ABSTRACT
Objetivos. Evaluar la tasa de éxito de los implantes y la tasa de supervivencia de las prótesis oculopalpebrales, así como la calidad de los tejidos blandos periimplantarios. Material y método. Con aprobación del Comité de Ética, fue realizado un estudio retrospectivo de las historias clínicas de todos los pacientes oncológicos con deformidades orbitarias que recibieron implantes para la rehabilitación con prótesis oculopalpebrales, entre los años 2003 y 2015. Se consideraron 2variables de resultado para el estudio: la tasa de éxito de los implantes y la tasa de supervivencia de las prótesis. Los datos fueron analizados mediante el método de Kaplan-Meier. Resultados. Fueron instalados 33 implantes extraorales en 14 pacientes. La tasa de éxito de los implantes fue del 96,9% y la tasa de supervivencia de las prótesis oculopalpebrales a los 2 años fue del 92,3%. Conclusiones. La rehabilitación de la región orbitaria con implantes extraorales es una técnica segura, confiable y predecible para restaurar la estética facial del paciente y mejorar su calidad de vida
Objectives. To evaluate the success rate of the implants and the survival rate of the eyelid prosthesis, as well as the quality of the peri-implant soft tissue. Material and method A retrospective study was conducted, after approval of the Ethics Committee, using the medical records of all cancer patients with orbital deformities, and who received implants for rehabilitation with eyelid prosthesis, between the period 2003 to 2015. Two outcome variables were considered for the study: the success rate of the implants and the survival rate of the eyelid prosthesis. Data were analysed using the Kaplan-Meier test. Results. A total of 33 extra-oral implants were installed in 14 patients. The success rate of the implants was 96.9%, and the survival rate of the eyelid prosthesis was 92.3% at 2 years. Conclusions. The rehabilitation of the orbital region with extra-oral implants is a safe, reliable and predictable technique to restore the facial aesthetics of the patient and improve their quality of life
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Orbit/surgery , Orbital Neoplasms/surgery , Orbital Implants , Quality of Life , Orbit/abnormalities , Retrospective Studies , Survival Rate , Eye Neoplasms/surgery , Dental ProsthesisABSTRACT
PURPOSE: Surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been performed in an attempt to increase healing rates of the affected cases. This literature review aimed to identify clinical studies of surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in order to assess their surgical treatment modalities, outcome and the follow-up. METHODS: A search in the PubMed (Medline) database using specific terms and/or phrases as "bisphosphonate-related osteonecrosis" or "jaw osteonecrosis", and "surgical treatment" or "surgical management" was conducted in order to identify clinical trials and cases of surgical treatment of BRONJ. The review search covered the time period from 2004 to 2014. All studies identified in the search were selected according to the inclusion criteria. Relevant information was recorded according to the following items: author, year, number of patients, BRONJ clinical stage, surgical treatment modality, clinical success, and follow-up. RESULTS: The initial database search yielded 345 titles. After filtering, 67 abstracts were selected culminating in 67 full text articles. A variety of surgical approach was found in this review: debridement, sequestrectomy bone resection, and bone reconstruction. Adjunctive therapies included hyperbaric oxygen, laser therapy, growth factors, and ozone. CONCLUSION: Although there are many indexed studies about BRONJ, well-documented reports concerning surgical therapeutically techniques are scarce, resulting from a lack of well-established protocols. Considerable differences were found regarding sample size, surgical treatment modalities and outcomes. Clinical studies with larger number of patients and longer follow-up are required to provide best information for each surgical treatment modality and its outcomes.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/surgery , Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnosis , Follow-Up Studies , Humans , Jaw/pathology , Orthognathic Surgical Procedures , Treatment OutcomeABSTRACT
Introdução: as fraturas de côndilo mandibular são extremamente comuns, e seus tratamentos são bastante controversos. Durante o tratamento ortodôntico, podem surgir alguns imprevistos, e é importante que o cirurgião-dentista esteja atento a sinais clínicos e aos relatos do paciente. Relatamos o caso de uma paciente portadora de aparelho ortodôntico, em que, em um de seus retornos mensais ao consultório, observou-se desvio de linha média, diminuição da dimensão vertical de oclusão (DVO), dificuldade nos movimentos de lateralidade e abertura bucal, sem sintomatologia dolorosa. Métodos: imediatamente, foi solicitada radiografia panorâmica, e, assim que constatada fratura bicondilar, foi instalado um dispositivo interoclusal associado a elástico Classe II do lado direito e Classe III do lado esquerdo,para estabilização da mandíbula na linha média. Foram solicitadas tomografias da região condilar para verificar a extensão da fratura. Considerando a idade da paciente (10 anos) e o fato do diagnóstico ter sido realizado tardiamente, descartou-se a opção do tratamento cirúrgico. Optou-se por um tratamento conservador, com o uso de dispositivo interoclusal (placa de acrílico posterior para levantamento de mordida) associado a elásticos e a aparelho protrator de mandíbula (APM). Resultados: após 10 meses, os fragmentos condilares resultantes da fratura foram reabsorvidos e a cabeça da mandíbula sofreu remodelação. Conclusão: ao se optar pelo tratamento conservador, obteve-se sucesso, o que nos leva a crer que, em casos semelhantes, o tratamento conservador deve ser priorizado
