. The orthognathic option is sometimes considered aggressive and difficult but with proper knowledge of the technique and surgical experience, correct and stable modification of inter arch space can be reached with predictability.

Conclusion

correct surgical and dental prosthetic planning are important to achieve a stable functional and aesthetic solution for patients.

Botox treatment has become a popular method for reducing facial lines and wrinkles and rejuvenating the signs of aging. However, like any procedure, Botox can lead to temporary and minor complications. In the presence of certain systemic diseases such as diabetes mellitus, it is essential to take additional precautionary measures that should not be ignored, as it could turn into a life-threatening situation which may need to surgical intervention. Therefore, the key to success lies in ensuring that the procedure is carried out by skilled professionals, conducting a comprehensive medical history assessment, despite the simplicity of the procedure. Thus, we present a case of A 52-year-old diabetic woman came with a severe facial phlegmon persisting for 7 days and mentioned a previous Botox treatment 8 days ago. Drainage of the phlegmon was performed under general anesthesia using an intraoral vestibular approach.

Brown tumor is a condition associated with hyperparathyroidism that can affect various bones, including the facial skeleton. These tumors are typically well-defined radiolucent lesions but can grow large and cause disfigurement. It is crucial to diagnose brown tumors especially in the jaws early, as those involving the maxillo-mandibular region can exhibit highly aggressive behavior. Also, following parathyroidectomy or normalization of parathyroid hormone (PTH) levels, patients should be closely monitored for the presence of brown tumors. It is advisable to consider the removal of brown tumors even after the correction of underlying hyperparathyroidism. Regular follow-up examinations are necessary to assess the progression or regression of these tumors. In this study, we present a case of a 42-year-old female with renal failure and a history of parathyroidectomy presented with brown tumors in both jaws. The tumors showed aggressive characteristics such as cortical expansion and significant patient discomfort. After clinical and radiological evaluation, the patient underwent surgical excision, which involved total mandibulectomy and maxillectomy. The excised tissue was then subjected to histopathological analysis; the results confirmed brown tumor in both jaws.

Soft tissue reconstruction of oral cavity defects, such as glossectomy defects secondary to malignancy, pose a challenge for head and neck, oral, and maxillofacial surgeons. Reconstruction options for mucosal defects include primary closure, healing by secondary intention, full mucosal and split-thickness skin grafts, pedicled flaps, and microvascular free flaps. Biological grafts have become an integral part of the modern reconstructive ladder and are widely used for the regeneration of various soft tissue defects, including oral defects. This case series describes our initial experience using ovine forestomach matrix grafts in tongue and oral cavity reconstruction. Oral reconstruction using ovine forestomach matrix grafts was undertaken on three patients post wide excision and resulted in good functional and cosmetic outcomes. The rate of tissue formation provided by the graft and the grafts’ relative resistance to the hostile environment of the oral cavity support further clinical research to validate the use of these devices in oral reconstruction.

Surgically assisted rapid palatal expansion (SARPE) is a type of surgical intervention to correct a transverse maxillary deficiency in skeletally mature patients. Complications associated with SARPE can be divided into intraoperative complications such as hemorrhage, or postoperative complications that are associated with inadequate suture release. We present a case of a twenty-four year old female patient who reported a left-sided lingual anesthesia following the surgery. We hypothesized the cause to be related to peri-operative hematoma formation at the left maxillary region. Patient was managed conservatively, followed up periodically for three months and showed gradual improvement and complete recovery.