Maxillofacial Reconstructive Surgery Research Articles

Plastic and Reconstructive Surgery in the Wake of the Eid al-Adha: A Single-Center, Five-Year Investigation.

(1) Background: The Festival of Sacrifice, commonly known as Eid al-Adha, has a profound religious and cultural impact on nations with a Muslim majority. This festival is celebrated every year in Muslim countries; however, it is a time in which patients present to the emergency department with serious injuries. In our study, we examined current injuries occurring during Eid al-Adha in one of the largest hospitals in Türkiye, providing the largest patient population to date. This included mapping tendon and maxillofacial injuries, a first in the literature. To the best of our knowledge, this is the largest case series of injuries sustained during Eid al-Adha. The significance of this study lies in its potential to significantly benefit patients and healthcare systems by providing reference data. (2) Methods: Patients admitted to Ankara City Hospital during Eid al-Adha between 2019 and 2023 were examined. The demographic characteristics, injury patterns, and injury sites of patients admitted on the four days of Eid al-Adha were collected and analyzed. Maxillofacial traumas during the festival were analyzed. Tendon injuries on the left hand, which is the most commonly injured body part in the literature, were mapped into a figure. To compare the change in the number of patients, a comparison was made with the number of patients in our hospital for four consecutive days 2 weeks before Eid. Statistical analysis was performed using IBM SPSS Statistics for Windows. (3) Results: A total of 610 patients, including 101 female and 509 male patients, were included in this study. A statistically significant increase (p < 0.001 for all years) in hospital admission due to injury was observed. Individuals between the ages of 30 and 40 years were the most frequently admitted patients (n = 182, 29.8%). Knife injuries were significantly more common in all patients (p < 0.001). When the total number of patients was evaluated in terms of injured areas where patients present to the emergency department, left-hand injuries were found to be significantly more common than injuries in other areas (p < 0.001 for all). The extensor pollicus longus tendon was the most commonly injured tendon among all extensor and flexor tendon injuries (n = 104). The most commonly injured tendon was the flexor tendon in zone 2 of the first finger (n = 45). This study showed that injuries to the extensor tendon in zone 1 of the fifth finger, the flexor tendon in zone 4 of the first finger, and the flexor tendon in zone 1 of the fifth finger were never seen. Twenty-five patients with maxillofacial injuries were admitted to the hospital. Orbital floor fractures were the most common type of maxillofacial injury. The anesthesia technique we preferred for all patients was local anesthesia (n = 267). Wide-awake local anesthesia no tourniquet (WALANT) was the second most preferred anesthetic technique. The number of patients who were selected in a random 4-day period for each year were compared with the number of patients who came during Eid al-Adha. The Mann-Whitney U tests revealed a significant increase in injuries on the first day of Eid al-Adha compared to non-festival days (p < 0.001). However, no significant differences were observed on the subsequent days or in the overall injury counts during the festival period (p = 0.841 for day 2, p = 0.151 for day 3, p = 0.310 for day 4). (4) Conclusions: According to this study, which is the largest known case series in the literature, the number of patients admitted to the hospital increased annually. In our study, we observed a significant increase in injuries only on the first day of Eid al-Adha compared to a randomly selected 4-day period of the same year. Left-hand extensor tendon injuries from a knife were the most common injuries in middle-aged men. The extensor pollicis longus tendon was the most commonly injured extensor tendon, with zones 3 and 4 being the most commonly affected. The flexor pollicis longus tendon was the most commonly injured flexor tendon in zone 2. During this period, patients may not only need hand surgery but also maxillofacial plastic surgery. We recommend, in addition to the indications I,n the literature that during Eid al-Adha, the WALANT technique should be widely adopted in patients where local anesthesia will be insufficient. We also recommend utilizing a diagram to manage the patient load during Eid al-Adha and prevent overburdening the healthcare system.

