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  • 1
    Online Resource
    Online Resource
    Patient-specific Implants for Treating Atrophic Mandibles
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 10, No. 6 ( 2022-06), p. e4359-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 6 ( 2022-06), p. e4359-
    Abstract: Extremely atrophic mandibles are difficult to treat. Most patients choose to live with removable dentures. However, what if the atrophy is so extreme that spontaneous fractures occur? The objective of this report is to offer a single-stage augmentation method, which uses patient-specific crib-shaped implants (PSI) combined with autogenous free bone grafts. PSI were planned using three-dimensional (3D) segmentation and 3D virtual-planning software. Implants were designed according to the patient’s mandible with a mesh-like structure and included large holes for allowing blood supply recovery. During surgery, the PSI fitted perfectly. In cases exhibiting malposition of the mandibular fragments, repositioning was performed using 3D virtual planning. When repositioning mandibular segments, the PSI served as a guide for the correct positioning. Iliac-crest bone graft was harvested and fixed as an onlay over the residual mandibular basal bone. External approach was used to avoid contamination. Six months following surgery, fixation wires were removed, and dental implants were positioned in the newly formed bone. The PSI allowed for rigid fixation, thus leading to optimal incorporation of the iliac-crest bone graft. No further augmentation was required. Bony continuity for future stability and secession of the spontaneous fractures was achieved. Dental implants were placed effortlessly. Treating extremely atrophic mandibles is an entity of its own and is considered one of the most challenging in craniofacial reconstruction. It mostly requires multiple operations with high rates of failure. We offer a novel method of 3D mandibular reconstruction, both vertically and horizontally, showing promising results and achieving enough bone for further dental rehabilitation.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000004359
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Solitary Frontal Sinus Fractures Compared to Multiple Facial Fractures, Energy Impact Dependency
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Craniofacial Surgery Vol. 28, No. 7 ( 2017-10), p. 1812-1815
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 7 ( 2017-10), p. 1812-1815
    Abstract: Frontal sinus fractures account for 2% to 15% of maxillofacial injuries. Up to 66% to 87% of the patients with frontal sinus fractures experience associated facial fractures. The majority of classifications used today categorize frontal sinus fractures depending on the integrity of the anterior table, posterior table, and the nasofrontal outflow. A retrospective study was performed, which included 24 patients diagnosed with frontal sinus fractures. Treatment in all patients consisted of open reduction and bone fixation. We analyzed population variables, injury etiology, fracture site, associated craniofacial injuries, surgical technique employed, handling of the nasofrontal duct, and postoperative complications. The most frequent etiology was falling accidents. Fifty-eight percent of the fractures involved both the anterior and posterior tables. Sixty-six percent experienced associated facial fractures. Fifty percent of frontal sinus fractures were treated by open reduction internal fixation as the only treatment, 33.3% underwent sinus obliteration, and 16.6% were treated with cranialization. Frontal sinus fractures resulting from high-energy impact exhibited additional facial bone fractures in 100% of the cases, whereas fractures following low-energy impact showed involvement of additional facial fractures in only 27% of the cases. In this report, we suggest a modification to the anteroposterior classification of frontal sinus fractures. In addition to the involvement of the anterior and posterior walls and the degree of dislocation, high and low energy impact can direct us to the involvement of additional facial fractures and influence the surgical strategy.
    Type of Medium: Online Resource
    ISSN: 1049-2275 , 1536-3732
    URL: Article
    DOI: 10.1097/SCS.0000000000003832
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 3
    Online Resource
    Online Resource
    Antral Wall Approach for Reconstruction of Orbital Floor Fractures Using Anterior Maxillary Sinus Bone Grafts
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Craniofacial Surgery Vol. 29, No. 4 ( 2018-06), p. e421-e426
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 4 ( 2018-06), p. e421-e426
    Abstract: Isolated orbital wall fractures account for 4% to 16% of all facial fractures. Even a modest change in the position of the bony walls can have a significant impact on orbital volume and globe position. Alloplastic materials or autogenous bone grafts such as the antral maxillary wall can be used to reconstruct small- to medium-size orbital fractures. The main advantage of an antral wall graft is the intraoral approach with minimal morbidity. Nine patients underwent repair of orbital floor fractures using the extraoral and the intraoral antral wall approach. The patients underwent preoperative computed tomography imaging and a minimum of 1 year follow-up. The size of the defects ranged from 0.5 to 1.4 cm. Two patients experienced minor immediate postoperative complications; infraorbital hypoesthesia. On follow-ups, none of our patients suffered from ocular movement restrictions or complications regarding the maxillary antral wall approach. The use of harvested bone grafts from the anterolateral wall of the maxillary sinus is a promising approach for the reconstruction of small- to mid-size orbital floor defects with minimal complications and excellent cosmetic and functional results.
