Advances in Oral and Maxillofacial Surgery最新文献

Inferior alveolar nerve bypass during tilted implant insertion: A 3-year retrospective cohort study 倾斜种植体植入过程中的下牙槽神经旁路：一项为期 3 年的回顾性队列研究

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-11-22 DOI: 10.1016/j.adoms.2024.100502

Nadim Sleman

Objective

Implant placement in atrophic mandibles can be challenging due to insufficient bone volume. To overcome this problem, bone grafts are often required to increase bone volume and provide a stable base for the implant. However, bone grafting procedures can be invasive, time-consuming, and costly. Tilted implants are a viable option to bypass the inferior alveolar nerve (IAN) and increase the contact surface and primary stability.

The aim of this study was to evaluate the survival rate of tilted implants in posterior atrophic mandible and complications related to injury of the inferior alveolar nerve (IAN).

Methods

Accepted patients in this study were only those who suffered from teeth loss in the posterior atrophic mandible. The analysis of this study focused on tilted implants to investigate the survival rate following insertion and during the loading stage. Clinical assessment was conducted to analyze any occurrences of IAN injury.

Results

A total of 31 implants were placed in the posterior mandible of 26 patients with insufficient bone volume. Over a 36-month observation period, all implants exhibited a 100 % survival rate. Three patients experienced temporary neurosensory disturbances.

Conclusions

The use of tilted implants is a viable option for patients with atrophic edentulous mandible that lack the required alveolar height for traditional dental implants. Despite limited study observation time, bypassing the IAN during implant placement presents a predictable option for atrophic posterior mandible treatment.

目的由于骨量不足，在萎缩的下颌骨中植入种植体可能具有挑战性。为了解决这个问题，通常需要植骨来增加骨量，为种植体提供一个稳定的基底。然而，植骨手术可能是侵入性的、耗时的、昂贵的。本研究的目的是评估倾斜种植体在后萎缩下颌骨中的存活率以及与下牙槽神经损伤（IAN）相关的并发症。本研究的分析重点是倾斜种植体，以调查插入后和加载阶段的存活率。结果在骨量不足的 26 位患者的下颌后部共植入了 31 个种植体。在 36 个月的观察期内，所有种植体的存活率均为 100%。结论对于下颌骨萎缩无牙颌、牙槽高度达不到传统种植体要求的患者来说，使用倾斜种植体是一种可行的选择。尽管研究观察时间有限，但在种植体植入过程中绕过 IAN 为萎缩性下颌后牙治疗提供了一种可预测的选择。

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引用次数: 0

Histological characteristics of benign jaw tumours in Cameroon; A 10-year appraisal 喀麦隆颌骨良性肿瘤的组织学特征；10 年评估

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-11-12 DOI: 10.1016/j.adoms.2024.100501

Zilefac Brian Ngokwe , Ntep Ntep David Bienvenue , Bola Antoine Siafa , Nokam Kamdem Stephane , Kouamou Audrey Tchiekou , Bengondo Charles Messanga , Sando Zacharie

Introduction

The diagnosis of jaw tumours is histological. Jaw tumours can be classified as benign or malignant. Benign jaw tumours can be classified as epithelial, mesenchymatous or epithelio-mesenchymatous based on their origin or with respect to their relation to the development of the dental organ into odontogenic and non -odontogenic.

Methods

A retrospective study was conducted from the period from January 2010 to April 2020 in the Stomatology and maxillofacial surgery units and pathology units of 4 hospitals in Yaoundé. Participants who had been operated for a benign jaw tumour with available and exploitable histopathological workups were retained in this study. The histological slides found were examined by a team of pathologists in accordance with the 2005 World Health Organization classification of head and neck tumours.

Results

We retained 62 participants, ameloblastoma was the most represented tumour (25.81 %) followed by fibrous dysplasia (12.9 %) and Keratocystic odontogenic tumour (12.9 %). Ameloblastoma had 5 recurrences with a recurrence rate of 31.25 %.

Conclusion

Ameloblastoma was the most common benign jaw tumour and odontogenic tumour with Fibrous dysplasia being the most frequent non odontogenic tumour. Better description of histological characteristics and typing would help to prevent recurrence and complications such as malignant transformation. Digital recording of histopathological slides could help improve conservation and permit the carrying out long term retrospective studies in our settings.

