RESUMO
The aim of this systematic review was to determine the most prevalent complications resulting from total temporomandibular joint (TMJ) replacement. An electronic search was performed using the Embase, LILACS, MEDLINE (via PubMed), SciELO, Scopus, and Web of Science databases up to June 2022. Prospective and retrospective clinical studies on patients who underwent TMJ replacement were included. Two reviewers performed the study selection, data extraction, and individual risk of bias assessment using the Joanna Briggs Institute Critical Appraisal Tools. The pooled prevalence of each complication was calculated through a proportion meta-analysis using the random-effects model. Twenty-eight studies met the eligibility criteria and were included in the review. All of the eligible studies had a low risk of bias. The results of the meta-analysis revealed that the most prevalent complication was paresis or paralysis of the facial nerve branches (7.8%; 95% confidence interval (CI) 2.6-15.1%, I2 = 94.5%), followed by sensory alterations (1.8%; 95% CI 0.6-4.9%, I2 = 88.8%), heterotopic bone formation (1.0%; 95% CI 0.1-2.5%, I2 = 75.8%), and infection (0.7%; 95% CI 0.1-1.6%, I2 = 22.7%). In conclusion, TMJ replacement has a low prevalence of complications, and most of them can be managed successfully.
Assuntos
Prótese Articular , Transtornos da Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/complicações , Estudos Prospectivos , Estudos Retrospectivos , Articulação Temporomandibular/cirurgiaRESUMO
There have been few studies realized that evaluate the effects of adopting different nutritional systems in more than one phase of cattle production on carcass and meat characteristics. This study was realized to evaluate carcass and meat characteristics from bulls submitted to different nutritional systems during two production phases. The experiment was conducted at Figueira's farm during two production phases: I (cow-calf) - 80 calves (99.6±2.72 days of age and 109.7±2.99 kg of BW) with their mothers were randomly assigned into two supplemental diets: cow-calf mineral supplement (n=40) or cow-calf creep-feeding (n=40); II (stocker) - the same 80 calves (201.2±2.11 days of age and 190.2±3.37 kg of BW) were redistributed into two production systems: stocker pasture (n=40) or stocker feedlot (SF; n=40). After, all 80 animals were kept on a pasture system (III) for 290 days, and then finished in a feedlot system (IV) for more 33 days. Then, they were slaughtered at an average 764.2±3.06 days of age and at 499.2±3.33 kg of final BW. After slaughter, the average daily gain was calculated, and the carcass and meat characteristics were measured. The statistical model design used was completely randomized in a 2×2 factorial arrangement (two treatment groups on cow-calf phase and two treatment groups on stocker phase). The single effects between the groups in each phase and the interactions between both phases (cow-calf v. stocker) were analyzed. The results were compared by Fisher's test, using the R statistical software. A cow-calf by stocker phases interaction occurred for carcass conformation and fiber diameter. For single effects, the greatest influences observed were in the stocker phase. The feedlot group was slaughtered 17 days earlier, with greater final BW (3.8%), hot carcass weight (5.7%), average daily gain (6.9%), dressing percentage (1.8%), carcass length (1.8%), carcass width (1.5%), longissimus muscle area (4.8%) and muscle depth (2.3%) than pasture group. The SF group also had influence on fat color; showing higher L* and lower b* values. These results reveal that bulls reared in feedlot at the stocker phase have higher muscle development and that the stocker phase has the greatest potential to influence carcass characteristics and meat quality.
Assuntos
Bovinos/fisiologia , Dieta/veterinária , Carne/análise , Estado Nutricional , Criação de Animais Domésticos , Animais , Brasil , MasculinoRESUMO
This study focused on three-dimensional (3D) airway space changes and stability following simultaneous maxillomandibular counterclockwise rotation, mandibular advancement, and temporomandibular joint (TMJ) reconstruction with custom-made total joint prostheses (TMJ Concepts(®)). Cone beam computed tomography (CBCT) scans of 30 consecutive female patients with irreversibly compromised TMJs were obtained at the following intervals: T1, presurgery; T2, immediately after surgery; and T3, at least 6 months after surgery. The CBCT volumetric datasets were analysed with Dolphin Imaging(®) software to evaluate surgical and postsurgical changes to oropharyngeal airway parameters. The average changes in airway surface area (SA), volume (VOL), and minimum axial area (MAA) were, 179.50 mm(2), 6302.60 mm(3), and 92.23 mm(2), respectively, at the longest follow-up (T3-T1) (P≤0.001). Significant correlations between the amount of mandibular advancement and counterclockwise rotation of the occlusal plane and 3D airway changes were also found (P≤0.01). The results of this investigation showed a significant immediate 3D airway space increase after maxillomandibular counterclockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses, which remained stable over the follow-up period.
