Biomedical subjects

Pier Francesco Nocini

Publications and source records attributed to Pier Francesco Nocini.

7 recordsLinked to original sources

PubMed2004

Cranioplasty using acrylic material: a new technical procedure.

AIM: Today, cranioplasty is performed using different procedures. Numerous materials may be used to reconstruct the cranial vault including autologous bone and different types of synthetic resins. When plastic materials are used, the main requirement for an effective cranioplasty is the preoperative shaping of the implant to fit the bony defect precisely. In this paper, experience with a new method for cranioplasty using an acrylic cranial implant is presented. MATERIAL AND METHODS: In this new technical procedure an acrylic implant, precisely shaped to the defect, is fabricated preoperatively using CT data. The study consists of 15 cases in whom cranioplasty was performed using this method. In all these, reconstruction was at least 3 months after the initial operation that lead to the cranial bony defect. RESULTS: No major complications occurred and the final functional and aesthetic results were good in all cases. The acrylic implant manufacture does not require the use of complex computer interface software or high-tech equipment, but involves simple, cheap, repeatable processes.

Adult↗

PubMed2004

Vertical distraction osteogenesis of the mandible applied to an iliac crest graft: report of a case.

OBJECTIVES: This clinical case represents a particular application of vertical distraction osteogenesis of the mandible. The surgical technique was applied to an iliac crest bone graft previously positioned on an anterior mandibular defect with the aim to restore the vertical height after a partial resorption in a trauma patient. CASE REPORT: Distraction osteogenesis was applied because it was necessary to restore the mandibular height in a young male patient who presented with a post-trauma anterior mandibular bony deficiency. Because of the irregularity of the mandibular surface and the depth of the defect, the patient first underwent an iliac crest bone grafting that, after 3 months, showed partial resorption. Vertical distraction osteogenesis was performed on the grafted mandible in order to obtain a satisfactory bony height of the mandibular ridge. Then the patient was successfully rehabilitated by means of an implant-supported prosthesis. CONCLUSION: Vertical distraction osteogenesis appears to be a versatile surgical procedure, which can be applied as a secondary treatment in patients presenting with mandibular trauma sequelae.

Adult↗

PubMed2003

Treatment of scars with Er:YAG laser in patients with cleft lip: a preliminary report.

OBJECTIVE: Although one goal in cleft lip surgery is to avoid serious scarring, residual scars are often observed after primary surgery. The goal of this preliminary report was to present the standardized application of laser technology to reduce the appearance of residual scars. DESIGN: Ten patients with scarring after unilateral and bilateral cleft lip surgery were treated with a Dual Mode erbium yttrium-aluminum-garnet laser. This laser was recently introduced and had been used only for cosmetic applications, skin resurfacing, and correction of acne scars. RESULTS: An improvement in the clinical appearance of the laser-treated scars was observed after the first treatment, with continued improvement after the second laser session. The clinically observed improvements were corroborated by the patients' reports concerning satisfaction with the result. CONCLUSIONS: The combined mechanisms of ablation/coagulation and shrinking of the skin caused by the laser, in addition to observed patient satisfaction and low risk associated with the procedure, suggest that this treatment approach can be effective in the correction of residual scarring in patients with cleft lip.

Adult↗

PubMed2002

Distraction osteogenesis of the mandible: evaluation of callus distraction by B-scan ultrasonography.

INTRODUCTION: Distraction osteogenesis is a new and reliable technique for lengthening of hard and soft tissue in cranio-maxillofacial surgery. Since its first applications, X-rays were often the preferred diagnostic method to monitor this treatment. Apart from adding an additional radiation dose, analysis cannot detect and follow the osteogenic process in the distraction gap on the one hand, nor can it evaluate the soft tissue around the distracted area. In this paper, the authors report their experience with B-scan imaging to control mandibular distraction and to overcome the shortcomings of X-rays analysis. METHOD: Comparison of B-scanning with the traditional X-ray methods was performed in 12 patients. RESULTS: B-scan evaluation appeared to be a precise technique in monitoring the different phases of distraction. It is easy to repeat whenever necessary. Early and late complications of soft tissue healing, movements of the bone segment, as well as the osteogenesis were easily detectable. CONCLUSION: In the authors' opinion B-scan evaluation can play an important role in monitoring distraction osteogenesis.

Adult↗

PubMed2002

Strict correlation between uPAR and plakoglobin expression in pemphigus vulgaris.

