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Guidelines For Natural Results In Dentistry One Simple Protocol 牙科自然结果指南——一个简单的方案
Pub Date : 2022-01-01 DOI: 10.37191/mapsci-2582-3736-4(1)-114
Lauro Delgado
The protocol to re-create the anatomy in oral rehabilitation is a need for long time.The mean of this article is to propose one simple, repectible and easy protocol to be used in anterior and later posterior sector to help dentist to achieve natural results in those restaurations. Doing this can offer better oral health services to the patient who ask for naturality and esthetic results in dentistry.
在口腔康复中重建解剖结构的方案是一个长期的需求。本文的目的是提出一种简单、可重复和简单的方案,用于前部和后部,以帮助牙医在这些重建中获得自然的结果。这样做可以为那些在牙科中要求自然和美观效果的患者提供更好的口腔健康服务。
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引用次数: 0
Menthol Crystal Vapor Inhalation In The Prevention And Remission Of Early Diagnosed Covid-19 Patients: Evidence Based 薄荷醇晶体蒸汽吸入预防和缓解早期诊断的新冠肺炎患者:基于证据
Pub Date : 2022-01-01 DOI: 10.37191/mapsci-2582-3736-4(1)-112
C. Ogunsalu
Purpose: The objectives of our study was to describe the effective use of menthol crystal vapor inhalationin the remission of the symptoms of COVID-19 patients (inclusive of the reversion of the positive status to negative) and to establish the preventive role that menthol plays as it relates to the transmission of the COVID-19 virus.Patients and Methods: These are clinical observational studies carried out in Jamaica between April 2020 to June 2021 at the Faculty of Dentistry of the International Postgraduate Medical College, Montego Bay Jamaica.We reported two (2) studies which includes:Study 1: A single-centre open label therapeutic trial study which comprise of four (4) elderly patients between the age of 67 years and 83 years with an average age of 77 years. Each patient was consecutively included in the study within 24-hours post positive testing for COVID-19 and placed on a menthol crystal Inhalation regimen (MCIR) for three to four days consistently, then tested on the third or fourth dayafter the commencement of the regimen. The immediate effect of menthol crystal inhalation on the oxygen saturation of three out of the four patients was also documented. All these elderly patients were symptomatic prior to the PCR testing.An additional group of three younger (middle age) patients of age range of between 35 and 49 and average age 41.3 Years were also consecutively included in this study.Again, each patient was included in the study less than 24 hours after a positive testing for COVID-19 and placed on a menthol crystal Inhalation regimen (MCIR) with one patient tested after 4-days, the second patient tested after 3-days, and the third patient tested after 2-days.In Study 2 (the prevention study of menthol crystals), the prolonged utilization of menthol in a dental practice for 14-months with the aim of preventing COVID-19, in both the patients and dental health care worker.Results: In study 1, all the four elderly patients became negative after four (4) days of use of menthol crystal with all the initial symptoms subsiding completely within this period. One elderly patient with progressive memory loss regained her memory fully at about the eight (8th) day post commencement of the MCIR. Similarly, each