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Diffusion01:12

Diffusion

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Diffusion is the passive movement of substances down their concentration gradients—requiring no expenditure of cellular energy. Substances, such as molecules or ions, diffuse from an area of high concentration to an area of low concentration in the cytosol or across membranes. Eventually, the concentration will even out, with the substance moving randomly but causing no net change in concentration. Such a state is called dynamic equilibrium, which is essential for maintaining overall...
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Diffusion01:21

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Diffusion is a type of passive transport. In passive transport, a substance tends to move from an area of high concentration to an area of low concentration until the concentration is equal across the space. For example, take the diffusion of substances through the air. When someone opens a perfume bottle in a room filled with people, the perfume is at its highest concentration in the bottle and is at its lowest at the edges of the room. The perfume vapor will diffuse, or spread away, from the...
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Less-Invasive Technique for Non-stabilized Mandibular Fracture in Mouse Models
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Total mandibular reconstruction following diffuse sclerosing osteomyelitis.

Jan Rustemeyer1, Birte Julia Siegmund2, Yunus Okcu2

  • 1Department of Oral and Maxillofacial Surgery and Plastic Operations, Klinikum Bremen-Mitte, School of Medicine, University of Göttingen, Bremen, Germany. janrustem@gmx.de.

Oral and Maxillofacial Surgery
|October 18, 2018
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Summary

Diffuse sclerosing osteomyelitis (DSO) in adults can be challenging. Extended surgical therapy, including total mandible reconstruction, can achieve satisfactory outcomes when conservative treatments fail.

Keywords:
Diffuse sclerosing osteomyelitisFree fibula flapImplantsSAPHO syndromeTemporomandibular joint prosthesiscad/cam

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Inflammatory Diseases
  • Skeletal Biology

Background:

  • Diffuse sclerosing osteomyelitis (DSO) is a chronic, non-purulent inflammatory condition frequently affecting the mandible.
  • DSO is categorized with autoinflammatory diseases, often associated with SAPHO syndrome in pediatric cases, typically managed non-surgically.
  • This report details an atypical presentation and management of DSO in an adult female patient.

Observation:

  • A 50-year-old female with DSO, lacking SAPHO syndrome, underwent prolonged conservative and surgical treatments without success.
  • Recurrent acute exacerbations necessitated multiple surgical interventions.
  • The treatment culminated in a complete mandibular resection and reconstruction using alloplastic and autoplastic materials, including both temporomandibular joints.

Findings:

  • Despite extensive prior treatments, surgical intervention was ultimately required for refractory DSO.
  • Total resection of the mandible was performed due to the severity and recurrence of the condition.
  • Successful reconstruction with prosthetic rehabilitation, including dental implants, was achieved post-surgery.

Implications:

  • Extended surgical management, including radical resection and complex reconstruction, is a viable option for refractory adult DSO when conservative methods fail.
  • Satisfactory functional and aesthetic rehabilitation is achievable even after total mandibular resection in DSO cases.
  • This case highlights the importance of considering aggressive surgical approaches for severe, treatment-resistant DSO in adults.