ABSTRACT
RESUMEN La craneoplastia es la reconstrucción de los elementos cutáneos, óseos, y meningeos que resguardan los elementos nobles del cráneo usando materiales aloplásticos, la búsqueda de la mejor alternativa a estos nos llevó a desarrollar una técnica que utiliza los propios tejidos peri lesiónales, practicada en un paciente, que luego de 15 días de haber sufrido un traumatismo con herramienta cortante que expuso tejidos nobles intracraneales comprometiendo su vida. Se realizó la reconstrucción de la bóveda craneal en un solo tiempo quirúrgico. Esta técnica permitió alcanzar resultados satisfactorios, logrando evitar rechazos de los materiales utilizados frecuente en otras técnicas.
ABSTRACT Cranioplasty is the reconstruction of the skin, bone, and meningeal elements that protect the noble elements of the skull using alloplastic materials, the search for the best alternative to these led us to develop a technique that uses the peri-lesion tissues themselves, practiced in a patient, who after 15 days of having suffered a trauma with a cutting tool that exposed intracranial noble tissues, compromising his life. Reconstruction of the cranial vault was performed in a single surgical time. This technique allowed to achieve satisfactory results, managing to avoid rejections of the materials used frequently in other techniques.
ABSTRACT
The aim of this investigation was to evaluate the potential effects of the systemically delivered combination of calcium, zinc and vit-d supplementation of the locally applied alloplastic bone graft. 28 male Wistar albino rats were used in this study. In each animal, bone defects (10 mm length ¥ 3 mm width ¥ 2 mm depth) were created in the tibias. The animals were divided into four groups. In Group 1 (Control Group) rats were fed with standard rat diet. In Group 2 (Calcium Group) rats received calcium carbonate (15 mg/kg body weight) suspended in saline. In Group 3 (Calcium/Zinc Group) rats received calcium carbonate (15 mg/kg body weight) and zinc sulfate (4 mg/kg body weight) suspended in saline. In Group 4 (Calcium/Vitamin D Group) rats received calcium carbonate (15 mg/kg body weight) and Vitamin D (500 IU/kg body weight) suspended in olive oil. Histopathological analysis of samples was performed to evaluate the process of osteoblastic activity, matrix formation, trabecular bone formation and myeloid tissue in bone defects. Total amounts of osteoblastic activity, matrix formation, trabecular bone formation and myeloid yissue in Ca Group (p= 0.002), Ca/Zinc Group (p= 0.002), and Ca/Vit.D Group (p= 0.001) were significantly higher than in Control Group. The total amounts of Ca/Vit.D Group were significantly different than Control Group and Ca Group. The results of the present study indicated that the oral calcium carbonate supplementation combination with zinc may have systemic effects on accelerating bone regeneration in alloplastic bone grafted tibial defects. Further human studies involving long-term follow up and different type of bone grafts should be conducted.
El objetivo de esta investigación fue evaluar los efectos potenciales de la combinación sistémica de calcio, zinc y vitamina D como suplemento de la aplicación local de un injerto óseo aloplástico. Fueron utilizadas 28 ratas Wistar albinas (machos). En cada animal, se crearon defectos óseos en las tibias (cuyas medidas fueron: 10 mm de longitud x 3 mm de ancho x 2 mm de profundidad). Los animales fueron divididos en cuatro grupos. En el Grupo 1 (control) las ratas fueron alimentadas con una dieta estándar. En el Grupo 2 (grupo de calcio) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) suspendido en solución salina. En el Grupo 3 (grupo de calcio/zinc) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) y sulfato de zinc (4 mg/kg de peso corporal) suspendido en solución salina. El Grupo 4 (calcio/vitamina D) recibió carbonato de calcio (15 mg/kg de peso corporal) y vitamina D (500 UI/kg de peso corporal) suspendidos en aceite de oliva. Se realizó un análisis histopatológico de las muestras para evaluar el proceso de actividad osteoblástica, formación de la matriz, hueso trabecular y tejido mieloide en defectos óseos. Las cantidades totales de actividad osteoblástica, formación de matriz, de hueso trabecular y tejido mieloide en los grupos Calcio (p= 0,002), Calcio/Zinc (p= 0,002), y Calcio/Vitamina D (p= 0,001) fueron significativamente mayores que en el grupo de control. Las cantidades totales de Calcio/Vitamina D Grupo fueron significativamente diferentes de los grupos Control y Calcio. Los resultados del presente estudio indican que lacombinación de suplementos de carbonato de calcio por vía oral con zinc puede tener efectos sistémicos sobre la aceleración de la regeneración ósea en defectos tibiales con injertos aloplásticos. Deben llevarse a cabo otros estudios en humanos, que involucren un largo plazo de seguimiento y también diferentes tipos de injertos óseos.