of the three younger patients became negative after the use of the regimen at 2 days, 3 days, and 4 days respectively. Finally in study 2, none of the 1516 patients seen at the mentholated dental clinic and 9 dental healthcare workers employed during this period contacted COVID-19 up to 2 to 3 months after attending the dental clinic for treatment, thus confirming the protection offered by our continuously mentholated environment.Conclusion: The periodic inhalation of menthol crystal utilizing the MCIR has been found to be therapeutic for COVID-19 patients. These studies are also confirmatory of the preventive role of menthol crystal inhalation for COVID-19 when it is used in the MCIR or by making the working area mentholated. The h
目的:本研究的目的是描述薄荷醇晶体蒸汽吸入在缓解COVID-19患者症状(包括将阳性状态转为阴性)中的有效使用,并确定薄荷醇在COVID-19病毒传播中所起的预防作用。患者和方法:这些是2020年4月至2021年6月在牙买加蒙特哥湾国际研究生医学院牙科学院进行的临床观察性研究。我们报道了两项研究,其中包括:研究1:一项单中心开放标签治疗试验研究,包括4名年龄在67岁至83岁之间的老年患者,平均年龄为77岁。每位患者在COVID-19检测呈阳性后24小时内连续纳入研究,并持续使用薄荷醇晶体吸入方案(MCIR) 3至4天,然后在该方案开始后的第三天或第四天进行测试。薄荷醇晶体吸入对四名患者中的三名的氧饱和度的直接影响也被记录下来。这些老年患者在PCR检测前均有症状。另外一组3例年龄在35 ~ 49岁,平均年龄41.3岁的年轻(中年)患者也被连续纳入本研究。同样,每位患者在COVID-19检测呈阳性后不到24小时被纳入研究,并接受薄荷醇晶体吸入方案(MCIR),其中一名患者在4天后接受检测,第二名患者在3天后接受检测,第三名患者在2天后接受检测。在研究2(薄荷醇晶体的预防研究)中,在牙科诊所延长使用薄荷醇14个月,目的是预防COVID-19,在患者和牙科保健工作者中。结果:在研究1中,4例老年患者在使用薄荷醇晶体4天后全部变为阴性,在此期间所有初始症状完全消退。一名进行性记忆丧失的老年患者在MCIR开始后大约8天完全恢复了记忆。同样,三名年轻患者在使用该方案后分别在第2天,第3天和第4天均为阴性。最后,在研究2中,在薄荷化牙科诊所就诊的1516名患者和在此期间雇用的9名牙科保健工作者在前往牙科诊所接受治疗后的2至3个月内都没有接触COVID-19,从而证实了我们持续薄荷化环境提供的保护。结论:利用MCIR周期性吸入薄荷醇晶体治疗COVID-19患者具有良好的疗效。这些研究也证实了薄荷醇晶体吸入在MCIR中使用或在工作区域薄荷化时对COVID-19的预防作用。这项原创工作的特点是,薄荷醇蒸气能够使COVID-19病毒丧失能力,并通过推断最终将在未来出现的新变体。
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引用次数: 0
An Observational Study Of 210 Cases Of Tumors In Himachal Pradesh 喜马偕尔邦210例肿瘤的观察研究
Pub Date : 2022-01-01 DOI: 10.37191/mapsci-2582-3736-4(1)-110
Nitish Bhat
Although relatively rare, tumors of the jaw often may rise to extensive sizes and even metastasize presenting a challenge in diagnosis and treatment. Profiling of such lesion is essential as it helps in understanding the nature of tumors in a particular geologic location. Aim: The study was framed to determine the incidence of tumors on the basis of institutional data in Himachal Pradesh and to compare it with previous studies. Methodology: Data was retrieved from archives of DEPARTMENT OF ORAL PATHOLOGY, HIDS within a time span of 3 years (January 2015 and December 2017). The cases were characterized on the basis of World Health Organization classification, 2005 and grouped in different categories. Cases with histopathological diagnosis of tumors were reassessed and re analysed on the basis of clinical history, radiographic records present in the department. Results: In the odontogenic group majority of cases were of ameloblastoma (33%) followed by Odontoma and AOT (Adenomatoid Odontogenic tumor) with 22.2% frequency, in the non-odontogenic group it was mainly a benign fibrous lesion fibroma with maximum frequency (33.3%) followed by other lesions i.e., SCC (Squamous cell carcinoma) 30% and CGCG (Central Giant Cell carcinoma) 7%. Conclusion: In our study, we found ameloblastoma (odontogenic) and fibroma (non-odontogenic) were most frequent tumors among their respective groups.
