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At least 613 records · Page 34Linked to original sources
PubMed1999

Ostrich eggshell as a bone substitute: a preliminary report of its biological behaviour in animals--a possibility in facial reconstructive surgery.

The aim of this study was to assess the biological behaviour of an implant of ostrich eggshell in various animal models of facial bone reconstruction. The implant was first bioassayed in a rat muscle pouch (n=10), and then tested as an interpositional graft in rat (n=10) and rabbit (n=5) cranial defects. It was finally used as an onlay graft on rabbit mandibles (n=5). Animals were killed after two months in the bioassay, three months in the interpositional model, and six months in the onlay model. The specimens were studied by contact radiography and standard histological techniques. All animals showed normal wound-healing. In the bioassay, the implants produced only a minimal inflammatory reaction. In the interpositional model, the implants maintained a good contour, but there was no sign of graft-remodelling. In the onlay model, the grafts were stable and partly osteointegrated. The onlay graft model gave the most promising results. Because ostrich eggshell is inexpensive and has good mechanical properties, it deserves further study. Long-term studies will clarify its possible role in maxillofacial surgery.

Animals↗
PubMed2005

Bone graft and implants in a patient with systemic mastocytosis.

BACKGROUND: Systemic mastocytosis (mast-cell proliferation in various organs, including the skeleton) is a rare disease. Reports on mastocytosis that affects facial bones are few. The bone lesions may be osteolytic or sclerotic. PURPOSE: To describe (for the first time) bone grafting followed by dental implant treatment yielding a good result in a patient with systemic mastocytosis. MATERIALS AND METHODS: A bone graft was performed on a 60-year-old woman with systemic mastocytosis. Dental implant treatment was performed 13 weeks after sclerotic bone of the iliac crest was grafted to the maxillary sinus bilaterally. A microimplant was installed simultaneously with the dental implants and was removed 6 months later for histomorphometric evaluation. Bone biopsy specimens from the donor site of the sclerotic iliac crest and later from the remodeled maxillary bone graft were histologically analyzed. A clinical examination of the patient with regard to her mastocytosis was performed by a dermatologist. The patient was followed up after 3 years. RESULTS: Bone grafting and dental implant treatment were successful, and the patient's clinical and radiologic situation was stable after 3 years. Histologic examination of the bone grafted from the iliac crest showed sclerotic lesions in the bone and a dense infiltration of mast cells. The bone graft seemed to remodel initially in a normal way in the maxillary sinus. However, computed tomography 3 years later showed regions of sclerosis in the remodeled maxillary bone. These lesions now had a pattern similar to the adjacent facial bone. Both the microimplant and the dental implants integrated well. Bone-implant contact measured on the microimplants was 20% higher in this actual case, compared to that of patients previously treated and grafted with the same technique. CONCLUSIONS: There are many clinical implications to be considered when treating this group of patients. Bone grafting, remodeling of the bone, and dental implant installation were successful in this patient with systemic mastocytosis and signs of osteosclerosis. Installation of microimplants in patients with pathologic bone conditions may allow successful dental implant treatment.

Aged↗
PubMed1999

Jaw fractures in Enugu, Nigeria, 1985-95.

A retrospective analysis of 900 patients with jaw fractures of the facial bones during the period January 1985 - December 1995 indicated that 747(83%) resulted from road traffic accidents, 75(8.4%) from interpersonal violence, 39(4.3%) from accidents during sporting events, and 36(4%) from occupational accidents, while the causes of 3(0.3%) were not stated. The left side of the face was affected more often than the right. The mandible was twice as likely to be fractured as the zygomaticomaxillary complex. The symphysis-body-angle and the condylar region were the most common sites of fracture of the mandible, while the zygoma was the area most often affected in the middle third of the face. Most maxillofacial fractures occurred in the age group 21-30 years, and the lowest among those over 60. Three times as many men were affected as women. We conclude that there is high incidence of fractures of the facial bones caused by traffic accidents in our environment and, in all age groups, men were more likely to be affected than women.

