Latest Results for Oral and Maxillofacial Surgery The latest content available from Springer
- Osteonecrosis of the jaws associated with protein kinase inhibitors: a systematic reviewon 10/10/2020 at 12:00 am
Abstract This systematic review analysed evidence relating to medication-related osteonecrosis of the jaws (MRONJ) associated with protein kinase inhibitors in antiresorptive naïve patients. A literature search of major biomedical databases was conducted in March 2020. Information extracted from relevant articles included bibliographic information, patient characteristics, MRONJ characteristics at diagnosis, management strategies and outcomes. Sixteen studies, representing data from 17 patients, were included for final analysis. Descriptive statistics were used to synthesis available data. Eleven protein kinase inhibitors were implicated, with a mean exposure of 13 months prior to MRONJ. Renal cell carcinoma was the primary diagnosis in 41.2% of patients. Patient symptoms, clinical features, radiographic findings and histological findings were consistent with those previously described in patients with MRONJ associated with antiresorptive medications. Overall, there was a 75% rate of cure, with a mean healing time of 17.2 weeks. Patients were treated surgically in 53.3% of the cases. Patients treated surgically achieved complete healing in 100% of cases, compared with 58% in those treated conservatively. Drug discontinuation was reported in 69.2% of patients. Patients who had the offending drug discontinued achieved complete healing in 75% of cases, compared with 50% in those who did not. Evidence relating to MRONJ associated with protein kinase inhibitors is of low quality. From the available data, there are notable differences relating to patient characteristics, treatment strategies and outcomes, between MRONJ associated with protein kinase inhibitors compared with antiresorptives. Higher quality evidence is required to support the findings of this review.
- Utility of esthetic eyebrow incision in the management of anterior table fracture of frontal bone: our experienceon 06/10/2020 at 12:00 am
Abstract Purpose The purpose of this study was to provide detailed information about the eyebrow approach for the reduction of the frontal bone and its esthetic results with the help of clinical data available. Thus, suggesting this technique is minimally invasive and highly esthetic for frontal bone management. Method In this series, 96 cases were studied, and results were based on variable clinical criteria and satisfaction of patients. All the surgeries were performed through eyebrow incision for the management of fractures. Intraoperatively, minimal tissue dissection, less invasion with reduced operating time was observed. Results Postoperatively, the eyebrow approach leads to its normal contour and esthetics. No complications related to the procedure were seen with partially recoverable neuropraxia and speedy recovery. This makes it an important technique to consider in carefully selected patients. Conclusion In craniofacial trauma, frequently involved site is the frontal bone, and its treatment should be completed more esthetically. Eyebrow approach is a good alternative to other surgical approaches, and it is a minimally invasive technique and thus should be practiced for esthetic management of frontal bone fractures.
- COMT rs4818, pain sensitivity and duration, and alveolar bone grafting of oral cleftson 29/09/2020 at 12:00 am
Abstract Purpose Verifying whether the mutation in COMT rs4818 could be involved in pain modulation. Methods Thirty-two individuals born with cleft lip and palate that underwent bone graft from the iliac crest bone were assessed at 12, 24, 48, 72 h, and 7 days regarding their pain experience using a visual analogic scale. DNA from each participant was collected from saliva samples, and genotyping of rs4818 was performed using TaqMan chemistry. Overrepresentation of rs4818 alleles was tested using chi-square or Fisher’s exact tests with an alpha of 0.05. Results Of the 32 individuals, eighteen reported long pain duration, nine reported high pain intensity, and fourteen low pain intensity up to 48 h. No differences were found in the distribution of individuals depending on the reported pain by sex (p = 0.12), age (p = 0.42), or cleft type (p = 0.5). The distribution of COMT r4818 alleles was different depending on the intensity and duration of pain. Carriers of the C wild-type allele were four times more likely to show high pain intensity and duration (odds ratio = 4.29, 95% confidence interval 1.13–16.18), meaning that the G variant allele is protective. Conclusion COMT rs4818 is associated with postoperative pain after alveolar bone grafting.
