RESUMO
Autogenous reconstruction of temporomandibular joint (TMJ) with costochondral graft (CCG) has been a popular method of growth center transfer in children. However, unpredictable growth pattern of CCG has been reported in children that often leads to dentofacial deformities in future. This institutional study describes the results of mandibular reconstruction with CCG in two growing children, one with plexiform ameloblastoma of mandible and the other with unilateral TMJ ankylosis. Long-term follow-ups showed a significant growth of the grafts in both the patients. However, there was a lack of uniformity in the amount and rate of growth. The authors support the theory that CCG possesses innate growth potential and is a desirable option for reconstruction of acquired mandibular defects involving the TMJ in pediatric population. However, regular postoperative monitoring is necessary for such patients as the graft shows an unpredictable growth pattern.
RESUMO
Facial degloving injuries are due to separation between the skin and subcutaneous tissues from the underlying muscles, bones, and fascia. These injuries often create a reconstructive challenge for surgeons especially when there are associated complications like wound infection or necrosis of the avulsed flap. This case report presents management of a case of facial degloving injury with full thickness necrosis of the avulsed flap. The authors concluded that treatment of such complex wounds requires a multi-disciplinary approach along with proper planning and staging of the surgical procedures for optimum aesthetic and functional outcomes.
RESUMO
Solitary intraosseous neurofibromas of mandible are very rare and only 40 cases are documented. This case report presents one of the youngest documented case of solitary neurofibroma of mandible, in a 2-years old male child. The tumour was symptomatic and presented as a swelling over right posterior region of mandible. The patient underwent conservative excision under general anaesthesia. The inferior alveolar nerve was preserved. Histopathology was suggestive of benign nerve sheath tumour. Immunohistochemistry showed moderate S-100 and strong CD34 positivity. Postoperative healing was uneventful. This report also reviews forty previously reported cases of solitary intraosseous neurofibromas of the mandible.
RESUMO
To evaluate fracture stability and complications such as infections, need for hardware removal, malunion, and nonunion when using 2.0-mm locking plating system in fixation of mandible fractures and to compare these to those associated with the 2.0-mm non-locking plating system. A prospective clinical study was conducted in a cohort of mandible fracture patients who were randomly assigned to two groups. Patients in the non-locking group were treated with 2.0-mm non-locking plating system, and those in locking group were treated with 2.0-mm locking plating system. Fracture stability, need for maxillomandibular fixation (MMF) and postoperative complications were assessed and compared. A total of 60 patients (30 in each group) were recruited. Significant differences were found between the two groups with respect to postoperative fracture stability (P = 0.001) and need for MMF (P = 0.005). Multivariate analysis revealed that type of fixation was not the only dependent variable which affected fracture stability. There were no significant differences in postoperative complications between the two groups. The 2.0-mm locking plating system provides greater stability and early functional restoration than the 2.0-mm non-locking plating system, with similar rates of postoperative complications. Thus, it can be used as a reliable and effective treatment modality for treating mandibular fractures.
