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Objectives: The aim of this study was to evaluate the survival rate of lithium disilicate overlays in increasing occlusal vertical dimension (OVD) in the setting of minimally invasive techniques and the restoration thicknesses at different tooth sites., Materials and Methods: This is an observational study evaluating 43 lithium disilicate overlays (Lithium IPS e.max Press, Ivoclar Vivadent) on 8 patients, prepared with minimally invasive criteria over a follow-up period between 19 to 45 months (mean follow-up of 32 months). Occlusal vertical dimension's increase was planned using occlusal treatment plan and diagnostic wax-up. Prior to adhesive cementation, restoration thicknesses were measured with a caliber. The survival rate was calculated by Kaplan-Meier analysis., Results: Restoration survival rates at 32 months were 97.7%. One infiltration was observed, no cases of fracture occurred. The greatest thickness in monolithic restorations was detected in the cusp sides of teeth, whereas the thinnest was highlighted in the central fossa. The average amount of dental tissue removed during preparation was 0.98 mm in non-functional cusps, 0.88 mm in functional cusps, and 0.57 mm in the central fossa., Conclusions: Lithium disilicate posterior overlays show an excellent complication-free survival rate, and the material allows for conservative restorations with minimum thickness., Clinical Relevance: Monolithic lithium disilicate overlays feature a satisfying 32-month survival rate. The technique allows to perform restorations with a minimal removal of dental tissue, while limiting fractures over time. Its esthetical performance is excellent.

Purpose: The purpose of this study was to describe a modified technique using only biological dura substitute (Lyoplant®) associated or not to a sheet of Medpore® (porous polyethylene plate) avoiding the use of Silastic® or Merocel® packing for endoscopic endonasal reduction of medial orbital wall fracture., Methods: An interventional case report was used involving two patients with medial orbital wall fracture that were treated with the modified technique. Postoperatively, the patients were evaluated for visual acuity, enophthalmos, extraocular motility, and diplopia., Result: Twelve months after surgery, patients recovered completely without any residual eye symptoms or complications, and postoperative CT showed a completely corrected medial orbital wall fractures., Conclusion: The reported technique proved itself to be safe and effective, and it may be expected to have advantages over the conventional endoscopic approach using a non-absorbable packing, avoiding the need for long-term nasal packing and a secondary removal procedure.

Extreme atrophy of the jaws constitutes a challenge for maxillofacial surgeons. The technique involving Le Fort I osteotomy, bone grafting, and endosseous implants remains the gold standard treatment for class V and class VI atrophy of the maxilla. As severe maxillary atrophy is associated to impaired microvascularization of overlying soft tissues, reconstruction using vascularized free fibula flaps together with endosseous implants is one of the possible treatment plans. When this approach fails, however, retreating these patients using traditional techniques often proves unsatisfactory. This study outlines our clinical experience with full-arch zygoma implant-supported prosthetic rehabilitation to treat severe atrophic maxilla following failure of strategies including multiple Le Fort I procedures or vascularized free fibular flaps.

Subcutaneous facial emphysema is a well-known consequence of oral and maxillofacial traumatic injury. In some rare cases, the subcutaneous air collection could spread through the retropharyngeal and paralatero-cervical spaces, reaching the mediastinum. This clinical entity is known as pneumomediastinum and represents a severe and, sometimes, life-threatening condition. Other reported causes of pneumomediastinum are esophageal and tracheal traumatic or iatrogenic rupture. Finally, the so-called spontaneous pneumomediastinum is caused by a sudden increase in alveolar pressure and is usually seen in young men. We present two cases of pneumomediastinum as a consequence of unusual traumatic damage of orofacial tissues, followed by repeated sneezing and Valsalva maneuver.