- Puncture points related to the tragal-lateral canthus line in conventional temporomandibular joint arthrocentesis: are they accurate? A cadaver studyon 25/09/2020 at 12:00 am
Abstract Purpose To evaluate the technical success of conventional TMJ arthrocentesis in cadavers, using the tragal-lateral canthus line as an anatomical reference for the puncture points. Methods Ten formalin-treated and 8 fresh cadavers were submitted to the arthrocentesis. A point located 10 mm anteriorly and 2 mm inferiorly to the beginning of the tragal-lateral canthus line (A) and another point 20 mm anteriorly and 10 mm inferiorly (B) were demarked on the cadavers’ skin. Following, 1 mL of methylene blue solution was injected through the needle at point A, and then another needle was placed at point B. Saline solution was injected through the first needle, identifying a free flow of bluish solution. Results Concerning the formalin-treated cadavers, TMJ arthrocentesis was not successfully performed in any case (0%). In the fresh cadavers, the procedure was properly conducted bilaterally in only one case (12.5%) and unilaterally in 3 cases (37.5%), 2 on the left side (25.0%) and one on the right (12.5%). Conclusion The traditional points related to the tragal-lateral canthus line seemed not to be accurate references for the insertion of the needles in conventional TMJ arthrocentesis when 1 mL of solution is used initially and the maximum mouth opening is not achieved.
- Apical surgery in cancer patients receiving high-dose antiresorptive medication—a retrospective clinical study with a mean follow-up of 13 monthson 24/09/2020 at 12:00 am
Abstract Purpose The aim of the study is to evaluate the results of apical surgery (AS) in patients receiving high-dose antiresorptive medication (HDAR). Methods Retrospective descriptive quality control study conducted in an Oral and Maxillofacial Department at a University Hospital. Fourteen patients on HDAR met the inclusion criteria. Only descriptive statistics were applied. Results Fourteen patients had operation on seventeen teeth. Mean HDAR treatment period before apical surgery: 25 months (SD, ± 24.27; range, 1–78 months). Drug holiday during surgery and initial healing: mean, 8 months (SD, ± 5.96; range, 0.4–22 months). Sixteen out of seventeen teeth healed clinically and showed complete or ongoing radiographic healing. All patients except one became free of symptoms. Mean follow-up: 13 months (SD, ± 9.05; range, 2–31 months). Radiographic healing according to Molven and Rud: 7, complete; 6, uncertain; 1, unsatisfactory. Three patients died during follow-up and were considered drop-outs. Conclusions The present case series suggest that apical surgery is a valid treatment option for apical periodontitis in patients on HDAR, where orthograde endodontic retreatment is not possible. None of the patients developed medication-related osteonecrosis of the jaw. Further studies in larger study groups and with longer follow-up periods are needed. The regional scientific ethical committee provided a document exemption, registration date 20 November 2013, and the local data protection agency approved handling of the recorded data (No. 2012-41-0045), registration date 11 January 2012.
- Implant placement with sinus floor elevation via the lateral approach using only absorbable collagen sponge: 12-month post-loading radiographical outcomes and implant survival rateon 22/09/2020 at 12:00 am
Abstract Purpose The purpose of the present study was to evaluate the radiographical outcomes and survival rate of implants placed during graftless lateral sinus lift approach (GLSLA) using an absorbable collagen sponge. Materials and methods Fourteen patients (14 sinus augmentations) were consecutively treated with GLSLA. After Schneiderian membrane elevation and implant insertion, only collagen sponges were used to fill the new sinus compartment. After 4 months of healing, implants were functionally loaded. The radiographical marginal bone variation and apical bone gain were assessed on periapical radiographs taken 4 months after the surgery (at crown insertion) and at 12 months post-loading. Results A total of 41 implants were placed in a mean initial residual bone height of 3.5 mm (range 1.6–6.7 mm). No failure was recorded and all the implants were successfully loaded with fixed prosthesis. Twelve months post-loading the mean radiographic bone remodeling was 2.22 mm. The mean ridge height was 8.4 mm and the mean apical bone gain amounted for 4.4 mm. Conclusions Within the limitations of this study, the placement of dental implants in conjunction with GLSLA using only a collagen sponge to fill the sinus compartment seems to be feasible and accompanied by a high implant survival rate. Further studies on a large population and with a longer follow-up are warranted to drawn definitive conclusions.