    Type of Medium: Online Resource
    ISSN: 1049-2275 , 1536-3732
    URL: Article
    DOI: 10.1097/SCS.0000000000004454
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 4
    Online Resource
    Online Resource
    Biphasic influence of hypoxia on tuftelin expression in mouse mesenchymal C3H10T1/2 stem cells
    Wiley ; 2011
    In:  European Journal of Oral Sciences Vol. 119, No. s1 ( 2011-12), p. 55-61
    Details
    In: European Journal of Oral Sciences, Wiley, Vol. 119, No. s1 ( 2011-12), p. 55-61
    Abstract: Deutsch D, Silverstein N, Shilo D, Lecht S, Lazarovici P, Blumenfeld A. Biphasic influence of hypoxia on tuftelin expression in mouse mesenchymal C3H10T1/2 stem cells. 
 Eur J Oral Sci 2011; 119 (Suppl. 1): 55–61. © 2011 Eur J Oral Sci Tuftelin, an acidic protein, thought to play a role in the initial stages of ectodermal enamel mineralization, has since been detected in mesenchymal‐derived tissues. During bone/cartilage development and regeneration, mesenchymal stem cells (MSCs) undergo an avascular period in a hypoxic environment, involving induction of hypoxia‐inducible factor 1‐alpha (HIF‐1‐alpha), a key component in this process. In the present study we investigated, in a mouse mesenchymal C3H10T1/2 stem cell model, the hypothesis that oxygen stress modulates tuftelin 1 expression in relation to HIF‐1‐alpha ( Hif1a ), in a mouse mesenchymal C3H10T1/2 stem cell model. The results of the present study showed a biphasic induction of tuftelin, similar to the pattern of HIF‐1‐alpha expression, in MSCs subjected to a hypoxic insult of 1% O 2 through a period of 2–24 h. Immunocytochemistry analysis of the cells exposed to hypoxic insult for 2–24 h revealed the same biphasic pattern of tuftelin protein expression. Tuftelin localization appears to be mainly in the cytoplasm, and concentrated at the perinuclear region of the cells by 24 h of hypoxic insult. Based on our previous studies using the neuronal PC12 cell model, in which tuftelin induction was mediated by Hif1a , we propose that tuftelin is a member of oxygen‐sensitive genes and implicated in the adaptive mechanisms regulating MSC function.
    Type of Medium: Online Resource
    ISSN: 0909-8836 , 1600-0722
    URL: Issue
    URL: Article
    DOI: 10.1111/eos.2012.119.issue-s1
    DOI: 10.1111/j.1600-0722.2011.00861.x
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 2025657-7
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  • 5
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    Online Resource
    Craniofacial Morphometric Features Associated With Pericondylar Fractures of the Mandible
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Craniofacial Surgery Vol. 30, No. 7 ( 2019-10), p. 2065-2068
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 7 ( 2019-10), p. 2065-2068
    Abstract: The research aimed at investigating potential correlations between craniofacial morphological measurements and mandibular pericondylar fractures, based on a retrospective study of 380 mandible fractures treated in our department, during 2010 to 2017. Predictors included morphological measurements and features. Primary outcome was presence of pericondylar fracture; 133 pericondylar fractures were found, including subcondylar, condylar neck, and condylar head fractures. Condylar neck fractures showed negative correlations with condylar neck width (5.7 mm versus 6.7 mm sagittaly, and 6.1 mm versus 6.8 mm coronally, respectively). Gonial angle (117.3 degrees versus 128.7), and mandibular length 106.2 mm versus 110.4 mm, respectively) showed negative correlation with all pericondylar fractures. Ramus height correlated positively with pericondylar fractures (53.6 mm versus 51.2 mm, respectively). Thus, our results showed condylar neck width was a predictor for condylar neck fractures. In addition, individuals suffering from pericondylar fractures had significantly smaller gonial angles, longer ramus height, and shorter mandibular length. These morphologic features are characteristic of individuals with decreased anterior facial height. Our results corroborated a previous study we had conducted, which suggested that increased anterior vertical growth correlates with angle fractures.
