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"Latar Belakang. Konvensional dua tutup palatoplasti akan mengakibatkan cacat lateral yang tanpa cakupan periosteal apapun. Hal ini membuat epitelisasi dari cacat lateral yang membutuhkan waktu lebih lama ( 3 - 4 minggu ). Dalam penelitian ini, penulis berhipotesis bahwa teknik dimodifikasi untuk palatoplasti dua - tutup dengan tidak mengangkat bagian lateral periosteum dengan flap, dan kemudian menerapkan madu cacat lateral yang mungkin mengakibatkan tingkat epitelisasi lebih cepat.Metode. Tiga puluh delapan pasien dengan sumbing langit-langit akan dibagi menjadi dua kelompok dengan intervensi, dimodifikasi teknik palatoplasti dua - tutup meninggalkan periosteum lateral dengan aplikasi madu pack pada kelompok perlakuan dan konvensional palatoplasti dua - tutup dalam kontrol. Kami mengamati tingkat epitelisasi setiap dua hari setelah keluar dari rumah sakit sampai penyembuhan penuh dicapai. Kami juga documentate beberapa parameter bedah - terkait seperti : panjang operasi, kehilangan darah intraoperatif, skala nyeri pasca operasi, masa rawat inap, dan komplikasi. Hasil. Penelitian ini menunjukkan perbedaan yang signifikan dari tingkat epitelisasi antara kelompok perlakuan dengan teknik modifikasi 2,4 ( 2,0 ; 3,0 ) mm / hari dengan yang konvensional 0.7 ( 0.6, 0.8 ) mm / hari ( p < 0,001 ). Parameter bedah terkait di kedua teknik yang relatif sama. Kesimpulan. Teknik modifikasi kami mempercepat laju epitelisasi dari cacat lateral. Ini dapat mencegah gangguan pertumbuhan rahang atas di masa depan karena penyembuhan lebih cepat mengurangi pembentukan parut dan kontraksi luka. Penelitian lebih lanjut diperlukan untuk mengkonfirmasi bahwa teknik modifikasi ini akan menghasilkan pertumbuhan rahang atas yang lebih baik.

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Background. The conventional two-flap palatoplasty will result in lateral defect without any periosteal coverage. It makes the epithelialization of the lateral defect takes longer time ( 3- 4 weeks). In this study, the authors hypothesized that the modified technique to the two-flap palatoplasty by not elevating the lateral part of the periosteum with the flap, and then apply honey to the lateral defect possibly resulting faster epithelialization rate.

Methods. Thirty eight patients with cleft palate will be divided into two groups with intervention, modified two-flap palatoplasty technique leaving lateral periosteum with application honey pack in treatment group and conventional two-flap palatoplasty in control. We observe the epithelialization rate every two days after came out from hospital until full healing is achieved. We also documentate some surgical-related parameters such as: the length of operation, intraoperative blood loss, postoperative pain scale, hospitalization period, and the complications.

Result. This study showed significant difference of the epithelialization rate between the group treated by the modified technique 2.4 (2.0;3.0) mm/day with the conventional ones 0.7 (0.6;0.8) mm/day (p<0.001). The surgical-related parameters in both technique were relatively same.

Conclusions. Our modified technique hasten the epithelialization rate of the lateral defect. It may prevent the maxillary growth disturbances in the future because faster healing reduces the scar formation and wound contraction. Further studies are required to confirm that this modified technique will result in better maxillary growth."

"ABSTRAKPendahuluan. Perkembangan analisis wajah pada bedah rekonstruksi wajah sangatlah pesat, sejalan dengan perkembangan teknologi pencitraan dan komputerisasi. Program perangkat lunak yang tersedia pada saat ini, seperti Rhinobase, hanya dapat mengukur daerah hidung, tidak seluruh wajah. Oleh sebab itu dibutuhkan suatu program perangkat lunak yang lebih lengkap, dapat menyimpan data medis, mengukur dan menganalisis foto (fotogrametri dan analisis fotografi) guna merencanakan tindakan operasi rekonstruksi wajah secara keseluruhan. Pengakat lunak ini diharapkan dapat digunakan sebagai alat ukur dan menjadi panduan untuk melakukan tindakan bedah rekonstruksi wajah (reaksilofasial)."