- What is the relapse after Le Fort I maxillary advancement in cleft lip and palate patients? A systematic reviewon 17/09/2020 at 12:00 am
Abstract Le Fort I osteotomy is the most common procedure for maxillary advancement in cleft patients, and a significant relapse is expected in the postoperative period. This study purpose is to evaluate the maxillary relapse and associated factors in cleft lip and palate (CLP) patients submitted to standard Le Fort I advancement. This systematic review sought studies in PubMed, SCOPUS, and Cochrane and included papers that evaluated the maxillary relapse with at least 1-year postoperative period. The quality assessment was adapted following PRISMA statement. The initial electronic search found 345 papers, and the final selection included 10 studies. In total, 275 CLP patients were evaluated 198 had unilateral CLP and 41 had bilateral CLP. Isolated maxillary advancement was performed in 166 patients, while 109 had bimaxillary surgery. The mean relapse in horizontal and vertical plane was 1.2 mm (19.7%) and 1.0 mm (29.4%), respectively. In conclusion, a relapse after maxillary advancement in patients with CLP is expected, being higher in vertical plane. Patients with UCLP and those who underwent bimaxillary surgery had a higher relapse rate. Due to the miscellaneous data and methodologies, future prospective clinical trials should apply rigorous selection of CLP patients sample and methods for variable analysis to obtain more accurate results.
- Functional tongue and floor of mouth reconstruction with a chimeric flap after total glossectomyon 14/09/2020 at 12:00 am
Abstract Purpose Presently, the functional reconstruction of the tongue in patients after subtotal or total glossectomy with the removal of the oral floor muscles and spearing of the larynx remains a complicated and unsolved issue. The aim of this case is to describe a method reconstruction of the tongue in patients after total glossectomy with the removal of the oral floor muscles using the chimeric latissimus dorsi and serratus anterior free flap (chimeric LD + SA flap) with motor innervation. Methods A 62-year-old woman with advanced cancer of the oral cavity was submitted to total glossectomy and then reconstruction with a chimeric LD + SA flap. With this method reconstruction of the tongue was made the creation a large mound (neotongue) lateral to the mandibular arch which can easily reach the palatal arch and also was made suspension of the larynx is essential given the ablative loss of supra-hyoid attachments. Results Our preliminary experience shows that this flap is a good reconstructive option for total glossectomy with the removal of the oral floor muscles and with larynx preservation. Functional and objective evaluation of the tongue reconstructed with chimeric LD + SA free flap requires further and standardized evaluation.
