RESUMEN
Nowadays, aesthetic concerns have gained attention, especially by patients looking for a less invasive alternative to minor facial corrections. Polymethylmethacrylate (PMMA) is widely used as a soft tissue filler; the demand for this polymer has increased, and along with it, there are some reports of adverse reactions. Such adverse reactions stem from consequences of immune and inflammatory reactions to PMMA. Some animal models have been used to unravel the causes of these reactions, among other factors involving the management of PMMA. The aim of this study was to determine the immunogenic profile of PMMA implantation in different anatomical planes of mice, over up to 360 experimental days. In this study, BALB/c mice were divided into 30 groups for immune evaluation of the interaction between the organism and the polymer; 2% PMMA was implanted subcutaneously, 10% intramuscularly and 30% in periosteal juxtaposition and followed during five experimental days (7, 30, 90, 180 and 360 days after implantation-DAI). Pro- and anti-inflammatory cytokines (IL-2, IL-4, IL-6, IFN-gamma, TNF, IL-17A, IL-10 and TGF-beta) were quantified in all experimental days. There was no statistical difference between the groups analyzed considering the evaluated parameters. Therefore, at all implanted depths, PMMA behaved inertly in a murine model.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Asunto(s)
Cara , Polimetil Metacrilato , Humanos , Ratones , Animales , Polimetil Metacrilato/efectos adversos , Microesferas , InflamaciónRESUMEN
Abstract Cosmetic injections of fillers are common plastic surgery procedures worldwide. Polymethylmethacrylate (PMMA) is a filler approved only for minimally invasive procedures in facial tissue and is among the most frequently used injectable substances for cosmetic purposes. Injection of a large volume of PMMA may lead to the development of severe hypercalcemia and chronic kidney damage in a probably underestimated frequency. In such cases, hypercalcemia develops due to a granulomatous foreign body reaction with extrarenal production of calcitriol. In the present report, we describe the cases of two patients who received injections of large volumes of PMMA and developed severe hypercalcemia and advanced chronic kidney disease. These reports highlight the importance of adhering to regulations regarding the use of PMMA and properly informing patients of the possibility of complications before undertaking such procedures.
Resumo Injeções de preenchimento de caráter estético são procedimentos comuns em cirurgia plástica em todo o mundo. O polimetilmetacrilato (PMMA) é um material de preenchimento aprovado apenas para procedimentos minimamente invasivos no tecido facial, e está entre as substâncias injetáveis mais frequentemente usadas para fins estéticos. A injeção de um grande volume de PMMA pode levar ao desenvolvimento de hipercalcemia grave e lesão renal crônica em uma frequência provavelmente subestimada. Nesses casos, a hipercalcemia se desenvolve devido a uma reação granulomatosa de corpo estranho, secundária à produção extrarenal de calcitriol. No presente artigo, descrevemos os casos de dois pacientes que receberam injeções de grandes volumes de PMMA e desenvolveram hipercalcemia grave e doença renal crônica avançada. Esses relatos destacam a importância de seguir as regulamentações sobre o uso do PMMA e informar adequadamente os pacientes sobre a possibilidade de complicações antes de realizar tais procedimentos.
Asunto(s)
Humanos , Técnicas Cosméticas , Insuficiencia Renal Crónica/complicaciones , Hipercalcemia/inducido químicamente , Calcitriol , Polimetil Metacrilato/efectos adversosAsunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Polimetil Metacrilato/efectos adversos , Síndrome de Sjögren/tratamiento farmacológico , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/cirugía , Femenino , Humanos , Persona de Mediana Edad , Polimetil Metacrilato/administración & dosificación , Polimetil Metacrilato/uso terapéutico , Síndrome de Sjögren/diagnóstico , Síndrome de Sjögren/cirugía , Esteroides/administración & dosificación , Esteroides/uso terapéuticoRESUMEN
Cosmetic injections of fillers are common plastic surgery procedures worldwide. Polymethylmethacrylate (PMMA) is a filler approved only for minimally invasive procedures in facial tissue and is among the most frequently used injectable substances for cosmetic purposes. Injection of a large volume of PMMA may lead to the development of severe hypercalcemia and chronic kidney damage in a probably underestimated frequency. In such cases, hypercalcemia develops due to a granulomatous foreign body reaction with extrarenal production of calcitriol. In the present report, we describe the cases of two patients who received injections of large volumes of PMMA and developed severe hypercalcemia and advanced chronic kidney disease. These reports highlight the importance of adhering to regulations regarding the use of PMMA and properly informing patients of the possibility of complications before undertaking such procedures.
