Oral Rehabilitation Case Study

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Oral rehabilitation Implant-supported fixed prostheses, implant-retained removable overdentures, and implant-supported removable partial dentures /RPDs) have been used for the final rehabilitation of GSWs. Screw-retained fixed prostheses with acrylic resin teeth and metal substructures have been traditionally prescribed for implant-supported rehabilitation of the edentulous mandible. Their advantages include ease of retrievability, low cost in comparison to porcelain, as well as ease of repair. The metal substructure helps to enhance the strength of the acrylic resin, especially when there are distal cantilever extensions in the prosthesis. In addition, it helps to ensure that a passive fit is obtained and contributes to the rigidity of the…show more content…
The causes of nonunion are multifactorial. Osteomyelitis, edentulous mandible, alcohol and drug abuse delayed treatment, teeth in the fracture line, improper reduction, and poor fixation are among the causes. Nonunion is generally characterized by pain and abnormal mobility after treatment. Malocclusion may be present in dentate cases, and mobility exists across the fracture line. Radiographs demonstrate no evidence of healing and, in later stages, show rounding off of the bone ends. Although the main reason is thought to be early mobilization, the new fixation systems lessen the frequency of this complication. Also, it has been suggested that even without maxillomandibular fixation, patients must be encouraged to regain motion, hygiene, and nutrition. It has also been stated that only gaps less than 3 mm are expected to heal without the aid of graft materials. Lack of proper wound closure can also result in the contamination of the fracture site and infection-related osteomyelitis. A decreased blood supply can lead to delays in healing, too. Sometimes nonunion cases can be converted to delayed union cases by immobilization. However, open reduction is recommended when conservative treatment fails. The recommended protocol for the operative treatment of nonunion in the mandible is as follows: an extraoral approach, debridement of the infected and necrotic tissues down to the healthy and bleeding bone, placement of…show more content…
It is still unclear whether gelatin blocks, which are used as a well-accepted tissue simulant, allow the effects of projectiles to be adequately investigated and how these effects are influenced by caliber size. Gelatin is only of limited value for evaluating the path of high-velocity projectiles and the contamination of wounds by exogenous particles. There is a direct relationship between the presence of gas cavities in the tissue along the bullet path and caliber size. These cavities, however, are only mildly contaminated by exogenous particles.29 Due to the complications arising from gunshot wounds to the maxillofacial region, traditional models of gunshot wounds cannot meet our research needs. In this study, we established a finite element model and conducted preliminary simulation and analysis to determine the injury mechanism and degree of damage for gunshot wounds to the human mandible. The dynamic processes involved in gunshot wounds to the human mandible were successfully simulated using two projectiles, three impact velocities, and three entry angles. The stress distributions in different parts of mandible after injury were also simulated. Based on the computation and analysis of the modelling data, we found that the injury severity of the mandible and the injury efficiency of the projectiles differ under different injury conditions.
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