Accidents, Occupational↗
PubMed1981

A blow to the nose: common injury requiring skillful management.

The physician who initially examines the patient with a nasal or facial injury should thoroughly inspect the external and internal aspects of the nose and also evaluate the facial bones. General anesthesia may be necessary in examining children. Although roentgenograms of the nose and facial bones are usually obtained in cases of nasal injury, they rarely influence treatment. Treatment goals should be to maintain or restore satisfactory function and to ensure a good cosmetic result. The patient (or parents) should be advised to be alert to possible delayed abnormalities from the injury.

Adolescent↗
PubMed1990

Maxillofacial fractures related to work accidents.

Work-related maxillofacial fractures were studied retrospectively over a six-year period. There were 98 cases accounting for 4.5% of all facial bone fractures treated in our hospital between 1981 and 1986. Of the patients, 89.8% were male. The mean age of the injured was 36.4 years. The incidence of work-related maxillofacial fractures was 0.37 per 1000 workers. Most of the injuries (66%) occurred in factories and construction work. Such work was associated with an to 15 times higher risk of maxillofacial fracture than service and office work. Of the fractures, 20.4% were sustained on the way to or coming from work. At the place of work, the commonest causes of injury were blows from objects or falls from a height (70%). On the way to or coming from work, the aetiological factor was most often a traffic accident. Assault and battery had caused facial bone fractures in 11.2% of cases. Fifty-five patients with midface and 45 patients with mandibular fractures were found, of these, 8 patients had bimaxillary fractures. In 6 cases, only dentoalveolar fractures were found. Of the patients, 55.1% were treated operatively. Sixty-six patients were hospitalized, the mean length of hospital stay being 3.2 days (range 1-12 days).

Accidents, Occupational↗
PubMed2004

Maxillary brown tumor and uremic leontiasis ossea in a patient with chronic renal insufficiency.

Findings of renal osteodystrophy in cranial bones are not uncommon and include osteomalacia, osteosclerosis, erosion of the cortical bone, brown tumors and resorption of the lamina dura. However, massive thickening of the cranial vault and facial bones, called uremic leontiasis ossea, have been reported very rare. In the present article, we describe the case of an uncooperative female patient with a brown tumor, involving the left maxillary sinus and massive thickening of the cranial vault and facial bones, secondary to severe secondary hyperparathyroidism during 8 years of regular hemodialysis treatment.

Adult↗
PubMed2004

Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran.

BACKGROUND: Many studies have recently noted a shift in the causative mechanism of facial injuries away from traffic accident to assaults. AIMS: Our study aimed to investigate patterns of facial injuries in trauma patients during 13 months study of trauma patients in six general hospitals in Tehran. MATERIAL AND METHODS: Trauma patients who were hospitalized for more than 24 hours and had sustained injuries within seven days from admission were included in the study. Of the 8000 trauma patients, four hundred (5%) sustained facial injuries. RESULTS: Male to female ratio was 4.5:1. Among them, 53.3% were aged 11-30 years. Traffic accidents were by the far the commonest cause of injury. Motorcyclists who wore a helmet sustained facial fractures less often during traffic accident than those patients who did not wear helmet. Soft tissue injury and facial bone fracture comprised 43.3% and 40.8% of facial injuries, respectively. The majority of Soft tissue injuries (79%) were located extra orally. The mandible and nasal bone were the most commonly fractured facial bones. Victims of assault sustained more severe injuries compared to those involved in falls and traffic accidents. CONCLUSIONS: Use of helmets by motorcyclists and the separation of pedestrians routes from motor vehicles could reduce the number of victims and consequently injuries due to road traffic accidents. For implementation of effective prevention programs for reduction of facial injuries due to assault, it seems to be necessary to conduct studies investigating causes and pattern of injuries resulting in assault.

Adolescent↗
PubMed1994

Bone expansion in facial rejuvenation.

