Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method

Abstract

Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4), upper/lower maxilla (U/L), alveolar/basal bone (Alv/B), gingival tissues (G), soft tissues (S), adult/child (a/c), and reconstructed patient (R). Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning.

Dental Management of Maxillofacial Ballistic Trauma

“…The lower maxilla was involved in most cases (63.6% of the sample), the maxilla was involved in three cases (27.2% of the sample), and in only one patient was it necessary to rehabilitate both jaws. In all eleven patients, almost five dental elements were lost (T3/T4 according to Brauner et al, classification [ 25 ]).…”

“…Brauner et al introduced a new classification to define dentofacial traumas based on seven parameters: number of teeth lost (T1 < 2, T2 2–3, T3 4–5, T4 > 5), upper/lower maxilla (U/L), alveolar/basal bone (Alv/B), gingival tissues (G), soft tissues (S), adult/child (a/c), and reconstructed patient (R). This classification is useful for precisely define the entity of the trauma and to establish the best therapy choice, making the prognosis of these patients more predictable [ 25 ].…”

Bone mineralization and immediate function of six dental implants in patients with Klinefelter syndrome

“…The widespread recent interest in the ability of vitamin D to prevent bone fractures has also generated studies evaluating vitamin D and its effect on the bone composition of KS men. Undiscovered X chromosomal factors, a higher degree of adiposity, and lowered sunlight exposure may all contribute to a lower vitamin D status in KS, but these have not been investigated in previous studies and the exact cause of this deficiency remains unknown 22,23 . The impaired bone mineralization around dental implants in male KS patients is probably related to several factors including hypotestosteronemia, vitamin D deficiencies, and decreased physical activity and muscle strength 24 .…”

A New Medical Record Proposal to the Prognostic Risk Assessment for MRONJ in Oncologic Patients: “Sapienza Head and Neck Unit” Proposal

“…Patients should be kept under close observation, so during the dental examination it is extremely important to motivate the patient regarding dental care; the importance of fluoride applications and rinses with chlorhexidine (0.12% daily) must be clearly specified [ 34 ]. If despite all the attention, a surgical intervention becomes necessary (for example, a tooth extraction), the goal is to be the most conservative possible so as to minimize the trauma [ 32 , 33 , 34 , 35 ]. Bone manipulating should be minimal, burs should be avoided, as well as anesthetics with vasoconstrictors (which would decrease the blood supply), the local hemostasis must be accurate, the antibiotic coverage must be carried out with broad-spectrum antibiotics to be administered before and after surgical treatment for at least fifteen days.…”