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Shay B, Mijiritsky E, Bronstein M, Govani-Levi M, Ben Simhon T, Chackartchi T. Flapless Decoronation: A Minimally Invasive Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:603. [PMID: 36612921 PMCID: PMC9819250 DOI: 10.3390/ijerph20010603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.
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Affiliation(s)
- Boaz Shay
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Endodontics, Hadassah Medical Center, Jerusalem 9112102, Israel
| | - Eitan Mijiritsky
- Department of Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel
| | - Meital Bronstein
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Endodontics, Hadassah Medical Center, Jerusalem 9112102, Israel
| | - Mor Govani-Levi
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Endodontics, Hadassah Medical Center, Jerusalem 9112102, Israel
| | - Tal Ben Simhon
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Endodontics, Hadassah Medical Center, Jerusalem 9112102, Israel
| | - Tali Chackartchi
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Periodontology, Hadassah Medical Center, Jerusalem 9112102, Israel
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Choi JW, Alshomer F, Kim YC. Evolution and current status of microsurgical tongue reconstruction, part II. Arch Craniofac Surg 2022; 23:193-204. [PMID: 36373253 PMCID: PMC9663260 DOI: 10.7181/acfs.2022.00857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/11/2022] [Indexed: 01/25/2023] Open
Abstract
Tongue reconstruction remains a major aspect of head and neck reconstructive procedures. Surgeons planning tongue reconstruction should consider several factors to optimize the overall outcomes. Specifically, various technical aspects related to tongue reconstruction have been found to affect the outcomes. Multidisciplinary teams dedicated to oncologic, reconstructive, and rehabilitative approaches play an essential role in the reconstructive process. Moreover, operative planning addressing certain patient-related and defect-related factors is crucial for optimizing functional speech and swallowing, as well as quality of life outcomes. Furthermore, tongue reconstruction is a delicate process, in which overall functional outcomes result from proper flap selection and shaping, recipient vessel preparation and anastomosis, surgical approaches to flap insetting, and postoperative management. The second part of this review summarizes these factors in relation to tongue reconstruction.
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Affiliation(s)
- Jong-Woo Choi
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Feras Alshomer
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Chul Kim
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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