Management of Edentulous Patients with Maxillary Substance Loss: A Case Report

Depending on the location and extent of the loss of substance following maxillary resection surgery, all functions of the masticatory apparatus may be adversely affected. Eating and communication are impaired, which has a negative impact on the patient's psychological state [1]. When reconstructive maxillofacial surgery is not possible, rehabilitation with a maxillofacial prosthesis is essential. It must restore functions (phonation, eating, breathing, etc.) and reintegrate the patient into his psychosocial environment by masking his disability [2]. To achieve these objectives, this prosthesis, like a conventional removable prosthesis, must meet the Housset triad (support - retention - stabilisation), but also the objective of tightness. We therefore speak of a "prosthetic tetrad in PMF" (Housset's triad completed by the objective of tightness) [3]. In the case of a completely edentulous arch with substance loss, the treatment becomes more complex due to the reduced support surface. The maxillofacial prosthodontist must therefore be extremely vigilant to ensure the success of this appliance. A wise choice of technique and impression material, as well as respect for the occlusal parameters (occlusal plane, vertical dimension, centric relation, etc.) will ensure prosthetic stability and integration [4]. In this article, we will focus on the peculiarities of the management and the different stages in the fabrication of a maxillofacial prosthesis for a patient with total edentulism and loss of maxillary substance.

ELECTROMAGNETIC PROPERTIES OF CEMENTS FOR FIXATION OF ORTHOPEDIC CONSTRUCTIONS

Introduction. In practical dentistry, a significant number of various materials are used - for filling teeth, for implant restorative surgery, as well as materials for prosthetics. In this case, metals, dielectrics and their combinations are used. The article is devoted to the results of the study of electromagnetic properties of a group of dental materials - fixing cements, which belong to dielectric materials. Theoretical and experimental studies of EMC materials from the arsenal of maxillofacial reconstructive and restorative surgery were also conducted. Significant EMC deviations were detected in some materials. Scientific results of experimental studies and relevant recommendations are presented in a number of authors publications both in Ukraine and abroadMain purpose of this study. Usually, the orthopedic constructions and the fixation cement are in physical contact with both the patient's hard and soft tissues. Since dielectric materials at a human body temperature of 310K form their own electromagnetic radiation (EMR), it is important to ensure their electromagnetic compatibility - the coincidence of EMR with biological tissues adjacent to the implant to exclude the appearance of complications during their long-term use. A highly sensitive (10-14 W) microwave radiometric system was used for the measurements. In process of research, the five most commonly used cement samples in orthopedics were studied. Therefore, the purpose of this study is to determine the radiative capacity of cement as a material widely used in dental practice and to evaluate their level of electromagnetic compatibility with contacting biological tissues.Conclusions. 1. In the process of experimental and computational studies, the emissivity coefficients βM of 5 cement samples were determined, which range from 0.13 to 0.63 units.1.2. The first three samples (№№ 3-5) have a high level of electromagnetic compatibility (60...98 %), samples (№№ 6, 7) show much less coincidence with the EMR of the human body.3. The results of the conducted research can be used by orthopedic specialists to select materials with greater electromagnetic compatibility.

Features of the organization of dental care in besieged Leningrad

Not much information is available about the provision of dental care during the Great Patriotic War, and publications concerning dental care in besieged Leningrad are even limited. All dental care during the war in the country was mainly aimed at treating wounds on the face. On the home front, dental care was provided to workers and employees working in the defense industry. Therefore, medical and sanitary units were created at large defense enterprises, which included closed hospitals, polyclinics, and outpatient clinics. Three frontline evacuation hospitals were located in the clinics of the Military Medical Academy, where the doctors and entire medical staff of the academy worked. The chief dentist of the Red Army, David Abramovich Entin, and the chief dentist of the navy, Vladimir Mikhailovich Uvarov were primarily responsible for the organization of dental care and specialized assistance to servicemen with maxillofacial wounds. The hospitals were formed based on the clinics of the 1st Leningrad Medical Institute, including clinics for maxillofacial surgery. At the 2nd Leningrad Medical Institute during the blockade, extremely urgent problems related to combating scurvy developed. The Central State Institute of Traumatology named after Professor R.R. Vreden, where A.A. Limberg and his colleagues worked, occupied an important place in the provision of surgical and orthopedic care in besieged Leningrad. Dental care in besieged Leningrad was provided as part of medical and preventive institutions. As of November 1, 1942, dental outpatient clinics of Vasileostrovsky, Volodarsky, Kuibyshevsky, and Petrogradsky districts were successfully functioning. After the end of the siege in 1944, active work began on the restoration of the city. During the reconstruction of the city, the number of new medical institutions has also increased. In the autumn of 1944, the construction of the second clinical base of the State Institute for Further Training of Physicians was completed, in which the clinic of reconstructive maxillofacial surgery was located. The problem of the health of people who survived the blockade of Lenin remains relevant today, many decades later. Numerous publications have been devoted to generalizing the experience of treating wounded with maxillofacial injuries in combat conditions.

Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years

ObjectivesUp-to-date literature regarding long-term success of implant rehabilitations after microvascular reconstructions with free fibula flap (FFF) is still very scarce. This study aimed to evaluate clinical outcomes, especially related to oral hygiene conditions, of patients rehabilitated with this technique.Materials and methodsA total of 25 patients who underwent maxillofacial reconstructive surgery with FFF were retrospectively evaluated for soft tissues conditions, oral hygiene habits, and implant survival and success, assessed with a mean follow-up of 6 (range 2–15) years after loading.ResultsFourteen patients received full-arch fixed prostheses and 11 removable bar-supported overdentures. At the follow-up evaluation, 52% of prostheses did not allow proper accessibility for oral hygiene. Overall prosthetic survival was 100%, and implant survival and success were respectively 93.6% and 72%. Prevalence of peri-implantitis was 29% at implant level and that at patient level 96%.ConclusionsSix-year clinical outcomes of this study reveal that poor oral hygiene practices and compliance by patients who underwent maxillofacial reconstruction with FFF are significantly associated with peri-implant disease.Clinical relevanceFindings of the present study underline the need by clinicians for a careful assessment, in reference to a specific implant therapy, of patient’s prosthetic accessibility for oral hygiene procedures.

HISTOMORPHOMETRIC ASSESSMENT OF ARCHITECTONICS AND VASCULARIZATION IN MAXILLARY ALVEOLAR PROCESS BONE TISSUE

The expansion of the most relevant priority fields in fundamental and applied medicine, along with the progress in modern dentistry and reconstructive maxillofacial surgery, requires in-depth understanding of the morphological and functional status of the maxillary alveolar process bone tissue and knowledge of the mandibular alveolar part, thus allowing selecting a reasonable treatment tactics for maxillofacial pathologies. Qualitative features of maxillary alveolar process microarchitectonics, angioarchitectonics, as well as the periodontal ligament arrangement at various levels of the teeth roots, histological and morphometric studies of bone tissue in the frontal and distal sections, as well as the maxillary segments of the maxillary medial incisors and the first molars were studied in 5 certified male cadavers with preserved dentition. The histological findings show, that the microarchitectonics of the maxillary alveolar process features a lamellar bone consists of plates that are adjacent tightly to each other. The bone plates orientation in the frontal section is longitudinal, while in the distal part it is along concentric circles located around the Haversian canals. The angioarchitectonics of the maxillary alveolar process features tubular structures, which run mainly perpendicular to the bone surface, with numerous anastomoses. As the morphometric analysis of the maxillary alveolar process vascular system shows, in the frontal section the number of vessels per 1 mm2 is 22.41± 1.76 - 22.87± 2.08; in the distal section − 23.94± 1.88 - 25.02±2.69 (p≤0.01); the average diameter of vessels in the frontal section is 25.34±2.45 microns – 26.06 ±3.17 microns, in the distal section − 25.72±2.31 microns – 26.14± 2.93 microns (p≤0.05); the average wall thickness in the frontal section is 1.43± 0.09 microns - 1.48± 0.12 microns, in the distal section − 1.50± 0.11 microns – 1.54± 0.14 microns (p≤ 0.01). The vestibular surface of the maxillary medial incisors at the level of the root gingival part, as well as the oral surface at the root apical level have been found to be zones of periodontal ligament compression, while the oral surface at the root gingival level and the vestibular surface at the root apical level – zones of the periodontal ligament stretching. At the root gingival level of the first maxillary molars, the medial and vestibular surfaces are zones of the periodontal ligament compression, whereas the oral and the distal surfaces stand as the zones of the periodontal ligament stretching. As a quantitative assessment showed, the structural elements of the medial incisors periodontal ligament, and the first maxillary molars had loose connective tissue – taken by its specific area – prevailing in the periodontal ligament compression zone; the specific area of dense connective tissue, though, was found to be prevailing at the periodontal ligament stretching zone under chewing stress. The data obtained through a quantitative analysis of the periodontal ligament microvascular bed of the medial incisors, and the first maxillary molars, reveal that the area with blood vessels in the compression zones by far exceeds the area of blood vessels in the stretching zones. It appears rather reasonable that in case of a biomechanical stress experienced by the incisor-maxillary and molar-maxillary segments of the upper jaw, the periodontal ligament morphology will change throughout the root, depending on the compression and stretching zone localization.