虽然相对罕见,但颌骨肿瘤往往会扩大到很大的尺寸,甚至转移,这对诊断和治疗提出了挑战。这种病变的概况是必不可少的,因为它有助于了解肿瘤的性质在一个特定的地质位置。目的:本研究旨在根据喜马偕尔邦的机构数据确定肿瘤的发病率,并将其与以往的研究进行比较。方法:数据来源于HIDS口腔病理学系3年(2015年1月至2017年12月)的档案。根据世界卫生组织2005年的分类,将这些病例分为不同的类别。组织病理学诊断为肿瘤的病例重新评估和重新分析的基础上,临床病史,影像学记录目前在该科。结果:牙源性组以成釉细胞瘤居多(33%),其次为齿瘤和AOT(腺瘤样牙源性肿瘤),占22.2%;非牙源性组以良性纤维病变纤维瘤居多(33.3%),其次为其他病变,SCC(鳞状细胞癌)占30%,CGCG(中央巨细胞癌)占7%。结论:在我们的研究中,我们发现成釉细胞瘤(牙源性)和纤维瘤(非牙源性)是各自组中最常见的肿瘤。
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引用次数: 0
Juvenile Ossifying Fibroma of a 15-Year-old Girl: A Case Report 一例15岁女孩青少年骨化性纤维瘤
Pub Date : 2021-12-09 DOI: 10.37191/mapsci-2582-3736-3(4)-105
M. Awal
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.
幼年骨化性纤维瘤是一种局部侵袭性的良性纤维骨肿瘤。它通常发生在幼儿和颌面部。它的复发率很高。这种病理会尽早诊断和治疗,因为它具有快速进展和溶骨性,如果长期不治疗,可能会使手术切除复杂化。本病例诊断为青少年骨化性纤维瘤,累及上颌骨,导致一名15岁女性儿童面部畸形、突出和鼻阻塞。
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引用次数: 0
The COVID-19 Pandemic and its Impact on Knowledge, Attitude, and Practices among Dental Students in Davanagere City, Karnataka: A Cross-Sectional Survey 新冠肺炎大流行及其对卡纳塔克邦达万盖雷市牙科学生知识、态度和实践的影响:跨部门调查
Pub Date : 2021-12-03 DOI: 10.37191/mapsci-2582-3736-3(4)-106
Allama Prabhu CR
The spread of viral disease in community and its occurrence among healthcare workers is important evidence of person-to-person transition. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared as a pandemic by the WHO. It has affected most of the people and especially the ones with pre-existing medical illness. This prospective study was conducted in a dental college to evaluate impact of the COVID-19 on the knowledge, attitude and practice of the dental students. The students were aware of the Precautions to be taken care of while treating the patients with dental diseases.
病毒性疾病在社区的传播及其在医护人员中的发生是人际传播的重要证据。世界卫生组织宣布新冠肺炎(SARS-CoV-2)为全球大流行。它影响了大多数人,尤其是那些已有疾病的人。本前瞻性研究在某牙科院校开展,旨在评估新冠肺炎疫情对牙科学生知识、态度和行为的影响。学生们意识到治疗牙病患者时要注意的事项。
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引用次数: 0
Use of 3-D Printed Models for Implant Placement - A Case Series 3D打印模型在种植体植入中的应用——案例系列
Pub Date : 2021-12-03 DOI: 10.37191/mapsci-2582-3736-3(4)-108
Soundariya Bala Muralei
Long-term stability of a dental implant depends on various factors, one among them is proper position within the alveolar bone. Pre-operative thorough examination of the surgical site is preliminary step while planning dental implants. Conventional techniques such as Intra-Oral Periapical Radiograph and Ortho Pantamogram sometimes not sufficient and clinical scenario always surprises the surgeon. Later advent of Cone-Beam Computed Tomography alleviated this problem to some extent but there are some clinical situations such as resorbed ridge where better visualisation is needed. This led to the innovation of rapid prototyping techniques for the fabrication of three-dimensional complex structures. This technology has numerous applications from the development of an instrument, 3-D printed anatomical models to the fabrication of 3-D printed tissues for regeneration procedures. A 3-D printed model is much more useful than plaster models in many aspects such as demonstrating anatomical structures, better treatment planning, and better understanding for the patient. Hence, this case series focuses on the use of 3-D printed models in the placement of dental implants.