"LATAR BELAKANG: Di Indonesia, pembedahan koreksi bibir sumbing sering dilakukan sebagai aksi sosial di wilayah terpencil dengan sumber daya operasional alat dan obat-obatan yang terbatas. Ketamin merupakan obat yang murah dan mudah tersedia. Penelitian ini adalah untuk menilai penggunaan ketamin sebagai analgetik lokal dalam blok infraorbital dibandingkan bupivakain, untuk mengetahui apakah ketamin dapat menjadi alternatif sebagai analgetik lokal perioperatif. Yang dimaksud perioperatif dalam penelitian ini adalah periode intraoperatif dan pascaoperasi. METODE: Penelitian ini bersifat eksperimental dengan uji klinis tersamar tunggal pada anak dengan kelainan bibir sumbing berusia 2 bulan - 5 tahun yang akan menjalani operasi koreksi bibir sumbing di RSCM pada bulan Maret sampai Juli 2014. Anak dibagi menjadi kelompok ketamin dan bupivakain menurut randomisasi blok. Tiap-tiap kelompok dilakukan anestesia umum, induksi dengan inhalasi sevoflurane dan intubasi. Selanjutnya dilakukan blok infraorbital sesuai randomisasi. Intraoperatif dicatat jumlah penggunaan analgetik tambahan. Pascaoperasi dicatat skor nyeri FLACC selama di ruang pulih serta dilakukan wawancara per-telepon untuk mengetahui durasi analgesia pascaoperasi. HASIL: Sebanyak 36 subjek diikutsertakan dalam penelitian, 18 pada kelompok ketamin dan 18 pada kelompok bupivakain. Tidak terdapat perbedaan bermakna terhadap penambahan fentanyl intraoperatif dan skala nyeri FLACC pascaoperasi. Dengan skala nyeri FLACC di kelompok ketamin berada kategori nyeri ringan (<4). Rerata durasi analgesia pascaoperasi pada kelompok ketamin lebih lama (15 jam) sementara pada kelompok bupivakain 13,49 jam. Dan perbedaan ini secara statistik bermakna (P=0,031). SIMPULAN: Blok infraorbital dengan ketamin 1% 0,5 mg/kg tidak lebih efektif dibandingkan bupivakain 0,25% 0,5 ml sebagai analgetik perioperatif operasi ambulatori koreksi bibir sumbing.

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BACKGROUND: In Indonesia, cleft lip correction surgery is often done as a social action in remote areas with limited drugs and operational resources. Ketamine is a readily available and inexpensive drug. The objectives of this study is to asses the effectiveness of ketamine as a local analgetic in infraorbital block compare with bupivacaine, to determine whether ketamine can be an alternative local analgetic for perioperative. The definition of perioperative in this study were intraoperative and postoperative period.

METHODS: This is a randomized controlled trial in 2 months - 5 years children with cleft lip who underwent cleft lip correction surgery at RSCM from March until July 2014. Children were divided into ketamine group and bupivacaine group based on randomization. In each group we performed general anesthesia , induction with sevoflurane, intubation and infraorbital block according to the randomization. We recorded total amount rescue analgetic added intraoperative. Postoperatively we recorded pain scores based on FLACC scale and follow up by telephone to find out the duration of analgesia.

RESULTS: A total of 36 subjects enrolled in this study , with 18 subjects in ketamine group and 18 subjects in bupivacaine group . There were no significant difference of total amount fentanyl intraoperative addition and postoperative FLACC pain scale between two groups. The FLACC pain scale in ketamine group was categorized “mild pain” ( < 4 ). The mean duration of postoperative analgesia in ketamine group was longer (15 hours) than bupivacaine group (13.49 hours). And this difference was statistically significant (P = 0.031).

CONCLUSION: Infraorbital block with 1 % ketamine 0.5 mg / kg was not more effective than 0.25% bupivacaine 0,5 ml for perioperative analgesia in ambulatory cleft lip correction."