Asunto(s)
Técnicas Cosméticas , Hipercalcemia , Insuficiencia Renal Crónica , Calcitriol , Humanos , Hipercalcemia/inducido químicamente , Polimetil Metacrilato/efectos adversos , Insuficiencia Renal Crónica/complicacionesRESUMEN
Introdução: Os preenchedores permanentes, apesar de resultados duradouros, são verdadeiros problemas quando causam complicações. No Brasil, o PMMA é um produto aprovado pela Anvisa, mas seu uso extrapola suas indicações, levando a complicações graves. Há mais de uma década, existem recomendações sobre sua restrição, mas casos com consequências graves do seu uso irresponsável são atuais. Objetivo: Relatar complicação grave do uso irregular do PMMA e discutir a realidade brasileira atual baseado em determinações das entidades médicas, assim como dos órgãos reguladores. Métodos: É relatado um caso de necrose extensa da região glútea após a injeção de PMMA por profissional não qualificado e discutida a situação brasileira atual do produto com base nas entidades médicas e revisão da literatura do Brasil. Discussão: Apesar do esforço das entidades médicas, são inúmeros os casos de complicações agudas e crônicas relatados na literatura brasileira. No ano de 2016, foram registradas mais de 17 mil complicações relacionadas ao PMMA, mesmo assim, é difícil estabelecer dados epidemiológicos confiáveis, pois não há controle do número de aplicações, da qualidade do produto utilizado e da capacitação dos profissionais que o utilizam. Conclusão: No Brasil, há um número expressivo de procedimentos reparadores para correção de complicações decorrentes do uso do PMMA. A gravidade do caso relatado traz à tona a necessidade de combate à má prática por profissionais não capacitados, assim como um controle mais rigoroso da comercialização do produto por entidades reguladoras.(AU)
Introduction: Use of permanent fillers can lead to significant complications. In Brazil, polymethylmethacrylate (PMMA) is a product approved by the Agência Nacional de Vigilância Sanitária (ANVISA), but its use exceeds its indications, leading to serious complications. Recommendations for restricted use have been in place for more than a decade, but cases with serious consequences due to inappropriate use are still seen. Objective: To report a serious complication due to inappropriate use of PMMA and discuss the current status of PMMA use in Brazil based on recommendations of medical societies and regulatory agencies. Methods: This report describes a case of extensive necrosis of the gluteal region after injection of PMMA by a non-qualified practitioner; the report also reviews the literature on the current status of PMMA use in Brazil. Discussion: Despite the efforts of medical societies, acute and chronic complications are still reported in the Brazilian literature. In 2016, more than 17,000 PMMArelated complications were reported; nevertheless, reliable epidemiological data remain unavailable because the number of treatments, the quality of the product, and the training of practitioners remain unregulated. Conclusion: A significant number of repair procedures are performed in Brazil to correct complications resulting from the use of PMMA. The severity of the reported case highlights the need to combat bad practice by untrained professionals, as well as the need for greater control of PMMA marketing by regulatory agencies.(AU)
Asunto(s)
Humanos , Femenino , Adulto , Polimetil Metacrilato/análisis , Polimetil Metacrilato/efectos adversos , Procedimientos de Cirugía Plástica/efectos adversos , Necrosis/diagnósticoRESUMEN
Intralesional corticoid infiltration guided by 22-MHz ultrasound is a new, noninvasive, and safe dermatological method for the treatment of foreign body granuloma. The great advantage of the procedure is that the medication is delivered straight to the desired target, preventing adverse treatment effects in noninjured areas.