种植牙的长期稳定性取决于各种因素,其中之一是牙槽骨内的适当位置。术前彻底检查手术部位是计划种植牙的初步步骤。传统的技术,如口腔根尖周射线照相和Pantamogram有时是不够的,临床情况总是让外科医生感到惊讶。后来锥束计算机断层扫描技术的出现在一定程度上缓解了这个问题,但也有一些临床情况,如吸收脊,需要更好的可视化。这导致了用于制造三维复杂结构的快速原型技术的创新。这项技术有许多应用,从仪器的开发、3D打印的解剖模型到用于再生程序的3D打印组织的制造。3D打印模型在许多方面比石膏模型有用得多,例如演示解剖结构、更好的治疗计划和更好地理解患者。因此,本系列案例关注的是3D打印模型在种植牙植入中的应用。
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引用次数: 0
Mucosal Lesions Related to Toombak Dipping in the Sudanese 苏丹人与蘸香椿有关的粘膜病变
Pub Date : 2021-12-02 DOI: 10.37191/mapsci-2582-3736-3(4)-107
M. Abdalla
Background: Mucosal changes related to smokeless tobacco dipping appear to be influenced by many factors; including duration of dipping, frequency of dipping, chemical ingredients of the dipped stuff, in addition to possible genetic and racial factors. In the Sudan the habit of using smokeless tobacco (Toombak) is very common, and it is associated with pathological mucosal changes classified into five distinct clinical presentations: Presentation I; wrinkling with slight discoloration, Presentation II; Café au lait discoloration (Brownish discoloration), Presentation III; smoke-white discoloration, Presentation IV; grizzle discoloration, and Presentation V; cotton-white discoloration. Material and Methods: In this observational prospective study, a survey of oral cancer across 16 different localities was held in the Sudan. A total of 285 Toombak dippers agreed to be examined and of them 161 patients were found to have Toombak dipper-lesions. The clinical presentations of these lesions were identified and recorded into 5 different presentation categories. Furthermore, 64 specimens were cut and stained with Haematoxylin and Eosin (H&E). Microscopic diagnosis was obtained using both WHO-5-Point grading classification and the binary system. The history of the time span was matched with the related clinical and microscopic findings. Results: Regarding the 161 cases; the lower vestibule was the preferred dipping site in 75(46.6%) cases. The average Age of Commencement (AoC) was 24.5 years. The average Estimated Contact Hours (ECH) was 22,338 ± 40,824 hours; equal to 2.55 contact years in lifetime. The dominant mucosal clinical presentation was wrinkling with/without slight discolouration; found in 54 cases, and accounting for 33.6% of the sample. Of the 64 specimens, 51 cases showed hyperkeratosis, 11 cases showed mild dysplasia and the remaining three cases showed severe dysplasia; two cases were cotton- white presentations, and one case was a grizzle presentation.Conclusion: Twenty per cent of Toombak dippers-lesions showed dysplastic cells. The grizzle and the cotton- white clinical presentations are associated with high-risk dysplasia. A significant relationship was found between the clinical presentation and the AoC. No significant relationship was found between the clinical presentation and the Impact of Time Duration (TD), in terms of life-time duration of dipping, number of dippings/day, dip-duration and the Estimated Contact Hours (ECH).