- Cytokine Expression Pattern and Protein-Protein interaction network analysis of Leucocyte Rich Platelet Rich Fibrin and Injectable Form of Platelet Rich Fibrinon 11/09/2020 at 12:00 am
Abstract Purpose Platelet-rich fibrin (PRF) such as leucocyte-rich PRF (L-PRF) and injectable form of PRF (i-PRF) are widely used in various surgical applications. L-PRF- and i-PRF-derived cytokine variations and functional pathways are still unexplored. The aim of the study was to evaluate the expression pattern of Th1-, Th2-, and Th17-related cytokines by L-PRF and i-PRF under in vitro. Methods Cytokine levels were evaluated using multi-analyte ELISArray kit. Using elevated level of cytokines, the protein-protein interaction and pathway were predicted by computational method. Results The expressed cytokine levels were higher in L-PRF than in i-PRF. Specifically in L-PRF, IL8, IL2, IL6, and IL1A were expressed abundantly, whereas IL4, IL10, and IL6 were significantly high in i-PRF. Furthermore, protein-protein interaction (PPI) networks (cytokine-cytokine interactions) and pathway analyses were predicted using higher-order cytokines. PPI networks and gene ontology enrichment analysis showed functional variations between L-PRF and i-PRF. Kyoto Encyclopedia of Gene and Genome pathway analysis found that L-PRF mediates NF-k B signaling, Toll-like receptor signaling (TLR), and MAPK signaling via T-cell receptor signaling pathway. i-PRF is significantly involved in JAK-STAT signaling pathway through upregulation of STAT1. Conclusion Our study concludes that L-PRF and i-PRF act via different pathways that confirm functional variations between them. Therefore, we speculate that L-PRF may be effective in acute phase of chronic wounds such as in diabetes mellitus and immunocompromised patients whereas i-PRF may have a better outcome in acute wounds.
- Does initial reduction at infra-orbital rim first improve malar height and vertical dystopia in ZMC fractures?on 10/09/2020 at 12:00 am
Abstract Purpose To estimate the clinical and functional results of patients who underwent distinctive types of open reduction and internal fixation of ZMC fractures, with particular emphasis on malar height and vertical dystopia. Materials and methods A randomized clinical trial was conducted from August 2016 to October 2019 in which 40 adult patients with ZMC fractures of maxillofacial region were included. Patients were randomly allocated to group A (n = 20; frontozygomatic (F-Z) first 3-point reduction and fixation) or group B (n = 20; group B infra-orbital first 3-point reduction and fixation). All patients were evaluated objectively for malar height and vertical dystopia pre- and post-operatively at 3 months. The data were scrutinized by applying mean and standard deviation and unpaired t test. Results Mean values of the malar height and vertical dystopia were statistically significant (P < .05) for group B compared with group A at all intervals. Data analyzed for other secondary variables showed a statistically non-significant difference between the groups (P > 0.05). Conclusion The results showed improvement in the malar height and vertical dystopia for infra-orbital first three-point fixation (group B) compared with F-Z first approach for initial reduction and fixation (group A). Furthermore, group B was better in terms of malar width and antero-posterior projection of the zygomaticomaxillary complex.
- Objective and subjective comparison of submucosal and intravenous routes of single-dose preoperative dexamethasone for mandibular third molar surgery—a prospective randomized observer-blind studyon 09/09/2020 at 12:00 am
Abstract Purpose Adjuvant corticosteroid administration through local routes has gained popularity due to ease of technique, lesser morbidity and presumed advantage of achieving therapeutic dosage at the site. To evaluate this, present study has compared submucosal route with an intravenous route control using single-dose preoperative dexamethasone. The study investigated objective facial measurements, mouth opening and compared them with subjective scores on a visual analogue scale and quality of life (QOL) recovery questionnaire. Materials and methods This was a prospective, randomized, open-label study with blinded end-point assessment of submucosal and intravenous routes of single preoperative dexamethasone administration, in patients undergoing mandibular third molar surgery. Patients were randomly divided into two groups and received 8 mg DX as either submucosal or intravenous injection 5 min after administration of local anaesthesia. Data was collected at 2nd and 7th post-op intervals. Statistical analysis was done keeping a P value < 0.05 as significant. Results Thirty patients were evaluated in the study. SM route behaved similarly to IV route in producing changes in facial measurements [P = 0.533], mouth opening [P = 0.533] and pain [VAS] scores [P = 0.533] at early and late intervals. Questionnaire subscale scores were not significantly different between groups, but total mean score was significant [P = 0.050] with a measure of variance 17.54 in group IV compared with 39.54 of group SM showing that subjectively, IV route brought better recovery. Conclusion and clinical relevance Submucosal route can be an effective less invasive, painless, straightforward alternative to systemic administration of corticosteroid for improving QOL recovery in mandibular third molar surgery.
