Background and Objectives: The loss of teeth in the posterior maxillary region often leads to significant alveolar bone resorption and maxillary sinus pneumatization, complicating dental implant placement. Maxillary sinus grafting, typically using autogenous bone, is a common solution. However, autogenous bone grafts require additional surgical procedures, leading to increased morbidity. This study aims to compare the efficacy of two xenografts, Bio-Oss and Cerabone, in promoting new bone formation in maxillary sinus grafting through histomorphometric analysis and micro-computed tomography (micro-CT). Materials and Methods: A total of 22 maxillary sinuses (12 right and 10 left) were grafted, with 12 using Cerabone and 10 using Bio-Oss. Six months post-grafting, biopsies were collected for histomorphometric analysis to measure new bone formation, connective tissue, and residual biomaterial. Additionally, micro-CT analysis was performed to assess bone volume fraction, trabecular thickness, number, and separation. Results: Histomorphometric analysis showed that the Cerabone group had a higher average new bone formation (25.94% ± 10.55) compared to the Bio-Oss group (17.29% ± 4.61), with a statistically significant difference (p = 0.02). Micro-CT analysis revealed that the bone volume fraction in the Cerabone group was significantly higher compared to the Bio-Oss group, with significant differences in trabecular thickness (p = 0.02) but not in trabecular number or separation. Conclusions: The study demonstrates that both xenografts are effective in promoting new bone formation in maxillary sinus grafting. However, Cerabone showed superior performance in terms of new bone formation and bone volume fraction, suggesting it may be a more effective option for maxillary sinus augmentation procedures.
The facial skeleton in pediatric patients can undergo several changes during development, according to their growth zones and the traumas they suffer. Thus, some of these traumas can lead to multiple complications if not treated properly. Epidemiology can vary according to the social, cultural, and environmental aspects of each individual. Therefore, each case must be treated individually, and it is important to consider age-specific aspects, such as the high osteogenic potential, which leads to faster bone healing. The use of resorbable fixation materials in facial fractures of pediatric patients is widespread, with good acceptance and great advantages over conventional titanium materials, mainly for the elimination of a second surgery to remove the materials. The present study aims to report a series of clinical cases of infants, who suffered trauma and evolved with fractures in the facial bones. Surgical treatment was instituted to reduce and fix fractures, using the resorbable system. Patients are followed up with periodic outpatient follow-up visits and have a good case evolution.
12 April 2017 in Journal of Maxillofacial and Oral Surgery
Background: Traumatic optic neuropathy (TON) following orbital roof fractures is rare in pediatric populations but represents a surgical emergency due to risk of permanent blindness. Approximately 1.6% of traumatic brain injury cases involve direct optic nerve injury. Orbital roof fractures in children are uncommon and may be associated with frontal lobe injury, dural tears, and proptosis. Early recognition and multidisciplinary intervention are critical for visual preservation. Case Presentation: A 2-year-old girl sustained high-energy motor vehicle trauma resulting in left orbital roof fracture with optic nerve compression. Clinical examination revealed proptosis, anisocoric pupil without photoreaction, and restricted ocular movement. Computed tomography confirmed displaced orbital roof fracture compressing the optic nerve. Emergency multidisciplinary surgery was performed via medial superior palpebral approach with bone fragment repositioning and optic nerve decompression. Intraoperative cerebrospinal fluid leak resolved spontaneously with conservative management. At 28 months postoperatively, the patient demonstrates complete visual recovery without diplopia, exophthalmos, or dystopia. Conclusion: Pediatric orbital roof fractures with optic nerve compression require immediate surgical decompression to prevent permanent visual loss. Multidisciplinary collaboration between neurosurgery, oral-maxillofacial surgery, and ophthalmology is essential. Despite potential complications including CSF fistula, timely intervention can achieve excellent functional outcomes.
1 January 2021 in Research, Society and Development
Panfacial fractures are due to high-energy trauma, making the treatment of patients since the first visit is challenging. Generally, these involve soft tissue injuries, comminuted fractures and even fragment loss. In addition to this, the surgical approach to facial reconstruction through the fixation of bone fragments can be postponed due to the patient's clinical conditions, which can lead the treatment to a more complex condition due to the possibility of infection, poor union of bone fragments and tissue contraction. The aim of this study is to discuss the clinical case of high-energy trauma caused by an air accident, leading to multiple facial and body fractures. And in this way contribute to the extremely limited scientific literature on the subject, with such etiology and significant facial trauma.