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Glucocorticoides/administración & dosificación , Granuloma de Cuerpo Extraño/terapia , Triamcinolona/administración & dosificación , Anciano , Biopsia , Técnicas Cosméticas/efectos adversos , Rellenos Dérmicos/administración & dosificación , Rellenos Dérmicos/efectos adversos , Femenino , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Granuloma de Cuerpo Extraño/etiología , Humanos , Inyecciones Intralesiones , Polimetil Metacrilato/administración & dosificación , Polimetil Metacrilato/efectos adversos , Piel/diagnóstico por imagen , Piel/efectos de los fármacos , Piel/patología , Resultado del Tratamiento , Ultrasonografía IntervencionalRESUMEN
The lips are essential part of the beauty and attractiveness of the human face. Lip augmentation has become an increasingly used method to improve appearance. Soft tissue fillers are the most commonly used tools. Permanent fillers, however, have been associated with unwanted side effects after lip augmentation. In the present article the present authors will focus on permanent fillers based on polymethylmethacrylate (PMMA). The present authors provide a short review on PMMA fillers and known associated adverse events. The present authors provide a critical review of treatment options. Illustrated by clinical cases The present authors report our preferred treatment of PMMA nodules on lips by intralesional neodymium:YAG laser and blunt suction cannula with or without minor surgery.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Rellenos Dérmicos/efectos adversos , Granuloma de Cuerpo Extraño/cirugía , Terapia por Láser/instrumentación , Láseres de Estado Sólido/uso terapéutico , Labio/cirugía , Polimetil Metacrilato/efectos adversos , Rellenos Dérmicos/administración & dosificación , Estética , Femenino , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/patología , Humanos , Terapia por Láser/efectos adversos , Láseres de Estado Sólido/efectos adversos , Labio/patología , Persona de Mediana Edad , Polimetil Metacrilato/administración & dosificación , Rejuvenecimiento , Factores de Riesgo , Succión , Resultado del TratamientoRESUMEN
Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, "Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?" A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54-1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57-4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37-2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.
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Sustitutos de Huesos/efectos adversos , Trasplante Óseo/efectos adversos , Procedimientos de Cirugía Plástica/efectos adversos , Polimetil Metacrilato/efectos adversos , Cráneo/cirugía , Resinas Acrílicas/efectos adversos , Materiales Biocompatibles , Humanos , Factores de Riesgo , Titanio/efectos adversos , Trasplante Autólogo/efectos adversosRESUMEN
PURPOSE: To report a case of Purtscher-like retinopathy with paracentral acute middle maculopathy preceded by febrile illness after filler injection into the buttock muscles bilaterally for cosmesis to achieve a "Brazilian booty." METHODS: Retrospective case report. RESULTS: A 35-year-old female presented with febrile illness and then decreased vision after repeat polymethyl methacrylate injections into her buttock muscles in Mexico. Examination was significant for retinal whitening, especially in the perifoveal areas, and intraretinal hemorrhages. Optical coherence tomography and fluorescein angiography imaging were consistent with small-vessel ischemic disease in the retina and choroid. Once systemic infection was ruled out, patient was treated with high-dose intravenous and then oral steroids. Vision recovery was good, with retinal atrophy on optical coherence tomography in the previous areas of retinal whitening. CONCLUSION: A Purtscher-like retinopathy with paracentral acute middle maculopathy and loss of vision may occur after filler injection below the neck, not just the face. This is the first report of vision loss caused by filler injected outside the face.
Asunto(s)
Mácula Lútea/patología , Polimetil Metacrilato/efectos adversos , Enfermedades de la Retina/inducido químicamente , Agudeza Visual/efectos de los fármacos , Enfermedad Aguda , Administración Oral , Adulto , Cementos para Huesos/efectos adversos , Nalgas , Femenino , Angiografía con Fluoresceína/métodos , Fondo de Ojo , Glucocorticoides/administración & dosificación , Humanos , Inyecciones , Polimetil Metacrilato/administración & dosificación , Prednisona/administración & dosificación , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/tratamiento farmacológico , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
Abstract Polymethyl methacrylate (PMMA) has been considered a suitable material for cranioplasty. However, no consensus has been reached concerning the best material for cranioplasty with regard to minimizing complications. Thus, this systematic review and meta-analysis aimed to compare the complication rates of PMMA with those of autologous bone and titanium mesh. This review was registered with PROSPERO (CRD42016042725). Systematic searches were conducted on PubMed/MEDLINE, Scopus, and Web of Science. The focus question was, "Do PMMA prostheses used in cranioplasty have complications rates similar to those of autologous bone and titanium mesh?" A meta-analysis of complication rates was performed on the basis of dichotomous outcomes assessed by risk ratio (RR) with corresponding 95% confidence intervals (CI). From 1014 data sources, 11 articles were selected according to eligibility criteria. These articles involved 1,256 individuals and 1,278 cranioplasties using autologous bone (n = 408), PMMA (n = 379), or titanium (n = 151). The follow-up period ranged from 63 days to 54.3 months. No difference was observed between the complication rates of PMMA and autologous bone (p = 0.94; RR, 0.98; 95%CI, 0.54-1.75) or between PMMA and titanium (p = 0.38; RR, 1.59; 95%CI, 0.57-4.48). Sub-analysis of the reasons for craniotomy (trauma/non-trauma) was conducted, which revealed no significant difference (p = 0.91; RR, 0.95; 95%CI, 0.37-2.42). The meta-analysis indicated that the use of PMMA yields complication rates that are near those of autologous bone and titanium mesh.