背景:与无烟烟草浸泡相关的粘膜变化似乎受到许多因素的影响;包括浸渍的持续时间、浸渍的频率、浸渍材料的化学成分,以及可能的遗传和种族因素。在苏丹,使用无烟烟草(Toombak)的习惯非常常见,它与病理性粘膜变化有关,分为五种不同的临床表现:表现I;皱纹轻微变色,展示II;Caféau lait变色(棕色变色),演示III;烟白色变色,演示IV;灰白色变色和呈现V;棉白色变色。材料和方法:在这项观察性前瞻性研究中,对苏丹16个不同地区的口腔癌症进行了调查。共有285名Toombak铲斗同意接受检查,其中161名患者被发现患有Toombak斗病变。这些病变的临床表现被确定并记录为5种不同的表现类别。此外,64个标本被切割并用苏木精和曙红(H&E)染色。使用WHO-5分分级分类和二元系统进行显微镜诊断。时间跨度的历史与相关的临床和显微镜检查结果相匹配。结果:161例;下前庭是75例(46.6%)患者的首选浸渍部位。平均开工年龄为24.5岁。平均估计接触时间(ECH)为22338±40824小时;相当于2.55年的接触寿命。主要的粘膜临床表现是起皱,有/没有轻微变色;发现54例,占样本总数的33.6%。64例标本中,51例表现为角化过度,11例表现为轻度发育不良,其余3例表现为严重发育不良;两例为棉白色表现,一例为灰色表现。结论:20%的Toombak铲斗病变表现为发育异常细胞。灰熊和棉白色的临床表现与高危发育不良有关。临床表现与AoC之间存在显著关系。在浸渍的寿命、浸渍次数/天、浸渍持续时间和估计接触时间(ECH)方面,临床表现与持续时间影响(TD)之间没有发现显著关系。
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引用次数: 1
Vertical Ridge Augmentation of Edentulous Posterior Inferior Jaw Using Lumina Bone Porous Large®: A Clinical Case Report Lumina Bone Porous Large®在无牙后下颌骨垂直嵴增强术中的临床应用
Pub Date : 2021-12-01 DOI: 10.37191/mapsci-2582-3736-3(4)-104
Sergio Charifker Ribeiro Martins
The use of guided bone regeneration (GBR) has been gaining more and more ground in the field of implant dentistry, due to higher confidence in the materials available. As this is a highly versatile technique, the same biological basis-cell exclusion–can be used to treat any type of defect. Vertical augmentation in the alveolar ridge is currently treated by the GBR principle, predictably and with high success rates, using a rigid framework associated with a mix of hydroxyapatite and autogenous bone. Lyophilized bovine bone is the hydroxyapatite of choice for this condition because it allows bone volume to be maintained over a long period of time, due to its slow resorption. Another important char-acteristic found in hydroxyapatite is its porosity since it allows – in addition to graft neo-vascularization–a greater ease of cell adhesion when compared to crystalline materials. Thus, this clinical case presents the use (for the first time in the literature) of a vertical augmentation of an atrophic ridge using Criteria Lumina Bone Porous® as the hydroxy-apatite of choice for association with autogenous bone particles.
由于对可获得的材料有更高的信心,引导骨再生(GBR)的使用在种植牙科领域获得了越来越多的基础。由于这是一种高度通用的技术,相同的生物基础-细胞排斥-可用于治疗任何类型的缺陷。牙槽嵴垂直增强目前采用GBR原理治疗,可预测且成功率高,使用羟基磷灰石和自体骨混合的刚性框架。冻干牛骨是这种情况下羟基磷灰石的选择,因为它允许骨体积在很长一段时间内保持,由于其缓慢的吸收。羟基磷灰石的另一个重要特征是它的多孔性,因为它允许-除了移植物的新血管形成-与晶体材料相比,更容易细胞粘附。因此,本临床病例提出(在文献中第一次)使用Criteria Lumina Bone Porous®作为选择羟基磷灰石与自体骨颗粒结合的萎缩脊的垂直增强。
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引用次数: 2
A 10 Day Tooth Brushing Pilot Study- Report 为期10天的刷牙试点研究报告
Pub Date : 2021-11-07 DOI: 10.37191/mapsci-2582-3736-3(4)-103
Anishma Ram
A major dental problem in persons with mental retardation/developmental disabilities is poor dental hygiene resulting in poor plaque control which leads to gingivitis, periodontal disease and dental caries. The most obvious reason for poor oral hygiene of such persons is their inability to clean the oral cavity adequately. Caregivers face many challenges in providing good oral care for such individuals. The electric toothbrush has been shown to be effective in plaque removal and gingivitis in both healthy and disabled/ special needs people. They are more superior at removing plaque and reducing gingivitis in both short- and long-term clinical trials. This study assessed the effectiveness of using electric toothbrushes as a means of plaque control in a 10-day pilot program. It was implemented as part of a life skills program at a special needs school in South Auckland. A total of 11 children participated in the program. Informed consent was obtained from parents/caregivers prior to the study. Electric toothbrushes and toothpastes were provided by the author of the study along with and oral hygiene instructions to the teachers/caregivers. The study was evaluated by comparing photos of the teeth before and after the pilot study. Plaque disclosing tablets were used to aid this process as it dyes the plaque making it visible to the eyes. Evaluation /feedback forms were also completed by teachers/caregivers of the special needs unit to ascertain the efficacy of the program. The findings of the study showed that using electric toothbrushes improved both the general plaque distribution and boosted children’s motivation to brush their teeth. The conclusion drawn from this study indicates that while electric toothbrushes are effective at plaque control, a longer intervention period is postulated to obtain clinically significant results or see a significant change in behavior.