Assuntos
Imageamento Tridimensional/métodos , Prótese Articular , Avanço Mandibular/métodos , Osteotomia Maxilar/métodos , Orofaringe/patologia , Articulação Temporomandibular/cirurgia , Adolescente , Adulto , Placas Ósseas , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Relação Central , Cefalometria/métodos , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Seguimentos , Humanos , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Modelos Anatômicos , Planejamento de Assistência ao Paciente , Desenho de Prótese , Estudos Retrospectivos , Rotação , Transtornos da Articulação Temporomandibular/cirurgia , Adulto JovemRESUMO
The purpose of this study was to evaluate soft tissue response to maxillo-mandibular counter-clockwise rotation, with TMJ reconstruction and mandibular advancement using TMJ Concepts total joint prostheses, and maxillary osteotomies in 44 females. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Eighteen patients had genioplasties with either porous block hydroxyapatite or hard tissue replacement implants (Group 2) 26 had no genioplasty (Group 1). Surgically, the maxilla moved forward and upward by counter-clockwise maxillo-mandibular rotation with greater horizontal movement in Group 2. Vertically, both groups showed diversity of maxillo-mandibular mean movement. Group 1 showed a consistent 1: 0.97 ratio of hard to soft tissue advancement at pogonion; Group 2 results were less consistent, with ratios between 1: 0.84 and 1: 1.02. Horizontal changes in upper lip morphology after maxillary advancement/impaction, VY closure, and alar base cinch sutures showed greater movement in both groups, than observed in hard tissue. Counter-clockwise rotation of the maxillo-mandibular complex using TMJ Concepts total joint prostheses resulted in similar soft tissue response as previously reported for traditional maxillo-mandibular advancement without counter-clockwise rotation of the occlusal plane. The association of chin implants, in the present sample, showed higher variability of soft tissue response.
Assuntos
Artroplastia de Substituição , Face/anatomia & histologia , Prótese Articular , Avanço Mandibular , Transtornos da Articulação Temporomandibular/cirurgia , Adolescente , Adulto , Cefalometria , Queixo/anatomia & histologia , Queixo/cirurgia , Feminino , Humanos , Modelos Lineares , Lábio/anatomia & histologia , Maxila/cirurgia , Pessoa de Meia-Idade , Nariz/anatomia & histologia , Osteotomia de Le Fort , Implantação de Prótese , Procedimentos de Cirurgia Plástica , Rotação , Disco da Articulação Temporomandibular/cirurgia , Adulto JovemRESUMO
The purpose of this study was to evaluate the anatomical changes and stability of the oropharyngeal airway and head posture following TMJ reconstruction and mandibular advancement with TMJ Concepts custom-made total joint prostheses and maxillary osteotomies with counter-clockwise rotation of the maxillo-mandibular complex. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). The lateral cephalograms of 47 patients were analyzed to determine surgical and post-surgical changes of the oropharyngeal airway, hyoid bone and head posture. Surgery increased the narrowest retroglossal airway space 4.9 mm. Head posture showed flexure immediately after surgery (-5.6+/-6.7 degrees) and extension long-term post surgery (1.8+/-6.7 degrees); cervical curvature showed no significant change. Surgery increased the distances between the third cervical vertebrae and the menton 11.7+/-9.1 mm and the third cervical vertebrae and hyoid 3.2+/-3.9 mm, and remained stable. The distance from the hyoid to the mandibular plane decreased during surgery (-3.8+/-5.8 mm) and after surgery (-2.5+/-5.2 mm). Maxillo-mandibular advancement with counter-clockwise rotation and TMJ reconstruction with total joint prostheses produced immediate increase in oropharyngeal airway dimension, which was influenced by long-term changes in head posture but remained stable over the follow-up period.
Assuntos
Artroplastia de Substituição/métodos , Avanço Mandibular/instrumentação , Maxila/cirurgia , Orofaringe/anatomia & histologia , Osteotomia de Le Fort/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Adolescente , Adulto , Resistência das Vias Respiratórias/fisiologia , Artroplastia de Substituição/instrumentação , Cefalometria , Feminino , Seguimentos , Humanos , Osso Hioide/anatomia & histologia , Prótese Articular , Masculino , Avanço Mandibular/métodos , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Procedimentos Cirúrgicos Bucais/métodos , Orofaringe/fisiopatologia , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Rotação , Articulação Temporomandibular/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
47 end-stage TMJ patients with high occlusal plane angulation, treated with TMJ custom-fitted total joint prostheses and simultaneous maxillo-mandibular counter-clockwise rotation were evaluated for pain and dysfunction presurgery (T1) and at the longest follow-up (T2). Patients subjectively rated their facial pain/headache, TMJ pain, jaw function, diet and disability. Objective functional changes were determined by measuring maximum interincisal opening (MIO) and laterotrusive movements. Patients were divided according to the number of previous failed TMJ surgeries: Group 1 (0-1), Group 2 (2 or more). Significant subjective pain and dysfunction improvements (37-52%) were observed (Assuntos
Artroplastia de Substituição/métodos
, Reação a Corpo Estranho/etiologia
, Prótese Articular/efeitos adversos
, Transtornos da Articulação Temporomandibular/cirurgia
, Articulação Temporomandibular/cirurgia
, Adolescente
, Adulto
, Artroplastia de Substituição/instrumentação
, Remoção de Dispositivo/métodos
, Dor Facial/etiologia
, Dor Facial/cirurgia
, Feminino
, Seguimentos
, Reação a Corpo Estranho/cirurgia
, Humanos
, Mandíbula/patologia
, Mandíbula/cirurgia
, Avanço Mandibular/métodos
, Maxila/patologia
, Maxila/cirurgia
, Pessoa de Meia-Idade
, Procedimentos Cirúrgicos Bucais/instrumentação
, Procedimentos Cirúrgicos Bucais/métodos
, Desenho de Prótese
, Amplitude de Movimento Articular
, Procedimentos de Cirurgia Plástica/instrumentação
, Procedimentos de Cirurgia Plástica/métodos
, Reoperação
, Estudos Retrospectivos
, Rotação
, Articulação Temporomandibular/patologia
, Transtornos da Articulação Temporomandibular/complicações
, Transtornos da Articulação Temporomandibular/patologia
, Resultado do Tratamento
, Adulto Jovem
RESUMO
The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total joint prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9+/-8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9+/-3.5 mm at the lower incisor tips, 12.4+/-5.4 mm at Point B, 17.3+/-7.0 mm at menton, 18.4+/-8.5 mm at pogonion, and 11.0+/-5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9+/-4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the maxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.