导言：颌骨肿瘤的诊断是组织学诊断。颌骨肿瘤可分为良性和恶性。良性颌骨肿瘤可根据其起源或与牙器官发育的关系分为上皮性、间充质性或上皮-间充质性，分为牙源性和非牙源性。本研究保留了曾因颌骨良性肿瘤接受过手术且有可用和可利用的组织病理学检查的参与者。病理学家小组根据 2005 年世界卫生组织的头颈部肿瘤分类标准对所发现的组织病理切片进行了检查。结论釉母细胞瘤是最常见的颌骨良性肿瘤和牙源性肿瘤，纤维发育不良是最常见的非牙源性肿瘤。更好地描述组织学特征和分型有助于预防复发和并发症，如恶性转化。组织病理学切片的数字化记录有助于改善保存，并允许在我们的环境中进行长期的回顾性研究。

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引用次数: 0

Clinical application of submandibular endotracheal intubation in craniomaxillofacial fracture 颌下气管插管在颅颌面骨折中的临床应用

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-10-09 DOI: 10.1016/j.adoms.2024.100499

Kaifang Yuan, Qudong Liao, Meixing Ren, Lin Lu, Guotao Wu, Junwen Wang

Objective

To explore the clinical application of submandibular endotracheal intubation in craniomaxillofacial fractures.

Methods

The submandibular endotracheal intubation was used to treat 10 patients with cranio-maxillofacial fractures and contraindications to nasal intubation.Ventilator monitoring data including SPO2(oxygen saturation of blood), Freq,VT,MV,PEEP, PLAT and PEAK were monitored before and after the operation of submandibular endotracheal intubation. The technique of submandibular intubation was assessed intraoperatively and in the postoperative period. The outcomes and complications are presented.

Results

The study included 10 patients aged between 18 and 63 years(6 males and 4 females). All patients had mandibular fractures, with 6 midface fractures (60 %), 5 nasal bone fractures (50 %), 6 zygomatic bone fractures (60 %). The procedure time ranged from 6 to 10 min (mean, 7.9 min). NO delayed extubation was performed in 10 cases. The technique has proved to be straightforward and satisfactory. A postoperative superficial infection occurred in 1 patients, whereas hypertrophic scars occurred in another 1 patients.

Conclusion

Submandibular endotracheal intubation is a safe procedure for intraoperative airway control in maxillofacial trauma patients who present contraindication to nasotracheal intubation.

摘要] 目的探讨颌下气管插管在颅颌面骨折中的临床应用。方法采用颌下气管插管治疗 10 例有鼻腔插管禁忌症的颅颌面骨折患者，在颌下气管插管手术前后监测呼吸机监测数据，包括 SPO2（血氧饱和度）、频率、VT、MV、PEEP、PLAT 和 PEAK。对术中和术后的颌下插管技术进行了评估。结果该研究包括 10 名年龄在 18 岁至 63 岁之间的患者（6 名男性和 4 名女性）。所有患者均为下颌骨骨折，其中面中部骨折 6 例（60%），鼻骨骨折 5 例（50%），颧骨骨折 6 例（60%）。手术时间为6至10分钟（平均7.9分钟）。在 10 个病例中进行了无延迟拔管。事实证明，该技术简单易行，效果令人满意。结论下颌气管插管是一种安全的术中气道控制方法，适用于鼻气管插管禁忌症的颌面部创伤患者。

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引用次数: 0

Maxillo-orbital gunshot trauma in a pediatric patient 一名儿科患者的颌眶部枪伤

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-09-26 DOI: 10.1016/j.adoms.2024.100497

Maram Adil Mansour , Elnagar E. Elgasim , Esameldin Adam Nagi , Ibtisam Hussein , Malaz Mansour

Gunshot injuries to the maxillofacial region vary in severity from minor harm to critical situations necessitating urgent medical intervention. Effective handling of facial gunshot wounds mandates a multidisciplinary approach to deliver thorough care to the individual.

We present a pediatric patient presenting to the Emergency Department following an accidental machine gun injury.

