Volume changes of grafted autogenous bone in sinus augmentation procedure

to evaluate associations between the osseous remodelling add 3-dimensional features of both the grafted bone and the recipient site as well as the density of the grafted bone,and to assess the relation between the degree of bone resorption and the type of autogenous bone.grafting procedure or the source(block or particulate bone from iliac crest or block bone from chin

Trattamento delle fratture blow-out dell’orbita: endoscopia versus chirurgia tradizionale

2014 - 2015In the last decades, diagnostical imaging, surgical techniques, alloplastic materials, and surgical instruments development, allowed a great progress in management of orbital fractures. The aim of the present study was to evaluate the benefits of endoscopic repair of orbital blow-out fractures of the floor and of the medial wall. Therefore we compared the endoscopic surgical treatment and the traditional external surgical treatment to the orbit, using objective criteria. This study included 30 patients treated from April 2011 and December 2013, 15 with orbital blow-out floor fracture (Group 1) and 15 with orbital medial wall fracture (Group 2), for each group there was a control group treated with surgical traditional approach. For Group 1 seven patients were treated with endoscopic intranasal approach and eight patients were treated with external cutaneous incision to the medial orbital wall. For Group 2 eight patients were treated with endoscopic assisted transconjunctival approach and seven patients with transconjunctival approach to the orbital floor. Phisical examination, included an Hess Lancaster scheme and an Hertel exophthalmometer exam; CT scans were done pre and post surgery for each patient. The follow up period was of 12 months and included a CT scan control after six months post surgery, an endoscopic intranasal control at one, three, six and twelve months after 2 surgery, an Hess Lancaster scheme and an Hertel exophthalmometer exam at one, three and six months after surgery. To evaluate and compare the two approaches were used, for all patients, the following parameters: reduction rate of the herniated orbital tissue, enophthalmos, operation time, hospital stay, postoperative complications. One case in the endoscopic endonasal reduction group had a more than 2 mm enophthalmos after surgery. Among patients with medial orbital wall fracture, the average reduction rate of the herniated orbital tissue was of 90% for the endoscopic endonasal reduction group and 92% for the traditional approach reduction group. Among patients with orbital floor fracture, the average reduction rate was of 87% for the transconjunctival endoscopic assisted reduction group and 86% for the transconjunctival approach reduction group. None of the above differences were statistically significant. However, among the patients that were treated with an endoscopic reduction the average hospital stay and the presence of postoperative complications were lower than in patients treated with the traditional approach, the difference was statistically significant. Among patients treated with endoscopic approach the average operation time was significantly greater than in patients treated with traditional approach, the difference was statistically significant. The two surgical methods seems to have a similar effectiveness; however endoscopic approach seems to be more advantageous with respect of the length of hospital stay and the postoperative complications. [edited by author]XIV n.s

Diastasis of rectus abdominis muscles : patterns of anatomical variation as demonstrated by ultrasound

Purpose: The aim of our study was to categorise the anatomical variations of rectus abdominis muscle diastasis (diastasis recti) by using ultrasound (US). Material and methods: In a one-year period 92 women were evaluated with US because of suspected diastasis of rectus muscles. Patients were examined in a supine position, with head extended, upper limbs aligned to the trunk, and knees flexed. US was performed with high-frequency, broad-band transducers. Trapezoid field-of-view and extended field-of-view were employed to measure diastasis exceeding 5 cm. Diastasis was defined as a margin-to-margin distance > 20 mm at rest and classified according to the following anatomical patterns: open only above the navel, open only below the navel, open at the navel level, open completely but wider above the navel, and open completely but wider below the navel. Results: Diastasis was found in 82 patients (30-61 years old, mean age 35 years). The width was 21-97 mm, mean 39 mm. The prevalence and severity of the anatomical patterns was as follows: open only above the navel in 48 patients (21-88 mm, mean 40 mm), open only below the navel in one patient (33 mm), open at the navel level in seven patients (23-39 mm, mean 34 mm), open completely but wider above the navel in 24 patients (21-97 mm, mean 41 mm), open completely but wider below the navel in two patients (21-29 mm, mean 25 mm). Conclusions: The above-navel patterns of recti muscle diastasis are the most common. Even when open completely, diastasis is usually wider above the navel. Knowledge of the anatomical type of rectus muscle diastasis could be of value to the patient (exercises to do and to avoid) and to the surgeon (abdominoplasty planning)

Marginal masticatory mucosa dimensional changes in immediate post-extractive implants: a 2 year prospective cohort study

The present two-year prospective cohort study was undertaken to evaluate marginal masticatory mucosa dimensional changes around immediate post-extractive implants positioned transgingivally with a non-submerged healing screw. Material and methods: Twenty-one immediate post-extractive implants from 21 patients were enrolled, peri-implant gap was filled with bovine bone mineral, and soft tissue was allowed to heal around a non-submerged healing screw. Post-extractive socket dimension was recorded. Intraoperative (T0) vertical distances: bone margin level (BML) from the bone margin to the implant platform and mucosal margin height (MMH) from marginal mucosa to implant platform were taken; MMH measurement was repeated 4 months later (T4). Horizontal mucosal level (HML): from customized stent to marginal mucosa at 0, 4, 12, and 24 months postoperatively (T0, T4, T12, T24) and vertical mucosal level (VML): from the stent to marginal mucosa at T4, T12, T24 were registered. Results: One implant failed at 3 weeks; in the remaining 20 cases the MMH, coronally positioned with respect to the BML ≅2 mm at T0, showed a statistically significant vertical contraction of the mucosa at T4. Other vertical mucosal measurements (VML) did not show further changes over time. HML measures showed a, statistically significant, shrinkage of the mucosa on the transverse plane between T0/T12 and T0/T24 and between T4/T12 and T4/T24. Conclusions: Immediate post-extractive implant inserted transgingivally with a non-submerged healing screw and internal peri-implant gap filled with bovine bone mineral may favor an early and stable peri-implant soft tissue healing over 2 years