Mandibular Myxoid Liposarcoma: a Case Study.

Liposarcomas are described as soft tissue sarcomas derived from adipose tissue. The finding of this tumor in the mandibular region is exceedingly rare. As of now, it has been described mainly in case reports and small series. A multidisciplinary approach is required to offer optimal treatment and may involve surgery, radiation and systemic therapies. Surgical repair of these defects represents a major challenge in oral and maxillofacial reconstructive surgery. We present the case of a 54-year-old man referred to our center with a progressively increasing mass in the anterior portion of the mandible. Biopsy revealed a well-differentiated myxoid liposarcoma. Resection of the tumor was performed with an additional primary reconstruction.

Microbiology of Facial Skin Infections—Strains, Susceptibility, and Therapeutic Consequences

Skin and soft tissue infections (SSTIs) are common conditions with severe and potentially life-threatening outcomes. However, the use of antibiotics to treat these infections is controversial. This study was to identify the microorganisms responsible for facial SSTIs, their antibiotic sensitivities, and the therapeutic outcomes of treatment. This was a retrospective, observational cohort study conducted at a single oral and maxillofacial plastic surgery department. The study sample included 103 patients with facial SSTIs (61 men, 42 women) with a mean age of 41.8years (standard deviation±20.4). The predictor variables included patient characteristics, antibiotic use before the clinic visit, and the infection's site and origin. The primary outcome variable was the presence of antibiotic resistance in the bacterial strains isolated from the infections. The data were collected by reviewing the results of microbiological swabs and patient records obtained from patients with facial SSTIs. Categorical variables were described using absolute and relative frequencies, and continuous variables were described using mean and standard deviation. The association between antibiotic resistance and the predictor variables was analyzed using Pearson's χ2 test and student's t test. The most common cause of SSTI was an infected epidermal cyst (60.1%). Of all the microorganisms identified, 80.6% were Gram-positive, and 55.8% showed antibiotic resistance against one or more of the evaluated antibiotics, including several backup antibiotics. There were no identified risk factors that significantly influenced the probability of resistance, and there were no adverse events observed. The results of this study suggest that surgery should be the primary approach for treating SSTIs, as antibiotic administration may not be effective due to the unknown susceptibility of the causative strains. Antibiotics should be reserved for severe cases and high-risk patients, and if deemed necessary for SSTI management, a broad-spectrum antibiotic should be administered to cover resistant organisms.

Application of three-dimensional printing technology in renal diseases.

Three-dimensional (3D) printing technology involves the application of digital models to create 3D objects. It is used in construction and manufacturing and has gradually spread to medical applications, such as implants, drug development, medical devices, prosthetic limbs, and in vitro models. The application of 3D printing has great prospects for development in orthopedics, maxillofacial plastic surgery, cardiovascular conditions, liver disease, and other fields. With in-depth research on 3D printing technology and the continuous update of printing materials, this technology also shows broad development prospects in renal medicine. In this paper, the author mainly summarizes the basic theory of 3D printing technology, its research progress, application status, and development prospect in renal diseases.

