pedicle flap

带蒂皮瓣
  • 文章类型: Case Reports
    系统的治疗计划和适当的手术技术选择是有效闭合口窦瘘(OAF)的关键要求。一名45岁的女性患者在20年前接受了手术拔牙后出现了鼻窦开口。在她经常去看牙医时,进行了一些关闭的尝试,包括手术干预,只是为了让病变恢复。进行了计算机断层扫描(CT)扫描以排除任何病变的骨扩展,由于上颌窦底部的骨缺损以及上颌窦衬里的增厚,CT显示1×1cm的射线可透过性,从牙槽骨到右上颌窦的直通通信。缺损的闭合是通过从右侧凸起的外侧蒂皮瓣升高并横向滑动以覆盖缺损而没有张力,并用4-0可吸收的间断缝合线缝合,同时保持裸露的手术床被骨膜覆盖和结缔组织薄层。这种技术为患者提供了立即修复的缺陷,并且还保持口腔相对正常的解剖结构。术后八个月的随访显示OAF完全关闭,无任何并发症。这种情况的结果表明,横向滑动蒂皮瓣可能是管理长期OAF的保守方法。
    A systematic treatment plan and an appropriate selection of surgical technique are the critical requirements for an effective closure of oroantral fistula (OAF). A 45-year-old female patient had sinus opening after she underwent a surgical tooth extraction 20 years back. On her frequent visits to the dentists some attempts were made for closure including surgical intervention, only for the lesion to return back. Computerized tomography (CT) scan was taken to rule out any bony extension of a lesion, the CT revealed a 1 × 1 cm radiolucency with a through - through communication from the alveolar bone to the right maxillary sinus because of the bony defect in the floor of maxillary sinus along with thickening of the maxillary sinus lining. The closure of the defect was done by a lateral pedicle flap raised from the right side was elevated and laterally slid to cover the defect without tension and was sutured with 4-0 resorbable interrupted suture while maintaining a bare surgical bed covered by the periosteum and a thin layer of connective tissue. This technique provides immediate repair of the defect to the patient, and also maintains comparatively normal anatomic architecture to the oral cavity. Eight months postoperative follow-up revealed a complete closure of OAF without any complications. The findings of this case suggest that lateral sliding pedicle flap can be a conservative approach in managing a long-standing OAF.
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  • 文章类型: Journal Article
    Urethral amyloidosis is a rare condition in which eosinophilic amyloid proteins are deposited in the urethra. Only a small number of reports on urethral amyloidosis have been published. Increased interest has been associated with this disease due to its clinical similarities with urothelial carcinoma. A biopsy of the lesion and a histological examination are essential for the correct diagnosis. Conservative management has been suggested by various urologists as the optimal treatment approach for urethral amyloidosis; however, recurrence and urethral stricture are common, and typically further treatment is required. Urethroplasty has been used in a limited number of urethral amyloidosis cases, with beneficial short-term outcomes; however, long-term follow-up data are lacking. The present case report describes the cases of 2 patients with urethral amyloidosis who underwent urethroplasty without recurrence or progression for >2 years. These findings indicate that urethroplasty is beneficial for the long-term management of urethral amyloidosis.
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  • 文章类型: Case Reports
    Soft tissue deficiencies and defects around dental implants have been observed frequently. Soft-tissue defects after implant procedures originate from the process of modelling of periimplant mucosa and often cause aesthetic disharmony, food debris accumulation and soft tissue shrinkage. Periimplant mucogingival surgery focuses on creating an optimum band of keratinized tissue resulting in soft tissue architecture similar to the gingiva around natural teeth. A 23-year-old male reported to the Department of Periodontology with a complaint of gum soreness, foul smell and food accumulation at a site where a 3.75 x 11.5mm implant was placed previously. On clinical examination, fenestration of tissue above the cover screw was observed and there appeared to be a keratinized tissue of 1mm surrounding the implant. The case was managed by use of a rotated double-pedicle flap during second-stage implant surgery to correct the soft-tissue fenestration defect and to obtain a keratinized periimplant soft tissue. A periosteal bed was prepared by giving a horizontal incision at the mucogingival junction to a depth of 4 mm. Two split-thickness keratinized pedicles were dissected from the mesial and distal interproximal tissues near the implant. After rotation, both the pedicles were sutured to each other mid-buccally and the pedicles were rigidly immobilized with sutures. At 1 month, there was a 3mm band of stable and firm keratinized tissue over the underlying tissues. The procedure resulted in an aesthetic improvement due to enhanced soft tissue architecture and optimum integration between the peri-implant soft tissue and the final prosthesis.
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