ABSTRACT
Propósito: Este artículo describe el uso del injerto de mentón para el aumento de la eminencia articular, como tratamiento para la luxación crónica mandibular. Pacientes y métodos: El presente estudio se llevó a cabo en 12 pacientes, con una edad promedio de 44 años a quienes se les diagnosticó luxación crónica mandibular, con sintomatología dolorosa mayor o igual a 8 en la escala visual análoga (EVA), evolución de 1.5 años en promedio, y una apertura bucal de 55 mm o mayor a ésta, tratados en forma conservadora durante por lo menos tres meses sin presentar mejoría. Dichos pacientes fueron tratados con una modificación a la técnica de Norman donde se les realiza aumento de la eminencia articular mediante la colocación de un injerto de mentón, a través de un abordaje preauricular. Resultados: En ninguno de los casos se presentaron nuevos eventos de luxación durante los 18 meses posteriores a la cirugía. Conclusiones: Se demostró que la corrección de la luxación crónica mandibular, mediante colocación de tope precondíleo con injerto de mentón es una técnica eficaz y segura.
Aim: The aim of the present article was to describe use of chin bone graft to increase articular eminence as preferred treatment for mandibular chronic luxation. Patients and methods: The present study was undertaken with 12 patients, average age 44 years. Patients had been diagnosed as suffering from chronic mandibular luxation (dislocation), with pain symptomatology rating 8 or more in the Analogous Visual Scale (AVS). Patients had experienced an average 1.5 year evolution and 55 mm or more oral opening. Patients had been conservatively treated for at least three months, with no visible improvement. Patients were then treated following a modified Norman technique, in which an articular eminence augmentation is performed with a chin bone graft placed through pre-auricular approach. Results: None of the patients presented new dislocation events during the 18 month follow up period after surgery. Conclusions: The present study showed the fact that mandibular chronic dislocation correction with placement of pre-condylar stop with chin bone graft is an effective and safe technique.
ABSTRACT
BACKGROUND: Odontogenic necrotizing fasciitis of the neck is a fulminant infection of odontogenic origin that quickly spreads along the fascial planes and results in necrosis of the affected tissues. It is usually polymicrobial, occurs frequently in immunocompromised patients, and has a high mortality rate. CASE PRESENTATION: A 69-year old Mexican male had a pain in the maxillar right-canine region and a swelling of the submental and submandibular regions. Our examination revealed local pain, tachycardia, hyperthermia (39°C), and the swelling of bilateral submental and submandibular regions, which also were erythematous, hyperthermic, crepitant, and with a positive Godet sign. Mobility and third-degree caries were seen in the right mandibular canine. Bacteriological cultures isolated streptococcus pyogenes and staphylococcus aureus. The histopathological diagnosis was odontogenic necrotizing fasciitis of the submental and submandibular regions. The initial treatment was surgical debridement and the administration of antibiotics. After cultures were negative, the surgical wound was treated with a growth factor-enriched autologous plasma eight times every third day until complete healing occurred. CONCLUSIONS: The treatment with a growth factor-enriched autologous plasma caused a rapid healing of an extensive surgical wound in a patient with odontogenic necrotizing fasciitis. The benefits were rapid tissue regeneration, an aesthetic and a functional scar, and the avoidance of further surgery and possible complications.