Assuntos
Artroplastia de Substituição/métodos , Avanço Mandibular/instrumentação , Maxila/cirurgia , Osteotomia de Le Fort/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/cirurgia , Adolescente , Adulto , Artroplastia de Substituição/instrumentação , Cefalometria , Terapia Combinada , Oclusão Dentária , Feminino , Seguimentos , Humanos , Prótese Articular , Masculino , Avanço Mandibular/métodos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Rotação , Resultado do Tratamento , Adulto JovemRESUMO
The present study evaluated Nelore cattle with different degrees of resistance to natural infections by gastrointestinal nematodes. One hundred weaned male cattle, 11-12 months of age, were kept on the same pasture and evaluated from October 2003 to February 2004. Faecal and blood samples were collected for parasitological, haematological and immunological tests. In February 2004, the 10 most resistant and the 10 most susceptible animals were selected based on individual means of nematode faecal egg counts (FEC). Such animals were slaughtered for worm burden determination and nematode species identification. The repeatability estimates for FEC (+/-S.D.), log-transformed FEC and packed-cell volume (PCV) in all animals were 0.3 (+/-0.05), 0.26 (+/-0.04) and 0.42 (+/-0.05), respectively. The resistant group showed lower FEC and worm burdens than the susceptible group (P<0.05). There were no significant differences between groups regarding mean body weight, weight gain, PCV and total serum protein values (P>0.05). The resistant group showed higher total serum IgE levels (P<0.05) and higher mean eosinophil blood counts. However, the latter was statistically significant only 42 days after the beginning of the study. Nematodes Cooperia punctata and Haemonchus placei were predominant and the correlation between Cooperia and Haemonchus burdens was 0.64 (P<0.05), which indicated that animals presenting increased numbers of one of those genera probably had increased numbers of the other. The current study provides further evidence of IgE active role in nematode immunity and suggests that total serum IgE level might serve as an additional marker to select Nelore cattle that are responsive to H. placei and C. punctata infections.
Assuntos
Cruzamento , Doenças dos Bovinos/parasitologia , Gastroenteropatias/veterinária , Imunidade Inata/imunologia , Nematoides/imunologia , Infecções por Nematoides/veterinária , Animais , Anticorpos Anti-Helmínticos/sangue , Peso Corporal , Bovinos , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/fisiopatologia , Eosinófilos/citologia , Fezes/parasitologia , Gastroenteropatias/parasitologia , Imunoglobulina E/sangue , Masculino , Nematoides/isolamento & purificação , Infecções por Nematoides/imunologia , Infecções por Nematoides/parasitologia , Contagem de Ovos de Parasitas/veterinária , Fatores de TempoRESUMO
BACKGROUND AND AIM OF THE STUDY: Aprotinin is effective in promoting hemostasis, notably in cardiac surgery with cardiopulmonary bypass. Its efficacy has been shown in coronary bypass graft operations. However, few reports exist of aprotinin use in valve operations, and in those studies only the full dose was used. Thus, our aim was to evaluate the effects of low-dose aprotinin in patients undergoing heart valve reoperation. METHODS: Eighteen patients having reoperative valve surgery received 10(6) KIU aprotinin after induction of anesthesia, and a further 10(6) KIU in the pump prime. A group of 18 similar patients who were operated on but did not receive aprotinin were used as controls. RESULTS: A significant reduction in postoperative blood loss (approximately 470 ml) occurred in patients receiving aprotinin. These patients also presented less postoperative bleeding than untreated patients in 70.4% of cases. No adverse effects of the drug were noted, except for one case of allergic reaction. CONCLUSION: The systematic use of low-dose aprotinin should be considered in valve reoperation, except in cases of re-exposure to the drug, or allergic reaction.