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Functional loading of the implant leads to compression of its interface to the bone, which is mechanically favorable to the ill-conditioned load transfer called for by conventional tuberosity transposition, where the full force of the patellar tendon is transferred to the tibia by pins and a figure eight wire.
After removal of the nasotracheal anesthetic tube, orotracheal intubation and redraping were performed. The entire forehead area was injected with 30 ml of tumescent solution (normal saline 1 L, 8.4 % sodium hydrogen carbonate solution 10 ml, 2 % lidocaine 40 ml, 0.1 % epinephrine 1 ml). After a wait of 20 min, a 4-cm incision down through the periosteum was made with a no. 10 scalpel in the mid-scalp area, about 3 cm superior to the hairline. Subperiosteal dissection was performed to expose the supraorbital rim, carefully avoiding damage to the supraorbital neurovascular bundles. The dissection was fully extended so that the silicone implant could freely rest in the intended position without buckling or being prevented from proper positioning. After proper positioning, the implant was inserted. After profuse irrigation with antibiotic solution, the scalp incision was approximated with surgical staples without a drain. The patient safely recovered from maxillomandibular orthognathic and facial contouring surgery. The 7-month follow-up photographs are presented in Fig. 2.
On Jan 13, 2016, under general anesthesia with nasotracheal intubation, narrowing genioplasty and reduction and rotational malarplasty were performed. Then, the anesthetic tube was changed from the nasotracheal to the orotracheal position. After redraping, frontal augmentation was performed as described above. We marked the center of the silicone implant as a V-shaped wedge to ensure proper positioning after insertion. The implant was rolled for ease of insertion because it was larger than the length of the coronal incision. After insertion, it was unrolled with a proper instrument. The implant was carefully palpated through the skin layer to ensure proper positioning. The coronal incision was approximated with surgical staples. A pressure dressing was applied on the forehead, and middle and lower face, using an elastic bandage and plaster.
The new 3D movie Peri-implantitis and its Prevention, the sixth episode of the cutting edge HD video animation series on Cell-to-Cell Communication describes the processes from peri-implant health to mucositis, the transition from peri-implant mucositis to peri-implantitis and finally healing and prevention by visualizing the highly complex intercellular interactions and signaling pathways. Special attention is given on the situation around the healthy, functional dental implant, the aggregation of bacteria on the dental implant surface and the biofilm in the niches. 2b1af7f3a8