RESUMO
Perioperative hyperglycemia is common and associated with increased rates of surgical wound infections, length of hospital stay, morbidity, and mortality. Improved perioperative glycemic control has the potential to improve patient outcome. Surgery and anesthesia induce a stress response with hormonal cascades that influences glucose control. In patients with diabetes and prediabetes, a focused history is necessary to create a plan that optimizes glycemic control in the perioperative setting. The goal of perioperative glycemic control is to keep glucose levels as normal as possible, while avoiding complications associated with hypoglycemia. Metabolic consequences of surgery and preoperative considerations of an inpatient with diabetes are discussed in this paper.
RESUMO
The surgery-first approach (SFA) or Surgery-first Orthognathic approach (SFOA) without pre-surgical orthodontic treatment, has become favoured in the treatment of dentomaxillofacial deformities. Conventional orthognathic surgery treatment involves orthodontic interventions both before and after orthognathic surgery, making the total treatment period of 3-4 years and temporary worsening of facial profile. Surgery-first approach involves orthognathic surgery being carried out first, followed by orthodontic treatment to align the teeth and occlusion and it takes the advantage of corticotomy- facilitated orthodontics allowing rapid tooth movement thus reducing treatment duration. The purpose of this article is to present a case of skeletal class III malocclusion treated with surgery-first approach with emphasis on selection of case, treatment protocol, indications, advantages and disadvantages of surgery-first approach.