Notes

Loss of Treatment Use and Reimbursement Costs throughout Ophthalmic Plastic-type and also Reconstructive Medical procedures: 2010-2019.
The oroantral fistula (OAF) is an epithelialized communication between the oral cavity and the maxillary sinus. In most of the cases, this communication occurs after molars and premolars extractions, but other factors may be cause of the communication, such as trauma. This article demonstrates an alternative surgical technique illustrated with a case report in which we perform the surgical treatment of OAF with palatal flap rotation combined with the use of titanium mesh in a victim of gunshot projectile wound in oral cavity.The bones of the maxillary complex are vital for normal oro-nasal function and facial cosmetics. Maxillary tumor excision results in large defects that commonly include segments of the alveolar and palatine processes, compromising eating, speech and facial appearance. Unlike the conventional approach to maxillary defect repair by vascularized bone grafting, transport disc distraction osteogenesis (TDDO) stimulates new bone by separating the healing callus, and stimulates growth of surrounding soft tissues as well. Bone formed in this way closely mimics the parent bone in form and internal structure, producing a superior anatomical, functional and cosmetic result. Historically, TDDO has been successfully used to close small horizontal cleft defects in the maxilla, not exceeding 25 mm. Selleckchem Rapamycin Fujioka et al. reported in 2012 that "no bone transporter corresponding to the (large) size of the oro-antral fistula is marketed. The authors report the successful treatment of 4 cases involving alveolar defects of between 25 mm and 80 mm in length.A novel maxillary osteotomy is designed which is a technical modification of the standard Le Fort I osteotomy, termed the paramedian unilateral Le Fort I osteotomy. This technique has been used to correct an anterior open bite in a given patient based on the current clinical scenario as described, secondary to post ankylosis surgery. Its use may be extrapolated to various clinical situations to correct occlusal discrepancies including distraction osteogenesis.
The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal.

The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications.

One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications.

Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life.
Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life.
Purpose of this retrospective study was to evaluate outcomes autogenous bone block grafts obtained from mandible for different indications. The healing of the donor and recipient sites in the postoperative period, morbidity and the resorption of the graft were investigated.

Twenty-nine patients grafted with mandibular bone block graft were participated in the present study. Grafting was applied in these patients for three indications; reconstruction of alveolar cleft, lateral crest augmentation before dental implantation and sinus floor augmentation. All operations were performed under local anesthesia and in some cases sedation was used as well.

Minimal exposure of the block graft occurred in three alveolar cleft patients. Secondary epithelization was achieved in all cleft patients with no symptoms of infection. In one patient infection was seen in donor site 1-week after the operation. The region was curetted and antibiotics administrated again. Two patients showed an infection of recipient site, after 4 weeks the grafts were removed. In all the patients, as the screw head became apparent until 1 thread, amount of the resorption were considered <1.5 mm.

The usage of mandibular block grafts is a simple and effective treatment modality for reconstruction of different types of alveolar defects and it also reduces cost of treatment.
The usage of mandibular block grafts is a simple and effective treatment modality for reconstruction of different types of alveolar defects and it also reduces cost of treatment.
This retrospective study was conducted to reveal usability of surgical treatment in the cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) stage 2 with sequestrum.

Study subjects included 18 patients having BRONJ stage 2 with sequestrum and 12 non-BRONJ patients with nearly equal clinical states of BRONJ stage 2. Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results were compared between BRONJ group and non-BRONJ groups. In addition, correlation between treatment methods (conservative therapy, sequestrum curettage, and sequestrectomy) and treatment results and correlation between the administration route of bisphosphonates (BPs) (oral or intravenous) and treatment results were examined statistically. The Student's t-test and Fisher's exact test were performed for statistical analysis.

Patient characteristics, frequency of inciting factors of osteonecrosis, and treatment results showed no significant differences between the two groups. In the BRONJ group, treatment result of sequestrectomy was significantly better than conservative therapy/sequestrum curettage (P < 0.001), however, no significant difference was observed in the non-BRONJ group. No significant difference was found in correlation between the administration route of BPs and treatment results in the BRONJ group.

