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Results for “Maxillofacial Prosthesis”

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At least 649 records · Page 36Linked to original sources
PubMed2001

Candida albicans colonization on thermal cycled maxillofacial polymeric materials in vitro.

In the present study, the colonization of a single isolate of Candida albicans on saliva-, serum-coated or protein free (uncoated), thermocycled (4-70 degrees C for 1 min, respectively; 0, 1000 and 10 000 times) 15 commercial maxillofacial materials were investigated, by adenosine triphosphate (ATP) analysis. In the case of control specimens (not thermocycled and uncoated), the fungal colonization appeared to depend upon the type of commercial products used. Thus, the lowest colonization was observed with additional silicone materials, soft acrylic liners with visible light curing, except for one product, whereas visible light curing liners comprising of single paste or single gel exhibited the highest colonization capacity, and cold cured acrylic liners exhibited the intermediate. However, the fungal colonization on the materials was significantly promoted both by thermal cycling (ANOVA; P < 0.01) and a layer of protein coating (saliva, P < 0.01; serum, P < 0.01). When the inter-relation between the fungal colonization and the surface hydrophobicity of the materials were analysed, fungal colonization on 1000- and 10 000-thermocycled materials correlated well with the contact angles of the materials (Student's t-test, P < 0.01), being consistent with the thermodynamic theory. These results, taken together, suggest that the ageing of the materials and the biological fluids of the host promote yeast colonization on maxillofacial materials.

Acrylic Resins↗
PubMed2001

Candida albicans growth on thermal cycled materials for maxillofacial prostheses in vitro.

In the present study, the growth of a single isolate of Candida albicans on saliva-, serum-coated or protein free (uncoated), thermocycled (4-70 degrees C for 1 min, respectively; 0, 1000 and 10 000 times) 15 commercial maxillofacial materials was investigated, by monitoring pH changes in growth media. The inhibitory effect of the tissue conditioners on fungal growth was analysed using three parameters viz: (i) delay in the onset of the rapid decline in pH (ii) reduction in the rate of pH change and (iii) the pH minima reached. In the case of control materials (non-thermocycled and uncoated), significant antifungal effect was observed with two products. However, the antifungal effect of the materials was significantly reduced both by thermal cycling (Analysis of covariance [ANOVA]; P < 0.01) and a layer of protein coating (saliva, P < 0.05; serum, P < 0.01). When the interrelation between three parameters of fungal growth and the surface hydrophobicity of the materials were analysed, minimum pH of fungal growth on 10 000-thermocycled materials correlated well with the contact angles of the materials (Student t-test, P < 0.01), suggesting that thermocycling process reduced the unpolymerized components of the materials which showed the antifungal effects, resulted in that the cell growth depends on the surface hydrophobicity of the specimens. These results, taken together, suggest that the ageing of the materials and the biological fluids of the host enhanced the fungal growth on maxillofacial materials.

Acrylic Resins↗
PubMed2002

Difficult tracheal intubation induced by maxillary distraction devices in craniosynostosis syndromes.

BACKGROUND: Difficult intubation occurred during anaesthesia for removal of maxillary distraction devices in five of seven children with syndromal craniosynostoses (four with Apert, two with Pfeiffer and one with Crouzon syndrome). METHODS: Intubation was assessed in terms of laryngeal view and an established intubation difficulty score and had been straightforward before device insertion. Difficulty was induced by trismus due to device insertion and by increased maxillary prominence. This was compounded by preexisting mandibular hypoplasia. Cephalometric analysis, with each child acting as their own control, demonstrated anterior displacement of the maxilla and increased maxillary vertical height, as well as increased protuberance of the maxillary incisors. RESULTS: All five difficult tracheal intubations were associated with preoperative Mallampati scores of 3 or 4 and the nine straightforward intubations with scores of 1 or 2. Maximal interincisor distance was less than the lower 95% confidence limit for age in all five children who were difficult to intubate at the time of device removal. No child had a failed intubation, but all had significantly increased intubation difficulty. CONCLUSIONS: In view of the risks of trauma, hypoxia and aspiration associated with difficult direct laryngoscopy, we recommend elective fibreoptic intubation at anaesthesia for removal of maxillary distraction osteogenesis devices in these children.

Adolescent↗
PubMed2003

Metastatic basal cell carcinoma.

BACKGROUND: Basal cell carcinoma is the most common malignancy of humans. Although it is axiomatic that this tumor does not evolve into metastatic disease, such events rarely occur, and this possibility should not be overlooked. OBJECTIVES: The reader should better understand the sequence of events that resulted in metastatic disease and how these events are emblematic of the rare cases of basal cell carcinoma that systemically spread. METHODS: We present a case report of basal cell carcinoma that underwent distant metastasis. A short review of the literature is included. RESULTS: Although basal cell carcinoma is commonly considered a regional tumor with virtually no propensity for distant spread, this case reveals that metastatic disease does occur and with devastating results. CONCLUSION: Metastatic disease in basal cell carcinoma is a very rare but catastrophic consequence of this very common skin malignancy.