智力迟钝/发育障碍者的一个主要牙齿问题是牙齿卫生状况不佳,导致牙菌斑控制不佳,从而导致牙龈炎、牙周病和龋齿。这些人口腔卫生状况不佳的最明显原因是他们无法充分清洁口腔。护理人员在为这些人提供良好的口腔护理方面面临许多挑战。电动牙刷已被证明对健康人和残疾人/有特殊需求的人都能有效去除牙菌斑和牙龈炎。在短期和长期临床试验中,它们在去除牙菌斑和减少牙龈炎方面更为优越。这项研究评估了在为期10天的试点项目中使用电动牙刷作为牙菌斑控制手段的有效性。它是作为南奥克兰一所特殊需求学校生活技能项目的一部分实施的。共有11名儿童参加了该项目。研究前,获得了父母/照顾者的知情同意。研究作者向教师/护理人员提供了电动牙刷和牙膏以及口腔卫生说明。通过比较试点研究前后的牙齿照片来评估这项研究。斑块披露片被用来帮助这一过程,因为它对斑块进行染色,使其对眼睛可见。特殊需求部门的教师/护理人员还填写了评估/反馈表,以确定该计划的有效性。研究结果表明,使用电动牙刷可以改善牙菌斑的总体分布,并提高儿童刷牙的动机。这项研究得出的结论表明,虽然电动牙刷在控制牙菌斑方面是有效的,但假设更长的干预期可以获得临床上显著的结果或看到行为的显著变化。
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引用次数: 0
Antero-parotid Trans-massetric Approach For Reduction Of Mandibular Subcondylar Fractures; Clinical Tricks 前腮腺经乳突入路治疗下颌髁下骨折临床技巧
Pub Date : 2021-10-01 DOI: 10.37191/mapsci-2582-3736-4(1)-113
S. Khan
Introduction: Mandibular fractures in the subcondylar area are frequent in the trauma of the maxillofacial area. This injury is frequent almost at the same rate in adults and children. These fractures are treated by open reduction along with internal fixation or closed reduction. The patient’s age, general health condition, and healthcare setting must be taken into account when deciding on the surgical option. Most of the approaches for open reduction and internal fixation of subcondylar fractures carry the risks of injury to the facial nerve branches and developing sialocele. Although the antero-parotid trans-masseteric approach which was introduced by Wilson in 2005and has the least post-operative complications among other approaches, it is still not widely used by maxillofacial surgeons. The article will give some clinical tricks after ten years of clinical experience, in using this approach for treating about 245 mandibular condylar fractures, on 205 patients.Methodology: This is a retrospective cohort study to evaluate the results of adult population group comprising 205 patients.There were totally 245 fractures of which 205 patients’ surgery was done. Data were gathered from January 2010 to December 2020. Only minimal complications were observed within the first ten days after surgery, including slight transient weakening of the facial nerve, particularly buccal branches, in 3.4 percent of cases and unusual edema and trismus in 8.7% of cases, both of which recovered within the first ten days. In none of these cases, a parotid leak/sialocele was discovered.Discussion: Although the antero-parotid trans-masseteric