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
Cieľ: Práca je retrospektívnym zhodnotením použitia transkonjunktiválneho operačného prístupu v maxilofaciálnej chirurgii ku zlomeninám dolného orbitálneho marga a ku spodine očnice analýzou dĺžky operačného času, výskytu perioperačných a pooperačných komplikácií a zhodnotením funkčného a estetického výsledku otvorenej chirurgickej liečby týchto zlomenín pomocou transkonjunktiválneho prístupu. Materiál a metódy: Práca prezentuje súbor všetkých pacientov, u ktorých sme v období od decembra 2017 do decembra 2021 využili transkonjunktiválny prístup. Uvádzame epidemiologické príčiny vzniku zlomeniny strednej etáže tváre. Dĺžku operačného času analyzujeme porovnaním dvoch skupín pacientov, kde v prvej skupine sme využili transkonjunktiválny prístup s laterálnou kantotómiou a v druhej kontrolnej skupine sme laterálnu kantotómiu nahradili kožným supraorbitálnym prístupom. Súčasne analyzujeme výskyt perioperačných a pooperačných komplikácii a ich výskyt porovnávame s publikáciami iných pracovísk. Výsledky: Transkonjunktiválny prístup sme využili 103-krát u 89 pacientov (u 14 pacientov sme využili bilaterálny transkonjunktiválny prístup). V prípade využitia laterálnej kantotómie k rozšíreniu transkonjunktiválneho prístupu, laterálna kantotómia operačný čas nepredlžuje. Perioperačné komplikácie v zmysle perforácie dolnej mihalnice sme zaznamenali u 2 pacientov. Pooperačné komplikácie sme zaznamenali u 3 pacientov. Ektropium dolnej mihalnice bolo prítomné u jedného pacienta a entropium dolnej mihalnice sme pozorovali u dvoch pacientov, percento perioperačných a pooperačných komplikácii neprevyšuje výskyt týchto komplikácii pri transkutánnych prístupoch na infraorbitálne margo. Záver: Na základe výsledkov analýzy nášho súboru pacientov môžeme považovať transkonjunktiválny prístup za bezpečnú chirurgickú techniku spojenú s nízkym rizikom komplikácií, ktorá samostatne alebo v spojení s laterálnou kantotómiou nepredlžuje operačný čas a vďaka slizničnej incízii spojovky dolnej mihalnice úplne eliminuje kožnú jazvu na tvári. Naše výsledky sú porovnateľné s publikovanými výsledkami zahraničných autorov a pracovísk s väčšími súbormi pacientov, ktoré transkonjuktiválny prístup hodnotia ako rýchly, bezpečným chirurgický prístup k dolnému orbitálnemu margu, s nízkym rizikom komplikácii.
Aims: The aim of this study is to retrospectively evaluate the use of a transconjunctival surgical approach in maxillofacial surgery on the fractures of the infraorbital rim and the orbital floor by analyzing the operating time, the incidence of perioperative and postoperative complications, as well as the functional and aesthetic outcomes of transconjunctival surgical treatment. Materials and methods: All the patients on whom we used a transconjunctival approach from December 2017 to December 2021 were included in this retrospective study. The epidemiological causes of fractures of the midface skeleton were analyzed. The length of the operating time of the transconjunctival approach with lateral canthotomy was compared with a control group in which the supraorbital eyebrow approach was performed. In addition, we analyzed the incidence of perioperative and postoperative complications in comparison with publications from other centers. Results: We used the transconjunctival approach 103 times on 89 patients (in 14 patients the transconjunctival approach was performed bilaterally). In cases where the lateral canthotomy was used to extend the transconjunctival approach, there was no prolongation of the operating time. Perioperative complications included the perforation of the lower eyelid in 2 patients. In the postoperative period we recorded complications in 3 patients. Ectropion of the lower eyelid was present in one patient and entropion of the lower eyelid was observed in two patients. The percentage of perioperative and postoperative complications does not exceed the incidence of complications in transcutaneous approaches on the infraorbital rim. Conclusion: Based on the results of our study, we can consider the transconjunctival approach, either alone or in combination with lateral canthotomy,
- Klíčová slova
- transkonjunktivální přístup, otevřená operace,
- MeSH
- délka operace MeSH
- fraktury očnice * chirurgie MeSH
- lidé MeSH
- maxilofaciální poranění chirurgie etiologie MeSH
- oftalmologické chirurgické výkony metody MeSH
- peroperační komplikace MeSH
- pooperační komplikace MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- MeSH