    Type of Medium: Online Resource
    ISSN: 1049-2275 , 1536-3732
    URL: Article
    DOI: 10.1097/SCS.0000000000005960
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 6
    Online Resource
    Online Resource
    Functional Reconstruction in Mandibular Avulsion Injuries
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Journal of Craniofacial Surgery Vol. 27, No. 8 ( 2016-11), p. 2113-2116
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 27, No. 8 ( 2016-11), p. 2113-2116
    Type of Medium: Online Resource
    ISSN: 1049-2275
    URL: Article
    DOI: 10.1097/SCS.0000000000003104
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
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  • 7
    Online Resource
    Online Resource
    3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
    MyJove Corporation ; 2020
    In:  Journal of Visualized Experiments , No. 162 ( 2020-08-04)
    Details
    In: Journal of Visualized Experiments, MyJove Corporation, , No. 162 ( 2020-08-04)
    Type of Medium: Online Resource
    ISSN: 1940-087X
    URL: Article
    DOI: 10.3791/60929
    Language: English
    Publisher: MyJove Corporation
    Publication Date: 2020
    detail.hit.zdb_id: 2259946-0
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  • 8
    Online Resource
    Online Resource
    3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
    MyJove Corporation ; 2020
    In:  Journal of Visualized Experiments , No. 162 ( 2020-08-04)
    Details
    In: Journal of Visualized Experiments, MyJove Corporation, , No. 162 ( 2020-08-04)
    Type of Medium: Online Resource
    ISSN: 1940-087X
    URL: Article
    DOI: 10.3791/60929-v
    Language: English
    Publisher: MyJove Corporation
    Publication Date: 2020
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  • 9
    Online Resource
    Online Resource
    Treatment of Facial Asymmetry Using Distraction Osteogenesis in a Mandible First Approach
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 11, No. 9 ( 2023-09-11), p. e5255-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 9 ( 2023-09-11), p. e5255-
    Abstract: Facial asymmetry includes several etiologies, among them trauma to the condylar area during early childhood and congenital malformations such as hemifacial microsomia. This article describes the management of facial asymmetry in adolescents and young adults using a mandible first approach by distraction osteogenesis, followed by maxillary Le-Fort I as a second stage. Methods: Eighteen patients 14–25 years of age presented with unilateral hypoplasia of the jaws which manifested clinically by deviation of the chin and canting of the occlusal plane. Etiology included hemifacial microsomia and trauma injuries at early childhood. All patients underwent orthodontic treatment and two phases of surgical treatment. Surgical treatment included unilateral mandibular distraction followed by Le-Fort I osteotomy for alignment of the maxilla. Additional bone graft in the affected side and sliding genioplasty were done as required. Results: Marked ramal elongation of 18.94 mm concomitant with mandibular forward traction of 12.5 mm was noted while achieving symmetry. In all cases, the maxilla was centered to the midline in proper occlusion. Post distraction, posteroanterior cephalometric radiographs demonstrated elongation of the affected ramus, improvement in facial symmetry, and correction of the occlusal canting. Relapse was minimal based on long-term follow-ups of 47.4 months. Conclusions: The two-stage surgical approach that includes elongation of the mandible as a first stage followed by adaptation of the maxilla is useful in correcting facial asymmetry. Using this protocol at the correct age (14–18) is very stable, as demonstrated by our results, yet one should always remember the transverse deficiency in the gonial angle requires additional bone grafting or patient specific implants.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000005255
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 10
    Online Resource
    Online Resource
    Cleft Palate Fistula Closure Utilizing Acellular Dermal Matrix
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 6, No. 3 ( 2018-03), p. e1682-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 3 ( 2018-03), p. e1682-
    Abstract: Fistulas represent failure of cleft palate repair. Secondary and tertiary fistula repair is challenging, with high recurrence rates. In the present retrospective study, we review the efficacy of using acellular dermal matrix as an interposition layer for cleft palate fistula closure in 20 consecutive patients between 2013 and 2016. Complete fistula closure was obtained in 16 patients; 1 patient had asymptomatic recurrent fistula; 2 patients had partial closure with reduction of fistula size and minimal nasal regurgitation; 1 patient developed a recurrent fistula without changes in symptoms (success rate of 85%). We conclude that utilizing acellular dermal matrix for cleft palate fistula repair is safe and simple with a high success rate.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000001682
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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