Frecuencia y caracterización de foramen mental accesorio en una población chilena mediante tomografía computarizada de haz cónico / Frequency and characterization of accessory mental foramen in a Chilean population using cone beam computed tomography

RESUMEN: En la práctica clínica odontológica, reconocer estructuras anatómicas es determinante en la planificación de distintos tratamientos que involucren algún riesgo. Uno de los exámenes complementarios recomendados para la planificación de diferentes tratamientos en odontología es la Tomografía Computarizada de Haz Cónico (CBCT). Con este examen, se pueden pesquisar variantes anatómicas como el Foramen Mental Accesorio (FMA), el cual es importante identificar para prevenir complicaciones. El objetivo de este trabajo fue determinar la frecuencia y caracterización de FMA en una población chilena adulta, de la ciudad de Valdivia, Chile. Este estudio es de tipo observacional descriptivo. Se revisaron 247 exploraciones de diferentes centros radiológicos de la ciudad de Valdivia, cumpliendo 143 con los criterios de selección. Este estudio fue aprobado por el Comité ético científico del Servicio de Salud de Valdivia. Se encontró presencia de FMA en el 17,48 % que corresponde a 25 pacientes de un total de 143, correspondiendo un 80 % al sexo femenino. El rango etario en que se encontró con mayor frecuencia correspondió a 18-39 años. La distancia promedio entre FMA y FM (Foramen Mental) fue de 5,76 mm, correspondiendo a 2 mm la distancia mínima y 11,5 mm la distancia máxima. La distancia promedio entre FMA y ápice dentario más cercano fue de 5,36 mm. La distancia mínima y máxima fueron de 0,8 mm y 10,2 mm respectivamente. El ápice radicular mayormente asociado al FMA correspondió al segundo premolar con una frecuencia de 60 % (n=15). Este estudio confirma la importancia de la correcta evaluación de la región mental ante procedimientos en la zona, la cual es vital para prevenir lesiones en relación a esta variante anatómica.

SUMMARY: The recognition of key anatomical structures is decisive to avoid complications in the dental clinical practice. Cone Beam Computed Tomography (CBCT) is a complementary exam recommended for the planning of different procedures in dentistry. With this exam, anatomical variants can be identified, such as the Accessory Mental Foramen (AMF). The objective of this work was to determine the frequency and characteristics of AMF in an adult Chilean population from the city of Valdivia, Chile. This is an observational study that included 247 CBCT exams from different radiological centers in Valdivia. According to the selection criteria, 143 CBCT exams were included. This study was approved by the Scientific Ethics Committee of the Valdivia Health Services. AMF was identified in 25 patients representing 17.48 %. From this result, 80 % were found in females. AMF was most frequently identified in patients from 18 to 39 years old. The average distance between AMF and Mental Foramen (MF) was 5.76 mm, which corresponds to 2 mm the minimum distance and 11.5 mm the maximum distance. The average distance between AMF and the nearest dental apex was 5.36 mm, and the minimum and maximum distance were 0.8 mm and 10.2 mm, respectively. The root apex of the second premolar was most frequently associated with the AMF, representing 60 % (n=15). This study confirms the importance of the correct evaluation of the mental region before initiating procedures in the area, which is vital to prevent injuries associated with this anatomical variant.

Occurrence and remission of loss of sensitivity of inferior alveolar nerve in mandibular fractures

ABSTRACT Purpose: to evaluate the occurrence of loss of sensitivity of the inferior alveolar nerve, and to monitor the remission of this change in patients with mandibular fractures subjected to surgical treatment. Methods: patients with mandibular fractures, surgically treated within one year, were prospectively evaluated. Data regarding etiology, fracture location, type and displacement, and surgical access, were obtained. The tactile and thermal tests were applied at eighteen points in the mental region, within a period of six months. Statistical tests were applied to compare the categories of variables and the period of observation (p ≤ 0.050). Results: during the study, 37 patients were included. There were 24 bilateral and 13 unilateral fractures. Sensory changes occurred in 56.8% of the patients in the preoperative period, in 83.8% of the patients, in the postoperative period, and 35.1% of the patients presented complete remission during the final period of the study. Conclusion: sensory changes occurred in about half of the patients, due to the fracture, increasing greatly in the postoperative period, with complete remission in about one third of the cases. The fracture type, degree of displacement and surgical access type influenced the occurrence of sensory alterations.

