Temporomandibular disorders (TMD) are common disorders that usually involve temporomandibular joint (TMJ), masticatory muscles, and other relevant structures. The symptoms may vary limiting the patients’ quality of life. Many treatment options were proposed during the last years with the aim to treat the pathology. In this article, we analyze the effect of the injection of the fat-derived stem cell in the joint as a new treatment option.
The MRI method in fetal patients allows to obtain more details regarding the CL-CLP studied, allowing the medical-surgical team to plan, before the birth, the type of postnatal assessment and surgery to be performed, thus minimizing the impact on neonatal health and improving quality of life of both the patient and his family.
BackgroundHigh-energy non-missile penetrating injuries (stab injuries) account for a small percentage of penetrating head injuries and they present a series of special features.Case presentationA 35-year-old man suffered orbito-frontal? and trans-cranial injuries after falling five meters from a terrace onto a rod iron fence. The removal of the metal rod was performed outside the operating room. The orbital roof was exposed and repaired through a bifrontal craniotomy and the frontal sinuses were cranialised. The orbital floor and zygoma were plated with micro-screws.ConclusionThe patient recovered without significant complications, apart from a slight paresis of the right superior rectus; the ocular globe remained intact.The positive outcome obtained in this very challenging case is attributable to the competency of the Neurotrauma Unit and to the use of a synergistic approach which involved the contribution of neurosurgeons, maxillo-facial surgeons, radiologists and anaesthesiologists.
The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".
The aims of this study were to present a personal surgical technique throughout the review of international literature concerning surgical techniques, objectives, and outcomes in early secondary alveoloplasty and to describe our personal surgical techniques in alveolar bone defect repair in cleft lip and palate.Throughout a literature analysis, it is now settled that early secondary alveoloplasty could reestablish the continuity of alveolar bone and prevent upper dental arch collapse after presurgical orthopedic upper maxilla expansion; it also might give a good bone support for teeth facing the cleft and allow the eruption of permanent elements with the bone graft and rebalance the symmetry of dental arch, improve facial aesthetic, guarantee an adequate amount of bone tissue for a further prosthetic reconstruction with implant, and finally close the eventual oronasal fistula.The surgical technique we are presenting permitted a total number of 35 early secondary alveoloplasty on which a long-term follow-up is still taking place.We can assess that early secondary alveoloplasty must be performed before permanent canine eruption. Iliac crest is the suggested donor site for bone grafting; orthopedic and orthodontic treatments must be performed in association with surgery, and if there is the dental element agenesia, an implantation treatment must be considered.
The purpose of this study is to evaluate patient's outcomes after condylar fractures treated with the modified external fixation system from 2008 to 2012.A group of 58 patients with unilateral and bilateral fractures of mandibular condyle was admitted in the authors' study.The final sample included a total of 44 patients, 24 males (54.6%) and 20 females (45.4%).The remaining 14 (24%) patients were excluded because they did not fulfill all the criteria requested.After 12 months from surgery, the functional-clinical evaluation of mouth's maximum opening and mostly extent of lateral excursion and of protrusion showed the following results: 8% of the sample showed a maximum mouth opening <30 mm, 72% of the sample showed a maximum mouth opening between 30 and 40 mm, 20% of the sample showed a maximum mouth opening >40 mm lateral excursion (contralateral to fracture) and protrusion was respectively of 9.5 and 3.9 mm.Only 2 (4.5%) of the 44 evaluated patients reported headaches. 86.5% of the patients showed no postoperative temporomandibular joint dysfunction; 9% of them reported occasional clicking, while 4.5% reported recurrent disorders. The average satisfaction score of surgery outcome reported by patients was 94.5/100, and it ranged between 50/100 and 100/100.
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