-
National Journal of Maxillofacial... 2022We present a new technique of reconstruction of a partial defect of vermilion in a case of post traumatic defect of lower lip. The vermilion defect was reconstructed by...
We present a new technique of reconstruction of a partial defect of vermilion in a case of post traumatic defect of lower lip. The vermilion defect was reconstructed by the myomucosal flap taken from the labial side of lip posterior and below the anterior lip defect. The lower rounded part of this 3 cm × 2 cm rectangular flap was brought on the outer anterior lip defect through a hole made by splitting the orbicularis oris muscle below the vermilion and its lower end was rotated upward to reconstruct the defect in the anterior and inferior part of vermilion. The secondary defect on the inner lip was closed by mobilization of mucosa. The triangular-shaped skin loss of anterior lower lip and its underlying muscle was closed in anatomic layers meticulously after mobilization of muscle and skin on both sides. The orocutaneous communication created was closed after 3 weeks by a minor operation under local anesthesia. The mouth opening remained normal between the period of lip repair and closure of iatrogenic orocutaneous communication. Good shape with normal color of vermilion and length having proper lip fullness was achieved without any microstomia. The surface of vermilion was smooth without any irregularity. The single scar of lower lip was supple and mobile over the underlying muscle. There was no deglutition, chewing, labial phonation, or any drooling saliva problems. The procedure provided functionally and esthetically satisfying result. We authors have not found a similar technique of lip reconstruction in the literature.
PubMed: 35911806
DOI: 10.4103/njms.NJMS_197_20 -
The Journal of Clinical Pediatric... May 2022The present case report highlights the management of a 6 years old female child who suffered oral and maxillofacial injury due to explosion of a fire cracker inside the...
The present case report highlights the management of a 6 years old female child who suffered oral and maxillofacial injury due to explosion of a fire cracker inside the mouth which was managed by primary closure after complete debridement and to prevent the post treatment microstomia, a modified microstomia prevention intraoral prosthetic appliance was given and followed up for 15 months.
Topics: Burns; Child; Face; Female; Humans; Maxillofacial Injuries; Microstomia
PubMed: 35830633
DOI: 10.17796/1053-4625-46.3.3 -
BioMed Research International 2022Epidermolysis bullosa (EB) is a group of skin disorders with skin fragility characterized by blistering from minimal mechanical trauma with rupture at the dermoepidermal... (Review)
Review
Epidermolysis bullosa (EB) is a group of skin disorders with skin fragility characterized by blistering from minimal mechanical trauma with rupture at the dermoepidermal junction. There are four major classical heritable EB types, due to mutations in as many as 20 distinct genes: EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), and Kindler EB (KEB). This study is aimed at reporting case series on patients ( = 8; males, = 5 and females, = 3, age range 12-68 years) affected by EB and performs a review of the literature on this topic. This group of disorders can affect oral soft and hard tissues in various ways, resulting in various effects including enamel hypoplasia, dental caries, microstomia, ankyloglossia, oral blistering, and ulcerations early-onset periodontal disease. From the sample results, it can be concluded that the clinical manifestation of EB patients is highly variable and very different in prognosis. Oral health deeply influences the quality of life of EB patients. Dental management is essential to prevent the aggravation of soft tissue damage and tooth loss and to improve the quality of life through prosthetic and restorative therapies. Dentists should consider the oral alterations of EB subtypes to perform a personalized approach to the patients' needs in a preventive and therapeutic point of view.
Topics: Adolescent; Adult; Aged; Child; Dental Caries; Epidermolysis Bullosa; Epidermolysis Bullosa Dystrophica; Epidermolysis Bullosa, Junctional; Female; Humans; Male; Middle Aged; Quality of Life; Young Adult
PubMed: 35686231
DOI: 10.1155/2022/6493156 -
GMS Interdisciplinary Plastic and... 2022The lip has functional and aesthetic importance. Lip defects occur due to the variety of etiology and the choice of their reconstruction has profound effect on...
The lip has functional and aesthetic importance. Lip defects occur due to the variety of etiology and the choice of their reconstruction has profound effect on functions and cosmesis. There are multiple options available for reconstruction according to defect size, but superiority of one method over another is still debated and hence the methods and their outcome were analyzed prospectively. Twenty-one patients with all sizes and locations of defects in upper and lower lip with acquired etiology were included in the evaluation. Reconstruction was performed according to defect size, availability of local/regional and distant donor tissue, defect location, patients' comorbid conditions and patients' preference. Patients were assessed at 1 month and 6 months postoperatively. Observers' and patients' input were also taken into account for outcome. Out of 21 patients, 5 free radial artery forearm flap reconstructions, 4 nasolabial flap reconstructions, 5 primary closures of defect, 4 Estlander flap reconstructions, 2 lip advancements, and one Karapandzic flap reconstruction were done. Free flap and nasolabial flap had hypoesthesia and incompetence if commissure is reconstructed and problem of bulk, restricted mobility and vermilion mismatch. Local and lip flaps were associated with decreased stoma size and some form of local scarring and asymmetry. However, all patients were satisfied with the functional and aesthetic outcome. Local flaps are better in terms of functional and aesthetic outcome but with some degree of microstomia which was well tolerated by most patients. Regional and distant flaps provide reconstruction where no other option is available and provide good functional support and acceptable cosmesis.