Manejo inmediato de un traumatismo máxilo-mandibular. Presentación de un caso / Immediate management of maxillo-mandibular trauma. Case presentation

RESUMEN Las fracturas faciales son poco frecuentes en los niños, motivo por el cual se presenta el caso de una niña de 10 años de edad, de color de piel mestiza, procedencia urbana, con antecedentes de salud, la que, tras una caída de aproximadamente 2,5 m de altura, sufrió un severo traumatismo dentoalveolar anterosuperior y anteroinferior que le ocasionó fractura dentoalveolar en el sector anterosuperior de 12 a 22, luxación de 12, 11 y 22 y avulsión de 21(el cual pudo ser recuperado en el lugar del trauma) y fractura dentoalveolar en el sector anteroinferior de 32 a 42. Fue recibida en el cuerpo de guardia del Hospital Pediátrico Universitario Paquito González Cueto y atendida en el salón de Cirugía Maxilofacial de este hospital. Se aplicó tratamiento quirúrgico para heridas de partes blandas realizando sutura, reducción y estabilización de la fractura en el sector anterosuperior mediante férula de Erich y en el sector anteroinferior mediante osteosíntesis con alambre en ocho. Se reimplantó 21 y se fijó a la férula mediante osteosíntesis con alambre. Se indicó tratamiento con dieta blanda y líquida, analgésicos, antibioticoterapia, termoterapia y buchadas tibias con solución salina. Se mantuvo la férula durante 21 días, logrando consolidar las fracturas y 21 en su alveolo. Se logró reimplantar el diente avulsionado evitando las secuelas estéticas, funcionales y psíquicas del trauma; la niña se reincorporó a la sociedad.

ABSTRACT Facial fractures are rare in children, for that reason the case of a 10-year-old girl is presented. She is a mestizo, urban origin, with a history of health who after a fall of approximately 2.5 m in height, suffered a severe anterior and inferior anterior dentoalveolar trauma causing a dentoalveolar fracture in the anterior superior sector from 12 to 22, dislocation of 12, 11 and 22 and avulsion of 21 (which could be recovered at the site of the trauma) and dentoalveolar fracture in the anteroinferior sector from 32 to 42. The case was received at the emergency department of the Pediatric Hospital Paquito González Cueto University and attended in the Maxillofacial Surgery room. Surgical treatment for soft tissue wounds was performed by suturing, reducing and stabilizing the fracture in the anterior superior sector by means of Erich's splint and in the anteroinferior sector by means of osteosynthesis with wire in figure-eight. Twenty first was reimplanted and fixed to the splint by osteosynthesis with wire. Treatment with soft and liquid diet, analgesics, antibiotic therapy, thermotherapy and warm mouth rinse with saline solution was indicated. The splint was maintained for 21 days, managing to consolidate the fractures and 21 in its socket. It was possible to reimplant the avulsed tooth avoiding the aesthetic, functional and psychic consequences of trauma; the girl rejoined society.

Screening for variations in anterior digastric musculature prior to correction of post-traumatic anterior open bite by injection of botulinum toxin type A: a technical note

It has recently been reported that long-standing post-traumatic open bite can be successfully corrected with botulinum toxin type A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM). The report documented an individual with bilaterally symmetrical and otherwise unremarkable anterior digastric musculature. However, the existence of variant anterior digastric musculature is common and may complicate the management of anterior open bite with BTX-A injection. Screening for variant ABDM can be accomplished via ultrasound, computed tomography, and magnetic resonance imaging. Screening for variant ABDM should be performed prior to BTX-A injection in order to account for musculature that may exert undesired forces, such as inferolateral deviation, on the anterior mandible in patients with anterior open bite.

