Juxtacortical mandibular chondrosarcoma during pregnancy : a case report

Chondrosarcoma is one of the most common malignant bone tumors in adults. It use to affect upper arm, pelvis and thigh bone. A wide surgical extirpation represent the gold standard to treat this disorder. In fact, radiotherapy and chemotherapy are no useful. Interestingly, chondrosarcoma is rare in head and neck (HNCS) and extremely uncommon during pregnancy. Thus, there is a lack of evidence about the proper treatment in these cases. A wide surgical extirpation is also considered the most effective procedure in HNCS. There are no consistent evidences about the he role of radiation and chemotherapy. In view of that, the present study describes a case of juxtacortical mandibular chondrosarcoma affecting a 28-year-old pregnant woman. After a multidisciplinary analysis of the case, we decided to treat the patient with a wide surgical resection and and immediately reconstruction

Why is the Aetiology of Facial Bone Fractures in West of Libya is Diffrent

A maxillofacial fracture is a serious clinical problem because of its functional and aesthetic significance. If these injuries are treated improperly may ultimately result in a patient’s low quality of life. Diagnosis and treatment of these fractures remain a challenge for oral and maxillofacial surgeons, demanding a high level of proficiency. Objective: This study aims to analyze the epidemiology of maxillofacial fractures treated in ministry hospital, Ali Omar Askar Neuro Center in Sbea Tripoli, Libya, to identify the causative factors, and to help in planning programs to control the incident in a population. Study Design: A retrospective review of all patients with maxillofacial fracture presented to Oral & Maxillofacial Surgery Department of Ali Omar Askar Neuro Center Sbea, Tripoli between January 2010 and December 2015 was performed. Result: Total of 437 patients obtained 752 maxillofacial fractures. Male were mostly affected comprising 83%, with the majority occurring in individuals 21-30 year age range. Road traffic accident was the most common cause of maxillofacial fractures with a total of 63.84%. Mandible fracture was mostly affected consisting 59.18% of all maxillofacial fractures. The most fractured anatomical part of the mandible is parasymphysis containing 23% of all mandible fractures. Open reduction and internal fixation was the most common treatment modality. Thirteen percent of patients had associated injuries, and four percent had complications. Conclusion: According to the World Health Organization established in May 2014, Libya is the leading country of traffic deaths per capita. This retrospective study of maxillofacial fracture is congruent to the research that road traffic accident in the country was the most common incident. It is capturing to both government officials to implement legislation and healthcare providers to develop programs to educate the public and reduce such injurie

Development of new Bombyx mori silk fibroin membranes for periodontal guided tissue regeneration

