Cooperation of the maxillofacial and plastic surgeon in reconstructive surgical procedures in gunshot injury - a case report.

Lower and middle face defects resulting from gunshot wounds often cause severe functional and cosmetic deformities. The purpose of this case report is to refer to our experiences in the treatment of facial gunshot trauma associated with attempted suicide that resulted in a complex facial injury. The goal of the treatment of complex facial injuries is a proper reconstruction of the hard and soft tissue defects and sufficient rehabilitation of the relevant functions, such as speech, nutrition and appearance. A close cooperation of the maxillofacial and plastic surgeon is essential to achieve a satisfactory outcome.

Aggressive periodontitis.

AIM: Horizontally impacted mandibular molars may cause loss of bone, and development of periodontal pockets on the distal root surface of adjacent second molars. The reported patient was confirmed to have aggressive periodontitis. The aim of this presentation is to describe a novel view of a complex treatment approach to promote periodontal healing in a patient. MATERIAL AND METHODS: Our study presents the results of a patient with generalized aggressive periodontitis, horizontally impacted left third mandibular molar, and a second molar with a deep periodontal pocket. The treatment concept was recommended based on the idea of "one-stage treatment". The removal of the third molar was followed by deep scaling and root planing, and the xenogenic grafting material was placed on the bone defect. The flap completely covered the wound. The patient received systemic antibiotics. RESULTS: The probing pocket depth was 9 mm before surgical treatment and 0-2 mm 1, 5, and 10 years postoperatively. The radiographic bone level was 50 % before surgery and 100 % after the surgical approach. CONCLUSION: This presentation with a 10-year follow-up describes the implementation of one-stage treatment management to promote periodontal healing in a patient via full-mouth periodontal and surgical therapy (Fig. 4, Ref. 33).

Motivational interviewing for improving periodontal health.

Periodontal health should be defined as a state free from inflammatory periodontal disease that allows an individual to function normally and not suffer any consequences (mental or physical) as a result of past disease. Tissues located in the vicinity of implants, known as peri-implantation tissues, have specific and in many ways similar anatomy. The elaborate protocol of preventive measures to ensure periodontal health is extremely important. There is compelling evidence that motivational interviewing frequently leads to more favourable clinical responses than conventional preventive tools. Herein, we describe that the periodontal health can serve as a vital common reference point for assessing disease, determining meaningful preventive methods and treatment outcomes. This article mainly focuses on the role of new clinical data regarding periodontal health and motivational interviewing, which received a particular attention in recent years such as motivation for abidance and on the prognosis of periodontal health (Tab. 3, Ref. 26). Text in PDF www.elis.sk Keywords: periodontal health, gingivitis, periodontitis, motivation, motivational interviewing.

Hyaluronic acid application vs arthroscopy in treatment of internal temporomandibular joint disorders.

AIMS: The goal of this study was to compare the treatment outcome after two different treatment modalities in cases of disc displacement of the temporomandibular joint diagnosed via magnetic resonance technique, namely surgical procedure in form of arthroscopic lysis and lavage vs. hyaluronic acid superior joint space application. MATERIALS AND METHODS: Magnetic resonance imaging was performed before and one year after treatment. Simultaneously, pre- and post-treatment visual analogue scales and maximal mouth opening distance were documented. RESULTS: In our study, out of the total of 145 patients who were initially diagnosed with magnetic resonance imaging to have internal derangements and treated with arthroscopic lysis and lavage or hyaluronic acid application, we observed progression of internal derangement in 27 cases (18.6 %), improvement in 37 cases (25.5 %) and stationary state in 81 patients (55.9 %). Both treatment methods significantly improved the followed maximal mouth opening distance and visual analogue scale, as confirmed upon the 12­month follow-up examination. Maximal mouth opening was 4.7mm for hyaluronic acid application and 12.2mm for arthroscopic lysis and lavage (p<0.005). The mean visual analogue scale values decreased from 6.2 to 2.1 for hyaluronic acid application and from 6.9 to 1.2 for arthroscopic lysis and lavage (p<0.005). CONCLUSION: Our study shows that both arthroscopic lysis and lavage and hyaluronic acid injections are effective and safe in the treatment of disc displacement in the temporomandibular joint (Tab. 3, Ref. 30).