Soft tissue stretch combined with physical factors improves trismus and mandibular function after third molar removal / 中国组织工程研究

BACKGROUND:The third molar extraction may lead to different degrees of soft tissue damage. Ultrasound and ultrashort waves belong to hyperthermia, which can increase tissue temperature and improve the therapeutic efficacy of soft tissue stretch. OBJECTIVE:To observe the effects of soft tissue stretch combined with ultrasound and ultrashort wave therapy for patients who were recently diagnosed with trismus and pain folowing third molar removal. METHODS:Sixteen patients with trismus and pain after third molar removal were randomly divided into two groups: patients in stretch group received soft tissue stretch with ultrasound and ultrashort wave therapy, while those in control group received only ultrasound and ultrashort wave therapy. Patients received the treatment five times per week, totaly for 2 weeks. RESULTS AND CONCLUSION:It was found that after treatment pain was significantly reduced at the temporomandibular joint, and the range of maximum active mouth opening increased significantly. The improvement in mouth opening and temporomandibular joint function was better in the stretch group than the control group. These findings indicate that ultrasound and ultrashort wave therapy can improve symptoms of trismus and pain folowing third molar removal, and the combination of ultrasound and ultrashort wave therapy and soft tissue stretch therapy can achieve more effective results.

Three-dimensional finite element simulation and biomechanical analysis of mandible chin blast injury / 中华创伤杂志

Objective To simulate a finite element model for biomechanical analysis of mandible chin blast injury and analyze the mechanism of maxillofacial blast injury.Methods The three-dimensional element model of human mandible blast injury was established to simulate the dynamic process of injury to the mandible chin.Von Mises stress and effective strain were evaluated in biomechanical study of the simulation results.Results The dynamic damage process of human mandible chin blast injury was simulated successfully.In the condition of 1 000 mg and 3 cm,the Von Mises stress and effective were maximum at condylar neck region (9.1 × 106 Pa,0.62 × 10-3ε),were second at mandibular angle region (6.1 × 106 Pa,0.42 × 10-3ε),and minimum at mental foramen region (6.1 × 106 Pa,0.39 × 10-3ε).Blast distance rather than blast equivalent produced more effect on the mechanical parameters and damage degree.Conclusions Von Mises stress and effective strain can be applied to the evaluation of bone tissue damage.The finite element method is effective in simulating mandible blast injury and can provide a new thought and approach to clinical treatment of oral and maxillofacial blast injury.

A Clinical Study of Mandibular Angle Fracture / 대한악안면성형재건외과학회지

PURPOSE: To establish management protocol for mandibular angle fracture, we describe pertinent factors including cause, impacted third molar and recent treatment tendency. METHODS: We examined the records of 62 patients who had unilateral mandibular angle fracture. Sixty patients who had open reduction surgery were examined at postoperative weeks 1, 4, 8, 12, and 28. RESULTS: Left mandibular angle fracture is frequent in younger males. Presence of the mandibular third molar can increase fracture risk. Because of attached muscle, favorable fractures occurred primarily in the mandibular angle area. CONCLUSION: Extracting the mandibular third molar can prevent angle fractures, and open reduction with only one plate adaptation is generally the proper treatment method for mandibular angle fracture.

Tratamento cirúrgico de fratura bilateral de côndilo associada à fratura de corpo mandibular: relato de caso / Surgical management of condylar fracture associated with body mandibular fracture: case report

O côndilo mandibular apresenta-se como um dos locais mais comumente acometidos nas fraturas mandibulares, sendo, na maioria das vezes, decorrente de um trauma na região de sínfise ou de para-sínfise mandibular. A ptar pelo tratamento cirúrgico ou conservador é motivo de controvérsias, principalmente devido às diversas complicações pós-tratamento relatadas na literatura. Uma das principais indicações para a redução cirúrgica consiste na impossibilidade de estabelecer uma satisfatória oclusão dentária pelo tratamento conservador, geralmente associado às fraturas bilaterais. O sucesso do tratamento está relacionado a uma aderência cuidadosa nos princípios cirúrgicos e fisiológicos e em um acompanhamento pós-operatório rigoroso, aumentando a capacidade funcional a longo prazo e possibilitando uma menor incidência de complicações. Este trabalho objetiva relatar um caso clínico de redução cirúrgica de fratura bilateral de côndilo associada à fratura de corpo mandibular, enfocando, principalmente, os aspectos relacionados às indicações e complicações desse tipo de tratamento.