- COVID-19 * komplikace MeSH
- jazyk MeSH
- lidé MeSH
- SARS-CoV-2 MeSH
- vřed MeSH
- vředy v ústech * etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- komentáře 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
Dentists play a key role in the primary prevention of oral diseases and related systemic complications; therefore, their views on behavioural interventions need to be aligned with the current agendas for oral health. Likewise, dental students' oral health-related knowledge, attitudes, and behaviours (KAB) are of practical importance, as they are the future opinion leaders for oral health in their respective communities. A cross-sectional survey-based study was designed to evaluate the oral health KAB of dental students in both the Czech Republic and Slovakia. The study utilized translated versions of the Hiroshima University Dental Behavioural Inventory (HU-DBI), and it aimed to recruit students from all Czech and Slovak dental schools. A total of 487 students were included in this study, out of which 372 (76.4%) were females, 271 (55.6%) were enrolled in preclinical years, 68 (14%) reported smoking tobacco at least once a week, and 430 (88.3%) reported problematic internet use. The mean HU-DBI score of Czech and Slovak dental students (8.18 ± 1.80) was comparable with the previously reported scores of dental students in Nordic and Western European countries. Czech students (9.34 ± 1.29) had a significantly higher score than their Slovak counterparts (7.56 ± 1.73). In both countries, preclinical students (8.04 vs. 8.35), the students who reported tobacco smoking (7.63 vs. 8.27), and those who reported problematic internet use (8.11 vs. 8.70) had significantly lower HU-DBI scores than their counterparts, respectively. In the Czech Republic, the significant increases in HU-DBI scores occurred after the first academic year when the students received preventive dentistry courses; therefore, one can put forward that early implementation of preventive elements in undergraduate dental curricula may yield better and more sustainable oral health gains for the students. Future research on Czech and Slovak dental curricula need to re-evaluate the oral hygiene and anti-smoking components and their impact on students' views and attitudes.
- MeSH
- lidé MeSH
- orální hygiena MeSH
- orální zdraví * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- studenti stomatologie * MeSH
- zdravé chování MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
- MeSH
- COVID-19 * MeSH
- halitóza * etiologie MeSH
- infekční nemoci * MeSH
- lidé MeSH
- orální zdraví MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- komentáře 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
mRNA-based COVID-19 vaccines such as BNT162b2 have recently been a target of anti-vaccination campaigns due to their novelty in the healthcare industry; nevertheless, these vaccines have exhibited excellent results in terms of efficacy and safety. As a consequence, they acquired the first approvals from drug regulators and were deployed at a large scale among priority groups, including healthcare workers. This phase IV study was designed as a nationwide cross-sectional survey to evaluate the post-vaccination side effects among healthcare workers in Slovakia. The study used a validated self-administered questionnaire that inquired about participants' demographic information, medical anamneses, COVID-19-related anamnesis, and local, systemic, oral, and skin-related side effects following receiving the BNT162b2 vaccine. A total of 522 participants were included in this study, of whom 77% were females, 55.7% were aged between 31 and 54 years, and 41.6% were from Banska Bystrica. Most of the participants (91.6%) reported at least one side effect. Injection site pain (85.2%) was the most common local side effect, while fatigue (54.2%), headache (34.3%), muscle pain (28.4%), and chills (26.4%) were the most common systemic side effects. The reported side effects were of a mild nature (99.6%) that did not require medical attention and a short duration, as most of them (90.4%) were resolved within three days. Females and young adults were more likely to report post-vaccination side effects; such a finding is also consistent with what was previously reported by other phase IV studies worldwide. The role of chronic illnesses and medical treatments in post-vaccination side effect incidence and intensity requires further robust investigation among large population groups.
- Publikační typ
- časopisecké články MeSH