Therapeutic effects of arthrocentesis in treatment of temporomandibular joint disorders.

OBJECTIVE: Analyse, compare and evaluate the effects of the treatment arthrocentesis with a control group of non-steroid drugs treated patients. MATERIAL AND METHODS: 1752 out-patients (1293 females, 459 males) were examined within the years 2013-2017. We evaluated the following criteria: gender, age, visual analog scale for pain (VAS), inter-incisal distance and reducing intake of orally administered analgesics. RESULTS: The pain level of the group of patients with arthrocentesis had stabilized at mark 2.5 on the pain scale, unlike in the control group after treatment with non-steroidal anti-inflammatory drugs, pain had stabilized at mark 9 on the pain scale. The inter incisal distance amongst the first group was 37 mm and in the control group only 27 mm, after completed treatment. The amount of applied analgesics in the group with arthrocentesis decreased to 100 mg daily, while in the control group, the dose was adjusted to 700 mg daily. CONCLUSION: In the observed study, arthrocentesis was effective in reducing pain, amount of analgesics per day and improving the mobility of temporomandibular joint (TMJ). The results of this study we use in the ongoing project, that focuses on progressive and innovative methodology of endoscopically assisted arthrocentesis. (Tab. 4, Fig. 5, Ref. 39).

Biodegradable versus titanium plates and screws for paediatric facial skeleton fractures.

OBJECTIVE: The use of biodegradable materials represents a new option in the treatment of paediatric facial skeleton fractures. The benefits of a resorbable system include reductions in time for long-term stability, diminished immobilisation period, and elimination of painful procedures for implant removal. The resorption of the material did not influence bone repair and growth. Bioresorbable plates and screws get completely excreted through physiological routes. MATERIAL AND METHODS: The age of the patients ranges from that of pre-schoolers till 18 years. The mean age of boys and girls was 12.18 (range 4-18 years) and 13.59 (range 5-18 years), respectively. RESULTS: During the ten-year period, 168 children and adolescents, 136 boys and 32 girls, were treated. The conservative treatment was performed in 67 patients (39.9 %). Open surgical reduction was performed in 101 patients (60.1 %). Bioresorbable plates were applied in 44 patients (43.6 % of surgically treated). CONCLUSION: The implementation of biodegradable osteosynthetic materials is optimal for the treatment of fractures of the middle third of the facial skeleton, lower part of the upper third of the facial skeleton, mandibular body and parasymphysis (Tab. 3, Fig. 3, Ref. 31).

[Homicide, suicide or fatal accident?]. / Vrazda, samovrazda alebo náhodný úraz?

A forensic explanation of womandrinker's death is presented in the article. Exsanguination from multiple cut wounds was cause of death. Origin of wounds was unable to explain due to its atypical character and localisation on body surface. Only a subsequent exact allocation of wounding object made clear biomechanical aspects of wounds. A hard ethanol alteration of psychical, senzorical et motorical functions with strong posttraumatic et toxometabolic changes of the body took share on mechanism of death.

[Atypical maxillofacial shot wound]. / Atypické strelné poranenie maxilofaciálnej oblasti.

Maxillofacial shot wounds belong to the relatively less frequent injuries. The soft tissues might be affected in particular, however the most of injuries are combined with infliction of hard tissues. Shot wounds by the bow or crossbow are very rare. They might result as a consequence of either accident or suicide. In the literature some cases of a suicidal experiments had been published, all of these cases were due to arrow from the crossbow. There was no injury being documented due to arrow from the bow. The authors present a case of maxillofacial injury done by shoot of arrow from the bow in the course of a child's play.