The mandibular condyle is presented as one of the most commonly sites involved in jaw fractures, most often due to trauma in the region of the mandibular symphysis. The choice of surgical or conservative treatment is a highly controversial issue, mainly due to the various post-treatment complications reported in the literature. One of the main indications for surgical reduction is the inability to establish a satisfactory dental occlusion by conservative treatment, usually associated with bilateral fractures. Successful treatment is related to a careful adherence to surgical and physiological principles with a rigid follow up, increasing the long-term functional capacity and allowing a lower incidence of complications. This study reports a case of surgical reduction of bilateral condyle fracture associated with fracture of the mandibular body, focusing on aspects related with indications and complications of this treatment.

Fratura de mandíbula: estudo epidemiológico de 70 casos / Mandible fracture: epidemiological study of 70 cases

INTRODUÇÃO: As fraturas de mandíbula são frequentemente causadas por traumatismo direto, mas, eventualmente, podem surgir fraturas patológicas, em função de lesões tumorais. A abordagem cirúrgica é determinada pelo tipo e pela localização da fratura na mandíbula. O objetivo deste estudo foi avaliar o perfil epidemiológico de 70 pacientes que sofreram fratura de mandíbula e foram operados no Instituto Dr. José Frota (Fortaleza, CE) no período de janeiro de 2005 a dezembro de 2009. MÉTODO: Foram analisados prontuários de 70 pacientes submetidos a cirurgia para correção de fratura de mandíbula, avaliando-se sexo, idade, cor, procedência, sítio anatômico da fratura, etiologia, fraturas associadas, tratamento, tempo de internação e complicações. RESULTADOS:Houve predomínio do sexo masculino (90 por cento), com média de idade de 28,25 + 11,04 anos. A maioria dos pacientes (80 por cento) era de cor branca e procedente do interior (68 por cento). Os locais da mandíbula mais acometidos foram a região da parassínfise, o corpo e o ângulo, tendo como principal causa os acidentes de trânsito (70 por cento), sendo os acidentes motociclísticos (55,7 por cento) mais prevalentes. As principais fraturas de face associadas foram de maxila do tipo Le Fort e zigomático-orbitário. O tratamento cirúrgico foi feito com fixação interna rígida na maioria dos pacientes (75 por cento). A única complicação foi infecção, observada em um paciente. CONCLUSÕES: A redução e a fixação das fraturas mandibulares devem ocorrer tão precisa e rapidamente quanto possível, visto que a maloclusão é uma complicação grave a longo prazo. Neste estudo, essa complicação não foi observada, havendo apenas um caso de infecção. Coincidindo com os achados de outros estudos, houve prevalência de adultos jovens do sexo masculino e de acidentes de trânsito como etiologia. As fraturas foram localizadas preferencialmente na região da parassínfise e corrigidas por meio de fixação interna rígida em 75 por cento dos casos.

BACKGROUND: Mandible fractures are most often caused by direct trauma, but occasionally, pathologic fractures may occur due to tumor lesions. The surgical approach is determined by the type and the location of the mandible fracture. This study aimed to evaluate the epidemiological profile of 70 patients who suffered mandible fracture and underwent surgery at Instituto Dr. José Frota (Fortaleza, CE) between January 2005 and December 2009. METHODS: We analyzed medical records of 70 patients who underwent surgical treatment for mandibular fractures and assessed gender, age, skin color, anatomic site of fracture, etiology, associated fractures, treatment, hospitalization and complications. RESULTS: There was male predominance (90 percent) among patients, with a mean patient age of 28.25 + 11.04 years. Most patients (80 percent) were Caucasian and from small towns (68 percent). The most affected jaw sites, in descending order, were the parasymphysis region, body, and angle. The major cause was traffic accidents (70 percent), with motorcycle accidents being the most prevalent (55.7 percent). The main associated facial fractures were maxilla fracture type Le Fort and zygomatic-orbital. Surgical treatment was carried out with rigid internal fixation in most patients (75 percent). The only complication was infection in one patient. CONCLUSIONS: Reduction and fixation of mandibular fractures should occur as accurately and quickly as possible, since malocclusion is an important long-term complication. In our study, we did not observe such a complication; there was only one case of infection. Concurrent with the findings of other studies, there was a prevalence of young adult males among patients, and traffic accidents were the main cause. The fractures were frequently located in the parasymphysis region and were corrected through rigid internal fixation in 75 percent of cases.

