RESUMEN
Guided bone regeneration (GBR) describes the use of membranes to regenerate bony defects. A membrane for GBR needs to be biocompatible, cell-occlusive, non-toxic, and mouldable, and possess space-maintaining properties including stability. The purpose of this pilot study was to describe a new method of GBR using individualized ceramic sheets to perfect bone regeneration prior to implant placement; bone regeneration was assessed using traditional histology and three-dimensional (3D) volumetric changes in the bone and soft tissue. Three patients were included. After full-thickness flap reflection, the individualized ceramic sheets were fixed. The sites were left to heal for 7 months. All patients were evaluated preoperatively and at 7 months postoperative using cone beam computed tomography and 3D optical equipment. Samples of the regenerated bone and soft tissue were collected and analyzed. The bone regenerated in the entire interior volume of all sheets. Bone biopsies revealed newly formed trabecular bone with a lamellar structure. Soft tissue biopsies showed connective tissue with no signs of an inflammatory response. This was considered to be newly formed periosteum. Thus ceramic individualized sheets can be used to regenerate large volumes of bone in both vertical and horizontal directions independent of the bone defect and with good biological acceptance of the material.
Asunto(s)
Cerámica , Regeneración Tisular Guiada Periodontal/métodos , Membranas Artificiales , Adulto , Anciano , Regeneración Ósea , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fotografía Dental , Proyectos PilotoRESUMEN
The nature of the work done by oral and maxillofacial surgeons (OMFSs) potentially places them at risk of transmission of blood-borne viruses from patients. We investigated the incidence of exposure to infected blood among OMF surgeons, and whether enough protection is being used. An anonymous postal questionnaire was sent to all OMFS consultants working in the UK in 2008 (n=344) to investigate three areas relating to blood-borne viruses: incidence of surgeons experiencing and reporting exposure to potentially infected blood, their opinions about which patients pose a particular risk, and treatment plans and equipment selected when given two set clinical situations. A total of 148 consultants (43%) responded. Of the 80 respondents (61%) who had been exposed to blood within the last five years, more than two-thirds (n=55) did not always report such incidents. Eighty-five (60%) stated that they considered that all patients posed a risk to the surgeon, and 104 (73%) altered their practice depending on the perceived risk from the individual patient.
Asunto(s)
Actitud del Personal de Salud , Patógenos Transmitidos por la Sangre , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Cirugía Bucal , Virosis/transmisión , Virus , Adulto , Anciano , Notificación de Enfermedades , Etnicidad , Guantes Quirúrgicos , Humanos , Máscaras , Persona de Mediana Edad , Exposición Profesional , Planificación de Atención al Paciente , Ropa de Protección , Equipos de Seguridad , Factores de Riesgo , Conducta Sexual , Parejas Sexuales , Abuso de Sustancias por Vía Intravenosa , Reino Unido , Precauciones UniversalesRESUMEN
The aim was to report the distribution, frequency and aetiology of jaw fractures in patients treated at the University Hospital, Malmö, 1993-2003 and to compare two previous studies from 1952-1962 and 1975-1985. In 1993-2003, 461 patients, 137 women (mean age 42 years; range 15-82) and 324 men (mean age 28 years; range 17-59) were diagnosed and treated. Women were significantly older than men (P<0.001). The most frequent cause of jaw fractures was falls in women (45%). In men, interpersonal violence (46%) was most common followed by road traffic accidents (RTAs) (24%) mostly involving bicycles (14%). The frequency of falls in women and men was significantly different (P<0.001) as was the difference between violence in men and women (P<0.001). The proportion of fractures caused by RTAs was significantly higher in 1952-1962 than in 1993-2003 (P<0.001). There was a significant increase in the proportion of fractures caused by violence between the two studies (P=0.007). In 1993-2003 the proportion of fractures in women due to falls was significantly higher than in 1952-1962 (P=0.006). Violence has replaced RTAs as the main cause for jaw fractures in men; for women falling is the commonest cause.