Subject(s)
Animals , Rats , Bone Transplantation , Dietary Supplements , Tibia/pathology , Wound Healing/drug effects , Bone Substitutes , Calcium/administration & dosage , Rats, Wistar , Tibia/surgery , Vitamin D/administration & dosage , Wound Healing/physiology , Zinc/administration & dosageABSTRACT
BACKGROUND: Alloplastic materials are increasingly being used in augmentation of craniofacial defects because of its ready availability, good aesthetic outcome and absence of donor site morbidity. This paper highlights experience in the use of heat-cured acrylic in augmentation cranioplasty. SUBJECTS AND METHOD: The management of three patients with anterior skull defect who presented at the Dental and Maxillofacial Surgery Clinic of the Aminu Kano Teaching Hospital over a five-year period is presented. RESULTS: There was good aesthetic outcome in all the patients and no complications were recorded. CONCLUSION: Augmentation of craniofacial defects using customized prefabricated heat-cured acrylic provides patients with a durable, stable and structural repair ofcraniofacial defects with good aesthetic outcome.
ANTECEDENTES: Los materiales aloplásticos son usados cada vez más en la técnica de aumento para la reparación de defectos craneofaciales, debido a su disponibilidad inmediata, buen resultado estético y ausencia de morbosidad del sitio donante. Este trabajo destaca nuestra experiencia en el uso de acrílico curado por calor en las técnicas de aumento en la craneoplastia. SUJETOS Y MÉTODOS: Se describe el tratamiento de tres pacientes con defectos del cráneo anterior, que asistieron a la Clínica de Cirugía Maxilofacial y Dental del Hospital Docente Aminu Kano por un período de más de cinco años. RESULTADOS: Hubo un buen resultado estético en todos los pacientes y no se reportaron complicaciones. CONCLUSIÓN: La técnica de aumentación para los defectos craneofaciales, utilizando acrílico prefabricado curado con calor, proporciona a los pacientes una reparación duradera, estable y estructural de los defectos craneofaciales con buen resultado estético.
Subject(s)
Humans , Male , Female , Adult , Bone Cements/therapeutic use , Craniofacial Abnormalities/surgery , Plastic Surgery Procedures/methods , Prostheses and Implants , Skull/surgery , Methylmethacrylate/therapeutic use , Frontal Bone/surgeryABSTRACT
As limitações anatômicas do rebordo alveolar residual podem impedir a instalação de um implante osseointegrado. Nesses casos, procedimentos de regeneração óssea guiada são necessários para proporcionar osso alveolar suficiente em altura e/ou espessura para a inserção de implantes dentais. Este relato piloto de caso clínico apresenta um procedimento de aumento horizontal do rebordo ósseo usando um novo substituto ósseo aloplástico para proporcionar volume ósseo necessário para a colocação de um implante, avaliando também por meio de microtomografia o osso neoformado. O paciente do sexo masculino, 58 anos, não fumante, sem condições sistêmicas que pudessem afetar o procedimento cirúrgico, apresentava a ausência de um dente (primeiro pré-molar superior direito) e optou por instalar um implante para a reabilitação cirúrgico-protética desta área. A tomografia computadorizada pré-operatória mostrou que o osso residual tinha espessura insuficiente para a instalação de um implante, sendo necessária a realização de um procedimento cirúrgico para aumento ósseo horizontal. O paciente assinou um consentimento informado autorizando a realização dos procedimentos bem como a documentação científica do caso. Foi realizada cirurgia de regeneração óssea guiada (ROG) utilizando substituto ósseo particulado (Reprobone®) e uma membrana colágena (Biomend), para aumentar a espessura óssea vestíbulo-palatal. O paciente foi apropriadamente medicado e a cicatrização ocorreu sem intercorrências. Após 6 meses, a área foi reaberta e antes da instalação do implante uma biópsia óssea foi coletada para análise microtomográfica. A técnica de ROG proporcionou volume ósseo adequado para a colocação do implante. A análise microtomográfica da biópsia óssea resultou em 40,85% de volume ósseo cortical e 17,08% de biomaterial residual...
