The pursuit of predictable implant success in the aesthetic zone continues as technology develops. Creating stable marginal bone and an optimal peri-implant mucosal environment is the foundation for a long-term healthy and aesthetic implant treatment outcome. Tissue stability is dependent on multiple factors, including the regenerative materials used to create the peri-implant supporting tissues and maintain the tissue volume. The present study aims to describe a technique that combines a flapless approach to extract hopeless teeth in the aesthetic zone and implant insertion using an acellular dermal matrix placed to contain the coronal aspect of an innovative ossifying collagen scaffold designed to promote neoformation of vital native bone. This technique combines a minimally invasive approach with the application of a novel biomaterial that offers stable augmentation of the gingival thickness as well as bone fill in the facial gap, the space between the implant and the buccal plate, to ensure predictable aesthetic results. A collection of cases are presented to demonstrate the surgical technique and the situation over a follow-up period of 22 months. Pre- and post-treatment CBCT imaging were utilised to quantify the stability or changes noted in the alveolar bone, and pre-and post-treatment intraoral scanning were used for the same purpose in the peri-implant phenotype. This case series presents stable and aesthetic clinical outcomes evaluated through digital assessment.

Degloving injuries are caused by trauma with shear mechanisms, usually secondary to being run over in traffic accidents. It is characterized by the avulsion of skin and subcutaneous tissue, generating coverage deficit, and in severe cases, loss of the affected limb. Herein, we discuss a case of a six-year-old male run over by a truck, receiving a direct impact on the left lower extremity with a rubber tire. Debridement and surgical cleaning were performed and a negative pressure system was placed. Subsequently, dermal matrix and partial-thickness skin grafts were placed as coverage after the creation of a viable grafting bed.

暂无摘要。

BACKGROUND: Limited evidence exists on the outcome of the modified coronally advanced tunnel (MCAT) with acellular dermal matrix (ADM) for the treatment of gingival recession defects (GRD) especially when complicated by restored cervical lesions. Therefore, the aim of this case report was to assess the short- and long-term clinical outcomes of maxillary Type 1 recession defects (RT1) associated with restored cervical lesions treated with MCAT with ADM.
RESULTS: A 43-year-old female patient, presented with multiple adjacent RT1 recessions in the left maxilla, previously treated with overhanging cervical resin restorations. The case was approached with a careful evaluation of the diagnostic determinants of root coverage, removal of the aberrant resin restorations, treatment with MCAT with ADM, and periodical evaluation over a follow-up of 10 years. The treatment was followed by complete root coverage, improvement of gingival phenotype, and perfect root coverage esthetic score. Outcomes were periodically assessed and were maintained over 10 years of follow-up.
CONCLUSIONS: MCAT with ADM is an effective technique for the treatment of multiple GRD complicated by cervical restorations. Complete root coverage and excellent esthetic outcomes were obtained and maintained in the long term.

暂无摘要。

Pretibial lacerations resulting from trauma may evolve into chronic wounds with worsening infections without treatment. There is a limited amount of literature on the presentation and treatment of recalcitrant pretibial ulcerations.
This study aims to provide a review of surgical treatment methodology that successfully managed recalcitrant pretibial ulcerations.
The authors conducted a retrospective case review of patients with pretibial ulcerations. All wounds underwent aggressive debridement in the operative setting. Next, the wounds were fenestrated with a needle before placing one application of an antimicrobial acellular dermal tissue matrix derived from fetal bovine dermis, which was tightly adhered onto the wound bed. All wounds received a uniform multilayer compression dressing.
Three patients with pretibial ulcerations were included in this study. Each wound was a result of mechanical trauma and deteriorated into a refractory ulceration despite initial conservative treatment for more than 6 months. All ulcers exhibited local infection of cellulitis, hematoma, and a collection of purulent fluid. None of the wounds had any signs of radiographic osteomyelitis. The application of the allograft following debridement and fenestration led to wound volume reduction by 75%, 66.7%, and 50% in 3 patients in 28 days. All wounds healed successfully within 4 months.
The combination of a fenestration method and an antimicrobial fetal bovine dermal matrix successfully healed recalcitrant pretibial ulcerations in high-risk patients.

BACKGROUND: An omphalocele is an abdominal wall birth defect, and a giant omphalocele (GO) is defined as an omphalocele having a diameter >5 cm or containing a herniated liver. GOs are usually treated in stages and in this case, during the silo reduction, dehiscence occurred at the suture site of the axis ring and skin edge, which was repaired using synthetic absorbable mesh.
METHODS: A girl infant was born at 36 weeks with a GO of 8 cm diameter, and herniated multiple organs such as the small bowel, cecum, appendix, and the entire liver. Even after the staged repair technique for the GO silo, wound dehiscence between the ring of the silo and the edge of the skin occurred and gradual reduction failed.
METHODS: A GO of 8 cm diameter, which was found during prenatal ultrasonography.
METHODS: Revision was performed to repair the defect. The small bowel and liver were still prolapsed, and there were severe adhesions. After adhesiolysis, the muscle layer of the abdominal wall was repaired using the tissue matrix, but the skin could not be repaired. After the second operation, the defect wound was dressed as sterilely as possible.
RESULTS: The abdominal wall defect was repaired completely; there were no residual complications.
CONCLUSIONS: Repair of GOs using an acellular porcine dermal matrix can be considered a viable treatment option.

BACKGROUND: Self-repair of lower limb wounds has always been one of the research hotspots. Flaps and skin graft are the preferred treatment for lower extremity wound reconstruction. However, these treatments have many disadvantages, such as secondary damage, poor healing quality. In recent years, the use of acellular dermal matrix has emerged as an alternative treatment option for extremity ulcers.
METHODS: This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, were covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days.
RESULTS: After a maximum of 20 weeks, all the wounds were completely healed. During the 12 months follow-up period none of the patients developed skin wear on the treatment area. All patients maintained their postoperative ambulatory ability. All patients were satisfied with the appearance and feeling after wound healing.
CONCLUSIONS: These findings may mean acellular dermal matrix is a novel method offering opportunity for treatment of lower extremities cutaneous deficiency exposing bone or tendon. It also has the potential to close wounds of all uninfected, non-ischemic, full-thickness cutaneous deficiency.

A recently released commercially available novel porcine acellular dermal matrix (PADM) appears to possess acceptable biologic and clinical properties to be considered as an acceptable soft tissue replacement material. The aim of these three case reports is to present the treatment of multiple gingival recession by means of different variations of the tunnel and PADM as well as the clinical outcomes obtained at 3 years postoperatively. The healing outcomes demonstrated only minor surgical complications, with minimal patient-reported discomfort. At 3 years postoperative, ideal functional and esthetic outcomes were observed. PADM seems to be a promising xenogeneic soft tissue substitute. Further studies with a higher number of patients and defects are necessary to confirm the present findings.

暂无摘要。