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.

Orthognathic surgery is widely used to treat dentofacial deformities. Among the surgical techniques used for addressing dentofacial malformations, the Le fort I maxillary osteotomy remains a workhorse surgical technique; however, significant complications can arise. One of the most serious complications is a pseudoaneurysm that results from injury to a terminal branch of the internal maxillary artery. This report describes two cases of pseudoaneurysms following Le Fort I osteotomy during a 10-year period at our high surgical volume unit which were treated in 2 different ways.

Domestic animal bites are commonly encountered in Oral and Maxillofacial (OMF) practice, whereas bear attacks are a rare trauma situation that OMF surgeons deal with in their practice. Two case reports presented here are infrequent extensive injuries that required significant surgical undertaking. Two male victims who were mauled by bears, demonstrated injuries around the middle one third, periorbital and central face. Salient features of the injuries on these occasions were almost all degloved tissues, can be put together as a complex jigsaw. The approach taken was to clean, debride and build from deep to superficial with maximum preservation of tissues.

Traumatic neuroma is an exuberant and disorganized but non-neoplastic process of regeneration of the proximal stump of a peripheral nerve. Its occurrence in the oral cavity is rare and usually involves the mandible or tongue, almost always associated with a traumatic event such as surgery, tooth extraction or an inflammatory process.

It is characterized by the presence of pain, burning, or paresthesia and rarely involves hard palate. We present the case of a 35-year-old female patient with, approximately five years prior, a new growth in the left hard palate region. The patient did not report any significant medical history, nor any traumatic or inflammatory events involving the oral cavity. She provided facial CT images, which were negative for pathologies. A biopsy of the new growth was performed, and the histological report confirmed the diagnosis of "traumatic neuroma". The traumatic neuroma was completely excised preserving the adjacent bony structures. After complete removal of the lesion the symptoms disappeared.

Temporomandibular joint (TMJ) ankylosis can lead to complete or partial obliteration of the articular space and subsequent limited mouth opening. In children, ankylosis may lead to growth disturbance of the mandible, facial deformity, obstructive sleep apnea, impaired mastication and speech with subsequent nutritional deficiencies. Reconstruction of the condyle to restore facial deformities and TMJ function is recommended as soon as ankylosis is diagnosed. Surgical treatment options vary based on age, type and extent of the ankylosis and whether its uni-or bilateral. Different treatment modalities, such as distraction osteogenesis, gap arthroplasty, costochondral graft (CCG), sternoclavicular graft and alloplastic total joint reconstruction (ATJR) are common reconstruction choices.

We present a case of a long lasting bilateral TMJ ankylosis in a 5-year-old boy with severe OSA who was treated with bilateral alloplastic total joint reconstruction with successful outcome. Even though ATJR in growing children is controversial, the potential benefits of function and quality of life should to be considered in selected cases.

Granulomatosis with Polyangiitis previously called Wegener's granulomatosis is quite a rare condition that affects multiple organs. It's a serious disorder marked by inflammation that causes tissue damage in the upper and lower respiratory tract, glomerulonephritis, and vasculitis, which can be fatal. This illness can present in either a limited or generalized form. The limited version tends to progress slowly, while the more widespread form can rapidly lead to failure of multiple organs. One of the challenges in diagnosing is that its early symptoms are nonspecific.

We are presenting a case of 16-year-old girl come in with a rather unusual presentation. Her symptoms kicked off with strawberry gingivitis and swelling of the salivary glands. In our report, we delve into the details of her clinical signs, what we found on the radiological scans, and how we approached treatment.