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Coronavirus disease-19 (COVID-19) pandemic has spread to all countries, including Indonesia. This pandemic has caused a lot of losses in economic factors as well as losses of relatives including health care workers. This study aimed to determine the description of deaths among health care workers at Prof. Dr. R. D. Kandou Hospital, Manado, who were exposed to COVID-19. This was a retrospective and descriptive study using secondary data, namely all deaths of health care workers at Prof. Dr. R. D. Kandou Hospital exposed to COVID-19 in the period of 2020-2021. The results showed that there were four cases of deaths among health care workers at Prof. Dr. R. D. Kandou Hospital exposed to COVID-19 during the period 2020-2021. Three cases were over 55 years old and one case was between 25-55 years old. Three cases were male and one case was female. Four cases were medical personnel (general practitioners and specialists). Four cases had hypertension, three cases had diabetes, and one case had heart disease as comorbid. In conclusion, from the health workers at Prof. Dr. R. D. Kandou Hospital exposed to COVID-19, the majority of deaths occurred in males, aged over 55 years, medical personnel, and had hypertension as comorbid.Keywords: mortality; health care workers; coronavirus disease-19 Abstrak: Pandemi coronavirus disease-19 (COVID-19) melanda semua negara, termasuk Negara Indonesia. Pandemi ini menyebabkan banyak kerugian, dari faktor ekonomi hingga kehilangan kerabat termasuk tenaga kesehatan. Penelitian ini bertujuan untuk mendapatkan gambaran kematian tenaga kesehatan RSUP Prof. Dr. R. D. Kandou Manado yang terpapar COVID-19. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data sekunder, yaitu seluruh data kematian tenaga kesehatan RSUP Prof. Dr. R. D. Kandou Manado yang terpapar COVID-19 periode 2020-2021. Hasil penelitian mendapatkan empat kasus kematian pada tenaga kesehatan RSUP Prof. Dr. R. D. Kandou Manado yang terpapar COVID-19 selama periode 2020-2021 yaitu tiga kasus berusia di atas 55 tahun dan satu kasus berusia di antara 25-55 tahun. Terdapat tiga kasus berjenis kelamin laki-laki dan satu kasus berjenis kelamin perempuan; kesemuanya ialah tenaga medis (dokter umum dan dokter spesialis). Empat kasus dengan komorbid hipertensi, tiga kasus dengan komorbid diabetes, dan satu kasus dengan komorbid penyakit jantung. Simpulan penelitian ini ialah pada tenaga kesehatan RSUP Prof. Dr. R. D. Kandou Manado yang terpapar COVID-19, mayoritas kematian terjadi pada laki-laki, berusia di atas 55 tahun, tenaga medis, dengan komorbid hipertensi.Kata kunci: mortalitas; tenaga kesehatan; coronavirus disease-19

Intraoral soft tissue infections (OSTI) are a common problem in dentistry and oral surgery. These abscesses are mostly exacerbated dental infections (OIDC), and some emerge as postoperative infections (POI) after tooth extraction (OITR) or apicoectomy (OIRR). The main aim of this study was to compare OIDC with POI, especially looking at the bacteria involved. An additional question was, therefore, if different antibiotic treatments should be used with OSTI of differing aetiologies. The impact of third molars on OSTI was evaluated and also the rates of POI after removal of third molars were specified.Patient data was collected from the patients' medical records and the results were statistically evaluated with SPSS (SPSS version 21.0; SPSS, IBM; Chicago, IL, USA). The inclusion criterion was the outpatient treatment of a patient with an exacerbated oral infection; the exclusion criteria were an early stage of infiltration without abscess formation; and a need for inpatient treatment.Periapical exacerbated infections, especially in the molar region were the commonest cause of OIDC. In the OITR group, mandibular tooth removal was the commonest factor (p=0.016). Remarkably, retained lower wisdom teeth led to significant number of cases in the OITR group (p=0.022).In our study we could not define differences between the causal bacteria found in patients with OIDC and POI. Due to resistance rates we conclude that amoxicillin combined with clavulanic acid seems to be the antibiotic standard for exacerbated intraoral infections independent of their aetiology.

