Functional reconstruction of the mandible following resection or traumatic injury depends on the bony reconstruction and support dental implants. Microsurgical bone flaps allow the transfer of bone and soft tissue with a rich vascular supply and provide a firm basis for placement of dental implants in mandible reconstruction. Endosseous dental implants may improve functional restoration by ensuring the stable dentition essential for normal mastication and speech. In this review article, donor sites of microsurgical bone flaps, criteria for placement of dental implants, timing for dental implantation, bone resorption, role of radiotherapy and hyperbaric oxygen, and success rate of dental implants are discussed.
Studies describing healthcare workforce distribution are myriad. Little space, however, has been devoted to regional and local workforce issues. This literature review sought to first review national factors affecting healthcare supply, then progressively focus on the state and regional levels. The analysis concluded that, while healthcare workforce shortages are not present in Florida in terms of nursing, there is a significant gap between physician supply and demand. The results concluded that nearly all of the factors presented can be addressed through educational and health policy initiatives. Strategies were suggested to better meet the needs of Florida’s underserved populations through primary care providers.
The administration of regional or general anesthesia is dependent upon many factors to help reduce complications and improve patient outcomes after surgery. In this comparative analysis, the advantages and disadvantages of both types of anesthesia as well as their respective contraindications are reviewed. Both regional and general anesthetics come with adverse effects including morbidity/mortality, and a certain threshold that warrants a type of anesthesia suitable for a surgical procedure. Although there are risks associated with both, certain patient populations may be at higher risk of complications including the elderly, severely ill, and individuals with specific medical conditions. A review of current literature advises the following factors to be examined prior to choosing an anesthesia method most appropriate for the patient including: body mass index (BMI), medical history, age, current medications, fasting time, alcohol/drug intake, pharmaceutical drug use, dental work and airway inspection, as well as neck flexibility and head extension. The research suggests that the patient be fully informed of the risks and benefits of both regional and general anesthesia, as well as taking part in the decision-making process.
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