Treatment outcome of sequestrectomy was better than conservative therapy/sequestrum curettage in BRONJ stage 2 cases with sequestrum.
Treatment outcome of sequestrectomy was better than conservative therapy/sequestrum curettage in BRONJ stage 2 cases with sequestrum.
Velopharyngeal function is very important for patients with cleft palate to acquire good speech. For patients with velopharyngeal insufficiency, prosthetic speech appliances and speech therapy are applied first, and then pharyngeal flap surgery to improve velopharyngeal function is performed in our hospital. The folded pharyngeal flap operation was first reported by Isshiki and Morimoto in 1975. We usually use a modification of the original method.

The purpose of this research was to introduce our method of the folded pharyngeal flap operation and report the results.

The folded pharyngeal flap operation was performed for 110 patients with velopharyngeal insufficiency from 1982 to 2010. Of these, the 97 whose postoperative speech function was evaluated are reported. The cases included 61 males and 36 females, ranging in age from 7 to 50 years. The time from surgery to speech assessment ranged from 5 months to 6 years. In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery, and then the appropriate surgery was selected and performed. Postoperative velopharyngeal function was assessed by a trained speech pathologist.

Of the 97 patients who underwent the folded pharyngeal flap operation, 85 (87.6%) showed velopharyngeal competence, 8 (8.2%) showed marginal velopharyngeal incompetence, and only 2 (2.1%) showed velopharyngeal incompetence; in 2 cases (2.1%), hyponasality was present. Approximately 95% of patients showed improved velopharyngeal function.

The folded pharyngeal flap operation based on appropriate preoperative assessment has been shown to be an effective method for the treatment of cleft palate patients with velopharyngeal insufficiency.
The folded pharyngeal flap operation based on appropriate preoperative assessment has been shown to be an effective method for the treatment of cleft palate patients with velopharyngeal insufficiency.
Aesthetic impairment is a major concern for the cleft lip/palate patient. Thus, auditing of postsurgical esthetic outcome needs to be further explored as till date no universally accepted protocol exists. The study objective was to propose a new visual rating chart (VRC) for the aesthetic outcome of cleft lip and palate (CLP) surgery.

In a retrospective review of 200 repaired clefts, the common esthetic deficiencies were identified, categorized and ranked in the order of severity. A chart of the illustrative diagram with textual description of the defects was produced and used as a basis for rating outcome by two groups of raters (familiar raters and recruited raters). Intra- and inter-raters reliability was estimated using Cohen's kappa statistics and intra-class correlation coefficient (ICC). Comparison between mean group coefficient was achieved with Kendall's correlation coefficient of concordance.

The intra- and inter-rater reliability for familiar raters was found to be strong with kappa values range of 0.80-0.87 (P < 0.001). Similarly, inter-raters' reliability by recruited judges was very strong using ICC at both single (0.768) and average measures (0.982).

The VRC is a reliable tool for assessing the esthetic outcome of CLP repairs.
The VRC is a reliable tool for assessing the esthetic outcome of CLP repairs.
A study was conducted to evaluate the benefits of cyanoacrylate tissue adhesive as an alternative to suturing in management of pediatric lacerations.

A total of 7 patients were evaluated and followed for 3-month. The wound was evaluated on 1(st), 3(rd), and 7(th) postoperative day for swelling, infection, gaping and pain and at 1(st) and 3(rd) postoperative month for scar evaluation. The evaluation was based on different superficial facial wound repairs (i.e., low tension) with an average length <3 cm; and if the surgeon subjectively felt that subcuticular sutures were justified to reduce wound tension, then these were used. Isoamyl 2-cyanoacrylate glue was applied over lacerated wound margins after cleaning the wound and holding together for 15 s by means of tissue holding forceps.

Statistical analysis was done using Chi-square test after collection of data. Mean and standard error were estimated from the sample.

The mean total time taken for skin closure was 1-2.5 min. There was no wound infection in any of the cases; only one case showed wound dehiscence on 3rd postoperative day.
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