Reconstrucción con placa 2.4 mm. angulada con cabeza condilar de articulación temporo-mandibular en fracturas compleja de mandíbula: reporte de un caso / Temporomandibular joint reconstruction with a 2.4 mm. angled plate with condylar head in a complex mandible fracture: a case report

El trauma maxilofacial es muy frecuente y se encuentra asociado a una alta incidencia de fracturas faciales en diferentes combinaciones. Este puede ser causado por hechos viales, violencia personal, prácticas deportivas y heridas por proyectil percutido por arma de fuego, siendo estas últimas, lesiones devastadoras que pueden comprometer la vida del paciente. Teniendo en cuenta que el Hospital Universitario de los Andes es uno de los centros asistenciales más importantes de Venezuela, en el manejo del trauma de alta energía, incluyendo el trauma facial, reportamos el caso de un paciente masculino de 33 años, remitido a esta institución por presentar trauma mandibular secundario a herida por arma de fuego, el cual generó una fractura compleja del ángulo, rama y cóndilo izquierdo de la mandíbula. Esta lesión fue resuelta a través de reducción directa, osteosíntesis y hemiartroplastia con un solo implante. Mediante este procedimiento se logró obtener un adecuado resultado funcional y estético. El principal objetivo, a favor preservar la biomecánica de la Articulación Temporomandibular (ATM) afectada, a través del uso de implantes y técnicas especiales, desarrolladas para tal fin

Maxillofacial trauma is very common and is associated with a high incidence of facial fractures in different combinations. This can be caused by traffic accidents, personal violence, sports, and gunshot wound, being devastating injuries that can compromise the patient’s life. The Hospital Universitario de Los Andes is one of the most important health centers in Venezuela in the management of high energy trauma, including facial trauma. We report the case of a 33 year old male pacient, received in this institution for a mandible trauma secondary to a gunshot wound, generating an angle, branch and the left condyle complex fracture of the mandible. This lesion was treated by direct reduction, osteosynthesis and hemiarthroplasty with a single implant. This procedure is able to obtain adequate functional and cosmetic results. The main objective was to preserve the biomechanics of the affected temporomandibular joint, through the use of implants and techniques developed for this purpose

Fratura cominutiva grave de mandíbula por arma de fogo: relato de caso / Severe gunshot comminuted mandible fracture: case report

Relata-se o caso de paciente atendido no Pronto-Socorro com fratura exposta cominutiva grave de mandíbula, com perda óssea importante causada por projétil de arma de fogo. Foi submetido àa operação de urgência, sendo necessário o uso de placas de fixação e reconstrução. Apresentou evolução demorada, com período de internação hospitalar de 28 dias. À alta, apresentava deformidade facial e dificuldade na movimentação da mandíbula e articulação de palavras. Devido ao tratamento com cirurgia precoce e ao uso de recursos adequados, o paciente obteve bons resultados estéticos e funcionais no controle ambulatorial.

Mandible fractures are among the most common lesions encountered in the trauma centers. They are usually caused by assault or gunshot and the risk factors include low socioeconomic level, drug abuse and unemployment, being male young adults the most frequent victims. This report is about a patient who was brought to the emergency room with a severe gunshot comminuted mandible fracture. He was submitted to an early surgical repair, in which fixation and reconstruction plates were needed. There was a 28 day in-hospital stay and the patient showed facial deformation and difficulty in word pronunciation at discharge. Due to the aggressive management with early surgical repair and adequate resources the patient presented with good functional and aesthetical results in the follow up.