Periodontitis is one of the most common inflammatory diseases and a leading cause of tooth loss in adults, being characterized by progressive destruction of the tooth-supporting apparatus. Guided Tissue Regeneration (GTR) and Guided Bone Regeneration (GBR) procedures were established as basic techniques in periodontal regenerative medicine due to its promising results. These procedures are based, typically, on a membrane, that is placed between the gingiva and the alveolar bone in which the regenerative process will take place. However, the commercial available membranes present limitations at structural, mechanical and biofunctional level demonstrating the need for developing clinically effective materials. In this work a new generation of GTR/GBR membranes is presently being proposed using a natural-based material. Bombyx mori silk fibroin(SF)-based membranes have been developed using glycerol (GLY) and poly (vinyl alcohol) (PVA) as plasticizers to improve the flexibility and enhanceSF stabilization. The developed membranes, designed to be in contact with the gingiva, aim at providing an effective solution for mild periodontitis (the most prevalent form worldwide) by helping to restore the anatomy and function of lost or damaged periodontal tissues. Purified SF solution was mixed with GLYor PVA at weight ratios of 0, 10, and 30%. The membranes were obtained by casting the final solutions into Petri dishes and dried at 85 ºC in the oven for 6 hours some and 12 hours others for further characterization. A comparative study was undertaken using the pure SF membrane as control. The SF-based membranes were characterized in terms of their morphology, physical integrity, chemical structure, mechanical and thermal properties, swelling capability and in vitro degradation behavior. Membranes dried for 6 and 12 hours presented similar aspect and microstructure. Scanning electronmicroscopy (SEM) micrographs suggested that GLY is well distributed in SF matrix while PVA presented phase separation between the two polymers. Atomic force microscopy (AFM) revealed that the surface nanotopography and the average roughness of the SF-based membranes are affected by the exposure time and by the percentage of additive content. Contact angle measurements showed a decrease of water contact angle with GLY and PVA increasing, indicating that the surfaces become more hydrophilic. Attenuated infrared spectroscopy (ATR-FTIR) analysis demonstrated that the thermal treatment induced SF b-sheet conformation for both exposure periods. However, only the membranes dried for 12 hours were water stable for more than 24 hours. These membranes reached equilibrium hydration degree after 3 hours. With the addition of the synthetic polymers, the hydration capacity increased together with the weight loss both in PBS and PBS with enzyme. The mechanical properties revealed that GLY and PVA had a plasticizing effect on the membrane which became more ductile without compromising its mechanical strength. The developed membranes demonstrated to be promising systems to be used in a guided tissue regeneration approach for periodontal regeneration.A periodontite é uma das doenças inflamatórias mais comuns e uma das principais causas de perda dentária em adultos, sendo caracterizada por uma destruição progressiva das estruturas que suportam o dente. Procedimentos como a Regeneração Tecidular Guiada (RTG) e a Regeneração Óssea Guiada(ROG) foram estabelecidos como técnicas chave na medicina regenerativa periodontal devido aos seus resultados promissores. Estes procedimentos baseiam-se, tipicamente, numa membrana que é colocada entre a gengiva e o osso alveolar onde o processo regenerativo terá lugar. No entanto, as membranas comercialmente disponíveis apresentam limitações a nível estrutural, mecânico e biofuncional demonstrando a necessidade de se desenvolverem materiais clinicamente mais eficazes. Neste trabalho, propõe-se uma nova geração de membranas RTG/ROG utilizando um material de origem natural. Assim, desenvolveram-se membranas à base de fibroína de seda (FS), extraída de casulos Bombyx mori, plasticizadas com glicerol (GLY) e álcool polivinílico (PVA) de modo a melhorara sua flexibilidade e estabilização. As membranas produzidas, desenhadas para estarem em contato com a gengiva, visam fornecer uma solução eficaz para a periodontite moderada (o tipo de periodontite mais prevalente no mundo), ajudando a restaurar a anatomia e a função dos tecidos periodontais perdidos ou lesados. Soluções purificadas de FS foram misturadas com GLY ou PVA em proporções de 0, 10 e 30% em peso. As membranas foram obtidas pelo método de “solvent casting” e secas a 85°C durante 6 e 12 horas para posterior caracterização. Como controlo foi utilizada uma membrana deFS pura. As membranas foram caracterizadas em termos de morfologia, integridade física, estrutura química, propriedades mecânicas e térmicas, capacidade de inchamento e perfil de degradação in vitro. As membranas secas durante 6 e 12 horas apresentaram aspeto e microestrutura semelhante. As micrografias de microscopia eletrónica de varrimento (MEV) sugerem que o GLY está bem distribuído na matriz da FS enquanto o PVA apresenta separação de fases entre os dois polímeros. A microscopia de força atómica (MFA) revelou que a nanotopografia superficial e a rugosidade média das membranas são afetadas pelo tempo de exposição ao tratamento térmico e pela percentagem de polímero sintético. As medições de ângulo de contato mostraram uma diminuição do mesmo com a quantidade crescente de GLY e PVA, indicando que as superfícies se tornam mais hidrofílicas. As análises de espectroscopiade infravermelho com transformada de Fourier demonstraram que o tratamento térmico induziu a conformação “b-sheet” para ambos os períodos de exposição. Contudo, apenas as membranas secas por 12 horas apresentaram estabilidade por mais de 24 horas em água, atingindo o máximo grau de hidratação após 3 horas. Com a adição dos polímeros sintéticos, a capacidade de hidratação aumentou juntamente com a perda de peso tanto em PBS como em PBS com enzima. As propriedades mecânicas revelaram que o GLY e o PVA possuem um efeito plasticizante, tornando as membranas mais flexíveis e dúcteis sem comprometer a resistência mecânica necessária para esta aplicação. As membranas desenvolvidas demonstraram ser sistemas promissores para aplicação em regeneração guiada de tecido periodontal

Alcohol consumption and maxillofacial fractures in times of COVID-19: a cross-sectional study in a Cuban university hospital.