颌面部枪伤的严重程度各不相同，有的伤势较轻，有的情况危急，需要紧急医疗干预。要有效处理面部枪伤，必须采用多学科方法为患者提供全面护理。

引用次数: 0

Management of von Willebrand disease for orthognathic surgery: Evidenced-based recommendations and scoping review of the literature 正颌外科手术中的von Willebrand病管理：循证建议和文献综述

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-09-25 DOI: 10.1016/j.adoms.2024.100498

Marshall F. Newman , Dylan Walker , Aaron Flanders

<div><h3>Background</h3><div>The general management of von Willebrand Disease has evolved over the past several decades. Advances in blood product replacement manufacturing have led to changes in perioperative management of the bleeding diathesis in its various subtypes. Surgical management follows changes in medical management, but unique perioperative considerations exist depending on the type of surgery. Orthognathic surgery is considered a major surgery that can have life-threatening complications in patients with von Willebrand Disease (vWD) and updates in evidenced-based management are presented.</div></div><div><h3>Objectives</h3><div>The objectives of this report are to review available literature regarding management of patients with von Willebrand Disease and other bleeding disorder undergoing orthognathic surgery and to provide a case report regarding the management of a patient vWD type 2M undergoing orthognathic surgery.</div></div><div><h3>Eligibility criteria</h3><div>Articles included for review were studies addressing patients with bleeding disorders undergoing orthognathic surgery.</div></div><div><h3>Sources of evidence</h3><div>PubMed and Ovid were queried using the terms “orthognathic surgery OR jaw deformity” AND “von Willebrand OR bleeding disorders OR hemophilia.” Additional references relevant to the review were obtained from the reference lists of available articles ultimately deemed appropriate for inclusion in the review.</div></div><div><h3>Methods</h3><div>A recent example case of a patient with type 2M vWD undergoing orthognathic surgery and the patient's perioperative management is presented for consideration. A scoping review of the literature was undertaken for evaluation of available literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR).</div></div><div><h3>Results</h3><div>Insufficient evidence exists for significant analysis of perioperative management strategies previously reported compared to the currently utilized management strategy for the case presented. A review of the available literature with reference to updated literature regarding management of patients with vWD undergoing surgical procedures other than orthognathic surgery yields primarily case reports, two randomized controlled trials, and one systematic review. The results indicate that an evolution in the general management of patients with vWD undergoing surgery can be applied to patients undergoing orthognathic surgery and that the addition of hemostatic agents such as tranexamic acid may be considered with a low level of evidence.</div></div><div><h3>Conclusions</h3><div>For patients undergoing orthognathic surgery, the use of cryoprecipitate in large quantities has been replaced with the use of Humate-P infusion and will likely be replaced with the use of recombinant von Willebrand factor (VWF). The timing of infusion of adjuncts preoperatively for patients with vWD

背景在过去的几十年中，von Willebrand 病的一般治疗方法发生了变化。血液制品替代品制造技术的进步改变了各种亚型出血综合征的围手术期管理。手术治疗紧随内科治疗的变化，但根据手术类型的不同，围手术期的注意事项也有所不同。本报告旨在回顾有关接受正颌外科手术的von Willebrand病和其他出血性疾病患者管理的现有文献，并提供一份有关接受正颌外科手术的2M型vWD患者管理的病例报告。证据来源使用 "正颌手术或颌骨畸形 "和 "von Willebrand 或出血性疾病或血友病 "这两个词对PubMed和Ovid进行查询。从现有文章的参考文献列表中获取了与本综述相关的其他参考文献，最终认为适合纳入本综述。采用系统综述和荟萃分析首选报告项目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review，PRISMA-ScR）对文献进行了范围界定，以评估现有文献。结果没有足够的证据对之前报道的围手术期管理策略与目前采用的管理策略进行重要分析。对现有文献进行了回顾，并参考了有关接受正颌外科手术以外的外科手术的 vWD 患者管理的最新文献，结果主要是病例报告、两项随机对照试验和一项系统回顾。结论对于接受正颌外科手术的患者，大量使用低温沉淀已被使用 Humate-P 输注所取代，而且很可能会被使用重组冯-威廉因子（VWF）所取代。vWD 患者术前输注辅助药物的时间有可能延长到前一天，并可考虑添加氨甲环酸等止血药物。术后应考虑预防性使用额外的 VWF 辅助药物，并进行密切监测。使用更新的药物可以扩大颅颌面外科手术的范围，使 vWD 患者可以安全地接受手术。

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引用次数: 0

Get the lead out-unusual ballistic patterns can lead to diagnostic delay 找出线索--不寻常的弹道模式可能导致诊断延误

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-09-21 DOI: 10.1016/j.adoms.2024.100496

Alice Liu, Alice Cameron, Margaret Coyle

Slingshot injuries have been rarely reported in the literature and while the value of three dimensional imaging, intravenous antibiotics and exploration under anaesthesia remain the mainstay of treatment, this case highlights the need for careful examination when the clinical presentation is seemingly innocuous. Our initial working assumption was that the palpable lump was likely to be an old injury, supported by the single small laceration which seemed an unlikely entry wound due to its size and distant anatomical location. However, blunt exploration of the would revealed a tract, favouring emergent rather than elective management. We therefore highlight to the maxillofacial community the possibility of explosive residue having migrated or being found distant to impact location.