Cleidocranial dysplasia associated with the dentigerous cyst: review of the literature and report of the clinical case / Displasia cleidocraniana associada a cisto dentígero: revisão da literatura e relato de caso clínico

Cleidocranial dysplasia is a developmental anomaly of the skeleton and teeth. It can be inherited as an autosomal dominant characteristic with high penetrance and variable expressivity. It occurs with equal frequency in both genders and races. The clinical appearance of cleidocranial dysplasia is pathognomonic. The stature is mildly to moderately shortened, with neck appearing long and narrow and the shoulders markedly drooped. Maxillary hypoplasia gives the mandible a relatively prognathic appearance, although some patients may show variable mandibular prognathism due to increased length of the mandible in conjunction with short cranial base. The head and neck features are very variable. Herein, we are described one cleidocranial dysplasia case, in an 84 year female patient, with the dentigerous cyst, which she were not kwon the diagnosis of the her congenital syndrome.

A displasia cleidocraniana é uma alteração de desenvolvimento do esqueleto e dos dentes. É uma desordem autossômica dominante com alta penetrância e expressibilidade variada. Ocorre em igual frequência em ambos os gêneros e raças. Suas características clínicas são patognomônicas. Apresenta estatura baixa a moderada, com aparência do pescoço longo e os ombros caídos. Hipoplasia da maxila gera um aparente prognatismo. As características clinicas em cabeça e pescoço são muito variadas. Este relato descreve um caso de uma paciente de 84 anos com displasia cleidocraniana associada a cisto dentígero a qual não sabia ser portadora de tal síndrome congênita.

Effects of disc repositioning and condyle restoration in the treatment of type Ⅲ traumatogenic temporomandibular joint ankylosis / 中华创伤杂志

Objective To investigate the potential role of disc repositioning and condyle restoration in the treatment of type Ⅲ traumatogenic temporomandibular joint (TMJ) ankylosis. Methods Eight patients including four females and four males at age range of 7-22 years (mean 13.6 years) were enrolled in this study. The patients suffered from traumatogenic TMJ ankylosis for 1-12 years. The preoperative interincisal opening distances ranged from 2 mm to 10 mm. During surgery, the traumatogenic callus of the lateral condyle process was removed, the condyle process was formed, and then the dislocated disc was sutured to the articular capsule or soft tissues around. Results All patients were followed up for 6-38 months and the last follow-up examination showed that the average interincisal opening distance was 30 mm. No recurrence or TMJ symptoms were found during the period of follow-up. Conclusions Disc repositioning and condyle restoration has the advantages of simple procedures, minor trauma and little recurrence and proves to be a feasible and effective method for the treatment of type Ⅲ traumatogenic TMJ ankylosis.

Evaluation of simulated bone lesion in the head of the mandible by using multislice computed tomography

Conventional radiography has shown limitation in acquiring image of the ATM region, thus, computed tomography (CT) scanning has been the best option to the present date for diagnosis, surgical planning and treatment of bone lesions, owing to its specific properties. OBJECTIVE: The aim of the study was to evaluate images of simulated bone lesions at the head of the mandible by multislice CT. MATERIAL AND METHODS: Spherical lesions were made with dental spherical drills (sizes 1, 3, and 6) and were evaluated by using multislice CT (64 rows), by two observers in two different occasions, deploying two protocols: axial, coronal, and sagittal images, and parasagittal images for pole visualization (anterior, lateral, posterior, medial and superior). Acquired images were then compared with those lesions in the dry mandible (gold standard) to evaluate the specificity and sensibility of both protocols. Statistical methods included: Kappa statistics, validity test and chi-square test. Results demonstrated the advantage of associating axial, coronal, and sagittal slices with parasagittal slices for lesion detection at the head of the mandible. RESULTS: There was no statistically significant difference between the types of protocols regarding a particular localization of lesions at the poles. CONCLUSIONS: Protocols for the assessment of the head of the mandible were established to improve the visualization of alterations of each of the poles of the mandible's head. The anterior and posterior poles were better visualized in lateral-medial planes while lateral, medial and superior poles were better visualized in the anterior-posterior plane.