approach is not widely used between oral and maxillofacial surgeons worldwide, it has the least post-operative complicationscompared to the other approaches for treating mandibular condylar fractures. Data collected from January 2010 till December 2020 with a total of 245 fractures operated on 205 patients. Only minor complications were noticed during the 10 days post operative period with mild temporary weakness of the buccal branches of facial nerve in 3.4% of cases and post operative unusual edema and trismus in 8.7% which resolved during the first ten days post operatively.No parotid leak/sialocele was found in any of these cases.Our aim is to give some clinical tricks after ten years experience in using this approach to treat condylar fractures, to simplifying the technique and to achieve the best results with the least complications. The tricks include the type of fractures that can be treated with this approach, to identify the surgical site, to retract the parotid gland along with its attached fascia posteriorly to open through the masseter muscle, to identify facial nerve branches in surgical site, the needs for perfect retraction and the use of optimum muscle relaxant to aid during reduction ofdisplaced and dislocated subcondylar fractures of mandible.Results And Conclusion: Only minor complications were noticed d
下颌髁下骨折是颌面部外伤中常见的骨折类型。这种损伤在成人和儿童中的发生率几乎相同。这些骨折采用切开复位联合内固定或闭合复位治疗。在决定手术方案时,必须考虑到患者的年龄、一般健康状况和医疗保健环境。大多数髁下骨折的切开复位内固定入路都有损伤面神经分支和发生涎泡的危险。虽然威尔逊在2005年提出的经咬肌入路是其他入路中术后并发症最少的,但它仍然没有被颌面外科医生广泛使用。本文将根据十年来的临床经验,对205例患者,245例下颌髁突骨折进行了治疗,并给出了一些临床技巧。方法:这是一项回顾性队列研究,评估成人人群组205例患者的结果。骨折245例,手术205例。数据收集时间为2010年1月至2020年12月。术后10天内仅观察到最小的并发症,包括3.4%的病例出现面神经,特别是颊支的轻微短暂性衰弱,8.7%的病例出现不寻常的水肿和唇腭裂,这两种情况均在10天内恢复。在这些病例中,没有发现腮腺泄漏/涎腺囊肿。讨论:虽然腮腺前经咬骨入路在世界范围内的口腔颌面外科手术中并没有被广泛使用,但与其他入路相比,它的术后并发症最少。数据收集自2010年1月至2020年12月,共对205例患者进行245例骨折手术。术后10天内仅出现轻微并发症,3.4%的患者出现面神经颊支暂时性轻度无力,8.7%的患者出现异常水肿和牙关紧闭,术后10天内消失。所有病例均未发现腮腺渗漏/涎腺囊肿。我们的目的是在使用这种方法治疗髁突骨折的十年经验后,提供一些临床技巧,简化技术,以最少的并发症达到最佳效果。技巧包括可以用这种方法治疗的骨折类型,确定手术部位,将腮腺及其附着的筋膜向后缩回,通过咬肌打开,识别手术部位的面神经分支,需要完美的缩回以及使用最佳的肌肉松弛剂来帮助复位移位和脱位的下颌骨髁下骨折。结果与结论:术后10天内均出现轻微并发症,3.4%的患者出现轻度暂时性面神经颊支无力,8.7%的患者出现异常的中至重度面部水肿和牙关,术后10天内消失。所有病例均未发现腮腺渗漏/涎腺囊肿。我们推荐这种方法,因为它快速、简单、安全、有效地治疗下髁骨折。我们建议围手术期考虑这些临床技巧可以达到最佳效果,并发症最少,手术时间最短。
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引用次数: 1
期刊
Journal of dentistry and oral sciences
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