Finite element analysis of low-profile reconstruction plates for atrophic mandibles: a comparison of novel 3D grid and conventional plate designs.

OBJECTIVES: This study aimed to compare the reconstruction with type 2.4 and three-dimensional (3D) grid plates relating the areas of weakness to anatomical regions of force incidence in atrophic mandibles with and without segmentation using finite element analysis (FEA). MATERIALS AND METHODS: Strength and force quality in the mandible were also determined. The atrophic mandible models with and without segmentation were divided into four groups, and the behavior of each plate was analyzed using finite element analysis. In the atrophic mandible without segmentation using the type 2.4 reconstruction plate, the highest stress concentration in the plate was observed in the posterior region of the mandibular body and in the grid type 3D reconstruction plate was observed in the mandibular angle. RESULTS: In the segmented atrophic mandible with the 2.4 reconstruction plate, higher stress concentration was observed in the mandibular segment defect. Analysis of the 3D grid-like reconstruction plate revealed that the geometry of the plate conferred greater stiffness to the assembly, as the most significant stress concentration was observed at the mandibular angle. CONCLUSION: The width of the plate design may influence the strength, not the thickness.

Early Pediatric Multiple Facial Fractures Treatment With Resorbable Fixation.

ABSTRACT: The facial skeleton in pediatric patients can undergo several changes during development, according to their growth zones and the traumas they suffer. Thus, some of these traumas can lead to multiple complications if not treated properly. Epidemiology can vary according to the social, cultural, and environmental aspects of each individual. Therefore, each case must be treated individually, and it is important to consider age-specific aspects, such as the high osteogenic potential, which leads to faster bone healing. The use of resorbable fixation materials in facial fractures of pediatric patients is widespread, with good acceptance and great advantages over conventional titanium materials, mainly for the elimination of a second surgery to remove the materials. The present study aims to report a series of clinical cases of infants, who suffered trauma and evolved with fractures in the facial bones. Surgical treatment was instituted to reduce and fix fractures, using the resorbable system. Patients are followed up with periodic outpatient follow-up visits and have a good case evolution.

Management of an Unusual Blow-In Orbital Roof Fracture Associated an Intracranial Hematoma.

ABSTRACT: Pure orbital wall fractures represent until 25% of the facial fractures and its reconstruction it's considering a challenge for the maxillofacial surgeons. There are many biomaterials used to repair these fractures according to the literature however, the most common are the titanium mesh and autogenous bone graft.The aim of this work is to report a rare case of blow-in roof orbital fracture associated to an intracranial hematoma in the cranium base.

Harpoon Suicide Attempt: A Dramatic Experience of the Multidisciplinary Approach.

ABSTRACT: Craniofacial harpoon injuries are extremely rare, especially when caused by attempted suicide. The approach to surgical removal becomes dependent on the characteristics of the device, with or without barbs on the spear, and its path, which presents with significant changes between accidents and suicide attempts. This report presents the successful treatment carried out in a dramatic case of harpoon suicide attempt. The approaches to complete and cautious removal of the spear from the occipital region, reconstruction of the orbital cavity, evisceration of the left eyeball due to amaurosis and psychiatric follow-up were successful, which allowed the restoration of the patient's physical and mental health.

Orbital Trapdoor Facture in Child: More Predictable Outcomes and Less Consequences.

Orbital trapdoor fractures are characterized by tissue entrapment between the fractured bone fragment and the remnant of the orbital floor. This entrapment can result in immediate local and systemic complications and poor outcomes when approached late. This article presents the case of an orbital floor fracture in a child with dystopia, pain, edema and entrapment of the inferior rectus muscle and consequent limitation of ocular motility. The strategy proposed in the early approach to orbital floor reconstruction and release of incarcerated tissue allowed the patient to achieve satisfactory results without morbidity, as compared to the outcomes of corrective sequel surgery.

Maxillofacial Manifestation of a Giant Dimension Cranial Osteoma.

Osteoma is the most frequent benign tumor in the craniomaxillofacial region. The most common initial manifestation is facial pressure or headache.The clinical examination showed increased volume in the right supraorbital region, asymmetry of the orbital contour, exophthalmia, dystopia, proptosis and clinical restraint of ocular movement for supraversion. The lesion measured approximately 4 cm in diameter with irregular contour. Osteotomy was performed with saw surrounding the tumor, with aid of a surgical piezo on the orbital medial wall.The result of histopathological examination was osteoma. The patient is 2.5 years postoperatively and so far without complications.