BACKGROUND: Recent studies have reported nuclear delocalization of plakoglobin in acantholytic pemphigus vulgaris cells. The objective of this study was to evaluate the role of plakoglobin in the pathogenesis of acantholysis in pemphigus vulgaris (PV) and its relation with the urokinase-type plasminogen activator receptor (uPAR) expression. MATERIALS AND METHODS: Plakoglobin and uPAR expressions were evaluated by immunohistochemistry in 22 cases of PV at various stages of the disease, and as controls in 18 specimens of skin/oral mucosa from healthy patients. RESULTS: Healthy skin/normal oral mucosa showed strong plakoglobin expression in the basal and spinous layers with prevalent cellular membrane distribution; the intensity of staining progressively decreased toward the superficial layers of the epithelium. In PV patients, a progressive displacement of the plakoglobin signal toward the nucleus was found in 18/22 of the cases. Healthy skin/normal oral mucosa showed low uPAR expression with prevalent cellular membrane distribution. In the PV patients, strong uPAR expression was present in the acantholytic cells in 16/22 of the cases. There was direct correlation (p < 0.05) between the uPAR expression and nuclear plakoglobin. CONCLUSIONS: The uPAR overexpression in acantholytic PV may be considered a direct consequence of plakoglobin abnormal distribution. Nuclear delocalization of plakoglobin, a direct consequence of plakoglobin-Dsg-3 dissociation induced by PV IgG, probably induces uPAR overexpression. This evidence suggests a central role for plakoglobin in PV pathogenesis because of its delocalization toward the nucleus, which is the probable cause of the uPAR gene expression.

Adult↗

PubMedDate not supplied

Lipofilling of the lips: ultrastructural evaluation by transmission electron microscopy of injected adipose tissue.

OBJECTIVE: To determine if facial autologous fat grafts preserve the morphologic features of adipocytes and guarantee a successful long-term outcome. METHODS: In a previous study, we performed lipofilling in 99 patients between January 1, 1999, and December 31, 2001. In all patients, we performed 3 fat injections at 28-day intervals. We injected 0.4 mL of adipose tissue in the parafrenal area of the upper lip for each treatment. After 4 months, we obtained a biopsy specimen from the same area. We performed an ultrastructural evaluation on freshly harvested fat at the time of harvesting, on stored fat (-30 degrees C) at 8-week and 12-month intervals, and on the biopsy specimens obtained 4 months after treatment. RESULTS: We observed good preservation of the ultrastructure in the harvested tissue. On histologic examination of the parafrenal area 4 months after grafting, some zones of the biopsy specimens showed putative adipocytes, fat cysts, and collagen fibers adequate for volume increase of the treated area. Ultrastructural images showed lipid droplets intermingled in the connective tissue, phagocytes with internal lipid droplets, and well-preserved adipocytes. CONCLUSIONS: This study demonstrates that by using a less traumatic surgical technique, it is possible to increase the cell survival rate of transplanted fat, thereby maintaining a certain number of viable cells and creating a volume increase in the grafted area. The multiple-stage injection technique seems to be a good method, especially when performed with fat stored at -30 degrees C.

Adipocytes↗

PubMedDate not supplied

A customized distraction device for alveolar ridge augmentation and alignment of ankylosed teeth.

The purpose of this study was to develop an extraosseous, tooth-supported miniature intraoral device that could produce prosthetically driven bone distraction of small atrophic alveolar ridge segments. Extraosseous distraction requires that the distraction device be anchored to a dental implant previously placed into the ridge according to its anatomic axis. A distractor can also correct the position of implants placed in young patients before skeletal growth is completed. Similarly, it allows the alignment of ankylosed teeth not treatable by orthodontics. The device is made of (1) an engine consisting of an orthodontic micrometric screw; (2) a joint between the implant and the engine, ie, the ball attachment/o-ring system; and (3) an anchorage system to the oral cavity provided by an orthodontic appliance and a mini-implant for possible additional support. Surgery involves an osteotomy of the atrophic alveolar ridge segment, incorporating the implant, from the basal bone; afterward the device can be applied and distraction of the segment can be carried out. Distraction was successfully performed in 3 clinical cases: 2 bone-implant segments and 1 bone-ankylosed tooth segment. All cases were clinically uneventful. This mini-device for osteogenic distraction of small atrophic ridge segments can provide for accurate and precise ridge augmentation, as is required for ideal prosthetic rehabilitation.

Alveolar Bone Loss↗