ESTIMATION OF THE INFRAORBITAL FORAMEN LOCATION USING MORPHOMETRIC ANALYSIS

OBJECTIVE: Determining/ Identifying the localization of the infraorbital foramen (IOF) and its relationship with surrounding structures have great importance for many clinical disciplines. It is suggested that supraorbital foramen/notch (SOF/SON) can be used as a landmark to estimate the location of the IOF. In this study, using the morphometric relationships of the IOF with the SON and other neighboring anatomical structures, we aimed to determine the safe zone for the intervention of the IOF and give some regression formulas to estimate the location of the IOF.MATERIAL AND METHODS: On the 33 dry adult skulls which are of unknown gender, IOF was evaluated using the supraorbital foramen with the 14 parameters. After the photographs of the bones were taken, measurements were made with the Image J program.RESULTS: The mean values for all measurements were given and no side differences were seen. The safe zone for the intervention to the IOF was identified with the minimum values of the parameters. The mean values of the right and left sides were used to evaluate the correlation between parameters. As a result of Spearman’s correlation test, it was observed that some values showed a high correlation with each other. Some regression formulas were created to estimate the location of the IOF. The best formula was determined as IOF= 1.632 + (0.743* SON/SOF to the IMO) + (0.184*SON/SOF to the canine crestal bone); with 96% accuracy.CONCLUSIONS: The IOF is a focus point of maxillofacial plastic surgery and dentistry because the neurovascular bundle of IOF has a great damage risk. In this study, we have given some reliable regression formulas to estimate the location of the IOF with the high accuracy.

Evaluating patients’ satisfaction level after using 3D printed PEEK facial implants in repairing maxillofacial deformities

Backgroundit is generally the case in any traumatic accident where a loss in hard tissue occurs to preform restorative plastic surgery, as there are many materials and approaches used to restore the loss, this research sheds the light on the use of one such material and approach being 3D printed facial implants manufactured from PolyEther Ether Ketone (PEEK) and to evaluate the level of patients’ satisfaction following the use of said method in repairing maxillofacial deformities. Materials and methodsa research sample consisting of 10 patients with facial deformities underwent maxillofacial reconstructive surgery between 2020 and 2021 in the Department of Oral and Maxillofacial Surgery in the Tishreen University Hospital - Latakia - Syria. All patients underwent Computed Tomography (CT) scans, then the design of the required facial implant was carried out, the final form of the facial implant was printed from PolyEther Ether Ketone (PEEK), and then surgical work was performed, a check-up after 3 months of the surgical procedure was carried out to evaluate the level of satisfaction on a scale of 1–5. ResultsThe results from the 10 patients showed a good level of satisfaction except in one case where the facial implant had to be removed due to recurrent infection where the patient showed no signs of response to medicinal treatment following the surgery. Conclusionsthis research suggests that the use of 3D printed PEEK facial implants to be very agreeable in terms of functionality and aesthetics in treating various facial deformities.

Free Skin Grafting to Reconstruct Donor Sites after Radial Forearm Flap Harvesting: A Prospective Study with Platelet-Rich Fibrin (PRF).

Reconstruction of the donor site after radial forearm flap harvesting is a common procedure in maxillofacial plastic surgery. It is normally carried out with split-thickness or full-thickness free skin grafts. Unfortunately, free skin graft transplantation faces wound healing impairments such as necrosis, (partial) graft loss, or tendon exposure. Several studies have investigated methods to reduce these impairments and demonstrated improvements if the wound bed is optimised, for example, through negative-pressure wound therapy or vacuum-assisted closure. However, these methods are device-dependent, expansive, and time-consuming. Therefore, the application of platelet-rich fibrin (PRF) to the wound bed could be a simple, cost-effective, and device-independent method to optimise wound-bed conditions instead. In this study, PRF membranes were applied between the wound bed and skin graft. Results of this study indicate improvements in the PRF versus non-PRF group (93.44% versus 86.96% graft survival, p = 0.0292). PRF applied to the wound bed increases graft survival and reduces impairments. A possible explanation for this is the release of growth factors, which stimulate angiogenesis and fibroblast migration. Furthermore, the solid PRF membranes act as a mechanical barrier (“lubrication” layer) to protect the skin graft from tendon motion. The results of this study support the application of PRF in donor-site reconstruction with free skin grafts.

