ABSTRACT
Facial asymmetry is a common complaint in patients with facial concerns. Some patients have mandibular asymmetries that have light maxillary cant compensation due to a reduced gingival exposure. A common treatment in facial asymmetries is bimaxillary surgery treatment. However, there are no cases of non-severe occlusal plane canting (OPC) with mandibular asymmetry treated with mandibular surgery and miniscrews for the extrusion of the maxillary molars. The aim of this article is to show how to correct mandibular asymmetries combined with OPC by making a single mandibular "early surgery" combined with the extrusion of the maxilla with miniscrews to correct the occlusal plane in order to avoid a Le Fort I surgery. This type of treatment provides lower medical costs, shorter surgeries, and less postoperative discomfort and invasion for patients.
Subject(s)
Dental Occlusion , Facial Asymmetry/surgery , Malocclusion/diagnosis , Malocclusion/surgery , Mandible/surgery , Orthognathic Surgical Procedures/methods , Bone Screws , Cephalometry , Female , Humans , Male , Maxilla , Middle Aged , Molar , Orthodontic Anchorage Procedures/methods , Orthodontic Appliances, Fixed , Radiography, Dental , Tooth Movement Techniques , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously. MATERIAL AND METHODS: A comprehensive search of the PubMed, Scopus and ISI Web of Science databases was conducted to identify studies that evaluated the relationship between direct oral anticoagulants and dental procedures. The quality of the reported information was assessed following the PRISMA statement. RESULTS: Eleven studies that met the inclusion criteria were included in the review: 2 randomized clinical trials, 3 prospective studies, 3 retrospective studies, 2 case series and 1 case report. CONCLUSIONS: DOACs are safe drugs in terms of bleeding. The possible postoperative bleeding complications are manageable with conventional haemostasis measurements. The bridging approach with heparin does not seem to be recommended. Consensus among the professionals involved in the management of the patient is fundamental in invasive dental treatments and in complex patients. Key words:Oral anticoagulants, DOAC, NOAC, dabigatran, rivaroxaban, apixaban, edoxaban, bleeding, oral surgery.
ABSTRACT
En los últimos años, en la literatura se han recogido diversas series de osteoquimionecrosis asociadas a bifosfonatos. En algunos pacientes que tomaban bifosfonatos se observó dolor, exposición ósea y osteitis tras una exodoncia u espontáneamente. Presentamos nuestra experiencia desde nuestro servicio de cirugía oral y maxilofacial en el seguimiento de 15 pacientes que han presentado esta patología, incluyendo nuestro protocolo diagnóstico-terapéutico (AU)
Recently in the literature many papers concerning bone osteonecrosis of the jaws (BON) have appeared related with Biphosphonates. Some of the patients taking Biphosphonates developped oral lesions which are similar in appearance to those of radiation-induced osteonecrosis. Clinically, they appear as ragged oral mucosal ulcerations that expose underlying bone and often are extremely painful, many times related with previous manipulation and sometimes spontaneously. The lesions are persistent and do not respond to conventional treatment modalities. We present our experience and recommendations which are based on expert opinion from the literature, the guidelines for the diagnoses and management of care of patients who develop BON; the prevention of this complication based on current knowledge; and recommendations for the routine dental treatment of patients receiving bisphosphonate therapy (AU)
Subject(s)
Humans , Male , Female , Osteonecrosis/chemically induced , Osteonecrosis/diagnosis , Osteonecrosis/pathology , Diphosphonates/adverse effects , Diphosphonates/therapeutic use , Jaw Diseases/chemically induced , Jaw Diseases/complications , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Tomography, Emission-Computed/methods , Jaw Diseases/etiology , Jaw Diseases/pathology , Microbial Sensitivity Tests/methodsABSTRACT
We introduce the use of a piezoelectric device in order to harvest calvarial bone grafts. The vibration frequency of the instrument allows for the efficient cutting of bone without the risk of accidentally damaging the dura.
