Leventis Minas, Van Stralen Kenneth
Oral Surgery, Dental School, National and Kapodistrian University of Athens, Athens, GRC.
Dentistry, Marquette University, Milwaukee, USA.
Cureus. 2024 Jul 8;16(7):e64095. doi: 10.7759/cureus.64095. eCollection 2024 Jul.
In oral surgery, common surgical procedures such as the removal of impacted teeth, the treatment of intraosseous cysts and tumors, and endodontic surgery often require access through a palatal approach. Full-thickness flap surgery in the hard palate region can result in significant post-operative pain, swelling, and hematoma, adversely affecting the patient's function and well-being for several days. Moreover, post-operative infection can delay or compromise healing. Post-surgical traditional palatal stents have been shown to effectively reduce discomfort by minimizing swelling and pain during the early healing phases. Recent advances in materials with the incorporation of bioactive agents have led to the fabrication of a new generation of wound dressings that provide improved conditions for effective wound protection and healing. This case report illustrates the use of a novel, zinc-embedded, thermoplastic surgical polymer for the chairside fabrication of post-operative palatal stents. A 33-year-old female patient, who underwent mucoperiosteal flap surgery for the management of a nasopalatine duct cyst, was provided immediately post-surgery with a customized zinc-containing palatal stent. The bone defect was grafted using a fully resorbable synthetic bone substitute, and an oxygen and lactoferrin-releasing oral gel was provided post-operatively as an adjunct therapy. The innovative stent helped the patient maintain low levels of pain and minimal swelling during the initial post-operative period, resulting in uneventful healing, as documented during the one-week follow-up appointment. Further reviews at four weeks and six months post-surgery revealed successful healing and sensory recovery in the anterior palatal region. As emphasized in this report, the chairside fabrication of zinc-containing palatal stents for post-operative wound protection seems to constitute a valid, simple, time-saving, and cost-effective clinical solution. Moreover, the incorporation of zinc nanoparticles into the stent is of great clinical importance, potentially offering significant benefits in post-operative bacterial control and enhancement of the early-phase palatal soft-tissue healing.
在口腔外科手术中，诸如拔除阻生牙、治疗骨内囊肿和肿瘤以及牙髓外科手术等常见外科操作通常需要通过腭侧入路。硬腭区域的全层瓣手术可能会导致明显的术后疼痛、肿胀和血肿，在数天内对患者的功能和健康产生不利影响。此外，术后感染会延迟愈合或影响愈合效果。已证实术后传统腭托通过在早期愈合阶段将肿胀和疼痛降至最低，能有效减轻不适。随着含生物活性剂材料的最新进展，已制造出新一代伤口敷料，为有效伤口保护和愈合提供了更好的条件。本病例报告阐述了一种新型的、嵌入锌的热塑性手术聚合物用于在椅旁制作术后腭托。一名33岁女性患者因治疗鼻腭管囊肿接受了黏骨膜瓣手术，术后即刻为其提供了定制的含锌腭托。使用完全可吸收的合成骨替代物对骨缺损进行植骨，并在术后提供一种释放氧气和乳铁蛋白的口腔凝胶作为辅助治疗。这种创新的腭托帮助患者在术后初期保持低疼痛水平和最小程度的肿胀，从而实现顺利愈合，这在一周的随访预约中得到记录。术后四周和六个月的进一步复查显示腭前部区域愈合成功且感觉恢复。如本报告所强调的，在椅旁制作含锌腭托用于术后伤口保护似乎是一种有效、简单、省时且经济高效的临床解决方案。此外，将锌纳米颗粒融入腭托具有重要的临床意义，可能在术后细菌控制和促进腭部软组织早期愈合方面带来显著益处。