ПАТОГЕНЕТИЧЕСКИЕ ПАРАЛЛЕЛИ ОСТЕОПОРОЗА И ХРОНИЧЕСКОГО ПАРОДОНТИТА. ЛИТЕРАТУРНЫЙ ОБЗОР

Subject. Parallels in the pathogenesis of two severe diseases of the modern era, osteoporosis and periodontitis.&#x0D; Objectives. To review domestic and international research on pathogenetic relationship between osteoporosis and periodontal pathology.&#x0D; Methodology. In topic generalization, the review of publications (since 2016) available on PubMed, eLIBRARY, Web of Science, Scopus by keywords is made.&#x0D; Conclusion. Research studies have shown that bone tissue in the orofacial region, though lesser than bones of axial skeleton, tends to develop osteoporosis. That is why patients with osteoporosis are recommended regular periodontal maintenance visits, especially when periodontal disease is diagnosed at the appointment or during the complex rehabilitation program for patients in osteoplastic and maxillofacial reconstructive surgery. Future controlled longitudinal studies may be useful in research of this relationship based on the features of osteogenesis in the both diseases. This literature review helps to develop modern views of pathogenetic relationship between osteoporosis and periodontitis, evaluate general risk factors, promote understanding of tools in the diagnostic process and interpretation of results. Moreover, with the help of this paper by knowing the cell and molecular structure of bone tissue and mechanisms of bone remodeling a dental practitioner can arrange a personalized follow-up strategy for patients in the risk group for the above two diseases timely engaging general practitioners in interdisciplinary and complex therapy of patients with periodontal pathology.

Analysis of Quality of Life With 3D-Printed Model vis-á-vis Conventional Procedure in Oral &amp; Maxillofacial Surgery – An Empirical Study

Aims and Objectives 3d-printed models (bio-models) have become a useful tool in the armamentarium of surgeons for improved surgical planning in the recent past. This study directs at reinforcing the incorporation of these bio-models as a handy tool in treatment planning, resident training, patient education and record maintenance. The aim of this empirical study was to compare the outcome in reconstructive maxillofacial surgery when planned using 3d-printed model and without 3d-printed model (conventional). The objectives were to assess and compare the intraoperative time taken during reconstruction, the immediate post-operative experience (pain, mouth opening and incidence of infection) and the quality of life using University of Washington (UW-QOL) questionnaire during follow up. Methods This retrospective comparative study was conducted in Department of Oral &amp; Maxillofacial Surgery, from March 2018 to March 2020. It included 50 cases consisting variety of pathologic and traumatic maxillofacial defects and they were grouped into with 3d-printed model (Group A) and without 3d-printed model (Group B). The groups were further subclassified based on maxillary (MR) and mandibular reconstruction [vascularized flaps (VFFF), non-vascularised grafts (NVG), reconstruction plate alone (RP)]. We compared intra operative time taken along with immediate post-operative parameters (pain, mouth opening and presence of infection) and patient’s quality of life using UW-QOL questionnaire. These values were taken for comparison and statistical analysis was done by unpaired t-test. Result There was 14.75% (35.26 minutes) mean reduction in operative time (* P = .029) and reduction in mean visual analogue score (VAS) (* P = .003) with statistically significant difference. However, increase in immediate post-operative mouth opening was not found to be statistically significant difference ( P =.471). The comparison of the social and functional domain of UW-QOL showed statistically significant P-value in saliva (*0.004) and mood (*0.002) with regard to NVG. In RP group, pain (*0.026), swallowing (*0.041) and taste (*0.008) was found to be statistically significant. In MR group, only pain (*0.037) showed statistically significant difference. Conclusion Use of 3d-printed model to guide and assist in surgical procedures have provided promising results. Based on this study, we found that there is decreased intraoperative time and post-operative pain score when 3d-printed model were used. The patient’s quality of life was also found to be better in terms of reduction in pain, salivary secretion and mood elevation. With increased success rate, the authors are of the strong opinion that it is time to revisit the surgical protocol used for reconstruction and include 3d-printed model as a primary tool or technology across the board for all patients notwithstanding the comparative cost, as the results offset the financial aspect.

