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Awadalkreem F, Khalifa N, Ahmad AG, Suliman AM, Osman M. Oral rehabilitation of maxillofacial trauma using fixed corticobasal implant-supported prostheses: A case series. Int J Surg Case Rep 2022; 100:107769. [PMID: 36302317 PMCID: PMC9615311 DOI: 10.1016/j.ijscr.2022.107769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/23/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Maxillofacial trauma is associated with severe loss of soft and hard tissues that lead to aesthetic and functional disfigurements, adverse psychological impacts on the patient's general and oral health, and decreased quality of life. Therefore, treatment of maxillofacial trauma is challenging. Presentation of case We present three patients with maxillofacial trauma owing to road traffic accidents that were rehabilitated by immediate use of loaded fixed corticobasal implant-supported prostheses with follow-up periods of 6, 5, and 7 years. All treated patients had a 100 % implant survival rate, healthy peri-implant tissues, stable prosthesis with significant improvement in mastication and phonation, and high patient satisfaction. Discussion Rehabilitation of patients with intensive maxillofacial trauma requires a multidisciplinary approach to ensure the standard of care during treatment. The described treatment eliminates the need for bone grafting, reduces susceptibility to grafting complications, shortens treatment time, and provides the patient with a fixed prosthesis with predictable success, excellent implant survival, healthy peri-implant tissue, improved prosthetic stability, and high satisfaction rates. Conclusion Corticobasal implant-supported prostheses are a feasible treatment modality to rehabilitate patients with maxillofacial trauma with high success and survival rates and patient satisfaction. Treatment of maxillofacial trauma requires a multidisciplinary approach. Hard and soft tissue loss complicates treatment. Corticobasal implants do not require bone grafting and reduce treatment time. They help achieve satisfactory peri-implant health and patient satisfaction. Corticobasal implant-supported prostheses are a feasible treatment modality.
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Affiliation(s)
- Fadia Awadalkreem
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates,Corresponding author.
| | - Nadia Khalifa
- Department of Preventive and Restorative Dentistry, University of Sharjah/Faculty of Dental Medicine, Sharjah, United Arab Emirates
| | - Abdelnasir G. Ahmad
- International University of Africa, Oral and Maxillofacial Surgery Department, Khartoum, Sudan
| | - Ahmed Mohamed Suliman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Motaz Osman
- Implant Department, Khartoum Teaching Dental Hospital, Federal Ministry of Heath, Khartoum, Sudan
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Brauner E, Laudoni F, Amelina G, Cantore M, Armida M, Bellizzi A, Pranno N, De Angelis F, Valentini V, Di Carlo S. Dental Management of Maxillofacial Ballistic Trauma. J Pers Med 2022; 12:jpm12060934. [PMID: 35743719 PMCID: PMC9225066 DOI: 10.3390/jpm12060934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Maxillofacial ballistic trauma represents a devastating functional and aesthetic trauma. The extensive damage to soft and hard tissue is unpredictable, and because of the diversity and the complexity of these traumas, a systematic algorithm is essential. This study attempts to define the best management of maxillofacial ballistic injuries and to describe a standardized, surgical and prosthetic rehabilitation protocol from the first emergency stage up until the complete aesthetic and functional rehabilitation. In low-velocity ballistic injuries (bullet speed <600 m/s), the wound is usually less severe and not-fatal, and the management should be based on early and definitive surgery associated with reconstruction, followed by oral rehabilitation. High-velocity ballistic injuries (bullet speed >600 m/s) are associated with an extensive hard and soft tissue disruption, and the management should be based on a three-stage reconstructive algorithm: debridement and fixation, reconstruction, and final revision. Rehabilitating a patient with ballistic trauma is a multi-step challenging treatment procedure that requires a long time and a multidisciplinary team to ensure successful results. The prosthodontic treatment outcome is one of the most important parameters by which a patient measures the restoration of aesthetic, functional, and psychological deficits. This study is a retrospective review: twenty-two patients diagnosed with outcomes of ballistic traumas were identified from the department database, and eleven patients met the inclusion criteria and were enrolled.
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Affiliation(s)
- Edoardo Brauner
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
| | - Federico Laudoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Giulia Amelina
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Correspondence:
| | - Marco Cantore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Matteo Armida
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Andrea Bellizzi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Francesca De Angelis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00167 Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (E.B.); (F.L.); (M.C.); (M.A.); (A.B.); (N.P.); (F.D.A.); (V.V.); (S.D.C.)
- Implanto-Prosthetic Unit, Policlinico Umberto I, Viale Regina Elena 287b, 00161 Rome, Italy
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Picciolo G, Peditto M, Irrera N, Pallio G, Altavilla D, Vaccaro M, Picciolo G, Scarfone A, Squadrito F, Oteri G. Preclinical and Clinical Applications of Biomaterials in the Enhancement of Wound Healing in Oral Surgery: An Overview of the Available Reviews. Pharmaceutics 2020; 12:E1018. [PMID: 33114407 PMCID: PMC7692581 DOI: 10.3390/pharmaceutics12111018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative wound healing. A search in Medline was performed, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The literature was searched for reviews published up to July 2020. Reviews evaluating the clinical and histological effects of biomaterials on post-operative wound healing in oral surgical procedures were included. Review selection was performed by two independent reviewers. Disagreements were resolved by a third reviewer, and 41 reviews were included in the final selection. The selected papers covered a wide range of biomaterials such as stem cells, bone grafts, and growth factors. Bioengineering and biomaterials development represent one of the most promising perspectives for the future of oral surgery. In particular, stem cells and growth factors are polarizing the focus of this ever-evolving field, continuously improving standard surgical techniques, and granting access to new approaches.
