Ludwig's angina, a rare complication of mandibular fractures.

Traumas are a major problem worldwide. A considerable proportion of traumas are located in the cephalic extremity. Neglect of these disorders by patients or those responsible for patient management may result in particularly serious consequences. This paper presents the case of a 58-year-old male patient with an intraorally open mandibular fracture, which left untreated for 3 days, was complicated by Ludwig's angina. Following aggressive surgical treatment during which the mandibular fracture was manually reduced and immobilized with a metal splint fixed with circumdental wires and effective antibiotic therapy, the septic process was terminated and the patient's fracture and infected wound were healed. The correct and rapid treatment of open mandibular fractures is mandatory in order to avoid severe septic complications.

Subantral bone grafts, a comparative study of the degree of resorption of alloplastic versus autologous grafts.

The placement of dental implants in the posterior region of the maxillary may pose some difficulties caused by the quality and particularly, the quantity of the subantral bone reserve, which are overcome by subantral bone augmentation. The current study performs a comparative evaluation of the quality and especially, of the stability of alloplastic and autologous materials used for subantral bone augmentation. This study included 21 patients who underwent subantral bone augmentation with alloplastic and autologous material. The patients were followed-up over a 24-month period after bone augmentation, during which the osseointegration rate of dental implants and the stability of subantral grafts were evaluated. The rate of failure of dental implants placed in autologous material grafts was 1.89% (0.036±9.398), while the rate of failure of those placed in alloplastic material was 7.69% (1.960±19.194). Bone resorption was higher within 12 months of dental implant placement both for the alloplastic material (9.87±3.76%) and the autologous material (18.87±3.25%), while 12-24 months after bone augmentation it diminished. The implants placed in the autologous bone grafts had a lower rate of failure compared to those placed in the alloplastic material grafts; in contrast, alloplastic material had a lower resorption rate compared to autologous material.

Mandibular reconstruction using free vascularized iliac crest grafts and dental implants.

BACKGROUND AND AIM: The mandible is frequently affected by tumor masses present in the oral cavity and is included in the tumor ablation procedure, with major functional and esthetic consequences for the patient. A method of high current interest in mandibular reconstruction is based on the use of free vascularized iliac crest grafts, followed by reconstruction using dental implants. METHODS: This study presents the case of four patients benefiting from this treatment method, and monitors the treatment stages and their clinical evolution after mandibular reconstruction and dental implant placement. RESULTS: The postoperative evolution of the patients was favorable, with the integration of the iliac crest grafts and dental implants. After prosthetic loading, the masticatory as well as the esthetic function of the patients was restored to a standard close to the initial one. CONCLUSIONS: This mandibular reconstruction method proved to be effective, with a high degree of reliability and a significant improvement of the patients' quality of life.

Evolution assessment of head and neck infections in diabetic patients--a case control study.

This research aimed to assess the occurrence and progression of head and neck infections in diabetic compared to non-diabetic patients. A retrospective study was carried out over a period of 10 years in 899 patients with head and neck infections. The patients who met the inclusion criteria were divided into cases and controls according to the presence/absence of diabetes. Seventy-three patients (8%, 95% CI [6.45%-10.12%]) were included in the case group and 826 (92%, 95% CI [89.87%-93.55%]) were assigned to the control group. The extension of the infection proved to be significantly (p < 0.001) higher in diabetic patients compared to non-diabetic patients. The difference between the two groups was statistically significant (Mann-Whitney U statistics = 18205.500, p < 1.56 · 10(-8)). A more than 10 year history of diabetes was statistically related to a wider extent of head and neck infections (p < 0.001). Diabetes proved to be associated with large necrotic areas and the spread of head and neck infections to more than two cavities.