Anatomic limitations of the residual alveolar bone may impair implant placement. Alveolar ridge augmentation procedures are required in such cases to provide alveolar bone width and/or height for dental implant placement. This case report presents a horizontal ridge augmentation procedure using a new alloplastic bone substitute providing bone volume for implant placement, with micro-CT analysis of the newly formed bone. The patient was a 58-year-old male, non-smoker, with no systemic health conditions that could affect the surgical procedure, and reported the willingness of rehabilitating the edentulous area corresponding to the tooth 14 with an osseointegrated implant. The CBCT analysis revealed that residual alveolar bone width was too narrow for implant insertion, and therefore a bone augmentation procedure was necessary. The patient signed an informed consent form authorizing all procedures and scientific documentation. Guided bone regeneration was performed using ReproBone® granules and a collagen membrane (BioMend®) to increase the buccal-palatal bone width. The patient was properly medicated and healing was uneventful. After 6 months, the area was reopened and before placing an implant a bone biopsy was collected for micro-CT analysis. The bone augmentation procedure provided adequate bone volume for implant placement. The micro-CT results of the bone biopsy showed 40% of bone volume and 17% of remnant particles of the biomaterial after 6 months. It was concluded that this biomaterial may be used in such clinical situations as an alternative to autogenous bone blocks and still avoiding patient morbidity...
Subject(s)
Humans , Male , Middle Aged , Alveolar Process , Bone Regeneration , Dental Implantation, Endosseous , DurapatiteABSTRACT
Purpose: This experimental study aimed to assess the histological outcomes of orbit reconstruction with a polypropylene mesh implant in an animal model using dogs. Methods: The right and left orbits of 12 dogs were fractured in order to simulate orbital fractures similar to those occurring in humans as a result of trauma. The orbits were reconstructed with a polypropylene mesh positioned approximately 10 mm beyond the bone defect borders. The 24 orbits were divided into four groups of six: one group was given one polypropylene mesh layer; another group received two layers; a third group was given three polypropylene mesh layers; and the fourth group did not receive any implant (control group). The dogs were divided into clusters of four animals and were euthanized 15, 30, or 60 days after the surgery. The orbit medial wall was removed, and samples were subjected to histological polypropylene mesh analysis by optical microscopy. Data were analyzed using a non-parametric test with a 5% level of significance. Results: It was found that the polypropylene mesh caused a mild to moderate tissular reaction. Conclusion: The implant was well tolerated even with two or three overlapping layers.
Objetivo: Trata-se de estudo experimental em que se reconstruíram os continentes orbitais de 12 cães com implante de tela de polipropileno. Metodologia: Os continentes orbitais foram fraturados simulando as fraturas orbitais que ocorrem em humanos devido ao trauma e reconstruídas com tela de polipropileno cortadas com extensão de cerca de 10mm além da margem do defeito ósseo. Utilizaram-se uma, duas ou três camadas de tela de polipropileno nas órbitas teste e algumas órbitas, somente fraturadas, serviram como controle. Os cães foram sacrificados nos tempos de 15, 30 e 60 dias de pós-operatório; os tecidos das órbitas teste e controle foram removidos e preparados para análise histológica em microscopia óptica. Os resultados obtidos pela análise histológica foram submetidos a análise estatística não paramétrica com 5% de significância. Resultados: A tela de polipropileno causou reação tecidual de leve a moderada nos tecidos. Conclusão: O implante foi bem tolerado, mesmo quando a tela foi superposta em duas ou três camadas.
Subject(s)
Animals , Dogs , Orbital Fractures/surgery , Orbital Implants , Surgical MeshABSTRACT
La anquilosis de la A.T.M. es una patología clasificada conforme el local donde ocurre, el tipo de tejido envuelto y su extensión. El tratamiento debe ser quirúrgico, con remoción del cóndilo e interposición de algún tipo de material autógeno o alo plástico en el espacio formado
The anquilose of TMJ it is a pathology classified the place where happens accordingly, type of involved fabric and her extension. The treatment should be surgical, with removal of the condyle and interference of some type of autogenous material or aloplastic in the formed space