Patients with functional disorders of the temporomandibular apparatus often show painful myogelosis, especially of the masseter muscle. The cause is hypertonia of the affected muscle. The aim of the presented single-blinded clinical trial was to analyze the effects of low-energy extracorporeal shock waves on patients with pain sensitivity in this region. Participating in the trial were 50 patients with painful, palpable and sonographically evident myogelosis of the masseter muscle. Half of the patients received a single application of 250 impulses of 0.04 mJ/mm2. The second half received an equivalent placebo treatment with the shock-wave impact being inhibited by a neopren insert. It was shown that in 64% of the patients significant alleviation of pain with palpable and sonographically evident softening of the myogelosis could be achieved. In 40% of the patients the therapeutic result could be conserved over a period of 2 weeks. The difference from the placebo group was statistically highly significant. ESWT is thus an easy-to-use, non-invasive method of initial pain therapy for patients with functional disorders. To preserve the long-term therapeutic result, additional functional therapy is nevertheless necessary.

Intraoral orthognathic surgical procedures are clean-contaminated operations because of the facultative pathogenic flora of the oral cavity. Without antibiotic prophylaxis in this kind of operation a postoperative wound infection can be expected in 20-31% of cases. Therefore, a retrospective analysis of the clinical course of 545 patients with various dentofacial deformities was performed to evaluate the importance of perioperative antibiotic prophylaxis. The total rate of wound infections was 2.8% and lower than rates published in other comparable studies without antibiotic prophylaxis. The rate of wound infection after single mandibular osteotomy (4.1%) was significantly higher than the analogous amount after single maxillary osteotomy (0.8%) because of the mechanical strain of the surgical wound in the region of the mandibular angle and because of the high retention of food particles and other decay products in this area. The recognized rise in the wound infection rate by increasing the length of operation demonstrates that the extent of bacterial contamination of the surgical wound depends on the dimension and duration of surgery. Bacterial flora caused the noticed wound infections in 61.5% of cases aerobic-anaerobic mixed infections, which is in accordance with the results of similar publications. With increasing length of antibiotic prophylaxis, an increase in the incidence of antibiotic-associated side effects and in the wound infection rate could be observed. Therefore, an antibiotic prophylaxis which exceeds 3 days does not seem to be useful. In this study, in which cephalosporins were mostly used, the total rate of antibiotic-associated side effects (4.6%) was lower than analogous amounts of other groups of antibiotics. The analysis demonstrates that a short-term prophylaxis with broad-spectrum cephalosporins such as cefatoxime of 48 h is very effective and useful.

A retrospective and partly prospective study was conducted to analyse both clinically and cephalometrically the craniofacial growth pattern of patients with isolated and syndrome-related premature craniosynostosis after standardized fronto-orbital and midface advancement. The file data of 293 children with fronto-orbital advancement were evaluated over an average period of 4.4 years. In addition, lateral teleradiographies of 117 patients from this group were cephalometrically analysed. Moreover, late results of 36 children and 8 adults with midface-advancement with an average follow-up period of 4.5 years were assessed. In contrast to linear craniectomy and so-called lateral canthal advancement, in only 8.2% of cases (24 out of 293 patients) were relapses requiring reoperation found in this study after fronto-orbital advancement. The evaluations indicate that with simple forms of craniosynostosis such as trigonocephaly and plagiocephaly predominantly very good or good growth can be observed. Cephalometric evaluation confirmed the limited potential of growth in the area of the anterior skull base and in the midface in the presence of syndrome-related faciocraniosynostoses. In such cases the cephalometrically confirmed maxillary hypoplasia, which increases in severity in the following order of syndromes 'Saethre-Chotzen-Crouzon-Apert-Pfeiffer', could be influenced only to a limited degree by fronto-orbital advancement. For this reason midface advancement is of secondary importance in children with very severe anomalies. In the present evaluation, a high rate of relapse of midfacial hypoplasia was to be found in children and adolescents after this operation in accordance with other references. Therefore, the indication for Le Fort III osteotomy in the growth period should be limited.

Dystopies of the bony orbit are caused mainly by craniosynostosis, facial clefts and encephaloceles. This article presents the results of the surgical correction of orbital hypertelorism in 24 patients. Using this operation technique, the bony interorbital distance was decreased from an average of 47.6 mm to 22.8 mm. However, the distance between the soft tissues was not reduced by the same amount as the distance between the bony orbits. The intercanthal distance decreased from an average of 58.5 mm to 44.5 mm, whereby an additional refixation of the medial palpebral ligament resulted in a reduction of the intercanthal distance to 40.8 mm. A strabismus divergens was seen preoperatively in 18 patients, postoperatively only in 8 patients. Four of the latter had to undergo operative correction of the diplopia. We conclude that the operative technique is not reserved only for complex cases of hypertelorism because it shows satisfactory functional and aesthetic results with a low complication rate.