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Affiliation(s)
- Giacomo Picciolo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Giuseppe Picciolo
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Alessandro Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
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Awadalkreem F, Khalifa N, Ahmad AG, Suliman AM, Osman M. Prosthetic rehabilitation of maxillary and mandibular gunshot defects with fixed basal implant-supported prostheses: A 5-year follow-up case report. Int J Surg Case Rep 2020; 68:27-31. [PMID: 32113167 PMCID: PMC7044639 DOI: 10.1016/j.ijscr.2020.02.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 11/28/2022] Open
Abstract
Oral maxillofacial gunshot wounds have serious aesthetic and functional consequences. Rehabilitating mandibular gunshot defects is complicated and requires a long time. A multispecialty team is necessary to perform challenging rehabilitation procedures. Fixed basal implant-supported prosthesis placement does not require bone grafting. This procedure produces excellent aesthetic/functional outcomes and implant stability.
Introduction Gunshot injuries to the oral maxillofacial region have serious aesthetic and functional consequences. Presentation of case A 32-year-old male patient presented with a marginal mandibular resection owing to a gunshot wound. A clinical examination revealed destroyed crowns in teeth 12, 11, and 21; extraction in teeth 13, 22, 24, 31, 32-45; a fracture in tooth 38; and severe pain. Further, he had multiple submental scars and a completely obliterated sulcus. Consequently, a multidisciplinary team was formed who devised the following treatment plan: stage 1, root canal treatment for the maxillary anterior teeth, followed by crown construction and transitional mandibular removable partial denture construction, and stage 2, placement of immediately loaded basal implant definitive prostheses supported by 6 corticobasal screw implants. After 5 years of use, the patient presented with excellent peri-implant soft tissue health, prosthesis stability, and great improvements in aesthetics and function. The patient was highly satisfied with the treatment and restoration of his quality of life. Discussion Accurate treatment planning is vital for managing complicated cases, including gunshot defect cases, and should involve the selection of the most suitable reconstructive technique with lower susceptible complication rates and high success rates. The described treatment eliminates the need for bone grafting, reduces treatment duration, and involves fixed prosthesis placement. Conclusion To our knowledge, this is the first report on basal implant-based full-mouth rehabilitation in a gunshot mandibular defect patient. The fixed hybrid basal implant-supported prosthesis produced highly acceptable aesthetic and phonetic results and greatly improved the patient’s life.
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Affiliation(s)
- Fadia Awadalkreem
- Department of Oral Rehabilitation, Prosthodontics Division, Faculty of Dentistry, University of Khartoum, Sudan.
| | - Nadia Khalifa
- Chair of the Department of Preventive and Restorative Dentistry, University of Sharjah, Faculty of Dental Medicine, Sharjah, Sharjah, United Arab Emirates.
| | - Abdelnasir G Ahmad
- International University of Africa, Oral and Maxillofacial Surgery Department, Khartoum, Sudan.
| | - Ahmed Mohamed Suliman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan.
| | - Motaz Osman
- Implant Department, Khartoum Teaching Dental Hospital, Federal Ministry of Heath, Khartoum, Sudan.
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Titsinides S, Agrogiannis G, Karatzas T. Bone grafting materials in dentoalveolar reconstruction: A comprehensive review. JAPANESE DENTAL SCIENCE REVIEW 2019; 55:26-32. [PMID: 30733842 PMCID: PMC6354279 DOI: 10.1016/j.jdsr.2018.09.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/10/2018] [Indexed: 12/11/2022] Open
Abstract
Bone deficits of the jaws are often attributed to accidents, surgical removal of benign lesions or malignant neoplasms, congenital abnormalities, periodontal inflammation, tooth abscess or extraction and finally jaw atrophy due to advanced age or general disease. These bone defects require rehabilitation for a variety of reasons, e.g. maintaining the normal anatomic outline, eliminating empty space, aesthetic restoration and placing dental implants. Today, several techniques have been developed to eliminate these bone deformities including bone grafting, guided bone regeneration, distraction osteogenesis, use of growth factors and stem cells. Bone grafts consist of materials of natural or synthetic origin, implanted into the bone defect site, documented to possess bone healing properties. Currently, a variety of bone restorative materials with different characteristics are available, possesing different properties. Despite years of effort the 'perfect' bone reconstruction material has not yet been developed, a further effort is required to make this objective feasible. The aim of this article is to provide a contemporary and comprehensive overview of the grafting materials that can be applied in dentoalveolar reconstruction, discussing their properties, advantages and disadvantages, enlightening the present and the future perspectives in the field of bone regeneration.
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Affiliation(s)
- S. Titsinides
- Department of Oral Medicine and Pathology, Dental School, University of Athens, Athens, Greece
| | - G. Agrogiannis
- 1st Department of Pathology, Medical School, University of Athens, Athens, Greece
| | - T. Karatzas
- 2nd Department of Propedeutic Surgery, Laiko General Hospital, Medical School, University of Athens, Athens, Greece
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