Asunto(s)
Humanos , Cráneo/cirugía , Trasplante Óseo/efectos adversos , Sustitutos de Huesos/efectos adversos , Polimetil Metacrilato/efectos adversos , Procedimientos de Cirugía Plástica/efectos adversos , Titanio/efectos adversos , Trasplante Autólogo/efectos adversos , Materiales Biocompatibles , Resinas Acrílicas/efectos adversos , Factores de RiesgoRESUMEN
O uso de implantes sintéticos para o preenchimento na face pode acarretar reações adversas. Estas podem ocorrer da má técnica ou decorrentes do produto. Entre os materiais utilizados, está o polimetilmetacrilato (PMMA) na forma de microesferas. Trata-se do relato de um caso de reação nodular na face de paciente do sexo feminino, após 15 anos do uso de implante de Artecoll®, produto composto por microesferas de colágeno bovino e PMMA. Foi tratada com laser de gás carbônico. Evidenciou-se o efeito tardio provocado da aplicação de implantes sintéticos na face como o Artecoll®, os fatores limitantes para ressecção convencional com bisturi e tesoura, e a opção da utilização do laser de CO2. Destacando-se a função ablativa e precisa na remoção do tecido comprometido, a preservação dos tecidos sadios e nobres, o grande potencial hemostático e a baixa morbidade, com menor cicatriz, edema, equimose e a rápida recuperação pós-operatória.
The use of synthetic implants as dermal facial fillers may cause adverse reactions, which may occur owing to inappropriate techniques or the intrinsic nature of the product. Polymethylmetacrylate (PMMA) microspheres is one of the materials used. This is a report of a case of nodular reaction in the face of a female patient, after 15 years of Artecoll® implant use, a product composed of microspheres of bovine collagen and PMMA. She was treated with a carbon dioxide laser. The delayed effect caused by the application of synthetic implants in the face, such as Artecoll®; the limiting factors of conventional resection with a scalpel and scissors; and the option for the use of carbon dioxide laser are outlined. Highlighted are the ablative and precise functions in the removal of compromised tissue, the preservation of healthy and noble tissues, the high hemostatic potential, and low morbidity, with smaller scars, edema, ecchymosis, and rapid postoperative recovery.
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Humanos , Femenino , Persona de Mediana Edad , Historia del Siglo XXI , Complicaciones Posoperatorias , Cirugía Plástica , Atrofia Muscular , Polimetil Metacrilato , Cara , Huesos Faciales , Surco Nasolabial , Rayos Láser , Complicaciones Posoperatorias/cirugía , Cirugía Plástica/métodos , Atrofia Muscular/cirugía , Polimetil Metacrilato/efectos adversos , Polimetil Metacrilato/uso terapéutico , Cara/cirugía , Huesos Faciales/cirugía , Surco Nasolabial/cirugía , Rayos Láser/efectos adversosRESUMEN
Acrylic resin is a widely used material in clinical practice, and a satisfactory biocompatibility is essential. When the resin polymerization reaction is incomplete, residual monomers are released into the oral cavity. The aim of this study was to evaluate, through a literature review, the cytotoxicity caused by the denture base acrylic resin used, and its components. The selection of published studies was performed on the Pubmed database from January 2008 to July 2013. The keywords used were: "cytotoxicity and acrylic resins", "cytotoxicity and denture base resins" and "cytotoxicity and oral prosthesis". Inclusion criteria were: in vitro studies and literature reviews published in English that evaluated the acrylic resin cytotoxicity for denture base and its components. Studies with no reference to the search strategy were excluded. A total of 182 articles were found. Among these, only 13 were included for writing this review. The MTT test is the most common test used to evaluate acrylic resin cytotoxicity. Auto-polymerized resin is more cytotoxic than heat-polymerized resin because of its higher quantity of residual monomers which cause cell and tissue changes in the oral mucosa. However, more studies are necessary for the development of biocompatible materials.
