ABSTRACT
PURPOSE: Sialolithiasis is defined as the presence of one or more calcified structures within the duct of a major or minor salivary gland. It occurs as a result of deposition of calcium salts around an accumulation of organic debris in the duct lumen. The main signs and symptoms are edema and bacterial infection with abscess formation. METHODS: This study aimed to report two cases of submandibular sialolithiasis treated surgically with diode laser and conduct a review of the literature by means of a systematic search. In the two cases, the calculi were located in the distal part of the submandibular duct and could be palpated intraorally. Surgery was performed in an outpatient setting under local anesthesia. A linear incision was made in the floor of the mouth, in the region of the opening of Wharton's duct, to expose and remove the calculi. Laser cutting was performed using a diode laser module coupled to a 400-µm optical fiber emitting at a wavelength of 980 nm (infrared), 2.5 W output power, and in continuous pulse mode. RESULTS: The use of diode laser is a safe and minimally invasive option for this type of procedure. CONCLUSION: Offering advantages such as enhanced coagulation properties and high-quality incision, absence of bleeding, low risk of nerve damage, and few comorbidities.
Subject(s)
Lasers, Semiconductor/therapeutic use , Salivary Gland Calculi/surgery , Submandibular Gland/surgery , Adult , Aged, 80 and over , Cone-Beam Computed Tomography , Female , Humans , Male , Radiography, Dental , Salivary Ducts/diagnostic imaging , Salivary Ducts/surgery , Salivary Gland Calculi/diagnostic imaging , Submandibular Gland/diagnostic imagingABSTRACT
INTRODUCTION: Segmental maxillary osteotomy enables correction of anterior open bites. However, the outcome can be somewhat unstable, particularly if pseudarthrosis occurs. Bone grafts can be used to prevent this complication. Among the many biomaterials available for grafting, Bio-oss(®) has been used successfully in a range of modalities, with studies to support several indications. This report describes a case of segmental maxillary osteotomy in which Bio-oss(®) granules were used as bone grafts in the surgical gap. PRESENTATION OF CASE: A 24-year-old female presented with anterior open bite, Angle class III posterior occlusion, and Angle class II anterior occlusion. Virtual surgical planning of the procedure predicted a gap of approximately 5mm in the region of the osteotomy, which was bridged with Bio-oss(®) granules. DISCUSSION: Although autogenous bone grafting is the gold standard due to its osteoconductive, osteoinductive, and osteogenic properties, it involves increased morbidity for the patient, unpredictable resorption rates, increased operative time, and risk of infection at the donor site. Use of the Bio-oss(®) material can provide good bone stability, osteoconduction, and biocompatibility, while reducing operative time and surgical morbidity. CONCLUSION: This is the first report of bone grafting with a granular biomaterial in segmental maxillary osteotomy. Successful formation of new bone with density greater than that of the surrounding tissue was achieved, preventing pseudarthrosis and postoperative instability.
ABSTRACT
BACKGROUND: Locking reconstruction plates are used in the treatment of jaw trauma and diseases if there is a need for surgical resection and to prevent pathologic fracture after tumor excision. Fixation is typically performed using an extraoral approach. METHODS: This article describes a technique for the intraoral fixation of locking reconstruction plates that uses prototyping to model the plate before the procedure as well as an implant handpiece with adapted drills for bone drilling and the insertion of screws into relatively inaccessible areas. CONCLUSION: Intraoral fixation not only prevents nerve damage and facial scarring but also minimizes the plate's risk of extraoral exposure and reduces surgical morbidity. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1436-1439, 2016.
Subject(s)
Bone Plates , Fractures, Spontaneous/surgery , Imaging, Three-Dimensional , Mandibular Fractures/surgery , Mandibular Neoplasms/surgery , Plastic Surgery Procedures/instrumentation , Bone Screws , Female , Fracture Fixation/instrumentation , Fracture Fixation/methods , Fracture Healing/physiology , Fractures, Spontaneous/diagnostic imaging , Humans , Male , Mandibular Fractures/diagnostic imaging , Mandibular Neoplasms/diagnostic imaging , Oral Surgical Procedures/methods , Radiography, Panoramic/methods , Plastic Surgery Procedures/methods , Tomography, X-Ray Computed/methods , Treatment Outcome , Wound Healing/physiologyABSTRACT
Objetivo: Definir um protocolo de tratamento em fraturas orbitárias, comparando-o com as diversas formas de tratamento existentes na literatura atual. Metodologia: O protocolo proposto foi elaborado com base na experiência clínica adquirida por um cirurgião bucomaxilofacial junto a três hospitais em Porto Alegre - RS. Foram selecionados artigos de maior relevância sobre o assunto, discutindo diferentes formas de tratamento das fraturas orbitárias. Resultados: Após avaliação clínica e radiográfica, quando constatados lesões oculares ou neurológicas, os pacientes devem ser encaminhados ao oftalmologista e neurologista, respectivamente. Após o diagnóstico do cirurgião bucomaxilofacial, o tratamento deve ser realizado de acordo com a região anatômica orbitária envolvida. Conclusão: O estabelecimento de um protocolo num serviço de trauma de qualidade é de fundamental importância, visto que as fraturas orbitárias devem ser diagnosticadas com precisão e rapidez, visando a um tratamento adequado que minimize suas sequelas.