虽然三维成像、静脉注射抗生素和麻醉下探查仍是治疗的主要手段，但本病例强调了在临床表现看似无害时进行仔细检查的必要性。我们最初的假设是，可触及的肿块很可能是旧伤，并辅以单个小裂口，由于其大小和解剖位置较远，似乎不太可能是入口伤口。然而，钝性探查后发现了一个创面，因此需要紧急处理，而不是选择性处理。因此，我们向颌面外科界强调了爆炸残留物移位或在远离撞击位置的地方被发现的可能性。

引用次数: 0

Radiological characteristics of benign jaw tumours in Cameroon: 2010–2020 喀麦隆颌骨良性肿瘤的放射学特征：2010-2020 年

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-06-13 DOI: 10.1016/j.adoms.2024.100492

Zilefac Brian Ngokwe , Mballa Amougou Jean Claude , Ntep Ntep David Bienvenue , Edouma Bohimbo Jacques , Nokam Kamdem Stephane , Cheboh Cho-Fon , Kouamou Tchiekou Audrey , Bengondo Messanga Charles

Introduction

Benign jaw tumours or tumour-like swellings of the jaws can be classified as odontogenic; derived from odontogenic tissues or non-odontogenic.

Once a preliminary diagnosis is made, physicians have to conduct full radiographic investigations in order to make a fairly accurate description of the tumour.

Methods

This retrospective hospital-based study was conducted at the Stomatology and maxillofacial surgery and radiology units of 4 medical centres in Yaoundé. 62 participants with radiological work ups were retained in the study with 13 participants having at least one recurrence.

Results

The radiographic lesions were mostly unilocular (67.74 %, n = 42), 52(83.9 %) of our study participants had a tumour size ≥4 cm, the mandibular location was more represented in our study with 72.6 %(n = 45) and the fourth decade was the most represented age group with basal cortical perforation (44.4 %, n = 4).

In our study the orthopantomogram and CT (computed tomography) scans were the only imaging modality used as a result of the cost and accessibility.

Conclusion

Multilocular tumor presentation was associated with recurrence in our study and the fourth decade had the most cases of basal cortical perforation. Radiological characteristics of benign jaw tumour should be taken more into consideration as better description of these radiological characteristics can help with the treatment of benign jaw tumours and reduce complications like recurrence.

导言颌骨良性肿瘤或瘤样肿物可分为牙源性、源于牙源性组织或非牙源性。一旦做出初步诊断，医生就必须进行全面的放射学检查，以便对肿瘤做出相当准确的描述。62名参与者进行了放射学检查，其中13名参与者至少有一次复发。结果放射学病变大多为单发（67.74%，n = 42），52名参与者（83.9%）的肿瘤大小≥4厘米，下颌位置的肿瘤在我们的研究中更有代表性，占72.6%（n = 45）。在我们的研究中，由于成本和可及性的原因，正位像和 CT（计算机断层扫描）扫描是唯一使用的成像方式。应更多地考虑良性颌骨肿瘤的放射学特征，因为更好地描述这些放射学特征有助于治疗良性颌骨肿瘤并减少复发等并发症。

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引用次数: 0

Outcomes and complications of orthognathic surgery in older patients 老年患者正颌外科手术的效果和并发症

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-06-07 DOI: 10.1016/j.adoms.2024.100491

Liesbeth Govaers , Renée Beckers , Constantinus Politis

Purpose

Several studies have described the outcomes and complications following orthognathic surgery. However, the average patient age in these studies is 20–40 years. It is unclear whether results from these age groups can be extrapolated to older patients.

Methods

This retrospective observational study included 54 patients over 50 years of age, who underwent orthognathic surgery. From these patients’ medical records, we retrieved data regarding patient characteristics, surgery characteristics, outcomes, and complications.