PubMed: 35465154
DOI: 10.3205/iprs000163 -
BMJ Case Reports Apr 2022The case presented here shows the rare diagnosis of fetal otocephaly with lethal prognosis due to impossible airway management after birth. Otocephaly is characterised...
The case presented here shows the rare diagnosis of fetal otocephaly with lethal prognosis due to impossible airway management after birth. Otocephaly is characterised by fetal agnathia, microstomia and synotia. As in our case, otocephaly is usually not recognised until the third trimester and leads to challenging clinical situations and decision making.A woman in her 30s presented to our tertiary hospital at 27 weeks of gestation because of an unexplained polyhydramnios. 3D imaging illustrated the complex syndrome of otocephaly and helped understand the present disease patterns. After premature birth, palliative care was agreed on and the newborn was able to pass away peacefully in the arms of his parents.We recommend the implementation of 3D imaging into routine scans for the assessment of the fetal face and ears, especially in situations of unexplained polyhydramnios.
Topics: Craniofacial Abnormalities; Female; Humans; Imaging, Three-Dimensional; Infant, Newborn; Jaw Abnormalities; Polyhydramnios; Pregnancy; Prenatal Diagnosis; Ultrasonography, Prenatal
PubMed: 35459654
DOI: 10.1136/bcr-2022-249276 -
Limited cutaneous systemic sclerosis: Total rehabilitation with fixed prosthesis on dental implants.Journal of Scleroderma and Related... Oct 2021Limited cutaneous systemic sclerosis with special manifestations (calcinosis cutis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) is...
INTRODUCTION
Limited cutaneous systemic sclerosis with special manifestations (calcinosis cutis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) is part of the group of connective tissue diseases, these rare autoimmune systemic pathologies cause thickening and hardening of tissues in different parts of the body and can lead to complex disorders. Oral manifestations of systemic sclerosis may include limited ability to open the mouth, xerostomia, periodontal disease, enlarged periodontal ligament, and bone resorption of the jaw.
CASE DESCRIPTION
A 54-year-old Caucasian patient presented with oral pain, swallowing, phonation and chewing difficulties associated with dental instability, hygiene/handling difficulties and her main problem with microstomia, which prevented her from removing the skeletal prosthesis for 4 years, depriving her of social life. Gradual treatment with dental implants was diagnosed and planned to support a fixed total denture adapted to the ridge with self-cleaning characteristics. After implant insertion, panoramic radiographs with standardized parameters were taken to compare crestal bone levels at the time of prosthesis placement and with 10 years of follow-up.
CONCLUSION
The average crestal bone loss of the 12 implants after the 10 years of follow-up was 1.26 mm for the maxilla and 1.17 mm for the mandible. The survival of the 12 support implants of two total fixed prostheses in a clinical/radiographic follow-up of 10 years was 100%. After 10 years of follow-up, the 12 implants inserted had a bone loss similar to that of healthy patients and no pathologies were registered, recovering function, aesthetics, and self-esteem. This therapy must be implemented before the interincisal distance decreases to 30 mm to allow intraoral surgical/prosthetic access. Implant-supported total fixed rehabilitation is a viable, predictable, and recommended therapy in patients with limited cutaneous systemic sclerosis.
PubMed: 35387213
DOI: 10.1177/23971983211004362 -
Case Reports in Dentistry 2022Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function...
Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function and esthetics. Prosthodontic management of edentulous patients with microstomia is a challenging task. Use of conventional methods for recording an impression and fabricating prosthesis is not effective in such patients. To fabricate well-fitting prosthesis, accuracy of impression recording important anatomic landmarks is essential. Formation of an exacting custom tray and diagnostic cast is critical for final impression accuracy. Provision of a well-fitting prosthesis in microstomia patient will restore esthetics, comfort, and function with oral and systemic patient wellbeing. This paper presents a case report of managing an edentulous microstomia patient with sectional removable prosthesis. Furthermore, it proposes a novel classification system for microstomia patients according to severity of the condition.