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the “Carlos Manuel de Céspedes” General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p<0.001), the fractures of the zygomaticomaxillary complex (p=0.023), and the traumas that occurred during the weekends (p<0.001) or during the month of June (p=0.029) were factors associated with a higher frequency of fractures related to the consumption of alcoholic beverages. There was a lower frequency of fractures associated with alcohol consumption during the months of January (p=0.006) and March (p=0.001). Conclusion: Six out of ten cases were under the influence of alcoholic beverages. There was a greater number of young and male patients, mainly due to interpersonal violence

The Impact of the COVID-19 Pandemic on the Pattern of Trauma Presenting to a Tertiary Care Trauma Center in Oman

Objective: We noticed a change in the pattern of presentation of trauma cases at SQUH, before the pandemic and during the two waves. Our study aimed at studying this observation. Methods: This retrospective study was from January 2019 to October 2021. Data of all trauma patients was collected from the hospital information system after ethics committee approval. The pattern of trauma was divided into pediatric, adult, and geriatric age groups. Location of trauma was described as outdoor, home and roads along with the details of mechanism of trauma was collected. Patients with incomplete data were excluded. Results: Based on the inclusion criteria 589 records were analyzed.&nbsp;The mean age of presentation was 29 years. Majority were male (71%). Adults were (54.2%),&nbsp;pediatrics (34%) and geriatric (11.9%). There was a gradual increase in percentage of pediatric trauma during pre-COVID, COVID wave 1&nbsp;and COVID wave 2 (29%, 32%, 51%), respectively. A significant decline in the number of geriatric trauma by almost 50% between pre-covid and covid phase II. Increase in trauma at home during COVID phase II (65.9%) as was an increase in penetrating trauma during COVID phase II (16.5%). ICU admissions increased during the first wave of the pandemic (10.5%). Conclusion:&nbsp; We noted a true change in the pattern of trauma cases before and during the COVID -19 pandemic. Observations made could lead to better safety guidelines for the pediatric age groups and take steps to reduce penetrating trauma. Keywords: Trauma, coronavirus, COVID-19, Oman, Muscat, Epidemiology

Prevalence, etiology, and types of dental trauma in children and adolescents: Systematic review and meta-analysis

Background: Dental traumas are common among children and adolescents in many societies posing health and social problems. The aim of this study was to conduct a systematic review and metaanalysis on prevalence, etiology, types, and other epidemiologic aspects of dental trauma in children and adolescents (0-18 years old). Methods: In this systematic meta-analytical review, data were collected searching for key words including traumatic dental injuries, dental trauma, dental injury, dental trauma, tooth injuries, tooth trauma, traumatized teeth, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, incidence, occurrence, child*, and adolescence in the following databases: Scopus, CINAHL, Science Direct, PubMed and Google scholar. Results: From the total of 3197 articles, 44 completely relevant papers were included in the study. The prevalence of dental trauma was variable based on geographical area and was estimated 17.5 in the population, with higher prevalence in boys. Falling was the major cause for dental trauma, and the most frequent location was home. The most frequent type of trauma was enamel fracture. Conclusion: A relatively high prevalence was detected for dental trauma, which calls for effective planning and intervention to prevent the occurrence in children and adolescents. These may include special care for children, eliminating fall-prone areas, installing safety measures at homes, using protective appliances in sports, education, and raising the knowledge and availability of services to address enamel fracture. Region-specific criteria should be taken into account in programs and interventions