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Bases para Dentadura/efectos adversos , Polimetil Metacrilato/efectos adversos , Pruebas de Toxicidad , Animales , Bioensayo , Línea Celular , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Humanos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Pruebas de Toxicidad/métodosRESUMEN
This study evaluated the abrasiveness of mechanical and combined methods of denture hygiene, by the analysis of mass loss and surface roughness. Acrylic resin specimens (Plexiglass) were brushed by a tooth brushing machine (Mavtec) with a soft brush (Tek) and water (control) or four dentifrices (Sorriso, Colgate, Polident and Corega) (Experimental groups) for 50 min, representing one year of brushing (mechanical method). After brushing, the specimens were immersed in 0.5% sodium hypochlorite simulating a daily cleaning of 20 min for one year (combined method). Distilled water (23 ºC) was employed as control. The mass loss (g) was analyzed by an analytical balance and the surface roughness (µm) by a rugosimeter. Data were subjected to ANOVA and Bonferroni test (α=0.05). Polident dentifrice showed lowest values of mass loss for both methods (mechanical: -0.0072±0.0017, combined:-0.011±0.002) and the combined method resulted in greater mass loss than the mechanical, except for Corega. For the surface roughness, after the mechanical method, the lowest values were registered for water (-0.007±0.016) and Polident (0.402±0.378); for the combined method, water (-0.063±0.013) showed the lowest values; there was no statistically significant difference between methods. It was concluded that Polident was the less abrasive dentifrice and the association between chemical and mechanical methods increased the mass loss but did not change the surface roughness of specimens.
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Limpiadores de Dentadura , Dentaduras , Polimetil Metacrilato/efectos adversos , Propiedades de SuperficieRESUMEN
This study evaluated the abrasiveness of mechanical and combined methods of denture hygiene, by the analysis of mass loss and surface roughness. Acrylic resin specimens (Plexiglass) were brushed by a tooth brushing machine (Mavtec) with a soft brush (Tek) and water (control) or four dentifrices (Sorriso, Colgate, Polident and Corega) (Experimental groups) for 50 min, representing one year of brushing (mechanical method). After brushing, the specimens were immersed in 0.5% sodium hypochlorite simulating a daily cleaning of 20 min for one year (combined method). Distilled water (23 ºC) was employed as control. The mass loss (g) was analyzed by an analytical balance and the surface roughness (μm) by a rugosimeter. Data were subjected to ANOVA and Bonferroni test (α=0.05). Polident dentifrice showed lowest values of mass loss for both methods (mechanical: -0.0072±0.0017, combined:-0.011±0.002) and the combined method resulted in greater mass loss than the mechanical, except for Corega. For the surface roughness, after the mechanical method, the lowest values were registered for water (-0.007±0.016) and Polident (0.402±0.378); for the combined method, water (-0.063±0.013) showed the lowest values; there was no statistically significant difference between methods. It was concluded that Polident was the less abrasive dentifrice and the association between chemical and mechanical methods increased the mass loss but did not change the surface roughness of specimens.