PubMed: 35154831
DOI: 10.1155/2022/2686983 -
Clinical, Cosmetic and Investigational... 2022Mucormycosis, a rare fungal infection seen in diabetes, is now very frequent owing to the deadly triad of COVID-19 infection, diabetes, and rampant use of...
Mucormycosis, a rare fungal infection seen in diabetes, is now very frequent owing to the deadly triad of COVID-19 infection, diabetes, and rampant use of corticosteroids. Immediate management revolves around therapeutic drugs like antifungals, antibiotics, and aggressive surgical debridement. The cases described in the article explain prosthetic rehabilitation of maxillectomy defects. The findings focus on prosthetic rehabilitation of patients with acquired maxillectomy defects after mucormycotic necrosis post-COVID-19 infection and the techniques to overcome the complications like lack of supporting tissues and post-surgical microstomia. The maxillectomies were performed on patients who suffered a superinfection of mucormycosis after COVID-19 contraction and uncontrolled blood sugar levels. Case 1 elaborates a technique to overcome the complications like lack of supporting structures and microstomia by fabrication of sectional and hollow obturator prostheses using sectional impression technique and lost salt technique. Case 2 explains the management of an extensive defect with a mobile soft tissue flap and lone standing tooth by using a functional impression technique to gain retention and support from the remaining soft and hard tissues. Both the techniques overcome the clinical complications and give predictable outcomes. Prosthetic rehabilitation of such challenging cases needs modifications depending upon the clinical challenges encountered.
PubMed: 35023975
DOI: 10.2147/CCIDE.S346315 -
Dental Research Journal 2021Tricho-dento-osseous syndrome (TDO) is a rare autosomal dominant disorder with complete penetrance. Common clinical features include abnormalities of hair, teeth, and...
Tricho-dento-osseous syndrome (TDO) is a rare autosomal dominant disorder with complete penetrance. Common clinical features include abnormalities of hair, teeth, and skull. Dental management of TDO patients is quite challenging in terms of existing dental and skeletal problems. The current article presents a 12-year-old girl suffering TDO, followed by a review on the published literature pertaining to the dental management of TDO patients. Patient history included, rejected corneal transplantation, stone-forming kidneys, and several previous dental treatments. She was noted to have signs of mandibular prognatia, frontal bossing of the skull, mild bilateral tibial bowing, microstomia, and labial fissures. Dental findings included severe generalized enamel defects, discolored teeth, microdontia, anterior open-bite, posterior cross-bite, deep periodontal pockets, hyperplastic inflamed gingiva, taurodontism of permanent molars, dental periapical radiolucencies, and missing teeth. She was the only child of healthy, nonconsanguineous parents with no familial history of similar congenital syndrome or dental abnormalities. A treatment plan was established based on medical/dental history and findings, using a team-based approach. This article emphasizes the importance of a multidisciplinary approach for the dental management of patients suffering TDO.
PubMed: 35003563
DOI: 10.4103/1735-3327.330879 -
Genes Dec 2021We present a complex chromosomal anomaly identified using cytogenetic and molecular methods. The child was diagnosed during the neonatal period with a multiple... (Review)
Review
We present a complex chromosomal anomaly identified using cytogenetic and molecular methods. The child was diagnosed during the neonatal period with a multiple congenital anomalies syndrome characterized by: flattened occipital region; slight turricephaly; tall and broad forehead; hypertelorism; deep-set eyes; down slanting and short palpebral fissures; epicanthic folds; prominent nose with wide root and bulbous tip; microstomia; micro-retrognathia, large, short philtrum with prominent reliefs; low set, prominent ears; and congenital heart disease. The GTG banding karyotype showed a 46,XY,der(10)(10pter→10q26.2::4q26→4qter) chromosomal formula and his mother presented an apparently balanced reciprocal translocation: 46,XX,t(4;10)(q26;q26.2). The chromosomal anomalies of the child were confirmed by MLPA, and supplementary investigation discovered a quadruplication of the 4q35.2 region. The mother has a triplication of the same chromosomal fragment (4q35.2). Using array-CGH, we described the anomalies completely. Thus, the boy has a 71,057 kb triplication of the 4q26-q35.2 region, a 562 kb microdeletion in the 10q26.3 region, and a 795 kb quadruplication of the 4q35.2 region, while the mother presents a 795 kb triplication of the 4q35.2 region. Analyzing these data, we consider that the boy's phenotype is influenced only by the 4q partial trisomy. We compare our case with similar cases, and we review the literature data.
Topics: Abnormalities, Multiple; Adult; Chromosome Deletion; Chromosomes, Human, Pair 10; Chromosomes, Human, Pair 4; Female; Humans; Infant, Newborn; Male; Phenotype; Prognosis; Translocation, Genetic; Trisomy
PubMed: 34946906
DOI: 10.3390/genes12121957