Mandibular reconstruction and second generation locking reconstruction plates: outcome of 110 patients.

Mandibular reconstruction plates have revolutionized the treatment of mandibular continuity defects following ablative or trauma surgery. This retrospective study of patients requiring mandibular reconstruction over a six year period describes the authors' experience with second generation mandibular locking reconstruction plates and identifies complications and risk factors. The use of second-generation locking reconstruction plates for the treatment of mandibular continuity defects has a 36% complication rate, which includes plate fracture, screw loosening, plate exposure, wound infection and malocclusion. The average time frame until a hardware failure (plate fracture, screw loosening) occurs is 14 months. Plate exposure is closely associated with patients who received radiation therapy, and have lateral defects reconstructed with a plate only or plate/soft tissue flap reconstruction. Plate fracture was associated with lateral defects, the presence of a postoperative dentition, and a plate only or plate/soft tissue flap reconstruction. The authors recommend the use of a primary vascularized bone reconstruction. This provides additional soft tissue support around the plate to minimize the chances of exposure. It also provides osseous support for the plate, reducing the time frame the plate endures load bearing, and minimizing the risk of plate fracture.

The effects of alcoholic beverages on composite wear.

OBJECTIVES: In vivo wear of composite restorative materials appears to be, in part, dependent on various patient factors. Specifically, consumption of alcoholic beverages has the potential for increasing the degradation rate. The hypothesis tested in this experiment was that composite wear is dependent on the type of alcohol-containing liquid the materials are exposed to during three-body abrasive wear. METHODS: To test this hypothesis, composite wear experiments were performed using the ACTA three-body wear machine. Abrasive slurries containing either beer, wine, 9 vol% ethanol or water were used during the wear experiments. The data were analyzed using ANOVA and Tukey's test. RESULTS: The wine and ethanol solutions caused significantly more wear compared to the beer and water. There was no significant differences in the wear between the wine and 9 vol% ethanol groups, and the beer groups were not significantly different from the water groups. Furthermore, there was no significant interaction between the composite type and the various abrasive slurries. SIGNIFICANCE: These results indicate that alcoholic beverages with at least 9 vol% ethanol will increase the wear of composite. The observed increase in wear of composite by the wine was caused primarily by the ethanol content of the wine. Other constituents in the wine do not appear to have an effect on composite wear. The ethanol effect was consistent among different composite types.