Repair of canine segmental mandibular defects by using autogenous bone marrow stromal cells and?-tricalcium phosphate / 中华创伤杂志

Objective To repair segmental mandibular defects with autogenous bone marrow stromal cells(BMSCs)and?-triealcium phosphate.Methods Isolated BMSCs were in vitro expand- ed.A 3 cm-long segmental mandibular defect was created at right mandible in 12 canines,of which de- fects in six canines were repaired with BMSCs and?-tricalcium phosphate(?-TCP)and that in other six cases repaired with?-TCP,which was used as control.The engineered bone was evaluated by X-ray, CT,DXA,gross and histological examination,immunohistochemistry and biomechanical test 4,12,26,32 weeks after operation respectively.Results In induced BMSCs,histochemistry showed AKP activity. Oral X-ray showed obvious callus formation 4-26 weeks after operation in experimental group but minimal bone formation in control group.At 32 weeks after operation,gross observation,X-ray and CT demonstra- ted well bony-union in experimental group but bony-nonunion in control group.DXA indicated that the bone density of experimental group was significantly higher than that of control group.Biomechanical test revealed no statistical difference upon mechanical strength of mandibula between experimental group and normal group.Conclusions Canine segmental mandibular defects can be well repaired with the tissue- engineered bone generated by autogenous osteogenic BMSCs and?-TCP scaffold.

An experimental study on injury characteristics of blast injury in maxillofacial region wounded by spherical explosive / 实用口腔医学杂志

Objective: To study the injury characteristics of blast injury in maxillofacial region wounded by spherical explosive. Methods: Spherical explosive was used to wound maxillofacial region in rabbits , after gross observation of the trauma , bone tissue specimens were collected from 0.5 or 1.0 cm to the boundary of wound 6 hours, 3 and 7 days after wounding respectively, the samples were prepared and stained with HE and modified Mallory's trichrome staining and observed under light microscope . Microcirculation in wounded bone was studied by ink injection and observed in ground bone sections. Results: No changes were found 6 hours after injury. Inflammatory infiltration were found 3 days after injury.Osteonecrosis was observed 7 days after injury, the structure of bone beyond 0.1 cm of the wound was found to be normal and restoration of bone was observed. Conclusion : Pathological changes of mandible injured by spherical explosive are similar to those of usual fracture except that the wound of blast injury is seriously polluted.

Immunohistochemical study on the expression of IL-6, IL-8 and TNF-? in gunshot wounds in soft tissues / 第二军医大学学报

Objective: To study the relationship between interleukin(IL) 6, IL 8, tumor necrosis factor alpha (TNF ?) and wound healing. Methods: In lower jaw gunshot wound, the expression of IL 6, IL 8, TNF ? in local soft tissues was assayed by using immunohistochemistry methods. The current levels of IL 6, IL 8, TNF ? in wound tissues was analysed by using image assay. Results: High expressions of these cytokines were observed in local soft tissues of wounds during the first 3 d after the gunshot. The cytokines expressions were different between the area near the bullet path and that far from the path. There was only one peak of the cytokines concentration in the area far from the bullet path, while there were 2 peaks of the cytokines concentration in the area near the bullet path.Conclusion: These results suggest that IL 6, IL 8, TNF ? play an important role in regulating inflammatory reactions of local injured tissues. They may improve the functions of fibroblasts, mononuclear phagocytes and endothelial cells and stimulate wound cells to produce and release other cytokines.

Early reconstructive surgery for oromaxillofacial soft tissue defect due to gun-shot wound in dogs / 第三军医大学学报

In order to assess whether there is any possibility of early reconstructive surgery to repair oromaxillofacial soft tissue defect resulting from gun-shot wound.8 dogs were wounded in the left cheek with model Mm bullet of 5.56 mm in diameter fired from a M]6 rifle made in USA with a firing distance of 6 meters.As a result,there was a hole in the left cheek of the dogs.Debridement was performed,immediately and it was repeated 72 hours after wounding.Meanwhile,saphenous artery skin flap was excised and used to repair the skin defect of the left cheek with microvascular anastomosis.The defect of the mucous membrane was repaired by drawing the adjacent mucous membrane together or by a sliding mucous membrand flap.The dogs were observed for 2 to 6 months postoperatively.The survival rate of the free skin flap was 75%.Our findings suggest that it is practicable to perform early reconstructive surgery for the repair of the oromaxillofacial soft tissue defect resulting from gunshot wound with vascular anastomotic free skin flap.