Активность

Objectives Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P less then 0.001). Conclusion Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.Objectives In this study, we determined the incidence and pattern of screw loosening in patients who received dental implants. Materials and Methods Patients who received implants between January 2008 and October 2013 and completed their prosthetic rehabilitation were evaluated for the incidence, frequency, and onset of screw loosening using dental charts and radiographs. The association between each factor and screw loosening was analyzed using the chi-square test and a multivariate analysis with binary logistic regression models (P less then 0.05). Results Total 1,928 implants were placed in 837 patients (448 males, 389 females), whose follow-up period after loading varied from 0.25 to 70 months (mean period, 31.5 months). Screw loosening occurred in 7.2% of implants. Transmembrane Transporters inhibitor Most cases occurred less than six months after loading. Among those, 22.3% experienced recurrent screw loosening. Screw loosening was most common in the molar region (8.5%) and frequently associated with an implant diameter of ≥5 mm (14.2%). External implant-abutment connections (8.9%) and screw-retained implant prostheses (10.1%) showed higher incidence of problems than internal implant-abutment connections and cement-retained implants, respectively. Screw loosening was most common in implant prostheses with single crowns (14.0%). Conclusion Within the limits of the current study, we conclude that the incidence of screw loosening differs significantly according to the position of implant placement, the type of implant and manufacturer, implant diameter, the type of implant-abutment connection, the type of retention in the implant prosthesis, and the type of implant prosthesis.Objectives The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting. Materials and Methods The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed. Results A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P less then 0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; P less then 0.001). Conclusion Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score less then 3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.Objectives Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery. Materials and Methods A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated. Results The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient’s sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery. Conclusion Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.