Free Fibula Flap in Mandibular Reconstruction : A Case Report

The reconstruction of the mandible is a complex procedure and continues to be a challenge in reconstructive maxillofacial surgery. Indications for mandibular reconstruction are varied and include pathological resections, traumatic injuries and residual deformities amongst others. The mandible is an important anatomical unit of maxillofacial skeleton in terms of both aesthetics and function which necessitates its immediate reconstruction after resection.&#x0D; A 16 years old female patient, diagnosed with ameloblastoma of left hemi -mandible underwent resection with immediate reconstruction using free fibula flap. Twenty two months follow up reveals excellent bony union and facial contours. The objective of the treatment is to resecting the mandibular defects and reconstruction with free fibular flap.&#x0D; Our experience combined with positive literature references enhances the reliability of free fibular vascularized graft as a suitable and versatile reconstructive option for complex anatomical contours of the mandible.

Professor Alexander E. Rauer – one of the founders of maxillofacial plastic surgery in the USSR (on the 150&lt;sup&gt;th&lt;/sup&gt; anniversary of birthday)

The paper presents the main years of the life and scientific work of the prominent Russian surgeon and scientistinnovator Professor A.E. Rauer (1871–1948). Little-known milestones from the scientist's life are marked. The paper analyzes the fact that from 1922 to the end of life (26 years) Alexander Eduardovich headed the maxillofacial department of the Central Institute of Traumatology and Orthopedics (CITO). Since 1932, Professor A.E. Rauer was the head of the Department of Maxillofacial Surgery of the CIU, organized by him on the basis of the maxillofacial department of the CITO (Moscow). It is noted that Alexander Eduardovich is the author of about 100 scientific works. He summarized all his rich experience in his final work “Plastic Surgery on the face”, awarded in 1946. The Stalin Prize. The range of scientific and surgical interests of A.E. Rauer was wide and diverse. His main works were devoted to the problems of maxillofacial surgery. Rauer proposed a number of valuable ways to eliminate facial disfigurement, which have become widespread (for example, oblique osteotomy for ankylosis of the jaws, surgery for habitual dislocations, plastic surgery of through facial defects, etc.). Under the leadership of Alexander Eduardovich, the clinic also developed methods of plastic surgery for fan-shaped neck scars after thermal injuries and restoration of the pharyngeal arches with soft palate defects. It is noted that he worked a lot on plastic surgery of other organs and proposed methods of interventions for congenital malformations of the bladder, limbs, etc. During the Great Patriotic War, A.E. Rauer introduced into practice a method of treating granulating surface wounds by forming secondary plate ligatures. It is shown that after him there were many worthy students who continued his work on the further development of maxillofacial surgery, which has become an important and necessary branch of clinical medicine.

COMPLICATION OF TISSUE EXPANDERS IN MAXILLOFACIAL SURGERY

Oral and maxillofacial reconstructive surgery manages and deals with the re-conditioning, reestablishment and restoration of damaged and deformed anatomy of bone, skin, mucosa, muscle and nerves. And many a times, flaps are not sufficient to close the defect with help of local flaps and therefore it might become necessary to incorporate tissue expander to expand the surrounding tissue for restoring a defect. Tissue expansion is multifaceted technique for reconstruction surgeries providing well- vascularised surrounding tissues. This technique requires vigilant selection of patients to execute this process which lasts for approximately 8-12 weeks. Any remiss can lead to unfavourable outcome and complications, some minor &amp; others major. This paper seeks to highlight the complications faced while incorporating a tissue expander. Major complications, might result in a delay in reconstruction but not tissue loss. Keywords: tissue expanders, complications, reconstruction, reconstructive surgery

A Narrative Review of u-HA/PLLA, a Bioactive Resorbable Reconstruction Material: Applications in Oral and Maxillofacial Surgery.

