Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

The objective of this investigation was to evaluate the indications for and the functional and cosmetic results of mandible reconstruction using free vascularized fibular flaps. It was also designed to assess the patients' quality of life, daily activities, and self-esteem, with special emphasis on patient satisfaction. We conducted a retrospective chart review of all patients who underwent osseus or osteocutaneous free flap reconstruction of the mandible over a 10-year period (1992-2002). Those in whom a vascularized fibular flap was used were included in the study and invited for a follow-up comprehensive physical examination and x-ray evaluation. A questionnaire was also administered to evaluate patient satisfaction. Twenty-six patients were included in the study. Fourteen patients died after an average of 2years and 9months postoperatively due to their prognosis despite surgical intervention and adjuvant therapy. Of the remaining 12 patients, 6 appeared for the follow-up evaluation, 2 were unavailable for follow-up, and 4 denied participating. Of these 6 patients, all experienced a decrease in pain and were satisfied with their results. At the time of the latest follow-up, they experienced some difficulties swallowing, and in 3 patients, their articulation was impaired. All 6 patients would undergo the procedure again. Reconstruction of the mandible using a vascularized fibular graft produces satisfactory functional and cosmetic results. In benign lesions, the procedure is highly indicated. However, in the case of malignancy, most patients do not survive their primary tumor. Given the patients limited life expectancy, the improvement in their quality of life as a result of the improved appearance and function of the reconstructed mandible needs to be weighed against the potential morbidity of the operative intervention on an individual basi

Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

The objective of this investigation was to evaluate the indications for and the functional and cosmetic results of mandible reconstruction using free vascularized fibular flaps. It was also designed to assess the patients' quality of life, daily activities, and self-esteem, with special emphasis on patient satisfaction. We conducted a retrospective chart review of all patients who underwent osseus or osteocutaneous free flap reconstruction of the mandible over a 10-year period (1992-2002). Those in whom a vascularized fibular flap was used were included in the study and invited for a follow-up comprehensive physical examination and x-ray evaluation. A questionnaire was also administered to evaluate patient satisfaction. Twenty-six patients were included in the study. Fourteen patients died after an average of 2years and 9months postoperatively due to their prognosis despite surgical intervention and adjuvant therapy. Of the remaining 12 patients, 6 appeared for the follow-up evaluation, 2 were unavailable for follow-up, and 4 denied participating. Of these 6 patients, all experienced a decrease in pain and were satisfied with their results. At the time of the latest follow-up, they experienced some difficulties swallowing, and in 3 patients, their articulation was impaired. All 6 patients would undergo the procedure again. Reconstruction of the mandible using a vascularized fibular graft produces satisfactory functional and cosmetic results. In benign lesions, the procedure is highly indicated. However, in the case of malignancy, most patients do not survive their primary tumor. Given the patients limited life expectancy, the improvement in their quality of life as a result of the improved appearance and function of the reconstructed mandible needs to be weighed against the potential morbidity of the operative intervention on an individual basi

Mineral maturity and crystallinity index are distinct characteristics of bone mineral

The purpose of this study was to test the hypothesis that mineral maturity and crystallinity index are two different characteristics of bone mineral. To this end, Fourier transform infrared microspectroscopy (FTIRM) was used. To test our hypothesis, synthetic apatites and human bone samples were used for the validation of the two parameters using FTIRM. Iliac crest samples from seven human controls and two with skeletal fluorosis were analyzed at the bone structural unit (BSU) level by FTIRM on sections 2–4 lm thick. Mineral maturity and crystallinity index were highly correlated in synthetic apatites but poorly correlated in normal human bone. In skeletal fluorosis, crystallinity index was increased and maturity decreased, supporting the fact of separate measurement of these two parameters. Moreover, results obtained in fluorosis suggested that mineral characteristics can be modified independently of bone remodeling. In conclusion, mineral maturity and crystallinity index are two different parameters measured separately by FTIRM and offering new perspectives to assess bone mineral traits in osteoporosis

Submicron-to-nanoscale structure characterization and organization of crystals in dentin bioapatites

The aim of this research was to ascertain the crystal morphology, and to assess the ultrastructure and texture changes of sound (SD) and caries-affected dentin (CAD) after being restored with Zn-free and Zn-containing amalgam. Dentin surfaces were studied by X-ray diffraction (XRD2), and Transmission Electron Microscopy (TEM) through selected area diffraction (SAED) and bright-field (BF) imaging. Crystals, at the dentin surface, were identified as hydroxyl-apatite with augmented crystallographic maturity, crystallite and grain sizes, and lower microstrain, in CAD dentin after Zn-containing amalgam removal, at 310 plane. This group, at this reflection, achieved lower microstrain than before amalgam placement. Opposed trend was followed at 002 reflection. Texture increased in CAD at both reflections, after the removal of Zn-containing amalgams. Crystallinity increased in SD after amalgam restorations at 002 and 310 reflections. In CAD, crystallinity decreased after amalgam restorations at 002 plane. Block-like and needle-like apatite crystals constituted the bulk of minerals in SD. Needle-like apatite crystals were observed, in CAD surfaces, before and after Zn-free amalgam restorations. Polyhedral and rounded drop-like shaped crystals characterized the CAD surfaces before Zn-containing amalgam placement. After the restoration removal, plate-like polygons and three-dimensional agglomerated crystals were determined. Crystallites, with improved crystallographic orientation, became shorter and thinner in CAD treated with Zn-containing amalgams, thus increasing mineralization and maturity.Project MAT2014-52036-P supported by the Ministry of Economy and Competitiveness (MINECO) and European Regional Development Fund (FEDER) and FIS2013-41821-R

Zn-doped NPs in dentistry

Objectives: The aim was to state the different applications and the effectiveness of polymeric zinc-doped nanoparticles to achieve dentin remineralization. Data, Sources and Study selection: Literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. A narrative exploratory review was undertaken. Conclusions: Polymeric nanospheres (NPs) were efficiently loaded with zinc. NPs sequestered calcium and phosphate in the presence of silicon, and remained effectively embedded at the hybrid layer. NPs incorporation did not alter bond strength and inhibited MMP-mediated dentin collagen degradation. Zn-loaded NPs remineralized the hybrid layer inducing a generalized low-carbonate substitute apatite precipitation, chemically crystalline with some amorphous components, and an increase in mechanical properties was also promoted. Viscoelastic analysis determined that dentin infiltrated with Zn-NPs released the stress by breaking the resin-dentin interface and creating specific mineral formations in response to the energy dissipation. Bacteria were scarcely encountered at the resin-dentin interface. The combined antibacterial and remineralizing effects, when Zn-NPs were applied, reduced biofilm formation. Zn-NPs application at both cervical and radicular dentin attained the lowest microleakage and also promoted durable sealing ability. The new zinc-based salt minerals generated covered the dentin surface totally occluding cracks, porosities and dentinal tubules. Clinical significance: Zinc-doped NPs are proposed for effective dentin remineralization and tubular occlusion. This offers new strategies for regeneration of eroded cervical dentin, effective treatment of dentin hypersensitivity and in endodontically treated teeth previous to the canal filling. Zn-NPs also do reduce biofilm formation due to antibacterial properties