Este estudo avaliou a abrasividade causada pelos métodos mecânico e combinado de higiene de próteses totais, por meio da análise da perda de massa e rugosidade de superfície. Corpos de prova de resina acrílica (Plexiglass) foram escovados em máquina de escovação (Mavtec) com escova macia (Tek) e água ou dentifrícios (Sorriso, Colgate, Polident e Corega) (Grupos Experimentais) por 50 min, simulando 1 ano de escovação (método mecânico). Após a escovação, os corpos de prova foram imersos em hipoclorito de sódio a 0,5%, simulando imersões diárias de 20 min por 1 ano (método combinado). Água destilada (23 °C) foi empregada como controle. A perda de massa foi analisada por meio de balança analítica de precisão (g) e a rugosidade de superfície por rugosímetro (μm). Os dados foram submetidos à ANOVA e teste de Bonferroni (α=0,05). Em relação à perda de massa, os menores valores foram obtidos para o Polident em ambos os métodos (mecânico: -0,0072±0,0017; combinado: -0,011±0,002) e o método combinado resultou em maior perda de massa que o método mecânico, exceto para o Corega. Para a rugosidade de superfície, após aplicação do método mecânico, os valores mais baixos foram registrados para água (-0,007±0,016) e Polident (0,402±0,378); para o método combinado, os valores mais baixos foram obtidos para água (-0,063±0,013); não houve diferença estatística entre os métodos. Conclui-se que o Polident foi o dentifrício menos abrasivo e que a associação do método químico ao método mecânico aumentou a perda de massa, porém não alterou a rugosidade de superfície dos corpos de prova.
Asunto(s)
Limpiadores de Dentadura , Dentaduras , Polimetil Metacrilato/efectos adversos , Propiedades de SuperficieAsunto(s)
Microesferas , Enfermedades de la Boca/inducido químicamente , Polimetil Metacrilato/efectos adversos , Anciano , Biopsia , Cementos para Huesos/efectos adversos , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades de la Boca/diagnóstico , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Polimetil Metacrilato/administración & dosificaciónRESUMEN
BACKGROUND: The lipodystrophy syndrome is characterized by selective loss of subcutaneous fat on the face and extremities (lipoatrophy) and/or accumulation of fat around the neck, abdomen, and thorax (lipohypertrophy). The aim of this study has been to assess the impact of polymethylmethacrylate facial treatment on quality of life, self-perceived facial image, and the severity of depressive symptoms in patients living with HIV/AIDS. METHODS: A non-randomized before and after interventional study was developed. Fifty-one patients underwent facial filling. The self-perceived quality of life, facial image, and degree of depressive symptoms were measured by the Short-Form 36 and HIV/AIDS--Targeted quality of life questionnaires, by a visual analogue scale and by the Beck depression inventory, respectively, before and three months after treatment. RESULTS: Six of the eight domains of Short-Form 36 and eight of the nine dimensions of the HIV/AIDS--Targeted quality of life questionnaires, together with the visual analogue scale and by the Beck depression inventory scores, revealed a statistically significant improvement. The only adverse effects registered were edema and ecchymosis. CONCLUSION: The treatment of facial lipoatrophy improved the self-perceived quality of life and facial image as well as any depressive symptoms among patients with HIV/AIDS.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Fármacos Dermatológicos/administración & dosificación , Cara , Síndrome de Lipodistrofia Asociada a VIH/psicología , Síndrome de Lipodistrofia Asociada a VIH/terapia , Polimetil Metacrilato/administración & dosificación , Calidad de Vida , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Anciano , Fármacos Anti-VIH/uso terapéutico , Depresión/psicología , Fármacos Dermatológicos/efectos adversos , Equimosis/inducido químicamente , Edema/inducido químicamente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polimetil Metacrilato/efectos adversos , Escalas de Valoración Psiquiátrica , Enfermedades de la Piel/inducido químicamente , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: This article is a review of the several types of complications due to facial fillers containing polymethylmethacrylate (PMMA). BACKGROUND: Polymethylmethacrylate facial fillers are used to soften the results of the ageing process and to augment tissue. Although considered safe for the most part by advocates, they have been associated with many adverse reactions such as ecchymosis, haematomas, swelling, itching, erythema, hypertrophic scarring, hypersensitivity, palpable nodules, tissue necrosis, blindness and foreign body granuloma. MATERIALS AND METHODS: The articles presented in this review are the result of a search and selection of literature from the National Center for Biotechnology Information (NCBI) database, which met the inclusion criteria for the study. CONCLUSION: Polymethylmethacrylate is widely used because it is inexpensive, readily accessible and simple to apply. However, some complications are severe and permanent and can be confused with other types of stomatological lesions.