RESUMO
A review of the literature on treatment of chronic osteomyelitis of the jaws shows that hyperbaric oxygen is often recommended as an adjunct in treatment of this disease. Definite criteria to indicate this treatment and to evaluate the results have not been reported. The results of hyperbaric oxygen treatment of chronic osteomyelitis of the jaws in 16 patients are presented. In contrast to the good results reported in the literature, only 7 of our patients could be considered as cured. The reasons for this discrepancy are discussed. Our results, as well as the data from the literature, indicate that a combined antibiotic and surgical approach is the treatment of choice in chronic suppurative osteomyelitis. However, in chronic diffuse sclerosing osteomyelitis and in patients in whom decortication and antibiotic therapy have failed, hyperbaric oxygen treatment in combination with antibiotics and surgery seems to be indicated.
Assuntos
Oxigenoterapia Hiperbárica , Doenças Maxilomandibulares/terapia , Osteomielite/terapia , Doença Crônica , Terapia Combinada , Humanos , Esclerose/patologia , Supuração/patologiaRESUMO
A modified technique for reconstruction of the atrophic mandible is presented. The caudal part of the mandible is mobilized through a combined intra-extraoral approach or an entirely extraoral approach. The bone graft is then inserted between the osteotomized fragments. The results in terms of bone resorption are comparable with those of the original method, but the risk of a lesion of the mandibular nerve is substantially reduced. Moreover, supplementary vestibuloplasty is only occasionally necessary.
Assuntos
Mandíbula/cirurgia , Osteotomia/métodos , Aumento do Rebordo Alveolar/métodos , Atrofia , Reabsorção Óssea/patologia , Transplante Ósseo , Seguimentos , Humanos , Ílio , Mandíbula/patologia , Transplante AutólogoRESUMO
In spite of all the attempts that have been made so far to bring about an absolute augmentation of the mandible, this procedure remains more or less at the experimental stage. The greatest difficulty in the known techniques is that the transplanted bone is resorbed to a great extent in a relatively short time. In the last 2 years at our department we have developed a new technique in which the resorption has up to now been minimal. Bone is no longer transplanted subperiosteally on the alveolar process, but the resorbed mandible is split into cranial and caudal portions from the region of the left 3rd molar to the region of the right 3rd molar, and between these two fragments the bone transplant is placed. In this way the resorption after 2 years is practically nil and, moreover, the patient can wear a normal prothesis.