Soft tissues and bone structures of the face are both affected by aging, but the bone is the more important element in the three-dimensional contour and suspension of the soft tissue. Bone expansion augments bone volume in the midface. A lamellar split osteotomy of the midface is used for bone expansion, and cranial bone grafts fill spaces created by the expansion. These grafts, which resorb less than onlay grafts located on the resorption zones, are placed in contact with the apposition zone. This technique changes the three-dimensional contour of the outer lamella of the midface while maintaining its morphology. Bone expansion restores bone mass lost to resorption. It is performed along with a facelift. Yielding a face with a younger appearance, not just a face with less wrinkles.

Adult↗
PubMedDate not supplied

Pathogenesis of encephaloschisis in retinoic-acid-treated hamster embryos I: a morphometric study of the craniofacial structures.

The severity of the developmental disorders of the paraxial mesoderm and neuroectoderm must objectively be compared to determine which of the two structures is more deeply involved in the pathogenesis of encephaloschisis. In the present study, hamster fetuses were obtained from dams that had been treated with retinoic acid, and divided into two groups: fetuses with encephaloschisis and those without apparent external malformations in the cranium and face. Mid-sagittal serial sections of the head were prepared, histologically processed, and utilized for the reconstruction of the profile of the head structures. Using this reconstructed profile, we measured the length of the skull base bone structures (basisphenoid and basiocciput), which develop from the paraxial mesoderm, brain structures (mesencephalon and metencephalon), which develop from the neuroectoderm, and facial bone structures (nasal septum and hard palate), which develop from cephalic neural crest cells. The measured length of each structure was compared between the treated and control groups. It was found that treatment with retinoic acid resulted in significantly (P < 0.05) shortened lengths of the skull base bone structures both in fetuses with encephaloschisis and those without apparent external malformations in the cranium and face. In the brain structure of fetuses without encephaloschisis, as well as in the facial bone structures, however, this shortness was not observed. These results suggest that developmental disorders in the paraxial mesoderm may play an important role in the pathogenesis of encephaloschisis.

Animals↗
PubMed2004

Introduction of a novel internal spring-driven craniofacial bone distraction device.

A study of craniofacial bone distraction using an internal self-expanding bone device designed by the authors was performed in a young rabbit skull model. Ten 30-day-old New Zealand white rabbits were divided into two groups: 5 underwent distraction with the device, and 5 served as controls. Serial cephalograms, defleshed skull measurements, and histological examinations were performed on the study animals. The distracted group demonstrated a significant midface lengthening and overbite compared with the control group. Histologically, more fibroblasts and osteoblasts were seen in the front nasal bone in the distracted group in comparison with the nondistracted controls. The self-expanding internal bone distractor can effectively lengthen certain facial bones in an animal model and avoid some of the disadvantages associated with the external distraction techniques. This new device offers clinical potential as a useful distraction technique, but further work is needed to determine the effects of continuous postoperative tension loads on bone healing, the amount of tension generated by certain spring loads and lengths, and the feasibility of applying this concept in confined bone spaces.

Animals↗
PubMed1978

Changing manifestations of brown tumors on bone scan in renal osteodystrophy.

In a patient with chronic renal failure and secondary hyperparathyroidism, brown tumors, visualized initially as photon-deficient areas on bone scintigraphy, reverted to areas of abnormally increased activity following parathyroidectomy. This dual appearance on bone scan paralleled the functional state of the parathyroid gland. The possible relationship of hyperhosphatemia to the increased bone-scan activity noted in the calvarium, mandible, and facial bones is discussed.

Adult↗
PubMed1975

[Bone statics of the face: the frontal-sphenoid-pterygoid bone pillars as biomechanic equivalents of the mandible].