The advent of bioresorbable materials to overcome limitations and replace traditional bone-reconstruction titanium-plate systems for bone fixation, thus achieving greater efficiency and safety in medical and dental applications, has ushered in a new era in biomaterial development. Because of its bioactive osteoconductive ability and biocompatibility, the forged composite of uncalcined/unsintered hydroxyapatite and poly L-lactic acid (u-HA/PLLA) has attracted considerable interest from researchers in bone tissue engineering, as well as from clinicians, particularly for applications in maxillofacial reconstructive surgery. Thus, various in vitro studies, in vivo studies, and clinical trials have been conducted to investigate the feasibility and weaknesses of this biomaterial in oral and maxillofacial surgery. Various technical improvements have been proposed to optimize its advantages and limit its disadvantages. This narrative review presents an up-to-date, comprehensive review of u-HA/PLLA, a bioactive osteoconductive and bioresorbable bone-reconstruction and -fixation material, in the context of oral and maxillofacial surgery, notably maxillofacial trauma, orthognathic surgery, and maxillofacial reconstruction. It simultaneously introduces new trends in the development of bioresorbable materials that could used in this field. Various studies have shown the superiority of u-HA/PLLA, a third-generation bioresorbable biomaterial with high mechanical strength, biocompatibility, and bioactive osteoconductivity, compared to other bioresorbable materials. Future developments may focus on controlling its bioactivity and biodegradation rate and enhancing its mechanical strength.

FEATURES OF PREOPERATIVE MANAGEMENT AND METHODS OF EXAMINATION OF PATIENTS OF GROUPS UNDER RESEARCH

Despite the active ability to repair, it is frequently noticed that the independent potentialof bone tissue is insufficient, that is a serious problem in reconstructive maxillofacialsurgery, orthopedics and traumatology. In recent years, there has been an activesearch for implant material that would match the autologous bone in its properties andcharacteristics. Tissue engineering technologies allow to create tissue equivalents tobone tissue using autogenous stromal cells deposited on biocompatible or biologicalmaterial of tissue engineering design. The article presents the features of preoperativemanagement, description of the used examination methods and bone augmentationmaterials in patients of the groups under study.Objective – to use a set of adequate methods of examination and optimal preoperativemanagement of patients of the group under study during sinus lifting, post-extractionsocket preservation, osteosynthesis for mandibular fractures and impacted wisdom teethextraction, which were accompanied by the use of bone augmentation materials based onmultipotent mesenchymal stromal cells.Material and methods. 280 people aged 18 to 55 with partial or complete adentiaand atrophy of the alveolar process of the jaws, with chronic periodontium infectionand chronic generalized periodontitis, with fractures and impacted third molars wereexamined in the Department of Surgical Dentistry and Maxillofacial Surgery of theChernivtsi Regional Clinical Hospital. All patients were planned to make orthopedicstructures based on dental implants.Results. The use of computed tomography in preoperative examination of patients in thestudied group allows not only visually to examine the object, but also to perform directdensitometric analysis with measurement of attenuation coefficients in Hounsfield units,that is a significant advantage over X-ray examination.Conclusions. The use of bone augmentation materials based on multipotent mesenchymalstromal cells of adipose tissue during dental operations improves the regenerativeproperties of bone tissue and helps to reduce the duration of inpatient treatment.

Research progress on shared decision making in maxillofacial plastic surgery and aesthetic surgery

Research progress on shared decision making in maxillofacial plastic surgery and aesthetic surgery