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Clinical consideration for implant installation in haematologic disorder patients
Free Papers—Poster Presentations and is should be considered when the viability of the skin is at risk. doi:10.1016/j.ijom.2009.03.641
P169 Clinical consideration for implant installation in haematologic disorder patients M.S. Han ∗ , J.R. Jang, B.S. Kim, S.G. Jung, Y.J. Park, G.H. Choi, M.S. Kook, H.J. Park, H.K. Oh, S.Y. Ryu Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnal National University, Donggu, Gwangju, Korea
The aim of this study was to investigate whether implant supported restoration constitute a valid technique for haematologic disorder patients. Recurrent bleeding from the wound site led to persistence of iron in the tissue and excessive tissue iron has link to poor wound healing, high angiogenesis as well as fibrosis that may interfere in implant osseointegration. Four patient’s sufferings from different haematologic problems were rehabilitated by using Osstem implant system. A total of 21 implants were placed on those 4 compromised patients. Radiological and clinical parameters were elevated during prosthetic loading and after prosthesis. Peri-implant bone losses at the time of healing and remodelling period were mean 0.88 mm and 1.14 mm respectively and fine trabecular bone in intimate contact enclosing the implant fixture supposed to enough osseointegration for log time success. Cumulative success and survival rate of implant were 85.71% and 100.0% after 17.23 months of prosthetic loading. Despite high risk of bleeding and subsequent impaired healing, all the procedures were uneventful. The outcome of this study supposed that Implant supported restoration is safe and reliable procedure even in haematologic disorder patients but careful handling during implant installation, soft tissue healing and ideal prosthesis fixation is imperative to overcome the possible complications.
M.S. Kook, H.J. Park, H.K. Oh, S.Y. Ryu Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnal National University, Donggu, Gwangju, Korea
Background and Objectives: Secondary space infections may be lethal if lifethreatening complications occur, especially in immunocompromised hosts such as diabetic patients. This study was performed to evaluate the effect of diabetes mellitus on prognosis in secondary space infections clinically. Methods: We reviewed the records and radiographic images of 42 patients (20 diabetic patients, 22 non-diabetic patients) who were diagnosed with secondary space infections and received treatment at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital from January 2007 to September 2008 retrospectively. Results: Compared with the non-diabetic patients, diabetic patients tended to involve multiple secondary spaces and undergo more surgical operations (mean, 1.6 versus 0.9). The diabetic group showed older age (mean, 64.1 versus 49.8 years); prolonged hospitalisation (mean, 30.1 versus 15.9 days); more increased white blood cells and C-reactive protein (17,130/mm3 versus 13,150/mm3 and 17.0 mg/dL versus 13.6 mg/dL); higher complication rate (35.0% versus 9.0%); and higher tracheostomy rate (15.0% versus 4.5%). Causative microorganisms were Klebsiella pneumoniae and Staphylococcus sps in diabetic patients. Conclusions: These results suggest that diabetic patients show poorer prognosis than non-diabetic patients in secondary space infections due to more involved spaces, abnormal haematologic findings, higher complication ratio, and more additive procedures such as tracheostomy. doi:10.1016/j.ijom.2009.03.643
Plastic and Aesthetic Surgery
doi:10.1016/j.ijom.2009.03.642
P171 Orthomorphic correction of mandibular asymmetry—a case report
P170 The effect of diabetes mellitus on prognosis in secondary space infection
S. Shetty Department of Oral and Maxillofacial Surgery, J.S.S. Dental College and Hospital, Mysore, Karnataka, India
M.S. Han ∗ , J.R. Jang, B.S. Kim, S.G. Jung, Y.J. Park, G.H. Choi,
Introduction: The term ‘orthomorphic’ refers to an osteotomy aimed at restoring
581
the morphology. When the cause of mandibular asymmetry includes an alteration in the shape of the jaws as in temporomandibular joint (TMJ) ankylosis, orthognathic surgery is unable to correct the resulting contour deformity. Orthomorphic correction aims to correct deformities related to shape and contour of the jaws without affecting the status of occlusion. Case Report: A 23-year-old male patient presented to us with the complaint of flattening of the right side of the face. Patient gave a history of childhood trauma to the chin. The case was diagnosed as mandibular asymmetry secondary to left TMJ ankylosis without any functional deficits and a stable occlusion. The patient underwent orthomorphic correction on the right side of the mandible, where a full thickness osteotomy of the lower one third of the body of the mandible which continued on to the lateral aspect of the ramus as a split thickness osteotomy. The segment was realigned to correct the chin midline and the contour on the right side. Fixation is performed with the bone plates and corticocancellous blocks are sandwiched to bridge the overlapping edges. Optimal aesthetic result was achieved postoperatively. Conclusion: The described technique has the ability to alter the entire area of the contour defect in any desired dimension as a single unit. doi:10.1016/j.ijom.2009.03.644
P172 Linear nevus sebaceous syndrome: case report T. Tamme ∗ , J. Tiigimäe-Saar, T. Raie Department of Maxillofacial Surgery, Tartu University Hospital, L. Puusepa 8, Estonia
Introduction: Linear nevus sebaceous syndrome is a rare neurocutaneous disorder characterised by extensive cutaneous sebaceous nevi associated with congenital abnormalities involving the brain and other organs. Although the lesion may be present at birth, it does not typically manifest until late adolescence when, secondary to hormonal influences, it enlarges to a well demarcated, waxy verrucous lesion. We present a case of large cutaneous nevi on the face with other neurological abnormalities. Case Report: A 48-year-old man presented multiple verrucous, warty lesions on his left side of the face that had been present since the age of 9 years, and become darker and bigger over time. Physical examination revealed multiple verrucous lesions
P169 Clinical consideration for implant installation in haematologic disorder patients M.S. Han ∗ , J.R. Jang, B.S. Kim, S.G. Jung, Y.J. Park, G.H. Choi, M.S. Kook, H.J. Park, H.K. Oh, S.Y. Ryu Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnal National University, Donggu, Gwangju, Korea
The aim of this study was to investigate whether implant supported restoration constitute a valid technique for haematologic disorder patients. Recurrent bleeding from the wound site led to persistence of iron in the tissue and excessive tissue iron has link to poor wound healing, high angiogenesis as well as fibrosis that may interfere in implant osseointegration. Four patient’s sufferings from different haematologic problems were rehabilitated by using Osstem implant system. A total of 21 implants were placed on those 4 compromised patients. Radiological and clinical parameters were elevated during prosthetic loading and after prosthesis. Peri-implant bone losses at the time of healing and remodelling period were mean 0.88 mm and 1.14 mm respectively and fine trabecular bone in intimate contact enclosing the implant fixture supposed to enough osseointegration for log time success. Cumulative success and survival rate of implant were 85.71% and 100.0% after 17.23 months of prosthetic loading. Despite high risk of bleeding and subsequent impaired healing, all the procedures were uneventful. The outcome of this study supposed that Implant supported restoration is safe and reliable procedure even in haematologic disorder patients but careful handling during implant installation, soft tissue healing and ideal prosthesis fixation is imperative to overcome the possible complications.