"Textbook of Oral and Maxillofacial Surgery is a comprehensive guide to the field for trainee dental students. The book covers basic procedures performed in general practice, as well as more advanced and complex surgical management techniques in the hospital environment. Presented in an easy to follow format, the text is divided into twelve sections, each discussing different oral and maxillofacial disorders, their diagnosis and appropriate medical and surgical management techniques. The final sections offer trainees advice on thesis writing and seminar presentation, and quick reference appendices describe commonly prescribed investigations in surgical practices, their values and interpretation. Photographs and drawings show various clinical conditions and demonstrate basic surgical techniques. Salient points for each topic are highlighted in text boxes, along with extensive referencing in every chapter. Key points * Comprehensive guide to oral and maxillofacial surgery for trainee dental students * Covers basic and advanced medical and surgical management techniques * Includes advice on thesis writing and seminar presentation * Includes more than 1200 clinical photographs, drawings and tables"

"Textbook of Oral and Maxillofacial Surgery is a comprehensive guide to the field for trainee dental students. The book covers basic procedures performed in general practice, as well as more advanced and complex surgical management techniques in the hospital environment. Presented in an easy to follow format, the text is divided into twelve sections, each discussing different oral and maxillofacial disorders, their diagnosis and appropriate medical and surgical management techniques. The final sections offer trainees advice on thesis writing and seminar presentation, and quick reference appendices describe commonly prescribed investigations in surgical practices, their values and interpretation. Photographs and drawings show various clinical conditions and demonstrate basic surgical techniques. Salient points for each topic are highlighted in text boxes, along with extensive referencing in every chapter. Key points * Comprehensive guide to oral and maxillofacial surgery for trainee dental students * Covers basic and advanced medical and surgical management techniques * Includes advice on thesis writing and seminar presentation * Includes more than 1200 clinical photographs, drawings and tables."

"Midfacial rejuvenation is a comprehensive review of the majority of procedures and options for midfacial aesthetic and corrective surgery. Each contributor offers a unique approach to the midfacial area, with detailed specifics for every technique. Chapters on midfacial anatomy, complications and their management complete the comprehensive coverage of the subject matter, resulting in a reference text that will benefit every practitioner dealing with the midfacial region. Features, one of the first books to focus exclusively on the midfacial area, highly illustrated and with clear, step-by-step instructions on performing a variety of midface lifts, implants, sutures, grafts, and fillers, over 300 full color images, includes in-depth chapters on midfacial anatomy and the anatomic basis of aging, multiple approaches to midfacial rejuvenation by well-known surgeons in fields such as oculoplastics, facial plastics, general plastics, and dermatologists."

"Textbook of Oral and Maxillofacial Surgery is a comprehensive guide to the field for trainee dental students. The book covers basic procedures performed in general practice, as well as more advanced and complex surgical management techniques in the hospital environment. Presented in an easy to follow format, the text is divided into twelve sections, each discussing different oral and maxillofacial disorders, their diagnosis and appropriate medical and surgical management techniques. The final sections offer trainees advice on thesis writing and seminar presentation, and quick reference appendices describe commonly prescribed investigations in surgical practices, their values and interpretation. Photographs and drawings show various clinical conditions and demonstrate basic surgical techniques. Salient points for each topic are highlighted in text boxes, along with extensive referencing in every chapter. Key points * Comprehensive guide to oral and maxillofacial surgery for trainee dental students * Covers basic and advanced medical and surgical management techniques * Includes advice on thesis writing and seminar presentation * Includes more than 1200 clinical photographs, drawings and tables."

"Textbook of Oral and Maxillofacial Surgery is a comprehensive guide to the field for trainee dental students. The book covers basic procedures performed in general practice, as well as more advanced and complex surgical management techniques in the hospital environment. Presented in an easy to follow format, the text is divided into twelve sections, each discussing different oral and maxillofacial disorders, their diagnosis and appropriate medical and surgical management techniques. The final sections offer trainees advice on thesis writing and seminar presentation, and quick reference appendices describe commonly prescribed investigations in surgical practices, their values and interpretation. Photographs and drawings show various clinical conditions and demonstrate basic surgical techniques. Salient points for each topic are highlighted in text boxes, along with extensive referencing in every chapter. Key points * Comprehensive guide to oral and maxillofacial surgery for trainee dental students * Covers basic and advanced medical and surgical management techniques * Includes advice on thesis writing and seminar presentation * Includes more than 1200 clinical photographs, drawings and tables."