Bone Neoplasms↗
PubMed2001

Measurement of the maxilla and zygoma as an aid in installing zygomatic implants.

PURPOSE: This study used maxillary and zygomatic measurements to obtain information for installing zygomatic implants. PATIENTS AND METHODS: Angular and linear distances between the maxilla and the zygoma were measured in 12 cadavers (n = 22 sides) classified into short and tall groups by height (140 to 159 cm and 160 to 180 cm, respectively). RESULTS: Based on mean and standard deviation values, the installation angle of zygomatic implants was between 43.8 degrees and 50.6 degrees. The distance between the crest of the maxillary alveolar process near the palate and the jugale (Ju) point of the zygoma was between 44.3 and 54.3 mm. The minimum distance between the most lateral corner of the maxillary sinus and the Ju point was 6.41 mm, and the minimum anteroposterior length of the zygoma was 5.68 mm in the shorter group. CONCLUSIONS: When the installation angle of zygomatic implants is 43.8 degrees or less, perforation of the maxilla and the zygoma or the infratemporal fossa must be avoided. When the angle is 50.6 degrees or more, perforation of the orbital floor must be avoided. Special attention is needed to ensure osseointegration in shorter patients, because the distance between the most lateral corner of the antrum supporting the zygomatic implant and the Ju point is 10 mm or less. The apex of the implant is 3.75 mm in diameter, and the thickness of the zygoma must be 5.75 mm or more. The threads of the implant must not be exposed from the zygoma in shorter patients.

Body Height↗
PubMed2002

Soft tissue healing after parasagittal palatal incisions in segmental maxillary surgery: a review of 311 patients.

PURPOSE: This study retrospectively evaluated the soft tissue healing after using parasagittal soft tissue incisions for surgical segmental maxillary expansion. PATIENTS AND METHODS: The records of 311 patients (224 females, 87 males), with an average age of 28.5 years (range, 12 to 62 years) who had transverse maxillary hypoplasia, were retrospectively evaluated. All patients underwent segmental maxillary osteotomies, surgical maxillary expansion greater than 5 mm, and placement of midpalatal porous block hydroxyapatite (PBHA). Parasagittal palatal soft tissue incisions were used to facilitate expansion, minimize soft tissue damage, and maintain soft tissue coverage over the PBHA implants. At postoperative follow-up visits, any signs or symptoms of complications associated with the use of the parasagittal incisions were recorded. RESULTS: Average patient follow-up was 3.4 years (range, 1.0 to 7.2 years). In 293 patients (94%), the palates healed uneventfully without complications. Eighteen patients (6%) had complications; 9 (2.9%) had infections associated with the midpalatal implants, 8 (2.6%) had oronasal communications, and 1 (0.3%) had problems associated with a palatal wire. Six patients with midpalatal implant problems required removal of the implant, 4 patients required closure of their oronasal communications, and 1 patient required removal of a palatal wire. Therefore, 11 patients (3.5%) required minor secondary surgical procedures. No teeth or alveolar bone were lost in any of the cases. CONCLUSIONS: The use of parasagittal palatal incisions appears to be a safe technique for soft tissue management during large surgical maxillary expansions associated with segmental maxillary osteotomies and midpalatal placement of PBHA implants.

Adolescent↗
PubMed2001

Outcome of extra-oral craniofacial endosseous implants.

We report our experience of endosseous implants designed to retain various types of facial prostheses that were inserted by the West of Scotland Oral and Maxillofacial Surgery Service between January 1988 and September 1998. Forty-seven patients were given a total of 150 implants, most of which were auricular (n= 85) or orbital (n= 53). The functioning success rates were 100% and 75%, respectively. Soft tissue infection was the commonest complication, and could occur at any time after exposure of the implant, suggesting that life-long follow-up is required.

Adolescent↗
PubMed2000

A 5-year review of 71 consecutive anterior skull base tumours.

Techniques used in craniofacial surgery have found extensive application in the management of skull base tumours. The improved exposure gained via osteotomies for facial disassembly has facilitated the en-bloc resection of tumours with clear surgical margins, and the advent of vascularised seals has significantly reduced the risk of meningeal contamination. We present our experience with the extirpation and reconstruction of 71 benign and malignant tumours of the anterior skull base over a 5-year period. Survival and functional outcome data are presented, with an emphasis on the wide range of pathologies and primary treatment strategies seen at presentation. Criteria used in flap selection and the role of prosthetics are discussed. Observations are offered on salvage surgery, demonstrating that excellent palliation can be achieved, even in cases with massive recurrent disease.