Autolysierter, Antigen-extrahierter, allogener Knochen (AAA-Knochen) wird aus kortikalem Knochen von Multiorganspendern hergestellt und besitzt aufgrund seiner Freisetzung von knocheneigenen BMPs osteoinduktive Eigenschaften. Im Rahmen einer prospektiven Studie wurden uber einen Zeitraum von mehr als 7 Jahren 37 Schadeldachdefekte mit AAA-Knochenimplantaten rekonstruiert. Die Patienten wurden standardisiert nachuntersucht. Radiologische Untersuchungen sowie Knochenszintigraphien ergaben eine Knochenintegration und Remodellierung der ehemaligen AAA-Knochenimplantate. In 1/4 der Falle wurde ein erneuter operativer Eingriff 10–18 Monaten nach der Kranioplastik durchgefuhrt (Entfernung von Osteosynthesematerial, Tumorrezidiv). Alle 9 AAA-Knochen-Rekonstruktionen zeigten blutende Oberflachen und eine knocherne Konsolidierung. Aus dem Zentrum eines dieser AAA-Knochenimplantate wurde eine Biopsie entnommen, welche eine, von der Oberflache ausgehende, Knochenneubildung zeigte. In 1 Fall kam es zu einem infektionsbedingten Verlust eines AAA-Knochenimplantats. Dies ist insbesondere bemerkenswert, da bei ca. 1/3 der Falle die Knochenimplantate in direktem Kontakt zur Stirnhohle standen. Die klinischen Resultate unterstreichen eindrucksvoll den therapeutischen Nutzen von osteoinduktivem AAA-Knochen bei Schadeldachplastiken. Grosflachige AAA-Knochen-Chips aus menschlichen Schadelkalotten erleichtern die Rekonstruktion in Schadelbereichen mit groser Konvexitat. Dies gilt insbesondere dann, wenn ein stereolithographisches Modell des Defekts zur praoperativen Planung zur Verfugung steht.

Ein neuer Kalziumphosphatzement besteht aus 73% Tetrakalziumphosphat und 27% Kalziumhydrogenphosphat. Er bindet bei Korpertemperaturen nach Zugabe von Wasser innerhalb von 20 min ab. Innerhalb von 4 h wird der Zement zu Hydroxylapatitkristallen umgesetzt und damit wasserunloslich. Der Abbindeprozes verlauft nahezu isotherm im pH-Bereich von 6,5–8,5 ohne Schrumpfung. Die Druckfestigkeit liegt im ausgeharteten Zustand oberhalb von 50 MPa, die Zugfestigkeit bei mehr als 8 Mpa. Der Zement ist fur alle nicht lasttragenden Knochenaugmentationen und Knochenersatzanwendungen insbesondere am Gesichtsschadel geeignet. Bei 9 von 10 Patienten benutzten wir den Zement erfolgreich fur Rekonstruktionen im kraniofazialen Bereich. Beim klinischen Einsatz mus besonders auf sorgfaltige Trockenlegung des Operations- und Implantationsfelds geachtet werden. Weitere Anwendungsmoglichkeiten sind das Auffullen von ausgeraumten und verblockten Schadelhohlen, die Fixation von implantierten Horelektroden in der Hals-Nasen-Ohren-Heilkunde sowie das Auffullen von Zysten und Wurzelspitzenresektionsdefekten in der dentoalveolaren Chirurgie. Besondere Perspektiven bietet der Hydroxylapatitzement wegen seiner isothermen Abbindereaktion und seiner intrinsischen osteokonduktiven Eigenschaften als Tragermaterial fur osteogene Proteinkomplexe.

The standardized bilateral fronto-orbital advancement method of osteotomy established at the University of Wuerzburg is applied in all forms of craniosynostosis except scaphocephalus. The intention behind early operation is to halt progression of the disorder and to institute the physiological direction that growth should take. The preoperative severity of the disorder, the particular symptoms of the various malformations concerned, and the postoperative course of growth were analyzed and assessed both clinically and cephalometrically using the retrospective evaluations of the file data of 131 children with various forms of craniosynostosis. In contrast to linear craniectomy and so-called lateral canthal advancement, which have sometimes been thought to lead to undesirable postoperative growth development, only 11 relapses requiring renewed operation were found postoperatively in our own study of 131 children. It became evident that the greater the severity of the malformation, the more probable it was that a relapse would occur. Fronto-orbital advancement can only affect the pathologic growth pattern to a limited degree, especially when craniosynostosis is related to a syndrome. Cephalometric evaluation confirmed the limited potential for growth in the area of the anterior skull base and in the mid-face in the presence of syndrome-related brachycephaly and severe facio-craniosynostoses. In such clinical cases, compensatory growth of maxillary hypoplasia cannot be expected after fronto-orbital advancement.