M.S. Kook, H.J. Park, H.K. Oh, S.Y. Ryu Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnal National University, Donggu, Gwangju, Korea
Background and Objectives: Secondary space infections may be lethal if lifethreatening complications occur, especially in immunocompromised hosts such as diabetic patients. This study was performed to evaluate the effect of diabetes mellitus on prognosis in secondary space infections clinically. Methods: We reviewed the records and radiographic images of 42 patients (20 diabetic patients, 22 non-diabetic patients) who were diagnosed with secondary space infections and received treatment at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital from January 2007 to September 2008 retrospectively. Results: Compared with the non-diabetic patients, diabetic patients tended to involve multiple secondary spaces and undergo more surgical operations (mean, 1.6 versus 0.9). The diabetic group showed older age (mean, 64.1 versus 49.8 years); prolonged hospitalisation (mean, 30.1 versus 15.9 days); more increased white blood cells and C-reactive protein (17,130/mm3 versus 13,150/mm3 and 17.0 mg/dL versus 13.6 mg/dL); higher complication rate (35.0% versus 9.0%); and higher tracheostomy rate (15.0% versus 4.5%). Causative microorganisms were Klebsiella pneumoniae and Staphylococcus sps in diabetic patients. Conclusions: These results suggest that diabetic patients show poorer prognosis than non-diabetic patients in secondary space infections due to more involved spaces, abnormal haematologic findings, higher complication ratio, and more additive procedures such as tracheostomy. doi:10.1016/j.ijom.2009.03.643
Plastic and Aesthetic Surgery
doi:10.1016/j.ijom.2009.03.642
P171 Orthomorphic correction of mandibular asymmetry—a case report
P170 The effect of diabetes mellitus on prognosis in secondary space infection
S. Shetty Department of Oral and Maxillofacial Surgery, J.S.S. Dental College and Hospital, Mysore, Karnataka, India
M.S. Han ∗ , J.R. Jang, B.S. Kim, S.G. Jung, Y.J. Park, G.H. Choi,
Introduction: The term ‘orthomorphic’ refers to an osteotomy aimed at restoring
581
the morphology. When the cause of mandibular asymmetry includes an alteration in the shape of the jaws as in temporomandibular joint (TMJ) ankylosis, orthognathic surgery is unable to correct the resulting contour deformity. Orthomorphic correction aims to correct deformities related to shape and contour of the jaws without affecting the status of occlusion. Case Report: A 23-year-old male patient presented to us with the complaint of flattening of the right side of the face. Patient gave a history of childhood trauma to the chin. The case was diagnosed as mandibular asymmetry secondary to left TMJ ankylosis without any functional deficits and a stable occlusion. The patient underwent orthomorphic correction on the right side of the mandible, where a full thickness osteotomy of the lower one third of the body of the mandible which continued on to the lateral aspect of the ramus as a split thickness osteotomy. The segment was realigned to correct the chin midline and the contour on the right side. Fixation is performed with the bone plates and corticocancellous blocks are sandwiched to bridge the overlapping edges. Optimal aesthetic result was achieved postoperatively. Conclusion: The described technique has the ability to alter the entire area of the contour defect in any desired dimension as a single unit. doi:10.1016/j.ijom.2009.03.644
P172 Linear nevus sebaceous syndrome: case report T. Tamme ∗ , J. Tiigimäe-Saar, T. Raie Department of Maxillofacial Surgery, Tartu University Hospital, L. Puusepa 8, Estonia
Introduction: Linear nevus sebaceous syndrome is a rare neurocutaneous disorder characterised by extensive cutaneous sebaceous nevi associated with congenital abnormalities involving the brain and other organs. Although the lesion may be present at birth, it does not typically manifest until late adolescence when, secondary to hormonal influences, it enlarges to a well demarcated, waxy verrucous lesion. We present a case of large cutaneous nevi on the face with other neurological abnormalities. Case Report: A 48-year-old man presented multiple verrucous, warty lesions on his left side of the face that had been present since the age of 9 years, and become darker and bigger over time. Physical examination revealed multiple verrucous lesions