Adolescent↗
PubMed2001

Dynamic study about metal release from titanium miniplates in maxillofacial surgery.

It has been shown that titanium (Ti) has had dramatic success in many surgical procedures as a result of its excellent mechanical properties and resistance to corrosion. There is still concern, however, about the release of metal and controversy surrounding whether or not the plates should be removed after bone healing. This study has been conducted to investigate whether or not there is a relationship between duration of plating and metal release from Ti miniplates in maxillofacial surgery. A prospective cohort study design was used. The concentration of Ti, in the soft tissues covering the plates, was examined in all patients who underwent removal of Ti miniplates from January 1998 to April 1999 (51 cases). Inductively Coupled Plasma-Optical Emission Spectrometry was used to measure Ti. Total ti and soluble Ti levels were compared to duration of plating (ranged from 15 days to 3 years, mean = 8 months). Correlation coefficients and two-way ANOVA were data processed. The average amount of total Ti in the soft tissues surrounding the plates was 1306 micrograms/g dry tissue. The mean of soluble Ti was 0.53 microgram/g dry tissue. The results of this study do not support the existence of a relationship between duration of plating and total Ti (correlation coefficient = 0.093 (P > 0.1) nor soluble Ti (correlation coefficient = 0.009 (P > 0.1) in the soft tissue surrounding the plates. Moreover, the only independent factor of Ti release found was associated with mechanical constraints during surgery. Almost 100% of Ti is released during the osteosynthesis. Then Ti levels remain constant in the surrounding tissues. Most of the time, Ti seems to be clinically inert. Compared to the possible risks of a second operation, removal of Ti miniplates should not be a routine procedure except in the case of complaints from patients, particularly in the case of infection, hypersensitivity, dehiscence or screw loosening.

Adolescent↗
PubMed2002

Skeletal stability of Le Fort I osteotomy in patients with isolated cleft palate and bilateral cleft lip and palate.

The skeletal stability of Le Fort I osteotomy was evaluated retrospectively in 14 patients with isolated cleft palate (CP, mean age 27.2 years) and 11 patients with bilateral cleft lip and palate (BCLP, mean age 23.7 years). The osteotomy was fixed with titanium plates and the osteotomy gap was grafted with autologous bone. Neither intermaxillary fixation nor occlusal splints were used postoperatively. Skeletal stability was analysed both horizontally and vertically by cephalograms taken shortly before operation, immediately afterwards, and at six months and at one year postoperatively. In the CP group the mean maxillary horizontal advancement (point A) was 4.7 mm (range 0.3-7.8) and the mean vertical lengthening 3.6 mm (range 0.7-6.1). One year postoperatively the mean relapse was 8.5% (0.4 mm) horizontally and 16.7% (0.6 mm) vertically. In the BCLP group the mean horizontal advancement was 5.3 mm (range 0.2-10.7) and the mean vertical lengthening 7.3 mm (range 0.6-11.8). The mean postoperative relapse was 9.4% (0.5 mm) horizontally and 17.8% (1.3 mm) vertically. The skeletal stability and relapse were similar in both cleft types although BCLP patients had more residual cleft problems and their mean surgical advancement was greater. There was great individual variation.

Adolescent↗
PubMed1999

Skeletal implants in aesthetic facial surgery.

The features of the nose, mentum, and malar complex define a person's profile and give the essence of character to the visage. Whether profile deficiencies are due to congenital, traumatic, or aging factors, facial plastic surgeons are able to meet patients' and their own exacting demands more thoroughly with skeletal implants. Although the search for the perfect implant continues, today's armamentarium of implant materials is vast and, with appropriate selection and attention to technique, facial skeletal implants can be successful in creating change impossible to obtain with soft tissue techniques alone. This article reviews both the biomaterials used in mandibular and malar complex implants and the techniques.

Biocompatible Materials↗
PubMed1999

Treatment of Romberg's disease with parascapular free flap and polyethylene porous implants.

Romberg's disease is a rare condition characterized by progressive hemifacial atrophy. The atrophic process typically has its onset in the first or second decade of life, it continues for a few years (usually 2, but up to 10), and then it stops spontaneously. The subcutaneous tissue is the first to be involved by the disease, followed by muscles, bones, and, rarely, the skin. The etiology of the disease is unknown. The only available treatment is surgical. Several techniques have been reported in the literature, from fat transplant, to silicon prostheses, to the use of flaps. We present our experience in successfully treating six patients (3 males and 3 females) affected by Romberg's hemifacial atrophy of intermediate or severe degree. A technique including a free parascapular microvascular flap with the adjunct of porous polyethylene implants was used. Further correction was performed with remodeling or resuspension.

Adipose Tissue↗