- Complications after osteosynthesis of craniofacial fractures—an analysis from the years 2015–2017on 03/09/2020 at 12:00 am
Abstract Background Complications mean a recurring problem in everyday clinical practice. Complication rates between 6 and 13% are described for the treatment of bony injuries to the head and neck area. This paper aims to provide a detailed analysis of the complications after osteosynthesis in facial skull fractures. Material and method In this retrospective study, we reviewed all patient records of injured treated in the Department of Cranial and Maxillofacial Surgery at the Dortmund General Hospital between 2015 and 2017. Results Of the 22,031 head and neck injuries, 685 were treated with osteosynthesis. A clinically significant complication was reported in 32 patients (4.76%). The number of total complications was 63. In total, 66.7% of all complications have been identified in the paramedian mandible (44%), median mandible, mandibular angle, and in the collar area (each 12.7%). Eleven implants (in 5 patients) showed a cancellous bone impaction. Broken implants have been recognized in two cases. In 8 cases, there was a pseudarthrosis in the fracture area; in one case, there was a broken implant and pseudarthrosis in combination. Conclusion Osteosynthesis is a safe method of treating facial skull fractures, which is why we consider it the gold standard of therapy. The complication rate is well below 5%. The 3-dimensional adaptation (bending) and shortening of the osteosynthesis implants do not lead to an increase in complications.
- Investigation of fluctuations in blood glucose level due to dietary restrictions during impacted mandibular third molar extraction under intravenous sedation: effect of perioperative glucose administrationon 01/09/2020 at 12:00 am
Abstract Objective We aimed to investigate the usefulness of glucose administration for maintaining perioperative glycemic control in patients with dietary restrictions during 4 h prior to impacted mandibular third molar extraction under intravenous sedation. Methods Fifty-four individuals scheduled to undergo extraction of impacted mandibular third molars under intravenous sedation, with preoperative blood glucose levels (GL) of 70–110 mg/dL, were evaluated and divided into 3 groups (n = 18 each): control group receiving glucose-free sodium lactate Ringer’s solution, perioperative GL group receiving 100 mL of 5% glucose solution immediately after local anesthesia, and postoperative GL group receiving 100 mL of 5% glucose solution immediately after surgery completion. Blood glucose levels, systolic blood pressure, diastolic blood pressure, and heart rate were measured. Results Glucose levels of those in the control and perioperative GL groups decreased within the standard range 90 min after surgery, compared with the preoperative blood glucose level. However, in the postoperative GL group, glucose levels were similar to the preoperative levels. Systolic and diastolic blood pressure and heart rate were not affected by glucose administration, and sedation could be maintained without an invasive procedure. Conclusions Following a restriction on eating and drinking 4 h prior to surgery, the blood glucose level gradually decreased in the perioperative period but remained within the reference range until 90 min following surgery. The administration of 100 mL 5% glucose solution immediately after surgery was sufficient for the prevention of postoperative hypoglycemia. This approach may be useful for perioperative glycemic control during third molar extraction.
- Evaluation of complications following stock replacement of the temporomandibular joint performed between the years 2006 and 2015: a retrospective studyon 01/09/2020 at 12:00 am
Abstract Purpose Alloplastic total temporomandibular joint replacement (TMJR) is now considered to be a standard procedure for temporomandibular joint (TMJ) reconstruction. TMJR can improve mandibular mobility, restore the dental occlusion and improve facial aesthetics. The purpose was to assess the presence of intraoperative and post-operative complications, including the presence of post-operative chronic pain. Methods This retrospective study evaluated the use of 62 stock TMJR devices implanted in 45 patients who underwent surgery between the years 2006 and 2015 by the same surgeon at the Department of Oral and Maxillofacial Surgery, Stomatology Clinic, General Teaching Hospital (VFN) Charles University, Prague, Czech Republic. Results Intraoperative and post-operative complications recorded were facial nerve dysfunction (14–22%), open bite/malocclusion (2–3.2%), condylar component dislocation (1–1.6%), infection requiring revision surgery (1–1.6%) and (27–43%) reported chronic pain 24 months after surgery. Conclusions As with any surgical procedure, TMJR can have complications. The results of this study demonstrate that the most common post-operative complication was continued pain. Chronic pain after TMJR was more common in patients with a preoperative diagnosis of degenerative joint disease. Also, the incidence of post-operative TMJR pain increased with the duration of symptoms prior to TMJR, leading to a question of the best timing for TMJR.
