Placing dental implants in microvascular bone free flaps used for reconstructing the mandible or maxilla has been previously reported. However, there is scarce information available on the restorative protocol using short dental implants placed in a deep circumflex iliac artery (DCIA) microvascular free flap and the rationale behind it. This case report describes a 18-year-old patient referred to the hospital for numbness and dull pain of the left mandible, which she observed for three months. The patient underwent mandible resection and reconstruction using the DCIA free flap due to "giant cell lesion" on the left side of the mandibular angle. Short dental implants were placed and prosthetic reconstruction of the dentition involved in the resection was performed in a young patient with two integrated abutment crowns. The placement of short dental implants did not negatively affect the vascular pedicle and vitality of free flap. In our case report, two years after the healing, excellent aesthetic and function were accomplished with the DCIA flap followed by restoration with short implants.
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
There is limited information regarding implant and prosthetic survival after osseous microvascular free flap (OMFF). This case series aims to describe the placement of short and extra short implants in osseous microvascular free flaps to support prostheses, and present an up to 40-month retrospective follow-up. Short and extra short dental implants were placed in six fibula free flaps (FFF) and in two microvascular deep circumflex iliac artery (DCIA) flaps. In total, 27 short and extra short dental implants have been placed into two different types of free flaps. Kaplan-Meyer (K-M) survival analyses were performed to evaluate the survival and success outcomes of implants and prostheses. Out of the eight patients reconstructed with free flap, five were rehabilitated with prostheses, one patient has a temporary prosthesis, and two patients are in the process of prosthetic rehabilitation. Twenty-seven implants were followed up for up to 40 months, and K-M analyses showed 100% implant survival probability (95% confidence interval: 100%), while the implant success probability was 91.0% (95% confidence interval: 68.6-97.7%). Short and extra short dental implants placed in OMFF presented high survival and success rates in a retrospective case series after up to 40 months.
- Publikační typ
- časopisecké články MeSH
Článek poskytuje základní informace o možnostech zavedení dentálních implantátů do mikrovaskulárních kostních laloků. Mikrovaskulární kostní laloky jsou nyní zlatým standardem pro léčbu nejen onkologických pacientů s malignitami v oblasti hlavy a krku, ale také u pacientů s pokročilou osteonekrózou nebo posttraumatickými defekty maxily a mandibuly. Univerzální metoda používaná pro rekonstrukci horní nebo dolní čelisti je rekonstrukce fibulárním lalokem, který je dnes jedním z nejčastěji používaných mikrovaskulárních laloků. Rehabilitace onkologických pacientů s pomocí konvenčních celkových nebo částečných snímatelných náhrad je obtížná nebo nemožná, i když je rekonstrukce čelisti pomocí laloku ideální. Zavedení dentálních implantátů do mikrovaskulárního laloku komplikuje široká škála faktorů od změněných anatomických poměrů v dutině ústní, snížené nebo zvýšené výšky kosti laloku – neoalveolu oproti mandibule nebo maxile, nebo omezeného otevírání úst. V neposlední řadě musíme brát v úvahu časové hledisko pro eventuální radioterapii. Velká pozornost je věnovaná i obnově objemu a kvality měkkých tkání nově vytvořené čelisti. V přehledu jsme dále shrnuli poznatky o časových faktorech důležitých pro implantaci, způsobu implantace i komplikacích. Na konci článku jsme se zaměřili na doporučení pro praktické zubní lékaře, pokud v praxi ošetřují pacienta s volným lalokem rekonstruovaným dentálními implantáty.
The article provides basic information about the possibilities of jaw reconstruction with microvascular bone flaps and dental implants. Microvascular bone flaps remain the gold standard for the treatment of not only oncological patients with malignancy of the head and neck, but also of patients with advanced osteonecrosis or post-traumatic defects of maxilla or mandible. The universal method used for the reconstruction of the upper or lower jaw is a free fibular flap, which is today one of the most commonly used microvascular flap. Rehabilitation of oncological patients with the help of complete or partial removable dentures is difficult or impossible, although the reconstruction of the jaw with the flap is ideal. Insertion of dental implants into the microvascular flap is complicated by a wide range of factors ranging from altered anatomical conditions in the oral cavity, reduced height of the fibular flap compared to the mandible or maxilla or limited mouth opening. Last but not least, time factor for eventual radiotherapy has to be considered. In the review, we have further summarized the knowledge of time factors important for implantation, the method of dental implant placement and complications. Special attention has been paid to the renewal of the volume and quality of the soft tissues. At the end of the article, we focused on recommendations for general dentists in practice, who treat and follow patients with a free osseous flap with dental implants.
- Klíčová slova
- mikrovaskulární kostní lalok,
- MeSH
- lidé MeSH
- volné tkáňové laloky chirurgie transplantace MeSH
- zubní implantáty * MeSH
- zubní lékaři MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- chirurgická dekomprese metody MeSH
- cysty * chirurgie MeSH
- lidé MeSH
- maxilofaciální poranění chirurgie MeSH
- senioři MeSH
- stomatochirurgické výkony * metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- COVID-19 * MeSH
- kožní nemoci * MeSH
- lidé MeSH
- recidiva MeSH
- SARS-CoV-2 MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
BACKGROUND: The critically ill patients suffering from coronavirus disease (COVID-19) and admitted to the intensive care units (ICUs) are susceptible to a wide array of complications that can be life-threatening or impose them to long-term complications. The COVID-19 oral mucocutaneous complications require multidisciplinary management and research for their pathophysiological course and epidemiological significance; therefore, the objective of this study was to evaluate the prevalence and characteristics of the critically ill COVID-19 patients with oral complications. METHODS: We described the clinical and microbiological characteristics of the critically ill COVID-19 patients in our ICU department (Banska Bystrica, Slovakia). In addition, we reviewed the current body of evidence in Ovid MEDLINE®, Embase, Cochrane Library, and Google Scholar for the oral mucocutaneous complications of ICU patients with COVID-19. RESULTS: Three out of nine critically ill patients (33.3%) in our ICU department presented with oral complications including haemorrhagic ulcers and necrotic ulcers affecting the lips and tongue. The microbiological assessment revealed the presence of opportunistic pathogens, confirming the possibility of co-infection. On reviewing the current literature, two hundred ten critically ill patients were reported to have oral complications due to their stay in the ICU setting. Perioral pressure ulcers were the most common complication, followed by oral candidiasis, herpetic and haemorrhagic ulcers, and acute onset macroglossia. The prolonged prone positioning and mechanical ventilation devices were the primary risk factors for those oral complications, in addition to the immunosuppressive drugs. CONCLUSIONS: The multidisciplinary approach is strongly advocated for monitoring and management of COVID-19 patients, thus implying that dermatology and oral healthcare specialists and nurses should be integrated within the ICU teams.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