In general biomechanics, trabecular osteo-architectonics is considered as a response to the mechanical strains present in the bone (compression or traction). The facial and cephalic skeleton is no exception to this law. The study of the bony architectionic provides the proof, since we have demonstrated in the fixed facial bone mass (at the limits of the facial skeleton and the skeleton of the base of the skull) the biomechanical equivalent of the mandible: the cranio-facial pterygo-spheno-frontal bony pillars. Paired, symmetrical and with a medio-frontal junction, they represent an embryological, anatomical and functional entity. Their ossification (mixed) may be compared to that of the mandible. They are made up of directional trabecular bone which may be analysed by stereology, electron microscope scanning and by strain gauges. Each pillar is made up of: - A part free of musculature corresponding to the supra-orbital frontal arch, which receives the four vertical pillars (naso-maxillary and maxillo-malo-frontal) of the superficial system of the face which transmit to the supra-orbital frontal arch the ascending mechanical strains of mastication registered in the spongy hard palate. The supra-orbital frontal arch is the biomechanical homologue in the fixed facial mass of the tooth bearing bony base of the mandible. - A spheno-pterygoid part, into which are inserted the alimentary muscles of the cephalic region (masticators, velar and superior pharyngeal). There is further functional homology between the ascending ramus of the mandible and the pterygoid greater wings and apophyses complex of the sphenoid. The 2 pterygo-spheno-frontal pillars also participate in the osseous statics of the orbit and the osseous statics of the temporo-mandibular joint. The basi-sphenoid plays a role of first importance in the general statics of the cephalic region. Thus the two pterygo-spheno-frontal pillars, biomechanical homologues of the mandible in the fixed facial mass, underline the functional interdependence of the osseous, dental and muscular systems of the cephalic region, a region which should be viewed as being in a stade of permanent dynamic equilibrium during growth and in the adult.

Biomechanical Phenomena↗
PubMed1999

Polyostotic fibrous dysplasia with craniofacial localization presenting with frontal lobe compression in a 14-year-old girl.

We describe a rare case of polyostotic fibrous dysplasia with craniofacial localization associated with involvement of the spine and extremities. A 14-year-old girl presented with progressive headache, left frontal swelling, exophthalmos of the left eye, deformity and palpable mass in the left frontal area. Cranial computerized tomography revealed extensive involvement of all cranial bones except right frontal and right parietal bones. Most of the facial bones were invaded. Especially, there was the involvement of ethmoidal air sinuses and frontal sinus also. Computerized tomography showed left frontal lobe compression. In addition, the spine and bones of the extremities were involved in the patient. Craniofacial approach was planned. Cranial surgery was performed by an extradural frontal approach. Firstly, the frontal cyst was excised. For left frontal lobe decompression, we removed successfully all the abnormal bones causing mass effect and frontal deformity. Secondly, facial surgery was performed with external approach. An attempt to remove all of the involved bone is necessary, as the lesion may recur and grow if a portion of dysplastic bone is left in place. However, the present case suggests that removal of all the involved bones in the polyostotic fibrous dysplasia may be possible in spite of extensive involvement. In this situation, it may be removal of only abnormal bones responsible for compression of affected neural elements is indicated.

Adolescent↗
PubMed2005

Value of multidetector computed tomography in assessing blunt multitrauma patients.

PURPOSE: To find out if multidetector computed tomography (MDCT), using a dedicated trauma protocol, provides sufficient diagnostic information of the injuries of blunt multitrauma patients to enable the planning of treatment for all body compartments. MATERIAL AND METHODS: One-hundred-and-thirty-three patients exposed to high-energy trauma were referred and scanned with the standardized MDCT multitrauma protocol. The imaging protocol consisted of axial scanning of the head and helical scanning of the facial bones, cervical spine, thorax, abdomen, and pelvis. The scanning times were 12 s for the head, 19-21 s for the facial bones and cervical spine (1 mm collimation), and 32-50 s for the thorax, abdomen, and pelvis (2 mm collimation). One-hundred-and-forty milliliters of non-iodinated contrast material (300 mg I/ml) was administered intravenously at 3 ml/s. RESULTS: Ninety-nine of the patients (74%) had at least one finding consistent with trauma. The most frequent findings were in the thorax in 58 patients (44%). Nineteen false-negative findings and two false-positive findings were made. The overall sensitivity of MDCT was 94%, specificity 100%, and accuracy 97%. CONCLUSION: MDCT is accurate in the assessment of blunt multitrauma patients. The decision to treat the patient can be made on the basis of MDCT with a reasonable level of certainty.

Adolescent↗