Resultados de la craneoplastia con el uso de cemento Genta 1 en los defectos óseos postraumáticos / Cranioplasty Results Using Genta 1 Cement in Posttraumatic Bone Defects

Introducción: la reconstrucción de defectos de la bóveda craneana constituye un reto para el cirujano. Durante las últimas décadas, muchas han sido las variantes quirúrgicas para su aplicación, así como los materiales utilizados para ello. Objetivo: mostrar los resultados en la realización de craneoplastias con el uso de cemento Genta 1 en pacientes con defecto óseo del cráneo, secundario a traumatismo craneoencefálico. Métodos: se realizó un estudio de serie de casos que abarca desde el año 2009 hasta septiembre de 2014 a 20 pacientes con traumatismo craneoencefálico que les dejó como secuela un defecto óseo del cráneo, requiriendo posteriormente de craneoplastia. Resultados: predominó en el adulto joven y el sexo masculino. En cuanto al diámetro del defecto, predominó el pequeño, seguido de los medianos. En relación con la topografía, prevalecieron los frontales derechos. Predominó la modalidad de abordaje tardío de la craneoplastia luego de la aparición del defecto. Las principales complicaciones fueron el hematoma subgaleal y la deformidad cosmética residual. Conclusiones: la mayoría de los defectos tratados fueron pequeños y medianos, localizados en la región frontal derecha, la modalidad de abordaje más empleada fue la tardía y existió un mínimo de complicaciones(AU)

Introduction: The reconstruction of defects of the cranial cavity constitutes a surgical challenge. Many have been the surgical variants for its application during the last decades, as well as the material used for it. Objectives: To evaluate the results in craneoplasty realized with cement Genta 1 in patients with osseous defect secondary to cranial injury. Methods: It was done a descriptive, retrospective and longitudinal study extended from 2009 to 2014 in 20 patients with cranial injury that left them as consequence an skull's osseous defect which needed subsequent craneoplasty. Results: The injuries predominated in young adults and male sex. Small defects were the more frequent, followed by middle sized and only a large one. In relation with topography, they prevailed in right frontal region of the skull. The belated approach was the most used treatment adopted for the craneoplasty. Subgaleal haematoma and the residual cosmetic deformity were the main complications. Conclusions: Majority of cranial defects were small and middle sized, topographycally situated on the right frontal region and the belated approach was the most frequent treatment adopted for the craneoplasty(AU)

Guided bone regeneration in the treatment of fenestration osseous defect.

This article presents a case with a fenestration defect which was treated by placing a resorbable barrier alone. In the case presented, the osseous defect was a natural space maker with the wall of the defect providing sufficient support to prevent collapse of the membrane into the space. So the use of membrane alone is the preferred treatment. Resorbable collagen membrane was placed in order to avoid a second surgical procedure to remove the nonresorbable membrane. The membrane was positioned by placing a resorbable sling suture such that it covered the defective site adequately. Postsurgical healing of the defect was evaluated 1 month after the surgery and it was satisfactory. Thus guided bone regeneration of the fenestration defect is a reliable treatment procedure.

Spontaneous healing capacity of rabbit cranial defects of various sizes

PURPOSE: This study evaluated the spontaneous healing capacity of surgically produced cranial defects in rabbits with different healing periods in order to determine the critical size defect (CSD) of the rabbit cranium. METHODS: Thirty-two New Zealand white rabbits were used in this study. Defects of three sizes (6, 8, and 11 mm) were created in each of 16 randomly selected rabbits, and 15-mm defects were created individually in another 16 rabbits. The defects were analyzed using radiography, histologic analysis, and histometric analysis after the animal was sacrificed at 2, 4, 8, or 12 weeks postoperatively. Four samples were analyzed for each size of defect and each healing period. RESULTS: The radiographic findings indicated that defect filling gradually increased over time and that smaller defects were covered with a greater amount of radiopaque substance. Bony islands were observed at 8 weeks at the center of the defect in both histologic sections and radiographs. Histometrical values show that it was impossible to determine the precise CSD of the rabbit cranium. However, the innate healing capacity that originates from the defect margin was found to be constant regardless of the defect size. CONCLUSIONS: The results obtained for the spontaneous healing capacity of rabbit cranial defects over time and the underlying factors may provide useful guidelines for the development of a rabbit cranial model for in vivo investigations of new bone materials.

Effect of resorbable membrane on immediate placement of implant in extraction socket during periradicular surgery / 대한치주과학회지

PURPOSE: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. MATERIALS AND METHODS: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. RESULTS: The control group showed a significantly higher bone to implant contact (BIC) (74.14+/-16.18) than experimental group 1 (40.28+/-15.96) and 2 (48.70+/-17.75)(p<0.05). However, there was no significant difference between experimental group 1 and 2. CONCLUSION: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.

Esthetic reconstruction of iliac crest donor deffect with tow titanium plates after harvesting a dcia composite free flap

THE TRANSPOSITION OF PEDICLED MEDIAL LOWER PART OF HUMERUS FLAP WITH VESSELS / 中华显微外科杂志

Objective:In order to provide a new area of bone flap were supplied for non-unions, osseous defect of upper limbs and chondral defect of elbow joint.Methods:The origin,course,distribu- tion and anastomosis of inferior ulnal collateral artery and ulnal recurrent artery were observed on 40 adult cadaver upper limbs.Based on the results,transposition of pedicled medial lower part of humerus bone flap with vessels was designed.Results:Satisfactary results were achieved in 9 case of patients (non-unions of 3 case and osseous defect of 2 case on medial part of humerus bone;non-unions of 3 case on medial upper part of ulna and radius;chondral defect of 1 case on elbow joint.)Conclusion:This pe- riosteal flap that there are constant vessels and abundant anastomosis with inferior ulnar collateral artery form many area of bone flap were supplied with blood supply for repairing the non-unions,os- seous defect of humerus,ulna,radius and chondral defect of elbow joint.