- Impact of orthognathic surgery on the treatment of gummy smile: an integrative reviewon 01/09/2020 at 12:00 am
Abstract The gingival smile is considered unpleasant and can be treated in different ways according to its etiological factor. When caused by maxillary vertical growth excess, orthognathic surgery may be indicated to correct the vertical excess. The aim of this integrative review was to evaluate the impact of orthognathic surgery on the treatment of gingival smile. An electronic search was performed of the PubMed/Medline, Cochrane Library, Scopus, and Google Scholar databases. The selection of studies was performed by two blinded reviewers. Firstly, studies were selected by reading the titles and the abstracts of articles. The references from each study selected were then searched to find articles that were not found in the electronic search. After reading the full-text articles, studies that met the inclusion criteria were selected. A total of 667 studies were identified, but only 19 were selected for the integrative review after applying the inclusion and exclusion criteria. The selected articles reported maxillary impaction from 2 to 10 mm, but this amount of superior repositioning of maxilla does not appear to be related to the initial gingival exposure described. Orthognathic surgery is not the first choice of treatment for gingival smile, but it appears to be a suitable therapy for other conditions in the same patient for improving a gummy smile by correction of gingival exposure.
- Temporal region myeloid sarcoma: When to suspect and how to approach?on 01/09/2020 at 12:00 am
- The various meanings and imperfections of wordson 01/09/2020 at 12:00 am
Abstract In this reply to a letter, the Authors discuss the raised points regarding the nomenclature and management of Lymphatic Malformations / Lymphangiomas.
- Don’t call me “Lymphangioma!”on 01/09/2020 at 12:00 am
- Reply to Letter to the Editor commenting on the article “Myeloid sarcoma on the temporal region before the onset of the acute myeloid leukemia: an extremely rare case report”on 01/09/2020 at 12:00 am
- Checkrein deformity: a case report of two patients with hallux deformity and pain following mandibular reconstruction in oral cancer treatmenton 01/09/2020 at 12:00 am
Abstract Background Checkrein deformity is an uncommon disease with a well-described etiology. It is characterized by a dynamic deformity of the hallux or great toe. We report two cases of checkrein deformity due a fibular graft harvesting in two patients with a mandibular bone defect secondary to an oral cancer treatment. Case report We report two young patients with mandibular cancers that had been treated several years before our visit and were currently free of disease. The patients had a mandibular bone defect due to the maxillofacial treatment, solved with a free fibular graft. The current complaint was a great toe deformity that caused pain and made them walk with difficulties. Diagnosis was a checkrein deformity, and after a surgical release of the flexor hallucis longus tendon, both cases returned to normal activities with no walking limitations. Conclusion Our cases highlight that an accurate patient examination is warranted following these reconstructions as many of them can be misdiagnosed, and a relatively simple surgery can improve the patients’ limitations.
- Μενού Περιοδικών
- The New England Journal of Medicine
- Journal of Oral and Maxillofacial Surgery
- International Journal of Oral and Maxillofacial Surgery
- Journal of Cranio-Maxillofacial Surgery
- British Journal of Oral and Maxillofacial Surgery
- Oral and Maxillofacial Surgery (DGMKG)
- Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
- Oral and Maxillofacial Surgery Clinics
- Oral Oncology
- Clinical Oral Implants Research
- Otolaryngology — Head and Neck Surgery
- Implant Dentistry
- Head & Neck
- American Journal of Orthodontics and Dentofacial Orthopedics