Results

The patients’ mean age was 56 years (range, 50–69 years), and mean ASA score was 2. A bad split occurred in one patient, and immediate postoperative complications occurred in two patients. There were no long-term sequelae. Neurosensory disturbances (NSD) occurred in 30 patients. Preoperative temporomandibular dysfunction (TMD) was present in 9 patients—among whom, five were cured after surgery. Four patients postoperatively developed de novo TMD. Hardware removal was performed in 22 patients. The mean length of stay was two days for monomaxillary procedures, and three days for bimaxillary procedures.

Conclusions

This study demonstrated apparent differences between patients over 50 years of age and the general orthognathic population. In particular, neurosensory disturbances and hardware removal were more prevalent in our study population.

目的多项研究描述了正颌手术后的效果和并发症。然而，这些研究中患者的平均年龄为 20-40 岁。方法这项回顾性观察研究纳入了 54 名 50 岁以上接受正颌手术的患者。结果患者的平均年龄为 56 岁（范围为 50-69 岁），平均 ASA 评分为 2 分。无长期后遗症。30名患者出现神经感觉障碍（NSD）。9名患者术前存在颞下颌功能障碍（TMD），其中5人术后痊愈。4 名患者术后出现了新的 TMD。22 名患者进行了硬件移除手术。单颌手术的平均住院时间为两天，双颌手术的平均住院时间为三天。特别是在我们的研究人群中，神经感觉障碍和硬件移除更为普遍。

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引用次数: 0

Odontogenic cysts decompression: Myth or reality? A case report 牙源性囊肿减压术：神话还是现实？病例报告

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-05-26 DOI: 10.1016/j.adoms.2024.100490

Samir Mainassara Chekaraou , Abdoul-Hafizou Rabe Amani , Abdoul-Majid Habibou , Malika Mascou , Amadou Ali , Abarchi Boubé Djafarou , Inoussa Daouda Bako , Kadre Ousmane Kadre Alio , Mahamadou Dandi Abarchi

Introduction

Odontogenic cysts are cysts that originate from the odontogenic epithelium and are found in the areas of the jaw that bear teeth. Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental radiographs and/or as asymptomatic swellings. Treatment usually involves cyst enucleation or tooth extraction, although decompression may be used for larger lesions.

Case report

We report the case of an 8-year-old patient referred by his ENT physician following the swelling of the left maxilla for whom the clinical, radiological examination associated with biopsy suggested a dentigerous cyst.

Conclusion

management consisted of decompression of the lesion after eight months which allowed the disappearance of the cystic. The patient continues to be followed clinically and radiologically.

导言：牙源性囊肿是源于牙源性上皮的囊肿，存在于颌骨的生牙部位。牙源性囊肿是口腔中最常见的发育型牙源性囊肿之一，通常表现为牙科 X 光片上的偶然发现和/或无症状肿物。病例报告我们报告了一例由耳鼻喉科医生转诊的 8 岁患者的病例，患者左上颌骨肿胀，经临床、放射学检查和活组织检查提示为牙源性囊肿。患者将继续接受临床和放射学随访。

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引用次数: 0

Multi-organ IgG4-related sialadenitis diagnosed via core needle biopsy: A case report 通过核心针活检确诊的多器官 IgG4 相关性浆液性腺炎：病例报告

Advances in Oral and Maxillofacial Surgery

Pub Date : 2024-04-23 DOI: 10.1016/j.adoms.2024.100486

Shishuo Ma , Xiaojuan He , Weijia Huang

Diagnosing Immunoglobulin G4-related sialadenitis (IgG4-RS) remains challenging due to its rarity and similarity to other forms of sclerosing sialadenitis. Controversies persist regarding biopsy approaches. We presented a case with sclerosing sialadenitis in the major salivary glands, pancreatitis, elevated serum IgG4 levels, and core needle biopsy (CNB) revealed lymphoplasmacytic infiltration. This case report aims to raise awareness of the potential use of CNB in suspected IgG4-RS cases, minimizing associated risks compared to open biopsy.

由于免疫球蛋白 G4 相关性浆液性腺炎（IgG4-RS）的罕见性以及与其他形式的硬化性浆液性腺炎的相似性，对其进行诊断仍具有挑战性。关于活检方法的争议一直存在。我们报告了一例主要唾液腺硬化性唾液腺炎、胰腺炎、血清 IgG4 水平升高的病例，核心针活检（CNB）发现淋巴浆细胞浸润。本病例报告旨在提高人们对在疑似 IgG4-RS 病例中可能使用 CNB 的认识，与开放活检相比，CNB 可最大限度地降低相关风险。

引用次数: 0